TABLE 5-2 An Integrated Service System Performance Approach (Population-Level Developmental Assessment Examplea)

Performance Attributes



Care/service intervention or action achieves desired results at individual, family, and community levels


Achieving desired results with most cost-effective use of resources


Ability of clients/patients to obtain care/service at the right place and right time, based on needs and is equitable


Care/service provided is relevant to client/patient needs and based on established standards


Self-assessment of skill to conduct appropriate risk assessment


Potential risks of an intervention or the environment are avoided or minimized


Ability to provide uninterrupted care/service across programs, practitioners, organizations, and levels of care/service over time


Care/service provided meets expectations of client, community, providers, and paying organizations


Different aspects of care are connected seamlessly


Absence of systematic differences across population subgroups

aAt national level, if we want to measure how care of children can impact development.

mented to assess the effect of specific policies. For the most part, laws are passed and regulations written without specification of the aspects of health that are likely to be affected, the mechanisms by which that is likely to occur, or funding for rigorous evaluations. As a general rule, evaluations of the effect of new policies on children’s health, including not only health policies, but also most environmental, education, welfare, and other social policy, come from academic research studies conducted after the policy is implemented.

The kinds of data systems that are the focus of the committee’s report can be used to provide a limited assessment of certain policies. In general, however, there is little activity in the United States to measure the effect of policies on children’s health. The United Kingdom, Canada, and Australia have gone several steps further by developing approaches that attempt to assess policy effects more systematically and comprehensively.

Data collection by agencies such as the National Center for Health Statistics and ongoing surveys by the MCHB and the Agency for Healthcare Research and

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