| Sumario: | Performance monitoring is one of several quality enhancing activities designed to improve quality and accountability in health care. During the past years, there has been an increasing interest in such measurement and reporting systems worldwide. Particular emphasis seems to have been put in the design and implementation of systems monitoring hospital performance in a valid and reliable way. The aim of this project has been to gather evidence in the field of hospital performance monitoring systems, by evaluating and comparing six selected national initiatives with regard to policy and methodological approach. The monitoring systems included in the review were developed by the international organisations OECD and WHO, as well as by governmental agencies in Canada, the United States, Denmark and Sweden. Information on each system was identified by searches in Pub Med and on Internet, during the period April 2006 through April 2007. We performed an assessment of each system based on predefined criteria, covering:1. Context2. Conceptual framework3. Objectives and target groups4. Evaluation criteria5. Selection procedures6. Publication format7. Empirical testing8. System for updating and revision Even though the monitoring systems chosen represent only a small number of the ones we poten-tially might have included in our review, they illustrate several ways of approaching health policy and methodological issues. They also represent a great amount of background experience that may be valuable in a Norwegian context. The authorities and organisations responsible for the systems have put extensive resources into the course of their development, both with regard to economical input and scope of expertise. We recommend that the further development of the Norwegian national monitoring system: 1. Is based on internationally recognized procedures that are described in this report2. Particularly build on systems that give explicit information concerning their evidence base and selection procedures. In addition, theoretical and empirical tests for reliability and validity in a Norwegian context should be performed3. Ensure legitimacy and acceptance for the system by ivolving professional and other relevant user goups in the processes4. Design a conceptual framework that should form an overarching strategy and articulate guiding principles for both value-based and professional priorities5. Develop a long-term strategic plan, taking into account how expertise can be built up and how the needs and requirements concerning research and development in this area can be met.
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