Public Health Systems

Author(s): Harry Hellard


There is pressure on public health systems around the world to provide healthcare in the face of rising financial resource constraints. Therefore, it's important to maximise the benefits of public healthcare spending on health. The purpose of this work is to establish and summarise the current evidence basis for system management-level methods to efficiency improvement.


Utilizing Rapid Evidence Assessment (REA) technique. A search technique was created, and when it was used (PUBMED, MEDLINE), it produced 5,377 different titles. 82 papers were included in the final review after 172 full-text articles were evaluated for relevance. A narrative synthesis was created after data describing the nation, study design, major findings, and efficiency improvement strategies were retrieved. Publications on developednation health systems were among them.


Policy reviews, qualitative reviews, mixed-methods reviews, systematic reviews, literature reviews, retrospective analyses, scoping analyses, narrative papers, regression analyses, and opinion pieces were among the study designs that were identified. Despite the lack of broad frameworks for system-wide efficiency improvement found in the research, a number of particular centrally guided improvement initiatives were found. Dedicated central functions to drive system-wide efficiency improvement, managing efficiency in parallel with quality and value, and comprehensive stakeholder engagement were factors associated with success in present approaches.


The need for public health systems to become more effective is likely to keep growing. Reactive cost-cutting strategies and short-term initiatives that merely attempt to lower costs are unlikely to lead to a sustained increase in efficiency. Public health system management organisations can improve financial, health service and stakeholder results by offering dedicated central system-wide efficiency improvement support.