Abstract
BackgroundPreventive care has gained increasing attention in health reforms around the world due to its ability to reduce the burden of disease and to save health costs. Nevertheless, there is a gap in terms of the development of reliable systems to measure and evaluate performance of preventive care in order to support decision-making and increase service outcomes. The aim of this study is to define a methodology for designing a performance management system (PMS) in order to effectively support the planning, control and evaluation of preventive care and to identify the factors that influence such a process.MethodsThe methodology is based on the participatory action research approach, which implies collaboration between researchers and practitioners. The study was articulated in four phases and carried out in an Italian regional healthcare system that was undergoing a major reorganization process.ResultsThe findings provide insights into the peculiarities that affect preventive care and highlight two categories of critical factors: general issues regarding the process and specific issues regarding preventive care. The first category includes the importance of interactions between academics, physicians and policy-makers, the impact of workloads and red tape on employee involvement and the increased conservation mechanisms during periods of institutional change. The second category concerns the strong heterogeneity of preventive activities within health organizations, the huge amount of regulations and the incompleteness of information systems.ConclusionThe development of a PMS for preventive care can best be served by collaborative methods that involve academics, professionals and policy-makers, whose roles and responsibilities must be clearly defined, and by an improvement in transparency and communication within organizations in order to enhance the involvement of different professionals at appropriate times and in appropriate ways. Key recommendations that may improve the maintenance and use of information systems are proposed to policy-makers.
Highlights
Preventive care has gained increasing attention in health reforms around the world due to its ability to reduce the burden of disease and to save health costs
The discussion of the results focuses on the identification of critical factors in two distinct areas: general issues regarding the process of the development of a performance management system (PMS) in public healthcare and specific issues regarding the design of such a tool in the context of preventive care
Notwithstanding the increased attention on prevention care in health policy reforms around the world due to its combined effect of improving public health and reducing the costs of health systems, decision-makers continue to suffer from a lack of information and managerial tools to effectively plan and control the organization and delivery of preventive services
Summary
Preventive care has gained increasing attention in health reforms around the world due to its ability to reduce the burden of disease and to save health costs. There is a gap in terms of the development of reliable systems to measure and evaluate performance of preventive care in order to support decision-making and increase service outcomes. The aim of this study is to define a methodology for designing a performance management system (PMS) in order to effectively support the planning, control and evaluation of preventive care and to identify the factors that influence such a process. The US Affordable Care Act of 2010 and the European Health Policy framework, ‘Health 2020’, are examples of the major role that prevention plays in the global health agenda. From a methodological point of view, whilst a number of studies have provided general recommendations to develop performance measurement systems in the healthcare sector and have highlighted the need to create a common language between and within countries [6,7,8,9], such a contribution has never been provided with reference to preventive care
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