Lifelong Learning Programme

This project has been funded with support from the European Commission.
This material reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein

Also available in:


Homepage > Databases > Publications


back to the list

Document Typology: Report
Methodology addressed by the publication:International Classification of Functioning, Disability and Health
Title of document: Health Management
Name of author(s): Kalediene Ramune
Name of publisher: Medicina (Kaunas, Lithuania
Language of the publication: English
Language of the review: English
Reform of the Lithuanian health system is a challenging process. The aim of this article is to assess the role of health managers in the process of health reform, evaluating the perception of health management and their training needs, as the possible determinants for the success of the reform. The results of several questionnaire surveys of Lithuanian health managers, particularly the one carried out in 2002 are used. The studies demonstrate great diversity in the conceptual understanding of health management, with prevailing rational and technical understanding. This might be associated with the rapid structural and organizational changes in the early stages of health reform and insufficient involvement of health managers in the planning and management of changes. General management, health policy, economic and law are considered as the most important study areas for health managers. The major lacking knowledge is in the subjects of law, economics and health financing. Health managers should act as mediators between politicians and health professionals. Enlargement of the area of competences, increasing autonomy in solving problems and meeting of the training needs of health managers is essential.

Reviewer's comments on the document:
Health systems provide the critical interface between life-saving, life-enhancing interventions and the people who need them. If health systems are weak, the power of these interventions is likewise weakened, or even lost. Health systems thus deserve the highest priority in any efforts to improve health management or ensure that resources are wisely used. In recent decades, health systems have contributed enormously to better health for most of the global population. As the new century begins, they have the potential to achieve further improvements in human wellbeing, especially for the poor. But very little has yet been done to unravel the complex factors which explain good or bad performance by individual health systems. Given equal resources, why do some succeed where others fail? Is performance simply driven by the laws of supply and demand, or does another logic apply? Why is dissatisfaction with services so widespread, even in wealthy countries offering the latest interventions? If systems need improvement, what tools exist to measure performance and outcomes? These are some of the many questions addressed in this report. Drawing upon a range of experiences and analytical tools, the report traces the evolution of health systems, explores their diverse characteristics, and uncovers a unifying framework of shared goals and functions. Using this as a basis for analysis, the report breaks new ground in presenting an index of health system performance based on three fundamental goals: improving the level and distribution of health, enhancing the responsiveness of the system to the legitimate expectations of the population, and assuring fair financial contributions. As the report convincingly argues, good performance depends critically on the delivery of high-quality services. But it relies on more than that. Health systems must also protect citizens from the financial risks of illness and meet their expectations with dignified care. The report goes on to show how the achievement of these goals depends on the ability of each system to carry out four main functions: service provision, resource generation, financing, and stewardship. Chapters devoted to each function offer new conceptual insights and practical advice on how to assess performance and achieve improvements with available resources. In doing so The World Health Report 2000 aims to stimulate a vigorous debate about better ways of measuring health system performance and thus finding a successful new direction for health systems to follow. By shedding new light on what makes health systems behave in certain ways, WHO also hopes to help policy-makers understand the many complex issues involved, weigh their options, and make wise choices.
Įgyvendinant sveikatos sistemos reformos
tikslus, sveikatos vadyba turi tapti prioritetiniu sveikatos
sistemos funkcionavimo elementu. Sveikatos
vadybininkai turėtų veikti kaip mediatoriai tarp sveikatos
politikų ir sveikatos profesionalų, taip pat kintant
sveikatos sistemos paradigmai, padėti sveikatos profesionalams
„peržengti“ tradicines jų profesijai būdingas
ribas. Sveikatos sistemos tikslai turi būti visiems
suprantami ir priimtini. Tik tada galėsime tikėtis
veiksmų vieningumo bei sėkmingo sveikatos sistemos
įgyvendinimo pokyčių.
Where to find it:

back to the list