SNF-PVS - Adolescent and Adult Perspectives on European Health System Performance: A Four-Country Study
Project Abstract
Background:
Population trust in health systems is crucial both during public health crises like the COVID-19 pandemic and during normal times, as it influences people’s willingness to contribute resources to the health system, to utilize the services it offers, and to follow public health guidance. However, people´s perceptions of health systems and their experiences of care are currently not captured systematically in any national or international data system. Data is particularly scarce on the perspectives of high-needs groups, including adolescents, migrants, and gender and sexual minorities, that historically have been underserved by health systems. Understanding people’s perspectives on health system performance is critical for creating higher-quality, more equitable, and more people-centred health systems for the future.
Objectives:
We aim to use a new study tool developed by an international team of researchers led by the Harvard School of Public Health to measure health system performance from the population perspective in four target countries: Latvia, the Netherlands, Scotland and Switzerland. The People’s Voice Survey (PVS) is designed to measure health system quality (e.g., care pathways, experiences of care, and trust and confidence in the health system) in a systematic and comparable way, using nationally representative samples. Applying an equity lens, we plan to also conduct focused analyses of responses from migrants; adolescents under age 18; and gender and sexual minorities to assess to the extent to which health systems are meeting the unique needs of these groups. Through this project, we aim to generate and disseminate insights into health system performance that can inform advocacy efforts, policy reforms, and, ultimately, contribute to strengthening health systems to better meet population needs.
Methods:
We will implement the People’s Voice in Latvia, the Netherlands, Scotland, and Switzerland. The PVS has been extensively validated in a wide range of settings around the world using cognitive interviews, pre-testing, and piloting. In each of the four target countries, we will translate and adapt the survey tool with input from stakeholder groups. We will then randomly select 2500-3000 individuals ages 15 and older for the survey, and get their input on health systems performance using a combination of phone, online and mail surveys. The surveys will cover a range of domains related to health system quality, including: expectations of care, care pathways and utilization patterns, perceptions of care quality in different domains (including quality ratings of health facilities, as well as different aspects of the public and private health system), endorsement of the health system, trust and confidence in the health system, and equity across different population subgroups. We will conduct country-specific analyses as well as multi-country analyses that compare performance across different health systems.
Impact:
The PVS enables a rapid assessment of health system performance from a population perspective. The results can inform health system design and financing to maximize positive health outcomes and inform community demand for improvement. By focusing on adolescents, migrants, and gender and sexual minorities, we will also be able to bring attention to their particular health needs and inform health system reforms to better meet these needs.
We plan to develop targeted policy briefs for policy dialogue in each country. We also plan to organize a joint event for dissemination of findings as the basis for further health systems transformation for all people including children and adolescents. Finally, we plan to develop scientific manuscripts communicating key findings from the surveys, directly comparing the four health systems with respect to their performance for the adult population as a whole as well as adolescent and migrant population.
