Developing Strategies for Improving Health Care Delivery : Guide to Concepts, Determinants, Measurement, and Intervention Design
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World Bank, Washington, DC
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This report is a user's guide for
defining, measuring, and improving the performance of health
service delivery organizations. The authors define six core
performance domains: quality, efficiency, utilization,
access, learning, and sustainability and provide a
compendium of metrics that have been used to measure
organizational performance in each of these six domains. The
compendium, which includes 116 distinct categories of
metrics, is based on a detailed literature review of
peer-reviewed empirical studies of health care
organizational performance in World Bank client countries.
Based on reading of the literature, the authors define seven
major strategy areas potentially useful for improving
performance among health care organizations: 1) standards
and guidelines, 2) organizational design, 3) education and
training, 4) process improvement and technology and tool
development, 5) incentives, 6) organizational culture, and
7) leadership and management. The authors provide
illustrations of facility-level interventions within each of
the strategy areas and highlight the conditions under which
certain strategies may be more effective than others. The
authors propose that the choice of strategy targeted at
organizational level to improve performance should be
informed by the identified root causes of the problem, the
implementation capabilities of the organization, and the
environmental conditions faced by the organization.
Palabras clave
ACCESS TO HEALTH SERVICES, ACHIEVEMENT, ADAPTATION, ADMINISTRATIVE SYSTEMS, ANTENATAL CARE, ATTENTION, BELIEFS, BEST PRACTICE, BEST PRACTICES, BURNS, CAPABILITIES, CAPABILITY, CLINICAL GUIDELINES, CLINICS, COGNITION, COGNITIVE PSYCHOLOGY, COMPETENCIES, CONDITIONING, CUSTOMER SATISFACTION, DECISION MAKING, DELIVERY SYSTEM, DELIVERY SYSTEMS, DOCTORS, DOMAIN, DOMAINS, ECOLOGY, ECONOMIC MODELS, ECONOMIC THEORIES, ECONOMICS, ECONOMISTS, EMPIRICAL EVIDENCE, EMPIRICAL STUDIES, ENABLING ENVIRONMENT, ENVIRONMENTAL, ENVIRONMENTAL FACTORS, ENVIRONMENTS, EPIDEMIOLOGICAL TRANSITION, EQUIPMENT, ETHICS, EXPLOITATION, FINANCIAL MANAGEMENT, FINANCIAL RESOURCES, FINANCIAL RISK, FINANCIAL SUPPORT, GENDER, GEOGRAPHIC REGION, GROUP DYNAMICS, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE DELIVERY, HEALTH CARE FACILITIES, HEALTH CARE ORGANIZATIONS, HEALTH CARE SERVICES, HEALTH CARE WORKERS, HEALTH CLINICS, HEALTH FACILITIES, HEALTH MANAGEMENT, HEALTH OUTCOMES, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEM PERFORMANCE, HEALTH SYSTEMS, HEALTH SYSTEMS RESEARCH, HEALTH WORKFORCE, HORIZONTAL INTEGRATION, HOSPITAL MANAGEMENT, HOSPITALS, HUMAN BEHAVIOR, HUMAN DEVELOPMENT, HUMAN RESOURCE, HUMAN RESOURCE MANAGEMENT, HUMAN RESOURCES, IMMUNIZATION, INCOME, INDIVIDUAL BEHAVIOR, INFORMATION FLOW, INFORMATION SYSTEMS, INFORMATION TECHNOLOGY, INNOVATION, INSURANCE, INTEGRATION, INTERFACE, INTERNAL DATA, INTERNATIONAL STANDARDS, INTERVENTION, LAWS, LEADERSHIP, LEARNING, LEGAL STANDARDS, LEGAL SYSTEMS, MARKET COMPETITION, MATERIAL, MEDICAL CARE, MEDICAL RECORDS, MEDICAL SUPPLIES, MODELING, MOTIVATION, NEEDS ASSESSMENT, NETWORKS, NEW TECHNOLOGY, NURSES, NUTRITION, OPEN SYSTEM, OPEN SYSTEMS, OPPORTUNITY COSTS, ORGANIZATIONAL OBJECTIVES, ORGANIZATIONAL PSYCHOLOGY, PATIENT, PATIENT SATISFACTION, PATIENTS, PERCEPTION, PERFORMANCE MEASURES, PHARMACIES, PHARMACISTS, PHYSICIAN, PHYSICIANS, POLICY MAKERS, PREGNANT WOMEN, PROBLEM SOLVING, PROCUREMENT, PRODUCTION FUNCTIONS, PROTOCOLS, PROVIDER PAYMENT, PSYCHOLOGY, PUBLIC HEALTH, PUBLIC HOSPITALS, QUALITY MANAGEMENT, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, QUALITY OF SERVICE, REGULATORY ENVIRONMENT, RELIABILITY, RESULT, RESULTS, SOCIAL SERVICES, SOCIALIZATION, SUPERVISION, SUPPLY CHAIN, SUPPLY CHAIN MANAGEMENT, SUPPORT STAFF, TARGETS, TAXONOMY, TECHNICAL EXPERTISE, TECHNICAL KNOWLEDGE, TECHNICAL STANDARDS, TECHNOLOGICAL INNOVATION, THERAPY, THINKING, TRANSACTION, USER, USERS, USES, VACCINATION, WASTE, WASTE DISPOSAL, WORKERS, WORKING CONDITIONS