Management--> and Health Laboratory, Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
Human Resource Development Division, Ministry of Health, Riga, Latvia.
Int J Health Plann Manage. 2019 Oct;34(4):1408-1422. doi: 10.1002/hpm.2803. Epub 2019 May 15.
Managing the complexity that characterizes health systems requires sophisticated performance assessment information to support the decision-making processes of healthcare stakeholders at various levels. Accordingly, in the past few decades, many countries have designed and implemented health system performance assessment (HSPA) programmes. Literature and practice agree on the key features that performance measurement in health should have, namely, multidimensionality, evidence-based data collection, systematic benchmarking of results, shared design, transparent disclosure, and timeliness. Nevertheless, the specific characteristics of different countries may pose challenges in the implementation of such programmes. In the case of small countries, many of these challenges are common and related to their inherent characteristics, eg, small populations, small volumes of activity for certain treatments, and lack of benchmarks. Through the development of the case study of Latvia, this paper aims at discussing the challenges and opportunities for assessing health system performance in a small country. As a result, for each of the performance measurement features identified by the literature, the authors discuss the issues emerging when adopting them in Latvia and set out the potential solutions that have been designed during the development of the case study.
管理卫生系统的复杂性需要复杂的绩效评估信息，以支持各级医疗保健利益相关者的决策过程。因此，在过去几十年中，许多国家都设计并实施了卫生系统绩效评估（HSPA）计划。文献和实践都同意卫生绩效衡量应具有的关键特征，即多维性、基于证据的数据收集、结果的系统基准测试、共同设计、透明披露和及时性。然而，不同国家的具体特点可能会在实施此类方案时带来挑战。在小国的情况下，其中许多挑战是共同的，并且与它们的固有特征有关，例如，人口少、某些治疗方法的活动量小以及缺乏基准。本文通过对拉脱维亚案例的研究，旨在讨论在小国评估卫生系统绩效的挑战和机遇。因此，对于文献中确定的每项绩效衡量特征，作者都讨论了在拉脱维亚采用这些特征时出现的问题，并提出了在案例研究开发过程中设计的潜在解决方案。
