美国一种新的母婴健康绩效评估系统。
A new performance measurement system for maternal and child health in the United States.
作者信息
Kogan Michael D, Dykton Christopher, Hirai Ashley H, Strickland Bonnie B, Bethell Christina D, Naqvi Iran, Cano Carlos E, Downing-Futrell Sheri L, Lu Michael C
机构信息
Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Rockville, MD, 20857, USA,
出版信息
Matern Child Health J. 2015 May;19(5):945-57. doi: 10.1007/s10995-015-1739-5.
OBJECTIVE
The Title V Maternal and Child Health (MCH) Block Grant is the linchpin for US MCH services. The first national performance measures (NPMs) for MCH were instituted in 1997. Changing trends in MCH risk factors, outcomes, health services, data sources, and advances in scientific knowledge, in conjunction with budgetary constraints led the Maternal and Child Health Bureau (MCHB) to design a new performance measurement system.
METHODS
A workgroup was formed to develop a new system. The following guiding principles were used: (1) Afford States more flexibility and reduce the overall reporting burden; (2) Improve accountability to better document Title V's impact; (3) Develop NPMs that encompass measures in: maternal and women's health, perinatal health, child health, children with special health care needs, adolescent health, and cross-cutting areas.
RESULTS
A three-tiered performance measurement system was proposed with national outcome measures (NOMs), NPMs and evidence-based/informed strategy measures (ESMs). NOMs are the ultimate goals that MCHB and States are attempting to achieve. NPMs are measures, generally associated with processes or programs, shown to affect NOMs. ESMs are evidence-based or informed measures that each State Title V program develops to affect the NPMs. There are 15 NPMs from which States select eight, with at least one from each population area. MCHB will provide the data for the NOMs and NPMs, when possible.
CONCLUSIONS
The new performance measurement system increases the flexibility and reduces the reporting burden for States by allowing them to choose 8 NPMs to target, and increases accountability by having States develop actionable ESMs.
SIGNIFICANCE
The new national performance measure framework for maternal and child health will allow States more flexibility to address their areas of greatest need, reduce their data reporting burden by having the Maternal and Child Health Bureau provide data for the National Outcome and Performance Measures, yet afford States the opportunity to develop measurable strategies to address their selected performance measures.
目的
《第五章母婴健康（MCH）整笔拨款》是美国母婴健康服务的关键所在。1997年制定了首批全国母婴健康绩效指标（NPMs）。母婴健康风险因素、结果、卫生服务、数据来源的变化趋势以及科学知识的进步，再加上预算限制，促使母婴健康局（MCHB）设计了一个新的绩效评估系统。
方法
成立了一个工作组来开发新系统。采用了以下指导原则：（1）给予各州更大的灵活性并减轻总体报告负担；（2）提高问责制以更好地记录《第五章》的影响；（3）制定涵盖以下方面措施的全国绩效指标：孕产妇及妇女健康、围产期健康、儿童健康、有特殊医疗需求的儿童、青少年健康以及跨领域领域。
结果
提出了一个三层绩效评估系统，包括国家结果指标（NOMs）、全国绩效指标（NPMs）和基于证据/明智的策略指标（ESMs）。国家结果指标是母婴健康局和各州试图实现的最终目标。全国绩效指标是通常与流程或项目相关的指标，显示出对国家结果指标有影响。基于证据/明智的策略指标是每个州的《第五章》项目为影响全国绩效指标而制定的基于证据或明智的指标。有15个全国绩效指标，各州从中选择8个，每个领域至少选一个。母婴健康局将尽可能为国家结果指标和全国绩效指标提供数据。
结论
新的绩效评估系统通过允许各州选择8个全国绩效指标来针对，增加了灵活性并减轻了各州的报告负担，同时通过让各州制定可操作的基于证据/明智的策略指标来提高问责制。
意义
新的母婴健康全国绩效指标框架将使各州有更大的灵活性来满足其最迫切需求的领域，通过让母婴健康局为国家结果指标和绩效指标提供数据来减轻其数据报告负担，但同时为各州提供机会制定可衡量的策略来应对其选定的绩效指标。
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