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The performance measurement–management divide in public health

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  • Schwartz, Robert
  • Deber, Raisa

Abstract

What happens when performance measurement and management (PMM) is applied to public health systems? This review of the experiences of high-income jurisdictions reveals considerable challenges, some familiar from the general public management literature and some more unique to public health. To aid understanding, the PMM ladder, a framework for evaluating PMM systems is developed and applied to 55 public health measurement systems from Australia, Canada, EU, New Zealand, UK and US. Results indicate that: considerable measurement is occurring for informational purposes; measurement focuses more on clinical than on population health measures; and there is relatively little use of measurement results for improving management. Results demonstrate that much public health performance measurement is restricted to population health outcomes and fails to include more proximate activity and output measures that would be more useful for managing public health organizations. There are early signs of the emergence of a new breed of public health performance measurement that attempts to do just this. The PMM ladder proved useful for assessing efforts across a range of jurisdictions. It allows policymakers and managers to easily compare their PMM efforts with others and assists researchers in assessing what happens when PMM is applied to public health.

Suggested Citation

  • Schwartz, Robert & Deber, Raisa, 2016. "The performance measurement–management divide in public health," Health Policy, Elsevier, vol. 120(3), pages 273-280.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:3:p:273-280
    DOI: 10.1016/j.healthpol.2016.02.003
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    References listed on IDEAS

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    1. Lebas, Michel J., 1995. "Performance measurement and performance management," International Journal of Production Economics, Elsevier, vol. 41(1-3), pages 23-35, October.
    2. P.C. Smith, 2002. "Measuring health system performance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(3), pages 145-148, September.
    3. Soeren Mattke & Edward Kelley & Peter Scherer & Jeremy Hurst & Maria Luisa Gil Lapetra & HCQI Expert Group Members, 2006. "Health Care Quality Indicators Project: Initial Indicators Report," OECD Health Working Papers 22, OECD Publishing.
    4. Jeremy Hurst & Melissa Jee-Hughes, 2001. "Performance Measurement and Performance Management in OECD Health Systems," OECD Labour Market and Social Policy Occasional Papers 47, OECD Publishing.
    5. Edward Kelley & Jeremy Hurst, 2006. "Health Care Quality Indicators Project: Conceptual Framework Paper," OECD Health Working Papers 23, OECD Publishing.
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    Cited by:

    1. Milena Vainieri & Guido Noto & Francesca Ferre & Laura C. Rosella, 2020. "A Performance Management System in Healthcare for All Seasons?," IJERPH, MDPI, vol. 17(15), pages 1-10, August.
    2. Laurent Mériade & Corinne Rochette, 2022. "Governance tensions in the healthcare sector: a contrasting case study in France," Post-Print hal-03516559, HAL.

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