What is a health system?

A national health system is a complex system established by public policy to achieve certain socioeconomic goals.  The complex components--structure and instruments--used to establish the architecture of a health system is determined by political, institutional and economic considerations.  Setting a system’s goals is strongly influenced by the social ethics embraced by a society.  The accountability and monitoring of a health system’s performance require measurement and evaluation.  Therefore, the intellectual core of health systems study comes from the intersection of several disciplines—ethics, politics, economics, and evaluation sciences.

What questions are being addressed by health system studies?

Health systems study intends to answer questions such as:

• What is the architecture of a national health system? 
• How do the different components explain (or determine) system performance?  
• How do the different components of a health system interact with each other and how do their interactions affect performance?  
• How are health system reformed? What are the constraints?  What factors determines the successes or failures of a reform?

Health systems knowledge is applied to address broad and major policy issues, such as:

• How to design a system to assure equitable health care for all citizens?
• How to control national health expenditure inflation rate to sustain a system?
• How to protect citizens from medical impoverishment?
• How to combine government actions with market forces to improve the efficiency and effectiveness of health care?
• How to prepare and support human resources in health to achieve better quality of care?

What is the intellectual foundation and methods for health system studies?

Health system study applies theories and methods from relevant disciplines to understand and investigate systemic questions.  It’s grounded in evidence and not purely on theory.  The major disciplines involved are:  

• Ethics  
• Politics
• Economics
• Evaluation sciences (statistical methods, modeling, econometrics, survey and focus group methods
• Organization theory
• Psychology