Health Care System Flashcards
definition of health care system
according to Bertalanffy (1968) a system is an arrangement of parts and their interconnections coming tgt for a purpose
health system and functions consist of what parts
health system:
community
department of ministries of health
health care providers
health service organizations
pharmaceutical companies
health financing bodies
other org relating to health
function: (governance)
policymaking and regulation
health care service provision including clinical services and health information
financing
managing resources
“the combination of resources, organization, financing and management that culminate in the delivery of health services to the population.”
ROFM
Roemer (1991) defined health system
“all the organizations, institutions and resources that are devoted to producing health actions.”
WHO report in 2000
“any effort, whether in personal health care, public health services or through intersectoral initiatives, whose primary purpose is to improve health.”
health action
goals and functions of health system
- improving the health of the population
it is the overarching goal
strive for equity
inequitable disparities in health are to be minimized (income, ethnicity, occupation, gender, geographic location and sexual interaction) - improving the responsiveness of the health system
provides services in the manner that ppl want or desire and engages ppl as active partners
embodies values of respectfulness, non-discrimination, humaneness and confidentiality
respond to the legitimate non-health desires and expectations - fairness in financial contribution
provide social and financial risk protection in health and be fairly financed
all health systems must be financed
also adequate funding to provide essential services
does not deter indiv from receiving needed care due to payments required at that time of services and one in which each indiv pays appox. the same percentage of their income for needed services
4 vital health system functions
health service provision:
public and private health is the most visible in the most visible product of the health care system
promote health and avert illness through edu and preventive measures
health service inputs:
managing resources is the assembling of essential resources for delivering health services
examples: human resources, medications, medical equipment
immediate control of the health system policy makers who have to respond to short term population needs with available resources
stewardships:
overall system oversight sets the context and policy framework
it is the governmental responsibility
identifying the health priorities which public resources shld be targeted
activities shld be coordinated with other systems external to healthcare
trends in health priorities and resources generation and their implications
generating appropriate data for policymaking ranging from public health surveillance data to health system performance
provide basis for assessing health status, regulating the sector and track health system performance, effectiveness and impact
health financing:
- revenue collection: collect funds from taxes
- risk pooling: spreading the financial risks associated with healthcare costs across a large population group
- strategic purchasing: strategically allocating funds to healthcare providers and services to ensure quality healthcare for all
strategic purchasing means smartly buying the right mix of quality health services for the money available to meet a population’s needs
Certainly! I’ll explain these concepts in simple terms with examples:
- Revenue Collection:
This is about gathering money to fund healthcare. It’s like filling up a big piggy bank for health services.
Example: Imagine the government collects a small amount from everyone’s paycheck each month. This money goes into a special fund used to pay for hospitals, doctors, and medicines for the whole country.
- Risk Pooling:
This is about sharing the cost of healthcare across many people. It’s like everyone putting money into a pot to help whoever gets sick.
Example: Think of 1000 people each putting $10 into a shared fund every month. If one person needs an expensive surgery costing $5000, there’s enough money in the shared fund to cover it, even though that one person didn’t put in $5000 themselves.
- Strategic Purchasing:
This is about spending healthcare money wisely to get the best results. It’s like smart shopping for healthcare services.
Example: Instead of just giving money to any hospital that asks, the government might decide to pay more to hospitals that have better patient outcomes or that provide services in underserved areas. They might also choose to fund more preventive care programs to reduce costly emergency treatments later.
In simple terms, strategic purchasing means making smart choices about what healthcare services to buy and from whom, to get the best health results for the money available.
what are the 2 main models that most high income countries follow. elaborate.
- bismarck model (bismarck’s law on health insurance of 1883)
Prussian Chancellor Otto Von Bismarck
Insurance system
The insurers r called sickness funds
Usually financed jointly by employer and employees through payroll deduction
- beveridge model (from report on social insurance and allied service of 1942 - the beveridge report)
William Beveridge
Provided and financed by the government through tax payments
The govt owns many but not all, hospitals and clinics; some docs are government employees but some private docs collect their fees from the govt
WHO health system framework of 2000
SERVICE DELIVERY
HEALTH WORKFORCE
INFORMATION
LEADERSHIP & GOVERNANCE
MEDICAL PRODUCT, VACCINE AND TECHNOLOGIES
FINANCING
access coverage
quality safety
IMPROVE HEALTH (LEVEL AND EQUITY)
RESPONSIVENESS
IMPROVE EFFICIENCY
SOCIAL AND FINANCIAL RISK PROTECTION
what are inequitable disparities
income
ethnicity
occupation
gender
geographic location
sexual orientation
it is the most visible product of the health care system
health service provision
it also promotes health and try to avert illness through edu and preventive measures
it is the assembling of essential resources for delivering health services
health service input
this function is usually a governmental responsibility
stewardship
identify health priorities to which public resources should be targeted
what are the directions of the Philippine Health Sector
- The Philippine Health Agenda (DOH Administrative Order 2016-0038) by 2020
expanded the scope of Universal Health Care
3 health system guarantees
- popu and individual level intervention for all life stages that promote health and wellness, prevent and treat the triple burden of disease, delay complications, rehabilitation and provide palliation
- access to health interventions through financial service delivery networks
- financial risk protection - The Philippine Development Plan 2017-2022
4 key medium term plans to translate the vision of aspirations - NEDA AmBisyon Natin 2040
long term plan = better life for Filipinos and the country in the next 25 years - Sustainable Development Goals 2030
17 development goals
who were granted autonomy and responsibility for their own health services
Local Government Unit
