Samenvatting

This article provides an overview of the various initiatives in the past decades to measure the outcomes of health care systems from a public health perspective. It is described how on the one hand the performance measurement techniques and its associated indicators have become more sophisticated over the years but on the other hand how the indicators meet difficulties in being incorporated in policy and management by policymakers and politicians. The present health care reform in The Netherlands will enforce the debate on competing health care outcomes (effectiveness, efficiency, equity). Steps are described how to take the steering on health outcomes as a more central notion in health system redesign.