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The Health System Performance Assessment (HSPA) framework for Estonia acts as a tool for stakeholders and policy makers to guide health reforms in an evidence-based and targeted manner. This report outlines the Estonian HSPA framework and documents its development through a highly inclusive and consultative process.
This report, jointly developed by the European Observatory, OECD, and WHO Europe, serves as a proof of concept for a Health Systems Performance Assessment (HSPA) dashboard. HSPA is pivotal for health system transformation, providing policymakers with key indicators to identify and address system performance issues. This brief represents a step towards more policy-friendly dashboards, emphasizing the need for a focused set of HSPA indicators aligned with policy goals. The brief highlights the alignment and complementarity of the WHO-Observatory global HSPA framework and OECD's renewed framework, which aid policymakers in navigating health systems with actionable, policy-relevant indicators. These frameworks establish connections between performance indicators, health system functions, and overarching goals, supporting a coherent policy dashboard. Tracer indicators, like workforce, digital health, and service delivery outcomes, are emphasized as crucial for assessing key policy areas. The report underscores the importance of investing in data collection and infrastructure at national and international levels to make HSPA effective. It advocates for continuous improvement and collaboration among major international organizations, including WHO, OECD, EU, and the Observatory, to align methodologies and support informed policy decision-making.
Ensuring a robust and resilient health system involves policy actions which need to be implemented based on the best available evidence. This requires health systems to be monitored regularly to build on their strengths and to overcome any apparent shortcomings. In order to assist in that process, this volume, a collaboration between the World Health Organization and the European Observatory on Health Systems and Policies, presents a new framework to support monitoring of health system performance, with a focus on detailed conceptual links between health system functions and overall system goals. This HSPA framework for Universal Health Coverage thus represents a comprehensive attempt to address fundamental questions regarding regular assessment of health systems, including health system boundaries, component elements and outcomes. In this book, each of the health system function chapters outlines the purpose of the function, the sub-functions that enable it to carry out the key activities necessary to fulfil its purpose, as well as the assessment areas and proposed indicative measures to evaluate how well a system performs. The framework will thus assist policy-makers in understanding possible origins or impact of poor performance on a particular health system outcome, triggering more in-depth analysis.
The health system performance assessment (HSPA) framework for the Czech Republic is an initiative designed to help the Czech health system improve policy planning, monitoring, and decision taking. This report describes the HSPA framework for the Czech Republic, its development process, governance structure and implementation roadmap. It also details the Czech HSPA framework domains, populated by indicators selected through a comprehensive review process. As such, the framework enables the assessment of strengths and weaknesses of the Czech health system. Its implementation will increase the accountability of national authorities and principal healthcare stakeholders, improve public involvement, smooth flow of information across the health sector, and allow reform planning and monitoring.
This document presents the OECD’s renewed health system performance assessment framework. It incorporates new performance dimensions, notably people-centredness, resilience, and environmental sustainability, and places increased emphasis on addressing inequalities, including those related to gender.
Seizing a narrowing policy window in a post-pandemic context, the OECD and the European Observatory on Health Systems and Policies, with support from the European Commission, developed a comprehensive methodology culminating in a handbook on "Strengthening Health Systems: A Practical Handbook for Resilience Testing." Inspired by stress tests in various sectors, this methodology was piloted in Finland, Greece, and Spain throughout 2023.
Health spending continues to grow faster than the economy in most OECD countries. In 2010, the OECD published a study of strategies to increase value for money in health care, in which pay for performance (P4P) was identified as an innovative tool to improve health system efficiency in several OECD countries. However, evidence that P4P increases value for money, boosts quality of processes in health care, or improves health outcomes is limited.This book explores the many questions surrounding P4P such as whether the potential power of P4P has been over-sold, or whether the disappointing results to date are more likely rooted in problems of design and implementation or inadequate monitoring and evaluation. The book also examines the supporting systems and process, in addition to incentives, that are necessary for P4P to improve provider performance and to drive and sustain improvement. The book utilises a substantial set of case studies from 12 OECD countries to shed light on P4P programs in practice.Featuring both high and middle income countries, cases from primary and acute care settings, and a range of both national and pilot programmes, each case study features: Analysis of the design and implementationdecisions, including the role of stakeholders Critical assessment of objectives versus results Examination of the of 'net' impacts, includingpositive spillover effects and unintended consequences The detailed analysis of these 12 case studies together with the rest of this critical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. As a result, this book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability. This title is in the European Observatory on Health Systems and Policies Series.
Estonian living standards have doubled since 2000 and income convergence was steady prior to the pandemic, although per capita GDP and productivity remain below the OECD averages. The economy experienced a severe downturn due to disruptions in trade, weaker export demand, high inflation and tight monetary conditions. With improvements in external demand, growth should start to recover this year.
This internationally authored textbook demystifies the complexities that health systems pose in Low- and Middle-Income Countries.
The practice of health systems performance assessment (HSPA) varies across the WHO European Region. Consequently there is a need for baseline information about HSPA across Member States. This review summarizes HSPA domains and indicators used by Member States in their HSPA or health system-related reports. The evidence for this review was extracted through a purposive scoping analysis of online and publicly available health systems documents (e.g. national strategic plans for health or health systems national HSPA reports national health target reports) published in English by WHO European Region Member States from 2002 to 2015. Each document was reviewed to extract instances on the use of HSPA indicators and to analyse these in terms of the 14 domains of the WHO 2007 health system framework. Findings may be useful to identify similarities and differences in HSPA priorities across the Region inform future comparative assessments of health systems and provide preliminary information for potential areas that WHO may need to further support to strengthen health systems at both national and regional levels. The efficacy and accessibility of an HSPA for health system partners and citizens will be increased if it is robust with well-defined indicators that can be used for comparisons with other systems. Decision-makers responsible for overseeing HSPA management will benefit from this synthesis to further strengthen existing practices.