Examines various approaches, methodogies, and issues related to evaluation of the impact of health programs in developing countries and ways to make program evaluation more rigorous.

Considers potential efforts by the U.S. Department of Defense to assess the performance of military treatment facilities (MTFs) in cost-effectively managing health care. The authors first provide an overview of performance assessment in the nonmilitary health care sector; they then analyze the use of average MTF utilization and costs as performance measures, focusing on how MTF size and catastrophic cases affect these metrics.