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Morteza Khafaie
Morteza Khafaie

This document provides an overview of key concepts in understanding health systems, including: - It describes health systems using a framework of inputs, processes, and outcomes. Inputs include resources like staff, funding, and medical knowledge. Processes include interactions between staff and patients. Outcomes refer to changes in patients' health status. - It discusses some of the challenges facing health systems, such as balancing lay and formal care, adapting to new medical paradigms and diseases, and issues around professionalism and funding models. - It examines how health systems are organized and some approaches used in low, middle, and high income countries. Quality improvement strategies like performance assessment and defining quality metrics are also summarized.

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悴悋 悋惘悋 惆惘 愕悋惠 惴悋悋 惺 惡惆悋愆惠 擧悋惘愆悋愕
Why study health services? 1 Health is of primary importance to most people. 2 Health services contribute to maintaining and improving peoples health. There is uncertainty as to the effectiveness, humanity, equity and efficiency of many interventions. 4 There is a need to make health care professionals and services more accountable to the public. 5 Expenditure on health care represents a large and growing proportion of national budgets. 6 Health services are a major employer. 7 The medical-industrial complex that supplies health services is a major power and influence on national governments and international health organizations.
A systems approach to health services Introduction
Learning objectives After working through this chapter, you will be better able to: identify the basic features of a social system identify inputs, processes and outcomes in health care systems.
Key terms Inputs The resources needed by a system. Outcomes Change in status as a result of the system processes (in the health services context, the change in health status as a result of care). Outputs A combination of the processes and outcomes that constitute the total production of a system. Processes The use of resources or the activity within a system. System A model of a whole entity, reflecting the relationship between its elements at different levels of complexity.
What are health services?
What is a system?
Activity 1.1 Taking the transport system in the town where you live, carry out the following tasks. 1. Write a brief description of its main constituent parts. Think of the difference between the notion of a system and the elements it is made of. You may find it helpful to draw a rough sketch of the system showing the interrelationships between the parts you describe. 2. Make a list of the different aspects of transport you can look at, for example objectives, means and processes.
Feedback Obviously there is a wide range of possible answers. You may distinguish, for example, between inputs cars, boats and aircraft. Or you may look at the processes related to traffic, for example how a traffic jam builds up, the financing of public transport, road maintenance or infrastructure planning; or the objectives of the transport system, such as increasing mobility or controlling traffic flows.
A system has: a purpose or mission decision making processes that are themselves systems these interact so that their effects can be transmitted throughout the system resources that can be used by the decision making process some guarantee of continuity.
Furthermore its performance can be measured it exists in wider systems and/or environments with which it interacts but from which it is separated
A systems approach to health care There are clearly many different ways of describing a system but, whatever approach you choose, you need to put the elements in a coherent and meaningful order. The way health services are presented in this book is intended to increase your awareness of the results of health care and how these are achieved. Ultimately, the objective of any health system is to improve peoples health. Hence a meaningful approach would describe how health care affects health status. The approach followed in this book is:
A systems approach to.pptx
Activity 1.2
Feedback This way of looking at health care brings together elements that belong to a variety of categories. Inputs. Examples include resources such as staff, land, buildings, funds, medical knowledge, drugs and patients. Did you think of human resources? This is the most important input because it is staff who employ (or use) all other resources. You may not have thought of patients as an input, but without them there would be no processes and, as you will see in Chapters 10 and 11, they play key roles in the production of health. Processes. Processes are activities within the system, for example investigation and treatment of patients or referral of patients between facilities. Did you think of the therapeutic process? The patientstaff interaction is one of the essential processes of care and you will explore it more in detail later in the book. You may also think of organizational processes, for example drug supplies, electronic transmission of information, rationing of care, ways of raising money for the health sector or paying staff. Outcomes. These are the results of care, which can be measured in terms of changes in patients survival or quality of life. But there are many intermediate measures expressing changes in impairment, such as blood sugar levels, body weight or blood pressure, and changes in disability or functional ability, such as mobility or memory. You will explore the definition and use of outcome measures in Chapter 12.
Why outcomes and not outputs? You may wonder why you dont look at outputs as a result of inputs. Economists use the term output to describe the production process, for example the number of cars produced in an automobile factory. By analogy, health economists apply this concept to a combination of processes and outcomes of health services. You will explore the relationship between inputs and outputs, and between outputs and costs in the health economics books in this series. The systems theory approach used here is somewhat different. The focus is on outcomes as a result of inputs and processes, and this concept emphasizes the change in health status as a result of care.
Summary As with other social systems, health services can be seen as a set of interdependent elements that constitute a purposeful whole. In order to describe how health care affects health status, this book will consider the inputs, processes and outcomes of health services. Before you move on to study inputs, however, Chapter 2 will provide you with a brief introduction to the challenges that the planners and managers of health services face.
Challenges facing health services Introduction
Formal and lay care Introduction
Diseases and medical knowledge Inputs to health care:
Medical paradigms Inputs to health care:
Staff: the challenge of professionalism Inputs to health care:
Funding health care Inputs to health care:
The need and demand for health care Processes of health care
The relationship between need and use Processes of health care
Staffpatient interactions Processes of health care
Public as consumers and policy makers Processes of health care
Outcomes Outcome of health care
Analysing health systems Organization of services
Why are health systems as they are? Organization of services
Low and middle income countries: from colonial inheritance to primary care Organization of services
Low and middle income countries: from comprehensive primary care to global initiatives Organization of services
Health services in high income countries Organization of services
Defining good quality health services Quality improvement
Performance assessment Quality improvement
Improving quality of care Quality improvement

