HIM004/APT4: DEVELOP
POLICY TO IMPROVE
POPULATION HEALTH
All Learning Team Meetings, Training & Lectures
,Learning team meeting 1
Develop policy to improve population health(care), 15-11-2024
Sources:
- Papanicolas I, Rajan D, Karanikolos M, Soucat A, Figueras J.HealthSystem Performance
Assessment. A Framework for Policy World Health Organization, 2022:
o Chapter 1: Assessing healthsystems performance for UHC: rationale and
approach
o Chapter 2: Review of existing frameworks and tools
o Chapter 3 : Working towards a common approach: the HSPA Framework for UHC
- Rajan D, Papanicolas I, Karanikolos M, Koch K, Rohrer-Herold K, Figueras J. Health
system performance assessment. A primer for policymakers. Policy Brief. World Health
Organization, 2022.
- Wendt C, Frisina L, Rothgang H. Health system types: a conceptual framework for
comparison. Social Policy & Administration, 2009;43(1):70- 90.
- Böhm K, Schmid A, Götze R, Landwehr C, Rothgang H.Five types of OECD healthcare
systems: empirical results of a deductive classification. Health Policy, 2013;113:258-
269.
- Your goal should be to understand the health system analysis models and how they can
be applied to your authentic task; not to know which country has what type of health
system.
To understand what a health system is and what its main functions are
A health system is much more than just hospitals and clinics; it’s a comprehensive network of
organizations and individuals working collectively to improve health outcomes. This network
includes government health departments, private sector providers, insurance companies,
pharmaceutical suppliers, and public health organizations.
The main functions of a health system are (in line with WHO (2000):
- Service delivery: This involves providing health services that are safe, effective, timely,
and patient-centered. It includes preventive care (vaccinations, screenings), curative
services (treating diseases), rehabilitative services, and palliative care.
o Public health
o Primary care
o Specialist care
- Financing: This ensures that the system has sustainable funding. Financing may come
from various sources like taxes, private insurance, and out-of-pocket payments. Effective
financing includes risk pooling, where funds are collected from various sources to cover
the healthcare costs of a large population, reducing financial risk to individuals.
o Revenue raising, pooling, purchasing
- Resource generation: This involves producing and maintaining a supply of trained
healthcare professionals, medical facilities, and necessary technology. It also includes
research and innovation, such as developing new treatments or healthcare delivery
methods.
o Health workforce
o Infrastructure and medical equipment
o Pharmaceuticals and other consumables
, - Stewardship (Governance): The role of stewardship is to create a well-organized,
transparent, and equitable health system. This includes establishing health policies,
regulating standards, and ensuring accountability to the public. Effective governance
ensures that resources are used wisely and that services meet ethical and quality
standards.
o Policy and vision
o Stakeholder voice
o Information and intelligence
o Regulation and legislation
WHO (2000): the resources, actors and institutions related to the financing, regulation
and provision of health actions, where health actions are any set of activities whose
primary intent is to improve or maintain health.
All health systems must carry out some basic functions, regardless of how they are
organized.
WHO (2006): six system building blocks to represent the health system inputs
- Leadership and governance
- Health care financing
- Health workforce
- Medical products and technologies
- Information and research
- Service delivery
- Fair: access
è National dashboard for targeted monitoring and evaluation of health system
strengthening ePorts
DiPerences health systems
- Most frameworks do not hold the health system directly accountable for the social
determinants of health
- Variability around terminology and scope of objectives e.g. ePiciency, equity
- Number, scope and remit of factors that influence performance.
, è The same framework can be interpreted diPerently for diPerent countries e.g.
southern country and eastern country à reason why HSPA is made
Health system performance assessment seeks to monitor, evaluate and communicate
the extent to which the health system meets its key objectives.
Assessing health systems: delving into fundamental questions on the system’s
boundaries, component elements and goal; the HSPA UHC framework helping policy
makers = crucial to inform ePorts to strengthen health systems by identifying
opportunities for improvement
HSPA framework for universal health coverage (UHC): a tool that can assist stakeholders
with making the best use of information collected through existing HAS tools for the
purpose of health system performance assessment. It elaborates on the 4 health
system functions by WHO.
è Integrating diPerent systems for policy assessment to in the end improve health
systems
Health system boundaries: actors and actions whose primary intent is health
improvement
To understand what goals health systems aim to achieve
1. Health Improvement: Enhancing the population's health through prevention,
treatment, and rehabilitation.
2. People-Centeredness: Ensuring healthcare respects individual rights, needs, and
dignity.
3. Financial Protection: Preventing individuals from experiencing financial hardship due to
healthcare costs.
4. Equity: Providing fair and just distribution of health services and outcomes across all
population groups.
5. Efficiency: Maximizing resource use to achieve optimal health outcomes
Quality: the degree to which health services for individuals and populations increase the
likelihood of desired health outcomes and are consisted with current medical knowledge. 6
dimensions of quality of care:
- Safety
- Effectiveness
- Patient centeredness
- Timeliness
- Efficiency
- Equity
Very often, health status, health improvement, better health, population health
Objective HSPA framework for universal health coverage: provide a tool that assists
policy makers in using the information collected from other assessment for the purpose
of HSPA
- The grey functions influence one another; arrows
- Governance influences 3 functions, but is also present within other functions
- Access stated left; indicating that the population must first overcome the barriers
outlined before measures of quality is possible
o Quality: ePectiveness, safety, user experience
POLICY TO IMPROVE
POPULATION HEALTH
All Learning Team Meetings, Training & Lectures
,Learning team meeting 1
Develop policy to improve population health(care), 15-11-2024
Sources:
- Papanicolas I, Rajan D, Karanikolos M, Soucat A, Figueras J.HealthSystem Performance
Assessment. A Framework for Policy World Health Organization, 2022:
o Chapter 1: Assessing healthsystems performance for UHC: rationale and
approach
o Chapter 2: Review of existing frameworks and tools
o Chapter 3 : Working towards a common approach: the HSPA Framework for UHC
- Rajan D, Papanicolas I, Karanikolos M, Koch K, Rohrer-Herold K, Figueras J. Health
system performance assessment. A primer for policymakers. Policy Brief. World Health
Organization, 2022.
- Wendt C, Frisina L, Rothgang H. Health system types: a conceptual framework for
comparison. Social Policy & Administration, 2009;43(1):70- 90.
- Böhm K, Schmid A, Götze R, Landwehr C, Rothgang H.Five types of OECD healthcare
systems: empirical results of a deductive classification. Health Policy, 2013;113:258-
269.
- Your goal should be to understand the health system analysis models and how they can
be applied to your authentic task; not to know which country has what type of health
system.
To understand what a health system is and what its main functions are
A health system is much more than just hospitals and clinics; it’s a comprehensive network of
organizations and individuals working collectively to improve health outcomes. This network
includes government health departments, private sector providers, insurance companies,
pharmaceutical suppliers, and public health organizations.
The main functions of a health system are (in line with WHO (2000):
- Service delivery: This involves providing health services that are safe, effective, timely,
and patient-centered. It includes preventive care (vaccinations, screenings), curative
services (treating diseases), rehabilitative services, and palliative care.
o Public health
o Primary care
o Specialist care
- Financing: This ensures that the system has sustainable funding. Financing may come
from various sources like taxes, private insurance, and out-of-pocket payments. Effective
financing includes risk pooling, where funds are collected from various sources to cover
the healthcare costs of a large population, reducing financial risk to individuals.
o Revenue raising, pooling, purchasing
- Resource generation: This involves producing and maintaining a supply of trained
healthcare professionals, medical facilities, and necessary technology. It also includes
research and innovation, such as developing new treatments or healthcare delivery
methods.
o Health workforce
o Infrastructure and medical equipment
o Pharmaceuticals and other consumables
, - Stewardship (Governance): The role of stewardship is to create a well-organized,
transparent, and equitable health system. This includes establishing health policies,
regulating standards, and ensuring accountability to the public. Effective governance
ensures that resources are used wisely and that services meet ethical and quality
standards.
o Policy and vision
o Stakeholder voice
o Information and intelligence
o Regulation and legislation
WHO (2000): the resources, actors and institutions related to the financing, regulation
and provision of health actions, where health actions are any set of activities whose
primary intent is to improve or maintain health.
All health systems must carry out some basic functions, regardless of how they are
organized.
WHO (2006): six system building blocks to represent the health system inputs
- Leadership and governance
- Health care financing
- Health workforce
- Medical products and technologies
- Information and research
- Service delivery
- Fair: access
è National dashboard for targeted monitoring and evaluation of health system
strengthening ePorts
DiPerences health systems
- Most frameworks do not hold the health system directly accountable for the social
determinants of health
- Variability around terminology and scope of objectives e.g. ePiciency, equity
- Number, scope and remit of factors that influence performance.
, è The same framework can be interpreted diPerently for diPerent countries e.g.
southern country and eastern country à reason why HSPA is made
Health system performance assessment seeks to monitor, evaluate and communicate
the extent to which the health system meets its key objectives.
Assessing health systems: delving into fundamental questions on the system’s
boundaries, component elements and goal; the HSPA UHC framework helping policy
makers = crucial to inform ePorts to strengthen health systems by identifying
opportunities for improvement
HSPA framework for universal health coverage (UHC): a tool that can assist stakeholders
with making the best use of information collected through existing HAS tools for the
purpose of health system performance assessment. It elaborates on the 4 health
system functions by WHO.
è Integrating diPerent systems for policy assessment to in the end improve health
systems
Health system boundaries: actors and actions whose primary intent is health
improvement
To understand what goals health systems aim to achieve
1. Health Improvement: Enhancing the population's health through prevention,
treatment, and rehabilitation.
2. People-Centeredness: Ensuring healthcare respects individual rights, needs, and
dignity.
3. Financial Protection: Preventing individuals from experiencing financial hardship due to
healthcare costs.
4. Equity: Providing fair and just distribution of health services and outcomes across all
population groups.
5. Efficiency: Maximizing resource use to achieve optimal health outcomes
Quality: the degree to which health services for individuals and populations increase the
likelihood of desired health outcomes and are consisted with current medical knowledge. 6
dimensions of quality of care:
- Safety
- Effectiveness
- Patient centeredness
- Timeliness
- Efficiency
- Equity
Very often, health status, health improvement, better health, population health
Objective HSPA framework for universal health coverage: provide a tool that assists
policy makers in using the information collected from other assessment for the purpose
of HSPA
- The grey functions influence one another; arrows
- Governance influences 3 functions, but is also present within other functions
- Access stated left; indicating that the population must first overcome the barriers
outlined before measures of quality is possible
o Quality: ePectiveness, safety, user experience
