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Making performance indicators work: The experience of using consensus indicators for external assessment of health and social services at regional level in Spain

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  • Hilarion, Pilar
  • Suol, Rosa
  • Groene, Oliver
  • Vallejo, Paula
  • Herrera, Elisabeth
  • Saura, Rosa Maria

Abstract

Objectives To describe a methodology and the results of projects combining consensus processes for indicator development with methods of external assessment of health and social services.Methods Our methodology can be characterized by a four-step approach: (1) stakeholder involvement and creating an enabling environment, (2) using standardized consensus methods for indicator development, (3) using rigorous external evaluation methods to assess results and (4) developing and implementing quality improvement initiatives. We describe each step in detail and discuss factors of success and pitfalls based on our experience of applying the methodology in 648 health/social centres and reviewing overall 68,616 case records.Results We observe in four sectors (assisted living, elderly health care, care for people with drug abuse problems, and care for abused woman) improvements in overall quality improvement rates, ranging from 9.5% to 65.6%. Improvements in overall rates are accompanied by reduction in range of up to 48.8.Conclusions The conscientious setting up of an enabling environment and the systematic involvement of professionals in designing indicators and setting standards is a key to improving performance. Our research may entail lessons for policy makers on the current debate on pay for performance models.

Suggested Citation

  • Hilarion, Pilar & Suol, Rosa & Groene, Oliver & Vallejo, Paula & Herrera, Elisabeth & Saura, Rosa Maria, 2009. "Making performance indicators work: The experience of using consensus indicators for external assessment of health and social services at regional level in Spain," Health Policy, Elsevier, vol. 90(1), pages 94-103, April.
    • Handle: RePEc:eee:hepoli:v:90:y:2009:i:1:p:94-103
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    References listed on IDEAS

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    1. Norton, Edward C., 1992. "Incentive regulation of nursing homes," Journal of Health Economics, Elsevier, vol. 11(2), pages 105-128, August.
    2. Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
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    1. Iwona Markowicz & Iga Rudawska, 2021. "Struggling with COVID-19—A Framework for Assessing Health System Performance," Sustainability, MDPI, vol. 13(20), pages 1-13, October.
    2. El-Jardali, Fadi & Saleh, Shadi & Ataya, Nour & Jamal, Diana, 2011. "Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: Policy coherence and application lessons for low and middle income countries," Health Policy, Elsevier, vol. 103(2), pages 305-314.
    3. Sabina Nuti & Chiara Seghieri & Milena Vainieri, 2013. "Assessing the effectiveness of a performance evaluation system in the public health care sector: some novel evidence from the Tuscany region experience," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 17(1), pages 59-69, February.

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