Editing Health system

{{Short description|Organization of people, institutions and resources}}
{{Use dmy dates|date=December 2015}}

A '''health system''', '''health care system''' or '''healthcare system''' is an [[organization]] of people, institutions, and resources that delivers [[health care]] services to meet the [[health]] needs of target populations.

There is a wide variety of health systems around the world, with as many histories and [[organizational structure]]s as there are countries. Implicitly, countries must design and develop health systems in accordance with their needs and resources, although common elements in virtually all health systems are [[Primary health care|primary healthcare]] and [[public health]] measures.<ref>{{cite journal | author = White F | year = 2015 | title = Primary health care and public health: foundations of universal health systems | url= | journal = Med Princ Pract | volume = 24 | issue = 2| pages = 103–116 | doi = 10.1159/000370197 | pmid = 25591411 | pmc = 5588212 }}</ref>

In certain countries, the orchestration of health system planning is decentralized, with various stakeholders in the market assuming responsibilities. In contrast, in other regions, a collaborative endeavor exists among governmental entities, labor unions, philanthropic organizations, religious institutions, or other organized bodies, aimed at the meticulous provision of healthcare services tailored to the specific needs of their respective populations. Nevertheless, it is noteworthy that the process of healthcare planning is frequently characterized as an evolutionary progression rather than a revolutionary transformation.<ref name="liverpool-ha.org.uk">{{cite web |url=http://www.liverpool-ha.org.uk/health-care-system.html |title=''Health care system'' |publisher=Liverpool-ha.org.uk |access-date=6 August 2011 |archive-date=25 January 2021 |archive-url=https://web.archive.org/web/20210125051013/http://www.liverpool-ha.org.uk/health-care-system.html |url-status=live }}</ref><ref>[http://www.newyorker.com/reporting/2009/01/26/090126fa_fact_gawande?currentPage=all ''New Yorker'' magazine article: "Getting there from here."] {{Webarchive|url=https://web.archive.org/web/20140528144041/http://www.newyorker.com/reporting/2009/01/26/090126fa_fact_gawande?currentPage=all |date=28 May 2014 }} 26 January 2009</ref>

As with other social institutional structures, health systems are likely to reflect the history, culture and economics of the states in which they evolve. These peculiarities bedevil and complicate international comparisons and preclude any universal standard of performance.

==Goals==
According to the [[World Health Organization]] (WHO), the directing and coordinating authority for health within the United Nations system, healthcare systems' goals are good health for the citizens, responsiveness to the expectations of the population, and fair means of funding operations. Progress towards them depends on how systems carry out four vital functions: [[health care provider|provision of health care services]], resource generation, financing, and stewardship.<ref name="WHO2000">World Health Organization. (2000). ''World Health Report 2000 – Health systems: improving performance.'' Geneva, WHO [https://web.archive.org/web/20041120024127/http://www.who.int/whr/2000/en/index.html]</ref> Other dimensions for the evaluation of health systems include quality, efficiency, acceptability, and [[health equity|equity]].<ref name="liverpool-ha.org.uk"/> They have also been described in the United States as "the five C's": Cost, Coverage, Consistency, Complexity, and [[Chronic condition|Chronic Illness]].<ref>[http://web.jhu.edu/president/speeches/2007/health.html Remarks by Johns Hopkins University President William Brody: "Health Care '08: What's Promised/What's Possible?"] {{Webarchive|url=https://web.archive.org/web/20090211053444/http://web.jhu.edu/president/speeches/2007/health.html |date=11 February 2009 }} 7 September 2007</ref> Also, [[continuity of health care]] is a major goal.<ref name=cook2000>{{Cite journal | last1 = Cook | first1 = R. I. | last2 = Render | first2 = M. | last3 = Woods | first3 = D. | doi = 10.1136/bmj.320.7237.791 | title = Gaps in the continuity of care and progress on patient safety | journal = BMJ | volume = 320 | issue = 7237 | pages = 791–794 | year = 2000 | pmid =  10720370| pmc =1117777 }}</ref>

==Definitions==
Often health system has been defined with a reductionist perspective. Some authors<ref name="Frenk Global Health">{{cite journal | pmc = 2797599 | pmid=20069038 | doi=10.1371/journal.pmed.1000089 | volume=7 | issue=1 | title=The global health system: strengthening national health systems as the next step for global progress | year=2010 | journal=PLOS Med. | pages=e1000089 | author = Frenk J | doi-access=free }}</ref> have developed arguments to expand the concept of health systems, indicating additional dimensions that should be considered:
* Health systems should not be expressed in terms of their components only, but also of their interrelationships;
* Health systems should include not only the institutional or supply side of the health system but also the population;
* Health systems must be seen in terms of their goals, which include not only health improvement, but also [[Health equity|equity]], responsiveness to legitimate expectations, respect of dignity, and fair financing, among others;
* Health systems must also be defined in terms of their functions, including the direct provision of services, whether they are medical or public health services, but also "other enabling functions, such as stewardship, financing, and resource generation, including what is probably the most complex of all challenges, the health workforce."<ref name="Frenk Global Health"/>

===World Health Organization ===
The World Health Organization defines health systems as follows:
{{blockquote|A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is, therefore, more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behaviour change programmes; vector-control campaigns; health insurance organizations; occupational health and safety legislation. It includes inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, a well-known determinant of better health.<ref>{{cite web|publisher=WHO|year=2007|title=Everybody's business. Strengthening health systems to improve health outcomes : WHO's framework for action|url=https://www.who.int/healthsystems/strategy/everybodys_business.pdf|access-date=4 October 2020|archive-date=28 December 2021|archive-url=https://web.archive.org/web/20211228143304/https://www.who.int/healthsystems/strategy/everybodys_business.pdf|url-status=live}}</ref>}}

==Financial resources==
{{See also|Single-payer health care|Universal health care|National health insurance}}

[[File:NorfolkAndNorwichUniversityHospital(KatyAppleton)Aug2005.jpg|thumb|upright=0.9|[[Norfolk and Norwich University Hospital]], a [[National Health Service]] hospital in the [[United Kingdom]]]]
There are generally five primary methods of funding health systems:<ref name="WHO2">[http://www.searo.who.int/EN/Section1243/Section1382/Section1731.htm "Regional Overview of Social Health Insurance in South-East Asia] {{webarchive|url=https://web.archive.org/web/20070224050244/http://www.searo.who.int/en/Section1243/Section1382/Section1731.htm|date=24 February 2007}}, [[World Health Organization]]. And [http://whqlibdoc.who.int/searo/2004/SEA_HSD_274_eng.pdf] {{Webarchive|url=https://web.archive.org/web/20120903195354/http://whqlibdoc.who.int/searo/2004/SEA_HSD_274_eng.pdf|date=3 September 2012}}. Retrieved 18 August 2006.</ref>

