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Observatorio Europeo sobre Sistemas Sanitarios

Observatorio Europeo sobre Sistemas Sanitarios. Suszy Lessof Allicante, 26 May 2003 European Observatory on Health Care Systems www.observatory.dk. Contexto. Desafios/retos sanitarios comunes Globalizacion de las presiones

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Observatorio Europeo sobre Sistemas Sanitarios

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  1. Observatorio Europeo sobre Sistemas Sanitarios Suszy Lessof Allicante, 26 May 2003 European Observatory on Health Care Systems www.observatory.dk

  2. Contexto • Desafios/retos sanitarios comunes • Globalizacion de las presiones • Escasa evidencia sobre la efectividad real de muchas politicas sanitarias • La informacion disponible carece de relevancia para politicos sanitarios y agencias

  3. Respuestas • Convergencia en las estrategias adoptadas • Transferencia de modelos, reformas e ideas a traves de contextos socio-economicos, culturales distintos • Reforma rica en ideologia pero pobre en conocimiento • Politica sanitaria basada en la evidencia • Observatorios

  4. Politica sanitaria basada en la evidencia “A new drug cannot be introduced…without exhaustive scientific trials, but we usually introduce new ways of delivering health services with little or no scientific evaluation … If health care system changes were submitted to the same scrutiny as new drug evaluations, they would probably not even be allowed to move from the animal to the human experimentation stage”. Source: Hiullman 1998

  5. Politica sanitaria basada en la evidencia • De la ‘torre de marfil’ academica • Es necesaria mas investigacion • El jurado todavia esta deliberando • Demasiado pronto a comentar, …. • A la politica reactiva del dia a dia • Agenda politica • Electoral pressures - short termism, ideology • Necesidad de resultados ‘quick and dirty’ a corto plazo

  6. Un papel del Observatorios • Analisis comprensivo- disponibilidad de informacion en areas claves • Analisis riguroso - calidad scientifico • Oportuno -timely • Relevancia (pertinente, relacionado, apropriado) to policy maker’s needs • Accesible - target dissemination /communication

  7. Un papel del Observatorios • Cubrir el gap entre la evidencia y la politica sanitaria • Regional • Nacional • Internacional

  8. Observatorio Europeo sobre Sistemas Sanitarios Organizacion Mundial de la Salud Oficina Europea Gobierno de Espana Gobierno de Noruega Gobierno de Grecia Banco Mundial Open Society Institute Banco Europeo de Inversiones London School of Economics and Political Science London School of Hygiene & Tropical Medicine

  9. Mision del Observatorio Europeo • El Observatorio Europeo sobre sistemas sanitarios apoya y promueve la politica sanitaria basada en la evidencia a traves del analisis comprensivo y riguroso de los sistemas sanitarios en Europa

  10. Principios centrales • Cubrir el espacio entre la evidencia cientifica y las necesidades de los politicos sanitarios • Analisis comparativo de la evidencia existente • Desarrollo de lecciones practicas y alternativas en politica sanitaria

  11. Comparaciones internacionales “Most countries are dealing with health care reforms as if each was on Mars. Few have tried to learn from others. (...) Instead of each country trying out its own experiments, they should be studying each others for ideas and pitfalls.” The Economist (1991)

  12. Comparaciones internacionales International differences in health care systems and approaches to reform can provide analysts with a “natural experiment”, which, if rigorously analysed, can facilitate learning from other countries’ successes and failures.

  13. Actividades / Productos 1. Informacion por paises / Monitorizacion 2. Analisis 3. Diseminacion

  14. 1.Informacion por paises / Monitorizacion • Production of HiTs Sistemas Sanitarios en Transition; perfiles por pais • HiT Summaries • Living HiTs • Glossary (printed and on-line) • HiT template revision wide consultation

  15. HiTs • Analytical description of health systems organization, finance and delivery, and reforms in European countries • Full coverage of region + other key OECD countries • Routine and systematic update every 2/3 years • Approximately 20 profiles per year • Use of common template and standard set of definitions • Integrate quantitative data from existing databases • WHO, OECD, World Bank, EUROSTAT • Methodological challenges

  16. HiTs • Wide usage • Comparative analysis of experience across countries • Develop options for reform • Identify key experiences / in-depth analysis • Facilitate country technical support • Capacity building at country level • Monitor content and implementation of reforms

  17. HiTs • Have increasingly become the standard approach to look at health systems • Accepted and used by other international organizations • Widely used and replicated in other regions

  18. 2. Analisis • Key priority health system areas • Systematic conceptual framework • Comparaciones sub-regionales • Meta-analytical research • Synthesis of existing evidence • Brings networks of experts

  19. 2. Analysis / Estudios Analiticos • El papel apropriado del hospital • Regulacion del entrepreneurial behaviour • Financiacion sanitaria: options in Europe • Republicas Centro-Asiaticas

  20. 2. Analisis / Estudios underway • Sistemas de Seguro Sanitario en Europa Occidental • Paises en accesion en Europa del Este • Effective purchasing (contratacion) for health care • Primary care in the driving seat

  21. 2. Analysis / Estudios underway • Farmaceuticos • Mental health • Recursos Humanos • Decentralizacion

  22. 2. Analisis • Uptake of results and positive response • Builds on, complements and works with other organizations

  23. 3. Diseminacion Engaging with policy makers • Publicaciones • HiTs • Observatory OUP book series • Policy briefs • Newsletter: Euro Observer • Journal: Eurohealth • Translations • Journal articles

  24. 3. Diseminacion Engaging with policy makers • Web and listserve • 120,000 separate visitors in 2002 • Close to 1 million visits • Over 100,000 downloads • List serve approx 2,400 subscribers from 98 countries

  25. 3. Diseminacion Engaging with policy makers • International expert conferences • E.g. Annual sessions in EUPHA, EHMA, Gastein • Participation in key networks • National conferences & country meetings • Workshops and seminars for policy makers • HiT and study launches

  26. Structure, organization and staffing • Role of the Observatory partners • Steering committee • Project / matrix based management • Secretariat / Research Directors • Geographical hubs (30 staff FTE)

  27. Desafios y Lecciones • De las grandes ideas de la reforma ….. a la evidencia para la puesta en practica. • Retos metodologicos • Definicion • Evaluacion de desempeño • Medicion de impacto de los sistemas • Retos de diseminacion • Relevancia y objetividad

  28. Desafios y Lecciones • Informacion como un bien publico • Crear masa critica entre organizaciones para utilizar recursos limitados • Colaboracion y partnership no es solo deseable sino tambien necesario

  29. The European Observatory • Evidence for policy making • Comparative approach • Partnerships (technical, political, institutional) • Expert and policy makers networks • Focus on dissemination • No normative / policy agenda • Una filosofia fundada en la colaboracion

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