A Dynamic Balanced Scorecard for Managing Health Systems Performance

摘要

Health system performance management is a dynamically complex problem, affected by alarge number of factors which interact to produce health outcomes over time. A briefreview of current health system performance assessment instruments, including thebalanced scorecard, demonstrates only a limited ability to deal with the dynamiccomplexity of this problem. These are limitations that can be overcome with theincorporation of system dynamics methods. We propose a dynamic balanced scorecardfor managing regional health system performance in New South Wales, Australia.Central to this scorecard will be an understanding of the dynamic interactions of cost,quality and access and how these affect population health. Preliminary mapping suggeststhat the way the gap in resources required to provide medical services is managed willplay an important role in balancing these objectives.