Healthcare Systems Classification and Frameworks Essay

Reasons why the Crude Death Rate is higher in Germany than in the UAE

The crude death rate of a country refers to the ratio of people who die to those who remain alive in a specified country within a one-year period. Usually, the expression of this ratio is in terms of a number of deaths for every one thousand people in the population. The crude death rate in the UAE in 2010 was 1.34, while the crude death in Germany in the same year was 10.5 (WHO, 2010). On the other hand, the median age in UAE as of 2010 was 20.2 years, while the median age in German in the same year was 45.3 years (WHO, 2010). The reason for the disparity in the crude death rates is that age is a very strong source of bias in demographics (Jekel, 2007). This difference in age accounts for the disparity between the crude death rates of the two countries. Therefore, while the crude death rate is an accurate measure of the number of people dying in a particular country, it may be misleading if it does not take into account the age of the population in question.

Using Crude Death Rates to Compare Countries

The crude death rate is a true rating. It reports a vital statistic about a country regarding the mortality rate of the citizens. Comparison of the crude death rates of the two countries is possible provided several issues remain clear. First, the comparison process must account for the bias introduced by age. Age has a significant biasing effect on the crude death rate of a country (Jekel, 2007). Countries with a higher median age report a higher crude death rate. Secondly, the crude death rate is useful if the countries under comparison have similar demographic characteristics. Countries within the same region tend to have similar demographic characteristics. The crude death rate is an important way of comparing the mortality rate in the two countries. The third way of using the crude death rate as a means of comparing the demographic characteristics of countries is by using the crude death rate of a country at an earlier point as a base value for comparison with the value from another country. This approach enables researchers to investigate the impact of factors influencing demographic changes. For instance, how does a simultaneous disease outbreak in different countries affect the crude death rate in a particular year in each of the countries?

Measuring the Burden of Disease, and its Comparison to Infant Mortality

The burden of disease, in simple terms, refers to the cost caused by ill health on a variety of factors. There are several ways of measuring disease burden. World Health Organization (WHO) uses Disability Adjusted Life Years (DALY) to measure the burden of disease (WHO, 2010). This measure expresses the number of years that a person is in ill health, rendering them unable to have normal functioning. A similar measure of disease burden is Quality-Adjusted Life Years (QALY) (WHO, 2010). Infant mortality refers to the number of children under one-year-old that die within a specified year. This measure usually compares well with the overall health standards of the country. The relationship between the burden of disease and infant mortality is that each of these metrics can give an indication of the quality of life in a country (Akhtar, 2008). The computation of the burden of disease is more complex than the computation of infant mortality. The burden of disease requires a means of identifying the number of days people within a region spend on sick offs. This data is more difficult to collect as opposed to mortality data simply because of the finality of death. Disease burden is a lifetime measure while infant mortality covers a single year at a time.

Difference between WHO and World Banks Health System Frameworks

The Health system framework developed by the World Health Organization (WHO) has three main components. These components are, “actors, institutions, and components,” which interact to produce health benefits for communities, and ensure that wealth increases in the community (Shakarishvili, 2009, p. 4). World Bank, on the other hand, looks at health system frameworks in terms of their functional elements, which are, health service inputs, service provision, health financing, and stewardship (Shakarishvili, 2009). The definition from WHO describes what a health system framework ought to include. The definition from the World Bank, on the other hand, uses a systems approach and defines health systems frameworks in terms of the system components.

The definition from the World Bank seems more comprehensive and desirable for describing health systems. It gives a much clearer definition of what constitutes a health system. The definition from WHO requires further clarification hence it is more difficult to use it as the basis of developing a conceptual framework for understanding health system frameworks. Perhaps the reason why the model developed by the World Banks is more attractive for use a health system framework is that the World Bank does not specialize in health issues. Therefore its framework is more summative and comprehensive because it focuses on the big picture rather than too many specifics. WHO on the other hand, has a framework that has many specifics, which end up limiting the potential application of the framework.

Classification of Health Systems and the Main types of Health Systems

It is possible to classify health systems into three main categories. The first category is the descriptive health system frameworks (Shakarishvili, 2009). These frameworks simply explain how the health system looks and how it works. They do not address questions relating to how the components of the system interact. These frameworks simply concentrate on key relationships. Secondly, there are analytical models (Shakarishvili, 2009). These models move beyond simply describing how the health system works. They describe relationships and seek to find out how different parts of the health system interact. This way, they provide a stronger basis for the development of conceptual frameworks and the application of health system frameworks in different environments. The third type of health system frameworks is the deterministic and predictive models (Shakarishvili, 2009). These types of models go further than creating an understanding of what the health system framework is like. They also exceed the limits beyond describing how individual parts of the health system interact with other parts of the health system. The models here seek to uncover success and limiting factors. Deterministic and predictive models seek to provide answers related to the reasons why some models work better. As a result, these models provide practitioners and planners with the capacity to determine which model will apply best given a certain set of conditions. These models are very useful for predicting future scenarios thereby helping in the provision of healthcare. Deterministic and predictive models are invaluable for policymakers and macro-economic experts.

References

Akhtar, S. (2008). Epidemiologic Measures of Association. Karachi: Division of Epidemiology and Biostatistics, Aga Khan University.

Jekel, J. F. (2007). Epidemiology, Biostatistics, and Preventive Medicine. New York, NY: Elsevier Health Sciences.

Shakarishvili, G. (2009). Building on Health Systems Frameworks for Developing a Common Approach to Health Systems Strengthening. World Bank, the Global Fund and the GAVI Alliance (pp. 1-16). Washington DC: World Bank.

WHO. (2010). Advanced Search. Web.