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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Editor's Preface

The concern with measuring the performance of health systems and health care is not recent. In the 1860s Florence Nightingale pioneered the systematic collection, analysis and dissemination of comparative hospital outcomes data in order to understand and improve performance. Fifty years later, Ernest Codman promoted the need for scrupulous collection and public release of surgical outcome data (Spiegelhalter, 1999). However, there were many practical, professional and political impediments to making such principles operational. It is only in the last ten years that the vision of using large-scale data sources to help improve health system performance has become a reality...

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