# general [[Tax|taxation]] to the state, county or municipality
# [[national health insurance]]
# voluntary or private [[health insurance]]
# [[Out-of-pocket expense|out-of-pocket payments]]
# [[donation]]s to [[Charitable organization|charities]]

{| class="wikitable"
|+Healthcare models
!
! colspan="2" |Universal
! colspan="2" |Non-universal
|-
!
![[Single-payer healthcare|Single payer]]
!Multi-payer
!Multi-payer
!No insurance
|-
![[Public hospital|Single provider]]
|[[Beveridge model|Beveridge Model]], [[Semashko model]]
|
|
|
|-
![[Private hospital|Multiple Providers]]
|[[National health insurance|National Health Insurance]]
|[[Bismarck model]]
|Private health insurance
|[[Out-of-pocket expense|Out-of-pocket]]
|}
Most countries' systems feature a mix of all five models. One study<ref>[[Sherry Glied|Glied, Sherry A.]] [http://papers.nber.org/papers/w13881 "Health Care Financing, Efficiency, and Equity."] {{Webarchive|url=https://web.archive.org/web/20120224220954/http://papers.nber.org/papers/w13881 |date=24 February 2012 }} ''National Bureau of Economic Research'', March 2008. Accessed 20 March 2008.</ref> based on data from the [[OECD]] concluded that all types of health care finance "are compatible with" an efficient health system. The study also found no relationship between financing and cost control.{{citation needed|date=June 2023}} Another study examining single payer and multi payer systems in OECD countries found that single payer systems have significantly less hospital beds per 100,000 people than in multi payer systems.<ref>{{cite web |last1=Bengali |first1=Shawn M |title=A COMPARISON OF HOSPITAL CAPACITIES BETWEEN SINGLE-PAYER AND MULTIPAYER HEALTHCARE SYSTEMS AMONG OECD NATIONS |url=https://repository.library.georgetown.edu/bitstream/handle/10822/1062290/Bengali_georgetown_0076M_14878.pdf?sequence=1&isAllowed=y |access-date=5 July 2024 |location=Washington, D.C. |date=April 13, 2021}}</ref>

The term health insurance is generally used to describe a form of [[insurance]] that pays for medical expenses. It is sometimes used more broadly to include insurance covering [[Disability insurance|disability]] or [[Long-term care insurance|long-term nursing or custodial care]] needs. It may be provided through a [[social insurance]] program, or from private insurance companies. It may be obtained on a group basis (e.g., by a firm to cover its employees) or purchased by individual consumers. In each case premiums or taxes protect the insured from high or unexpected health care expenses.{{citation needed|date=August 2022}}

Through the calculation of the comprehensive cost of healthcare expenditures, it becomes feasible to construct a standard financial framework, which may involve mechanisms like monthly premiums or annual taxes. This ensures the availability of funds to cover the healthcare benefits delineated in the insurance agreement. Typically, the administration of these benefits is overseen by a government agency, a nonprofit health fund, or a commercial corporation.<ref>[http://www.kff.org/insurance/upload/How-Private-Insurance-Works-A-Primer-Report.pdf How Private Insurance Works: A Primer] {{webarchive|url=https://web.archive.org/web/20081221100523/http://www.kff.org/insurance/upload/How-Private-Insurance-Works-A-Primer-Report.pdf |date=21 December 2008 }} by Gary Claxton, Institution for Health Care Research and Policy, Georgetown University, on behalf of the Henry J. Kaiser Family Foundation</ref>

Many commercial health insurers control their costs by restricting the benefits provided, by such means as [[deductible]]s, [[Copayment|copayments]], [[co-insurance]], policy exclusions, and total coverage limits. They will also severely restrict or refuse coverage of pre-existing conditions. Many government systems also have co-payment arrangements but express exclusions are rare or limited because of political pressure. The larger insurance systems may also negotiate fees with providers.{{citation needed|date=June 2023}}

Many forms of social insurance systems control their costs by using the bargaining power of the community they are intended to serve to control costs in the health care delivery system. They may attempt to do so by, for example, negotiating drug prices directly with pharmaceutical companies, negotiating standard fees with the medical profession, or reducing [[unnecessary health care]] costs. Social systems sometimes feature contributions related to earnings as part of a system to deliver [[universal health care]], which may or may not also involve the use of commercial and non-commercial insurers. Essentially the wealthier users pay proportionately more into the system to cover the needs of the poorer users who therefore contribute proportionately less. There are usually caps on the contributions of the wealthy and minimum payments that must be made by the insured (often in the form of a minimum contribution, similar to a deductible in commercial insurance models).{{citation needed|date=March 2024}}

In addition to these traditional health care financing methods, some lower income countries and development partners are also implementing non-traditional or [[innovative financing]] mechanisms for scaling up delivery and sustainability of health care,<ref>{{cite journal|last=Bloom|first=G|title=Markets, Information Asymmetry And Health Care: Towards New Social Contracts|journal=Social Science and Medicine|year=2008|volume=66|issue=10|pages=2076–2087|url=http://www.futurehealthsystems.org/publications/markets-information-asymmetry-and-health-care-towards-new-so.html|access-date=26 May 2012|doi=10.1016/j.socscimed.2008.01.034|pmid=18316147|display-authors=etal|archive-date=27 April 2021|archive-url=https://web.archive.org/web/20210427220501/http://www.futurehealthsystems.org/publications/markets-information-asymmetry-and-health-care-towards-new-so.html|url-status=dead|url-access=subscription}}</ref> such as micro-contributions, [[Public–private partnership|public-private partnerships]], and market-based [[financial transaction tax]]es. For example, as of June 2011, [[Unitaid]] had collected more than one billion dollars from 29 member countries, including several from Africa, through an air ticket solidarity levy to expand access to care and treatment for HIV/AIDS, tuberculosis and malaria in 94 countries.<ref name="UNITAID">UNITAID. [http://www.unitaid.eu/en/resources/news/347-republic-of-guinea-introduces-air-solidarity-levy-to-fight-aids-tb-and-malaria.html ''Republic of Guinea Introduces Air Solidarity Levy to Fight AIDS, TB and Malaria.''] {{webarchive|url=https://web.archive.org/web/20111112114051/http://www.unitaid.eu/en/resources/news/347-republic-of-guinea-introduces-air-solidarity-levy-to-fight-aids-tb-and-malaria.html |date=12 November 2011 }} Geneva, 30 June 2011. Accessed 5 July 2011.</ref>

