Evolution of HealthCare Systems_1_2_3.pptx

healthcare system intro

1. HealthCare Systems I Dr. Walid Hassan, 2013

2. Table of Contents

3. Introduction Definitions: Healthcare: The prevention , treatment , and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions. [The American Heritage® Medical Dictionary Copyright © 2007] Healthcare System: the complete network of agencies , facilities , and all providers of health care in a specified geographic area . Nursing services are integral to all levels and patterns of care, and nurses form the largest number of providers in a health care system. [Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier]

4. Determinants of Health

5. Vocation Healthcare systems basically ensure: Provision of healthcare services. Resources generation. Financing of Healthcare. Healthcare management (stewardship).

6. Objectives Three main objectives are distinguished for HCS: Ensure good population health.. R esponsiveness to the expectations of the population. F air financial contribution.

7. Dimensions 2 dimensions for each objective:

8. Health system Functions

9. WHO Health-System Performance framework

10. Responsiveness Responsiveness: aspects related to the way and environment where individuals are treated. Responsive health system : Is more conducive for individuals to seek care earlier  to be more open in their interactions with health care providers  better assimilate health information. Contribute to increased utilization in settings where people might choose not to use available services because of their low responsiveness.

11. Responsiveness and quality of care Responsiveness

12. Responsiveness and patient satisfaction Let’s do it together…….

13. Scope : patient satisfaction focuses on clinical interaction in specific health care settings whereas responsiveness evaluates the health system as a whole; Range : patient satisfaction generally covers both medical and non-medical aspects of care while responsiveness focuses only on the non-health enhancing aspects of the health system; Rationale : patient satisfaction represents a complex mixture of perceived need , individually determined expectations and experience of care. Responsiveness evaluates individual’s perceptions of the health system against ‘legitimate ’ universal expectations. Responsiveness and patient satisfaction

14. Population Health The World Health Organization’s (WHO ) definition of health—that health is a state of complete physical , mental and social well-being, and not merely the absence of disease or infirmity —first appeared in the preamble to its constitution, which was signed in 1946 and ratified in 1948 . Population health can be regarded as a conceptual framework for thinking about why some people are healthier than others and the policy development, research agenda, and resource allocation that flow from this.

15. Measuring Health and diseases in population The two basic measures of disease occurrence in populations are incidence and prevalence. Incidence is the rate at which new events occur in a population in a defined time period.

16. Measuring Health and diseases in population Prevalence refers to the proportion of people who possess a certain attribute either at a certain point in time or within a specific time period .

17. Population Health indicators

18. Health financial contribution Fairness in financial contribution is an intrinsic goal of a health system. 4 main types of financing for health: government-raised (through general and specific taxes ). social insurance contributions (often levied through payroll and other taxes, as well as other contributions ) private insurance contributions. out of-pocket payments .

19. Equity in health finance: the extent to which all forms of health payments (taxes, social insurance payments, private insurance and out-of-pocket payments ) contribute to the redistribution of income. Catastrophic payments are undesirable and unfair. Imagine two systems, one in which health, health inequality, responsiveness and responsiveness inequality are identical but in one system two percent of households make catastrophic payments and in the other zero percent. Most would prefer the zero percent. Equity in health finance

20. Fairness Fairness in the philosophical literature is often associated with the concept of impartiality. One way to think about impartiality is using the device of the original position. If you do not know who you are in society, what would be a fair way to organize the financing of the health system. A health system is fairly financed if the ratio of total health system contribution of each household through all payment mechanisms to that households capacity to pay (effective non-subsistence income) is identical for all households, independent of the households health status or use of the health system.

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