Sekhri Feachem Neelam, Afshar Ariana, Pruett Cristina, Avanceña Anton L V
Global Health Sciences and Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California, USA.
University of California, San Francisco, San Francisco, California, USA.
Int Health. 2017 Jul 1;9(4):252-262. doi: 10.1093/inthealth/ihx005.
In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis.
Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities.
We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems.
As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses.
在过去十年中,关于运作良好的系统的价值的国际共识推动了大量卫生系统研究。这项研究分为两大类。第一类提供概念框架,这些框架将复杂的医疗保健系统进行简化,构建出相互作用和功能的简化结构。第二类关注具体的投入和产出。本文介绍了一种新颖的转化映射工具——加利福尼亚大学旧金山分校映射工具(该工具)——它弥合了这两个研究领域之间的差距,创建了一个用于多国比较分析的平台。
我们使用默里 - 弗伦克框架,创建一个国家结构的宏观层面表示,重点关注其医疗保健的融资和提供方式。该地图直观地描绘了医疗保健系统设计中的基本政策问题:资金来源以及通过每个来源支出的金额、购买者、覆盖人群、提供者类别;以及这些实体之间的关系。
我们使用该工具对印度和泰国医疗保健系统的结构进行宏观层面的比较分析。
作为加强系统的手段之一,该工具可以利用一个促进多国比较分析的通用框架,激发关于不同医疗保健系统结构设计的优点和后果的辩论。