===Payment models===
In most countries, [[wage]] costs for healthcare practitioners are estimated to represent between 65% and 80% of renewable health system expenditures.<ref>Saltman RB, Von Otter C. ''Implementing Planned Markets in Health Care: Balancing Social and Economic Responsibility''. Buckingham: Open University Press 1995.</ref><ref>{{cite journal | author = Kolehamainen-Aiken RL | year = 1997 | title = Decentralization and human resources: implications and impact | journal = Human Resources for Health Development | volume = 2 | issue = 1| pages = 1–14 }}</ref> There are three ways to pay medical practitioners: fee for service, capitation, and salary. There has been growing interest in blending elements of these systems.<ref name="docteur/oxley"/>

====Fee-for-service====
[[Fee-for-service]] arrangements pay [[general practitioner]]s (GPs) based on the service.<ref name="docteur/oxley"/> They are even more widely used for specialists working in [[ambulatory care]].<ref name="docteur/oxley"/>

There are two ways to set fee levels:<ref name="docteur/oxley">{{cite web|url=http://www.oecd.org/dataoecd/5/53/22364122.pdf|title=Health-Care Systems: Lessons from the Reform Experience|publisher=OECD|author1=Elizabeth Docteur|author2=Howard Oxley|year=2003|access-date=22 January 2009|archive-date=22 December 2015|archive-url=https://web.archive.org/web/20151222130354/http://www.oecd.org/dataoecd/5/53/22364122.pdf|url-status=live}}</ref>
* By individual practitioners.
* Central negotiations (as in Japan, Germany, Canada and in France) or hybrid model (such as in Australia, France's sector 2, and New Zealand) where GPs can charge extra fees on top of standardized patient reimbursement rates.

====Capitation====
In [[Capitation (healthcare)|capitation payment systems]], GPs are paid for each patient on their "list", usually with adjustments for factors such as age and gender.<ref name="docteur/oxley"/> According to OECD (Organization for Economic Co-operation and Development), "these systems are used in Italy (with some fees), in all four countries of the United Kingdom (with some fees and allowances for specific services), Austria (with fees for specific services), Denmark (one third of income with remainder fee for service), Ireland (since 1989), the Netherlands (fee-for-service for privately insured patients and public employees) and Sweden (from 1994). Capitation payments have become more frequent in "managed care" environments in the United States."<ref name="docteur/oxley"/>

According to OECD, "capitation systems allow funders to control the overall level of primary health expenditures, and the allocation of funding among GPs is determined by patient registrations". However, under this approach, GPs may register too many patients and under-serve them, select the better risks and refer on patients who could have been treated by the GP directly. Freedom of [[consumer choice]] over doctors, coupled with the principle of "money following the patient" may moderate some of these risks. Aside from selection, these problems are likely to be less marked than under salary-type arrangements.'{{citation needed|date=August 2022}}

====Salary arrangements====
In several OECD countries, general practitioners (GPs) are employed on ''[[salary|salaries]]'' for the government.<ref name="docteur/oxley"/> According to OECD, "Salary arrangements allow funders to control primary care costs directly; however, they may lead to under-provision of services (to ease workloads), excessive referrals to secondary providers and lack of attention to the preferences of patients."<ref name="docteur/oxley"/> There has been movement away from this system.<ref name="docteur/oxley"/>

====Value-based care====
In recent years, providers have been switching from fee-for-service payment models to a [[Pay for performance (healthcare)|value-based care]] payment system, where they are compensated for providing value to patients. In this system, providers are given incentives to close gaps in care and provide better quality care for patients.
<ref>{{Cite web |url=https://measuresmanager.com/blogs/articles/the-what-why-and-how-of-the-value-based-healthcare-model |title=What is Value-Based Care and How to Make the Transition - Measures Manager |access-date=13 May 2019 |archive-date=13 May 2019 |archive-url=https://web.archive.org/web/20190513153412/https://measuresmanager.com/blogs/articles/the-what-why-and-how-of-the-value-based-healthcare-model |url-status=dead }}</ref>

==Information resources==
{{Main article|Health care delivery|Health information management|Health informatics|eHealth}}
Sound information plays an increasingly critical role in the delivery of modern health care and efficiency of health systems. Health informatics&nbsp;– the intersection of [[information science]], [[medicine]] and [[Health care|healthcare]]&nbsp;– deals with the resources, devices, and methods required to optimize the acquisition and use of information in health and biomedicine. Necessary tools for proper health information coding and management include [[Medical guideline|clinical guidelines]], formal [[Medical terminology|medical terminologies]], and computers and other [[Information and communications technology|information and communication technologies]]. The kinds of [[health data]] processed may include [[Medical record|patients' medical records]], [[hospital information system|hospital administration and clinical functions]], and [[HRHIS|human resources information]].<ref name="NHS_2023">{{cite web |title=Records Management Code of Practice |url=https://transform.england.nhs.uk/information-governance/guidance/records-management-code |publisher=NHS England |access-date=29 June 2023 |date=2023}}</ref>

The use of health information lies at the root of [[evidence-based policy]] and [[evidence-based management]] in health care. Increasingly, information and communication technologies are being utilised to improve health systems in developing countries through: the standardisation of health information; computer-aided diagnosis and treatment monitoring; informing population groups on health and treatment.<ref>{{cite journal|last=Lucas|first=H|title=Information And Communications Technology For Future Health Systems In Developing Countries|journal=Social Science and Medicine|year=2008|volume=66|issue=10|pages=2122–2132|url=http://www.futurehealthsystems.org/publications/information-and-communications-technology-for-future-health.html|access-date=26 May 2012|doi=10.1016/j.socscimed.2008.01.033|pmid=18343005|archive-date=27 April 2021|archive-url=https://web.archive.org/web/20210427194302/http://www.futurehealthsystems.org/publications/information-and-communications-technology-for-future-health.html|url-status=dead|url-access=subscription}}</ref>

