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A Framework to Measure the Value of Public Health Services
OBJECTIVE: To develop a framework that public health practitioners could use to measure the value of public health services. DATA SOURCES: Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers. STUDY DESIGN: Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected. DATA COLLECTION/EXTRACTION METHODS: The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services. PRINCIPAL FINDINGS: Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability. CONCLUSIONS: We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.
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