Conceptual frameworks for health systems performance: A quest for effectiveness, quality, and improvement

International Journal for Quality in Health Care

Volumn 15, Issue 5, 2003, Pages 377-398

  Arah, Onyebuchi A ^a,b   Klazinga, N S ^b   Delnoij, D M J ^b   Ten Asbroek, A H A ^b   Custers, T ^b  

^a ERASMUS MEDICAL CENTER   (Netherlands)

^b UNIVERSITY OF AMSTERDAM   (Netherlands)

Author keywords

Conceptual framework; Effectiveness; Health system performance; Performance indicator; Performance management; Performance measurements; Quality

Indexed keywords

AUSTRALIA; CANADA; CONCEPT FORMATION; CONTROLLED STUDY; DYNAMICS; HEALTH CARE ORGANIZATION; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH ECONOMICS; HUMAN; ORGANIZATION AND MANAGEMENT; PRIORITY JOURNAL; REVIEW; TREATMENT OUTCOME; UNITED KINGDOM; WORLD HEALTH ORGANIZATION;

AUSTRALIA; CANADA; DELIVERY OF HEALTH CARE; EUROPE; HEALTH SERVICES RESEARCH; HUMANS; INTERNET; NATIONAL HEALTH PROGRAMS; QUALITY OF HEALTH CARE; STATE MEDICINE; UNITED STATES; WORLD HEALTH ORGANIZATION;

EID: 0141960090     PISSN: 13534505     EISSN: None     Source Type: Journal    
DOI: 10.1093/intqhc/mzg049     Document Type: Review

References (162)