==Management==
{{Main article|Health policy|Public health|Health administration|Disease management (health)}}
The management of any health system is typically directed through a set of [[health policy|policies and plans]] adopted by government, private sector business and other groups in areas such as personal healthcare delivery and financing, [[pharmaceutical policy|pharmaceuticals]], [[health human resources]], and [[public health]].{{citation needed|date=June 2023}}

Public health is concerned with threats to the overall health of a community based on [[population health]] analysis. The population in question can be as small as a handful of people, or as large as all the inhabitants of several continents (for instance, in the case of a [[pandemic]]). Public health is typically divided into [[epidemiology]], [[biostatistics]] and [[Health care|health services]]. [[Environmental health|Environmental]], social, [[Mental health|behavioral]], and [[Occupational safety and health|occupational health]] are also important subfields.{{citation needed|date=June 2023}}

[[File:Poliodrops.jpg|right|thumb|A child being immunized against [[polio]]]]
Today, most governments recognize the importance of public health programs in reducing the incidence of disease, disability, the effects of ageing and [[health equity|health inequities]], although public health generally receives significantly less government funding compared with medicine. For example, most countries have a [[vaccination policy]], supporting public health programs in providing [[vaccination]]s to promote health. Vaccinations are voluntary in some countries and mandatory in some countries. Some governments pay all or part of the costs for vaccines in a national vaccination schedule.{{citation needed|date=March 2024}}

The rapid emergence of many [[Chronic condition|chronic diseases]], which require costly [[chronic care management|long-term care and treatment]], is making many health managers and policy makers re-examine their healthcare delivery practices. An important health issue facing the world currently is [[HIV/AIDS]].<ref>{{cite web |url=http://www.euphix.org/object_class/euph_hiv_aids.html |title=European Union Public Health Information System – HIV/Aides page |publisher=[[EUPHIX|Euphix]].org |access-date=6 August 2011 |archive-url=https://web.archive.org/web/20110726043233/http://www.euphix.org/object_class/euph_hiv_aids.html |archive-date=26 July 2011 |url-status=dead }}</ref> Another major public health concern is [[diabetes]].<ref>{{cite web |url=http://www.euphix.org/object_class/euph_diabetes.html |title=European Union Public Health Information System – Diabetes page |publisher=Euphix.org |access-date=6 August 2011 |archive-url=https://web.archive.org/web/20110726043253/http://www.euphix.org/object_class/euph_diabetes.html |archive-date=26 July 2011 |url-status=dead }}</ref> In 2006, according to the World Health Organization, at least 171 million people worldwide had diabetes. Its incidence is increasing rapidly, and it is estimated that by 2030, this number will double. A controversial aspect of public health is the control of [[tobacco smoking]], linked to cancer and other chronic illnesses.<ref>{{cite web |url=http://www.euphix.org/object_class/euph_health_behaviours_smoking.html |title=European Union Public Health Information System – Smoking Behaviors page |publisher=Euphix.org |access-date=6 August 2011 |archive-url=https://web.archive.org/web/20110801225934/http://www.euphix.org/object_class/euph_health_behaviours_smoking.html |archive-date=1 August 2011 |url-status=dead }}</ref>

[[Antimicrobial resistance|Antibiotic resistance]] is another major concern, leading to the reemergence of diseases such as [[tuberculosis]]. The [[World Health Organization]], for its [[World Health Day|World Health Day 2011]] campaign, called for intensified global commitment to safeguard antibiotics and other [[antimicrobial]] medicines for future generations.{{citation needed|date=March 2024}}

==Health systems performance==
{{See also| Health services research}}
[[File:Life expectancy vs healthcare spending.jpg|thumb|upright=1.4|Life expectancy vs healthcare spending of rich [[OECD]] countries. [[List of countries by total health expenditure per capita|US average of $10,447 in 2018]].<ref name=life>[https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus Link between health spending and life expectancy: US is an outlier] {{Webarchive|url=https://web.archive.org/web/20220311193123/https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus |date=11 March 2022 }}. May 26, 2017. By [[Max Roser]] at [[Our World in Data]]. Click the sources tab under the chart for info on the countries, healthcare expenditures, and data sources.  See the later version of the chart [https://ourworldindata.org/us-life-expectancy-low here] {{Webarchive|url=https://web.archive.org/web/20220305030958/https://ourworldindata.org/us-life-expectancy-low |date=5 March 2022 }}.</ref>]]

Since 2000, more and more initiatives have been taken at the international and national levels in order to strengthen national health systems as the core components of the [[global health]] system. Having this scope in mind, it is essential to have a clear, and unrestricted, vision of national health systems that might generate further progress in global health. The elaboration and the selection of [[performance indicator]]s are indeed both highly dependent on the [[conceptual framework]] adopted for the [[evaluation]] of the health systems performance.<ref>Handler A, Issel M, Turnock B. A conceptual framework to measure performance of the public health system. ''American Journal of Public Health'', 2001, 91(8): 1235–39.</ref> Like most social systems, health systems are [[complex adaptive system]]s where change does not necessarily follow rigid management models.<ref>{{Cite journal|last1=Wilson|first1=Tim|last2=Plsek|first2=Paul E.|date=2001-09-29|title=Complexity, leadership, and management in healthcare organisations|journal=BMJ|language=en|volume=323|issue=7315|pages=746–749|doi=10.1136/bmj.323.7315.746|issn=0959-8138|pmid=11576986|pmc=1121291}}</ref> In complex systems path dependency, emergent properties and other non-linear patterns are seen,<ref>{{cite journal|last=Paina|first=Ligia|author2=David Peters|title=Understanding pathways for scaling up health services through the lens of complex adaptive systems|journal=Health Policy and Planning|date=5 August 2011|volume=26|issue=5|doi=10.1093/heapol/czr054|pmid=21821667|url=http://www.futurehealthsystems.org/publications/understanding-pathways-for-scaling-up-health-services-throug.html|access-date=18 May 2012|pages=365–373|doi-access=free|archive-date=30 May 2013|archive-url=https://web.archive.org/web/20130530173710/http://www.futurehealthsystems.org/publications/understanding-pathways-for-scaling-up-health-services-throug.html|url-status=dead}}</ref> which can lead to the development of inappropriate guidelines for developing responsive health systems.<ref name="Peters 2012">{{cite journal|last=Peters|first=David|author2=Sara Bennet|title=Better Guidance Is Welcome, but without Blinders|journal=PLOS Med|year=2012|volume=9|issue=3|doi=10.1371/journal.pmed.1001188|pages=e1001188|pmid=22448148|pmc=3308928|doi-access=free}}</ref>

