Jacobson Peter D, Neumann Peter J
Center for Law, Ethics, and Health, University of Michigan, School of Public Health, Ann Arbor, MI 48109-2029, USA.
Health Serv Res. 2009 Oct;44(5 Pt 2):1880-96. doi: 10.1111/j.1475-6773.2009.01013.x. Epub 2009 Aug 14.
To develop a framework that public health practitioners could use to measure the value of public health services.
Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers.
Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected.
DATA COLLECTION/EXTRACTION METHODS: The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services.
Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability.
We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.
制定一个公共卫生从业者可用于衡量公共卫生服务价值的框架。
2006年8月至2007年3月收集了原始数据。我们采访了四个州的46名公共卫生从业者、国家公共卫生组织的领导人以及学术研究人员。
我们采用半结构化访谈方案,进行了一系列定性访谈,以确定公共卫生服务价值的组成部分,并确定用于衡量价值的方法和所收集的数据。
数据收集/提取方法:主要分析形式是描述性的,综合受访者关于他们如何衡量服务价值的信息。
我们的访谈未就如何衡量价值或衡量价值的具体框架达成共识。尽管如此,访谈确定了一些潜在策略,如成本核算和基于绩效的合同制机制。访谈指出了实施障碍,包括工作人员能力和数据可用性的限制。
我们制定了一个考虑四个组成要素来衡量价值的框架:必须考虑的外部因素(即指令);地方卫生部门必须采取的关键内部行动(即工作人员评估);使用适当的定量措施;以及向当选官员和公众传达价值。