Evaluation of program performance and expenditures in a report of performance measures (RPM) via a case study of two Florida county tuberculosis programs

Health Department (HD) managers at both state and local levels are in desperate need of tools to assist in monitoring and evaluating programs. The purpose of this study is to assess the feasibility and utility of linking program performance scores and expenditures into a Report of Performance Measures (RPM). We analyzed secondary data on performance indicators, selected by HD staff, and expenditures, related to six surveillance activities, from two, similar, high-incidence, tuberculosis (TB) programs in Florida from 2002 to 2003. We compared the findings between the county HDs as an illustration of basic cost-effectiveness benchmarking, based on the cost-effectiveness grid. Data included here provide examples of: (1) two instances in which one county was operating relatively inefficiently compared to the other; (2) two instances in which performance and expenditures were similar for the counties; and (3) two instances in which one county spent more for higher performance scores than the other. These data illustrate how the RPM can be used to facilitate benchmarking, a basic evaluation tool. They also demonstrate ways to identify potential operational inefficiencies in a single time period and ultimately over time. It is thus likely to be a feasible and useful management tool.