Quality frameworks are essential tools for understanding and improving health systems. They help define, prioritize, and implement health system goals and functions. Among the key frameworks is the World Health Organization's building blocks model, which enhances health quality by focusing on elements like financing, workforce, information, medical products, governance, and service delivery. This model influences global health evaluation and contributes to indicator development and research.<ref>{{Cite book |last=Organization |first=World Health |url=https://iris.who.int/handle/10665/258734 |title=Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies |date=2010 |publisher=World Health Organization |isbn=978-92-4-156405-2 |language=en |access-date=15 May 2024 |archive-date=3 May 2024 |archive-url=https://web.archive.org/web/20240503072926/https://iris.who.int/handle/10665/258734 |url-status=live }}</ref>

The Lancet Global Health Commission's 2018 framework builds upon earlier models by emphasizing system foundations, processes, and outcomes, guided by principles of efficiency, resilience, equity, and people-centeredness. This comprehensive approach addresses challenges associated with chronic and complex conditions and is particularly influential in health services research in developing countries.<ref>{{Cite journal |last1=Kruk |first1=Margaret E. |author-link1=Margaret Elizabeth Kruk |last2=Gage |first2=Anna D. |last3=Arsenault |first3=Catherine |last4=Jordan |first4=Keely |last5=Leslie |first5=Hannah H. |last6=Roder-DeWan |first6=Sanam |last7=Adeyi |first7=Olusoji |last8=Barker |first8=Pierre |last9=Daelmans |first9=Bernadette |last10=Doubova |first10=Svetlana V. |last11=English |first11=Mike |last12=García-Elorrio |first12=Ezequiel |last13=Guanais |first13=Frederico |last14=Gureje |first14=Oye |last15=Hirschhorn |first15=Lisa R. |date=2018 |title=High-quality health systems in the Sustainable Development Goals era: time for a revolution |journal=The Lancet. Global Health |volume=6 |issue=11 |pages=e1196–e1252 |doi=10.1016/S2214-109X(18)30386-3 |issn=2214-109X |pmc=7734391 |pmid=30196093 }}</ref> Importantly, recent developments also highlight the need to integrate environmental sustainability into these frameworks, suggesting its inclusion as a guiding principle to enhance the environmental responsiveness of health systems.<ref>{{Cite journal |last1=Padget |first1=Michael |last2=Peters |first2=Michael A. |last3=Brunn |first3=Matthias |last4=Kringos |first4=Dionne |last5=Kruk |first5=Margaret E. |author-link5=Margaret Elizabeth Kruk |date=2024-04-30 |title=Health systems and environmental sustainability: updating frameworks for a new era |url=https://www.bmj.com/content/385/bmj-2023-076957 |url-status=live |journal=BMJ |language=en |volume=385 |pages=e076957 |doi=10.1136/bmj-2023-076957 |issn=1756-1833 |pmid=38688557 |archive-url=https://web.archive.org/web/20240503072926/https://www.bmj.com/content/385/bmj-2023-076957 |archive-date=3 May 2024 |access-date=15 May 2024|url-access=subscription }}</ref>

An increasing number of tools and guidelines are being published by international agencies and development partners to assist health system decision-makers to monitor and assess health systems strengthening<ref>World Health Organization. [https://web.archive.org/web/20110101154020/http://www.who.int/healthinfo/systems/monitoring/en/index.html ''Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies''.] Geneva, WHO Press, 2010.</ref> including [[Health human resources|human resources]] development<ref>Dal Poz MR et al. [https://web.archive.org/web/20091014232002/http://www.who.int/hrh/resources/handbook/en/index.html ''Handbook on monitoring and evaluation of human resources for health.''] Geneva, WHO Press, 2009</ref> using standard definitions, indicators and measures. In response to a series of papers published in 2012 by members of the World Health Organization's Task Force on Developing Health Systems Guidance, researchers from the Future Health Systems consortium argue that there is insufficient focus on the 'policy implementation gap'. Recognizing the diversity of stakeholders and complexity of health systems is crucial to ensure that evidence-based guidelines are tested with requisite humility and without a rigid adherence to models dominated by a limited number of disciplines.<ref name="Peters 2012"/><ref>{{cite journal|last=Hyder|first=A|title=Exploring health systems research and its influence on policy processes in low income countries|journal=BMC Public Health|year=2007|volume=7|pages=309|doi=10.1186/1471-2458-7-309|pmid=17974000|pmc=2213669|display-authors=etal|doi-access=free}}</ref> Healthcare services often implement Quality Improvement Initiatives to overcome this policy implementation gap. Although many of these initiatives deliver improved healthcare, a large proportion fail to be sustained. Numerous tools and frameworks have been created to respond to this challenge and increase improvement longevity. One tool highlighted the need for these tools to respond to user preferences and settings to optimize impact.<ref>{{cite journal|last1=Lennox|first1=Laura|last2=Doyle|first2=Cathal|last3=Reed|first3=Julie E.|last4=Bell|first4=Derek|title=What makes a sustainability tool valuable, practical and useful in real-world healthcare practice? A mixed-methods study on the development of the Long Term Success Tool in Northwest London|journal=BMJ Open|date=1 September 2017|volume=7|issue=9|pages=e014417|doi=10.1136/bmjopen-2016-014417|pmid=28947436|language=en|issn=2044-6055|pmc=5623390}}</ref>

Health Policy and Systems Research (HPSR) is an emerging multidisciplinary field that challenges 'disciplinary capture' by dominant health research traditions, arguing that these traditions generate premature and inappropriately narrow definitions that impede rather than enhance health systems strengthening.<ref>{{cite journal|last=Sheikh|first=Kabir|author2=Lucy Gilson |author3=Irene Akua Agyepong |author4=Kara Hanson |author5=Freddie Ssengooba |author6=Sara Bennett |title=Building the Field of Health Policy and Systems Research: Framing the Questions|journal=PLOS Medicine|year=2011|volume=8|issue=8|doi=10.1371/journal.pmed.1001073|pages=e1001073|pmid=21857809|pmc=3156683 |doi-access=free }} {{open access}}</ref> HPSR focuses on low- and middle-income countries and draws on the relativist social science paradigm which recognises that all phenomena are constructed through human behaviour and interpretation. In using this approach, HPSR offers insight into health systems by generating a complex understanding of context in order to enhance health policy learning.<ref>{{cite journal|last=Gilson|first=Lucy|author2=Kara Hanson |author3=Kabir Sheikh |author4=Irene Akua Agyepong |author5=Freddie Ssengooba |author6=Sara Bennet |title=Building the Field of Health Policy and Systems Research: Social Science Matters|journal=PLOS Medicine|year=2011|volume=8|issue=8|doi=10.1371/journal.pmed.1001079|pages=e1001079|pmid=21886488|pmc=3160340 |doi-access=free }}  {{open access}}</ref> HPSR calls for greater involvement of local actors, including policy makers, civil society and researchers, in decisions that are made around funding health policy research and health systems strengthening.<ref>{{cite journal|last=Bennet|first=Sara|author2=Irene Akua Agyepong |author3=Kabir Sheikh |author4=Kara Hanson |author5=Freddie Ssengooba |author6=Lucy Gilson |title=Building the Field of Health Policy and Systems Research: An Agenda for Action|journal=PLOS Medicine |year=2011|volume=8|issue=8|doi=10.1371/journal.pmed.1001081|pages=e1001081 |pmid=21918641 |pmc=3168867 |doi-access=free }} {{open access}}</ref>

