UNIVERSIDAD DE STA.

ISABEL
College of Health Sciences
Academic Year 2020-2021 | 1st Semester

VINCENTIAN LEARNING MODULE 1:

Health System

Module prepared by:

DAN CEAZAR O. BALDOZA, RMT

Clinical Instructor
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

MODULE 2:
HEALTH SYSTEM 2
INTRODUCTION

Module 1 has presented you the importance of educational

institution together with their vision, mission, core values, and objectives
and with regards to our health it is also important that we have to follow
a system.

All throughout the world we follow a methodical and organized

way of things whether it is in law and order, education, banking & finance,
government, health care or any industry that uses a systematic way. The
goal of every certain system is to divide things into a simpler part and
arrange this part into an interconnected unified whole. A health system,
just like any other system, is a set of all constituent parts linked or inter-
connected that have to function together to be effective. These health
systems are responsible for providing and delivering services that
maintain, restore, and improve the health of individuals and the
community.

This module will present you the concept of health system so that
you will be able to understand better how such system works in different
communities and countries.

Health System 2
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

LEARNING OUTCOMES
At the end of this module, you will:

1. Define health system in the international, national, and local

perspectives;

2. identify the goals and functions of a health system;

3. explain the relationship between the system building blocks and

health outcomes; and

4. develop a health system based on the different national models.

ENGAGE

Hey Momo fans out there! Did you know she has
scars on her left arm from the BCG vaccine?

BCG, or Bacille Calmette-Guerin (name after

Camille Guerin and Albert Calmette), is a vaccine
for tuberculosis (TB) disease.

According to the Remy et al, vaccination and

health care system have a direct link in having an
efficient healthcare system. It is one of the most
cost-effective healthcare interventions

Activity. How do vaccination and health system

relate with one another?

*Kindly comment your answer on our google classroom

under the attachment of this primary learning materials.

Health System 3
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

LEARNING EXPERIENCE

Let’s EXPLORE
To know the meaning of health system let us analyze the
words health and system separately.

Health System
A state of complete
physical, mental, and Is any collection of
social well-being, not related parts that
merely the absence of interact in an organized
disease or infirmity methodical way for a
(WHO). purpose.

HEALTH SYSTEM DEFINED

✓ According to World Health Organization “Health system refers to all the organizations,
institutions, resources, and people whose primary purpose is to improve health.”

✓ Health System is the combination of resources, organization, financing, and

management that culminate in the delivery of health services to the population
(Roemer, 1991).

Therefore, a well-performing health system provides direct health-improving

activities whether in personal health care, public health services, or
intersectoral initiatives, to achieve high health equity.

Health System 4
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

World Health Organization identifies THREE (3) MAIN GOALS OF A

HEALTH SYSTEM:

Improving the responsiveness of

the health system

GOALS OF A
HEALTH
SYSTEM

Improving the health of Providing fair health

populations financing

1. Improving the health of populations

✓ Improving the health of the population is the OVERARCHING goal of a health system.

✓ Health status should be measured over the entire population and across different
socioeconomic groups, income, ethnicity, occupation, gender, geographic location,
and sexual orientation among others.

✓ Disparities of health system from different group within country or region are most
effectively reduced when they are recognized and their minimization becomes a clear
national goal.

2. Improving the responsiveness of the health system

✓ Responsiveness refers to providing satisfactory health services and ENGAGING people

as active partners.

Health System 5
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

✓ It maximizes people’s autonomy and control, allowing them to make choices and
placing them at the CENTER of the health system.

✓ Non-health needs and expectation of the population are obligation that must be
responded to by the health system.

3. Providing fair health financing

✓ WHO defines a fairly financed health system as one that does not deter individuals
from receiving needed care due to payments required at the time of service, and one
in which individual pays approximately the same percentage of their income for needed
services.

✓ An ideal health system provides social and financial risk protection in health and must
be adequately funded to provide essential services to all citizens.
After knowing the goals of a health system now we will go to its different functions.
✓ A health financing system that is not fair and just will only dissuades people from
THE FOUR (4) VITAL HEALTH SYSTEM FUNCTIONS:
seeking needed health services.

After knowing the goals of a health system now we will go to its different functions.

