Health system assessment framework for integrated care
Student name: Mr Digvijay Singh Sandhu
Guide: Dr Prashant Kumar Singh
Year of completion: 2018
Host Organisation: Asian Development Bank
Supervisor (Host Organisation): Dr Eduardo P. Banzon
Abstract: Introduction: The health systems of most developing countries are designed to address acute and episodic diseases and are often ill equipped to meet the needs of those with chronic illnesses. Fragmented health systems may be brought about by politically driven decentralization of health service delivery, failure of the government to utilize and coordinate the private health sector, and inefficient use of government health purchasing power. This has resulted in care being delivered by different health care providers over time, often in different settings or institutions, even when patients have only a single disease. There is a need to shift in the way health services are funded, managed and delivered. Thus, a health system should be integrated so that services are coordinated around peoples’ needs, respecting their preferences, are of high quality, safe, effective, timely and affordable. Asian Development Bank has developed a health system assessment framework for integrated care.
Methods: An initial scoping exercise was undertaken to identify principles of integrated care and existing global indicators for health system assessment. A master list of indicators was created and an indicator prioritization process was applied to remove duplications and variations of similar indicators. This process resulted in the first draft of indicators that was further refined by consulting health experts at Asian Development Bank and Access Health International.
Results: The final list of indicator covers three of the World Health Organizations health system building blocks - Governance, Financing, and Service Delivery. The indicators are tested to be specific, measurable, achievable, relevant and time-bound. The indicator metadata includes the rationale, definition, and data sources. In total, 14 indicators were developed.
Conclusion: This project will benefit policy and decision-makers by providing an easily accessible set of indicators and tools to measure health system integration across different contexts. The tool will evaluate the success of integration strategies and initiatives that can improve health outcomes for patients and advance health system design.
