A Multi-Faceted Definition of Health is Essential to Developing Useful Measures

Developing a public health performance monitoring system

Between September 1994 and April 1997, the Institute of Medicine (IOM) at the National Academy of Science, Washington, examined how performance monitoring can improve the public's health.

The IOM convened an 18-member committee, which produced a 500-page report, Improving Health in the Community: A Role for Performance Monitoring (National Academy Press), a separate executive summary, and reports from two workshops.

Key Findings

  • Among the key findings of Improving Health in the Community: A Role for Performance Monitoring:

    • Various stakeholders affect, and can be held accountable for, community health.
    • Bringing together diverse groups that influence community health is critical to building support and acceptance of performance monitoring.
    • Performance monitoring is best applied within a framework that relies on a broad view of the determinants of health.
    • To apply performance monitoring locally, population-based data at the community level is needed not only on clinical services, but also on environmental health, education, social services, and other realms that may impact on health.
    • Special attention to vulnerable populations is important when developing an approach to performance monitoring because of the value of equity in community health.

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