THE FOUR (4) VITAL HEALTH SYSTEM FUNCTIONS:

Stewardship

Health Service Health Service

Inputs Provision

Health
financing

Health System 6
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

1. Health Service Provision

✓ It is the organization and management of service delivery.

✓ Health service is any service (not limited to clinical services) aimed at improving the
health of populations.

✓ It refers to the way it facilitates the health service provision such as money, equipment
and drugs are combined to deliver health interventions.

2. Health Service Inputs

✓ Also known as human & physical resources, means generating the essential physical
resources for the delivery of health services which include medications, human
resources & medical equipment.

✓ Trained doctors, medical staff, and supply of medications are example of resources.

3. Stewardship
✓ Also known as governance or oversight.

✓ This function sets direction, context, and policy framework for the overall health
system.

✓ The core of the stewardship function includes:

a) Identifying health priorities for allocation of public resources;

b) Identifying an institutional framework

c) Coordinating activities with other system related to external health care;

d) Analyzing health priorities and resource generation trends and their

implications; and

e) Generating appropriate data for effective decision-making and policymaking on

health matters.

4. Health financing

Health System 7
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 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

4. Health financing
✓ In a health system financing includes these 3 main sources to pay for health services

Collecting
Revenues

Health System Pooling Financial

Financing Risk

Allocating
Revenue
a. Revenue Collection
• Revenue is earned from payments for health care services.
• It includes general taxation, direct household, out-of-pocket expenditures,
mandatory payroll contributions, mandatory or voluntary risk-rated contributions,
donor financing, and other forms of personal savings.
• General taxation for public health system while mandatory payroll contributions from
workers and employers.
b. Risk pooling
• Financial risk pooling is a form of risk management which aims to spread financial
risk from an individual to all pool members.
• It is considered the core function of health insurance companies.
• A group of people contributes to a common pool and these funds are used to pay for
all or part of the cost of providing a defined set of health services for members of
the pool.
c. Strategic purchasing
• Also known as allocating revenue.
• The objectives of strategic purchasing are to enhance equity in the distribution of resources,
increase efficiency, manage expenditure growth and promote quality in health service
delivery. It also serves to enhance transparency and accountability of providers and
purchasers to the population.

Health System 8
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

Now that we understand what is a health system, goals, and functions we will discuss what
system do we guide our different health care system.

THE 4 TYPES OF HEALTH CARE SYSTEMS:

There are currently 4 types of health care systems that countries base their system upon. It may
be adopted after one model, while others choose a combination. These health care systems
include:

1. The Beveridge Model

✓ Beveridge report or the Social Insurance and Allied Services of 1942.

✓ It is named after William Beveridge, the social reformer responsible for designing
Britain’s Social Security System and the National Health Services.
✓ In this model, health care is provided and funded by the government through tax
payments. Health care providers like Doctors and pharmaceutical companies
collect their professional fees from the government thru the payment of taxes.
✓ Countries using Beveridge plan includes: Great Britain, Hong Kong, Spain, New
Zealand, and Cuba.

*To understand further watch the attached videos about the Beveridge Model “ How insurance
works: the Care in Kind or Beveridge Social Model ”

2. The Bismarck Model

✓ Bismarck’s Law on Health Insurance of 1883.

✓ It is name after Otto Von Bismarck, a Prussian Chancellor that is known for
inventing the welfare state in the 19th century as part of the unification of Germany.
✓ It is a more decentralized form of healthcare (Private institutions) where it is
provided through insurance companies who are paid by employer and employee
payroll deductions.

Health System 9
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

✓ In this model, everyone must be covered and no one is left with no access to care.
This system focuses on its resources on those who can contribute financially as to
those who are unable to work or afford contributions.
✓ Countries using Bismarck plan includes: Germany, France, Belgium, Netherlands,
Japan, Switzerland, and some parts in Latin America.

*To understand further watch the attached videos about the Bismarck Model “How insurance
works: the Mutual Insurance Fund or Otto von Bismarck social model”

3. The National Health Insurance Model

✓ It incorporates aspects of both the Bismarck and Beveridge models. Like the
Beveridge model, the government acts as the single payer for medical
procedures, and like the Bismarck model, providers are private.
✓ It uses private-sector providers, but payment comes from a government-
run insurance program that all citizens fund through a premium or tax.
✓ Countries using National Health Insurance Model includes: Canada (considered
to have the best health care system), Taiwan, and South Korea.

