Evaluating health care management programs and schools of public health: some experiences in Europe.

The European Healthcare Management Association (EHMA) has built upon the ACEHSA model of accreditation to develop a European version-- program review--which takes account of the variety of health systems, cultures, and languages in Europe. This article describes the manner in which EHMA's ¿program review¿ evolved, and the distinctive features of the process. It then analyzes some of the lessons that have emerged from the twenty-two evaluations completed in nine countries, distinguishing between issues of effectiveness (needs, objectives, and outcomes) and efficiency (inputs, processes, and outputs). It concludes by reviewing the efficacy of the methodology.