Assessing the performance of community systems for children

• Published in: Health services research Vol. 33; no. 4 Pt 2; pp. 1111 - 1142
• Main Authors: DuPlessis, H M, Inkelas, M, Halfon, N
• Format: Journal Article
• Language: English
• Published: United States Health Research and Educational Trust 01-10-1998; Blackwell Publishing Ltd
• Subjects: Accident prevention; Accountability; Child; Child health services; Child Health Services - organization & administration; Child Health Services - standards; Child welfare; Children & youth; Childrens health; Community Health Planning - organization & administration; Community health services; Community health services for children; Early intervention; Evaluation; Health care; Health care industry; Health promotion; Health risk assessment; Health risks; Health services; Health Services Research; Humans; Lead content; Mental health; Models, Theoretical; Outcome and Process Assessment (Health Care); Personal health; Population; Practice Guidelines as Topic; Primary care; Public health; Quality Assurance, Health Care; Quality improvement; Quality Indicators, Health Care; Quality of service; R&D; Research & development; Studies; Systems Analysis; United States; United States; United States > US
• ISSN: 0017-9124; 1475-6773

To present a framework for measuring the quality of community systems for children, based on key attributes of systems performance for children's services. We present a research agenda for refining the model, evaluating indicators across the performance domains identified, developing normative standards for performance, and assessing the empirical basis for performance criteria.
Systems performance can be measured. A systems approach to evaluating community systems for children needs to incorporate the multilevel service delivery networks, programs, and systems of care for children. A model of community systems performance for children includes key dimensions of structure, financing, and accountability. Attributes within these dimensions serve as indicators that communities can use to evaluate systems quality. Performance standards can be based on the evidence from field demonstrations as well as from normative assessments.
The model of community systems performance should be refined and developed using empirical findings of analyses of children's systems. A set of indicators that capture vital aspects of performance and that are relevant, scientifically valid, and feasible should be developed and tested in field studies. Once indicators are evaluated for use in performance monitoring, communities will be able to implement performance monitoring.