More Related Content

A systems approach to.pptx

  • 1. 悴悋 悋惘悋 惆惘 愕悋惠 惴悋悋 惺 惡惆悋愆惠 擧悋惘愆悋愕
  • 2. Why study health services? 1 Health is of primary importance to most people. 2 Health services contribute to maintaining and improving peoples health. There is uncertainty as to the effectiveness, humanity, equity and efficiency of many interventions. 4 There is a need to make health care professionals and services more accountable to the public. 5 Expenditure on health care represents a large and growing proportion of national budgets. 6 Health services are a major employer. 7 The medical-industrial complex that supplies health services is a major power and influence on national governments and international health organizations.
  • 3. A systems approach to health services Introduction
  • 4. Learning objectives After working through this chapter, you will be better able to: identify the basic features of a social system identify inputs, processes and outcomes in health care systems.
  • 5. Key terms Inputs The resources needed by a system. Outcomes Change in status as a result of the system processes (in the health services context, the change in health status as a result of care). Outputs A combination of the processes and outcomes that constitute the total production of a system. Processes The use of resources or the activity within a system. System A model of a whole entity, reflecting the relationship between its elements at different levels of complexity.
  • 6. What are health services?
  • 7. What is a system?
  • 8. Activity 1.1 Taking the transport system in the town where you live, carry out the following tasks. 1. Write a brief description of its main constituent parts. Think of the difference between the notion of a system and the elements it is made of. You may find it helpful to draw a rough sketch of the system showing the interrelationships between the parts you describe. 2. Make a list of the different aspects of transport you can look at, for example objectives, means and processes.
  • 9. Feedback Obviously there is a wide range of possible answers. You may distinguish, for example, between inputs cars, boats and aircraft. Or you may look at the processes related to traffic, for example how a traffic jam builds up, the financing of public transport, road maintenance or infrastructure planning; or the objectives of the transport system, such as increasing mobility or controlling traffic flows.
  • 10. A system has: a purpose or mission decision making processes that are themselves systems these interact so that their effects can be transmitted throughout the system resources that can be used by the decision making process some guarantee of continuity.
  • 11. Furthermore its performance can be measured it exists in wider systems and/or environments with which it interacts but from which it is separated
  • 12. A systems approach to health care There are clearly many different ways of describing a system but, whatever approach you choose, you need to put the elements in a coherent and meaningful order. The way health services are presented in this book is intended to increase your awareness of the results of health care and how these are achieved. Ultimately, the objective of any health system is to improve peoples health. Hence a meaningful approach would describe how health care affects health status. The approach followed in this book is:
  • 15. Feedback This way of looking at health care brings together elements that belong to a variety of categories. Inputs. Examples include resources such as staff, land, buildings, funds, medical knowledge, drugs and patients. Did you think of human resources? This is the most important input because it is staff who employ (or use) all other resources. You may not have thought of patients as an input, but without them there would be no processes and, as you will see in Chapters 10 and 11, they play key roles in the production of health. Processes. Processes are activities within the system, for example investigation and treatment of patients or referral of patients between facilities. Did you think of the therapeutic process? The patientstaff interaction is one of the essential processes of care and you will explore it more in detail later in the book. You may also think of organizational processes, for example drug supplies, electronic transmission of information, rationing of care, ways of raising money for the health sector or paying staff. Outcomes. These are the results of care, which can be measured in terms of changes in patients survival or quality of life. But there are many intermediate measures expressing changes in impairment, such as blood sugar levels, body weight or blood pressure, and changes in disability or functional ability, such as mobility or memory. You will explore the definition and use of outcome measures in Chapter 12.
