Les enjeux de l'évaluation de la performance : Dépasser les mythes

Since the 1990s, most Western countries have equipped themselves with frameworks and tools to measure health organizations and systems' performance. Paradoxically, several theoretical, methodological and usage issues remain unresolved. Conceptually, the notion of performance is vague and not well rooted in theory. From a methodological perspective, we are faced with numerous measures that don't always meet reliability, validity and usefulness criteria and don't help to grasp the complexity of the concept. Finally, the assessment results are not fully used to continuously improve performance. This article focuses on analyzing these issues by deconstructing the myths that slow down the development of better‐suited frameworks to meet decision‐makers' needs. It also proposes innovations based on the global and integrated assessment model of health systems.