<div style="display:inline-table; vertical-align:top;">
[[File:Overweight or obese population OECD 2010.png|thumb|none|Percentage of overweight or obese population in 2010. Data source: OECD's iLibrary, http://stats.oecd.org, retrieved 2013-12-12<ref name="OECDOverwObese">{{cite web|url=http://stats.oecd.org//Index.aspx?QueryId=53508|title=OECD.StatExtracts, Health, Non-Medical Determinants of Health, Body weight, Overweight or obese population, self-reported and measured, Total population|publisher=OECD's iLibrary|year=2013|format=Online Statistics|website=stats.oecd.org|access-date=24 April 2014|archive-date=2 April 2019|archive-url=https://web.archive.org/web/20190402154352/https://stats.oecd.org/index.aspx/?QueryId=53508|url-status=live}}</ref>]]
</div>
<div style="display:inline-table; vertical-align:top;">
[[File:Obese population OECD 2010.png|thumb|none|Percentage of obese population in 2010. Data source: OECD's iLibrary, http://stats.oecd.org, retrieved 2013-12-13<ref name="OECDObese">{{cite web|url=http://stats.oecd.org//Index.aspx?QueryId=53527|title=OECD.StatExtracts, Health, Non-Medical Determinants of Health, Body weight, Obese population, self-reported and measured, Total population|publisher=OECD's iLibrary|year=2013|format=Online Statistics|website=stats.oecd.org|access-date=24 April 2014|archive-date=2 April 2019|archive-url=https://web.archive.org/web/20190402163724/https://stats.oecd.org/index.aspx/?QueryId=53527|url-status=live}}</ref>]]
</div>

==Spending==
{{see also|Health economics|Health spending as percent of gross domestic product (GDP) by country|List of countries by total health expenditure per capita}}
Expand the [[OECD]] charts below to see the breakdown:
* "Government/compulsory": Government spending and compulsory health insurance.
* "Voluntary": Voluntary health insurance and private funds such as households' out-of-pocket payments, NGOs and private corporations.
* They are represented by columns starting at zero. They are not stacked. The 2 are combined to get the total.
* At the source you can run your cursor over the columns to get the year and the total for that country.<ref name=OECD-barcharts/>
* Click the table tab at the source to get 3 lists (one after another) of amounts by country: "Total", "Government/compulsory", and "Voluntary".<ref name=OECD-barcharts/>

<div style="display:inline-table; vertical-align:top;">
[[File:Health spending by country. Percent of GDP (Gross domestic product).png|thumb|none|upright=1.4|[[Health spending as a percent of GDP by country (gross domestic product)|Health spending by country]]. Percent of GDP ([[Gross domestic product]]). For example: 11.2% for Canada in 2022. 16.6% for the United States in 2022.<ref name=OECD-barcharts>[[OECD]] Data. [https://data.oecd.org/healthres/health-spending.htm Health resources - Health spending] {{Webarchive|url=https://web.archive.org/web/20200412163054/https://data.oecd.org/healthres/health-spending.htm |date=12 April 2020 }}. {{doi|10.1787/8643de7e-en}}. 2 bar charts: For both: From bottom menus: Countries menu > choose OECD. Check box for "latest data available". Perspectives menu > Check box to "compare variables". Then check the boxes for government/compulsory, voluntary, and total. Click top tab for chart (bar chart). For GDP chart choose "% of GDP" from bottom menu. For per capita chart choose "US dollars/per capita". Click fullscreen button above chart. Click "print screen" key. Click top tab for table, to see data.</ref>]]</div>
<div style="display:inline-table; vertical-align:top;">
[[File:Average annual health spending. US dollars (PPP) per person. OECD countries and more.png|thumb|none|upright=1.4|[[List of countries by total health expenditure per capita|Total healthcare cost per person]]. Public and private spending. US dollars [[Purchasing power parity|PPP]]. For example: $6,319 for Canada in 2022. $12,555 for the US in 2022.<ref name=OECD-barcharts/>]]
</div>

==International comparisons==
{{See also|List of countries by quality of health care|List of countries by health expenditure covered by government|Health care systems by country|Health care prices in the United States|Healthcare in Europe}}
[[File:Health systems comparison OECD 2008.png|thumb|upright=1.5|Chart comparing 2008 health care spending (left) vs. life expectancy (right) in OECD countries]]

Health systems can vary substantially from country to country, and in the last few years, comparisons have been made on an international basis. The [[World Health Organization]], in its ''[[World Health Report|World Health Report 2000]]'', provided a [[World Health Organization ranking of health systems in 2000|ranking of health systems]] around the world according to criteria of the overall level and distribution of [[health]] in the populations, and the responsiveness and fair financing of health care services.<ref name="WHO2000"/> The goals for health systems, according to the WHO's ''World Health Report 2000 – Health systems: improving performance'' (WHO, 2000),<ref>World Health Organization. (2000) [https://web.archive.org/web/20040915212359/http://www.who.int/whr/2000/en/ ''World Health Report 2000 – Health systems: improving performance'']. Geneva, WHO Press.</ref> are good health, responsiveness to the expectations of the population, and fair financial contribution. There have been several debates around the results of this WHO exercise,<ref>World Health Organization. [https://www.who.int/health-systems-performance/docs/overallframework_docs.htm ''Health Systems Performance: Overall Framework.''] {{webarchive|url=https://web.archive.org/web/20120617053343/http://www.who.int/health-systems-performance/docs/overallframework_docs.htm |date=17 June 2012 }} Accessed 15 March 2011.</ref> and especially based on the country [[ranking]] linked to it,<ref>{{cite journal | author = Navarro V | year = 2000 | title = Assessment of the World Health Report 2000 | journal = Lancet | volume = 356 | issue = 9241| pages = 1598–601 | doi=10.1016/s0140-6736(00)03139-1| pmid = 11075789 | s2cid = 18001992 | doi-access = free }}</ref> insofar as it appeared to depend mostly on the choice of the retained [[performance indicator|indicators]].

