Alshamsan Riyadh, Lee John Tayu, Rana Sangeeta, Areabi Hasan, Millett Christopher
1 College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11632, Saudi Arabia.
2 Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London SW7 2AZ, UK.
J R Soc Med. 2017 Sep;110(9):365-375. doi: 10.1177/0141076817724599.
Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage.
目的 评估和比较六个中等收入国家的卫生系统绩效，这些国家正在加强其卫生系统以实现全民健康覆盖。设计 横断面分析，数据来自世界卫生组织全球老龄化与成人健康研究，收集于2007年至2010年之间。背景 六个中等收入国家：中国、加纳、印度、墨西哥、俄罗斯和南非。参与者 年龄在50岁及以上的具有全国代表性的成年人样本。主要结局指标 我们展示了在卫生系统绩效关键指标方面在有效性、成本、可及性、以患者为中心和公平性领域的成就。结果 我们发现在慢性病预防和管理方面存在绩效不佳的领域，如高血压控制和癌症筛查覆盖率。我们还发现，尽管有保险计划，成本仍然是获得医疗服务的障碍。最后，我们发现许多指标存在差异的证据，特别是在有效性和以患者为中心的领域。结论 这些发现确定了这些国家在迈向全民健康覆盖过程中重要的行动重点领域和共同学习内容。
