A Process Model of Performance Management of Health Care Systems

Abstract

Health care is an inalienable right of every citizen. World over health care systems attempt to manage disease and health conditions load, as best as possible. Their performance is reflected in the basic health indices at the population level, including its distribution in subpopulations in form of inequalities. Focus on performance of health systems has considerably increased with increased use of technology, spread of communication channels and globalization. From 2000 AD when WHO did a feature on performance of health care systems, large number of commissions, taskforces and groups have worked on developing effective frameworks for evaluating health care systems at a country level. Despite all of this progress, inequalities persist highlighting issues with the prevalent frameworks. The core issues are that all such frame works are static in nature, and do not focus on management of the health care systems despite taskforces indicating the root cause of inequalities being ineffective implementation of programmes. We draw from a model developed from a study of successful implementation of health programmes-part of a larger defended dissertation-and transform it to create a process model for managing performance of a health system. Management of performance of a health system must cover – workload assessment, manning and facilities to effectively deliver services with prioritization of services to enable time sensitive development of skills and services to be used in the system. This needs to be done consistently over time by deploying a focused strategic planning unit. Given the large scale amount of resources spent on health care, any efficiency of health systems will increase equity and service quality.