engleski

Critical assessment of a health system

This study explores how to assess healthcare systems. Medicine, as the core business of a healthcare system, has historically developed from traditional medicine, where tradition and expert opinion were the most important parameters ; towards evidence-based medicine, where evidence is generated using strict scientific approaches and critical appraisal to help populations ; and further towards personalized medicine, where advanced diagnostics is used on individuals to deliver personalized treatment options. For a better understanding of the policy and management side, the agency theory is explored first. It explains the key players in health systems, where the health insurers (i.e., purchasers) are the principals (on behalf of the patients) and the healthcare providers the actual agents in the health systems. The differences in priorities and limitations of stakeholders are explored ; on a national level, the priority is population health and on a personal level, it is personal health. To measure the fulfilment of population-level priorities, additional tools such as quality- adjusted life-year and disability-adjusted life- year were developed. By providing a common measure, they enable a comparison of different health conditions and the economic effectiveness of treatment options. The tools reviewed in this study can be used in coordination to effectively assess and manage a health system.

healthcare systems, evidence-based medicine, agency theory, quality-adjusted life-year, QALY, disability-adjusted life-year, DALY, Standard Gamble, Time trade-off, Willingness-to-Pay

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