Health Performance Measurement In The Public Sector

There is growing interest in using performance measurement as a means of holding federal, state, and local health agencies accountable for their use of public funds. Health Performance Measurement in the Public Sector is the second of two books for the U.S. Department of Health and Human Services on using and improving performance measurement in publicly funded health programs and the implications for data needs and systems. This book focuses on data and information system issues at the federal, state, and local levels. Recommendations address: Policy framework for selecting performance measures and using performance measurement. Operational principles related to data and data systems that support performance measurement. Essential investments in data systems and in training and technical assistance. Research needed to improve performance measures and performance measurement.

The Panel on Performance Measures and Data for Public Health Performance Partnership Grants was established at the request of the U.S. Department of Health and Human Services (DHHS). Its charge is to examine the state of the art in performance measurement for public health and to recommend measures that could be used to monitor the Performance Partnership Grant agreements to be negotiated between each state and the federal government. The panel was asked to consider performance measures in ten areas, which are clearly a subset of the full range of traditional public health concerns: chronic diseases; sexually transmitted diseases (STDs), human immunodeficiency virus (HIV) infection, and tuberculosis; mental health; immunization; substance abuse; and three areas of prevention of special interest to DHHS-sexual assault, disabilities, and emergency medical services. This report focuses on measures that states and the federal government can use over the next 3 to 5 years to negotiate agreements and monitor performance in these areas. A later report will examine additional measures that might be developed from new research findings on program effectiveness or as improvements are made to state and federal surveys and data systems.

In a world where there is increasing demand for the performance of health providers to be measured, there is a need for a more strategic vision of the role that performance measurement can play in securing health system improvement. This volume meets this need by presenting the opportunities and challenges associated with performance measurement in a framework that is clear and easy to understand. It examines the various levels at which health system performance is undertaken, the technical instruments and tools available, and the implications using these may have for those charged with the governance of the health system. Technical material is presented in an accessible way and is illustrated with examples from all over the world. Performance Measurement for Health System Improvement is an authoritative and practical guide for policy makers, regulators, patient groups and researchers.

The Panel on Performance Measures and Data for Public Health Performance Partnership Grants was established at the request of the U.S. Department of Health and Human Services (DHHS). Its charge is to examine the state of the art in performance measurement for public health and to recommend measures that could be used to monitor the Performance Partnership Grant agreements to be negotiated between each state and the federal government. The panel was asked to consider performance measures in ten areas, which are clearly a subset of the full range of traditional public health concerns: chronic diseases; sexually transmitted diseases (STDs), human immunodeficiency virus (HIV) infection, and tuberculosis; mental health; immunization; substance abuse; and three areas of prevention of special interest to DHHS-sexual assault, disabilities, and emergency medical services. This report focuses on measures that states and the federal government can use over the next 3 to 5 years to negotiate agreements and monitor performance in these areas. A later report will examine additional measures that might be developed from new research findings on program effectiveness or as improvements are made to state and federal surveys and data systems.

Measuring the Performance of the Hollow State is the first in-depth look at the influence of performance measurement on the effectiveness of the federal government. To do this, the authors examine the influence of the Government Performance and Results Act of 1993 (with consideration of the later Program Assessment Rating Tool of 2002) on federal performance measurement, agency performance, and program outcomes. They focus a systematic examination on five agencies in the U.S. Department of Health and Human Services—the Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, the National Institutes of Health, and the Indian Health Service. Besides representing a wide range of federal government organizational structures and program formats, these agencies offer a diverse array of third-party arrangements including states, native American tribes, scientists, medical schools, and commercial and nonprofit health care intermediaries and carriers. Exploring the development of performance measures in light of widely varying program mandates, the authors look at issues that affect the quality of this measurement and particularly the influence of program performance by third parties. They consider factors such as goal conflict and ambiguity, politics, and the critical role of intergovernmental relations in federal program performance and performance measurement. Through their findings, they offer illumination to two major questions in public management today—what are the uses and limitations of performance measurement as a policy and management tool and how does performance measurement work when applied to the management of third-party government? While scholars and students in public administration and governmental reform will find this book of particular interest, it will also be of use to anyone working in the public sector who would like to have a better understanding of performance measurement.

There is growing interest in using performance measurement as a means of holding federal, state, and local health agencies accountable for their use of public funds. Health Performance Measurement in the Public Sector is the second of two books for the U.S. Department of Health and Human Services on using and improving performance measurement in publicly funded health programs and the implications for data needs and systems. This book focuses on data and information system issues at the federal, state, and local levels. Recommendations address: Policy framework for selecting performance measures and using performance measurement. Operational principles related to data and data systems that support performance measurement. Essential investments in data systems and in training and technical assistance. Research needed to improve performance measures and performance measurement.

Performance measurement is now a key management tool used by government to assess and enhance public services. It is also used as a tool for public sector transparency and accountability. Despite these noble objectives, performance measurement can also generate counterproductive and sometimes paradoxical outcomes. This book innovatively conceptualises performance measurement as a ‘policy instrument’. Such an approach necessarily invites careful and critical examination of instances of the formation, application and contestation of particular performance measurement regimes, the tools used to measure performance, the way in which performance data is produced and used, and the complex dynamics between professionals, managers and service users that arise from these practices. The book provides detailed empirical examples of performance measurement in the delivery of health, schooling and child welfare services, as well as the problematics of assessing national wellbeing. Instead of a form of scientific and rational management, performance measurement is revealed as an intrinsically contested, socio-politically charged and value laden practice. The book concludes that to succeed in delivering authentic performance improvements public sector managers must be aware of these complex, paradoxical dynamics and the circumstances that make performance measurement perform. This book was originally published as a special issue of Policy Studies.

A host of promising public sector reform efforts are underway throughout the world. In governments challenged by budget deficits and declining public trust, these reform efforts seek to improve policy decisions and public management. Along the way, program efficiency and effectiveness help rebuild public confidence in government. Whether through regular measurement of program inputs, activities, and outcomes, or through episodic one-shot studies, performance monitoring plays a central role in the most important current reform efforts. Monitoring Performance in the Public Sector, now available in paperback, is based on experiences derived from comparative analysis in different countries. It explains why there is interest in perfor!mance monitoring in a given setting, why it has failed or created uncertainties, and identifies criteria for improving its design and use.One of the challenges this book offers is the need to consider dimensions of performance beyond the traditional ones of economy, efficiency, and effectiveness. With an increasingly diverse, interdependent, and uncertain public sector environment, for some stakeholders meeting objectives fixed some time ago may not be as important as the capacity to adapt to current and future change. In this vein, the contributors address a number of themes: the criti!cal importance of organizational support for performance monitoring and making it consistent with the organizational culture, the need for active and effective leadership in defining criteria and implementing practical performance monitoring, the value of linking ongoing measurement with more than the traditional, strictly quantitative aspects of public sector performance.As we gain experience with performance monitoring and its uses, such systems should become more cost effective over time. This book will be of deep interest to public managers, government officials, economists, and organization theorists, and useful in courses on p