Overview: Health and the planning of health care systems

Abstract

Implicit functions of a health care system which are often omitted or improperly emphasized are the study and promotion of individual health. This situation stems from the fact that health care systems are primarily based on the concept of disease, while the attributes of health (positive health) have not been investigated and objectively defined. However, an operational definition of the elusive concept of health appears possible today and is discussed in this paper. If the hypotheses that health can be improved and deterioration due to age can be retarded are accepted, then the consequences of these possibilities must be analyzed in relation to the planning of health care systems and to the planning of national health care programs. Thus, any attempt to describe the natural history of the health process must include the effects of interventions aimed at the promotion of health in the absence of disease. These effects must be defined so that quantitative criteria, which would serve as the basis for predictive medicine, can be established. Quantitative predictive medicine is necessary in order to evaluate the effectiveness of preventive measures. While it is widely recognized that the prevention of disease is one of the major goals of a health care delivery system, the methods presently used to evaluate alternative courses of action are notoriously limited.