Management and Governance Paradigms in Health (SGHMANGOV) - Health System Performance Assessment
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Questions and Answers

What is the primary goal of financial risk protection in the health system?

  • To improve the efficiency of health care delivery
  • To protect the population from high and unexpected cost of serious illness (correct)
  • To promote client satisfaction with health services
  • To provide quality health care services

    • What is measured by population satisfaction surveys and customer exit surveys?

  • Client satisfaction with health services (correct)
  • Quality of health care
  • Responsiveness of the health system
  • Accessibility of health services

    • What is an intermediate outcome in the health system?

  • Instrumental goal
  • Means to an end goal (correct)
  • Root cause of health system problems
  • Final outcome of the health system

    • What is allocative efficiency in health care?

    <p>Measure of whether the right mix of goods or services are produced</p> Signup and view all the answers

    What do major final outputs refer to in the health system?

    <p>Goods and services that managers are accountable for</p> Signup and view all the answers

    What is the primary aspect of access to health care?

    <p>Physical availability of health care</p> Signup and view all the answers

    What is quality in health care?

    <p>Degree to which goods and services perform as desired</p> Signup and view all the answers

    What is technical efficiency in health care?

    <p>Measure of how outputs are produced</p> Signup and view all the answers

    What is fairness of the health system?

    <p>Performance distribution of the health system</p> Signup and view all the answers

    What is goodness of the health system?

    <p>Performance level of the health system</p> Signup and view all the answers

    What are the three levels of performance assessment in a health system?

    <p>Final performance outcomes, intermediate performance outcomes, and major final outputs</p> Signup and view all the answers

    What is an intermediate performance outcome in a health system?

    <p>Utilization</p> Signup and view all the answers

    What is a final performance outcome in a health system?

    <p>Health status</p> Signup and view all the answers

    What is a measure of health status in a health system?

    <p>Life expectancy</p> Signup and view all the answers

    What is a goal of health status in a health system?

    <p>To make health status of entire population as good as possible over a people’s whole life cycle</p> Signup and view all the answers

    What is a component of the final performance outcome of health status in a health system?

    <p>Premature mortality</p> Signup and view all the answers

    The primary goal of the health system is to improve financial risk protection.

    <p>False</p> Signup and view all the answers

    Intermediate performance outcomes are a measure of health status in a health system.

    <p>False</p> Signup and view all the answers

    Major final outputs represent the problems that the health system is accountable for.

    <p>True</p> Signup and view all the answers

    Life expectancy is a measure of client satisfaction in a health system.

    <p>False</p> Signup and view all the answers

    The three final performance outcomes in the health system are health status, financial risk protection, and quality of care.

    <p>False</p> Signup and view all the answers

    Preventing premature death is a goal of health status in a health system.

    <p>True</p> Signup and view all the answers

    Disability adjusted life years measures the level of satisfaction of clients with the goods and services expected in the health system.

    <p>False</p> Signup and view all the answers

    Responsiveness is a measure of how health system responds to clinical aspects of care.

    <p>False</p> Signup and view all the answers

    Financial risk protection is protection of the population from low and expected cost of serious illness.

    <p>False</p> Signup and view all the answers

    Intermediate outcomes are the end goals of the health system.

    <p>False</p> Signup and view all the answers

    Access to health care refers to the degree to which goods and services perform as desired.

    <p>False</p> Signup and view all the answers

    Quality of care is measured by the physical availability of health services.

    <p>False</p> Signup and view all the answers

    Efficiency in health care refers to the ability of patients to use services they want.

    <p>False</p> Signup and view all the answers

    Performance levels assess the differences of performance among individuals or groups.

    <p>False</p> Signup and view all the answers

    Performance distribution is a measure of the overall level of performance of a health system.

    <p>False</p> Signup and view all the answers

    Client satisfaction surveys are used to measure the quality of health care.

    <p>False</p> Signup and view all the answers

    Study Notes

    Three Levels of Performance Assessment

    • Three levels of performance assessment in health systems: final performance outcomes, intermediate performance outcomes, and major final outputs

    Final Performance Outcomes

    • Consequences in the general population that have intrinsic value and impact on outcomes desired for the entire population
    • Represent the problems that the health system is accountable for
    • Three final performance outcomes in the health system:
      • Health Status: reflects improvements in the well-being of the general population, improving health, reducing disease, preventing premature death
      • Client Satisfaction and Responsiveness: level of satisfaction of clients with the goods and services expected in the health system
      • Financial Risk Protection: protection of the population from high and unexpected costs of serious illness

    Health Status

    • Reflects improvements in the well-being of the general population
    • Measured by:
      • Premature mortality (e.g. IMR, MMR)
      • Morbidity and disability (e.g. prevalence rate, incidence rate)
      • Life expectancy
      • Nutritional status
      • Burden of disease and non-fatal outcomes (e.g. disability-adjusted life years, health-adjusted life expectancy)

