european observatory on health systems and …...2011/11/30 · european observatory on health...

Dimitra Panteli

Departmet of Healthcare Management

Berlin University of Technology

European Observatory on Health

Systems and PoliciesActivities, Health Systems in Transition Template and

Review for Hungary 2011

1. Dezember 2011 11. Dezember 2011 1

Observatory, HiT Template and 2011 Review for Hungary

Structure

1. What is the Observatory on Health Systems and Policies?

2. Health Systems in Transition Country Reviews

3. Template: contents and examples from the 2011 Review for

Hungary

1. Dezember 2011 2


• International agencies: WHO Regional Office for Europe, the European Commission, the World Bank, the European Investment Bank

• National and regional governments: Belgium, Finland, Ireland, the Netherlands, Norway, Slovenia, Spain, Sweden, and the Veneto Region of Italy

• Academia: the London School of Economics and Political Science (LSE), the London School of Hygiene & Tropical Medicine (LSHTM)

• Social insurance: UNCAM (association of sickness funds)/ France

The European Observatory partnership

3


Research teams, hubs and management

� Hubs based in academia

• Berlin University of Technology

• London School of Economics

• London School of Hygiene and Tropical Medicine

• Emory University (USA)

� Academic inputs – networks

4


The Observatory: Central Principles

� Comparative description of health systems & policies and analysis of

existing evidence

� Bridge the gap between scientific evidence and the needs of policy makers

� Development of practical lessons and options in health policy making

� Partnership

5


The Observatory: Functions

1. Country monitoring

2. Studies: Health system and policy analysis, performance assessment

3. Dissemination

6


Health Systems in Transition (HiT) reviews

� provide a detailed description and assessment

� follow a standardised format

� are based on a template with guidelines to authors

� cover all European and some other OECD

countries

� are partly translated into other languages

1. Country monitoring

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1. Country monitoring: merging of two networks, October 2011

8

OBS Network of

National Lead Institutions+

Health Policy Monitor

Network+

New Online Tool

HiT Information and updates

Policy-related contributions

News section

Advanced search function


2. Studies: health systems and policy analysis, performance assessment

Selection of topics:

• relevance to policy/ open questions

• can build on existing primary research

• Steering Committee discussed and decided on detailed proposals

9


Disseminating generated evidence to decision-makers in the health sector to inform policy by means of:

• Online resources

• Publications

• Journals

• Conferences

• Workshops, Seminars

• Policy dialogues

• Summer School

4. Dissemination: Reaching policy makers

10


Eurohealth and EuroObserver before 2011

11


Policy briefs

12


Annual Observatory Venice Summer School

A platform for policy-makers to directly exchange experiences and information

Topics in recent years:

I. Human Resources for Health (2007)

II. Hospital Re-engineering (2008)

III. Innovation and HTA: ImprovingHealth System Quality (2009)

IV. EU integration and healthsystems: challenges andopportunities (2010)

V. Ageing (2011)

13


Structure




Hungary

1. Dezember 2011 14


1. Dezember 2011 15

The HiT

Health Systems in Transition (HiT)

� Describe and analyze a country’s health system and key reform initiatives

� Follow the same structure, facilitating cross-country comparisons

� Seek to provide relevant information to support policy-makers and analysts in the development of health systems in Europe and beyond


1. Dezember 2011 16

The HiT production process

� Phased approach

� Managed by editor(s) from one of the research hubs, each hub is responsible for a

region of Europe

� Overall management is centralised in Brussels

� Updates every 3-4 years


Structure




Hungary

1. Dezember 2011 17


1. Dezember 2011 18

The HiT Template (2010)

Chapter 1: Introduction

Chapter 2: Organization and Governance

Chapter 3: Financing

Chapter 4: Physical and Human Resources

Chapter 5: Provision of Services

Chapter 6: Principal Health Reforms

Chapter 7: Assessment of the Health System

Chapter 8: Conclusions

Chapter 9: Appendices (references, legal references etc.)


