Performance measurement in healthcare: part I--concepts and trends from a State of the Science Review.
OBJECTIVE
Performance measurement is touted as an important mechanism for organizational accountability in industrialized countries. This paper describes a systematic review of business and health performance measurement literature to inform a research agenda on healthcare performance measurement.


METHODS
A search of the peer-reviewed business and healthcare literature for articles about organizational performance measurement yielded 1,307 abstracts. Multi-rater relevancy ratings, citation checks, expert nominations and quality ratings resulted in 664 articles for review. Key themes were extracted from the papers, followed by multi-reader validation. Information was supplemented with grey literature.


RESULTS
The performance literature was diverse and fragmented, and relevant evidence was difficult to locate. Most literature is non-empirical and originates from the United States and the United Kingdom. No agreement on definitions or concepts is evident within or across disciplines. Study quality is not high in either field. Performance measurement arose in public services and business at about the same time. The evolution of thought on performance measurement ranges from unfettered enthusiasm to sober reassessment.


CONCLUSIONS
The research base on performance measurement is in its infancy, and evidence to guide practice is sparse. A coherent multidisciplinary research agenda on the topic is needed.
Adair
Carol E
CE
Department of Community Health Sciences, University of Calgary, Calgary, AB.
Simpson
Elizabeth
E
Casebeer
Ann L
AL
Birdsell
Judith M
JM
Hayden
Katharine A
KA
Lewis
Steven
S