*To understand further watch the attached video about the National Health Insurance Model
“NHI (National Health Insurance) Explained in 3 Minutes ”

4. The Out-of-Pocket Model

✓ In this model patients must pay for their procedures out-of-pocket.

✓ This model is considered to be anti-poor and only the wealthy people can have
robust access to health care systems. Disparities in wealth lead to disparities in
health outcomes in these areas.
✓ Countries using out-of-pocket model includes: rural areas in Philippines, India,
China, Africa, and South America.

*To understand further watch the attached video about the Out-of-pocket Model “How
insurance works: the Out of Pocket model”

Health System 10
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

High income countries follow the Beveridge, Bismarck model, and national health
insurance model while other developing countries uses the multiple and fragmented forms
like the national health insurance model and out-of-pocket model.

Now let us analyze health system framework to know how health systems are build, improve, & contribute
to strengthen the overall health outcomes.

WHO HEALTH SYSTEM FRAMEWORK

World Health Report 2000 defines six building blocks and priorities which are necessary in
strengthening health systems and improving the overall health outcomes.

Health System 11
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

THE (6) SIX BUILDING BLOCKS:

Figure 2.1 WHO Health Systems Framework

(Figure by World Health Organization (2007), licensed under CC BY-SA 4.0)

1. Service Delivery - Refers to timely delivery of quality and cost-effective personal and
non-personal health services.
2. Leadership & Governance - It involves the task of ensuring effective stewardship of
the entire health system. This building block, also covers the monitoring of accountability
of private & public health agencies, proper system design, and appropriate regulation of
health systems.

3. Financing - Is a building block which takes care of the funding for health care services
to guarantee that people can use health services when needed without fear of having not
enough resources to pay for them.

Health System 12
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 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

4. Health products, vaccines, & technologies - It is made possible through

uninterrupted supply, well-managed pharmaceutical services, and education on proper
use of medication.
5. Health workforce - It includes individuals and groups working towards the
achievement of the best health outcomes by being responsive, fair, and efficient.
6. Information - It analyzes, disseminates, and use reliable and relevant information on
health status, determinants, and systems performance.

The six building blocks contribute to the strengthening of health systems in different ways.
Inevitably, any type of division of a complex construct such as the health system is fraught with
problems. It does not take into account actions that influence peoples’ behavior’s, both in
promoting and protecting health and the use of health-care services. The framework does not
address the underlying social and economic determinants of health, such as gender inequities or
education, and also does not deal with the substantial and dynamic links and interactions that
exist across each component. On the other hand, focusing on these separate components helps
put boundaries around this complex construct and permits the identification of indicators and
measurement strategies for monitoring progress thus resulting in positive outcomes

Health System 13
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

KEY POINTS TO REMEMBER:

✓ Health system is defined as all the organizations, institutions, resources, and people
whose primary purpose is to improve health.

✓ Health system combines resources, organization, financing and management to

deliver health services to the population.

✓ The primary goals of the health system are improved health outcomes (attaining
the best average level of health care for the entire population by minimizing disparities),
more responsive health system (meeting the people’s expectations of and satisfaction
from health service delivery), and more equitable health care financing (protecting each
individual from financial risks).

✓ The four functions of the health system are:

1. Health services provision – for appropriate and cost-effective health delivery.

2. Health service inputs – for generating human resources, technology, and capital.

3. Health financing – by revenue collection, risk pooling, and strategic purchasing.

4. Stewardship and initiatives – to strengthen governance, accountability and

responsiveness.

✓ 4 types of health care systems:

1. The Beveridge Model: single-payer national health service

2. The Bismarck Model: social health insurance model

3. The National Health Insurance Model: single-payer national health insurance

4. The Out-of-Pocket Model: market-driven health care

✓ A health system can be analyzed in its totality by using a framework consisting of six
building blocks, i.e., leadership and governance, health financing, health workforce, health
products, vaccines, and technologies, health information, and service delivery.

