Management Issues in Healthcare System

Abstract

While quality management has become essential in the industrial field, it is still looking for a place in the social field. Experiences remain very divergent, and consensus on the appropriate method and effective tools is still far from being reached.
This paper aims to review the literature in the field of performance measurement and management in health care. Studies concerning performance measurement and management in health in all settings were included. Studies before 2018 were identified from PubMed, Scopus, Web of Science, and Google Scholar. We conducted a thematic analysis of the international literature, identifying themes around the terms “performance assessment, performance evaluation, performance measurement, health indicators, conceptual framework, assessment framework, health system performance, and monitoring and evaluation. Thirty-seven articles were reviewed, and a set of conceptual frameworks were analyzed. Results were interpreted following the seven areas of the conceptual framework: Fundamental questions in performance evaluation, aims and objectives, role and goals, performance, conceptual frameworks, dysfunction of the health system, and performance assessment. All areas of care were involved, health promotion, preventive and curative care. For most organizations, performance measurement was in a relatively early stage of development or implementation. However, some dysfunctions were identified: a lack of systematic outcome assessment, a lack of documentation, a lack of resource evaluation related to quality for specific diseases, and persisting variations among providers in care for similar patients.