[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v85y2008i3p263-276.html
   My bibliography  Save this article

Assessing health system performance in developing countries: A review of the literature

Author

Listed:
  • Kruk, Margaret Elizabeth
  • Freedman, Lynn P.
Abstract
With the setting of ambitious international health goals and an influx of additional development assistance for health, there is growing interest in assessing the performance of health systems in developing countries. This paper proposes a framework for the assessment of health system performance and reviews the literature on indicators currently in use to measure performance using online medical and public health databases. This was complemented by a review of relevant books and reports in the grey literature. The indicators were organized into three categories: effectiveness, equity, and efficiency. Measures of health system effectiveness were improvement in health status, access to and quality of care and, increasingly, patient satisfaction. Measures of equity included access and quality of care for disadvantaged groups together with fair financing, risk protection and accountability. Measures of efficiency were appropriate levels of funding, the cost-effectiveness of interventions, and effective administration. This framework and review of indicators may be helpful to health policy makers interested in assessing the effects of different policies, expenditures, and organizational structures on health outputs and outcomes in developing countries.

Suggested Citation

  • Kruk, Margaret Elizabeth & Freedman, Lynn P., 2008. "Assessing health system performance in developing countries: A review of the literature," Health Policy, Elsevier, vol. 85(3), pages 263-276, March.
    • Handle: RePEc:eee:hepoli:v:85:y:2008:i:3:p:263-276
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(07)00200-X
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Habicht, Jarno & Kunst, Anton E., 2005. "Social inequalities in health care services utilisation after eight years of health care reforms: a cross-sectional study of Estonia, 1999," Social Science & Medicine, Elsevier, vol. 60(4), pages 777-787, February.
    2. Ensor, Tim & Ronoh, Jeptepkeny, 2005. "Effective financing of maternal health services: A review of the literature," Health Policy, Elsevier, vol. 75(1), pages 49-58, December.
    3. Jeremy Hurst & Melissa Jee-Hughes, 2001. "Performance Measurement and Performance Management in OECD Health Systems," OECD Labour Market and Social Policy Occasional Papers 47, OECD Publishing.
    4. Brownell, Marni D. & Roos, Noralou P. & Roos, Leslie L., 2001. "Monitoring health reform: a report card approach," Social Science & Medicine, Elsevier, vol. 52(5), pages 657-670, March.
    5. Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
    6. Eggli, Yves & Halfon, Patricia & Chikhi, Mehdi & Bandi, Till, 2006. "Ambulatory healthcare information system: A conceptual framework," Health Policy, Elsevier, vol. 78(1), pages 26-38, August.
    7. Elola, J. & Daponte, A. & Navarro, V., 1995. "Health indicators and the organization of health care systems in Western Europe," American Journal of Public Health, American Public Health Association, vol. 85(10), pages 1397-1401.
    8. Chukwuani, Chinyere Mercellina & Olugboji, Akindeji & Akuto, Edward Erdorga & Odebunmi, Akim & Ezeilo, Ezenta & Ugbene, Emmanuel, 2006. "A baseline survey of the Primary Healthcare System in South Eastern Nigeria," Health Policy, Elsevier, vol. 77(2), pages 182-201, July.
    9. Lynn P Freedman, 2005. "Achieving the MDGs: Health systems as core social institutions," Development, Palgrave Macmillan;Society for International Deveopment, vol. 48(1), pages 19-24, March.
    10. Siddiqi, S. & Haq, I. U. & Ghaffar, A. & Akhtar, T. & Mahaini, R., 2004. "Pakistan's maternal and child health policy: analysis, lessons and the way forward," Health Policy, Elsevier, vol. 69(1), pages 117-130, July.
    11. Rosero-Bixby, Luis, 2004. "Spatial access to health care in Costa Rica and its equity: a GIS-based study," Social Science & Medicine, Elsevier, vol. 58(7), pages 1271-1284, April.
