NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Funding for this project was provided by the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services (contract no. 282-94-0032); The Robert Wood Johnson Foundation (grant no. 024336); and the Kellogg Endowment Fund of the National Academy of Sciences and the Institute of Medicine. The views presented in this report are those of the Committee on Using Performance Monitoring to Improve Community Health and are not necessarily those of the funding organizations.

Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee on Using Performance Monitoring to Improve Community Health.

Improving health in the community : a role for performance monitoring / Committee on Using Performance Monitoring to Improve Community Health ; Jane S. Durch, Linda A. Bailey, and Michael A. Stoto, editors.

p. cm

Includes bibliographical references and index.

1. Community health services—United States—Evaluation. 2. Health status indicators—United States. 3. Health promotion— United States. I. Durch, Jane. II. Bailey, Linda A. III. Stoto, Michael A. IV. Title.

[DNLM: 1. Community Health Services—standards—United States. 2. Quality Assurance, Health Care—organization & administration— United States. 3. Community Health Planning—methods—United States. 4. Health Status Indicators—United States. WA 546 AA1 I59i 1997]

RA445.I575 1997

362.1′2—dc21

DNLM/DLC

for Library of Congress 97-6336

CIP

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.