Program performance measurement models for rural health

There are fifty State Offices of Rural Health (SORH) in the U.S., funded by the Office of Rural Health Policy in the Health Resources and Services Administration. Their core functions are to: 1) collect and disseminate information, 2) coordinate rural health activities statewide, and 3) provide training and technical assistance to rural communities. A frequent topic of discussion among the SORHs is how to meaningfully measure their performance in these core areas and present findings to a variety of audiences, including policy makers, constituents, and government agencies. The Government Improvement and Performance Review Act has also increased the need for this measurement. Because the scope of rural health activities among the SORHs is so diverse, it is difficult to obtain consensus on the aspects of coordination, training, and technical assistance that will, when measured, accurately represent the SORH program. Even so, measurement models can be developed that may help to advance the discussion about exactly what needs to be measured and how it can be effectively presented. This paper will describe performance measurement models developed by one State Office of Rural Health, utilizing tabulations, graphs, and GIS maps to present the data, and will make recommendations for furthering performance evaluation to include impact analysis and inform strategic community health planning and policy development.