Conceptual Framework For The Comparative Analysis Of Health Systems Flashcards
Learning Onjectives
- What is a healthcare system?
- Universal Health Coverage
- Comparative analysis of healthcare systems
- Healthcare spending as a proportion of GDP
- A focus on primary healthcare
- Indices of heath care performance
- See potential sources of bias in comparative health system assessment
What is universal health coverage?
- Equity of access to health services: those who need services should get them
- The quality of health services is good enough to improve health
- Financial risk protection: the cost of care should not create financial hardship
Define Health system
The ensemble of all public and private organizations, institutions and resources mandated to improve or restore health. Health systems encompass both personal and population services as well as activities to influence the policies and actions of other sectors to address the social, environmental and economic determinants of health.
What are the WHO’s health systems pressures building blocks?
- Service delivery
- Health workforce
- Health information
- Medical products, vaccines, and technologies
- Financing
- Leadership and governance
What are some issues to consider with health systems?
- Level of population access
- System organization
- Position and priority for primary care, and how primary care works
- Gatekeeping and direct access to specialists
- Strength of health promotion and disease prevention
- Functioning of primary and secondary care
- Method of financing
- Level of public sector financing
- Out-of-pocket payments and catastrophic expenditure
What was the Alma Ata Declaration 1978
Focused on primary health care being the hub to other levels of care
Make an analysis of comparative health systems (Part 1)
- A country’s health care system represents the outcome of a political policy decision-making process, which involves political and social actors and institutions.
- This policy process is crucial to the ways in which a health cares system is shaped in terms of (a) regulation and (b) finance.
- A commonly used ‘benchmark’ for health system analysis is spending on health care as a percentage of Gross Domestic Product (GDP)
Make an analysis of comparative health systems (Part 2)
- Comparative health system analysis:
- Acts as a ‘benchmark’ for the assessment of the performance of individual national systems
- Helps propose causes of poor health system performance and suggests reform policies and strengthening strategies
- Contributes to health system strengthening efforts
Make an analysis of comparative health systems (Part 3)
- However, using % of GDP) does not account for significant differences in the structure and scope of national health systems, nor reflect comparative outcomes
- The comparison of health care arrangements of a wide range of countries requires an assessment of not just quantitative metrics but also qualitative inputs and outputs
- Many countries have developed their own national systems of health information and performance assessment
- However, the application of comparative analyses for ‘health care strengthening’ purposes in the case of low-income countries (LIC) can be problematic, because of governance and data deficiencies.
What was the Bloomberg health efficiency index?
- The Bloomberg Health Efficiency Index utilizes three criteria to assess the performance of HCS’s and rank the least and most efficient of 56 national healthcare systems:
- Life expectancy;
- Healthcare cost as percentage of GDP
- Health care cost per capita
What is the common health fund?
- The Commonwealth Fund (CWF) produces annual reports comparing health system performance in selected HIC’s (e.g., Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, UK, USA)
- Its methodology involves 72 indicators form a wide range of sources corresponding to the five domains below:
- Care processes
- Access-waiting times
- Administrative efficiency
- Equity
- Healthcare outcomes
What are the biases present in the comparative HCS ranking analysis?
- The methodology needs to be sensitive to differing cultural and political contexts of cross-national health policy.
- Analyses may not account for cross-national differences in demographics and the relative burden of disease.
- The elements of care differ between health care systems and may not be comparable.
- National health system data are not always directly comparable
- Seemingly similar nomenclature may have different meanings within different country systems.
