title: A novel method for measuring health care system performance: experience from QIDS in the Philippines.
abstract: OBJECTIVE
  Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q was developed, implemented in hospitals in the Philippines and how it compares with typical measures.
  
  
  METHODS
  Q consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q.
  
  
  RESULTS
  Q was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2(1/2) years. We found Q to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled USD2133 or USD305 per assessment per site.
  
  
  CONCLUSIONS
  Q appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings.
authors.affiliation: University of the Philippines, School of Economics, Diliman, Philippines.
authors.forename: Orville
authors.initials: O
authors.lastname: Solon
authors.forename: Kimberly
authors.initials: K
authors.lastname: Woo
authors.forename: Stella A
authors.initials: SA
authors.lastname: Quimbo
authors.forename: Riti
authors.initials: R
authors.lastname: Shimkhada
authors.forename: Jhiedon
authors.initials: J
authors.lastname: Florentino
authors.forename: John W
authors.initials: JW
authors.lastname: Peabody
mesh_terms: D002675:Child, Preschool; D002983:Clinical Competence; D006268:Health Facilities / Q000592:standards*; D006284:Health Plan Implementation / Q000191:economics; D006291:Health Policy; D006761:Hospitals / Q000592:standards; D006801:Humans; D007223:Infant; D017060:Patient Satisfaction; D010679:Philippines; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires