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KEY MESSAGES
- Preoccupation with the value created by health systems has been longstanding, and will likely only intensify given the ongoing health systems strains and shocks such as the COVID-19 pandemic. But the focus so far has usually been limited to value as seen from the perspectives of certain actors in the health system and/or to certain dimensions of value.
- In this policy brief we call for a shared understanding of value that embraces the health system in its entirety, including preventive services and other public health functions. We then define value to be the contribution of the health system to societal wellbeing.
- Any meaningful formulation of the concept of wellbeing includes health, and by extension health systems, as an important contributor to our wellbeing.
- Health improvement, responsiveness, financial protection, efficiency and equity are widely accepted as health systems’ core contributions to wellbeing. Health systems can also contribute to wellbeing indirectly through the spillover effects that its actions have on other sectors.
- Health systems are shaped by a wide array of actors, including national policy-makers, purchasers, providers, practitioners, citizens and patients. These different actors make important but discrete contributions to value, so in order to maximize it, their actions should be aligned. The aim should be to create a value-based health system.
- A range of policy levers can be used to enhance value, ranging from cross-sectoral policies to involving patients in decision-making. While such levers normally focus on one or two dimensions of value, it is important to ensure that they do not undermine other dimensions or the efforts of other actors.
- Effective governance of the whole health system is needed to ensure that stakeholder perspectives and policy levers are aligned to promote a common concept of health system value and, ultimately, of societal wellbeing. There are governance tools, such as the Transparency, Accountability, Participation, Integrity and Capacity (TAPIC) framework, that can help achieve this.
- Moving towards a value-based health system will often be a gradual process, focusing first of all on the areas where it might make the biggest difference.
Contents
- ACKNOWLEDGMENTS
- How do Policy Briefs bring the evidence together?
- Executive summary
- POLICY BRIEF
- 1. Introduction
- 2. Clarifying the key concepts: what do we mean by societal wellbeing and health system value?
- 3. How can various actors in the health system contribute to value?
- 4. Key policy levers for enhancing value: what do we know?
- 5. The central role of governance in aligning the levers
- 6. Conclusions
- References
- Joint Policy Briefs
About the Series
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All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full.
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization.
This policy brief is one of a new series to meet the needs of policy-makers and health system managers. The aim is to develop key messages to support evidence-informed policy-making and the editors will continue to strengthen the series by working with authors to improve the consideration given to policy options and implementation.
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What is a Policy Brief?
- NLM CatalogRelated NLM Catalog Entries
- Review Building on value-based health care: Towards a health system perspective.[Health Policy. 2023]Review Building on value-based health care: Towards a health system perspective.Smith PC, Sagan A, Siciliani L, Figueras J. Health Policy. 2023 Dec; 138:104918. Epub 2023 Sep 23.
- Review Making Health for All Policies: Harnessing the co-benefits of health[ 2023]Review Making Health for All Policies: Harnessing the co-benefits of healthGreer SL, Falkenbach M, Siciliani L, McKee M, Wismar M, Vissapragada P, Montás MC, Perroud J, Rockwell O, Figueras J. 2023
- Review Tuberculosis.[Major Infectious Diseases. 2017]Review Tuberculosis.Bloom BR, Atun R, Cohen T, Dye C, Fraser H, Gomez GB, Knight G, Murray M, Nardell E, Rubin E, et al. Major Infectious Diseases. 2017 Nov 3
- Managing COVID-19 within and across health systems: why we need performance intelligence to coordinate a global response.[Health Res Policy Syst. 2020]Managing COVID-19 within and across health systems: why we need performance intelligence to coordinate a global response.Kringos D, Carinci F, Barbazza E, Bos V, Gilmore K, Groene O, Gulácsi L, Ivankovic D, Jansen T, Johnsen SP, et al. Health Res Policy Syst. 2020 Jul 14; 18(1):80. Epub 2020 Jul 14.
- Local health governance in Tajikistan: accountability and power relations at the district level.[Int J Equity Health. 2020]Local health governance in Tajikistan: accountability and power relations at the district level.Jacobs E, Baez Camargo C. Int J Equity Health. 2020 Mar 2; 19(1):30. Epub 2020 Mar 2.
- Building on value-based health careBuilding on value-based health care
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