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From page 35...
... Contents PREFACE EXECUTIVE SUMMARY INTRODUCTION Origins of the Study, 16 Performance Partnership Grants, 16 / Other Influences, 17 Charge to the Panel, 18 Essential Definitions, 19 Performance Measurement and Related Concepts, 19 / Categories of Performance Measures, 20 Phase I: Focus on Selection of Performance Measures, 22 Use of Measures of Process and Capacity as Well as Outcomes, 22 / Guidelines for Selecting Performance Measures, 24 /Limitations of a Program-Specific Approach to Performance Measurement, 25 /Need to Strengthen State and Local Capacity for Data Collection and Analysis, 26/ Inadvisability of Using Performance Measures Alone for Resource Allocation Purposes, 26 Phase II: Data and Information System Development to Support Performance Measurement, 27 A Vision for a National Health Information Network, 27/ Critical Issues, 28 Structure of the Report, 29 References, 29 35 1X 15
From page 36...
... 36 MEASURING HEALTH PERFORMANCE IN THE PUBLIC SECTOR: 2 PUTTING PERFORMANCE MEASUREMENT IN CONTEXT 30 Use of Performance Measurement in Accountability Systems, 30 Performance-Based Accountability Systems, 31 / Operation of Performance-Based Systems, 33 /Applications of Performance Measurement, 37 Examples of Performance Monitoring and Accountability Systems, 40 Government Performance and Results Act, 41/ Use of Performance Measures in the Maternal and Child Health Services Block Grant Program, 42 /Reporting Requirements for the Temporary Assistance for Needy Families Program, 44 / State Developments in Performance-Based Budgeting, 45 /Health Care Performance Measurement in the Private Sector, 48 Conclusions, 52 References, 55 3 PERFORMANCE MEASUREMENT CONSIDERATIONS FOR PUBLICLY FUNDED HEALTH PROGRAMS Broad Array of Health-Related Services and Service Relationships, 60 Measurement Considerations for Population-Based Health Services, 61 Population Health Services, 61 /Monitoring Population Health Services, 62 Monitoring the Infrastructure for Publicly Funded Health Programs, 64 Some Peformance Measurement Considerations Related to Program Specific Matters, 66 Environmental Health Programs, 66/Mental Health Programs, 68 / Substance Abuse Programs, 71 Process Guidelines as a Basis for Performance Measurement, 74 Guidelines for Personal Health Services, 75 / Guidelines for Population-Based Health Services, 76 /Research Needs for Practice Guidelines and Performance Measurement, 76 Conclusions, 78 References, 79 4 DATA AND INFORMATION SYSTEMS: ISSUES FOR PERFORMANCE MEASUREMENT Health Data Resources, 84 Registries, 85 / Surveys, 86/ Patient Records and Related Clinical Encounter Data, 87/Administrative Data, 89 / Claims Data, 90 /Linkage of Data Sets, 91 / Steps Toward Integration of Data Sets, 93 59 83
From page 37...
... A SUMMARY OF TWO REPORTS Assuring the Quality of Data and Data Analysis, 95 Random Variation and Bias, 96/Data Management, 97 / Challenges in Data Analysis, 98 Developing and Implementing Standards for Data and Data Systems, 103 Standardization Activities, 103/Balancing Standardization and Change, 108 Enhancing Performance Measurement through Advances in Information Technology, 109 Data Collection and Transmission Technologies, 109/Data Management and Analysis, 110/ Computer-Based Patient Records, 111 / The Internet and the World Wide Web, 111 / Limits of Technology, 114 Privacy, Confidentiality, and Security of Health Data, 114 Investing in Health Data and Data Systems, 116 Data and Information Systems, 117/Technology, 119/ Training and Technical Assistance, 120 Taking a Collaborative Approach to the Development of Health Data and Information Systems, 122 Meeting the Needs of Many Data Users, 123/ Collaboration in the Design and Implementation of Data Systems, 125 Conclusions, 126 References, 127 5 STRATEGIES FOR SUPPORTING PERFORMANCE MEASUREMENT THROUGH A NATIONAL INFORMATION NETWORK Conclusions Regarding Performance Partnership Agreements, 133 A National Information Network for Health-Related Data, 134 Essential Features of a Health Information Network to Serve Different Levels of Decision Making, 135 Major Policy Actions Needed, 138 National Collaboration, 138 / Integration of Data Systems, 143 / Technology Policy, 144 Operational Principles, 145 Involve a Broad Range of Public Agencies, 145 /Build on Existing Information Systems, 146/ Implementation Standards, 147 Required Investment for an Information Network, 152 Data Systems, 152 / Training and Technical Assistance, 154 A National Research Agenda, 156 Final Observations, 157 References, 158 37 132

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