کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5723334 1411444 2017 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Uncomfortable trade-offs: Canadian policy makers' perspectives on setting objectives for their health systems
ترجمه فارسی عنوان
ناهماهنگی: دیدگاه های سیاست گذاران کانادایی در تعیین اهداف نظام سلامت آنها
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی


- Studies of health system performance can benefit from seeking health policy makers' views about health system objectives and desired outcomes.
- Health care delivery and population health goals are the most clearly stated objectives for health systems.
- Acute care system objectives are routinely prioritized over population health, prevention and chronic disease management.
- Policy makers face challenges operationalizing objectives into measurable outcomes, which involve setting priorities and making trade offs.
- The results of this study can be used to improve the quality and uptake of health system performance studies.

BackgroundAlthough a wide range of health system performance indicators are commonly reported on, there has been little effort to establish their relevance to the objectives that health systems actually pursue.ObjectiveThe aim of this study was to identify, explore and better understand health policy makers' views regarding the objectives and outcomes for their health systems, how they are prioritized, and the underlying processes that yield them to inform the development of health system efficiency measures.MethodsA descriptive, qualitative methodology was employed using key informant interviews with 17 current and former senior health ministry officials in 8 Canadian provinces and 2 territories.Key findingsHealth ministries have clearly stated objectives for health systems focused on the achievement of health system delivery and population health goals and, increasingly, public, patient and financial accountability. Acute care objectives are routinely prioritized over population health objectives and viewed as resulting from challenges associated with difficult trade-off decisions shaped by organized interests and the media rather than explicit, evidence-based processes.ConclusionThis study provides insights beyond publicly available documents to explore the processes that underlie simple statements of health system objectives. Our findings suggest that despite respondents giving priority to improving individual and population health, it is more commonly portrayed as an ideal objective than as a realistic one. By understanding what lies behind statements about what health systems are striving for, we offer a more robust avenue for increasing the uptake of future studies of health system performance.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Health Policy - Volume 121, Issue 1, January 2017, Pages 9-16
نویسندگان
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