Competing demands for resources within the health care system require health care providers to ensure the most effective and efficient use of resources. The evidence from the United States, the United Kingdom and other jurisdictions suggests that integrated health delivery systems (IDS) may be a cost-effective way to meet the health care needs of a population. This article introduces a framework for use in monitoring and evaluating the performance of an integrated delivery system. The establishment of a consistently used evaluation framework for integrated delivery systems will provide the government, governing bodies and other evaluators with an effective assessment tool that will enable greater understanding of the impact of the IDS on the health care system. It will also provide information to enable ongoing performance improvements within the system.
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References
1.
ShortellSMGilliesRRAndersonDAMitchellJBMorganKL. Creating organized delivery systems: The barriers and facilitators. Hospital & Health Services Administration1993; 38(4): 447–466.
2.
MarriottJMabelAL. Integrated Models — International Trends and Implications for Canada. A paper for the National Forum on Health. Ottawa, 1996.
3.
LeattPPinkGHNaylorCD. Integrated delivery systems: Has their time come in Canada?Canadian Medical Association Journal1996; 154(6): 803–809.
4.
RoosNP. From research to policy: What have we learned from designing the population health information system?Medical Care1995; 33(12): DS132–DS145.
5.
KanterRMBrinkerhoffD. Organizational performance. Annual Review of Sociology1981; 7: 321–49.
6.
Premier's Council on Health, Well-being and Social Justice.A Framework for Evaluating Devolution. Queen's Printer for Ontario, 1994.
FloodABShortellSMScottWR. Organizational performance: Organizing for efficiency and effectiveness. In: ShortellSMKaluznyAD (eds). Health Care Management: Organization Design and Behavior (3rd ed). Albany, NY, Delmar Publishers Inc, 1994.
9.
ZuckermanHSKaluznyADRickettsTC. Alliances in health care: What we know, what we think we know, and what we should know. Health Care Management Review1995; 20(1): 54–64.
10.
KaplanRSNortonDP. Using the balanced scorecard as a strategic management system. Harvard Business Review1996; January—February: 75–85.
11.
KaplanRSNortonDP. Putting the balanced scorecard to work. Harvard Business Review1993; September—October: 134–147.
12.
KaplanRSNortonDP. The balanced scorecard — measures that drive performance. Harvard Business Review1992; January—February: 71–79.
13.
BakerGRPinkGH. A balanced scorecard for Canadian hospitals. Healthcare Management Forum1995; 8(4): 7–13.
14.
RothAVJacksonWE. Strategic determinants of service quality and performance: Evidence from the banking industry. Management Science1995; 41(11): 1720–1733.
15.
ShortellSMGilliesRRAndersonDA. The new world of managed care: Creating organized delivery systems. Health Affairs1994; 13(5): 46–64.
16.
PointerDDAlexanderJAZuckermanHS. Loosening the Gordian knot of governance in integrated health care delivery systems. Frontiers of Health Services Management1995; 11(3): 3–37.
17.
ShortellSMGilliesRRAndersonDAEricksonKMMitchellJB. Remaking Health Care in America: Building Organized Delivery Systems. San Francisco, Jossey-Bass, 1996.
18.
LeggatSGLeattP. Monitoring and evaluating strategic alliances in health care. In: LeattPLemieux-CharlesLAirdCLeggatSG (eds). Strategic Alliances in Health Care. Ottawa, Canadian College of Health Service Executives, 1996: 199–209.
19.
ClarksonMBE. A stakeholder framework for analyzing and evaluating corporate social performance. Academy of Management Review1995; 20(1): 92–117.
20.
BlairJDFottlerMD. Challenges in Health Care Management. San Francisco, Jossey-Bass, 1990.
21.
PerrowC. Three types of effectiveness studies. In: Goodman PS, Pennings JM and Associates. New Perspectives on Organizational Effectiveness. San Francisco, Jossey-Bass, 1977.
22.
WeissCH. Where politics and evaluation research meet. In: PalumboDJ (ed.) The Politics of Program Evaluation. London, Sage Publications, 1987.
23.
RushBOgborneA. Program logic models: Expanding their role and structure for program planning and evaluation. The Canadian Journal of Program Evaluation1991; 6(2): 95–106.
HallRHClarkJPGiordinoPCJohnsonPVVanRockelM. Patterns of interorganizational relationships. Administrative Science Quarterly1977; 22: 457–470.
26.
ChildJ. Managerial and organizational factors associated with company performance — Part I. Journal of Management Studies1974; 11: 175–189.
27.
SteersRM. Problems in the measurement of organizational effectiveness. Administrative Science Quarterly1975; 20: 546–557.
28.
MarkhamBLomasJ. Review of the multi-hospital arrangements literature: Benefits, disadvantages and lessons for implementation. Healthcare Management Forum1995; 8(3): 24–35.
29.
KaluznyADLaceyLMWarneckeRHynesDMMorrisseyJFordL. Predicting the performance of a strategic alliance: An analysis of the community clinical oncology program. Health Services Research1993; 28(2): 159–182.
