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Measuring and managing health system performance: An update from New Zealand

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  • Chalmers, Linda Maree
  • Ashton, Toni
  • Tenbensel, Tim

Abstract

In July 2016, New Zealand introduced a new approach to measuring and monitoring health system performance. This ‘Systems Level Measure Framework’ (SLMF) has evolved from the Integrated Performance and Incentive Framework (IPIF) previously reported in this journal. The SLMF is designed to stimulate a ‘whole of system’ approach that requires inter-organisational collaboration. Local ‘Alliances’ between government and non-government health sector organisations are responsible for planning and achieving improved health system outcomes such as reducing ambulatory sensitive hospitalisation for young children, and reducing acute hospital bed days. It marks a shift from the previous regime of output and process targets, and from a pay-for-performance approach to primary care. Some elements of the earlier IPIF proposal, such as general practice quality measures, and tiered levels of performance, were not included in the SLM framework. The focus on health system outcomes demonstrates policy commitment to effective integration of health services. However, there remain considerable challenges to successful implementation. An outcomes framework makes it challenging to attribute changes in outcomes to organisational and collaborative strategies. At the local level, the strength and functioning of collaborative relationships between organisations vary considerably. The extent and pace of change may also be constrained by existing funding arrangements in the health system.

Suggested Citation

  • Chalmers, Linda Maree & Ashton, Toni & Tenbensel, Tim, 2017. "Measuring and managing health system performance: An update from New Zealand," Health Policy, Elsevier, vol. 121(8), pages 831-835.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:8:p:831-835
    DOI: 10.1016/j.healthpol.2017.05.012
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    References listed on IDEAS

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    1. van Herten, Loes M. & Gunning-Schepers, Louise J., 2000. "Targets as a tool in health policy: Part I: lessons learned," Health Policy, Elsevier, vol. 53(1), pages 1-11, August.
    2. Busse, Reinhard & Wismar, Matthias, 2002. "Health target programmes and health care services--any link?: A conceptual and comparative study (part 1)," Health Policy, Elsevier, vol. 59(3), pages 209-221, March.
    3. Van Herten, Loes M. & Gunning-Shepers, Louise J., 2000. "Targets as a tool in health policy. Part II: guidelines for application," Health Policy, Elsevier, vol. 53(1), pages 13-23, August.
    4. Ashton, Toni, 2015. "Measuring health system performance: A new approach to accountability and quality improvement in New Zealand," Health Policy, Elsevier, vol. 119(8), pages 999-1004.
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    1. Akmal, Adeel & Podgorodnichenko, Nataliya & Foote, Jeff & Greatbanks, Richard & Stokes, Tim & Gauld, Robin, 2021. "Why is Quality Improvement so Challenging? A Viable Systems Model Perspective to Understand the Frustrations of Healthcare Quality Improvement Managers," Health Policy, Elsevier, vol. 125(5), pages 658-664.

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