Health indicators or health system analysis? Extracts from a French survey

1976 ◽  
Vol 3 (1) ◽  
pp. 37-74 ◽  
Author(s):  
F. Fagnani ◽  
G. Dumenil
Keyword(s):  
Health System ◽  
System Analysis ◽  
Health Indicators

Managing the effectiveness of the regional health system

2020 ◽  
Vol 26 (3) ◽  
pp. 698-720
Author(s):  
E.V. Lobkova ◽  
A.S. Petrichenko
Keyword(s):  
Public Health ◽  
Health System ◽  
System Analysis ◽  
Health Indicators ◽  
Krasnoyarsk Krai ◽  
Regional Health ◽  
Luenberger Observer ◽  
Efficiency Assessment ◽  
Public Health Indicators

Subject. This article studies the mechanism of State health regulation and methods of management of efficiency of regional healthcare institutions. Objectives. The article aims to analyze the territorial health system in the context of the urgent need to optimize budget expenditures and address public health problems, as well as develop directions to improve the effectiveness of the regional health system of the Krasnoyarsk Krai. Methods. For the study, we used the method of index numbers and calculation of dynamics indicators using official statistics data. Results. We have developed and now present a system of indicators of regional health efficiency assessment, focused mainly on public health indicators and quality of medical services. We also offer our own version of the Luenberger observer modification adapted to the objectives of the regional health system analysis. Conclusions and Relevance. The article concludes that it is necessary to optimize the regional health system using the parameters of medical and social efficiency of the system. The proposed approach to assessing the effectiveness of regional health system can be used as a mechanism to develop recommendations for the management of the network of medical and prophylactic institutions of the region.

scholarly journals Health care network for chronic conditions: an intervention and evaluation in the health system

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C S Cardoso ◽  
N R Baldoni ◽  
C F Melo ◽  
L O Rezende ◽  
K Noronha ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Chronic Conditions ◽  
Panel Study ◽  
Health Indicators ◽  
Institutional Capacity ◽  
Local Health ◽  
Care Network ◽  
Health Care Network

Abstract Background Health assessments are necessary for the (re) formulation of effective public policies and to guarantee the quality of care offered. This study aim to evaluate the perception of health professionals concerning the institutional capacity of the health system to care for Chronic Conditions (CC) after intervention in a medium-sized municipality in Minas Gerais, Brazil. Methods It is a panel study with evaluation before, during and after an intervention in the health system with a focus on three CC, i.e., i) diabetes; ii) hypertension; and iii) pregnant women. Health care professionals from primary and specialized care units were interviewed using the Assessment of Chronic Illness Care (ACIC) scale, which was applied in nine focal groups organized by health care unit. Results A total of 240 professionals participated of this evaluation, being 94, 63 and 82 participants in 2013, 2015 and 2018 respectively. The ACIC scores showed an positive evolution in the capacity of the health system to care for CC over the years. In the first wave the global score was 5.40 (basic capacity), while in the third wave the score was 9.38 (optimal capacity), with a significant increase in the scores (p < 0.01). Conclusions An important gain in the institutional capacity of the municipality was evidenced for the care of chronic conditions after intervention in the health system. Such an enhancement of the health system to operate in the CC might be sustainable over the time. Furthermore, its impact may directly reflect on the health indicators of the population. Key messages The results showed a strengthening of the local health system. These findings can subsidize other municipalities with a similar reality in the organization of the health care network and, consequently improve the care provided to chronic conditions.

