> Publications & presentations > PHC RIS infonet > June 2008 > Performance management and accountability

Performance management and accountability

The performance of health systems is always a hot topic with the public. For accountability and to improve quality, many countries have put in place systems to measure different dimensions of performance at the level of individual practitioners, practices, or health care organisations, or most difficult of all, the way different components of the system fit together to provide coordination and continuity. Just as measuring the performance of athletes at the forthcoming Olympic Games needs many specific measures, rules, and criteria, there is no single measure for a health system.

In the current ‘plandemic' of discussions about health reform, many people have expressed the need for better data about the quality of our health system and the outcomes for people using it. Systems of measuring performance require specific targets and standards, accurate data, incentives and reporting mechanisms, and system design is determined by the purpose of the system.

Many initiatives are underway relating to performance management in Australia. The National Health and Hospitals Reform Commission has delivered its first report on accountability mechanisms between jurisdictions in the next round of Australian Health Care Agreements. Work to identify indicators of safety and quality is progressing, with primary care as a case study. A reduced number of National Performance Indicators has been developed for the next phase of funding for the divisions of general practice program, with emphasis on outcomes rather than process.

Australians working to develop new systems are aware of countries such as UK, NZ, USA, Canada and the Netherlands which assess the performance of their health care practitioners, practices and/or organisations against different frameworks of specific standards and targets, with varying uses of incentives to suit their local context.

For up to date information on these systems, check the PHC RIS website at www.phcris.org.au/infobytes/

See Beyond the Blame Game: Accountability and performance benchmarks for the next Australian Health Care Agreements. A report from the National Health and Hospitals Reform Commission, April 2008.
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