Measuring and comparing perfomance of health services: a conceptual model to support selection and validation of indicators

The main purpose of this paper is to report the results of a research1 aimed at designing a general conceptual framework for reading, monitoring and evaluating performance of healthcare services as a basic requirement for supporting statistical comparability of organizations which have common missions and goals. Obviously, such conceptual model alone may be inadequate for the complexity of day-to-day management problems. Moreover, operational issues are undeniably relevant when comparing data from different health systems. Nevertheless, we maintain that a common conceptual framework would offer a great opportunity to speak a common language. Consequently, our target was proposing a model rather than providing an immediately operational set of indicators. The conceptual framework proposed here is intended to be general, applicable to many levels of the healthcare organizations: i.e., national and regional health systems, local community services or clinically specific healthcare departments. Nevertheless, we chiefly focus on more complex systems, from a healthcare government and comparability perspective, at both national and european levels.