  • 16. Why outcomes and not outputs? You may wonder why you dont look at outputs as a result of inputs. Economists use the term output to describe the production process, for example the number of cars produced in an automobile factory. By analogy, health economists apply this concept to a combination of processes and outcomes of health services. You will explore the relationship between inputs and outputs, and between outputs and costs in the health economics books in this series. The systems theory approach used here is somewhat different. The focus is on outcomes as a result of inputs and processes, and this concept emphasizes the change in health status as a result of care.
  • 17. Summary As with other social systems, health services can be seen as a set of interdependent elements that constitute a purposeful whole. In order to describe how health care affects health status, this book will consider the inputs, processes and outcomes of health services. Before you move on to study inputs, however, Chapter 2 will provide you with a brief introduction to the challenges that the planners and managers of health services face.
  • 19. Formal and lay care Introduction
  • 20. Diseases and medical knowledge Inputs to health care:
  • 22. Staff: the challenge of professionalism Inputs to health care:
  • 23. Funding health care Inputs to health care:
  • 24. The need and demand for health care Processes of health care
  • 25. The relationship between need and use Processes of health care
  • 27. Public as consumers and policy makers Processes of health care
  • 30. Why are health systems as they are? Organization of services
  • 31. Low and middle income countries: from colonial inheritance to primary care Organization of services
  • 32. Low and middle income countries: from comprehensive primary care to global initiatives Organization of services
  • 33. Health services in high income countries Organization of services
  • 34. Defining good quality health services Quality improvement
  • 36. Improving quality of care Quality improvement

Editor's Notes

  • #3: Before embarking, it is worth considering why health services should be a subject of study. There are several reasons (and you may have others):
  • #7: Before studying health care systems, you need to consider which activities are included under the term health services. For the purposes of this book, the full range of activities that are undertaken primarily for health reasons are included. Although some of the most dramatic health benefits are the result of wider policies such as those affecting the environment, education, housing and employment, this book is confined to services that are first and foremost undertaken to have a direct effect on peoples health. These extend from health promotion and disease prevention, through curative services, to long term care, rehabilitation and even custody.
  • #8: The term system is in common use the human body can be seen as a biological system; an engine can be seen as a technical system. But what is meant by health system as opposed to health care or health services? The following activity is designed to allow you to reflect on the basic features of a social system.
  • #12: Generally, a social system represents a set of interdependent elements, which can be seen as a purposeful whole. This means that the perception of a single element cannot account for understanding the whole arrangement. For example, the combination of different transport subsystems (such as road, water and air transport) increases mobility more than a single element of transport. Understanding interdependent phenomena as a system lets you understand how things are organized and how the whole responds to change, if one of its parts changes.
  • #15: Copy and complete the table below by writing down two examples against each heading. An example of each has been provided to get you started.