View
216
Download
0
Category
Tags:
Preview:
Citation preview
The results of activities of an organization or investment over a given period of time.
Organizational Performance:◦ A measure of how efficiently and effectively
managers use available resources to satisfy customers and achieve organizational goals.
3
A measure of how productively resources are
used to achieve a goal. Organizations are
efficient when managers minimize the
amount of input resources or the amount of
time needed to produce a given output of
goods or services.
5
A measure of the appropriateness of the
goals that managers have selected for the
organization and of the degree to which the
organization achieves those goals.
Organizations are effective when managers
choose appropriate goals and then achieve
them.
6
The accumulated end results of the
organization's work processes and activities.
Designing strategies, work processes, and
work activities.
Coordinating the work of employees.
7
The term Health System Performance Assessment describes a
series of activities including measuring the health system's
contribution to socially desirable goals;
Measuring Measuring the health system and non-health system resources used
to achieve these outcomes;
EstimatingEstimating the efficiency with which the resources are used to attain
these outcomes;
EvaluatingEvaluating the way the functions of the system influence observed
levels of attainment and efficiency;
Designing and implementing Designing and implementing policies to improve attainment and
efficiency and monitoring the effect.
8
Importance:
To enable countries to monitor their own
performance and to modify their policies as
necessary it is important to be able to
measure and compare performance over
time.
9
WHO's work aims to support the
development of systematic ways to
monitor performance in countries, in a
way that allows comparison across time
within individual systems, across different
levels of a system, and between health
systems.
10
To empower decision makersdecision makers, by providing them with reliable information
for policy and system development.
To empower the public,public,with information relevant to their well-being.
11
The essential concepts underpinning the health system performance framework are:
Health Health System System
FunctionFunctionss
Health Health System System
FunctionFunctionss
Health Health System System GoalsGoals
Health Health System System GoalsGoals
Health Health System System EfficiencEfficienc
y y
Health Health System System EfficiencEfficienc
y y
Health Health System System
BoundariBoundaries es
Health Health System System
BoundariBoundaries es
12
The system includes all actors, institutions and
resources that undertake health actions .Four key
functions determine the way inputs are
transformed into outcomes that people value –
resource generation, financing, service provision
and stewardship.
“Health Action”: Any set of activities whose primary
intent is to improve or maintain health
E.g. Seatbelt.
14
Health system financing is: the process by which
revenues are collected from primary and
secondary sources.
For the purposes of analysis, it is useful to
subdivide health system financing into three sub-
functions: a) revenue collection, b) fund pooling.c) purchasing.
18
Revenue collection refers to the mobilization of money from
primary sources ( individuals, households and firms) and
secondary sources (governments and donor agencies).
Funds can be mobilized through 4 basic mechanisms:
out-of-pocket payments,
General taxation,
Statutory health insurance,
Private health insurance.
19
Fund pooling refers to the accumulation of revenues for the
common advantage of participants. Indeed, pooling means
that financial resources in the pool are no longer tied to a
particular contributor. In the language of insurance, pooling
means that contributors share financial risk.
Pooling is distinct from revenue collection as some
mechanisms of revenue collection such as medical savings
accounts do not share financial risks across contributors.
20
Purchasing is the process through which revenues that have
been collected and placed in fund pools are allocated to
institutional or individual providers in order to deliver a
specified or unspecified set of interventions.
Purchasing can range from simple budgeting exercises in
highly integrated public systems, where the government
collects revenue through general taxation and allocates it to
programs and facilities for staff and other costs, to more
complicated strategies where specified units of inputs,
outputs or outcomes are purchased
21
This function refers to the combination of inputs into a
production process that takes place in a particular
organizational setting and that leads to the delivery of a
series of interventions.
In analyzing provision, it is useful to keep in mind the
conventional distinction between personal and non-
personal health services.
personal health services: refer to services that are
consumed directly by an individual, whether they are
preventive, diagnostic, therapeutic, or rehabilitative.
22
non-personal health services: refer to actions that are
applied either to collectivities (e.g., mass health education)
or to the non-human components of the environment (e.g.,
basic sanitation).
23
Health systems are not limited to the set of institutions that
finance or provide services, but include a diverse group of
organizations that produce inputs to those services,
particularly human resources, physical resources such
as facilities and equipment, and knowledge. This set of
organizations encompasses universities and other
educational institutions, research centers, construction
firms, and the vast array of organizations producing
specific technologies such as pharmaceutical products,
devices and equipment.
24
A neglected function in most health systems, stewardship goes
beyond the conventional notion of regulation. It involves three
key aspects: setting, implementing and monitoring the rules of
the game for the health system; assuring a level playing field
among all actors in the system (particularly purchasers, providers
and patients); and defining strategic directions for the health
system as a whole. In order to deal with these aspects,
stewardship can be subdivided into six sub-functions: overall
system design, performance assessment, priority setting,
intersectional advocacy, regulation and
consumer protection.
25
Recommended