A major challenge in monitoring universal health coverage (UHC) is identifying an indicator that can adequately capture the multiple components underlying the UHC initiative. Effective coverage, which unites individual and intervention characteristics into a single metric, offers a direct and flexible means to measure health system performance at different levels. We view effective coverage as a relevant and actionable metric for tracking progress towards achieving UHC. In this paper, we review the concept of effective coverage and delineate the three components of the metric — need, use, and quality — using several examples. Further, we explain how the metric can be used for monitoring interventions at both local and global levels. We also discuss the ways that current health information systems can support generating estimates of effective coverage. We conclude by recognizing some of the challenges associated with producing estimates of effective coverage. Despite these challenges, effective coverage is a powerful metric that can provide a more nuanced understanding of whether, and how well, a health system is delivering services to its populations.
Vyšlo v časopise: Effective Coverage: A Metric for Monitoring Universal Health Coverage. PLoS Med 11(9): e32767. doi:10.1371/journal.pmed.1001730 Kategorie: Collection Review prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001730
1. World Health Organization (2010) The world health report - Health systems financing: the path to universal coverage. WHO. Available: http://www.who.int/whr/2010/en/. Accessed 24 October 2013.
2. BennettS, OzawaS, RaoKD (2010) Which Path to Universal Health Coverage? Perspectives on the World Health Report 2010. PLoS Med 7: e1001001 doi:10.1371/journal.pmed.1001001
3. World Health Organization (2013) World health report 2013: Research for universal health coverage. WHO. Available: http://www.who.int/whr/en/. Accessed 24 October 2013.
4. Alfonso EA, Diaz Y, Giedion U (2013) The impact of universal coverage schemes in the developing world: a review of the existing evidence. The World Bank. Available: http://documents.worldbank.org/curated/en/2013/01/17291221/impact-universal-coverage-schemes-developing-world-review-existing-evidence. Accessed 22 October 2013.
5. World Health Organization (n.d.) Monitoring universal health coverage WHO. Available: http://www.who.int/healthinfo/country_monitoring_evaluation/universal_health_coverage/en/. Accessed 8 March 2014.
6. CampbellJ, BuchanJ, ComettoG, DavidB, DussaultG, et al. (2013) Human resources for health and universal health coverage: fostering equity and effective coverage. Bull World Health Organ 91 : 853–863 doi:10.2471/BLT.13.118729
7. KnaulFM, González-PierE, Gómez-DantésO, García-JuncoD, Arreola-OrnelasH, et al. (2012) The quest for universal health coverage: achieving social protection for all in Mexico. Lancet 380 : 1259–1279 doi:10.1016/S0140-6736(12)61068-X
8. O'ConnellT, RasanathanK, ChopraM (2014) What does universal health coverage mean? Lancet 383 : 277–279 doi:10.1016/S0140-6736(13)60955-1
9. Murray CJL (2003) Health Systems Performance Assessment: Debates, Methods and Empiricism. World Health Organization. 919 p.
10. LozanoR, SolizP, GakidouE, Abbott-KlafterJ, FeehanDM, et al. (2006) Benchmarking of performance of Mexican states with effective coverage. Lancet 368 : 1729–1741 doi:10.1016/S0140-6736(06)69566-4
11. LozanoR, NaghaviM, ForemanK, LimS, ShibuyaK, et al. (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380 : 2095–2128 doi:10.1016/S0140-6736(12)61728-0
12. SachsJD (2012) Achieving universal health coverage in low-income settings. Lancet 380 : 944–947 doi:10.1016/S0140-6736(12)61149-0
13. OzgedizD, HsiaR, WeiserT, GosselinR, SpiegelD, et al. (2009) Population Health Metrics for Surgery: Effective Coverage of Surgical Services in Low-Income and Middle-Income Countries. World J Surg 33 : 1–5 doi:10.1007/s00268-008-9799-y
14. SullivanR, PeppercornJ, SikoraK, ZalcbergJ, MeropolNJ, et al. (2011) Delivering affordable cancer care in high-income countries. Lancet Oncol 12 : 933–980 doi:10.1016/S1470-2045(11)70141-3
15. MurrayCJL, RichardsMA, NewtonJN, FentonKA, AndersonHR, et al. (2013) UK health performance: findings of the Global Burden of Disease Study 2010. Lancet 381 : 997–1020 doi:10.1016/S0140-6736(13)60355-4
16. MurrayCJL, AbrahamJ, AliMK, AlvaradoM, AtkinsonC, BaddourLM, et al. (2013) The state of us health, 1990-2010: Burden of diseases, injuries, and risk factors. JAMA 310 : 591–608 doi:10.1001/jama.2013.13805
17. Yang G, Wang Y, Zeng Y, Gao GF, Liang X, et al. (8) Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 381 : 1987–2015 doi:10.1016/S0140-6736(13)61097-1
18. World Health Organization (n.d.) Cost effectiveness and strategic planning (WHO-CHOICE). WHO. Available: http://www.who.int/choice/en/. Accessed 18 December 2013.
19. Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, et al., editors (2006) Disease Control Priorities in Developing Countries. 2nd ed. Washington (DC): World Bank. Available: http://www.ncbi.nlm.nih.gov/books/NBK11728/. Accessed 18 December 2013.
20. SaltmanRB, Ferroussier-DavisO (2000) The concept of stewardship in health policy. Bull World Health Organ 78 : 732–739.
21. VictoraCG, HansonK, BryceJ, VaughanJP (2004) Achieving universal coverage with health interventions. Lancet 364 : 1541–1548 doi:10.1016/S0140-6736(04)17279-6
22. Farzadfar F, Murray CJ, Gakidou E, Bossert T, Namdaritabar H, et al. (7) Effectiveness of diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study. Lancet 379 : 47–54 doi:10.1016/S0140-6736(11)61349-4
23. FentonKA, JohnsonAM, McManusS, ErensB (2001) Measuring sexual behaviour: methodological challenges in survey research. Sex Transm Infect 77 : 84–92 doi:10.1136/sti.77.2.84
24. BoermaJT, HoltE, BlackR (2001) Measurement of Biomarkers in Surveys in Developing Countries: Opportunities and Problems. Popul Dev Rev 27 : 303–314 doi:10.1111/j.1728-4457.2001.00303.x
25. Macro International Inc. (2009) MEASURE DHS. Demographic and Health Surveys. Available: http://www.measuredhs.com/.
26. World Health Organization (2013) Consolidated ARV guidelines 2013 WHO. Available: http://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents_rationale/en/. Accessed 11 March 2014.
27. KaplanRM, GaniatsTG, FroschDL (2004) Diagnostic and Treatment Decisions in US Healthcare. J Health Psychol 9 : 29–40 doi:10.1177/1359105304036100
28. MakinenM, WatersH, RauchM, AlmagambetovaN, BitranR, et al. (2000) Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition. Bull World Health Organ 78 : 55–65 doi:10.1590/S0042-96862000000100006
29. JamesSL, LozanoR, RomeroM, GómezS, RamírezD, et al. (2013) Can computers measure the chronic disease burden using survey questionnaires? The Symptomatic Diagnosis Study. Lancet 381: S65 doi:10.1016/S0140-6736(13)61319-7
30. LimSS, SteinDB, CharrowA, MurrayCJ (2008) Tracking progress towards universal childhood immunisation and the impact of global initiatives: a systematic analysis of three-dose diphtheria, tetanus, and pertussis immunisation coverage. Lancet 372 : 2031–2046 doi:16/S0140-6736(08)61869-3
31. RobertsTJ, CarnahanE, GakidouE (2013) Can breastfeeding promote child health equity? A comprehensive analysis of breastfeeding patterns across the developing world and what we can learn from them. BMC Med 11 : 254 doi:10.1186/1741-7015-11-254
32. BurtonA (2009) WHO and UNICEF estimates of national infant immunization coverage: methods and processes. Bull World Health Organ 87 : 535–541 doi:10.2471/BLT.08.053819
33. FlaxmanAD, FullmanN, OttenMWJr, MenonM, CibulskisRE, et al. (2010) Rapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: a systematic synthesis of supply, distribution, and household survey data. PLoS Med 7: e1000328 doi:10.1371/journal.pmed.1000328
34. World Health Organization (2012) World Malaria Report 2011 WHO. Available: http://www.who.int/malaria/publications/atoz/9789241564403/en/index.html. Accessed 1 November 2013.
35. DonabedianA (2005) Evaluating the Quality of Medical Care. Milbank Q 83 : 691–729 doi:10.1111/j.1468-0009.2005.00397.x
36. DonabedianA (1978) The quality of medical care. Science 200 : 856–864.
37. Roemer MI, Montoya-Aguilar C, Organization WH (1988) Quality assessment and assurance in primary health care/M. I. Roemer and C. Montoya-Aguilar. Available: http://apps.who.int/iris/handle/10665/40663. Accessed 2 November 2013.
