Health systems : improving performance
World health report, 2000
Statistics
xix, 215 pages : illustrations, portrait ; 26 cm.
9789241561983, 924156198X
53224744
Overview
How health systems have evolved
Potential to improve
Providing better services
Finding a better balance
Protecting the poor
Why do health systems matter?
Changing landscape
What is a health system?
What do health systems do?
Why health systems matter?
How modern health systems evolved
Three generations of health system reform
Focusing on performance
How well do health systems perform?
Attainment and performance
Goals and functions
Goodness and fairness: both level and distribution matter
Measuring goal achievement
Overall attainment: goodness and fairness combined
Performance: getting results from resources
Improving performance: four key functions
Health services: well chosen, well organized?
Organizational failings
People at the centre of health services
Choosing interventions: getting the most health from resources
Choosing interventions: what else matters?
Choosing interventions: what must be known?
Enforcing priorities by rationing care
After choosing priorities: service organization and provider incentives
Organizational forms
Service delivery configurations
Aligning incentives
Integration of provision
What resources are needed?
Balancing the mix of resources
Human resources are vital
Adjusting to advances in knowledge and technology
Public and private production of resources
Legacy of past investments
Health care resource profiles
Changing investment patterns
Way forward
Who pays for health systems?
How financing works
Prepayment and collection
Spreading risk and subsidizing the poor: pooling of resources
Strategic purchasing
Organizational forms
Incentives
How financing affects equity and efficiency
How is the public interest protected?
Governments as stewards of health resources
What is wrong with stewardship today?
Health policy: vision for the future
Setting the rules, ensuring compliance
Exercising intelligence, sharing knowledge
Strategies, roles and resources: who should do what?
What are the challenges?
How to improve performance