Healthcare systems are facing ever-evolving challenges; they have to adapt to evolving needs and megatrends such as population ageing, digitalisation, and climate change, as well as withstand natural or man-made shocks, like pandemics, natural and environmental disasters, biological, chemical, cyber, financial and nuclear threats, as well as social unrest.
This renewed framework acts as a foundational guide to facilitate a collective vision for health system performance.
New challenges, new performance framework
Such challenges are calling for a new approach to assessing health system performance, centred around factors like resilience, people-centeredness, and environmental sustainability.
Health System Performance Assessment (HSPA) is vital for ensuring that health systems meet these needs effectively by systematically evaluating their performance and guiding policy decisions to improve resource allocation and achieve policy objectives.
Leveraging past framework, building towards collaboration and mutual learning
The updated Framework builds upon existing structures guiding the OECD's health-related work and emphasises placing individuals at the core of health systems and integrates new objectives like sustainability, encompassing both economic and environmental aspects. Furthermore, it highlights the interconnectedness and potential trade-offs across various dimensions of health systems, such as balancing efficiency and equity, efficiency and people-centeredness, or sustainability and resilience. The revised Framework aims to enhance international collaboration by establishing a common language, definitions, and shared understanding among policymakers, stakeholders, and organisations. It serves as a groundwork for developing future indicators, collecting data, conducting policy analyses, and integrating knowledge. While its purpose is not to supplant national-level health system performance assessment frameworks, it intends to foster international benchmarking and mutual learning.
Structure for the new roadmap
The updated OECD Health System Performance Assessment Framework provides a foundational roadmap to guide collective efforts towards improving health system performance. At the heart of the framework is the consideration of health system outcomes, which are assessed at both individual and population levels. These outcomes are influenced by various factors including social, demographic, economic, and environmental contexts, which shape and are shaped by individual and population health as well as the supporting health systems. These elements form the backdrop against which the framework operates.
Central to the Framework are the health needs and preferences of individuals, which serve as both an objective of health systems and a means to achieve broader policy objectives. Health systems strive to provide access to high-quality healthcare services and public health interventions encompassing curative care, long-term care, mental health, prevention, and health promotion activities. Additionally, the updated Framework emphasises four "cross-cutting" dimensions of health system performance, namely efficiency, equity, sustainability, and resilience.
The structural components of health systems, including resources and characteristics, represent the inputs necessary for their functioning and are integral aspects considered within the framework.
Populating each dimension of the Framework with indicators
To put the Framework into practice, the various concepts in the Framework need to be broken down into more specific and measurable elements and then populated with indicators. Since various components of the Framework draw from existing frameworks, the OECD has already developed many of such indicators. Consequently, several dimensions of the renewed Framework can already boast a robust collection of indicators. Nevertheless, the HSPA Framework revision also presents opportunities for introducing fresh indicators and enhancing the quality of existing ones.
Source: OCDE
Image Credit: OCDE
