Scorecards for health system performance assessment: The New Zealand example

Abstract

Objective To develop a national scorecard for assessing health system performance derived from routine data. Methods We drew upon national and international data to develop benchmarks for health system performance, then applied basic ratio scores to compare New Zealand performances to the benchmark. 64 indicators were included in four assessment categories: healthy lives, quality, access, and efficiency. In a fifth category, 27 of these indicators were used to score health system equity. Indicator scores in each category were then averaged to give a health system score out of 100. Results New Zealand's health system achieved an overall score of 71 out of 100. The system scored relatively well on quality and efficiency, but poorly on equity despite considerable government investment in reducing inequalities. Conclusions The scorecard offers a useful method for combining a range of data to give an overall picture of health system performance, highlighting strengths, weaknesses and areas for improvement. This initial study provides a baseline for assessing New Zealand's performance over time and, where data permit, a template for other countries to follow.