Address correspondence to Peter D. Jacobson, J.D., M.P.H., Professor of Health Law and Policy, Director, Center for Law, Ethics, and Health, University of Michigan, School of Public Health, 109 Observatory, Ann Arbor, MI 48109 2029; e-mail: pdj@umich.edu. Peter J. Neumann, Sc.D., is with the Center for the Evaluation of Value & Risk in Health, Tufts University School of Medicine, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA.
A Framework to Measure the Value of Public Health Services
Article first published online: 17 AUG 2009
DOI: 10.1111/j.1475-6773.2009.01013.x
© Health Research and Educational Trust
Additional Information
How to Cite
Jacobson, P. D. and Neumann, P. J. (2009), A Framework to Measure the Value of Public Health Services. Health Services Research, 44: 1880–1896. doi: 10.1111/j.1475-6773.2009.01013.x
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Address correspondence to Peter D. Jacobson, J.D., M.P.H., Professor of Health Law and Policy, Director, Center for Law, Ethics, and Health, University of Michigan, School of Public Health, 109 Observatory, Ann Arbor, MI 48109 2029; e-mail: pdj@umich.edu. Peter J. Neumann, Sc.D., is with the Center for the Evaluation of Value & Risk in Health, Tufts University School of Medicine, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA.
Publication History
- Issue published online: 1 SEP 2009
- Article first published online: 17 AUG 2009
Keywords:
- Public health systems;
- measures of value;
- public health services
Objective. To develop a framework that public health practitioners could use to measure the value of public health services.
Data Sources. Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers.
Study Design. Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected.
Data Collection/Extraction Methods. The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services.
Principal Findings. Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability.
Conclusions. We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.

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