38. FentonJJ, JerantAF, BertakisKD, FranksP (2012) The cost of satisfaction: A national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med 172 : 405–411 doi:10.1001/archinternmed.2011.1662
39. PebodyR, GayN, HeskethL, VyseA, Morgan-CapnerP, et al. (2002) Immunogenicity of second dose measles–mumps–rubella (MMR) vaccine and implications for serosurveillance. Vaccine 20 : 1134–1140 doi:10.1016/S0264-410X(01)00435-2
40. SterneJA, HernánMA, LedergerberB, TillingK, WeberR, et al. (2005) Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study. Lancet 366 : 378–384 doi:10.1016/S0140-6736(05)67022-5
41. VerguetS, LimSS, MurrayCJL, GakidouE, SalomonJA (2013) Incorporating Loss to Follow-up in Estimates of Survival Among HIV-Infected Individuals in Sub-Saharan Africa Enrolled in Antiretroviral Therapy Programs. J Infect Dis 207 : 72–79 doi:10.1093/infdis/jis635
42. EiseleTP, LarsenDA, AnglewiczPA, KeatingJ, YukichJ, et al. (2012) Malaria prevention in pregnancy, birthweight, and neonatal mortality: a meta-analysis of 32 national cross-sectional datasets in Africa. Lancet Infect Dis 12 : 942–949 doi:10.1016/S1473-3099(12)70222-0
43. WongK, CampitelliMA, StukelTA, KwongJC (2012) Estimating influenza vaccine effectiveness in community-dwelling elderly patients using the instrumental variable analysis method. Arch Intern Med 172 : 484–491 doi:10.1001/archinternmed.2011.2038
44. StraneyLD, LimSS, MurrayCJL (2012) Disentangling the Effects of Risk Factors and Clinical Care on Subnational Variation in Early Neonatal Mortality in the United States. PLoS ONE 7: e49399 doi:10.1371/journal.pone.0049399
45. YipWC-M, HsiaoWC, ChenW, HuS, MaJ, et al. (2012) Early appraisal of China's huge and complex health-care reforms. Lancet 379 : 833–842 doi:10.1016/S0140-6736(11)61880-1
46. ReddyKS, PatelV, JhaP, PaulVK, KumarAS, et al. (2011) Towards achievement of universal health care in India by 2020: a call to action. Lancet 377 : 760–768 doi:10.1016/S0140-6736(10)61960-5
47. FrenkJ, González-PierE, Gómez-DantésO, LezanaMA, KnaulFM (2006) Comprehensive reform to improve health system performance in Mexico. Lancet 368 : 1524–1534 doi:10.1016/S0140-6736(06)69564-0
48. Monitoring Disparities in Chronic Conditions Study: The MDCC Study (2013). Available: http://www.healthmetricsandevaluation.org/research/project/monitoring-disparities-chronic-conditions-study-mdcc-study. Accessed 30 October 2013.
49. Kingdom of Saudi Arabia Health Tracking (2013). Available: http://www.healthmetricsandevaluation.org/research/project/kingdom-saudi-arabia-health-tracking. Accessed 30 October 2013.
50. HajjarI, KotchenTA (2003) Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA 290 : 199–206 doi:10.1001/jama.290.2.199
51. FangP, DongS, XiaoJ, LiuC, FengX, et al. (2010) Regional inequality in health and its determinants: Evidence from China. Health Policy 94 : 14–25 doi:10.1016/j.healthpol.2009.08.002
52. Barraza-LlorénsM, BertozziS, González-PierE, GutiérrezJP (2002) Addressing Inequity In Health And Health Care In Mexico. Health Aff (Millwood) 21 : 47–56 doi:10.1377/hlthaff.21.3.47
53. MackenbachJP, KunstAE, CavelaarsAE, GroenhofF, GeurtsJJ (1997) Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet 349 : 1655–1659 doi:10.1016/S0140-6736(96)07226-1
54. SrebotnjakT, MokdadAH, MurrayCJ (2010) A novel framework for validating and applying standardized small area measurement strategies. Popul Health Metr 8 : 26 doi:10.1186/1478-7954-8-26
Zvýšte si kvalifikáciu online z pohodlia domova
Nemáte účet? Registrujte sa
Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.
