ISO Health Indicators Conceptual FrameworkHealth system performance

Health system performance

Factors that are able to capture outcomes, or processes that may be related to outcomes that result from contact with the health care system. Nine categories of indicators are considered within this health system performance dimension.

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.