MPH/HSMP 2007-2008: CC1: DHS: GI: The model of the integrated local health system

this topic is the part of CC1: Vocabulary & terms, LHS by Tom Huree & JP Unger

 In a local health system all felt health needs of a defined population are cared for within the limits of the available and efficiently managed resources.

Integrated local health systems (LHS) model is descriptive, predictive and prescriptive model.

Functions of model

1. Descriptive: describe reality, displaying the essential characteristics in convenient form
2. Predictive: help to anticipate how change in one aspect could affect other aspects of the whole
3. Prescriptive: present an ideal situation that one should try to attain

                 Integrated means that the system is deliberately organized and co-ordinate as a whole and that all system functions are conceived as complementary, General consumption is that performance of an integrated system more and more than sum of performances of its constituting parts.

                 System: System is a set of interesting elements or functions constituting a whole. Systemic approach focus on the interactions between the composing elements (functions) and interactions with the environment

                Open system: How a system develops depends on how the interactions between the elements and between the system and the environment develop. Modification of one element or of an interaction can affect the system as a whole. More complex systems develop less predictably.

                 Composing elements of LHS

1. Care provision: operation actors: - Care provider: modern/traditional, public/private/NGOs, legal/illegal, health center/clinic/hospital - Beneficiaries: community, families, individuals in their social environment
2. Stakeholders: government, politicians, funding agencies, care providers, beneficiaries
3. Governing/regulating body

                  Characteristics of Integrated local health system

1. No gaps in health problem coverage: provides adequate responses to the demand of the population taking into account their needs and within the limits of available resources and their efficient use
2. No overlaps in functions: Each element of the system has specific functions that are best suited to its characteristicsDecentralized, permanent, multipurpose first line services (develop the interface between the service & community, provide patient centred care, accomplish the synthesis function)Centralized, specialized, periodic referral levels (cater who require care that can’t be decentralized, avoid to carry out first line functions but back up the first line services)
3. Optimal flow of patients (subsidiarity) and information (Accessibility in useful tier, information accompany with patient, operational technical decentralization/synthesis function at FLHS level)

Quality criteria of Integrated local health system

1. Health care level: patient centred care (Holistic, integrated, continuous), effective
2. Health services level: Acceptable, accessible, affordable
3. Health system level: Integrated (no gaps, no overlaps, optimal flow of patients & information), FLHS (decentralized, permanently accessible, polyvalent), Referral services (centralized, periodically accessible, specialized)

Phichet Banyati,

November 11, 2007.

Verbondstraat 52, Antwerp