The provision of relevant, accurate and timely performance information is essential for assuring and improving the performance of health systems. Citizens, patients, governments, politicians, policy-makers, managers and clinicians all need such information in order to assess whether health systems are operating as well as they should and to identify where there is scope for improvement. Without performance information, there is no evidence with which to design health system reforms; no means of identifying good and bad practice; no protection for patients or payers; and, ultimately, no case for investing in the health system.

Performance information offers the transparency that is essential for securing accountability for health system performance, thereby improving the health of citizens and the efficiency of the health system. However, most health systems are in the early stages of performance measurement and still face many challenges in the design and implementation of these schemes. This book brings together some of the world's leading experts on the topic and offers a comprehensive survey of the current state of the art. It highlights the major progress that has been made in many domains but also points to some unresolved debates that require urgent attention from policy-makers and researchers.

This book arises from the WHO European Ministerial Conference on Health Systems: ‘Health Systems, Health and Wealth’, Tallinn, Estonia, 25–27 June 2008. During the conference, the WHO, Member States and a range of international partners signed the Tallinn Charter that provides a strategic framework, guidance for strengthening health systems and a commitment to promoting transparency and accountability.