Struggling with COVID-19—A Framework for Assessing Health System Performance

Abstract

Currently, no guidelines exist on how to evaluate the performance of health systems fighting the SARS-CoV-2 pandemic. Therefore, this study seeks (1) to develop a conceptual framework that would be helpful in the given context, and (2) to test the feasibility of the proposed approach. The framework is conceptualized based on investigating critical dimensions and indicators for the successful design of a method for evaluating the performance of health systems. Subsequently, the taxonomic measure of development is used and a correlational analysis made in order to run a pilot test of the proposed concept. The finalized conceptual framework has five input dimensions (demographical burden, epidemiological burden, health-related quality of life, financial resources, and access) described by 18 indicators, and two output domains (outcomes, productivity) described by six indicators to monitor system performance under the COVID-19 pandemic. The pilot-test conducted in European Union countries and the United States proved the model to be useful and feasible. The proposed framework can be used to assess the performance of health systems fighting novel pathogens, such as SARS-CoV-2, worldwide. Our methodological approach can be used as a benchmark for international agencies such as the World Health Organization in developing their own frameworks. The paper presents the first research exploring the evaluation of a health system during the COVID-19 pandemic. It has the potential to help monitor a health system’s performance during the pandemic by accounting for specific country-related circumstances. In a broader sense, it can contribute to boosting health market competitiveness in terms of quality.