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            "title": "Resolving the challenges in the international comparison of health systems: The must do's and the trade-offs.",
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                    "firstName": "",
                    "lastName": "Forde I."
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                    "lastName": "Morgan D."
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                    "lastName": "Klazinga N.S."
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            "abstractNote": "Countries are increasingly publishing health system performance statistics alongside those of their peers, to identify high performers and achieve a continuously improving health system. The aim of the paper is to identify, and discuss resolution of, some key methodological challenges, which arise when comparing health system performance. To illustrate the issues, we focus on two OECD flagship initiatives: the System of Health Accounts (SHA) and the Health Care Quality Indicators (HCQI) project and refer to two main actors: a coordinating agency, which proposes and collates performance data and second, data correspondents in constituent health systems, who submit data to the coordinating centre. Discussion is structured around two themes: a set of must-do's (legitimacy of the coordinating centre, validity of proposed indicators, feasibility of data collection and technical support for data correspondents) and a set of trade-offs (depth vs. breadth in the number of system elements compared, aggregation vs. granularity of data, flexibility vs. consistency of indicator definitions and inclusion criteria). Robust fulfillment of the must-do's and transparent resolution of the trade-offs both depend upon effective collaboration between the coordinating centre and data correspondents, and a close working relationship between a technical secretariat and a body of experts. 2013 The Authors.",
            "publicationTitle": "Health Policy",
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            "date": "2013",
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            "DOI": "http://dx.doi.org/10.1016/j.healthpol.2013.01.018",
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            "creatorSummary": "Davis P. et al.",
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            "title": "Efficiency, effectiveness, equity (E3). Evaluating hospital performance in three dimensions.",
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                    "lastName": "Davis P."
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                    "lastName": "Milne B."
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                    "lastName": "Parker K."
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                    "lastName": "Hider P."
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                    "lastName": "Lay-Yee R."
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                    "lastName": "Cumming J."
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                    "lastName": "Graham P."
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            "abstractNote": "There are well-established frameworks for comparing the performance of health systems cross-nationally on multiple dimensions. A sub-set of such comprehensive schema is taken up by criteria specifically applied to health service delivery, including hospital performance.We focus on evaluating hospital performance, using the New Zealand public hospital sector over the period 2001-2009 as a pragmatic and illustrative case study for cross-national application. We apply a broad three-dimensional matrix - efficiency, effectiveness, equity - each based on two measures, and we undertake ranking comparisons of 35 hospitals.On the efficiency dimension - relative stay, day surgery - we find coefficients of variation of 10.8% and 8.5% respectively in the pooled data, and a slight trend towards a narrowing of inter-hospital variation over time. The correlation between these indicators is low (.20). For effectiveness - post-admission mortality, unplanned readmission - the coefficient of variation is generally higher (24.1% and 12.2%), and the trend is flat. The correlation is again low (.21). The equity dimension is assessed by quantifying the degree of ethnic and socio-economic variation for each hospital. The coefficient of variation is much higher - 40.7-66.5% for ethnicity, 55.8-84.4% for socio-economic position - the trend over time is mixed, and the correlation is moderate (.41). On averaging the rank of hospitals across all measures it is evident that there is limited consistency across the three constituent dimensions.While it is possible to assess hospital performance across three dimensions using an illustrative set of standard measures derived from routine data, there appears to be little consistency in hospital rankings on these New Zealand data for the period 2001-2009. However, the methodology of using rankings derived from readily available data - possibly allied with multiple or composite indicator models - has potential for the cross-national comparison of hospital profiles, and assessments in three dimensions provide a more holistic and rounded account of performance. 2013 The Authors.",
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            "title": "Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union.",
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                    "lastName": "Footman K."
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                    "lastName": "Roberts B."
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                    "lastName": "Richardson E."
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                    "lastName": "McKee M."
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            "abstractNote": "Measurement of health system performance increasingly includes the views of healthcare users, yet little research has focussed on general population satisfaction with health systems. This study is the first to examine public satisfaction with health systems in the former Soviet Union (fSU). Data were derived from two related studies conducted in 2001 and 2010 in nine fSU countries, using nationally representative cross-sectional surveys. The prevalence of health system satisfaction in each country was compared for 2001 and 2010. Patterns of satisfaction were further examined by comparing satisfaction with the health system and other parts of the public sector, and the views of health care users and non-users. Potential determinants of population satisfaction were explored using logistic regression. For all countries combined, the level of satisfaction with health systems increased from 19.4% in 2001 to 40.6% in 2010, but varied considerably by country. Changes in satisfaction with the health system were similar to changes with the public sector, and non-users of healthcare were slightly more likely to report satisfaction than users. Characteristics associated with higher satisfaction include younger age, lower education, higher economic status, rural residency, better health status, and higher levels of political trust. Our results suggest that satisfaction can provide useful insight into public opinion on health system performance, particularly when used in conjunction with other subjective measures of satisfaction with government performance. 2013 The Authors.",
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