Template Chapter 1: Introduction

1. Dezember 201119

Introduction

Organization and governance

Financing

Physical and Human Resources

Provision of Services

Principal reforms

Assessment

Conclusions

Appendices

1.1 Geography and sociodemography

• trends in population (demographic indicators)

1.2 Economic context

• macroeconomic indicators, time trend

1.3 Political context

• system of governance, governance indicators, decision-making process

1.4 Health status

• changes in health indicators (mortality and health indicators, main causes

of death, morbidity and factors affecting health, maternal and child health)


Example 2011 Review for Hungary: main demographic indicators, 1980-2009 (selected years)

1. Dezember 201120

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Example 2011 Review for Hungary: factors affecting health status, 1980 -2009 (selected years)

1. Dezember 201121

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Template Chapter 2: Organization and governance

1. Dezember 201122

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

2.1 Overview of the health system

2.2 Historical background

2.3 Organization

2.4 Decentralization and centralization

2.5 Planning

2.6 Intersectorality

2.7 Health information management

2.8 Regulation (third party payers, providers, human resources, pharmaceuticals etc.)

2.9 Patient empowerment (information, choice, rights, participation, arbitration etc.)


Example 2011 Review for Hungary: Organizational structure of the health system

1. Dezember 201123

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Template Chapter 3: Financing

1. Dezember 201124

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

3.1 Health expenditure

3.2 Sources of revenue and financial flows

3.3 Overview of the statutory financing system

• coverage, collection, pooling, purchasing

3.4 Out-of-pocket payments

• cost-sharing, direct payments, informal payments

3.5 Voluntary health insurance

• market role and size, structure, conduct and public policy

3.6 Other financing

• parallel health systems, external sources of funds, other sources of

funding

3.7 Payment mechanisms

• paying for health services, health workers


Example 2011 Review for Hungary: Trends in health expenditure as a share of GDP in Hungary and comparators

1. Dezember 201125

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Example 2011 Review for Hungary: Total expenditure on health according to source and administering agent, 2009

1. Dezember 201126

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Example 2011 Review for Hungary: Provider payment mechanisms

1. Dezember 201127

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Template Chapter 4: Physical and human resources

1. Dezember 201128

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

4.1 Physical resources

• capital stock and investments

• infrastructure

• medical equipment

• information technology

4.2 Human resources

• health workforce trends

• professional mobility of health workers

• doctor career paths

• other health worker career paths


Example 2011 Review for Hungary: Trend in the mix of beds, 1990 -2009

1. Dezember 201129

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Example 2011 Review for Hungary: Number of physicians per 1000 population

1. Dezember 201130

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Template Chapter 5: Provision of services

1. Dezember 201131

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

5.1 Public health

5.2 Patient pathways

5.3 Primary/ambulatory care

5.4 Specialized ambulatory/inpatient care (including day care)

5.5 Emergency care

5.6 Pharmaceutical care

5.7 Rehabilitation/intermediate care

5.8 Long-term care

5.9 Services for informal carers

5.10 Palliative care

5.11 Mental health care

5.12 Dental care

5.13 Complementary and alternative medicine

5.14 Health services for specific populations


Example 2011 Review for Hungary: Outpatient contacts per person per year, 2009 or latest available year

1. Dezember 201132

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Example 2011 Review for Hungary: Number and main type of pharmacies, 2000 - 2010

1. Dezember 201133

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Template Chapter 6: Principal health reforms

1. Dezember 201134

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

6.1 Analysis of recent reforms

6.2 Future developments


Example 2011 Review for Hungary

1. Dezember 201135

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

6.1 Analysis of recent reforms

• reforms on health system governance and organization (managed

competition, HISA, capacity regulation, ownership and management of

providers, CCS)

• financing reforms (revenue collection, pharmaceuticals, provider payment

mechanisms, private expenditure on health)

6.2 Future developments

• Programme on national cooperation (Government of Hungary, May

2010)

• Development plan for the health system (Ministry of National Resources,

October 2010)


Template Chapter 7: Assessment of the health system

1. Dezember 201136

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

7.1 Stated objectives of the health system

7.2 Financial protection and equity in financing

7.3 User experience and equity of access to health care

7.4 Health outcomes, health service outcomes and quality of care

7.5 Health system efficiency (allocative and technical)

7.6 Transparency and accountability


Example 2011 Review for Hungary: sources of health care financing and their progressivity

1. Dezember 201137

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Example 2011 Review for Hungary: crude quality indicators in acute inpatient care

1. Dezember 201138

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices


Template Chapter 8: Key messages

1. Dezember 201139

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

Policy-relevant insights from all previous chapters


Template Chapter 9: Appendices

1. Dezember 201140

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

Usually includes:

• references

• suggestions for further reading

• useful links

• a note on HiT methodology and production process

• notes on the authors


Example 2011 Review for Hungary: referencing of legislation and list of laws and regulations

1. Dezember 201141

Introduction


Financing



Principal reforms

Assessment

Conclusions

Appendices

In-text reference to legislation (Ch. 2, page 20)

List of laws and regulations in the Appendices


Thank you for your attention

www.healthobservatory.eu

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european observatory on health systems and …...2011/11/30 · european observatory on health...

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