Towards High Quality Health Care and Sustainable Financing – the Role of Health Care Programmes
| Author | Panos Kanavos,Nicola Boekstein,Maxine Mackintosh,Mackenzie Mills |
| DOI | http://doi.org/10.1111/1758-5899.12360 |
| Date | 01 March 2017 |
| Published date | 01 March 2017 |
Towards High Quality Health Care and
Sustainable Financing –the Role of Health
Care Programmes
Mackenzie Mills and Nicola Boekstein
Medical Technology Research Group at LSE Health, London School of Economics
Maxine Mackintosh
University College London
Panos Kanavos
Medical Technology Research Group at LSE Health, London School of Economics
Abstract
This article develops a taxonomy of health care programmes, and assesses whether or not these programmes represent a
viable option for addressing key health policy objectives, including efficiency, equity and sustainable financing. A broad litera-
ture review was undertaken to identify the various types of health care programmes to develop a taxonomy. Then, a targeted
literature review of each type of health care programme was undertaken to collect evidence on the ability of programmes to
address health policy objectives. Many health care programmes were identified and grouped into six categories: financial sup-
port, patient education, integrated care, special population, national/regional plans, and disease management. Design and
implementation of these programmes varied widely within and across categories. Evidence surrounding impact of health care
programmes was largely mixed, with evidence of both successful and unsuccessful initiatives. The evidence suggests that
when properly implemented, health care programmes can help generate cost savings, improve patient adherence to treat-
ment, address inequities in access to health care, and improve patient health outcomes. However, the evidence relies on a
highly heterogeneous sample of studies, study populations and diseases studied; studies are often of variable quality. Further
research on this subject would therefore be beneficial.
1. Introduction
On 9 October 2014, the European Commission’s Expert
Panel on Effective ways of Investing in Health (EXPH)
stressed the importance of health education programmes to
improving patient safety and quality of health care. They
recommended the implementation of a European-wide
health education programme with a patient centered
approach in order to improve health literacy (Expert
Panel on effective ways of investing in Health (EXPH), 2014).
Health care programmes play an important role in disease
prevention, in the coordination of health care delivery and
efforts to fight disease, and in addressing inequities in
health and in access to health care. Specifically, health edu-
cation and disease management programmes aim to
improve patient self-care, with important implications in
terms of prevention, health outcomes, and quality of care
(e.g. chronic obstructive pulmonary disease (COPD) patient
education programmes; Sari and Osman, 2015). Meanwhile,
other health care programmes, such as financial support
and special population programmes can help reduce
inequities in access to health care (e.g. programmes on
pharmaceutical patient assistance; Felder et al., 2011; WHO,
2013a). Health care programmes are also implemented at
national or supra-national levels to fight specific diseases
(e.g. Scotland Hepatitis C Action Plan; The Scottish Govern-
ment, 2008; The King Baudouin Foundation, 2010). Despite
their widespread implementation, the importance of health
care programmes not only in promoting high quality care,
but also in addressing issues of financial sustainability is not
well documented. This paper presents several types of
health care programmes and explores the ability of different
programmes to address health system objectives and chal-
lenges associated with financial sustainability.
An overarching objective of a health care system is to
improve the health of a population. It is widely recognized
that good health across a population both improves quality
of life and is essential for economic and social development
(WHO, 2010) While many determinants of good health, such
as education, housing, and lifestyle choices lie outside the
realm of health systems, promoting widespread and timely
access to health care services while protecting individuals
©2016 University of Durham and John Wiley & Sons, Ltd. Global Policy (2017) 8:Suppl.2 doi: 10.1111/1758-5899.12360
Global Policy Volume 8 . Supplement 2 . March 2017
46
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