![health system indicators health system indicators](https://image.slideserve.com/937593/indicators-of-health-n.jpg)
This is particularly apparent in the analyses of health systems performance in high income countries and does not appear to have been materially influenced by the development of wider frameworks of analysis. Notwithstanding this very broad description of a health system, when it comes to the analysis of health systems performance, the operational (nonprocess) approaches have tended to be narrow, focusing on those aspects of the system that relate directly to the delivery of healthcare. In the World Health Report 2000, a health system is discussed in terms of "all the organizations, institutions and resources that are devoted to producing health actions" (p xi). Further research will be needed to assess the causal relationship, and its generalizability beyond U5MR as a health outcome measure, as well as the geographical generalizability of the results. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. The association suggests there might be a causal relationship. This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. Governance was not, however, significantly associated with equity in U5MR outcomes. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR.
![health system indicators health system indicators](https://images.livemint.com/r/LiveMint/Period1/2015/12/15/Photos/web_PlainFacts_Chart_2.jpg)
Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. The under-five mortality rate (U5MR) was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. The data were analysed using multiple linear regression and a standard progressive modelling procedure. Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets.Įpidemiology/public health health performance international comparison performance frameworks performance indicators quality of care.The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Of these, 45 indicators are reported in more than one country. The search found 401 indicators that fulfilled the 'nationally consistent and locally relevant' criteria. The most commonly used domains in performance frameworks were safety, effectiveness and access. Two dimensions of indicators - that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) - were deemed important. Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Few studies make comparative assessments of different countries' performance indicator frameworks.
![health system indicators health system indicators](https://cdn.slidesharecdn.com/ss_thumbnails/healthindicators-anoverview-121206235919-phpapp02-thumbnail-4.jpg)
Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management.