HEALTH CARE SYSTEM - LECTURE Flashcards
-Arrangement of parts
-interconnections come together for a purpose
System
What are the parts of a health care system?
-community
-department or ministries of health
-health care providers
-health service organizations
-pharmaceutical companies:
-health financing agencies
What are the functions of a health care system?
-governance (policy making and regulation)
-health care service provision including clinical services and health promotion
-financing
-managing resources serve as the interconnections of a health system.
- defines the “combination of resources, organization, financing and management that culminate in the delivery of health services to the population”.
Roemer (1991)
“all the organizations, institutions, and resources that are devoted to producing health
actions.”
World Health Organization (WHO), 2000
- defined as “any effort, whether in personal health care, public health services or through
intersectoral initiatives, whose primary purpose is to improve health
Health Care
What are the goals of the health system?
- IMPROVING THE HEALTH OF THE POPULATION
- IMPROVING THE RESPONSIVENESS OF THE HEALTH SYSTEM TO THE POPULATION
IT SERVES - FAIRNESS IN FINANCIAL CONTRIBUTION
-“the overarching goal”
Improving the Health of the Population
What are the inequitable disparities in health?
-Income
-Ethnicity
-Occupation
-Gender
-Geographic location
-Sexual orientation
-preparation for resilience to future but still unknown health risks
Improving the health of population
-health status measured over entire population and across socioeconomic groups
Improving the health of population
-Health systems should strive for equity in health
Improving the health of population
-Variations and outcomes across the world, within the regions and within countries.
Improving the health of population
Disparities are most effectively reduced when they are recognized, and their minimization is an explicit normal goal.
Improving the health of population
health system provides services the way people want or desire
Responsiveness
Health system have an obligation to respond to the legitimate non-health desire and expectation of the population.
Improving the responsiveness of health system to the population it serves
Respectfulness, non-discrimination, humaneness and confidentially.
Improving the responsiveness of health system to the population it serves
Maximize people’s anatomy and control, allowing them to make choices, placing them at the of the health care system.
Improving the responsiveness of health system to the population it serves
provide social and financial risk protection in health and be fairly financed
fairness in financial contribution
paying for health care should not impoverish individuals or families
fairness in financial contribution
a fairly financed, health system is one that does not deter individuals from receiving needed care due to payments required at the time of service and one in which each individual pays approximately the same percentage of their income for needed services
fairness in financial contribution
What are the 4 vital health system function?
Health Service Provision
Health Service Input
Stewardship
Health Financing
public and private health service provision is the most visible product of the health care system
Health Service Provision
“managing resources” - assembling of essential resources for delivering health services
Health Service Inputs
function is generally outside the immediate control of health system policy makers who must
respond to short-term population needs with whatever resources are available
Health Service Inputs
- policy framework of the overall health
- governmental responsibility
Stewardship
the overall system oversight sets the context and policy framework for the overall health system.
generate appropriate data for policy making ranging from public health surveillance.
Stewardship
What are the core stewardship function?
- Identifying the health priorities to which public resources should be targeted
- the institutional framework in which the system and its many actors should function
- activities that should be coordinated with other systems external of health care and trends in
health priorities - resource generation and their implications
includes collecting revenues, pooling financial risk, and allocating revenue
health financing
-for health care services
-collection of money to pay for health care services
revenue collection
this refers to the collection and management of financial resources in a way that spreads financial risk from an individual to all pool members (WHO, 2000)
risk pooling
is the way most risk-pooling organizations or purchasers use collected and pooled financial resources to finance or buy health care services for their members.
strategic purchasing
In what countries does the Bismarck Model is observed?
-Germany
-France
-Belgium
-Netherlands
-Japan
-Switzerland
-in Latin America
What are the mechanism of revenue collection?
a) general taxation
(b) donor financing
(c) mandatory payroll contributions
(d) mandatory or voluntary risk-rated contributions
(e) direct household out of pocket expenditures
(f) other forms of personal savings
named after the Prussian Chancellor Otto von Bismarck who invented the welfare state as part of the unification of Germany in the 19th century
Bismarck Model
uses an insurance system-the insurers are called- sickness funds.
Bismarck Model
From the report on social insurance and allied services of 1942
Beveridge Model
named after William Beveridge, the social reformer who designed Britain’s National Health Service
Beveridge Model
Bismarcks law of health insurance of 1883
Bismarck Model
Countries using the Beveridge plan or variations of it includes;
-Britain
-Spain
-Most of Scandinavia
-New Zealand
-Cuba
-Hongkong
What are the six essential group that are needed to improve targeted health outcomes or overall goals?
