Skip to main content

Challenges of Measuring the Performance of Health Systems

  • Living reference work entry
  • First Online:
Data and Measures in Health Services Research

Part of the book series: Health Services Research ((HEALTHSR))

Abstract

Improving the measurement of the performance of health systems is a wise policy option for federal, provincial, and territorial governments because it provides essential information for understanding the inevitable trade-offs involved in trying to reduce costs while striving to improve quality of care, access, and the health of the population. Performance measurement – monitoring, evaluating, and communicating the degree to which health-care systems address priorities and meet specific objectives – is also garnering increased attention from many stakeholders at other levels of the system.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

References

  • Alkin M. Evaluation roots: tracing theorists’ views and influences. Thousand Oaks: CA Sage; 2004.

    Book  Google Scholar 

  • Canadian Institute for Health Information (CIHI). Health indicators 2012. http://waittimes.cihi.ca/

  • Evans DB, Edejer TT, Lauer J, et al. Measuring quality: from the system to the provider. Int J Qual Health Care. 2001;13:439–46.

    Article  CAS  PubMed  Google Scholar 

  • Goeree R, Levin L, Chandra K, et al. Health technology assessment and primary data collection for reducing uncertainty in decision making. J Am Coll Radiol. 2009;6:332–42.

    Article  PubMed  Google Scholar 

  • Health Canada – Health Technology Assessment Task Group on behalf of the Federal/Provincial/Territorial Advisory Committee on Information and Emerging Technologies Technology Strategy 1.0. 2004. Available at http://www.hc-sc.gc.ca/hcs-sss/pubs/ehealth-esante/2004-tech-strateg/index-eng.php

  • Hutton J, McGrath C, Frybourg JM, et al. Framework for describing and classifying decision-making systems using technology assessment to determine the reimbursement of health technologies (fourth hurdle systems). Int J Technol Assess Health Care. 2006;22:10–8.

    Article  PubMed  Google Scholar 

  • Ibrahim JE. Performance indicators from all perspectives. Int J Qual Health Care. 2001;13:431–2.

    Article  CAS  PubMed  Google Scholar 

  • Jacob R, McGregor M. Assessing the impact of health technology assessment. Int J Technol Assess Health Care. 1993;13:68–80.

    Article  Google Scholar 

  • Klazinga N, Stronks K, Delnoij D, Verhoeff A. Indicators without a cause. Reflections on the development and use of indicators in health care from a public health perspective. Int J Qual Health Care. 2001;13:433–8.

    Article  CAS  PubMed  Google Scholar 

  • Lafortune L, Farand L, Mondou I, et al. Assessing the performance of health technology assessment organizations: a framework. Int J Technol Assess Health Care. 2008;24:76–86.

    Article  PubMed  Google Scholar 

  • Levin L, Goeree R, Sikich N, et al. Establishing a comprehensive continuum from an evidentiary base to policy development for health technologies: the Ontario experience. Int J Technol Assess Health Care. 2007;23:299–309.

    Article  PubMed  Google Scholar 

  • Levy AR. Categorizing outcomes of health care delivery. Clin Invest Med. 2005;28:347–50.

    PubMed  Google Scholar 

  • Levy AR, McGregor M. How has extracorporeal shock-wave lithotripsy changed the treatment of urinary stones in Quebec? Can Med Assoc J. 1995;153:1729–36.

    CAS  Google Scholar 

  • Levy AR, Terashima M, Travers A. Should geographic analyses guide the creation of regionalized care models for ST-segment elevation myocardial infarction? Open Med. 2010;1:e22–5.

    Google Scholar 

  • Manitoba, Minister of Health and Healthy Living. Manitoba’s comparable health indicator report. Winnipeg: Manitoba Health; 2004.

    Google Scholar 

  • McGregor M, Brophy JM. End-user involvement in health technology assessment (HTA) development: a way to increase impact. Int J Technol Assess Health Care. 2005;21:263–7.

    PubMed  Google Scholar 

  • Murray CJL, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, MA: Harv Sch Public Health/WHO/World Bank; 1996; Report No. 1.

    Google Scholar 

  • Osbourne D, Gaebler T. Reinventing government. Lexington: Addison-Wesley; 1992.

    Google Scholar 

  • Raftery J, Roderick P, Stevens A. Potential use of routine databases in health technology assessment. Health Technol Assess. 2005;9:1–iv.

    Article  Google Scholar 

  • Roberts MJ, Hsiao W, Berman P, Reich M. Getting health reform right – a guide to improving performance and equity. Oxford, UK: Oxford University Press; 2008.

    Book  Google Scholar 

  • Roos LL, Gupta S, Soodeen RA, Jebamani L. Data quality in an information-rich environment: Canada as an example. Can J Aging. 2005;24 Suppl 1:153–70.

    Article  PubMed  Google Scholar 

  • Roski J, Gregory R. Performance measurement for ambulatory care: moving towards a new agenda. Int J Qual Health Care. 2001;13:447–53.

    Article  CAS  PubMed  Google Scholar 

  • Shepherd RP. In search of a balanced Canadian federal evaluation function: getting to relevance. Can J Program Eval. 2012;26:1–45.

    Google Scholar 

  • Snowdon A, Schnarr K, Hussein A, Alessi C. Measuring what matters: the cost vs. values of health care. Ivey International Centre for Health Innovation. http://sites.ivey.ca/healthinnovation/thought-leadership/white-papers/measuring-what-matters-the-cost-vs-values-of-health-care-november-2012/

  • Sobolev B, Sanchez V, Kuramoto L. Health care evaluation using computer simulation: concepts, methods and applications. New York: Springer; 2012; 480 pages ISBN: 978-1-4614-2232-7.

    Google Scholar 

  • Suissa S, Henry D, Caetano P, et al. CNODES: the Canadian network for observational drug effect studies. Open Med. 2012;6, e134.

    PubMed  PubMed Central  Google Scholar 

  • Tu JV, Bowen J, Chiu M, et al. Effectiveness and safety of drug-eluting stents in Ontario. N Engl J Med. 2007;357:1393–402.

    Article  CAS  PubMed  Google Scholar 

  • Velasco GM, Gerhardus A, Rottingen JA, Busse R. Developing health technology assessment to address health care system needs. Health Policy. 2010;94:196–202.

    Article  Google Scholar 

  • Weintraub WS, Grau-Sepulveda MV, Weiss JM, et al. Comparative effectiveness of revascularization strategies. N Engl J Med. 2012;366:1467–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This chapter is reprinted from Levy, Adrian R., and Boris G. Sobolev. “The Challenges of Measuring the Performance of Health Systems in Canada.” Health Care Federalism in Canada. Eds. Katherine Fierlbeck and William Lahey. Montreal: McGill-Queen’s University Press, 2013. Print.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Adrian R. Levy or Boris G. Sobolev .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this entry

Cite this entry

Levy, A.R., Sobolev, B.G. (2016). Challenges of Measuring the Performance of Health Systems. In: Sobolev, B., Levy, A., Goring, S. (eds) Data and Measures in Health Services Research. Health Services Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7673-4_19-1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-7673-4_19-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Online ISBN: 978-1-4899-7673-4

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics