Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-25T08:35:18.582Z Has data issue: false hasContentIssue false

Chapter 12 - Performing Health Systems

Attributes and Approaches to Assessment

from Section 1 - Analyzing Health Systems: Concepts, Components, Performance

Published online by Cambridge University Press:  08 December 2022

By
Viroj Tangcharoensathien ,
Walaiporn Patcharanarumol ,
Titiporn Tuangratananon ,
Nattadhanai Rajatanavin  and
Shaheda Viriyathorn
Edited by
Sameen Siddiqi ,
Awad Mataria ,
Katherine D. Rouleau  and
Meesha Iqbal
Sameen Siddiqi
Affiliation:
Aga Khan University
Awad Mataria
Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau
Affiliation:
University of Toronto
Meesha Iqbal
Affiliation:
UTHealth School of Public Health, Houston
Get access

Summary

Health system performance assessment (HSPA) is a promising tool to evaluate health system capacity in achieving health systems goals and informed policy for health systems strengthening. Despite its importance, no universal definition is available at global level to support HSPA implementation. This chapter highlights the evolution of HSPA frameworks, which mostly follow the scope and boundaries of health systems. Key characteristics of successful HSPA include regularity, transparency, comprehensiveness, being analytical and systematic, which result in valid assessment and inform policy. HSPA requires selection of indicators suitable to the country context; the criteria for selecting indicators include importance, relevance, feasibility, reliability and validity. Hospital performance assessment, a subset of the HSPA, is necessary as it consumes signification portion of health resources. HPSA also contributes to monitoring achievement of SDG targets 3.8.1 and 3.8.2 on Universal Health Coverage as committed by countries. The chapter concludes by providing evidence how Thailand's health system performed in response to COVID-19 pandemic.