Health System 14
*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

REFERENCES

Main Reference Book:

Nuevo, J.J. M. (2019). Health Information System for Medical Laboratory Science. C& E
Publishing Inc. Quezon City, Philippines

Online Sources:
Chung, M. (2017). HEALTH CARE REFORM: LEARNING FROM OTHER MAJOR HEALTH
CARE SYSTEMS. Princeton Public Health Review. Retrieved July 14, 2020 from
https://pphr.princeton.edu/2017/12/02/unhealthy-health-care-a-cursory-
overview-of-major-health-care-systems/
Collaboration for Health Policy & Systems Analysis in Africa (CHEPSAA). (2015,
January 15). What is a health system? [Slides]. SlideShare.
https://www.slideshare.net/hpsa_africa/what-is-a-health-system
Dayrit MM, Lagrada LP, Picazo OF, Pons MC, Villaverde MC. (2018) The Philippines
Health System Review. Vol. 8 No. 2. New Delhi: World Health Organization, Regional
Office for SouthEast Asia. From
https://apps.who.int/iris/bitstream/handle/10665/274579/9789290226734-
eng.pdf?sequence=1&isAllowed=y
Fan, K. F. R. (2018, May). A Correlative Study on International Healthcare System Variables
and Opioid Consumption Data (Honors College Thesis). Oregon State University.
https://ir.library.oregonstate.edu/concern/honors_college_theses/f7623j43f
Health Care Systems: Types & Concept. (2017, February 3). Retrieved July 14, 2020
from https://study.com/academy/lesson/health-care-systems-types- lesson-
quiz.html.
Mathauer, I. et al, (2017). Health Financing. World Health Organization. Retrieved July
14, 2020 from https://www.who.int/health_financing/documents/strategic-
purchasing-discussion-
summary/en/#:~:text=The%20objectives%20of%20strategic%20purchasing,and
%20purchasers%20to%20the%20population.
Syafinaz, I. et al, (2016). HEALTH CARE PROVISION AND EQUITY. International Journal
of Public Health and Clinical Sciences, 3(4). Retrieved July 13, 2020 from
https://www.researchgate.net/publication/324328670_HEALTH_CARE_PROVISIO
N_AND_EQUITY

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*No part of this learning module may be reproduced in any form without prior permission in writing from the author.
 Universidad de Sta. Isabel Vincentian Learning Module
College of Health Sciences HEALTH INFORMATION SYSTEM FOR LABORATORY SCIENCE
Medical Technology Program Dan Ceazar O. Baldoza, RMT

Vanessa Rémy, York Zöllner & Ulrike Heckmann (2015) Vaccination: the cornerstone of an
efficient healthcare system, Journal of Market Access & Health Policy, 3:1, 27041,
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World Health Organization. (2010). MONITORING THE BUILDING BLOCKS OF HEALTH
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Instead%2C%20it%20is%20structured%20around,governance%20(see%20Figure%201)

Image:
Cod1. (n.d.). Dora the Explorer.png [Cartoon character]. Fandom.
https://muc.fandom.com/wiki/Dora_the_Explorer?file=Dora_the_Explorer.png
Enuqidze, G. (n.d.). Discord Transparent Background Thinking Emoji, HD Png
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transparent-background-thinking-emoji-hd-png-download/
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https://onehallyu.com/topic/517355-momos-arm-scars/
Smart, K. (n.d.). Establishing Rapport in the Classroom [Illustration]. Inside Higher Ed.
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classroom-essay
Video:
Filip Declercq. (2014a, June 11). How insurance works: the Care in Kind or Beveridge Social
Model [Video]. YouTube. https://www.youtube.com/watch?v=QLQRhTCa744

Filip Declercq. (2014c, June 11). How insurance works: the Out of Pocket model [Video].
YouTube. https://www.youtube.com/watch?v=jzaMe1i_Clc
Filip Declercq. (2014, June 11). How insurance works: the Mutual Insurance Fund or Otto
vonBismarck social model [Video]. YouTube.
https://www.youtube.com/watch?v=oj7CwNwSQ3A
ZASA Magazine (2020, Feb. 27) NHI (National Health Insurance) Explained in 3 Minutes.
Retrieved from https://www.youtube.com/watch?v=_w-FBoYqpo8

Health System 16
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