ISO Health Indicators Conceptual FrameworkHealth system performance

Health system performance

Dimensions of this framework

• Acceptability

  All care/services provided meet the expectation s of the client, community, providers and payment organisations, recognizing that there may be conflicting, competing interests between stakeholders and that the needs of the clients/patients are paramount.

• Accessibility

  The ability of clients/patients to obtain care/service at the right place and the right time, based on respective needs.

  Examples include waiting times, practice availability and availability of dentists.

• Appropriateness

  Care/service is relevant to the clients/patients' needs and based on established standards.

  Examples include inappropriately used surgery, appropriate use of ACEI at discharge for heart failure.

• Competence

  An individual's knowledge and skills are appropriate to the care/service being provided.

• Continuity

  The ability to provide uninterrupted coordinated care/service across programs, practitioners, organisations, and levels of care/service, overtime.

• Effectiveness

  The care/service, intervention or action achieves the desired result.

  Examples include cancer survival, recurrence of hernia after repair, smoking cessation during pregnancy (effectiveness of maternal health care), chronic care management: admission rates for asthma, diabetes, epilepsy.

• Efficiency

  Achieving the desired results with the most cost-effective use of resources.

  Examples include avoidable hospitalizations, cost per casemix-adjusted separation, cost-effective prescribing.

• Safety

  Potential risks of an intervention of the environment are avoided or minimized.

  Examples include hospital-acquired infection rate.