In both developed and developing countries, health care systems have become more pluralistic. Health service professionals, suppliers and citizens are fulfilling their changing needs against a backdrop of possibilities of modern medicine. Policy-makers and health care organizations worldwide face a common challenge of balancing resources to ensure that people enjoy equitable access to effective health care. Central to this challenge are the interactions between the various stakeholders in the health system domain.

Within the field of health care systems, the activities of ECORYS concentrate on the following main topics:

Health care strategies
The holy grail of health services research is finding ways to provide universal coverage at affordable prices. This involves developing, implementing and evaluating health care strategies that can deal with the challenges of, among others, a growing world population, occupational mobility of health professionals, expanding technological solutions, changing patterns of chronic and pandemic disease, ageing populations, the use of public and private market mechanisms and cross-border health care.

Priority setting in health care
Resources for health care are limited. Priorities for allocating them are inevitably set, whether explicitly or implicitly. Allocation of health resources involves several dimensions, including the relationship of health care resources to other public needs (e.g. education), the distribution of health care, priority setting in health care, and the criteria on the basis of which these priorities are set.

Determining health care benefit packages
All health care systems have a defined ‘package’ of benefits or ‘covered services’. Central to defining the health care benefit package is the process of coverage decision-making.  An evidence-based approach has become an increasingly important part in this process. Assessing the impact of health services on health benefits is based on criteria including efficacy, (cost-) effectiveness, value for money, and improved equity of access to services. ECORYS is well-versed in evaluating and comparing practices of coverage decision-making and identifying barriers and solutions to determine health care benefit packages.

More information
For more information, please contact:

Arthur ten Have
Partner Health
T +31 (0)10 453 86 82
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Wija Oortwijn
Partner Health
T +31 (0)10 453 84 21
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Project references

Project: Surinam, Strengthening of Preventive and Primary Health Care Services
Country: Surinam
Client: Surinam Ministry of Health
Activities: In this project ECORYS provided the Surinam Government with practical suggestions on how to make rapid health gains, in particular by strengthening primary health care. The work focused on prevention, primary health care, and human resource development and organization of primary health care in general.

Project: Framework contract lot 8: Health policy, health systems, public health, health financing, health promotion, drug management and human resource management
Country: Worldwide
Client: European Commission - EuropeAid
Activities: ECORYS manages several framework contracts for the European Commission including lot 8 on health related issues: health policy and health systems, public health, health financing, health promotion, drug management and human resources management. ECORYS is responsible for project management, quality control and technical backstopping. In total, 35 projects were implemented from 2005 till 2009. In 2009, the contract has been renewed for at least another two years.

Project: Support to secondary health care reform in the Ukraine
Country: Ukraine
Client: European Commission
Activities: The project offers long-term support to the Ministry of Health for systematic secondary health care reform with the aim to establish an effective, cost-efficient and equitable health care system in Ukraine. In cooperation with regional health administration, hospital master plans have been developed for three pilot regions to offer an alternative health care financing and organisation structure that should increase efficacy and quality of health care. Capacities of local and regional governments have been developed for the preparation and implementation of these reforms. Furthermore, health care management personnel have been trained to prepare for the introduction of reforms.

Project: Reimbursement of preventive health care
Country: The Netherlands
Client: Health Care Insurance Board
Activities: In the Netherlands, the Health Care Insurance Board (CVZ) plays an important role in advising the Minister of Health about which health care interventions are reimbursed. ECORYS has been asked to assist CVZ in clarifying which preventive care with regard to tobacco use, alcohol use and overweight as well as the diseases diabetes and depression is or should be reimbursed for which indications.

Project: Development of health strategy in the light of the 9th EDF
Country: Benin
Client: European Commission
Activities: The overall objective of the project was to define a strategy for health sector intervention in the light of the 9th European Development Fund (EDF). More specifically, the assignment comprised an inventory to highlight the changes in the health sector in Benin, current challenges, constraints and prospect. Subsequently, logical interventions were identified and prioritized taking account of crosscutting themes such as gender, environment and good governance.

Project: International comparison of long-term care systems 
Country: The Netherlands
Client: National Council on Public Health and Health Care
Activities: ECORYS experts prepared an international comparison of the organisation of long-term care. A wide range of subjects was covered: an inventory of regulations and arrangements, organisation of long-term care provision, decentralisation, trends in outpatient care and three practical cases based on ‘typical’ patients as well as a report for every country.
The project contributed to an overview of interesting regulations that could be used for the Dutch system, which was to be reformed shortly. The following countries were examined: Austria, Belgium, France, Germany, Spain, Sweden and United Kingdom.