A Systematic Literature Review Comparing Primary and Community Health Care Indicators and Measurement Frameworks

Measurement frameworks are essential in primary and community healthcare to help reduce unsustainable healthcare costs in many jurisdictions including Ontario, Canada. This paper presents a literature review of studies measuring the success of primary and community healthcare initiatives around the world carried out after 2003 in more than 15 countries. Some initiatives were fully deployed and others were in research or pilot mode. A comprehensive set of indicators is identified spanning four categories and nine domain areas. We discuss our observations showing the discrepancies that exist amongst the various studies and analyze the problems associated with these gaps. We proposed a new approach that we intend to pursue in more detail in future work. There is a lack of maturity in measuring the success of primary and community healthcare initiatives. There are opportunities in improving the situation by defining aggregate indices, working on standardization of indicators, and identifying measures that contribute to improving the system in place based on mining existing data and using a heuristics-based approach.