Assessment of perinatal indicators for the measurement of programmatic effectiveness.

Over the past decade, policymakers and consumers have increased their expectation that health care institutions and providers will compile evidence that services are effective. This article presents approaches and issues regarding the assessment of programmatic effectiveness in perinatal health care settings and identifies issues and problems in the selection and measurement of perinatal quality indicators. The importance of a plan for systematic, ongoing data collection for program assessment is stressed. Three models for the facilitation of the selection of indicators are presented and problems that interfere with effective programmatic assessment are discussed. In addition, 11 issues in the measurement of program outcomes are addressed.