HSH211 Lecture Notes - Lecture 9: Open Data, The Who, Comparator

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27 May 2018
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How does Australia’s health care syste copare iteratioally
Frameworks for comparative analysis
In any analysis, the first thing to remember is that analysis is comparative. Therefore we need to ask
'How good is X, compared to Y'?
Often, the comparator is historical- this is what we do in a before and after study design. For
example 'Were the outcomes better after the change compared to before? In health analysis, we
often do this when we look at the change in health outcomes over time 'Was the use of hospital
emergency department higher after a change in out of pocket costs to see a GP? 'Was access to
specialists in rural areas increased after the incentive payment policy began?
The other common comparator is contemporary ie. The time outcomes are measured is the same,
by comparing to a different group or population. This is what we do in randomised controlled trials;
it is also what we do in international comparisons of health care systems.
One thing to remember in an analysis is that your comparison needs to bear in mind that there may
be other things that differ between the two groups being compared. This is what people mean when
they talk about comparing apples and oranges. Apples and oranges are not the same thing, but they
are both fruit. If we were comparing them on colour outcomes then that analysis would be
substantially biased by their initial differences. But if we were comparing them on taste or nutrient
content then the analysis may be useful, but we would want to explicitly account for or at least
describe initial differences that may affect the comparative analysis results.
For health care systems, the world health organisation has developed a framework and has already
used this framework to describe and compared the health care systems of most of the countries for
the world. So it seems silly not to use the same one this week. We will do this below.
The WHO framework: 6 building blocks
The world health organisations 6 building blocks are the foundation of the HWO health systems
framework. This framework was introduced in WHO'S 2000 world health report, which focused on
the importance of health care systems and which presented the largest international health care
system comparative analysis ever conducted. Australia came 2nd in the world in terms of average
health outcomes, but once other factors were considered (included superior wealth), we were
ranked 32nd overall.
Summary
We compare Australia's performance to that of other countries as a way of assessing how well
Australia is doing
International comparisons need a common framework, and the WHO health systems
framework provides this
Any health system can be described in terms of the 'six building blocks'
Comparing performance needs data on recent outcomes; open data resources can provide this
find more resources at oneclass.com
find more resources at oneclass.com
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Document Summary

How does australia"s health care syste(cid:373) co(cid:373)pare i(cid:374)ter(cid:374)atio(cid:374)ally. In any analysis, the first thing to remember is that analysis is comparative. Often, the comparator is historical- this is what we do in a before and after study design. The other common comparator is contemporary ie. the time outcomes are measured is the same, by comparing to a different group or population. This is what we do in randomised controlled trials; it is also what we do in international comparisons of health care systems. One thing to remember in an analysis is that your comparison needs to bear in mind that there may be other things that differ between the two groups being compared. This is what people mean when they talk about comparing apples and oranges. Apples and oranges are not the same thing, but they are both fruit. If we were comparing them on colour outcomes then that analysis would be substantially biased by their initial differences.

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