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Strategy and policy
Reform Support

Setting up a Framework for Health System Performance Assessment

Supporting reforms to improve the quality and sustainability of our healthcare systems

Funding Programme
Year
  • 2021

Setting up a Framework for Health System Performance Assessment

The European Commission enabled national authorities in Czechia to implement an institutional framework for reporting health system performance indicators.

Context

Czechia operates a Social Health Insurance system, in which seven health insurance funds act as purchasers of care and negotiate annually with health providers to set prices and volumes, regulated by the Ministry of Health. The population enjoys a broad benefit package and has access to a large number of hospitals, most of which are owned either by the state (27 %) or the regions and municipalities (45 %). Health insurance funds may offer additional services to their insured in the area of prevention. Such decentralised nature of the health system poses challenges in the assessment of its overall performance, as well as the benchmarking and monitoring of health insurance funds.

Czechia currently lacks a Health System Performance Assessment (HSPA) framework, which is considered by public authorities a valuable approach for measuring and evaluating their health system. Therefore, Czechia has requested support to identify areas of the health system that should be systematically measured, find the right indicators for measuring them, verify that they have reliable data and define precise methodology for calculating the indicators (so that the calculation is transparent, repeatable, and to the largest possible extent, internationally comparable).

Support Delivered

The project included the following key activities:

  • Organise and carry out workshops with key stakeholders in the Czech health system on the purposes of HSPA, HSPA governance, and the content (domains/indicators) of  the HSPA framework.
  • Organise in-depth, technical focus groups discussions on the data available for HSPA and methodologies for calculation of indicators in the various domains of the HSPA.
  • Organise and carry out meetings with a high-level advisory group representing the core organisations involved in HSPA governance to encourage ownership of the HSPA and its governance.
  • Organise one study visit or an exchange with international experts on HSPA to provide an overview of HSPA in other countries, notably countries with similar roles of public insurers.
  • Incorporate the conclusions of the meetings and discussions, as deemed appropriate by the OECD, into a draft HSPA framework.

Results achieved

The project developed the following outputs:

One report containing:

  1. A description of the HSPA framework for reporting health system performance  indicators
  2. A set of standard methodologies describing key domains/indicators, and the data that is used to calculate these indicator for the HSPA framework.
  3. A description of the governance related the further implementation and use of the HSPA framework.

More about the project

You can read the documents related to the project here: