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Measuring Up

Improving Health System Performance in OECD Countries

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How can we measure the performance of different health systems, and how can we use such information to support on-going health systems improvement? Those are the central questions addressed in this volume. Health policy makers have a growing interest in finding ways of encouraging health systems to improve their performance, where performance is measured against quality, efficiency or equity goals. Improving performance has the potential to reduce the tensions between rising demands and limited resources. There is also a growing demand for accountability among funders and providers of health services.

This book highlights the core elements of a possible performance measurement framework to assess health systems at the international and national levels. It also addresses further challenges which remain: how do we overcome the lack of health outcome measures? How do we better align performance information and incentives with policy objectives? And how do we reconcile the traditional professional self-regulation approach with greater public accountability for health care quality?

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Developing Composite Indicators for Assessing Health System Efficiency

There exist several dimensions along which health system performance might be measured, and numerous indicators of performance have been proposed. Many such indicators do indeed capture important aspects of system behaviour, but each is to some extent partial, and as a result potentially misleading. Given the intense policy interest in system performance, the question therefore arises: can some form of aggregation of indicators yield a more satisfactory insight into performance than the partial view offered by individual indicators? This paper examines the extent to which some sort of aggregation is possible and useful. It starts with a discussion of some of the key economic concepts associated with system performance…

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