Inter-state Disparities of Efficiency in Foreshortening Under-five Mortality Rate in Rural India

2021 ◽  
pp. 097300522110515
Author(s):  
Shrabanti Maity ◽  
Ummey Rummana Barlaskar
Keyword(s):  
Mortality Rate ◽  
Health System ◽  
Rural Health ◽  
Health Sector ◽  
State Level ◽  
Health Indicators ◽  
Health System Performance ◽  
Indian States ◽  
Under Five ◽  
Efficient Management

The present study aims to assess the efficiency of the rural health system to foreshorten the under-five (U5) mortality rates across Indian states. The study further attempts to pinpoint the factors responsible for state-level inefficiency of the rural health system performance. The empirical results reveal that among the Indian states, Kerala is the most-efficient in foreshortening the U5 mortality rate. The results convey that the states with better health indicators may not have efficient health systems. The study concludes that along with investment in the health sector, efficient management of the investment is intrinsic to better health outcomes.

scholarly journals Family medicine in Denmark: Are there lessons for Botswana and Africa?

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Vincent Setlhare
Keyword(s):  
Family Medicine ◽  
Health System ◽  
Patient Care ◽  
Health Expenditure ◽  
Health Indicators ◽  
Improve Patient Care ◽  
Good Health ◽  
Task Shifting ◽  
Resource Utilisation ◽  
African Countries

Family medicine is a new specialty in Botswana and many African countries and its definitionand scope are still evolving. In this region, healthcare is constrained by resource limitation andinefficiencies in resource utilisation. Experiences in countries with good health indicators canhelp inform discussions on the future of family medicine in Africa. Observations made duringa visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice offamily medicine and the role of support staff in a family practice were often different andsometimes unimaginable by African standards. Danish family practices were friendly andenmeshed in an egalitarian and efficient health system, which is supported by an effectiveinformation technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to morecomplicated patient problems. Higher taxation and higher health expenditure seemed toundergird the effective health system. An egalitarian relationship amongst patients andhealthcare workers (HCW) may help improve patient care in Botswana. Task shifting shouldbe formalised, and all sectors of primary healthcare should have fast and effective informationtechnology systems. HCW training and roles should be revised. Higher health expenditure isnecessary to achieve good health indicators.Keywords: task shifting, Family Medicine, Family Physician, Denmark, health expenditure, egalitarian

Cuba and the Philippines: Contrasting Cases in World-System Analysis

1987 ◽  
Vol 17 (4) ◽  
pp. 681-701 ◽  
Author(s):  
Suzanne de Brun ◽  
Ray H. Elling
Keyword(s):  
Health Status ◽  
Health Services ◽  
Health System ◽  
Citizen Participation ◽  
System Analysis ◽  
World System ◽  
The United States ◽  
The Philippines ◽  
Historical Background ◽  
Capitalist Development

Cuba and the Philippines are countries with broad similarities in historical background yet sharp divergences in political economic developments and relations to the capitalist world-system in recent times. U.S. economic and political interests dominated both countries during the first half of the 20th century. The changes generated by the Cuban revolution resulted in the end of U.S. power in Cuba in 1959. The Philippines, however, remain profoundly dependent on the United States. The approach taken in this article contrasts these countries, asking what the results of their divergent paths are in terms of health and health services. The ability of Cuba and the Philippines to support the primary health care (PHC) approach by fostering socioeconomic justice, authentic citizen participation, and a regionalized health system is examined. It is clear that the last 25 years of socialist-oriented development in Cuba reversed the negative effects of the previous market economy by providing improved social and health services. The success of the political economy and the fully regionalized health system, supportive of the PHC approach in Cuba, is reflected in the high-level health status of the people. In contrast, poverty, gross social and economic inequities, high prevalence of infectious disease, and inaccessible, inadequate, and uncoordinated health services persist in the Philippines after some 85 years of international and national capitalist development. The poor health status of the Philippine people is a direct reflection of this underdeveloped system.

scholarly journals Struggles for a universal health system in Brazil: successes, obstacles and setbacks

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C V Machado ◽  
G A Silva
Keyword(s):  
Private Sector ◽  
Health System ◽  
Health Inequalities ◽  
Latin American ◽  
Social Inequalities ◽  
National Development ◽  
Health Indicators ◽  
Political Influence ◽  
Universal System ◽  
Universal Health

