title: A methodological approach for register-based evaluation of cost and outcomes in health care.
abstract: BACKGROUND
  In health care, measures of performance are needed at producer level for improving the treatment processes and at system level for steering purposes. In addition, measures that enable reliable comparisons of producers with respect to each other should encourage them to develop their treatment processes to attain better positioning in benchmarking.
  
  
  METHODS
  The main innovation of the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT) project is to measure performance using existing linkable information available from registers within well-defined care episodes in a whole population. Finnish health care and related registers are used for constructing the disease-specific databases, with rich content on treatment processes and complete follow-up data.
  
  
  RESULTS
  The PERFECT project has developed numerous performance indicators that can be used to evaluate health policy actions as well as to create regional and hospital-level benchmarking data. In PERFECT, the idea is to eliminate individual-level variation from the performance indicators by using individual-level data and proper risk adjustment methods. The focus of our interest is in the variation at the producer or regional level.
  
  
  CONCLUSIONS
  Our experience shows that the utilization of population-level health care registers with an episode-of-care approach enables a continual system and producer-level performance measurement.
authors.affiliation: National Institute for Health and Welfare, Centre for Health and Social Economics, Helsinki, Finland. mikko.peltola@thl.fi
authors.forename: Mikko
authors.initials: M
authors.lastname: Peltola
authors.forename: Merja
authors.initials: M
authors.lastname: Juntunen
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Rosenqvist
authors.forename: Timo T
authors.initials: TT
authors.lastname: Seppälä
authors.forename: Reijo
authors.initials: R
authors.lastname: Sund
mesh_terms: D019985:Benchmarking / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D017050:Episode of Care; D005260:Female; D005387:Finland; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D020379:Risk Adjustment / Q000706:statistics & numerical data