Introduction:

Improving population health requires robust health systems, which involves implementing health policy actions based on the best scientific evidence. This paper proposes an approach for evaluating health system performance and analyze its feasibility by comparing public information from the Ministries of Health in Uruguay, Chile, and Spain.

Methods:

An unstructured review of performance evaluation frameworks was conducted. Two components were defined: a. Rigid: based on Organisation for Economic Co-operation and Development and Donabedian, utilizing the dimensions of structure, process, and outcome, along with their corresponding sub-dimensions. b. Flexible: a set of indicators (N:28) resulting from a prioritization process, based on their importance for system performance.

Results:

Most data are available on the websites of the three ministries, but they are not presented as performance indicators and do not follow the methodologies identified in this review. Among the indicators, the dimension of structure is complete in Spain and Chile. The outcome dimension has the fewest indicators across all three countries.

Discussion:

A standardized and feasible method for systematic performance evaluation using structure and process indicators, complemented by outcome measures and contextualized by social determinants of health, will enable the measurement of changes in population health and the design of appropriate policies.

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