    12. Weaver, Marcia & Deolalikar, Anil, 2004. "Economies of scale and scope in Vietnamese hospitals," Social Science & Medicine, Elsevier, vol. 59(1), pages 199-208, July.
    13. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, Center for Economic and Financial Research (CEFIR).
    2. Carla Alexandra da Encarnação Filipe Amado & Olena Kalinichenko & Sérgio Pereira dos Santos, 2013. "Performance Assessment in Primary Health Care: A Systematic Literature Review," CEFAGE-UE Working Papers 2013_03, University of Evora, CEFAGE-UE (Portugal).
    3. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, New Economic School (NES).
    4. Shengelia, Bakhuti & Tandon, Ajay & Adams, Orvill B. & Murray, Christopher J.L., 2005. "Access, utilization, quality, and effective coverage: An integrated conceptual framework and measurement strategy," Social Science & Medicine, Elsevier, vol. 61(1), pages 97-109, July.
    5. Weinhold, Ines & Gurtner, Sebastian, 2018. "Rural - urban differences in determinants of patient satisfaction with primary care," Social Science & Medicine, Elsevier, vol. 212(C), pages 76-85.
    6. G Oskrochi & Ahmed Bani-Mustafa & Y Oskrochi, 2018. "Factors affecting psychological well-being: Evidence from two nationally representative surveys," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-14, June.
    7. Mozhaeva, Irina, 2022. "Inequalities in utilization of institutional care among older people in Estonia," Health Policy, Elsevier, vol. 126(7), pages 704-714.
    8. van Hulsen, Merel A.J. & Rohde, Kirsten I.M. & van Exel, Job, 2023. "Preferences for investment in and allocation of additional healthcare capacity," Social Science & Medicine, Elsevier, vol. 320(C).
    9. Hoeck, Sarah & François, Guido & Van der Heyden, Johan & Geerts, Joanna & Van Hal, Guido, 2011. "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy, Elsevier, vol. 99(2), pages 174-182, February.
    10. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    11. Guglielmo Maria Caporale & Luis A. Gil-Alana, 2015. "Infant mortality rates: time trends and fractional integration," Journal of Applied Statistics, Taylor & Francis Journals, vol. 42(3), pages 589-602, March.
    12. Antonio Abatemarco & Massimo Aria & Sergio Beraldo & Michela Collaro, 2023. "Measuring Access and Inequality of Access to Health Care: a Policy-Oriented Decomposition," CSEF Working Papers 666, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
    13. Paul Allanson & Dennis Petrie, 2014. "Understanding The Vertical Equity Judgements Underpinning Health Inequality Measures," Health Economics, John Wiley & Sons, Ltd., vol. 23(11), pages 1390-1396, November.
    14. Basile, Luigi Jesus & Carbonara, Nunzia & Pellegrino, Roberta & Panniello, Umberto, 2023. "Business intelligence in the healthcare industry: The utilization of a data-driven approach to support clinical decision making," Technovation, Elsevier, vol. 120(C).
    15. Becchetti, Leonardo & Conzo, Pierluigi & Salustri, Francesco, 2017. "The impact of health expenditure on the number of chronic diseases," Health Policy, Elsevier, vol. 121(9), pages 955-962.
    16. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the ‘Fair Innings’ Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132, March.
    17. Marco Marozzi & Mario Bolzan, 2018. "An Index of Household Accessibility to Basic Services: A Study of Italian Regions," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(3), pages 1237-1250, April.
    18. Aoun, Nael & Matsuda, Hirotaka & Sekiyama, Makiko, 2015. "Geographical accessibility to healthcare and malnutrition in Rwanda," Social Science & Medicine, Elsevier, vol. 130(C), pages 135-145.
    19. Peter Zweifel, 2006. "Auftrag und Grenzen der Sozialen Krankenversicherung," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 7(s1), pages 5-26, May.
    20. Senn, Nicolas & Breton, Mylaine & Ebert, Sonja T. & Lamoureux-Lamarche, Catherine & Lévesque, Jean-Frédéric, 2021. "Assessing primary care organization and performance: Literature synthesis and proposition of a consolidated framework," Health Policy, Elsevier, vol. 125(2), pages 160-167.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:85:y:2008:i:3:p:263-276. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.