How do health systems and health contribute to the sustainable development goals?

While there is considerable research and policy interest into how factors outside the health system (i.e. social determinants) influence health outcomes, there has historically been less interest in how health and health systems affect other economic and societal objectives. Such evidence can be useful to health policymakers making the case for investing in health systems to demonstrate that health systems do more than just improve health. The European Observatory on Health Systems and Policies has put together a special issue of the journal Health Policy to explore the evidence on how health and health systems advance the Sustainable Development Goals (SDGs), which provides a helpful conceptual framework for considering economic and societal objectives. The articles each consider a particular SDG and review relevant literature with an emphasis on causal studies to explore the ways in which health and health systems have causal effects on key societal objectives such as poverty reduction, gender equality, climate change, and responsible consumption. In this presentation we will provide a summary of the findings from the special issue, highlighting areas with the strongest (and weakest) evidence and discuss how this work can be factored into budget negotiations and decisions about resource allocation

Coping with the economic burden of Diabetes, TB and co-prevalence - Evidence from Bishkek, Kyrgyzstan

Background: The increasing number of patients co-affected with Diabetes and TB may place individuals with low socio-economic status at particular risk of persistent poverty. Kyrgyz health sector reforms aim at reducing this burden, with the provision of essential health services free at the point of use through a State-Guaranteed Benefit Package (SGBP). However, despite a declining trend in out-of-pocket expenditure, there is still a considerable funding gap in the SGBP. Using data from Bishkek, Kyrgyzstan, this study aims to explore how households cope with the economic burden of Diabetes, TB and co-prevalence. Methods: This study uses cross-sectional data collected in 2010 from Diabetes and TB patients in Bishkek, Kyrgyzstan. Quantitative questionnaires were administered to 309 individuals capturing information on patients' socioeconomic status and a range of coping strategies. Coarsened exact matching (CEM) is used to generate socio-economically balanced patient groups. Descriptive statistics and logistic regression are used for data analysis. Results: TB patients are much younger than Diabetes and co-affected patients. Old age affects not only the health of the patients, but also the patient's socio-economic context. TB patients are more likely to be employed and to have higher incomes while Diabetes patients are more likely to be retired. Co-affected patients, despite being in the same age group as Diabetes patients, are less likely to receive pensions but often earn income in informal arrangements. Out-of-pocket (OOP) payments are higher for Diabetes care than for TB care. Diabetes patients cope with the economic burden by using social welfare support. TB patients are most often in a position to draw on income or savings. Co-affected patients are less likely to receive social welfare support than Diabetes patients. Catastrophic health spending is more likely in Diabetes and co-affected patients than in TB patients. Conclusions: This study shows that while OOP are moderate for TB affected patients, there are severe consequences for Diabetes affected patients. As a result of the underfunding of the SGBP, Diabetes and co-affected patients are challenged by OOP. Especially those who belong to lower socio-economic groups are challenged in coping with the economic burden

Sistemas de alocação de recursos a prestadores de serviços de saúde - a experiência internacional

O artigo apresenta as formas tradicionais de alocação de recursos a prestadores de serviços de saúde e se concentra na apresentação e discussão de experiências alternativas encontradas no contexto internacional. Aponta, ainda, as tendências atuais formuladas nos países da OECD, que consistem na adoção de sistemas mistos ou complementados pelo ajuste por desempenho, sendo este predominantemente referido a resultados sobre a saúde da população, ou seja, à efetividade dos serviços de saúde. Ainda, destaca-se uma tendência a adotar sistemas de alocação de recursos diferenciados, segundo o nível de atenção do prestador: aos centros de atenção primária responsáveis pela saúde da população de um dado território, corresponde a alocação de recursos per capita ajustada por risco (ou, em alguns casos, por linhas de cuidado), enquanto os hospitais são em alguns casos remunerados por orçamento global ajustado por desempenho e, em outros, por pagamento prospectivo por procedimento.This article presents the traditional ways of allocating resources to health service providers and focuses on the presentation and discussion of alternative experiences found in the international context. It also shows the current trends in the OECD countries, involving the adoption of mixed systems or performance-related bonuses, the latter being predominantly referred to the effects on the health of the population, i.e. the effectiveness of the health services. It further stresses the tendency to adopt resource allocation systems that are differentiated according to the level of care provider: to primary care centers, responsible for the health of the population of a given territory, a per capita adjusted for risk factor is granted (or, in some cases, resource allocation defined for lines of care), while in other cases hospitals are either paid according to a performance-adjusted global budget or through prospective payment per procedure

What does it mean to age in good health? An analysis of Time Use Survey data

Abstract Background While there is intrinsic value of ageing in good health, there is little evidence of how the daily lives of older people differ depending on their health status. Methods We use Time Use Survey data from the United Kingdom to assess how people at different ages spend their time, conditional on their self-reported health. Results While results are preliminary, we find stark differences between people's time use dependent on their health. For example, older people who report good health are more likely than comparable older people to engage in paid work, volunteer, and participate in leisure activities. Conclusions There are many benefits to supporting healthy ageing. By considering how time spent differs between those in good and poor health and attributing value to that time, one can take a more holistic perspective when conducting cost-benefit analysis of policy interventions. </jats:sec