Key Objectives:
- Discuss the main challenges of assessing the quality of health surveillance systems.
- Highlight the limitations of check-lists and other simplified quality assessments of health surveillance systems.
- Present a framework for evaluating and monitoring the quality of health surveillance systems using multi-criteria value analysis.
- Discuss the application of this framework in practice and the benefits that it can provide to health policy makers.
Brief Summary:
Health surveillance systems are crucial to ensure that health threats are detected, monitored, and dealt with. The quality of such a system ensures that it can provide continuous diagnostic services, clinical guidance, and inform adequate interventions to health professionals; track, investigate, and report disease outbreaks; promote communication activities; test the efficacy of interventions and develop new methods against health threats. Current surveillance evaluation frameworks target only technical attributes (e.g. sensitivity, specificity) and hence tend to ignore stakeholders´ values and other intangibles. They are also qualitative and do not allow aggregation of performances across multiple health quality dimensions. The evaluation of quality in this context is necessarily multi-dimensional, taking into account both quantitative criteria (e.g., the sensitivity of the system in detecting a disease outbreak) and qualitative criteria (e.g., the transparency level in which the system is run). It also involves determining trade-offs between these quality criteria, for instance between efficiency versus equity concerns, which can provide an overall index of quality for health surveillance systems. In this presentation we discuss a proposed adaption of a framework for health quality assessment of public health systems based on the 9 Public Health Aims for Quality, to the specific assessment of health surveillance systems using multi-criteria value analysis. The framework enables the evaluation of quality of health surveillance systems, the identification of quality gaps, the assessment of quality-improvement actions, the temporal monitoring of quality levels of these systems. It can thus support the accreditation, monitoring, and value-focused improvements of health surveillance systems. The framework is versatile and can be applied retrospectively on a surveillance system to assess its past performance. It can also be used prospectively to assess the value for money that different surveillance projects could return, or, in the face of budget cuts, the least damaging combination of de-investments.