Інструменти та методологія оцінювання ефективності системи надання первинної медичної допомоги: досвід ЄС
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Date
2021
Journal Title
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Publisher
Дніпропетровський регіональний інститут державного управління Національної академії державного управління при Президентові України, Дніпро
Abstract
UKR: Розглядаються європейські практики щодо розроблення і використання інструментів таметодології оцінювання системи надання первинної медичної допомоги на основі опрацюваннязвіту «Новий маршрут первинної медичної допомоги в Європі: переосмислення інструментівта методологій оцінювання», підготовленого створеною Європейською Комісією Експертноюгрупою з оцінювання ефективності систем охорони здоров’я. В ЄС вважають, що оцінюванняефективності систем охорони здоров’я є корисним для правильного розуміння функціонуваннята результатів діяльності цих систем, а отже, для ініціювання відповідної державної політикита заходів щодо їх поліпшення. Оцінювання ефективності пропонує прозорість, яка є важливоюдля забезпечення підзвітності систем охорони здоров’я, поліпшуючи в такий спосіб їхфункціонування. Обґрунтоване оцінювання має важливе значення для виявлення передовихта поганих практик, підвищення ефективності медичної допомоги, збільшення доступностімедичного обслуговування, поліпшення безпеки пацієнтів. Нарешті, знання того, як працюєсистема охорони здоров’я, є необхідною умовою розроблення та імплементації ефективнихреформ системи охорони здоров’я на благо всіх громадян.
ENG: The article examines the existing European practices for the development and use of tools and methodologies for assessment the primary health care system based on the report «A New Drive for Primary Care in Europe: Rethinking the Assessment Tools and Methodologies» prepared by Expert Group on Health Systems Performance Assessment (HSPA) which was created by the European Commission in 2012. The Expert group considers that primary care is the provision of universally accessible, integrated person-centered, comprehensive health and community services provided by a team of professionals accountable for addressing a large majority of pers onal health needs. These services are delivered in asustained partnership with patients and informal caregivers, in the context of family and community, andplay a central role in the overall coordination and continuity of people’s care. In this regard the Expertgroup draws the conclusion that what emerges from the definition of the primary care is its intrinsiccomplexity, related to its multiple dimensions, stakeholders and governance levels. Defining dimensions and domains to be taken into consideration in assessing the performance of primary care, the expertspropose to include some more eight classical dimensions of HSPA that can be applied to the assessment of primary care (Universal and accessible; Integrated; Person-centred; Comprehensive and communityoriented; Provided by a team of professionals for addressing a larger majority of personal health needs (quality); Sustained partnership with patients and informal caregivers; Coordination of people’s care; Continuity of people’s care) and domains that are specific to primary care. Due to the central role playedby the health professional workforce in influencing primary care results, two other dimensions: Primary Care Organization and Human Resources were added to the eight key dimensions. The Expert group in their consideration also emphasises the spill over effects of primary care, which except for improving thehealth of population, contributes to the population well-being. As primary care is concerned with the provision of health care across the life course, from birth to the end of life, it must operate in synergy with delivery of care at all levels of the health system and beyond. Thus, primary care should systematically collaborate with social services, hospitals, and, in the last part of a person’s life, with long term care settings and hospices. The EU believes that assessing the performance of health systems is useful to properly understand how they work, and therefore to carry out actions to improve them. Performance assessment offers the transparency that is essential for securing accountability for health systems, thereby improving their functioning. A sound assessment is essential to: identify good and bad practice; strengthen effectiveness of care; increase accessibility; improve the safety of patients. Knowing how the health system works is the precondition to design effective health system reforms for the benefit of citizens.
ENG: The article examines the existing European practices for the development and use of tools and methodologies for assessment the primary health care system based on the report «A New Drive for Primary Care in Europe: Rethinking the Assessment Tools and Methodologies» prepared by Expert Group on Health Systems Performance Assessment (HSPA) which was created by the European Commission in 2012. The Expert group considers that primary care is the provision of universally accessible, integrated person-centered, comprehensive health and community services provided by a team of professionals accountable for addressing a large majority of pers onal health needs. These services are delivered in asustained partnership with patients and informal caregivers, in the context of family and community, andplay a central role in the overall coordination and continuity of people’s care. In this regard the Expertgroup draws the conclusion that what emerges from the definition of the primary care is its intrinsiccomplexity, related to its multiple dimensions, stakeholders and governance levels. Defining dimensions and domains to be taken into consideration in assessing the performance of primary care, the expertspropose to include some more eight classical dimensions of HSPA that can be applied to the assessment of primary care (Universal and accessible; Integrated; Person-centred; Comprehensive and communityoriented; Provided by a team of professionals for addressing a larger majority of personal health needs (quality); Sustained partnership with patients and informal caregivers; Coordination of people’s care; Continuity of people’s care) and domains that are specific to primary care. Due to the central role playedby the health professional workforce in influencing primary care results, two other dimensions: Primary Care Organization and Human Resources were added to the eight key dimensions. The Expert group in their consideration also emphasises the spill over effects of primary care, which except for improving thehealth of population, contributes to the population well-being. As primary care is concerned with the provision of health care across the life course, from birth to the end of life, it must operate in synergy with delivery of care at all levels of the health system and beyond. Thus, primary care should systematically collaborate with social services, hospitals, and, in the last part of a person’s life, with long term care settings and hospices. The EU believes that assessing the performance of health systems is useful to properly understand how they work, and therefore to carry out actions to improve them. Performance assessment offers the transparency that is essential for securing accountability for health systems, thereby improving their functioning. A sound assessment is essential to: identify good and bad practice; strengthen effectiveness of care; increase accessibility; improve the safety of patients. Knowing how the health system works is the precondition to design effective health system reforms for the benefit of citizens.
Description
Н. Рудік: ORCID 0000-0002-8535-075X
Keywords
державне управління, державна політика у сфері охорони здоров’я, європейський досвід, первинна медична допомога, оцінювання ефективності первинноїмедичної допомоги, public administration, health care policy, European experience, primary health care, assessing the performance of primary care, КЕМ
Citation
Рудік Н. М., Побігай Л. Я. Інструменти та методологія оцінки ефективності системи надання первинної медичної допомоги: досвід ЄС. Державне управління та місцеве самоврядування. Дніпро, 2021. Вип. 1 (48). С. 122–131. DOI: 10.32782/palg/2021.1.1.