1. Wolfson M. Social propioception: measurement, data and information from a population health perspective. In Evans RG, Barer ML, Marmor T, eds, Why are Some People Healthy and Others Not? New York, NY: Aldine de Gruyter, 1994: p. 309.
2. Eagle CJ, Davies JM. Current models of 'quality' - an introduction for anaesthetists. Can J Anaesth 1993; 40: 851-862.
3. Ibrahim JE. Performance indicators from all perspectives. Int J Qual Health Care 2001; 13: 431-432.
4. Thompson BL, Harris JR. Performance measures: are we measuring what matters? Am J Prev Med 2001; 20: 291-293.
5. McLoughlin V, Leatherman S, Fletcher M, Owen JW. Improving performance using indicators: Recent experiences in the United States, the United Kingdom, and Australia. Int J Qual Health Care 2001; 13: 455-462.
6. McPake B, Mills A. What can we learn from international comparisons of health systems and health system reform? Bull World Health Organ 2000; 78: 811-820.
7. WHO. The World Health Report 2000. Health Systems: Improving Performance. Geneva: World Health Organization, 2000.
8. Department of Health. The National Health Service Plan for England: a Plan for Investment, a Plan for Reform. London: The Stationery Office, 2000.
9. Department of Health. The New NHS - Modern and Dependable. White Paper series. London: The Stationery Office, 1997.
10. Department of Health. A First Class Service: Quality in National Health Service. London: The Stationery Office, 1998.
11. Scottish Executive Health Department. The National Health Service Plan for Scotland: Our National Health: a Plan for Action, a Plan for Change. Edinburgh: Scottish Executive Health Department, 2000.
12. National Assembly for Wales. The National Health Service Plan for Wales. Improving Health in Wales: a Plan for the National Health Service with its Partners. Cardiff, UK: NAW, 2001.
13. NHS. The NHS Explained, United Kingdom. [On-line.] http:// www.nhs.uk/thenhsexplained/ (26 April 2002, date accessed).
14. Department of Health. NHS Performance Indicators: A Consultation. London: Department of Health, 2001.
15. Audit Commission. Aiming to Improve: The Principles of Performance Measurement. London: Audit Commission, 2000.
16. Audit Commission. On Target: The Practice of Performance Indicators. London: AC, 2000.
17. Kaplan RS, Norton DP. The balanced scorecard - measures that drive performance. Harv Bus Rep 1992; 70: 71-79.
18. Department of Health. NHS Performance Indicators, National Figures: February 2002. London: Department of Health, 2002.
19. Department of Health. Building a Safer NHS. London: Department of Health, 2001.
20. Secretary of State for Health. Delivering the NHS Plan: Next Steps on Investment, Next Steps on Reform. London: Crown Copyright, 2002
21. NHS Executive. Clinical Audit in the NHS. London: Department of Health, 1996.
22. The Commission for Health Improvement, United Kingdom. [On-line] http://www.chi.nhs.uk (1 May 2002, date accessed).
23. National Institute for Excellence, United Kingdom: http:// www.nice.org.uk. Accessed 1 May 2002.
24. The NHS Modernisation Agency, United Kingdom. [On-line.] http://www.modernnhs.nhs.uk (1 May 2002, date accessed).
25. National Patient Safety Agency, United Kingdom: http:// www.npsa.org.uk. Accessed 1 May 2002.
26. National Clinical Assessment Authority, United Kingdom. [Online.] http://www.ncaa.nhs.uk (1 May 2002, date accessed).
27. Scotland's health on the web, Scotland. [On-line.] http:// www.show.scot.nhs.uk/ (8 February 2003, date accessed).
28. Department of Health's Performance Ratings Website, United Kingdom. [On-line.] http://www.doh.gov.uk/performanceratings/ (8 April 2002, date accessed).
29. HM Treasury. Public Services for the Future. Modernisation, Reform, Accountability. London: HMSO, 1998.
30. Department of Health's NHS Performance Fund, United Kingdom. [On-line.] http://www.doh.gov.uk/performanceratings/2001/perfund.html (8 April 2002, date accessed).
31. Canadian Institute for Health Information. A portrait of Canada's health care system. In Health Care in Canada 2001. Ottawa: Canadian Institute for Health Information 2001.
32. Lomas J, Woods J, Veenstra G. Devolving authority for health care in Canada's provinces: An introduction to the issues. CMAJ 1997; 156: 371-377.
33. National Forum on Health. Canadian Health Action: Building on the Legacy. Ottawa: National Forum on Health, 1997.
34. Canadian Institute for Health Information, Statistics Canada. Canadian Health Information Roadmap Initiative Indicators Framework. Ottawa: Canadian Institute for Health Information, 2000.
35. Canadian Institute for Health Information, Statistics Canada. Roadmap Initiative ... Launching the Process. Ottawa: Canadian Institute for Health Information, 1999.
36. Canadian Council on Health Services Accreditation. A Guide to the Development and Use of Performance Indicators. Ottawa: Canadian Council on Health Services Accreditation, 1996.
37. Northcott HC, and Northcott JL. The 2000 Survey About Health and the Health System in Alberta. Alberta: Edmonton Population Research Laboratory, University of Alberta, 2000.
38. The Conference Board of Canada. Canadian's Values and Attitudes on Canada's Health Care system: A Synthesis of Survey Results. Ottawa: Conference Board of Canada, 2000.
39. Canadian Intergovernmental Conference Secretariat (CICS). First Ministers' Communiqué on Health, 11 September 2000, Canada. [On-line] http://www.scics.gc.ca/cinfo00/800038004_ehtml (26 March 2002, date accessed).
40. Canadian Institute for Health Information, Canada. [On-line.] http://www.cihi.ca/ (12 March 2002, date accessed).
41. Health Canada Online, Canada. [On-line.] http://www.hcsc.gc.ca (23 April 2002, date accessed).
42. Canadian Institute for Health Information, Statistics Canada. Health Indicators. Volume 2001 No. 3: December 2001. Ottawa: Statistics Canada and Canadian Institute for Health Information, 2001: 82-221-XIE.
43. Harrigan M., Quest for Quality in Canadian Health Care. Vancouver: Health Canada and Minister of Public Works and Government Services Canada, 2000.
44. Health Canada. An Inventory of Quality Initiatives in Canada. Maintaining and Improving Quality in Health Care. Ottawa: H Health Canada C, 1996.
45. The Canadian Medical Association, Canada. [On-line] http:// www.cma.ca/ (18 April 2002, date accessed).
46. Commission on the Future of Health Care in Canada. Shape the Future of Health Care. Interim Report. Canada: Commission on the Future of Health Care in Canada, 2002.
47. Australian Institute of Health and Welfare. Australia's Health 2000. Canberra: Australian Institute of Health and Welfare, 2000.
48. Australian Institute of Health and Welfare. Australia's Welfare 1999. Canberra: Australian Institute of Health and Welfare, 1999.
49. Commonwealth Department of Health and Aged Care. The Australian Health Care System: An Outline. Canberra: Commonwealth of Australia, 2000.
50. Commonwealth of Australia. Australian Health Care Agreements Annual Performance Reports 1998-1999. Canberra: Commonwealth Department of Health and Aged Care, 2000.
51. National Health Ministers' Benchmarking Working Group. First National Report on Health Sector Performance Indicators:. Public Hospitals - the State of the Play. Canberra: Australian Institute of Health and Welfare, 1996.
52. National Health Ministers' Benchmarking Working Group. Second National Report on Health Sector Performance Indicators. Canberra: Commonwealth Department of Health and Family Services, 1998.
53. National Health Ministers' Benchmarking Working Group. Third National Report on Health Sector Performance Indicators. Canberra: Commonwealth Department of Health and Aged Care, 1999.
54. National Health Performance Committee. Fourth National Report on Health Sector Performance Indicators - A Report to the Australian Health Ministers' Conference. Sydney: New South Wales Health Department, 2000.
55. National Health Performance Committee. National Health Performance Framework Report. Brisbane: Queensland Health, 2001.
56. Australian Institute of Health and Welfare. Integrating Indicators. Theory and Practice in the Disability Services Field. Canberra: Australian Institute of Health and Welfare, 2000: Disability Series (DIS 17).
57. National Public Health Partnership. Performance Indicator Frameworks for Population Health: Report on Workshop held on 16 March 2000. Melbourne: National Public Health Partnership, 2000.
58. Australian Institute of Health and Welfare. National Health Data Dictionary. Canberra: Australian Institute of Health and Welfare, 2000.
59. New South Wales Health. A Framework for Managing the Quality of Health Services in New South Wales. Gladesville: Better Health Centre - Publications Warehouse, 1999.
60. Ibrahim JE, Cicuttini FM, Majoor JW et al. Acute Health Clinical Indicators Project. Victoria: Department of Health Services, 1999.
61. Boyce N, McNeil J, Graves D, Dunt D. Quality and Outcome Indicators for Acute Healthcare Services. Canberra: Australian Government Publishing Service, Commonwealth of Australia, 1997.
62. Australian Council on Health Care Standards, Australia. [On-line.] http://www.achs.org.au/ (9 February 2003, date accessed).
63. Quality Improvement Council, Australia. [On-line.] http:// www.latrobe.edu.au/qic/about.htm (9 February 2003, date accessed).
64. National Expert Advisory Group on Safety and Quality in Australian Health Care. Implementing Safety and Quality Enhancement in Health Care. National Actions to Support Quality and Safety Improvement in Australian Health Care. Canberra: Commonwealth Department of Health and Aged Care, 1999.
65. National Health Information Knowledgebase, Australia. [On-line] http://www.aihw.gov.au/knowledgebase/index.html (17 April 2002, date accessed).
66. Organisation for Economic Cooperation and Development. OECD Health Data 2001. Paris: Organisation for Economic Cooperation and Development, 2001.
67. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st century. Washington, DC: National Academy Press, 2001.
68. Department of Health and Human Services. Healthy People 2010. Understanding and Improving Health. Washington, DC: US Government Printing Office, 2000.
69. Institute of Medicine. Envisioning the National Health Care Quality Report. Washington, DC: National Academy Press, 2001.
70. Reilly T, Zema C, Crofton C et al. Providing performance information for consumers: experience from the United States. In Smith P (ed.), Measuring Up. Improving Health Systems Performance in OECD Countries. Ottawa: OECD, 2002: pp. 97-116.
71. Centers for Medicare and Medicaid Services, United States. [On-line.] http://cms.hhs.gov/ (10 February 2003, date accessed).
72. Joint Commission on Accreditation of Healthcare Organizations, United States. [On-line.] http://www.jcaho.org (9 February 2003, date accessed).
73. Foundation for Accountability, United States. [On-line.] http:// www.facct.org/facct/site/facct/facct/Measures (9 February 2003, date accessed).
74. National Quality Measures Clearinghouse™, of the Agency for Healthcare Research and Quality, US Department of Health and Human Services, United States. [On-line.] http:// www.qualitymeasures.ahrq.gov/ (31 March 2003, date accessed).
75. The National Committee for Quality Assurance, United States. [On-line.] http://www.ncqa.org (20 April 2002, date accessed).
76. Institute of Medicine. Medicare: A Strategy for Quality Assurance. Vol. 2. Washington, DC: National Academy Press, 1990.
77. Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press, 1999.
78. Agency for Healthcare Research and Quality, United States. [On-line.] http://www.qualityindicators.ahrq.gov/data/hcup/qinext.htm (9 February 2003, date accessed).
79. The President's Advisory Commision on Consumer Protection and Quality in the Health Care Industry. Quality First: Better Care for all Americans. Washington, DC: US Government Printing Office, 1998.
80. Miller T, Leatherman S. Special report. The National Quality Forum: a 'me-too' or a breakthrough in quality measurement and reporting. Health Aff 1999; 18: 233-237.
81. The National Quality Forum, Washington, DC, United States. [On-line.] http://www.qualityforum.org/about/home.htm (21 April 2002, date accessed).
82. Leatherman S, McCarthy D. Public disclosure of health care performance reports: experience, evidence and issues for policy. Int J Qual Health Care 1999; 11: 93-105.
83. Marshall M, Shekelle P, Brook R, Leatherman S. Dying to Know: Public Release of Information About Quality of Health Care. London and Santa Monica, CA, The Nuffield trust and RAND, 2000: Nuffield Trust Series 12.
84. Leatherman S., Applying performance indicators to health systems improvement. In Smith P (ed.), Measuring Up. Improving Health Systems Performance in OECD Countries Ottawa: OECD, 2002: pp. 319-333.
85. Farley D, McGlynn E, Klein D. Health Plan Reporting Patterns for HEDIS Performance Measures. Santa Monica, CA: The RAND Corporation, 1998.
86. Emmanuel EJ, Emmanuel LL. What is accountability in health care? Ann Intern Med 1996; 124: 229-239.
87. World Health Organization's Evidence for Health Policy: Health System Performance, Geneva. [On-line.] http:// www.who.int/health-systems-performance/ (20 April 2002, date accessed).
88. DFID Resource Centre for Health Sector Reform. World Health Report 2000: Summary and Comments. London: Institute for Health Sector Development, 2000.
89. Editorial. Why rank countries by health performance? Lancet 2001; 357: 1633.
90. Almeida C, Braveman P, Gold MR et al. Methodological concerns and recommendations on policy consequences of the World Health Report 2000. Lancet 2001; 357: 1692-1697.
91. Nord E., Measures of goal attainment and performance in the World Health Report 2000. A brief critical consumer guide. Health Policy 2002; 59: 183-191.
92. Blendon RJ, Kim M, Benson JM. Authors respond to WHO critics. Health Aff (Millwood) 2001; 20: 253-254.
93. Blendon RJ, Kim M, Benson JM. The public versus the World Health Organization on health system performance. Health Aff (Millwood) 2001; 20: 10-20.
94. Evans DB, Tandon A, Murray CJL, Lauer JA. Comparative efficiency of national health systems: cross national econometric analysis. Br Med J 2001; 323: 307-310.
95. Houweling TA, Kunst AE, Mackenbach JP. World Health Report 2000: inequality index and socioeconomic inequalities in mortality. Lancet 2001; 357: 1671-1672.
96. Williams A., Science or marketing at WHO? A commentary on 'World Health Report 2000'. Health Econ 2001; 10: 93-100.
