Using performance indicators to improve health care quality in the public sector: A review of the literature

Article


Freeman, T. 2002. Using performance indicators to improve health care quality in the public sector: A review of the literature. Health Services Management Research. 15 (2), pp. 126-137. https://doi.org/10.1258/0951484021912897
TypeArticle
TitleUsing performance indicators to improve health care quality in the public sector: A review of the literature
AuthorsFreeman, T.
Abstract

Given the increasing importance of performance indicators in current UK health policy, this paper provides a systematic review of empirical and theoretical writings concerning their use to improve health care quality. The paper outlines potential problems and explores how best to derive, implement and use performance indicator data, presenting results thematically. The two principal uses of indicator systems are as summative mechanisms for external accountability and verification, and as formative mechanisms for internal quality improvement. In the UK, the use of performance indicators in assurance and performance management systems has heavily influenced debate over their value. Major problems reported include the potential to undermine the conditions required for quality improvement, perverse incentives and the difficulty of using data to promote change. Technical problems include indicator selection; the availability, validity and reliability of data; confounding; and problems with robustness, sensitivity and specificity. Factors that help in the derivation, implementation and use of indicator systems include clear objectives, involvement of stakeholders in development, and use of 'soft' data to aid interpretation.

LanguageEnglish
PublisherSAGE Publications
JournalHealth Services Management Research
ISSN0951-4848
Electronic1758-1044
Publication dates
PrintMay 2002
Publication process dates
Deposited25 Sep 2023
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.1258/0951484021912897
PubMed ID12028801
Scopus EID2-s2.0-0036247951
Web of Science identifierMEDLINE:12028801
Related Output
Has metadatahttp://www.scopus.com/inward/record.url?eid=2-s2.0-0036247951&partnerID=MN8TOARS
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