Robin Gauld, Ph.D., Suhaila Al-wahaibi, Johanna Chisholm, Rebecca Crabbe, Boomi Kwon, Timothy Oh, Raja Palepu, Nic Rawcliffe, and Stephen Soln
R. Gauld, S. Al-wahaibi, J. Chisholm et al., "Scorecards for Health System Performance Assessment: The New Zealand Example," Health Policy, published online July 4, 2011.
Health system performance "scorecards" can help identify gaps in performance on measures of quality, access, and efficiency in health care, yet few such scorecards exist outside the United States. The authors of this study developed a scorecard for assessing the performance of New Zealand's health system.
The scorecard compared New Zealand's performance on 64 measures that reflect dimensions of population health, quality, access, efficiency, and equity. These range from the infant mortality and wait times for cancer treatment to the percentage of patients who receive recommended screenings. The scores were benchmarked against data drawn from top-performing countries.
New Zealand's health care system achieved an overall score of 71 out of 100, and performed relatively well on measures of quality and efficiency, but poorly on measures of equity, despite the government's considerable investment in programs to reduce disparities. Individual dimension scores were: population health, 75; quality, 78.5; access, 63.9; efficiency, 80.9; and equity, 56.8.
The scorecard highlighted several areas of concern within these categories, including rates of infant mortality, obesity, and diabetes in minority groups; the need for better medication reconciliation; and cost barriers to care provided in primary care settings.
The first-ever scorecard on New Zealand's health system shows mixed results, with relatively good performance in terms of efficiency, quality of care, and population health. There is considerable room for improvement, however, in the areas of access and equity.