Direct comparisons of health statistics across nations are complex. The [[Commonwealth Fund]], in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the United States. Its 2007 study found that, although the United States system is the most expensive, it consistently underperforms compared to the other countries.<ref>{{cite web|url=http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2007/May/Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx|title=Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care|publisher=The Commonwealth Fund|date=15 May 2007|access-date=7 March 2009|archive-url=https://web.archive.org/web/20090329063255/http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2007/May/Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx|archive-date=29 March 2009|url-status=dead}}</ref> A major difference between the United States and the other countries in the study is that the United States is the only country without [[universal health care]]. The [[OECD]] also collects comparative statistics, and has published brief country profiles.<ref>{{cite web| author=Organisation for Economic Co-operation and Development| title=OECD Health Data 2008: How Does Canada Compare| url=http://www.oecd.org/dataoecd/46/33/38979719.pdf| access-date=9 January 2009| url-status=dead| archive-url=https://web.archive.org/web/20130531222830/http://www.oecd.org/health/health-systems/BriefingNoteCANADA2012.pdf| archive-date=31 May 2013| df=dmy-all| author-link=Organisation for Economic Co-operation and Development}}</ref><ref name="oecdstats">{{cite web |url=http://www.oecd.org/document/46/0,3343,en_2649_34631_34971438_1_1_1_1,00.html |title=Updated statistics from a 2009 report |publisher=Oecd.org |access-date=6 August 2011 |url-status=dead |archive-url=https://web.archive.org/web/20100305122330/http://www.oecd.org/document/46/0,3343,en_2649_34631_34971438_1_1_1_1,00.html |archive-date=5 March 2010 |df=dmy-all }}</ref><ref name="datasource">{{cite web |url=http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html |title=OECD Health Data 2009 – Frequently Requested Data |publisher=Oecd.org |access-date=6 August 2011 |archive-date=24 September 2015 |archive-url=https://web.archive.org/web/20150924123653/http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html |url-status=live }}</ref> [[Health Consumer Powerhouse]] makes comparisons between both national health care systems in the [[Euro Health Consumer Index|Euro health consumer index]] and specific areas of health care such as diabetes<ref>{{cite web | url= http://www.healthpowerhouse.com/index.php?option=com_content&view=category&layout=blog&id=46&Itemid=66 | title= The Euro Consumer Diabetes Index 2008 | publisher= Health Consumer Powerhouse | access-date= 29 April 2013 | archive-date= 22 April 2016 | archive-url= https://web.archive.org/web/20160422083455/http://www.healthpowerhouse.com/index.php?option=com_content&view=category&layout=blog&id=46&Itemid=66 | url-status= live }}</ref> or hepatitis.<ref>{{cite web | url= http://www.healthpowerhouse.com/index.php?option=com_content&view=category&layout=blog&id=58&Itemid=78 | title= Euro Hepatitis Care Index 2012 | publisher= Health Consumer Powerhouse | access-date= 29 April 2013 | archive-date= 12 April 2016 | archive-url= https://web.archive.org/web/20160412190301/http://www.healthpowerhouse.com/index.php?option=com_content&view=category&layout=blog&id=58&Itemid=78 | url-status= live }}</ref>

[[Ipsos MORI]] produces an annual study of public perceptions of healthcare services across 30 countries.<ref>{{cite news |title=Mental health replaces Covid as the top health concern among Americans |url=https://www.itij.com/latest/news/mental-health-replaces-covid-top-health-concern-among-americans |access-date=14 October 2022 |publisher=ITIJ |date=5 October 2022 |archive-date=14 October 2022 |archive-url=https://web.archive.org/web/20221014081220/https://www.itij.com/latest/news/mental-health-replaces-covid-top-health-concern-among-americans |url-status=live }}</ref>

