TY - JOUR
T1 - Tracking health system performance in times of crisis using routine health data
T2 - lessons learned from a multicountry consortium
AU - Turcotte-Tremblay, Anne Marie
AU - Leerapan, Borwornsom
AU - Akweongo, Patricia
AU - Amponsah, Freddie
AU - Aryal, Amit
AU - Asai, Daisuke
AU - Awoonor-Williams, John Koku
AU - Ayele, Wondimu
AU - Bauhoff, Sebastian
AU - Doubova, Svetlana V.
AU - Gadeka, Dominic Dormenyo
AU - Dulal, Mahesh
AU - Gage, Anna
AU - Gordon-Strachan, Georgiana
AU - Haile-Mariam, Damen
AU - Joseph, Jean Paul
AU - Kaewkamjornchai, Phanuwich
AU - Kapoor, Neena R.
AU - Gelaw, Solomon Kassahun
AU - Kim, Min Kyung
AU - Kruk, Margaret E.
AU - Kubota, Shogo
AU - Margozzini, Paula
AU - Mehata, Suresh
AU - Mthethwa, Londiwe
AU - Nega, Adiam
AU - Oh, Juhwan
AU - Park, Soo Kyung
AU - Passi-Solar, Alvaro
AU - Perez Cuevas, Ricardo Enrique
AU - Reddy, Tarylee
AU - Rittiphairoj, Thanitsara
AU - Sapag, Jaime C.
AU - Thermidor, Roody
AU - Tlou, Boikhutso
AU - Arsenault, Catherine
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - COVID-19 has prompted the use of readily available administrative data to track health system performance in times of crisis and to monitor disruptions in essential healthcare services. In this commentary we describe our experience working with these data and lessons learned across countries. Since April 2020, the Quality Evidence for Health System Transformation (QuEST) network has used administrative data and routine health information systems (RHIS) to assess health system performance during COVID-19 in Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, Republic of Korea and Thailand. We compiled a large set of indicators related to common health conditions for the purpose of multicountry comparisons. The study compiled 73 indicators. A total of 43% of the indicators compiled pertained to reproductive, maternal, newborn and child health (RMNCH). Only 12% of the indicators were related to hypertension, diabetes or cancer care. We also found few indicators related to mental health services and outcomes within these data systems. Moreover, 72% of the indicators compiled were related to volume of services delivered, 18% to health outcomes and only 10% to the quality of processes of care. While several datasets were complete or near-complete censuses of all health facilities in the country, others excluded some facility types or population groups. In some countries, RHIS did not capture services delivered through non-visit or nonconventional care during COVID-19, such as telemedicine. We propose the following recommendations to improve the analysis of administrative and RHIS data to track health system performance in times of crisis: ensure the scope of health conditions covered is aligned with the burden of disease, increase the number of indicators related to quality of care and health outcomes; incorporate data on nonconventional care such as telehealth; continue improving data quality and expand reporting from private sector facilities; move towards collecting patient-level data through electronic health records to facilitate quality-of-care assessment and equity analyses; implement more resilient and standardized health information technologies; reduce delays and loosen restrictions for researchers to access the data; complement routine data with patient-reported data; and employ mixed methods to better understand the underlying causes of service disruptions.
AB - COVID-19 has prompted the use of readily available administrative data to track health system performance in times of crisis and to monitor disruptions in essential healthcare services. In this commentary we describe our experience working with these data and lessons learned across countries. Since April 2020, the Quality Evidence for Health System Transformation (QuEST) network has used administrative data and routine health information systems (RHIS) to assess health system performance during COVID-19 in Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, Republic of Korea and Thailand. We compiled a large set of indicators related to common health conditions for the purpose of multicountry comparisons. The study compiled 73 indicators. A total of 43% of the indicators compiled pertained to reproductive, maternal, newborn and child health (RMNCH). Only 12% of the indicators were related to hypertension, diabetes or cancer care. We also found few indicators related to mental health services and outcomes within these data systems. Moreover, 72% of the indicators compiled were related to volume of services delivered, 18% to health outcomes and only 10% to the quality of processes of care. While several datasets were complete or near-complete censuses of all health facilities in the country, others excluded some facility types or population groups. In some countries, RHIS did not capture services delivered through non-visit or nonconventional care during COVID-19, such as telemedicine. We propose the following recommendations to improve the analysis of administrative and RHIS data to track health system performance in times of crisis: ensure the scope of health conditions covered is aligned with the burden of disease, increase the number of indicators related to quality of care and health outcomes; incorporate data on nonconventional care such as telehealth; continue improving data quality and expand reporting from private sector facilities; move towards collecting patient-level data through electronic health records to facilitate quality-of-care assessment and equity analyses; implement more resilient and standardized health information technologies; reduce delays and loosen restrictions for researchers to access the data; complement routine data with patient-reported data; and employ mixed methods to better understand the underlying causes of service disruptions.
KW - COVID-19
KW - Health systems
KW - Quality of care
KW - Routine health information systems
UR - http://www.scopus.com/inward/record.url?scp=85147281513&partnerID=8YFLogxK
U2 - 10.1186/s12961-022-00956-6
DO - 10.1186/s12961-022-00956-6
M3 - Comment/debate
AN - SCOPUS:85147281513
SN - 1478-4505
VL - 21
JO - Health Research Policy and Systems
JF - Health Research Policy and Systems
IS - 1
M1 - 14
ER -