97. Navarro V., Assessment of the World Health Report 2000. Lancet 2000; 356: 1598-1601.
98. Murray CJL, Frenk J. A framework for assessing the performance of health systems. Bull World Health Organ 2000; 78: 717-730.
99. Mathers CD, Sadana R, Salomon JA, Murray CJL, Lopez AD. Healthy life expectancy in 191 countries, 1999. Lancet 2001; 357: 1685-1691.
100. WHO Regional Office for Europe. European Regional Consultation on Health Systems Performance Assessment. 3-4 September 2001. Copenhagen: WHO Europe, 2001.
101. Organization for Economic Cooperation and Development, Paris. [On-line.] http://www.oecd.org/ (5 April 2002, date accessed).
102. OECD Health Policy Unit. Health at a Glance. Paris: Organisation for Economic Co-operation and Development, 2001.
103. Hurst J., Challenges for health systems in Member Countries of the Organisation for Economic Co-operation and Development. Bull World Health Organ 2000; 78: 751-760.
104. Hurst J, Jee-Hughes M. Performance Measurement and Performance Management in OECD Health Systems. Labour Market and Social Policy Occasional Papers No. 47, DEELSA/ELSA/ WD(2000)8. Paris: OECD, 2001
105. Hurst J., Performance measurement and improvement in OECD health systems: overview of issues and challenges. In Smith P (ed.), Measuring Up. Improving Health Systems Performance in OECD Countries. Ottawa: OECD, 2002: pp. 35-54.
106. Jee M, Or Z. Health Outcomes in OECD Countries: A Framework of Health Indicators for Outcome-oriented Policymaking. Labour Market and Social Policy - Occasional Papers No. 36, DEELSA/ELSA/WD(98)7. Paris: OECD, 1999.
107. Nutley S, Smith PC. League tables for performance improvement in health care. J Health Serv Res Policy 1998; 3: 50-57.
108. Anderson G, Hussey PS. Comparing health system performance in OECD countries. Health Aff (Millwood) 2001; 20: 219-232.
109. Jacobzone S, Moise P, Moon L. Opening the black box: what can be learned from a disease-based approach? In Smith P (ed.), Measuring Up. Improving Health Systems Performance in OECD Countries. Ottawa: OECD, 2002: pp. 159-195.
110. Eddy DM., Performance measurement: problems and solutions. Health Aff (Millwood) 1998; 17: 7-25.
111. Lalonde M., A New Perspective on the Health of Canadians. Ottawa: Government of Canada, 1974.
112. McKeown T., Determinants of health. Hum Nat 1978; 1: 57-62.
113. Mackenbach JP., The contribution of medical care to mortality decline: McKeown revisited. In 11th Honda Foundation Discoveries Symposium: Prosperity, Health and Well-Being, 16-18 October 1993. Toronto: The Canadian Institute for Advanced Research, 1993.
114. Long AF., Effectiveness: definitions and approaches. In Long AF, Harrison S, eds. Health Services Performance: Effectiveness and Efficiency. Kent, Sydney and Dover, New Hampshire: Croom Helm, 1985.
115. Giuffrida A, Gravelle H, Roland M. Measuring quality of care with routine data: avoiding confusion between performance indicators and health outcomes. Br Med J 1999; 319: 94-98.
116. West E., Management matters: the link between hospital organisation and quality of patient care. Qual Health Care 2001; 10: 40-48.
117. Mant J., Process versus outcome indicators in the assessment of quality of health care. Int J Qual Health Care 2001; 13: 475-480.
118. Seidman JJ, Greenfield S. Quality for good measure. Semin Med Pract 1998; 1: 7-10.
119. Navarro V., The new conventional wisdom: an evaluation of the WHO report, Health Systems: Improving Performance. Int J Health Serv 2001; 31: 23-33.
120. Thier SO, Gelijns AC. Improving health: the reason performance measurement matters. Health Aff (Millwood) 1998; 17: 26-28.
121. Purrin EB, Durch JS, Skillman SM, eds. Health Performance Measurement in the Public Sector: Principles and Policies for Implementing an Information Network. Washington, DC: The National Academy Press, 1999.
122. Andrews LB, Stocking C, Krizek T et al. An alternative strategy for studying adverse events in medical care. Lancet 1997; 349: 309-313.
123. Smith R., The NHS: possibilities for the endgame: think more about reducing expectations. Br Med J 1999; 318: 209-210.
124. Bodenheimer T., The American health care system: the movement for improved quality in health care. N Engl J Med 1999; 340: 488-492.
125. Chassin MR, Galvin RW. The urgent need to improve health care quality: National Institute of Medicine National Roundtable on Health Care Quality. J Am Med Assoc 1998; 280: 1000-1005.
126. Berwick DM., Developing and testing changes in delivery of care. Ann Intern Med 1998; 128: 651-656.
127. Bates DW, Gawande AA. Error in medicine: what have we learned? Ann Intern Med 2000; 132: 763-767.
128. Donabedian A., Explorations in Quality Assessment and Monitoring. The Definition of Quality and Approaches to its Assessment. Vol. 1. Ann Arbor, MI: Health Administration Press, 1980.
129. Madhok R., Crossing die quality chasm: lessons from health care quality improvement efforts in England. (Baylor University Medical Center) BUMC Proceedings 2002; 15: 77-83.
130. Marshall MN, Shekelle PG, Leatherman S, Brook RH. The public release of performance data: what do we expect to gain? A review of the evidence. J Am Med Assoc 2000; 283: 1866-1874.
131. Schneider EC, Riehl V, Courte-Wienecke S, Eddy DM, Sennett C. Enhancing performance measurement: NCQA's road map for health information framework. J Am Med Assoc 1999; 282: 1184-1190.
132. Jencks SF., Clinical performance measurement - a hard sell. J Am Med Assoc 2000; 283: 2015-2016.
133. Feinstein AR., Is "quality of care" being mislabeled or mismeasured? Am J Med 2002; 112: 472-478.
134. Blumenthal D., Quality of health care, part 1: quality of care - what is it? N Engl J Med 1996; 335: 891-894.
135. Freedman DB., Clinical governance - bridging management and clinical approaches to quality in the UK. Clin Chim Acta 2002; 319: 133-141.
136. Heard SR, Schiller G, Aitken M, Fergie C, McCready Hall L. Continuous quality improvement: educating towards a culture of clinical governance. Qual Health Care 2001; 10: ii70-ii78.
137. Buetow SA, Roland M. Clinical governance: bridging the gap between managerial and clinical approaches to quality of care. Qual Health Care 1999; 8: 184-190.
138. Plochg T, Klazinga NS. Community-based integrated care: myth or must? Int J Qual Health Care 2002; 14: 91-101.
139. Marshall MN., Time to go public on performance [editorial]? Br J Gen Pract 1999; 49: 691.
140. Schneider EC, Lieberman T. Publicly disclosed information about the quality of health care: response of die US public. Qual Health Care 2001; 10: 96-103.
141. Epstein AM., Public release of performance data: A progress report from the front. J Am Med Assoc 2000; 283: 1884-1886.
142. Epstein AM., Performance reports on quality: prototypes, prospects and problems. N Engl J Med 1995; 333: 57-61.
143. Davies HTO, Lampel J. Trust in performance indicators. Qual Health Care 1998; 7: 159-162.
144. Carter N, Klein R, Day P. How Organisations Measure Success. The Use of Performance Indicators in Government. London and New York: Routledge, 1992: p. 42.
145. Carroll JS, Edmondson AC. Leading organisational learning in health care. Qual Saf Health Care 2002; 11: 51-56.
146. Neely A, Mills J, Platts K et al. Performance measurement system design: developing and testing a process-based approach. Int J Oper Prod Manag 2000; 20: 1119-1145.
147. Scanlon DP, Darby C, Rolph E, Doty HE. Use of performance information for quality improvement. The role of performance measures for improving quality in managed care organizations. Health Serv Res 2001; 36: 619-641.
148. Klazinga NS, Stronks K, Delnoij D, Verhoeff A. Indicators without a cause. Reflections on the development and use of indicators in health care from a public health perspective. Int J Qual Health Care 2001; 13: 433-438.
149. Plsek PE, Greenhalgh T. The challenge of complexity in health care. Br Med J 2001; 323: 625-628.
150. Plsek PE, Wilson T. Complexity, leadership, and management in healthcare organisations. Br Med J 2001; 323: 746-749.
151. Goddard M, Mannion R, Smith PC. Assessing the performance of NHS Hospital Trusts: the role of 'hard' and 'soft' information. Health Policy 1999; 48: 119-134.
152. Weinberg N., Using performance measures to identify plans of action to improve care. Jt Comm J Qual Improv 2001; 27: 683-688.
153. Rouse J., Performance Management under the New Labour: Really New or Merely More of the Same? Working paper No. 5. Birmingham: University of Central England, 2001.
154. Walshe K., The rise of regulation in the NHS. Br Med J 2002; 324: 967-970.
155. Horton R., NICE: a step forward in the quality of NHS care. Lancet 1999; 353: 1028-1029.
156. Smee CH., Improving value for money in the United Kingdom National Health Service: performance measurement and improvement in a centralized system. In Smith P (ed.), Measuring Up. Improving Health Systems Performance in OECD Countries. Ottawa: OECD, 2002: pp. 57-85.
157. Marmor TR, Mashaw J. Rhetoric and reality. Health Manage Q 1993; 15: 21-24.
158. Klein R., Can policy drive quality? Qual Health Care 1998; 7: S51-S53.
159. Elkan R, Robinson J. The use of targets to improve the performance of health care providers: a discussion of government policy. Br J Gen Pract 1998; 48: 1515-1518.
160. Mooney G., Judging goodness must come before judging quality - but what is the good of health care? Int J Qual Health Care 2000; 12: 389-394.
161. Kates J, Marconi K, Mannle TE Jr. Developing a performance management system for a Federal public health program: the Ryan White CARE ACT Titles I and II. Eval Prog Planning 2001; 24: 145-155.
162. Davies HTO, Nutley SM, Mannion R. Organizational culture and quality of health care. Qual Health Care 2000; 9: 111-119.