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Table 1 Definitions of applied indicator (selection) criteria (n = 11)

From: Headline indicators for monitoring the performance of health systems: findings from the european Health Systems_Indicator (euHS_I) survey

Criterion Definition Source
(policy) Relevance The extent to which the measures represent the most critical issues and priorities of the health system.
An indicator measures an aspect of quality with high clinical importance, a high burden of disease or high health care use.
[18, 27, 31, 34, 35, 37, 38]
Actionability Monitors the overall performance related to the attainment of key objectives.
An indicator measures an aspect that is subject to control by providers and/or the health care system and is actually used at a national level for policy making, monitoring or strategy development.
[18, 27, 31,32,33, 35, 38]
Clear and easy to communicate & interpret Indicator is widely used with a high communicative and educational value.
Measure would be easily understood such that the meaning behind the numbers would be immediately apparent for all stakeholders, from statisticians and measure developers to students, patients, and other individuals.
[18, 26, 31, 32, 34, 37, 38]
Validity Sufficient scientific evidence exists to support a link between the value of an indicator and one or more aspects of health care quality. [18, 27, 31,32,33,34,35, 39]
Reliability Repeated measurements of a stable phenomenon get similar results. [27, 34, 38, 39]
International feasibility An indicator can be derived for international comparisons without substantial additional resources. [18, 27, 34, 38]
International comparability Reporting countries comply with the relevant data definition and where differences in the indicator values between countries reflect issues in quality of care rather than differences in data collection methodologies, coding or other non-quality of care reasons.
It should be possible to compare the indicator over time and ideally between places.
Comparability is ensured when concepts and definitions follow internationally agreed standards.
[18, 27, 31, 33, 35, 38]
Routine availability The indicator should be available for minimum 5 years for most MS. [18, 26, 31,32,33,34,35,36, 38, 39]
Far reaching A core measure set needs to capture not only progress on the specific measures it includes but also progress on overarching, meaningful priorities for health across the health system, touching on the full range of actors and stakeholders involved and driving improvement throughout [31, 37]
Coherent and balanced overall An indicator set should have an appropriate mix of indicators at different monitoring levels; e.g. there should be indicators to assess inputs, outputs, outcomes and impact. [34, 35, 38]
Minimum number of indicators A core measure set should comprise the minimum number of measures needed to assess health and health care system. [34, 35, 37]