Tracking health system performance in times of crisis using routine health data: lessons learned from a multicountry consortium

Health Research Policy and Systems

Commentary

Tarylee Reddy¹  Georgiana Gordon-Strachan²  Anna Gage³  Neena R. Kapoor³  Catherine Arsenault³  Anne-Marie Turcotte-Tremblay⁴  Sebastian Bauhoff⁵  Margaret E. Kruk⁵  Ricardo Enrique Perez Cuevas⁶  Svetlana V. Doubova⁷  Borwornsom Leerapan⁸  Phanuwich Kaewkamjornchai⁸  Thanitsara Rittiphairoj⁸  Jean Paul Joseph⁹  Soo Kyung Park^1,10  Suresh Mehata^1,11  Solomon Kassahun Gelaw^1,12  Mahesh Dulal^1,13  Freddie Amponsah^1,14  Paula Margozzini^1,15  Alvaro Passi-Solar^1,15  Jaime C. Sapag^1,15  Boikhutso Tlou^1,16  Londiwe Mthethwa^1,16  Damen Haile-Mariam^1,17  Wondimu Ayele^1,17  Adiam Nega^1,17  John Koku Awoonor-Williams^1,18  Dominic Dormenyo Gadeka^1,18  Patricia Akweongo^1,18  Roody Thermidor^1,19  Amit Aryal^2,20  Min Kyung Kim^2,21  Juhwan Oh^2,22  Shogo Kubota^2,23  Daisuke Asai^2,23 

[1] Biostatistics Unit, South African Medical Research Council, Durban, South Africa;Caribbean Institute for Health Research, University of West Indies, Kingston, Jamaica;Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 401 Park Drive, 3Rd Floor East, room L3-015A5, Landmark Center, 02215, Boston, MA, USA;Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 401 Park Drive, 3Rd Floor East, room L3-015A5, Landmark Center, 02215, Boston, MA, USA;Université Laval, Québec, Canada;Department of Global Health and Population, Harvard University, Boston, USA;Division of Social Protection and Health, Inter-American Development Bank, Kingston, Jamaica;Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico;Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;Hôpital Universitaire de Mirebalais, Zanmi Lasante, Arrondissement de Mirebalais, Haïti;Korea National Health Insurance Services, Health Insurance Research Institute, Wonju, Gangwon-Do, South Korea;Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal;Ministry of Health of Ethiopia, Addis Ababa, Ethiopia;Office of the Member of Federal Parliament Gagan Kumar Thapa, Kathmandu, Nepal;Policy, Planning, Monitoring and Evaluation, Ghana Health Services, Accra, Ghana;Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa;School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;School of Public Health, University of Ghana, Accra, Ghana;Studies and Planning Unit, Ministry of Public Health and Population, Port-Au-Prince, Haiti;Swiss TPH, University of Basel, Basel, Switzerland;Tufts Clinical and Translational Science Institute, Boston, USA;Tufts Clinical and Translational Science Institute, Boston, USA;Seoul National University College of Medicine, Seoul, South Korea;World Health Organization, Vientiane, Lao People’s Democratic Republic;

关键词: Routine health information systems;    Health systems;    Quality of care;    COVID-19;   

DOI  :  10.1186/s12961-022-00956-6

 received in 2022-03-29, accepted in 2022-12-28,  发布年份 2022

来源: Springer

【 摘 要 】

COVID-19 has prompted the use of readily available administrative data to track health system performance in times of crisis and to monitor disruptions in essential healthcare services. In this commentary we describe our experience working with these data and lessons learned across countries. Since April 2020, the Quality Evidence for Health System Transformation (QuEST) network has used administrative data and routine health information systems (RHIS) to assess health system performance during COVID-19 in Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, Republic of Korea and Thailand. We compiled a large set of indicators related to common health conditions for the purpose of multicountry comparisons. The study compiled 73 indicators. A total of 43% of the indicators compiled pertained to reproductive, maternal, newborn and child health (RMNCH). Only 12% of the indicators were related to hypertension, diabetes or cancer care. We also found few indicators related to mental health services and outcomes within these data systems. Moreover, 72% of the indicators compiled were related to volume of services delivered, 18% to health outcomes and only 10% to the quality of processes of care. While several datasets were complete or near-complete censuses of all health facilities in the country, others excluded some facility types or population groups. In some countries, RHIS did not capture services delivered through non-visit or nonconventional care during COVID-19, such as telemedicine. We propose the following recommendations to improve the analysis of administrative and RHIS data to track health system performance in times of crisis: ensure the scope of health conditions covered is aligned with the burden of disease, increase the number of indicators related to quality of care and health outcomes; incorporate data on nonconventional care such as telehealth; continue improving data quality and expand reporting from private sector facilities; move towards collecting patient-level data through electronic health records to facilitate quality-of-care assessment and equity analyses; implement more resilient and standardized health information technologies; reduce delays and loosen restrictions for researchers to access the data; complement routine data with patient-reported data; and employ mixed methods to better understand the underlying causes of service disruptions.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3