Mireia Jofre is the Head of Research and Vice President at the Office of Health Economics (OHE). She is a Senior Associated Researcher at the Department of Health Policy of LSE (London School of Economics and Political Sciences), and an Expert Advisor for the NICE Centre for Guidelines. She has been Professor in Economics and Deputy Head of the Department of Economics at City, University of London, as well as the Director of the MSc in Health Economics and the MSc in Economic Evaluation in Healthcare at the same University. Mireia is also a member of the Health Economics Study Group, of AES (Asociación de Economía de la Salud) and an Associated Researcher at CRES-UPF.

Alistair McGuire is Head of Department and Chair of Health Economics at the Department of Health Policy of LSE (London School of Economics and Political Sciences). He has been Professor of Economics at City, University of London after being a tutor in Economics at the University of Oxford. He has acted as an advisor to the United Kingdom government, the UK Competition Commission, the UK Medical Research Council (MRC), as well as to a number of international bodies (including the World Bank, the WHO, and the IMF) and pharmaceutical and health care insurance companies.

Abstract

The COVID-19 pandemic has highlighted the need for sustainable and resilient healthcare systems to protect population health. This research aims to design, construct and pilot a country-level healthcare system sustainability and resilience index (HSSRI) that reflects and combines the two dimensions, sustainability and resilience. The HSSRI captures the performance of a healthcare system across the different domains that contribute to its sustainability and resilience. As part of our analyses, we conduct a rapid evidence assessment to identify indicators reflecting the selected domains. We assess the indicators' suitability by the quantity and quality of the literature supporting their inclusion. We extract the variables in the indicators from publicly available data sources. The period covered is from 2000 to 2020. We use a weighted average of all indicators - and then domains - to calculate domain and dimension-level indices, respectively. For this pilot, we apply equal weights to all indicators and dimensions by obtaining the sub-indices and final index as geometric means of their components. We pilot-test the HSSRI with data from five high-income countries: France, Germany, Japan, Poland and the United Kingdom. The indices reveal heterogeneity in performance within and across countries during the period examined. This is likely to be driven by country-specific and policy-related differences. The dimension and domain-level indices enable policy-makers and stakeholders to observe how different factors have contributed to their sustainability and resilience. The HSSRI aims at facilitating a better understanding and monitoring of healthcare systems' absolute and relative weaknesses and strengths, allowing policy-makers to design interventions that can improve their resilience and sustainability. Nevertheless, questions arise on how to combine two indices for the two domains meaningfully.

Presentation