Abstract Brazil is a populous middle-income country, characterized by deep economic and social inequalities. Like most Latin American nations, Brazil historically constructed a health system that included, on the one hand, public health programs and, on the other, social insurance healthcare, which only covered formal workers. This study analyzes the implementation of a universal health system from the mid-1980s to the present, focusing on the context, political agendas, government orientations, and actors. Research techniques included a literature review, interviews with national health authorities, analysis of documents and selected health indicators. In the 1980s, against the backdrop of democratization, Brazil's health reform movement proposed a Unified Health System (SUS), which was incorporated into the 1988 Constitution. The combination of a democratic system with opportunities for interaction between various developmental and social agendas and actors has played a key role in shaping health policy since then. However, the expansion of public services has been hampered by insufficient public funding and by the strengthening of the private sector, subsidized by the state. Private enterprises have expanded their markets and political influence, in a process that has accelerated in recent years. Despite these obstacles, SUS has produced significant health-status improvements and some reductions in Brazil's health inequalities. A combination of long-term structural and contingent factors, international agendas and interests, and domestic political struggles, explains the advances and obstacles to building a universal system in an economically important yet unequal peripheral country. Further consolidation of SUS and reduction of health inequalities hinge on the uncertain prospects for democracy and national development, on enlarging the political coalition to support a public and universal health system, and on strengthening the state's ability to regulate the private sector. Key messages The implementation of a universal health system in Brazil has favored health improvements but has been hampered by insufficient funding and by state subsidies to the expansion of the private sector. A combination of structural and institutional factors, international and domestic political agendas and interests explains the advances and obstacles to building a universal system in Brazil.

scholarly journals Перспективність надання гігієністом зубним профілактичної стоматологічної допомоги населенню м. Житомира

2017 ◽  
Author(s):  
V. M. Kosenko ◽  
S. M. Chepiuk
Keyword(s):  
Internal Medicine ◽  
Oral Cavity ◽  
Dental Care ◽  
System Analysis ◽  
Periodontal Diseases ◽  
Dental Health ◽  
Health Indicators ◽  
Diagnostic Methods ◽  
Study Results ◽  
Dental Hospital

Preventive medicine is the basis for the development of health care systems in the European Union, and investment in prevention is recognized as the most effective investment in the industry of preserving and improving health. Prophylactic direction – one of the most important in modern dentistry.The aim of the study – analysis of treatment and prevention performance indicators of Municipal Institution Zhytomyr City Dental Hospital No.1 and defi nition of methods for improving the primary prevention.Materials and Methods. We analyzed the annual reports of internal medicine and surgical departments of Zhytomyr City Dental Hospital No. 1 for the period from 2015 till 2016; we held a poll of 115 patients of the establishment regarding the methods for teeth cleaning and using the accessories and means necessary for oral cavity care. The following methods were used: bibliosemantic, system analysis and logical concluding,interview, and mathematical processing of the collected data. Results and Discussion. Numeric materials refl ecting the work of Zhytomyr City Dental Hospital No.1 indicate that doctors employed in the establishment conduct numerous maneuvers related to oral cavity sanitation using modern fi lling materials and diagnostic methods. However (and predominantly), all the work is directed at secondary prevention. As a result, annually a lot of teeth are removed due to complex caries (23.370–23.898), and there are a lot of patients with signs of periodontal diseases (3.521–3.766). Dispensary for diseases includes 94 patients with pre-tumor pathology. Considering that public hygienic teaching and education is one of the main components of primary treatment, we held a poll involving 115 patients of Zhytomyr City Dental Hospital No. 1. Study results indicate that the patients of the dental care entity have insuffi cient knowledge on using the accessories and means necessary for hygienic procedures. All the respondents are more ready to invest into prevention care than internal medicine and surgical dental treatment. It is possible to reach an upward trend in dental health indicators only with primary caries and periodontal diseases prevention. Adding hygienist in the staffi ng list of dental care entities would allow not only for comprehensive primary prevention, but would also unload the high-class dentists enabling them to conduct more complex oral cavity operations.Conclusions. Zhytomyr City Dental Hospital No. 1 employs no hygienists, that is why its work is aimed at secondary treatment of oral cavity diseases. Low sanitary culture level of Zhytomyr residents is tightly connected with dental health indicators. Further development and reforming of dental care demands training of the new generation of highly qualifi ed junior medical staff (hygienists). Involving of hygienists in treatment care allows improving the quality of preventive dental services and decreasing dental diseases incidence rate.

