Assessing the performance of community systems for children.
OBJECTIVE
To present a framework for measuring the quality of community systems for children, based on key attributes of systems performance for children's services. We present a research agenda for refining the model, evaluating indicators across the performance domains identified, developing normative standards for performance, and assessing the empirical basis for performance criteria.


RESULTS
Systems performance can be measured. A systems approach to evaluating community systems for children needs to incorporate the multilevel service delivery networks, programs, and systems of care for children. A model of community systems performance for children includes key dimensions of structure, financing, and accountability. Attributes within these dimensions serve as indicators that communities can use to evaluate systems quality. Performance standards can be based on the evidence from field demonstrations as well as from normative assessments.


CONCLUSIONS
The model of community systems performance should be refined and developed using empirical findings of analyses of children's systems. A set of indicators that capture vital aspects of performance and that are relevant, scientifically valid, and feasible should be developed and tested in field studies. Once indicators are evaluated for use in performance monitoring, communities will be able to implement performance monitoring.
L. A. Care Health Plan, CA 90010, USA.
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DuPlessis
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Inkelas
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Halfon
D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000592:standards*; D018672:Community Health Planning / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D008962:Models, Theoretical; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D013597:Systems Analysis; D014481:United States