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Table 1 Structure and definitions for sub-dimensions of the framework for indicators of the health system in Baden-Wuerttemberg

From: Healthcare planning across healthcare sectors in Baden-Wuerttemberg, Germany: a stakeholder online survey to identify indicators

Framework sub-dimension

Description

Non-medical determinants of health

 Health behaviours

This sub-category includes self-harming and positive health behaviours. Actions of healthcare planning may aim to promote positive health behaviours.

 Social determinants

Social determinants of health embrace the two sub-categories living and working conditions and environmental factors of the Canadian framework. According to the WHO, social determinants of health describe conditions individuals are born, grow up, live, work, and grow old with.

 Demographic factors

Population characteristics such as age and gender fall under this sub-category.

Health status

 Morbidity

In this sub-category, primarily indicators concerning frequency of diseases focussed in the project are included.

 Mortality

Information on mortality was to be collected mainly for the calculation of health system performance indicators but also to approximate regional health status.

Utilisation of the health system

 Prevention and health promotion

Through indicators assigned to this sub-category, utilisation of prevention or health promotion services and structures is measured.

 Outpatient care

This sub-category includes the utilisation of services offered in practices, ambulatory healthcare centres, and domestic setting.

  (Semi-residential) inpatient care

This sub-category subsumes the utilisation of services offered in hospitals, rehabilitation clinics, and nursing homes.

Health system performance

 Accessibility

Derived from the OECD’s Health Care Quality Indicators Framework accessibility defines how easy healthcare services are accessible. Access can be physical, financial, or psychological and requires the existence of the particular healthcare service.

 Patient centeredness

Patient centeredness is achieved, when healthcare provision is orientated on patients’ wishes, expectations, and satisfaction.

 Continuity

Continuity describes the degree to which healthcare provision for specific users is coordinated between health professionals and other institutions.

 Effectiveness & efficiency

Effectiveness describes the degree to which a healthcare service achieves a desired result whereas efficiency means the optimal use of available resources to achieve maximum benefit.

 Safety

Safety describes the degree to which healthcare processes avoid, prevent, or improve adverse events resulting from healthcare itself.

Healthcare provision

 Facilities

This sub-category includes a variety of health facilities with a focus of those which are especially relevant for patient groups selected in the project.

 Professionals

Indicators of this sub-category were meant to include all health professionals having direct contact to either patients or their dependants such as physicians, psychologists, and nurses.

 Technology

This sub-category subsumes health related products such as medical machines like computer tomography scanner, and telemedicine.

 Honorary office

Besides health professionals health related support is also provided by other patients, e.g. in self-help groups or other patient organisations, and by other persons on a voluntary basis.