scholarly journals Oral Health in Primary Care through the Family Health Strategy

2019 ◽  
Vol 21 (2) ◽  
pp. 139
Author(s):  
Aline Claudia Ribeiro Medeiros Silva ◽  
Mário Molari
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Oral Health ◽  
Health System ◽  
Family Health ◽  
Health Indicators ◽  
Family Health Program ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

AbstractThe purpose of this article is to carry out a literature review on oral health team in primary care with their inclusion in the Family Health Strategy (FHS). The publications were consulted in national papers, official documents and other publications of Health Ministry (MS). In the literature it is observed that with the creation of the Unified Health System (SUS) a process of health restructuring services in Brazil began. The Primary Care National Policy (PNAB) is the result of several historical facts involved with the development and consolidation of SUS. The Family Health Program (PSF), now called the Family Health Strategy (ESF) was created in 1994 aimed at reorienting health care with new bases, centering family focus and attempting to achieve improvement in quality of life of Brazilians. In 2000, oral health teams were included in the PSF to extend access  of the Brazilian population to health promotion actions, prevention and recovery of oral health, improve health indicators and encourage the reorganization of dentistry in primary care. ESF is a unique strategy in the reorganization of the Brazilian health system and the inclusion of the ESB an important complement in primary care, aiming an integral dental practice. Keywords: Primary Health Care. Family Health Strategy. Oral Health. ResumoO presente artigo tem o objetivo de realizar uma revisão de literatura sobre a equipe de saúde bucal na atenção básica, através da sua inserção na Estratégia Saúde da Família (ESF). As publicações consultadas foram artigos científicos nacionais, documentos oficiais (leis e portarias) e outras publicações do Ministério da Saúde (MS).  Na literatura observa-se que com a criação do Sistema Único de Saúde (SUS) iniciou no Brasil um processo de reestruturação dos serviços de saúde. A Política Nacional de Atenção Básica (PNAB) é resultado da experiência acumulada de vários atores envolvidos historicamente com o desenvolvimento e a consolidação do SUS. O Programa Saúde da Família (PSF), atualmente denominado Estratégia Saúde da Família (ESF), foi implantado em 1994 visando a reorientação da prática da atenção à saúde sob novas bases, centrando o foco na família, na tentativa de alcançar uma melhoria na qualidade de vida dos brasileiros. Em 2000, as equipes de saúde bucal foram inseridas no PSF com o objetivo de ampliar o acesso da população brasileira às ações de promoção, prevenção e recuperação da saúde bucal, melhorar os indicadores de saúde, além de incentivar a reorganização da odontologia na atenção básica. A ESF consiste em uma estratégia ímpar na reorganização do sistema de saúde brasileiro e a inclusão da ESB um importante complemento na atenção básica, visando uma prática odontológica integral. Palavras-chave: Atenção Primária à Saúde. Estratégia Saúde da Família. Saúde Bucal.

scholarly journals 530: Revisiting the limits of labetalol in the pregnant population: a Trinity Health system analysis

2020 ◽  
Vol 222 (1) ◽  
pp. S342
Author(s):  
Katherine Riddle ◽  
Jason Hecht ◽  
Caleb Scheidel ◽  
Pooja Green ◽  
Jennifer Williams
Keyword(s):  
Health System ◽  
System Analysis
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