A methodology to design a performance management system in preventive care

Abstract

BackgroundPreventive care has gained increasing attention in health reforms around the world due to its ability to reduce the burden of disease and to save health costs. Nevertheless, there is a gap in terms of the development of reliable systems to measure and evaluate performance of preventive care in order to support decision-making and increase service outcomes. The aim of this study is to define a methodology for designing a performance management system (PMS) in order to effectively support the planning, control and evaluation of preventive care and to identify the factors that influence such a process.MethodsThe methodology is based on the participatory action research approach, which implies collaboration between researchers and practitioners. The study was articulated in four phases and carried out in an Italian regional healthcare system that was undergoing a major reorganization process.ResultsThe findings provide insights into the peculiarities that affect preventive care and highlight two categories of critical factors: general issues regarding the process and specific issues regarding preventive care. The first category includes the importance of interactions between academics, physicians and policy-makers, the impact of workloads and red tape on employee involvement and the increased conservation mechanisms during periods of institutional change. The second category concerns the strong heterogeneity of preventive activities within health organizations, the huge amount of regulations and the incompleteness of information systems.ConclusionThe development of a PMS for preventive care can best be served by collaborative methods that involve academics, professionals and policy-makers, whose roles and responsibilities must be clearly defined, and by an improvement in transparency and communication within organizations in order to enhance the involvement of different professionals at appropriate times and in appropriate ways. Key recommendations that may improve the maintenance and use of information systems are proposed to policy-makers.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3837-8) contains supplementary material, which is available to authorized users.

Mapping the Research on Health Policy and Services in the Last Decade (2009–2018): A Bibliometric Analysis

“…At different times, different countries have different priorities for health policy and services. In last decade, the focus of this field has gradually shifted from public environmental occupational health ( 12 – 16 ), health policy services ( 17 – 21 ), and health science services ( 22 – 26 ) to specific diseases such as psychiatric ( 27 – 29 ) and pediatric diseases as well as environmental science ecology ( 30 ), biomedical social sciences and other fields. It has undergone a transformation from macro to micro.…”

Strategies for Improving the Utilization of Preventive Care Services: Application of Importance–Performance Gap Analysis Method

“…Disease prevention has become a key consideration for public health policymakers around the world. The promotion of health programs focuses more on health promotion and disease prevention in order to reduce the burden of disease and associated risk factors [ 3 ]. Transforming health from disease treatment to disease prevention and health management, and from passive to active and predictive care [ 4 ], is the trend of global health progress.…”

“…In addition, the fragmentation of health planning and the difficulty in identifying the performance of the roles of different behaviors involved in preventive care services are also factors [ 23 , 24 ]. From a methodological view, these may be yet-to-be-established frameworks for measuring and evaluating preventive care [ 3 ], since preventive care services involve the strategic management issues of providers, customers, quality, efficiency, and resource allocation. The two-dimensional strategy matrix (importance–performance gap analysis, IPGA) [ 25 ] developed from the perspective of customers has been applied in various fields because it can quickly provide decision makers with useful information.…”

Knowledge, Understanding and Satisfaction with the Implementation of the Performance Management System at a District Hospital in the Madibeng Subdistrict, South Africa

“…Furthermore, the studies were cross-sectional or focused on past data contained in documents and published articles. None of the studies were longitudinal or assessed the impact of an intervention over time [ 18 , 19 , 20 , 21 , 22 , 23 ].…”

“…The authors of [ 17 ] state that a performance management system is an ideal asset created to add organisational value by motivating and measuring the effectiveness and relevance of employee performance to the healthcare institution’s targets. Performance management systems enhance the entire performance of health systems by emphasising rational decision-making [ 22 ]. However, a poorly implemented performance management system can have a negative impact on employee morale and on overall employee satisfaction levels.…”