Public Health Performance

Abstract

This review examines past, current, and future issues in developing and using public health performance data for improving the public health system. Issues are explored relating to public health performance data collection and analysis, and inferences made from those data, largely by examining public health performance data collected since the Year 2000. More research is needed to improve understanding of the context in which public health systems operate and how that context affects performance and its relationship to health outcomes. There are major areas of concern that must be addressed by the public health practice organizations, governmental public health entities, and the public health systems research communities, such as ensuring that data are collected on public health infrastructure, practice, and performance and that data from various sources are collected in a harmonious fashion. At issue also is the examination of the impact of new arrivals to the public health system, such as accreditation and credentialing of the public health workforce, on public health system performance.

Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform

“…These factors are also consistently documented in leading peer-reviewed longitudinal studies, 15,16 and PHSSR analyses. 5,10,14 PHSSR is complex and common limitations may affect these findings. First, a majority of PHSSR performance studies to date are cross-sectional, restricting our ability to draw causal relationship.…”

“…Fourth, the literature reported in Table 2 mostly relies on the analysis of only two specific US data sets. 10,12,13 The first database comes from the National Public Health Performance Standards program, developed by the Centers for Disease Control and US national public health organizations. This program regularly surveys public health departments, collecting data on the delivery of essential public health services through selfassessment tools.…”

“…Performance is a multifaceted concept: in Table 1, we adapt Handler and colleagues' public health performance framework 7 in order to summarize elements and dimensions of performance often reported in the PHSSR literature, notably productivity, effectiveness, efficiency and equity. 3,5,6,[8][9][10][11][12][13][14][15][16] Productivity is the relationship between structures and resulting…”

Recent Advances in Public Health Systems Research in the United States

“…Improving performance, accountability, and value of the public health system is complicated by the nature of the system because it is composed of a variety of very different organizations, each with different structured activities and the capacity to deliver services (60). Reviews of more than 90 years of effort to measure, describe, and improve public health practice and systems performance (82,94) show that many of the same basic challenges for measuring systems performance persist. In addition, new and re-emphasized priorities in public health practice, such as voluntary agency accreditation (46,58,72,91), workforce credentialing (12,16,23,68), quality improvement (74,75,85), and service value measurement (36,43,66), will increase expectations for PHSR science to integrate and understand effects of these efforts at multiple systems levels.…”

An Infrastructure to Support the Visual Analysis of Data from the Brazilian Public Health System

“…Concerns about gaps in both the availability and quality of public health services have hit the headlines in response to both new and persistent health risks [1]. For this reason, decision makers and practitioners must be careful about the allocation, management, and administration of public health resources [2].…”