Measuring the performance of the primary health care system is important, for a number of reasons. From a democratic perspective, return on investment of public money should drive performance measurement. Performance data also allow a more thorough understanding of primary health care and enable system and service improvements.77 Primary health care performance data also have the potential for broadening the public debate on health care, one which is dominated by acute care, in part because of availability of data on hospital-related issues.78
There is considerable debate about how to capture accurately the breadth and complexity of activity and outcomes in primary health care. However, in their absence the ability to build improved primary health care systems is limited.78 A number of developed nations have been struggling with the challenge of measuring performance in primary health care.79 Both the United Kingdom and Canada have progressed performance measurement through systems such as the Quality Outcomes Framework (United Kingdom) and the Pan-Canadian Primary Health Care Indicators project. In addition to measuring impact and outcomes these systems also measure patient experiences.80
Specific indicators are only now being considered for application across the GP Super Clinics Program. These indicators understandably are program-specific. They will enable assessment of the extent to which the models of care and activities of the GP Super Clinics achieve the GP Super Clinics Program objectives. They do not, nor are they intended to, provide an assessment of the activity and outcomes associated with this model of care. Clinicians expressed frustration at the lack of systems to provide robust and comparable activity and outcome data, but also recognised that this was a system rather than a GP Super Clinics issue. The processes being developed as part of the delivery of the broader health reforms and in particular the National Health Performance Authority may consider the measurement of broader primary health care systems and outcomes.
78Hogg W, Dyke E. Improving measurement of primary care system performance. Canadian Family Physician. July 1, 2011;57(7):758-760.
79Pan-Canadian Primary Health Care Indicators Report: 1 - Volume 2: Pan-Canadian Primary Health Care Indicator Development Project. Ottawa: Canadian Institute for Health Information;2006.
80Petek D, Kunzi B, Kersnik J, Szecsenyi J, Wensing M. Patients' evaluations of European general practice - revisited after 11 years. International Journal for Quality in Health Care. August 10, 2011.