Measuring Health Performance In The Public Sector

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.

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.

Confronted with rising citizen discontent, the Reinventing Government movement, and new technological challenges, public organizations everywhere are seeking means of improving their performance. Their quest is not new, rather, the concern with improving the performance of government organizations has existed since the Scientific Management Movement. Public Sector Performance brings together in a single volume the classic, enduring principles and processes that have defined the field of public sector performance, as written in the words of leading practitioners and scholars. Taken as a whole, this volume provides a performance compass for today's public managers, helping them to reconstruct the public's confidence in, and support of, government.Defined here as managing public organizations for outcomes, performance is examined in all its varied dimensions: organizing work, managing workers, measuring performance, and overcoming resistance to performance-enhancing innovations. The selected articles are interesting, thought provoking, and instructive. They are classics in that they have been widely cited in the scholarly literature and have enduring value to public managers who seek to understand the many dimensions of performance. The book is organized into three sections: Performance Foundations, Performance Strategies, and Performance Measurement. Excerpts from additional selected articles feature special topics and wisdom from performance experts.

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.

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.

Measuring the performance of public agencies and programmes is essential to ensure that citizens enjoy quality services and that governments can be sure that taxpayers receive value for money. As such, good performance measurement is a crucial component of improvement and planning, monitoring and control, comparison and benchmarking and also ensures democratic accountability. This book shows how the principles, uses and practice of performance measurement for public services differ from those in for-profit organisations, being based on the need to add public value rather than profit. It describes methods and approaches for measuring performance through time, for constructing and using scorecards, composite indicators, the use of league tables and rankings and argues that data-envelopment analysis is a useful tool when thinking about performance. This demonstrates the importance of allowing for the multidimensional nature of performance, as well as the need to base measurement on a sound technical footing.