• 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.