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<DIV><B>From:</B> <A title=ruglucia@PAHO.ORG
href="mailto:ruglucia@PAHO.ORG">Ruggiero, Mrs. Ana Lucia (WDC)</A> </DIV>
<DIV style="FONT: 10pt arial">
<DIV> <A title=EQUIDAD@LISTSERV.PAHO.ORG
href="mailto:EQUIDAD@LISTSERV.PAHO.ORG">EQUIDAD@LISTSERV.PAHO.ORG</A>
</DIV></DIV>
<DIV><FONT face=Arial size=2></FONT><BR></DIV>
<DIV class=Section1>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=#993300
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 11pt; COLOR: #993300; FONT-FAMILY: Arial">Health
Systems in Transition: Template for analysis<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal><B><FONT face=Arial color=navy size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=navy
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Edited
by Elias Mossialos, Sara Allin, Josep Figueras<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=navy
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">World
Health Organization 2007, on behalf of the European Observatory on Health
Systems and Policies<o:p></o:p></SPAN></FONT></B></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Arial color=navy
size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></B></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"><B><FONT
face=Arial color=navy size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Available
online as PDF file [145p,] at: </SPAN></FONT></B><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><A
href="http://www.euro.who.int/Document/E88699.pdf"><FONT color=#333399><SPAN
style="COLOR: #333399">http://www.euro.who.int/Document/E88699.pdf</SPAN></FONT></A><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"><FONT
face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in" minmax_bound="true"><B><FONT
face=Arial color=navy size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> </SPAN></FONT></B><FONT
face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">The Health Systems
in Transition (HiT) profiles are produced by country experts in collaboration
with the Observatory’s research directors and staff. The profiles are based on a
template that, revised periodically, provides detailed guidelines and specific
questions, definitions, suggestions for data sources, and examples needed to
compile HiTs. While the template offers a comprehensive set of questions, it is
intended to be used in a flexible way to allow authors and editors to adapt it
to their particular national context. </SPAN></FONT><FONT face=Arial color=navy
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"><FONT
face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"><FONT
face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">A typical HiT
profile consists of 10 chapters</SPAN></FONT><FONT face=Arial color=navy
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">:</SPAN></FONT><FONT
face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"><STRONG><B><FONT
face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">1
Introduction:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">
outlines the broader context of the health system, including geography and
sociodemography, economic and political context, and population
health.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">2 Organizational
structure:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"> provides an
overview of how the health system in the country is organized and outlines the
main actors and their decision-making powers; discusses the historical
background for the system; and describes the level of patient empowerment in the
areas of information, rights, choice, complaints procedures, safety and
involvement.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">3
Financing:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"> provides
information on the level of expenditure, who is covered, what benefits are
covered, the sources of health care finance, how resources are pooled and
allocated, the main areas of expenditure, and how providers are
paid.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">4 Regulation and
planning:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"> addresses the
process of policy development, establishing goals and priorities; deals with
questions about relationships between institutional actors, with specific
emphasis on their role in regulation and what aspects are subject to regulation;
and describes the process of HTA and research and
development.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">5 Physical and human
resources:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"> deals with the
planning and distribution of infrastructure and capital stock; the context in
which IT systems operate; and human resource input into the health system,
including information on registration, training, trends and career
paths.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">6 Provision of
services:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial"> concentrates on
patient flows, organization and delivery of services, addressing public health,
primary and secondary health care, emergency and day care, rehabilitation,
pharmaceutical care, long-term care, services for informal carers, palliative
care, mental health care, dental care, complementary and alternative medicine,
and health care for specific populations.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">7 Principal health
care reforms:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">
reviews reforms, policies and organizational changes that have had a substantial
impact on health care.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">8 Assessment of the
health system:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">
provides an assessment based on the stated objectives of the health system, the
distribution of costs and benefits across the population, efficiency of resource
allocation, technical efficiency in health care production, quality of care, and
contribution of health care to health
improvement.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">9
Conclusions:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">
highlights the lessons learned from health system changes; summarizes remaining
challenges and future prospects.<BR><BR><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal
style="BACKGROUND: white; MARGIN-LEFT: 0.5in; mso-margin-bottom-alt: auto"
minmax_bound="true"><STRONG minmax_bound="true"><B><FONT face=Arial
color=#333399 size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">10
Appendices:</SPAN></FONT></B></STRONG><FONT face=Arial color=#333399
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: #333399; FONT-FAMILY: Arial">
includes references, useful web sites, legislation.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face=Arial color=navy
size=1><SPAN
style="FONT-SIZE: 8pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
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