Global health financing and the need for a data revolution

Dieleman, Joseph L; Haakenstad, Annie

doi:10.1017/s1744133116000402

Cited by 4 publications

(2 citation statements)

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“…Unfortunately, the incredible cost of new treatments becomes a worldwide problem, often more than the question of efficacy alone. Payers, health insurances are thus asking for a "data revolution", with the harmonization of health financing data across countries that goes far beyond the simple question of EBM (15).…”

Section: Critics Against Ebmmentioning

confidence: 99%

The future of evaluation of child and adolescent psychiatric treatments

Falissard¹

2021

IACAPAP ArXiv

100

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Purpose of review: To imagine the future methods and paradigms for evaluating treatments in child and adolescent psychiatry (CAP). A historical perspective will be adopted first to explain the origin of methods and designs presently in use. Then an overview of methodological breakthroughs that occur currently will be presented. Recent findings: At the moment, mechanisms of action and randomized controlled trials are the two pillars of treatment evaluation. However, personalized medicine, digital health, big data, health economy, and patient organizations strongly question this state of affairs. As a result, new methodological approaches are arriving in force among which “n-of-1” studies, Bayesian designs, observational studies, and Qualitative researches. Summary: In CAP, psychological treatments are important, there are numerous age groups, and many moderators influencing treatment efficacy. This may be a reason why CAP has not benefited as much as many other medical specialties from Evidence-Based Medicine. Fortunately, the methodological revolution we are going through at the moment is likely to change this. If CAP can get the ball rolling, it will gain a lot in therapeutic efficacy.

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Section: Critics Against Ebmmentioning

confidence: 99%

The future of evaluation of child and adolescent psychiatric treatments

Falissard¹

2021

IACAPAP ArXiv

100

124

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“…This calls for a strong framework covering access, efficiency, equity and quality and their interrelation in order to understand the content and the scope of the cross-country comparison [ 9 , 10 ]. In undertaking international comparisons, it is crucial to have good understanding about the strengths and limitations of existing indicators, and their usefulness in assessing system performance [ 11 , 12 ]. .…”

Section: Introductionmentioning

confidence: 99%

Headline indicators for monitoring the performance of health systems: findings from the european Health Systems_Indicator (euHS_I) survey

2018

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BackgroundCross-country comparisons of health system performance have become increasingly important. Clear evidence is needed on the prioritization of health system performance assessment (HSPA) indicators. Selected “leading” or “headline” HSPA indicators may provide early warnings of policy impacts. The goal of this paper is to propose a set of headline indicators to frame and describe health system performance.MethodsWe identified overlaps and gaps in the availability of reported indicators by looking at HSPA initiatives in Member States (MSs) of the European Union (EU), the European Commission as well as international institutions (e.g. OECD, WHO-EUR). On that basis, we conducted a two-stage online survey, the european Health System_Indicator (euHS_I) survey. The survey sought to elicit preferences from a wide range of HSPA experts on i) the most relevant HSPA domain(s), i.e. access, efficiency, quality of care, equity, for a specific indicator, and ii) the importance of indicators regarding their information content, i.e. headline, operational, explanatory. Frequency analysis was performed.ResultsWe identified 2168 health and health system indicators listed in 43 relevant initiatives. After adjusting for overlaps, a total of 361 indicators were assessed by 28 experts in the 1st stage of the survey. In the 2nd stage, a more balanced set of 95 indicators was constructed and assessed by 72 experts from 22 EU MSs and 3 non-EU countries. In the domain access experts assessed share of population covered by health insurance as the top headline indicator. In the domain efficiency, the highest rank was given to Total health care expenditure by all financing agents, and in the domain quality of care to rate of hospital-acquired infections. Percentage of households experiencing high levels/catastrophic of out-of-pocket health expenditures results as the top headline indicator for domain equity.ConclusionsHSPA indicators from different initiatives largely overlap and public health indicators dominate over health systems aspects. The survey allowed to quantify overlaps and gaps in HSPA indicators, their expert allocation to domain areas and establishment of an informed hierarchy structure. Yet, results show that more multidisciplinary work is needed to ensure the availability of accurate efficiency indicators which are comparable across countries.Electronic supplementary materialThe online version of this article (10.1186/s13690-018-0278-0) contains supplementary material, which is available to authorized users.

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