title: Metrics for assessing improvements in primary health care.
abstract: Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts. It is informed by metrics that include long-term, meaning- and relationship-focused perspectives. Aspirational uses of metrics inspire evolving insights and iterative improvement, using a collaborative, developmental perspective. Performance metrics assess the complex interactions among primary care tenets of accessibility, a whole-person focus, integration and coordination of care, and ongoing relationships with individuals, families, and communities; primary health care principles of inclusion and equity, a focus on people's needs, multilevel integration of health, collaborative policy dialogue, and stakeholder participation; basic and goal-directed health care, prioritization, development, and multilevel health outcomes. Environments that support reflection, development, and collaborative action are necessary for metrics to advance health and minimize unintended consequences.
authors.affiliation: Department of Family Medicine and Community Health.
authors.forename: Kurt C
authors.initials: KC
authors.lastname: Stange
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Etz
authors.forename: Heidi
authors.initials: H
authors.lastname: Gullett
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Sweeney
authors.forename: William L
authors.initials: WL
authors.lastname: Miller
authors.forename: Carlos Roberto
authors.initials: CR
authors.lastname: Jaén
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Crabtree
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nutting
authors.forename: Russell E
authors.initials: RE
authors.lastname: Glasgow
mesh_terms: D003153:Community Health Services / Q000458:organization & administration; D004777:Environment; D006040:Goals; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards