Pathway framework 7 of 8
How to get a clear view of a health system by tracing where its money comes from and what it buys
The pathway follows the money in a health system, starting with how the system is organised and how it raises and pools funds for care. Later steps cover how providers are paid and manage their finances, and how their performance and quality are measured.
5 steps
This framework organises the concepts covered at each step of the pathway on the Knowledge Map.
Concepts from other branches of the Knowledge Tree that this pathway builds on.
Step 1
How a health system is arranged, who holds authority over funds and providers, and the policies and rules that govern care.
19 concepts
Why start here
Every later step happens inside a particular system, so the pathway starts with how health systems are organised and governed.
Step 2
How a system raises money for health and pools it so that people share the risk of high care costs, through taxes or insurance.
43 concepts
Why this comes next
Once the structure is clear, the next question is where the money comes from and how pooling protects people against the cost of illness.
Step 3
How purchasers pay doctors and hospitals, and the incentives that each payment method creates for the amount and kind of care given.
20 concepts
Why this comes next
With pooled funds in place, the next step is how purchasers spend those funds by paying the providers who deliver care.
Step 4
How hospitals and other providers plan budgets and read financial ratios to check whether they can pay their bills and stay solvent.
13 concepts
Why this comes next
The way a provider is paid shapes its income, so its budgets and financial health are looked at next.
Step 5
How the efficiency and quality of care are measured and compared across providers.
53 concepts
Why this comes next
The pathway ends by asking what the money buys, so measures of efficiency and quality come last, once funding and payment are understood.
Branches that take these methods further.