Managing the effectiveness of the regional health system

2020 ◽  
Vol 26 (3) ◽  
pp. 698-720
Author(s):  
E.V. Lobkova ◽  
A.S. Petrichenko

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.

Author(s):  
Philip Rocco ◽  
Jessica A. J. Rich ◽  
Katarzyna Klasa ◽  
Kenneth A. Dubin ◽  
Daniel Béland

Abstract Context: While the World Health Organization (WHO) has established guidance on COVID-19 surveillance, little is known about implementation of these guidelines in federations, which fragment authority across multiple levels of government. This study examines how subnational governments in federal democracies collect and report data on COVID-19 cases and mortality associated with COVID-19. Methods: We collected data from subnational government websites in 15 federal democracies to construct indices of COVID-19 data quality. Using bivariate and multivariate regression, we analyzed the relationship between these indices and indicators of state capacity, the decentralization of resources and authority, and the quality of democratic institutions. We supplement these quantitative analyses with qualitative case studies of subnational COVID-19 data in Brazil, Spain, and the United States. Findings: Subnational governments in federations vary in their collection of data on COVID-19 mortality, testing, hospitalization, and demographics. There are statistically significant associations (p<0.05) between subnational data quality and key indicators of public health system capacity, fiscal decentralization, and the quality of democratic institutions. Case studies illustrate the importance of both governmental and civil-society institutions that foster accountability. Conclusions: The quality of subnational COVID-19 surveillance data in federations depends in part on public health system capacity, fiscal decentralization, and the quality of democracy.


Author(s):  
Viju Raghupathi ◽  
Wullianallur Raghupathi

The authors use a health analytics approach to investigate the relationship between information and communication technology (ICT) and public health at a country level. The research uses the ICT factors of accessibility, usage, quality, affordability, trade, and applications, as well as the public delivery indicators of adolescent fertility rate, child immunization for DPT, child immunization for measles, tuberculosis detection rate, life expectancy, adult female mortality rate, and adult male mortality rate. ICT data was collected from the International Telecommunication Union ICT Indicator database. The public health data was collected from the World Bank website. Results of the analytics indicate that ICT factors are positively associated with some public health indicators. Nearly all of the ICT factors are positively associated with the public health indicators of immunization rates, TB detection rates, and life expectancy. The association with adult mortality is negative, which is also favorable. However, the association of ICT with fertility rate is negative, which is an unfavorable effect. These results offer insight into the importance of understanding the positive and adverse impacts of ICT on public health so as to guide national policy decisions in the future.


2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Adele Houghton ◽  
Jessica Austin ◽  
Abby Beerman ◽  
Clayton Horton

Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network’s framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as “high vulnerability.” Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment.


Epidemiology ◽  
2007 ◽  
Vol 18 (Suppl) ◽  
pp. S155 ◽  
Author(s):  
D Lobdell ◽  
P Murphy ◽  
R Calderon

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