Keywords

Health systems performance assessmentHealth performance assessmentHealth systems strengtheningUniversal Health CoverageResponsiveness of health systemHealth system frameworksPabon Lasso graphData Envelopment AnalysisDeterminants of HealthFinancial ProtectionMeasurementIndicatorsL&MIC
Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
 , pp. 171 - 185
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization. Key components of a well functioning health system. 2010. www.who.int/healthsystems/EN_HSSkeycomponents.pdf?ua=1 (accessed August 18, 2020).Google Scholar
European Public Health. Health system performance assessment. 2016. www.europeanpublichealth.com/health-systems/health-system-performance-assessment (accessed September 30, 2020).Google Scholar
World Health Organization. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2. 2010. https://apps.who.int/iris/bitstream/handle/10665/44489/9789241500852_eng.pdf (accessed June 30, 2020).Google Scholar
Bennett, S., Glandon, D., Rasanathan, K.. Governing multisectoral action for health in low-income and middle-income countries: unpacking the problem and rising to the challenge. BMJ Glob Health 2018; 10: 3.Google Scholar
World Health Organization. A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals. 2018. https://apps.who.int/iris/handle/10665/328065 (accessed July 30, 2020).Google Scholar
World Health Organization. Declaration of Astana. Global Conference on Primary Health Care. 2018. www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf (accessed July 15, 2020).Google Scholar
World Health Organization. The World Health Report 2000, Health Systems: Improving Performance. Geneva, World Health Organization, 2000.Google Scholar
Murray, C. J., Frenk, J.. A WHO framework for health system performance assessment. 1999. https://pdfs.semanticscholar.org/9ac0/3257fcffff670c40a2b9868c201742a30b4a.pdf (accessed March 19, 2021).Google Scholar
World Health Organization. Everybody’s business: strengthening health systems to improve health outcomes: WHO’s Framework for Action. 2007. www.who.int/healthsystems/strategy/everybodys_business.pdf (accessed March 19, 2021).Google Scholar
World Health Organization. Health System Performance Assessment: A Framework for Policy Analysis. Geneva, World Health Organization, 2022.Google Scholar
Papanicolas, I., Rajan, D., Karanikolos, M., et al. Health system performance assessment: a framework for policy analysis. World Health Organization, 2021.Google Scholar
European Public Health. Health system performance assessment. 2016. www.europeanpublichealth.com/health-systems/health-system-performance-assessment (accessed August 18, 2021).Google Scholar
Tashobya, C. K., da Silveira, V. C., Ssengooba, F., et al. Health systems performance assessment in low-income countries: learning from international experiences. Glob Health 2014; 10: 5.Google Scholar
Ahluwalia, S. C., Damberg, C. L., Silverman, M., et al. What defines a high-performing health care delivery system: a systematic review. Jt Comm J Qual Saf 2017; 43(9): 450–459.Google Scholar
World Health Organization. Estonia health system performance assessment. 2009. www.euro.who.int/__data/assets/pdf_file/0015/115260/E93979.pdf (accessed September 30, 2020).Google Scholar
World Health Organization. Georgia health system performance assessment. 2009. https://reliefweb.int/sites/reliefweb.int/files/resources/900DCDCC6D22843CC1257671004774F2-Full_Report.pdf (accessed September 30, 2020).Google Scholar
World Health Organization. Case study on health system performance assessment: a long-standing development in Europe. 2012. www.euro.who.int/__data/assets/pdf_file/0008/168875/Case-Studies-for-HSPA-ENG.pdf (accessed September 30, 2020).Google Scholar
Kumah, E., Ankomah, S. E., Fusheini, A., et al. Frameworks for health systems performance assessment: how comprehensive is Ghana’s holistic assessment tool? Glob Health Res Policy 2020; 5(1): 1–2.Google Scholar
WHO, UNICEF. Immunization, vaccines and biologicals: data, statistics and graphics. 2020. www.who.int/immunization/monitoring_surveillance/data/en/ (accessed September 30, 2020).Google Scholar
Veillard, J., Huynh, T., Ardal, S., et al. Making health system performance measurement useful to policy makers: aligning strategies, measurement and local health system accountability in Ontario. Healthcare Policy 2010; 5 (3): 49.Google Scholar
McKee, M., Healy, J.. Pressures for Change: In Hospitals in a Changing Europe. Milton Keynes, Open University, 2002.Google Scholar
World Health Organization Europe. How can hospital performance be measured and monitored? 2003. www.euro.who.int/__data/assets/pdf_file/0009/74718/E82975.pdf (accessed January 9, 2020).Google Scholar
Groene, O., Skau, J. K., Frølich, A.. An international review of projects on hospital performance assessment. Int J Qual Health Care 2008; 20(3): 162–171.Google Scholar
Rouis, S., Nouira, H., Khelil, M., et al. Development of a balanced scorecard for the monitoring of hospital performance in the countries of the Greater Maghreb: systematic review. Tunis Med 2018; 96(10–11): 774–788.Google Scholar
Aloh, H. E., Onwujekwe, O. E., Aloh, O. G., et al. Is bed turnover rate a good metric for hospital scale efficiency? A measure of resource utilization rate for hospitals in Southeast Nigeria. Cost Eff Resour Alloc 2020; 18: 21.CrossRefGoogle Scholar
World Health Organization. The Republic of the Union of Myanmar health system review. 2014. https://iris.wpro.who.int/handle/10665.1/11354 (accessed October 15, 2020).Google Scholar
Goshtasebi, A., Vahdaninia, M., Gorgipour, R., et al. Assessing hospital performance by the Pabon Lasso model. Iranian J Public Health 2009; 2: 119–124.Google Scholar
Lasso, P.. Evaluating hospital performance through simultaneous application of several indicators. Bull Pan Am Health Organ 1986; 20(4): 341–357.Google Scholar
Mohammadkarim, B., Jamil, S., Pejman, H., et al. Combining multiple indicators to assess hospital performance in Iran using the Pabon Lasso model. Australas Medical J 2011; 4(4): 175.Google Scholar
Rasi, V., Delgoshaee, B., Maleki, M.. Identification of common indicators of hospital performance evaluation models: a scoping review. JEHP 2020; 9.Google Scholar
Stefko, R., Gavurova, B., Kocisova, K.. Healthcare efficiency assessment using DEA analysis in the Slovak Republic. Health Econ Rev 2018; 8(1): 6.Google Scholar
Kohl, S., Schoenfelder, J., Fügener, A., et al. The use of data envelopment analysis (DEA) in healthcare with a focus on hospitals. Health Care Manag Sci 2018; 22(2): 245–286.CrossRefGoogle ScholarPubMed
World Health Organization. The Global Health Observatory: UHC service coverage index. www.who.int/data/gho/indicator-metadata-registry/imr-details/4834 (accessed July 8, 2021).Google Scholar
Patcharanaruamol, W., Issac, A., Asgari-Jirhandeh, N., et al. COVID-19 health system response monitor: Thailand. 2020. www.searo.who.int/entity/asia_pacific_observatory/publications/covid_thailand/en/ (accessed August 18, 2021).Google Scholar
YouGov. Thais most likely to wear facemasks in ASEAN. 2020. https://th.yougov.com/en-th/news/2020/05/19/thais-most-likely-wear-facemasks-asean/ (accessed September 29, 2020).Google Scholar
Marshall, A., Archer, R., Witthayapipopsakul, W., et al. Developing a Thai national critical care allocation guideline during the COVID-19 pandemic: a rapid review and stakeholder consultation. Health Res Policy Syst 2021; 19(1): 1–5.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×