{| class="wikitable sortable"
|-
!Country
!<small>[[Life expectancy]]</small><ref>{{Cite web|url=https://data.worldbank.org/indicator/SP.DYN.LE00.IN|title=Life expectancy at birth, total (years) {{!}} Data|website=data.worldbank.org|language=en-us|access-date=2018-08-03|archive-date=2 February 2021|archive-url=https://web.archive.org/web/20210202140034/https://data.worldbank.org/indicator/SP.DYN.LE00.IN|url-status=live}}</ref>
!<small>[[Infant mortality]] rate</small><ref>[https://web.archive.org/web/20070613003123/https://www.cia.gov/library/publications/the-world-factbook/fields/2091.html CIA – The World Factbook: Infant Mortality Rate]. Archived from the original on 18 December 2012 (Older data). Retrieved 15 May 2013.</ref>
!<small>Preventable deaths per 100,000 people in 2007</small><ref name=comamenable>"Mortality amenable to health care" {{cite journal|last=Nolte|first=Ellen|title=Variations in Amenable Mortality—Trends in 16 High-Income Nations| journal=Health Policy (Amsterdam, Netherlands) | year=2011 | volume=103 | issue=1 | pages=47–52 |url=http://www.commonwealthfund.org/Publications/In-the-Literature/2011/Sep/Variations-in-Amenable-Mortality.aspx|publisher=Commonwealth Fund| doi=10.1016/j.healthpol.2011.08.002 | pmid=21917350 |access-date=10 February 2012|archive-url=https://web.archive.org/web/20120205105617/http://www.commonwealthfund.org/Publications/In-the-Literature/2011/Sep/Variations-in-Amenable-Mortality.aspx|archive-date=5 February 2012|url-status=dead|url-access=subscription}}</ref>
!<small>[[Physician]]s per 1000 people</small>
!<small>[[Nurses]] per 1000 people</small>
!<small>[[List of countries by total health expenditure per capita|Per capita expenditure on health]] (USD PPP)</small>
!<small>Healthcare costs as a percent of [[Gross domestic product|GDP]]</small>
!<small>% of government revenue spent on health</small>
!<small>% of health costs paid by government</small>
|-
|[[Health care in Australia|Australia]]
|83.0
|4.49
|57
|2.8
|10.1
|3,353
|8.5
|17.7
|67.5
|-
|[[Healthcare in Canada|Canada]]
|82.0
|4.78
|77<ref name=canadacwa>data for 2003<br />{{cite journal|last=Nolte|first=Ellen|title=Measuring the Health of Nations: Updating an Earlier Analysis|journal=Health Affairs|year=2008|volume=27|issue=1|pages=58–71|url=http://www.commonwealthfund.org/Publications/In-the-Literature/2008/Jan/Measuring-the-Health-of-Nations--Updating-an-Earlier-Analysis.aspx|publisher=Commonwealth Fund|doi=10.1377/hlthaff.27.1.58|pmid=18180480|access-date=8 January 2012|archive-url=https://web.archive.org/web/20120111063137/http://www.commonwealthfund.org/Publications/In-the-Literature/2008/Jan/Measuring-the-Health-of-Nations--Updating-an-Earlier-Analysis.aspx|archive-date=11 January 2012|url-status=dead|url-access=subscription}}</ref>
|2.2
|9.0
|3,844
|10.0
|16.7
|70.2
|-
|[[Healthcare in Finland|Finland]]
|79.5
|2.6
|
|2.7
|15.5
|3,008
|8.4
|
|
|-
|[[Health care in France|France]]
|82.0
|3.34
|55
|3.3
|7.7
|3,679
|11.6
|14.2
|78.3
|-
|[[Healthcare in Germany|Germany]]
|81.0
|3.48
|76
|3.5
|10.5
|3,724
|10.4
|17.6
|76.4
|-
|[[Healthcare in Italy|Italy]]
|83.0
|3.33
|60
|4.2
|6.1
|2,771
|8.7
|14.1
|76.6
|-
|[[Health care system in Japan|Japan]]
|84.0
|2.17
|61
|2.1
|9.4
|2,750
|8.2
|16.8
|80.4
|-
|[[Healthcare in Norway|Norway]]
|83.0
|3.47
|64
|3.8
|16.2
|4,885
|8.9
|17.9
|84.1
|-
|[[Health care in Spain|Spain]]
|83.0
|3.30
|74
|3.8
|5.3
|3,248
|8.9
|15.1
|73.6
|-
|[[Healthcare in Sweden|Sweden]]
|82.0
|2.73
|61
|3.6
|10.8
|3,432
|8.9
|13.6
|81.4
|-
|[[Healthcare in the United Kingdom|UK]]
|81.6
|4.5
|83
|2.5
|9.5
|3,051
|8.4
|15.8
|81.3
|-
|[[Healthcare in the United States|US]]
|78.74
|5.9
|96
|2.4
|10.6
|7,437
|16.0
|18.5
|45.1
|}

Physicians and hospital beds per 1000 inhabitants vs Health Care Spending in 2008 for OECD Countries. The data source is [http://www.oecd.org OECD.org - OECD].<ref name="oecdstats" /><ref name="datasource" /> Since 2008, the US experienced big deviations from 16% GDP. In 2010, the year the [[Affordable Care Act]] was enacted, health care spending accounted for approximately 17.2% of the U.S. GDP. By 2019, before the pandemic, it had risen to 17.7%. During the COVID-19 pandemic, this percentage jumped to 18.8% in 2020, largely due to increased health care costs and economic contraction. Post-pandemic, health care spending relative to GDP declined to 16.6% by 2022.<ref>[https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata Centers for Medicare & Medicaid Services (CMS), National Health Expenditure Data]</ref><ref>[https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-relative-size-economy-u-s-spends-greater-amount-health-care-high-income-nations Peterson-KFF Health System Tracker, U.S. Health Spending Overview]</ref>

[[File:Health spending vs physicians oecd 2008.png|upright=1.8|alt=Physicians per 1000 vs Health Care Spending|Physicians per 1000 vs Health Care Spending in 2008 for OECD Countries. The data source is http://www.oecd.org]]
[[File:Health spending vs beds oecd 2008.png|upright=1.8|alt=Hospital beds per 1000 vs Health Care Spending|Hospital beds per 1000 vs Health Care Spending in 2008 for OECD Countries. The data source is http://www.oecd.org]]

==See also==
{{div col|colwidth=20em}}
* [[Acronyms in healthcare]]
* [[Catholic Church and health care]]
* [[Clinical Health Promotion]]
* [[Community health]]
* [[Comparison of the health care systems in Canada and the United States]]
* [[Consumer-driven health care]]
* [[Cultural competence in health care]]
* [[Global health]]
* [[Genetic testing#In Estonia|Genetic testing]]
* [[List of countries by health insurance coverage]]
* [[Health administration]]
* [[Health care]]
* [[Health care provider]]
* [[Health care reform]]
* [[Health crisis]]
* [[Health equity]]
* [[Health human resources]]
* [[Health insurance]]
* [[Health policy]]
* [[Health promotion]]
* [[Health services research]]
* [[Healthy city]]
* [[Hospital network]]
* [[Medicine]]
* [[National health insurance]]
* [[Occupational safety and health]]
* [[Philosophy of healthcare]]
* [[Primary care]]
* [[Primary health care]]
* [[Public health]]
* [[Publicly funded health care]]
* [[Single-payer health care]]
* [[Social determinants of health]]
* [[Socialized medicine]]
* [[Timeline of global health]]
* [[Two-tier health care]]
* [[Universal health care]]
{{div col end}}

== References ==
{{Reflist}}

{{Library resources box |others=no}}

==External links==
* [https://www.who.int/healthsystems/en/ World Health Organization: Health Systems]
* [http://www.eldis.org/healthsystems/ HRC/Eldis Health Systems Resource Guide] {{Webarchive|url=https://web.archive.org/web/20050802103517/http://www.eldis.org/healthsystems/ |date=2 August 2005 }} research and other resources on health systems in developing countries
* [http://www.oecd.org/department/0,3355,en_2649_33929_1_1_1_1_1,00.html OECD: Health policies], a list of latest publications by OECD

{{Health care}}
{{Public health}}
{{Portal bar|Medicine}}

{{Authority control}}

[[Category:Health care]]
[[Category:Health economics]]
[[Category:Health policy]]
[[Category:Health care quality]]
[[Category:Health care brands]]
[[Category:Health]]
[[Category:Public health education]]
[[Category:Universal health care]]
[[Category:Health sciences]]
[[Category:Primary care]]