Case 1: building blocks of a health system: from theory to practice Flashcards
What is a system?
Interconnected set of elements that is organised in a way that achieves something.
What must a system consist of?
- elements
- interconnections
- fucntion/purpose
What are the characteristics of a health system?
- are a means to an end
- open systems
- positive & negative feedback loops
- static complexity
- dynamic complexity
.
.
What is a health system?
Consists of organisations, institutions, resources & people whose primary purpose = improve health
What goals are health systems focused on?
- improving health of population
- responding to citizens’ expectations
- providing financial protection against costs of ill-health
Why is it important to classify EU health systems?
- rational way to label what is complex
- allows for international comparisons of characteristics & performance
- enables policy assessments & recommendations to be made
What does health systems economic and social sustainability rely on?
- policy makers ability to stress strengths of existing health system types
- overcoming their weaknesses in terms of equitable & timely access to care.
What are the 3 actors in the HC systems?
- state
- non-governmental actors
- Market
What is the role of the EU in national health systems?
- Member States chose for a hands-off policy on health systems in 1992
- Now have cross-border care and economic reform (incl. healthcare)
Why are there different systems in different countries?
- What the health issue are in country. E.g. in Europe much less attention to pandemics than now (health status)
- Funding
- Capacity
- Values
- Level of centralization
*What is vertical integration?
IC brings together services at different stages of care
How does the WHO framework describe health systems?
Describes health systems interms of 6 “building blocks”
What are the WHO building blocks?
- Service delivery
- health workforce
- health information systems
- medical products, vaccines & technologies
- financing
- leadership/governance
**What is the defintion of building block service delivery
WHO building block
- comprehensive range of provided services, accessibility, coverage of a defined target population, continuity of care across networks, high quality and patient-centred care, active coordination, accountability and efficiency
List the characterisitcs of a good service delivery
WHO building blocks
- Comprehensiveness - health services for needs of population
- accessibility
- coverage - defined target population
- continuity -
- quality -
- Person-centeredness - services organized around person, not disease.
- coordination
- accountability & efficiency
What is health workforce?
WHO building block
All people engaged in actions whose primary intent is to enhance health
What is the purpose of health information systems?
WHO building block
Enable decision-makers at all levels of health system to identify problems & needs
What are health information systems essential for?
WHO building block
- health system policy development and implementation
- governance and regulation,
- health research
- human resources development
- health education
What key functions does health infromation systems have?
WHO building block
- data generation
- compilation
- analysis and synthesis
- communication and use
Explain access to essential medicines building block
WHO building block
ensures equal access to medical products, vaccines & technologies, etc.
What is the building block health financing?
WHO building blocks
- allocation of money to cover health needs of people
- make funding available
- set financial incentives to providers to make sure all individuals have access to effective PH & personal HC
What does leadership & governance building block do?
WHO building blocks
Making sure strategic policy frameworks exist & are combined with:
- effective oversight
- coalition-building,
- regulation
- attention to system design
- accountability
What are 2 types of indicators for measuring governance?
WHO building block
- ruels based indicators
- outcome based indicators
What are strengths of the WHO building blocks framework?
- tool for planning, funding, decisions & establishing priorities.
- Useful reference point for national & global policymakers
- identify indicators & measurements to monitor & evaluate systems
- make easier to harmonize systems which can help get rid of large differences between MS in EU
What are limitations of the WHO building blocks framework?
- too static, not fully showing the complexity of health systems
- All buidling blocks have some underlying factor that has nothing to do with HC system. e.g. workforce qualitifcation more linked to education system
- Community organisations, societal partnerships, household production of health & information systems often NOT seen as part of the health system.
How can we montior & evaluate health systems strengthening?
See pages
What are health indicators for the performance of HC systems?
- health of the population
- Life expectancy at birth
- Total expenditure on health
- mortality rate
- infant mortality rate
- life expectancy
What are economic indicators for the performance of HC systems?
- HC expenditures per capita, HC expenditure as a percentage of GDP
- satisfaction with health care
Explain how to combine a tax-based & insruance based system? (Hybrid health system model)
- Multiple subsystems need to be governed centrally by providing right incentives for desired stakeholder behaviour.
- Tax- and insurance-based approaches can be combined in one system to assure efficiency, equity and quality.
See picture in pages
Why is it important to analyse health systems?
- Needed to understand how the public health system functioning
- Compares the system to its past performance
- Compares the system to those in other countries
- Lessons drawing and system improvement
Which building blocks is access to essential medicines linked with?
Monitoring access to essential medicines is linked with service delivery & governance
What is vertical intervention?
funding targets specific interventions & outcomes
What is horizontal intervention?
focuses on funding to strengthen health system more broadly
