Improving Health in the Community:: A Role for Performance Monitoring

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National Academies Press, Apr 21, 1997 - Medical - 496 pages
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How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities.

With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority.

Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction.

Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues.

Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

  

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Contents

Introduction
23
A BROADER UNDERSTANDING OF HEALTH
24
GROWING INTEREST IN PERFORMANCE MONITORING
26
A FRAMEWORK FOR COMMUNITY HEALTH IMPROVEMENT
30
ISSUES FOR CONSIDERATION
33
UNDERLYING ASSUMPTIONS
35
THE COMMITTEES REPORT
36
Understanding Health and Its Determinants
40
INDICATOR SETS FOR PERFORMANCE MONITORING FOR SPECIFIC HEALTH ISSUES
140
PROTOTYPE PERFORMANCE INDICATOR SETS
147
PRIVACY AND CONFIDENTIALITY
149
CONCLUSIONS
153
PROPOSED COMMUNITY HEALTH PROFILE INDICATORS
156
Conclusions and Recommendations
166
A FRAMEWORK FOR COMMUNITY HEALTH IMPROVEMENT
167
ENABLING POLICY AND RESOURCES
172

A BROADER DEFINITION OF HEALTH
41
A MODEL OF THE DETERMINANTS OF HEALTH
47
INTERVENTIONS TO IMPROVE HEALTH
53
IMPLICATIONS FOR COMMUNITIES
55
Managing a Shared Responsibility for the Health of a Community
59
SOCIAL AND POLITICAL CONTEXT FOR IMPROVING COMMUNITY HEALTH
60
KEY CONCEPTS FOR MANAGING CHANGE
66
IMPLICATIONS FOR PERFORMANCE MONITORING TO IMPROVE COMMUNITY HEALTH
72
CONCLUSIONS
73
A Community Health Improvement Process
77
PROPOSING A PROCESS FOR COMMUNITY HEALTH IMPROVEMENT
78
ADVANCING THE PROCESS
86
PROBLEM IDENTIFICATION AND PRIORITIZATION CYCLE
87
ANALYSIS AND IMPLEMENTATION CYCLE
95
LEARNING FROM AND ABOUT HEALTH IMPROVEMENT PROCESSES
103
ENHANCING THE CAPACITY FOR COMMUNITY HEALTH IMPROVEMENT
106
CONCLUSIONS
117
Measurement Tools for a Community Health Improvement Process
126
PROPOSED INDICATORS FOR A COMMUNITY HEALTH PROFILE
129
DEVELOPING THE COMMUNITY HEALTH IMPROVEMENT PROCESS
175
Appendixes
181
Prototype Performance Indicator Sets
183
Prototype Indicator Set Breast and Cervical Cancers
189
Prototype Indicator Set Depression
205
Prototype Indicator Set Elder Health
229
Prototype Indicator Set Environmental and Occupational Lead Poisoning
242
Prototype Indicator Set Health Care Resource Allocation
262
Prototype Indicator Set Infant Health
276
Prototype Indicator Set Tobacco and Health
300
Prototype Indicator Set VaccinePreventable Diseases
324
Prototype Indicator Set Violence
345
Methodological Issues in Developing Community Health Profiles and Performance Indicator Sets
360
Using Performance Monitoring to Improve Community Health Exploring the Issues
374
Using Performance Monitoring to Improve Community Health Conceptual Framework and Community Experience
416
Committee Biographies
452
Acronyms
460
Index
463
Copyright

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About the author (1997)

Durch (Committee to Develop Priorities for Vaccine Development, Institute of Medicine)

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