BMJ  2007;334:1333-1334 (30 June), doi:10.1136/bmj.39251.660127.AD

Editorials

Performance measurement and equity

To maximise benefits and minimise harm, equity must be built in from the start

The first 150 words of the full text of this article appear below.

Performance measurement is now a reality for clinicians around the world. It involves measuring and monitoring quality of care using standardised indicators. Shortcomings in the quality of care—the gap between what we know and what we do—are well documented.¹ So too are inequities in access, quality, and outcomes linked to gender, ethnic origin, and socioeconomic status.² Recognition of substandard and uneven quality of care has fuelled calls for providers to be more publicly accountable and for health systems to change.

Interest is growing in performance measurement as a way to drive improvements in health care. In this week's BMJ, McDonald and colleagues describe an ethnographic case study in which two English general practices changed their organisation to achieve high performance scores under the quality and outcomes framework.³ The quality and outcomes framework, and other high profile measurement and reporting efforts such as those in the US Veterans' Health Administration, . . . [Full text of this article]

Faculties of Medicine and Nursing, University of Toronto and Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada M5B 1W8

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Rapid Responses:

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Equity, ethnicity and performance measures

Mark R D Johnson
bmj.com, 4 Jul 2007 [Full text]

Performance measurement and health inequalities

Jocalyn Clark
bmj.com, 6 Jul 2007 [Full text]

Impact of pay for performance on health inequities - reporting systems should include patient level data

Christopher J Millett, et al.
bmj.com, 10 Jul 2007 [Full text]

Pay for Equity

Arlene S Bierman
bmj.com, 13 Jul 2007 [Full text]

Tying pay-for-performance to healthcare disparities should await mastery of measurement issues

James P. Scanlan
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