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 National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.

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.

Despite having the costliest medical care delivery system in the world, Americans are not particularly healthy. Recent international comparisons show that life expectancy in the U.S. ranks 49th among all nations, and infant mortality rates are higher in the U.S. than in many far less affluent nations. While these statistics are alarming, the bigger problem is that we do not know how to reverse this trend. Our lack of knowledge is due in large part to significant inadequacies in the health system for gathering, analyzing, and communicating health information about the population. To inform the public health community and all other sectors that contribute to population health, For the Public's Health: The Role of Measurement in Action and Accountability reviews current approaches for measuring the health of individuals and communities and creates a roadmap for future development. This book, the first of three in a series, focuses on data and measurement-not as ends in themselves, but rather tools to inform the myriad programs, policies, and processes developed or undertaken by governmental public health agencies and their many partners in the health system. For the Public's Health seeks to reinstate the proper and evidence-based understanding of health as not merely the result of medical or clinical care but the result of the sum of what we do as a society to create the conditions in which people can be healthy. To achieve this goal, the book suggests changes in the processes, tools, and approaches used to gather information about health outcomes and their determinants. The book also recommends developing an integrated and coordinated system in which all parties-including governmental and private sector partners at all levels-have access to timely and meaningful data to help foster individual and community awareness and action.

Performance Measurement is the first in a new series of an ongoing effort by the Institute of Medicine (IOM) to improve health care quality. Performance Measurement offers a comprehensive review of available measures and introduces a new framework to examine these measures against the six aims of the health care system: health care should be safe, effective, patient-centered, timely, efficient, and equitable. This new book also addresses the gaps in performance measurement and introduces the need for measures that are longitudinal, comprehensive, population-based, and patient-centered. This book is directed toward all concerned with improving the quality and performance of the nation's health care system in its multiple dimensions and in both the public and private sectors.

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.