What are Health Care Systems

3205PBH Lecture 1

3205PBH Health Care Systems

Learning Objectives

Students should be able to

Understand the definition of and appreciate the various

components to a health care system

3205PBH Health Care Systems

What are Health Care Systems

Health System - definition

A health system includes all the activities whose primary purpose is to promote, restore or maintain health In doing this there must be an assurance that the system is responsive in terms of fairness in access (equity) and payment for service (efficiency) (World Health Report, 2000) The health system is a collection of entities that are related to one another
3205PBH Health Care Systems

What are Health Care Systems

Health System key functions

Ultimate responsibility for health systems performance lies with Government (a National Priority) ie their responsibility is well being of the population by: Stewardship

Providing oversight and tailoring strategic direction for the entire system taking into account any reported failings Generating human & physical resources to make service delivery possible Raising & pooling the resources used to pay for health care

Providing services & Resource Allocation

3205PBH Health Care Systems

What are Health Care Systems

Health System key functions

Financing

Improving peoples health and protecting them against the financial cost of illness In low income countries out of pocket payments are burdensome

Focus on

both public sector finance & private finance, and provision of care

to achieve better levels of health systems performance & offset any private market failures
3205PBH Health Care Systems

What are Health Care Systems

Health System Includes

Professional delivery of health care Traditional healers Public health activities

Health promotion (behaviour modification strategies) Health education, and Health maintenance

Health enhancing activities eg road & environmental safety improvement NOTE most emphasis is on provision and investment in health services ie the health care system includes

Preventive Curative, and Palliative interventions for both individuals & populations
3205PBH Health Care Systems

What are Health Care Systems

Health Care System

a health care system is the combination of structures which determine how health care is made available to the population of a country (Curtis & Taket, 1996, p. 104) Roemer proposes a more detailed description of health care systems based on five components (resources, organisation, management, economic support and delivery of services) emphasis is placed on processes or ways of doing things

3205PBH Health Care Systems

What are Health Care Systems

Roemers Components of Health Care Systems (adapted from Roemer, 1993) Component Variations Resources Produced, acquired in a variety of ways and to different extents Elements Human resources (doctors, nurses, community health workers, etc.) Facilities (hospitals, health centres, etc.) Commodities (drugs, equipment, etc.) Knowledge Principal authority of government (various levels) Governmental agencies with health functions Voluntary health agencies Enterprises Private health care market Health planning Health administration Regulation Legislation Social insurance (statutory) Voluntary insurance Charities Foreign aid (for less developed countries) Family households Primary health care Secondary care Tertiary care Includes institutional and ambulatory care

Organisation

Great deal of variation across systems

Management

Varies mainly with a countrys dominant political ideology

Economic support

Relative proportions between the forms influence features of health systems Governmental tax revenues

Delivery of services The previous four components lead to this one. Special delivery for some conditions (e.g. mental health) and for some populations (e.g. ATSI)

3205PBH Health Care Systems

What are Health Care Systems

Health Care System

Lassey et al. (1997) emphasise some different components in their description of health care systems Their components are

health care institutions supporting human resources financing mechanisms information systems organisational structures that link institutions and resources, and management structures that collectively culminate in the delivery of health services to patients.

emphasis placed on institutions and organisations

Following table summarises the characteristics of these components

3205PBH Health Care Systems

3205PBH Health Care Systems

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Revision
When revising these notes you should aim to:
Be able to define the concept Health Care System Understand what comprises a health care system

3205PBH Health Care Systems

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