    Client Satisfaction

    • Level of satisfaction of clients with the goods and services expected in the health system
    • Measured by:
      • Population satisfaction surveys
      • Customer exit surveys

    Responsiveness

    • How the health system responds to non-clinical aspects of care and meets expectations of clients
    • Measured by:
      • Respect for client (respect for dignity, confidentiality, and autonomy)
      • Client orientation (prompt attention, quality amenities, social support systems)

    Financial Risk Protection

    • Protection of the population from high and unexpected costs of serious illness
    • Measured by:
      • Fair or equitable financing that distributes financial risks according to ability to pay, rather than risk of illness

    Intermediate Outcomes

    • Structural features of health systems that affect the level of performance on final outcomes
    • Three intermediate performance outcomes in the health system:
      • Access: ability of patients to use services they want
      • Quality: degree to which goods and services perform as desired
      • Efficiency: use of resources in the best possible way to achieve goals

    Access

    • Measured by:
      • Physical availability (distribution of inputs like beds, doctors, and facilities)
      • Effective availability (measures barriers to use of goods and services)

    Quality

    • Measured by:
      • Prescribed standard
      • Compliance to that standard
      • Quantity
      • Inputs and processes
      • Outcomes of quality inputs and process

    Efficiency

    • Measured by:
      • Technical efficiency (cost per output, cost per patient)
      • Allocative efficiency (right mix of goods or services produced)

    Major Final Outputs

    • Goods and services that managers are accountable for
    • Mandate and authority to produce goods and services
    • External clients expect such goods and services from them

    Assessing Goodness and Fairness in Health

    • Performance gauges: performance levels, performance distribution, and values upheld in national and international health systems
    • Goodness of the Health System: assess the best attainable average level for outcomes
    • Fairness of the Health System: differences of performance among individuals or groups, reflecting how health care goods and services are distributed among the population

    Three Levels of Performance Assessment

    • Three levels of performance assessment in health systems: final performance outcomes, intermediate performance outcomes, and major final outputs

    Final Performance Outcomes

    • Consequences in the general population that have intrinsic value and impact on outcomes desired for the entire population
    • Represent the problems that the health system is accountable for
    • Three final performance outcomes in the health system:
      • Health Status: reflects improvements in the well-being of the general population, improving health, reducing disease, preventing premature death
      • Client Satisfaction and Responsiveness: level of satisfaction of clients with the goods and services expected in the health system
      • Financial Risk Protection: protection of the population from high and unexpected costs of serious illness

    Health Status

    • Reflects improvements in the well-being of the general population
    • Measured by:
      • Premature mortality (e.g. IMR, MMR)
      • Morbidity and disability (e.g. prevalence rate, incidence rate)
      • Life expectancy
      • Nutritional status
      • Burden of disease and non-fatal outcomes (e.g. disability-adjusted life years, health-adjusted life expectancy)

    Client Satisfaction

    • Level of satisfaction of clients with the goods and services expected in the health system
    • Measured by:
      • Population satisfaction surveys
      • Customer exit surveys

    Responsiveness

    • How the health system responds to non-clinical aspects of care and meets expectations of clients
    • Measured by:
      • Respect for client (respect for dignity, confidentiality, and autonomy)
      • Client orientation (prompt attention, quality amenities, social support systems)

    Financial Risk Protection

    • Protection of the population from high and unexpected costs of serious illness
    • Measured by:
      • Fair or equitable financing that distributes financial risks according to ability to pay, rather than risk of illness

    Intermediate Outcomes

    • Structural features of health systems that affect the level of performance on final outcomes
    • Three intermediate performance outcomes in the health system:
      • Access: ability of patients to use services they want
      • Quality: degree to which goods and services perform as desired
      • Efficiency: use of resources in the best possible way to achieve goals

    Access

    • Measured by:
      • Physical availability (distribution of inputs like beds, doctors, and facilities)
      • Effective availability (measures barriers to use of goods and services)

    Quality

    • Measured by:
      • Prescribed standard
      • Compliance to that standard
      • Quantity
      • Inputs and processes
      • Outcomes of quality inputs and process

    Efficiency

    • Measured by:
      • Technical efficiency (cost per output, cost per patient)
      • Allocative efficiency (right mix of goods or services produced)

    Major Final Outputs

    • Goods and services that managers are accountable for
    • Mandate and authority to produce goods and services
    • External clients expect such goods and services from them

    Assessing Goodness and Fairness in Health

    • Performance gauges: performance levels, performance distribution, and values upheld in national and international health systems
    • Goodness of the Health System: assess the best attainable average level for outcomes
    • Fairness of the Health System: differences of performance among individuals or groups, reflecting how health care goods and services are distributed among the population

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    Description

    Assess the performance of a health system in terms of its outcomes, outputs, and goodness and fairness. Understand the three levels of performance assessment and how to evaluate health system performance.

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