Health performance measurement in the public sector : principles and policies for implementing an information network

목차 (Table of Contents)

• CONTENTS
• PREFACE = ⅸ
• EXECUTIVE SUMMARY = 1
• 1 INTRODUCTION = 15
• Origins of the Study = 16
• Performance Partnership Grants = 16
• Other Influences = 17
• Charge to the Panel = 18
• Essential Definitions = 19
• Performance Measurement and Related Concepts = 19
• Categories of Performance Measures = 20
• Phase Ⅰ : Focus on Selection of Performance Measures = 22
• Use of Measures of Process and Capacity as Well as Outcomes = 22
• Guidelines for Selecting Performance Measures = 24
• Limitations of a Program-Specific Approach to Performance Measurement = 25
• Need to Strengthen State and Local Capacity for Data Collection and Analysis = 26
• Inadvisability of Using Performance Measures Alone for Resource Allocation Purposes = 26
• Phase Ⅱ : Data and Information System Development to Support Performance Measurement = 27
• A Vision for a National Health Information Network = 27
• Critical Issues = 28
• Structure of the Report = 29
• References = 29
• 2 PUTTING PERFORMANCE MEASUREMENT IN CONTEXT = 30
• Use of Performance Measurement in Accountability Systems = 30
• Performance-Based Accountability Systems = 31
• Operation of Performance-Based Systems = 33
• Applications of Performance Measurement = 37
• Examples of Performance Monitoring and Accountability Systems = 40
• Government Performance and Results Act = 41
• Use of Performance Measures in the Maternal and Child Health Services Block Grant Program = 42
• Reporting Requirements for the Temporary Assistance for Needy Families Program = 44
• State Developments in Performance-Based Budgeting = 45
• Health Care Performance Measurement in the Private Sector = 48
• Conclusions = 52
• References = 55
• 3 PERFORMANCE MEASUREMENT CONSIDERATIONS FOR PUBLICLY FUNDED HEALTH PROGRAMS = 59
• Broad Array of Health-Related Services and Service Relationships = 60
• Measurement Considerations for Population-Based Health Services = 61
• Population Health Services = 61
• Monitoring Population Health Services = 62
• Monitoring the Infrastructure for Publicly Funded Health Programs = 64
• Some Peformance Measurement Considerations Related to Program-Specific Matters = 66
• Environmental Health Programs = 66
• Mental Health Programs = 68
• Substance Abuse Programs = 71
• Process Guidelines as a Basis for Performance Measurement = 74
• Guidelines for Personal Health Services = 75
• Guidelines for Population-Based Health Services = 76
• Research Needs for Practice Guidelines and Performance Measurement = 76
• Conclusions = 78
• References = 79
• 4 DATA AND INFORMATION SYSTEMS : ISSUES FOR PERFORMANCE MEASUREMENT = 83
• Health Data Resources = 84
• Registries = 85
• Surveys = 86
• Patient Records and Related Clinical Encounter Data = 87
• Administrative Data = 89
• Claims Data = 90
• Linkage of Data Sets = 91
• Steps Toward Integration of Data Sets = 93
• Assuring the Quality of Data and Data Analysis = 95
• Random Variation and Bias = 96
• Data Management = 97
• Challenges in Data Analysis = 98
• Developing and Implementing Standards for Data and Data Systems = 103
• Standardization Activities = 103
• Balancing Standardization and Change = 108
• Enhancing Performance Measurement through Advances in Information Technology = 109
• Data Collection and Transmission Technologies = 109
• Data Management and Analysis = 110
• Computer-Based Patient Records = 111
• The Internet and the World Wide Web = 111
• Limits of Technology = 114
• Privacy, Confidentiality, and Security of Health Data = 114
• Investing in Health Data and Data Systems = 116
• Data and Information Systems = 117
• Technology = 119
• Training and Technical Assistance = 120
• Taking a Collaborative Approach to the Development of Health Data and Information Systems = 122
• Meeting the Needs of Many Data Users = 123
• Collaboration in the Design and Implementation of Data Systems = 125
• Conclusions = 126
• References = 127
• 5 STRATEGIES FOR SUPPORTING PERFORMANCE MEASUREMENT THROUGH A NATIONAL INFORMATION NETWORK = 132
• Conclusions Regarding Performance Partnership Agreements = 133
• A National Information Network for Health-Related Data = 134
• Essential Features of a Health Information Network to Serve Different Levels of Decision Making = 135
• Major Policy Actions Needed = 138
• National Collaboration = 138
• Integration of Data Systems = 143
• Technology Policy = 144
• Operational Principles = 145
• Involve a Broad Range of Public Agencies = 145
• Build on Existing Information Systems = 146
• Implementation Standards = 147
• Required Investment for an Information Network = 152
• Data Systems = 152
• Training and Technical Assistance = 154
• A National Research Agenda = 156
• Final Observations = 157
• References = 158
• APPENDICES
• A POTENTIAL HEALTH OUTCOME AND RISK STATUS MEASURES = 163
• B WORKSHOP AGENDA = 168
• C BIOGRAPHICAL SKETCHES = 170