goals, functions of, and assessment of a healthcare system Flashcards
Healthcare System
- All organizations, institutions, and resources devoted to promoting, restoring, or maintaining health.
- Includes health professionals, policy makers, purchasers, regulators, managers, and consumers. (World Health Report 2000, Institute of Medicine)
3 Main Goals of a Health Care System
- Health Status Improvement
- Responsiveness
- Fair Financing
- Primary goal: Improvement
Goals of Health Care System: Health Status Improvement
- Promotion, protection, and improvement of health
- Fundamental reason for establishing the system
- Other systems (housing, education, etc.) can contribute indirectly
Goals of Health Care System: Responsiveness
- Responds to physical and psychological expectations of users
- Shows care, listens, and determines what is good for them
Goals of Health Care System: Fair Financing
- Fairness in how people pay for health care
- Risk distributed according to ability to pay rather than risk of illness
- Concerns for those without insurance
Functions of a Health Care System
- Stewardship
- Resource Generation
- Financing
- Service Provision
Functions of a Health Care System: Stewardship
- Ownership
- Setting strategic health policies
- Regulation of components (government, insurance)
- Integration & Coordination
- Management
Functions of a Health Care System: Resource Generation
- Capital Investment
- Equipment & Consumables
- Health Manpower Development
- Research (e.g., pharmacy school requirements)
Functions of a Health Care System: Financing
- Raising resources for health care
- Payment/financing of health care institutions and providers
- Examples: Medicaid (federal program) and Medicare
Functions of a Health Care System: Service Provision
- Organization of structures and services
- Includes preventive, curative, rehabilitative services
- Settings: ambulatory care, hospital care, long-term care
- Special services: mental health care, rehabilitation centers
Characteristics of a Functioning Health Care System
- Safety
- Effectiveness
- Patient-centeredness
- Timeliness
- Efficiency
- Equity
Characteristics of a Functioning Health Care System: Effectiveness
- Does what it is supposed to do
Characteristics of a Functioning Health Care System: Efficiency
- Provides more benefit from the same resources
3 Ways of Assessing A Health Care System
- Attainment of goals
- Performance (effectiveness & efficiency)
- Quality of care
Assessing a Health Care System: Measuring System Attainment
- Overall health status
- Distribution of health within population
- Overall responsiveness
- Distribution of financial burden within the population
Health System Attainment: Health Status Improvement
- Differences in health status based on demographics (race, gender, SES, age) indicate health disparities
Common Measures of Population Health
- Infant Mortality
- Under 5 Mortality
- Adult Mortality
- Life Expectancy
Health System Attainment: Responsiveness
- Measures how well the system meets patient expectations
- Components: Respect for Persons, Client Orientation
Survey Results: Relative Importance of 7 Measures of Responsiveness
- Respect for Persons:
- Respect for dignity (16.7%)
- Confidentiality (16.7%)
- Autonomy (16.7%)
- Client Orientation:
- Prompt attention (20%)
- Quality of amenities (15%)
- Access to social support networks (10%)
- Choice of provider (5%)
Health System Attainment: Fair Financing
- Health financing burden = Household health costs / Capacity to pay
- Fair if contribution is identical regardless of income, health status, or system use
- Unfair if people are pushed into poverty or go without needed care
Assessment of a Health Care System: Measuring Quality of Care
- Quality assessed by Structure, Process, Outcomes
Measuring Quality of Care: Structure
- Attributes of the system and delivery settings
- Includes organization, personnel qualifications, facilities, equipment, payment structure
Measuring Quality of Care: Process
- What is done in giving and receiving care
- Includes diagnosis, treatment, referrals, reviews, authorizations, provider searches, second opinions, prescriptions
Measuring Quality of Care: Outcomes
- Evaluates changes in health status, patient knowledge/behavior, and satisfaction with care
- Important for assessing quality
Dimensions of Patient Satisfaction
- Interpersonal relations
- Technical quality (competence)
- Accessibility & availability
- Continuity of care
- Patient convenience
- Physical setting
- Financial contribution
Measuring Quality of Care: Summary
- Include aspects of Structure, Process, and Outcomes in any quality assessment
