The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation's health. The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee's report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health. Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.
For the past three decades, the Department of Health and Human Services (HHS) has issued a national agenda aimed at improving the health of all Americans over each 10-year span. Under each of these Healthy People initiatives, HHS established health targets and monitored how well people were reaching them over time. In response to a request from the Department of Health and Human Services (HHS), the Institute of Medicine (IOM) established the Committee on Leading Health Indicators for Healthy People 2020 to develop and recommend 12 indicators and 24 objectives for consideration by HHS for guiding a national health agenda and for consideration for inclusion in Healthy People 2020. The work of the committee built upon the 1999 IOM report, Leading Health Indicators for Healthy People 2010, and on the work of the Committee on the State of the USA Health Indicators. Leading Health Indicators for Healthy People 2020 lays out the proposed agenda for the current decade, which will end in 2020.
Healthy People" is the nation's agenda for health promotion and disease prevention. The concept, first established in 1979 in a report prepared by the Office of the Surgeon General, has since been revised on a regular basis, and the fourth iteration, known as "Healthy People 2010," will take the nation into the 21st century. "Leading Health Indicators for Healthy People 2010: Final Report" contains a number of recommendations and suggestions for the Department of Health and Human Services that address issues relevant to the composition of leading health indicator sets, data collection, data analysis, effective dissemination strategies, health disparities, and application of the indicators across multiple jurisdictional levels.
During Spring 1998, the U.S. Department of Health and Human Services (DHHS) contracted with the National Academy of Sciences (NAS), Institute of Medicine (IOM) to conduct a multi phase project resulting in the development of sets of leading health indicators that would provide a 'face' for Healthy People 2010. Of equal or greater importance was the development of indicator sets that would attract and sustain public attention and motivation to engage in healthy behaviors. Development of such leading health indicators sets is intended to move the United States toward achievement of more positive health outcomes for the general population and for select population groups defined by race, ethnicity, gender, age, socio-economic status, level of education, and disability. This second interim report presents a summary of the efforts of the IOM Committee on Leading Health Indicators for Healthy People 2010 to develop sample sets of leading health indicators that would meet the requisite functions of attracting and sustaining attention and motivating engagement in healthier behaviors by the public. Reactions to this report and more specifically, to the potential leading health indicator sets and suggested measures, will be solicited from the public health community as well as representatives of diverse consumer audiences through electronic communication, regional public meetings convened by DHHS, focus group discussions with target populations, and other information-gathering techniques. Review of information from these various sources will be summarized in a third and final report for DHHS to be published in April 1999. The third report will also include the committee's final recommendations regarding the functions to be fulfilled by leading health indicators, will define specific criteria underlying the selection of leading health indicators, and will identify specific sets of leading health indicators to be promoted and monitored during the decade 2000 to 2010.
Every ten years, the Department of Health and Human Service's Healthy People Initiative develops a new set of science-based, national objectives with the goal of improving the health of all Americans. Defining balanced and comprehensive criteria for healthy people enables the public, programs, and policymakers to gauge our progress and reevaluate efforts towards a healthier society. Criteria for Selecting the Leading Health Indicators for Healthy People 2030 makes recommendations for the development of Leading Health Indicators for the initiative's Healthy People 2030 framework. The authoring committee's assessments inform their recommendations for the Healthy People Federal Interagency Workgroup in their endeavor to develop the latest Leading Health Indicators. The finalized Leading Health Indicators will establish the criteria for healthy Americans and help update policies that will guide decision-marking throughout the next decade. This report also reviews and reflects upon current and past Healthy People materials to identify gaps and new objectives.
Beginning in 1979 and in each subsequent decades, the U.S. Department of Health and Human Services (HHS) has overseen the Healthy People initiative to set national goals and objectives for health promotion and disease prevention. At the request of HHS, this study presents a slate of Leading Health Indicators (LHIs) that will serve as options for the Healthy People Federal Interagency Workgroup to consider as they develop the final criteria and set of LHIs for Healthy People 2030.
The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation's health. The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee's report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health. Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.
Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.
As the United States devotes extensive resources to health care, evaluating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care performance has improved over time, but they also have identified major shortcomings. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports. The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Despite having the costliest medical care delivery system in the world, Americans are not particularly healthy. Recent international comparisons show that life expectancy in the U.S. ranks 49th among all nations, and infant mortality rates are higher in the U.S. than in many far less affluent nations. While these statistics are alarming, the bigger problem is that we do not know how to reverse this trend. Our lack of knowledge is due in large part to significant inadequacies in the health system for gathering, analyzing, and communicating health information about the population. To inform the public health community and all other sectors that contribute to population health, For the Public's Health: The Role of Measurement in Action and Accountability reviews current approaches for measuring the health of individuals and communities and creates a roadmap for future development. This book, the first of three in a series, focuses on data and measurement-not as ends in themselves, but rather tools to inform the myriad programs, policies, and processes developed or undertaken by governmental public health agencies and their many partners in the health system. For the Public's Health seeks to reinstate the proper and evidence-based understanding of health as not merely the result of medical or clinical care but the result of the sum of what we do as a society to create the conditions in which people can be healthy. To achieve this goal, the book suggests changes in the processes, tools, and approaches used to gather information about health outcomes and their determinants. The book also recommends developing an integrated and coordinated system in which all parties-including governmental and private sector partners at all levels-have access to timely and meaningful data to help foster individual and community awareness and action.
During Spring 1998, the U.S. Department of Health and Human Services (DHHS) contracted with the National Academy of Sciences (NAS), Institute of Medicine (IOM) to conduct a multi phase project resulting in the development of sets of leading health indicators that would provide a 'face' for Healthy People 2010. Of equal or greater importance was the development of indicator sets that would attract and sustain public attention and motivation to engage in healthy behaviors. Development of such leading health indicators sets is intended to move the United States toward achievement of more positive health outcomes for the general population and for select population groups defined by race, ethnicity, gender, age, socio-economic status, level of education, and disability. This second interim report presents a summary of the efforts of the IOM Committee on Leading Health Indicators for Healthy People 2010 to develop sample sets of leading health indicators that would meet the requisite functions of attracting and sustaining attention and motivating engagement in healthier behaviors by the public. Reactions to this report and more specifically, to the potential leading health indicator sets and suggested measures, will be solicited from the public health community as well as representatives of diverse consumer audiences through electronic communication, regional public meetings convened by DHHS, focus group discussions with target populations, and other information-gathering techniques. Review of information from these various sources will be summarized in a third and final report for DHHS to be published in April 1999. The third report will also include the committee's final recommendations regarding the functions to be fulfilled by leading health indicators, will define specific criteria underlying the selection of leading health indicators, and will identify specific sets of leading health indicators to be promoted and monitored during the decade 2000 to 2010.
How good is the quality of health care in the United States? Is quality improving? Or is it suffering? While the average person on the street can follow the state of the economy with economic indicators, we do not have a tool that allows us to track trends in health care quality. Beginning in 2003, the Agency for Healthcare Research and Quality (AHRQ) will produce an annual report on the national trends in the quality of health care delivery in the United States. AHRQ commissioned the Institute of Medicine (IOM) to help develop a vision for this report that will allow national and state policy makers, providers, consumers, and the public at large to track trends in health care quality. Envisioning the National Health Care Quality Report offers a framework for health care quality, specific examples of the types of measures that should be included in the report, suggestions on the criteria for selecting measures, as well as advice on reaching the intended audiences. Its recommendations could help the national health care quality report to become a mainstay of our nation's effort to improve health care.
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