ABSTRACT
Growing public demands have led political leaders to call in the experts, and major rehabilitation projects are being proposed for health insurance coverage, benefits and markets, as well as health professions training, primary and preventive care, delivery system organization, quality assurance and government regulation. Advocates for new public data systems include among their ranks some of the most visionary reform enthusiasts, as well as some of the toughest-minded pragmatists. Three of these efforts—designed for public accountability—are described to illustrate measures that can be adapted for report card initiatives, their specific rationale, and how different measurement concepts could work together. Data include objective clinical measures, as well as patient-reported functional status and well-being. Outcomes have a strong theoretical claim as the ultimate measures of health system performance; as specific data elements are proved valid, reliable, and useful, they may strongly influence the report card movement.
