Health system performance assessment in small countries: The case study of Latvia

Noto, Guido; Corazza, Ilaria; Kļaviņa, K; Lepiksone, Jana; Nuti, Sabina

doi:10.1002/hpm.2803

Cited by 27 publications

(26 citation statements)

References 48 publications

(107 reference statements)

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“…According to an instrumental perspective [ 18 ], the performance domains usually assessed by P&C systems in health [ 21 , 22 ] are threefold: input, output, and outcome.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

The Challenges of Hospitals’ Planning & Control Systems: The Path toward Public Value Management

Nuti

Noto

Ruggieri

et al. 2021

IJERPH

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In the last decades, public management has been subjected to a shift from the New Public Management (NPM) paradigm to the Public Value Management (PVM) one. Thus, management practices such as Planning and Control (P&C) systems have been called to evolve accordingly. The health care sector has not escaped this process. This paper focuses on the evolution of hospitals’ P&C systems to support the paradigm shift from the NPM paradigm to the PVM one. In particular, the paper aims at exploring whether hospitals’ P&C systems in Italy evolved, or are evolving, consistently with PVM and what are the expected benefits related to such a paradigm switch. To address the research aim, the paper is based on a review of scientific and grey literature and the case study of the diabetic-foot pathway in an Italian Regional Healthcare System. The results of this study show that the current P&C systems in Italian hospitals are not yet designed to support the shift toward the PVM approach and are still mainly focused on financial aspects and intra-organizational dynamics. Combining traditional P&Cs with performance measures assessing the system’s outcomes may support hospitals in aligning their goals with the health system they are operating within and, therefore, P&C systems may represent an important driving force toward change. Such results provide suggestions for both practitioners and academics on how to adapt P&C systems to better support the implementation of current strategies of the public sector.

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“…According to an instrumental perspective [ 18 ], the performance domains usually assessed by P&C systems in health [ 21 , 22 ] are threefold: input, output, and outcome.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

The Challenges of Hospitals’ Planning & Control Systems: The Path toward Public Value Management

Nuti

Noto

Ruggieri

et al. 2021

IJERPH

Self Cite

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“…This is a unique feature of this study and it has not been the trend in the area, reinforcing the relevance of this review. In the last 5 years, studies related to the performance evaluation of health systems have been devoted, as usual, to the application of performance evaluation models in health care levels 106,107 or specific services and the role of their contextual factors. 108,109 This can be seen in studies that propose periodic assessment of the performance of the health system to achieve balanced development, studying the changing trends over a large period of investment.…”

Section: Discussionmentioning

confidence: 99%

A Meta-summarization of Qualitative Findings About Health Systems Performance Evaluation Models: Conceptual Problems and Comparability Limitations

Carnut

Narvai

2020

INQUIRY

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Due to the replacement of the issue of performance measurement in health policies worldwide this study identifies and analyzes the models for evaluating health systems performance. For this purpose, a systematic review of the literature on the topic “health systems performance evaluation” is done, making it compatible with a qualitative meta-synthesis of the type “meta-summarization.” It works with all databases related to the theme (PubMed, Scopus, EMBASE, PubAdm and Lilacs/Scielo). Portuguese, English, and Spanish are elected as language limit. Of the total number of articles (n = 32), 23 articles (71.8%) do not have a definition on “performance.” In those who have a definition, “performance” could be summed up in 6 central ideas. Among the most frequent subsidiary concepts that makes up the performance idea are the concepts of “efficiency” (11.9%), “quality” (9.5%) and “effectiveness” (7.1%). Six models were found in this review: “dashboard,” “balanced scorecard,” “open system model,” “PCATool,” “analyze dimension and performance indicators” and “standardized checklist and interview.” The “dashboard” was the most frequent performance evaluation model, found in 35.7% of studies. Only 25% of the reviewed studies presented the performance evaluation model applied specifically to health systems. Far from being configured as management tools useful to comprehension of health systems, these performance evaluation models have shortcomings that compromise their systemic evaluative power. This reinforces the inversion of reality in the relationship between quality and performance. Also, the performance evaluation models used try to adapt to the object, however in most them with relevant analytical problems compromising the specificities in depth of the health system under analysis. This generates inaccuracies and replaces the question about its use and their limitations to compare health systems.

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“…In Florence, the paediatric PREMs programme was developed as an extension to the ongoing collection of adult PREMs in several hospitals in the surrounding Tuscany region and more widely. In Riga, the pilot collection of paediatric PREMs was implemented as part of an European Commission Structural Reform Support Service (SRSS) to develop a Health System Performance Assessment (HSPA) system in Latvia [ 16 ]. The Children’s Clinical University Hospital elected to undertake the first PREMs collection and reporting in Latvia through that reform initiative.…”

Section: Methodsmentioning

confidence: 99%

Benchmarking experience to improve paediatric healthcare: listening to the voices of families from two European Children’s University Hospitals

Corazza

Gilmore

Menegazzo

et al. 2021

BMC Health Serv Res

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Background Patient Reported Experience Measures (PREMs) are recognized as an important indicator of high quality care and person-centeredness. PREMs are increasingly adopted for paediatric care, but there is little published evidence on how to administer, collect, and report paediatric PREMs at scale. Methods This paper describes the development of a PREMs questionnaire and administration system for the Meyer Children’s University Hospital in Florence (Meyer) and the Children’s Clinical University Hospital in Riga (CCUH). The system continuously recruits participants into the electronic administration model, with surveys completed by caregivers or adolescents at their convenience, post-discharge. We analyse 1661 responses from Meyer and 6585 from CCUH, collected from 1st December 2018 to 21st January 2020. Quantitative and qualitative experience analyses are included, using Pearson chi-square tests, Fisher’s exact tests and narrative evidence from free text responses. Results The large populations reached in both countries suggest the continuous, digital collection of paediatric PREMs described is feasible for collecting paediatric PREMs at scale. Overall response rates were 59% in Meyer and 45% in CCUH. There was very low variation in mean scores between the hospitals, with greater clustering of Likert scores around the mean in CCUH and a wider spread in Meyer for a number of items. The significant majority of responses represent the carers’ point of view or the perspective of children and adolescents expressed through proxy reporting by carers. Conclusions Very similar reported scores may reflect broadly shared preferences among children, adolescents and carers in the two countries, and the ability of both hospitals in this study to meet their expectations. The model has several interesting features: inclusion of a narrative element; electronic administration and completion after discharge from hospital, with high completion rates and easy data management; access for staff and researchers through an online platform, with real time analysis and visualization; dual implementation in two sites in different settings, with comparison and shared learning. These bring new opportunities for the utilization of PREMs for more person-centered and better quality care, although further research is needed in order to access direct reporting by children and adolescents.

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Health system performance assessment in small countries: The case study of Latvia

Cited by 27 publications

References 48 publications

The Challenges of Hospitals’ Planning & Control Systems: The Path toward Public Value Management

The Challenges of Hospitals’ Planning & Control Systems: The Path toward Public Value Management

A Meta-summarization of Qualitative Findings About Health Systems Performance Evaluation Models: Conceptual Problems and Comparability Limitations

Benchmarking experience to improve paediatric healthcare: listening to the voices of families from two European Children’s University Hospitals

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