Service Delivery
Health Workforce
Information
Medical products, vaccines, and technologies
Financing
Leadership and governance
those which deliver effective, safe, quality and non-personal health interventions.
Service Delivery
one which works in a way that are responsive, fair, and efficient to achieve the best health outcomes possible.
Health workforce
one that ensures the production, analysis, dissemination, and use of reliable and timely information on health determinants, health systems performance, and health status.
Information
ensure equitable access to essential medical products, vaccines and technologies of assured quality, safety, efficacy, and cost effectiveness, and their scientifically sound and cost-effective use.
Medical products, vaccines and technologies
raises adequate funds for health, in ways that ensure people can use needed services.
Health Financing
involve in ensuring strategic policy frameworks exist and combined with effective stewardship, coalition building, the provision of appropriate regulations and intensives, attention to system design, and accountability.
Leadership and Governance
Developed a largely centralized government-funded and operated health care system.
1970: Primary Health Care for All
promoted participatory management of the local health care system.
1979: Adoption of Primary Health Care
Integrated health and hospital services
1982: Reorganization of DOH
prevention and nutrition to promote breastfeeding
1986: Milk Code 1986
prescriptions are written using the generic name of the drug.
1988: The Generics Art
transfer of responsibility of health service provisions to the local government units.
1991: RA 7160 “Local Government Code”
aims to provide all citizens a mechanism for financial protection with priority given to the poor.
1995: National Health Insurance Act
major organizational restructuring of the DOH
1996: Health Sector Reform Agenda
adoption of operational framework to undertake reforms with speed, precision, and effective coordination.
2005: FOURmula One (F1) for Health
promotes and ensures access to affordable quality drugs and medicines for all.
2008: RA 9502 “Access to Cheaper and Quality Medicine Act”
universal health coverage and access to quality health care for all Filipinos.
2010: AO 2010-0036 Kalusugang Pangkalahatan
generating extra revenue for the department of health by discouraging harmful consumption.
2013: Sin Taxes for Health
enrolling all Filipino citizens automatically in the National Health Insurance Program administered by PhilHealth.
2019: Universal Health Care Law
“all for health towards health for all”. It expanded the scope of the Universal Health Care (UHC) directions, particularly through a whole-of-government approach.
The Philippine Health Agenda (DOH Administrative Order 2016-0038)
this is the four key medium-term plans to translate the vision of aspirations for the Filipinos and the country.
The Philippine Developmental Plan 2017-2022
this is a collective long-term plan which envisions a better life for the Filipinos and the country in the next 25 years.
NEDA Ambisyon Natin 2040
this is a compilation of 17 developmental goals that targets to end poverty, fight inequality and injustice and confront issues involving climate change and its effects.
Sustainable Developmental Goals 2030
According to WHO report in 2000, health system was defined as …..
”All the organizations, institutions and resources that are devoted to producing health actions.”
What are the primary goals of health care system?
-improved health outcomes (attaining the best average level of health care for the entire population and attaining the smallest feasible differences in health status among individuals and groups).
-more responsive health system (meeting the people’s expectations of how they should be treated by health workforce and the degree by which people are satisfied with the health system)
-more equitable healthcare financing (distributing the risk that each individual faces to cost the health care according to the ability to pay rather than the risk of illness).
consists of all organizations people, and actions whose primary interest is to promote, restore, or maintain health.
health system
this can be analyzed in its totality by using different groups or blocks such as leadership or governance, healthcare financing, health workforce, medical products, vaccines and technologies, health information and service delivery.
health system
What are the lead agency for Philippine health care?
The Department of Health (DOH)
According to the mandate ________________, the DOH shall be responsible for the following:
E.O No. 119, Sec. 3
The four health system functions are:
(a) delivery of health services - appropriate and cost-effective delivery
(b) resource generation - ensure the right level and mix of inputs, particularly human resources,
technology and capital
(c) financing - focusing оп two subfunctions, “revenue collection” and “pooling” to Improve
sustainability and solidarity) purchasing (with an emphasis on effective purchasing to
improve allocative and technical efficiency
(d) stewardship - and initiatives to strengthen governance, accountability, and responsiveness
- a health system consists of all organizations, people, and actions whose primary interest is to
promote, restore, or maintain health
The DOH as mandated, has the duty to:
- developing health policies and programs.
- enhancing partners’ capacity through technical assistance
- leveraging performance for priority health programs among these partners.
4.developing and enforcing regulatory policies and standards. - providing specific programs that affect large segments of the population; and
- providing specialized and tertiary level care.
