MEASURING HEALTHCARE ACCOUNTABILITY: ACCOUNTABILITY MATRIX Dr Ali Hamdulay - Head of Clinical Risk SolutionsMetropolitan Health Risk Management

Accountability

1

• How do we define it?

2• How do we

assign responsibility?

3• Can we/how

do we measure?

Definition of Accountability

Answerability Justification Sanction

Types of Accountability

Financial

• Sustainability• Rules• Cost

containment

Performance

• Utilisation• Quality• Satisfaction

Political/ Democratic

• Access• Advocacy• Care

Coordination

Strengthening the Health Citizens voice and power

The health sector role players are specifically accountable to this stakeholders.How strong is the level of accountability in the health sector to this stakeholder?

All consumers are not patients

Consumers are confused

Each consumer has different needs

Limited power and voice to articulate their needs and demands

Medical schemes represents an opportunity to articulate and

contextualise the needs of a Health Citizen cohort.

Benefits Advocacy Access to Quality

Health Outcomes

How does stronger accountability improve health system performance and sustainability?

• Increases the understanding of the health system operations and processes• System-wide perspective on health sector reform• Identify connections among individual improvement interventions• Translate priorities into action• Enhance process performance

Reduce Waste and

Abuse

Ensure Compliance

Improve Quality &

Performance

Academia

Unions

Health Citizens

Associations

NGO's

Managed Care

Administrators

Funders

Health Facilities

PractitionersActuaries

Hospitals

BrokersEmployers

HPCSACMS

Government

Health sector ecosystem and accountable role players

Accountability Mapping

Hea

lth C

itize

nsPr

actiti

oner

sH

ealth

Fac

ilitie

sFu

nder

sAd

min

stra

tors

Man

aged

Car

e Pr

ovid

ers

NG

O's

Prof

essi

onal

Ass

ocia

tions

Nati

onal

Gov

ernm

ent

Loca

l Gov

ernm

ent

Med

ical

Sch

emes

Cou

ncil

Hea

lth P

rofe

ssio

nals

Em

ploy

ers

Brok

ers

Hos

pita

lsU

nion

sH

ealth

Act

uarie

sAc

adem

ia

Health CitizensPractitioners

Health FacilitiesFunders

AdminstratorsManaged Care Providers

NGO'sProfessional Associations `

National GovernmentLocal Government

Medical Schemes CouncilHealth Professionals Council

EmployersBrokers

HospitalsUnions

Health ActuariesAcademia

Weak → Meduim Strong

Weak ↓ Meduim Strong

Demand Information, impose sanction

Supp

ly in

form

ation

, res

pond

to s

ancti

on

Health Sector Role Players

Health Sector Role Players Accountability Matrix

Capacity to demand information and impose sanctions: Capacity to supply information and repsond to sanctions:

Accountability linked to Health InterventionsWithin a population health approach, a much

greater emphasis is placed on accountability for health outcomes and determining the degree of

change that can actually be attributed to interventions.

Process evaluations to determine whether a policy or program is reaching its target population

Impact evaluations to measure the immediate results of a program or policy.

What are the principles we need to apply to measure accountability?

• Who demonstrates - Who measures? • Stakeholder relationships • Data quality• Expertise• Collaboration and consensus• Incentives, information

Breadth and Depth of Accountability

National Health

Private Sector

Terms of Employment

HEA

LTH

EC

OSY

STEM

• SustainabilityFINANCIAL

• Health outcomes

• SatisfactionPERFORMANCE

• Access• Advocacy

DEMOCRACY

MEASU

RE

Public Private Partnerships:

The Metropolitan Health Risk Management (MHRM) HIV YourLife Programme has partnered with government to assist in the achievement of the National Strategic Plan

(NSP) goals.

HCT Campaign

Circumcision Training

Decisions support tools

HIV Network

Woman's Health

“The roadmap will take into account issues such as the need for a unified approach, greater alignment and a

common purpose to ensure greater access, social solidarity, affordability and quality. The overarching

goal is to build a sustainable, integrated, patient-centric healthcare system. “

THANK YOU