HEALTH CARE SYSTEM - LECTURE Flashcards by Tipayyy Perlaaa

Q

-Arrangement of parts
-interconnections come together for a purpose

A

System

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Q

What are the parts of a health care system?

A

-community
-department or ministries of health
-health care providers
-health service organizations
-pharmaceutical companies:
-health financing agencies

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Q

What are the functions of a health care system?

A

-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.

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Q

defines the “combination of resources, organization, financing and management that culminate in the delivery of health services to the population”.

A

Roemer (1991)

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Q

“all the organizations, institutions, and resources that are devoted to producing health
actions.”

A

World Health Organization (WHO), 2000

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Q

defined as “any effort, whether in personal health care, public health services or through
intersectoral initiatives, whose primary purpose is to improve health

A

Health Care

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Q

What are the goals of the health system?

A

IMPROVING THE HEALTH OF THE POPULATION
IMPROVING THE RESPONSIVENESS OF THE HEALTH SYSTEM TO THE POPULATION
IT SERVES
FAIRNESS IN FINANCIAL CONTRIBUTION

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Q

-“the overarching goal”

A

Improving the Health of the Population

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Q

What are the inequitable disparities in health?

A

-Income
-Ethnicity
-Occupation
-Gender
-Geographic location
-Sexual orientation

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Q

-preparation for resilience to future but still unknown health risks

A

Improving the health of population

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Q

-health status measured over entire population and across socioeconomic groups

A

Improving the health of population

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Q

-Health systems should strive for equity in health

A

Improving the health of population

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Q

-Variations and outcomes across the world, within the regions and within countries.

A

Improving the health of population

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Q

Disparities are most effectively reduced when they are recognized, and their minimization is an explicit normal goal.

A

Improving the health of population

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Q

health system provides services the way people want or desire

A

Responsiveness

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Q

Health system have an obligation to respond to the legitimate non-health desire and expectation of the population.

A

Improving the responsiveness of health system to the population it serves

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Q

Respectfulness, non-discrimination, humaneness and confidentially.

A

Improving the responsiveness of health system to the population it serves

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Q

Maximize people’s anatomy and control, allowing them to make choices, placing them at the of the health care system.

A

Improving the responsiveness of health system to the population it serves

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Q

provide social and financial risk protection in health and be fairly financed

A

fairness in financial contribution

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Q

paying for health care should not impoverish individuals or families

A

fairness in financial contribution

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Q

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

A

fairness in financial contribution

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Q

What are the 4 vital health system function?

A

Health Service Provision
Health Service Input
Stewardship
Health Financing

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Q

public and private health service provision is the most visible product of the health care system

A

Health Service Provision

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Q

“managing resources” - assembling of essential resources for delivering health services

A

Health Service Inputs

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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:

1. developing health policies and programs. 2. enhancing partners’ capacity through technical assistance 3. leveraging performance for priority health programs among these partners. 4.developing and enforcing regulatory policies and standards. 5. providing specific programs that affect large segments of the population; and 6. providing specialized and tertiary level care.