Variation in Quality of Care Within Health Systems

2008 ◽  
Vol 34 (6) ◽  
pp. 326-332 ◽  
Author(s):  
Steve Hines ◽  
Maulik S. Joshi
Author(s):  
Susan Cleary

Abstract Health systems strengthening (HSS) is firmly on the global health and development agenda. While a growing evidence base seeks to understand the effectiveness of HSS, there is limited evidence regarding cost and cost-effectiveness. Without such evidence, it is hard to argue that HSS represents value for money and the level of investment needed cannot be quantified. This paper seeks to review the literature regarding the economic evaluation of HSS from low- and middle-income country (LMIC) settings, and to contribute towards the development of methods for the economic evaluation of HSS. A systematic search for literature was conducted in PubMed, Scopus and the Health Systems Evidence database. MeSH terms related to economic evaluation were combined with key words related to the concept of HSS. Of the 204 records retrieved, 52 were retained for full text review and 33 were included. Of these, 67% were published between January 2015 and June 2019. While many HSS interventions have system wide impacts, most studies (71%) investigated these impacts using a disease-specific lens (e.g. the impact of quality of care improvements on uptake of facility deliveries). HSS investments were categorized, with the majority being investments in platform efficiency (e.g. quality of care), followed by simultaneous investment in platform efficiency and platform capacity (e.g. quality of care and task shifting). This review identified a growing body of work seeking to undertake and/or conceptualize the economic evaluation of HSS in low- and middle-income countries. The majority assess HSS interventions using a disease-specific or programmatic lens, treating HSS in a similar manner to the economic evaluation of medicines and diagnostics. While this approach misses potential economies of scope from HSS investments, it allows for a preliminary understanding of relative value for money. Future research is needed to complement the emerging evidence base.


2017 ◽  
Vol 86 (2) ◽  
pp. 35-36
Author(s):  
Elizabeth Dent ◽  
Damilola Toki ◽  
Natalie Dupuis ◽  
Josiah Marquis ◽  
Tharmitha Suyeshkumar ◽  
...  

Diverse health systems within the Middle East continue to experience a high degree of variability with regards to accessibility, capacity, and the quality of care provided within each individual country. This paper summarizes the unique challenges and achievements within the healthcare systems of six countries in the Middle East region. Additionally, the review aims to provide evidence for how healthcare systems in the Middle East are managed and sustained despite differences in wealth and infrastructure, as well as the presence of conflict in certain areas. Canada can play an important role in supporting these countries with unique healthcare needs, and in supporting populations arriving to Canada from these countries.


2018 ◽  
Vol 39 (1) ◽  
pp. 34-46 ◽  
Author(s):  
Benjamin T.B. Chan ◽  
Jeremy H.M. Veillard ◽  
Krycia Cowling ◽  
Niek S. Klazinga ◽  
Adalsteinn D. Brown ◽  
...  

Author(s):  
Garcia Elorrio Ezequiel ◽  
Arrieta Jafet ◽  
Arce Hugo ◽  
Delgado Pedro ◽  
Malik Ana Maria ◽  
...  

Abstract The Covid-19 and other recent pandemics has highlighted existing weakness in health systems across the Latin-America and the Caribbean (LAC) region to effectively prepare for and respond to Public Health Emergencies. It has been stated that quality of care will be among the most influential factors on Covid 19 mortality rates and low systems performance is the common case in these countries. More comprehensive and system level strategies are required to address the challenges. These must focus on redesigning and strengthening health systems to make them more resilient to the changing needs of populations and based on quality improvement methods that have shown rigorously evaluated positive effects in previous local and regional experiences. A call to action is being made by the Latin American Consortium for Quality, Patient Safety and Innovation (CLICSS) and they provide specific recommendations for decision makers.


2007 ◽  
Vol 55 (8) ◽  
pp. 1260-1268 ◽  
Author(s):  
Joshua Chodosh ◽  
Brian S. Mittman ◽  
Karen I. Connor ◽  
Stefanie D. Vassar ◽  
Martin L. Lee ◽  
...  

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  

Abstract Quality of care is one of the most frequently quoted principles of health policy, and is currently high up on the agenda of policy-makers at national, European, and international levels. However, the understanding of the term and what it encompasses varies. Many organizations and movements, such as evidence-based medicine, health technology assessment, provider accreditation, clinical practice guidelines and patient safety, play an important role in improving quality of health care. However, this broad field of quality-related initiatives is fragmented, and there is often a lack of awareness about parallel activities because of different labels. Evidence on the effectiveness and cost-effectiveness of different quality strategies is not always readily available for policy-makers, who have to struggle with prioritizing initiatives for investment. To provide a solid foundation for addressing these challenges, the European Observatory on Health Systems and Policies in collaboration with the OECD has put together a comprehensive study on health care quality, its interpretation and the evidence on different strategies aiming to assure or improve it. Drawing on this 2019 study, the workshop has the following objectives: Provide an understanding of the multidimensional concept of quality of care and its relation to health system performance as well as a comprehensive framework for looking at different strategies and their potential contribution to improving health care quality;Introduce key components of international and European governance for quality of care;Highlight the effectiveness, cost-effectiveness and implementation of selected quality strategies, with a focus on the European context:Health professional regulation, including education, licensing and registration, continuous professional development and mechanisms to ensure fitness to practice;External institutional strategies for health care organizations, including accreditation, certification and supervision;“Pay for Quality”, wherein financial incentives are paid to providers or professionals for achieving quality-related targets within a specific timeframe.Discuss and refine lessons learned through audience participation, and identify further areas for research and action. Key messages Quality of care is a political priority and an important contributor to population health. Within an overall strategic framework, understanding the potential of different quality strategies is key. Evidence on the (cost-)effectiveness of different quality strategies is variable but largely inconclu-sive. Maintaining an overview and identifying areas for action is paramount for policy-makers.


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