Avaliação de impacte na Saúde

Figure 1 — Health inputs and health outputs

Excelente Encontro sobre avaliação do Impacte na Saúde e nos Sistemas de Saúde link
(…) A saúde deverá pois ser encarada, cada vez mais, como um investimento e não como um custo. Os ganhos em saúde necessitam de ser pensados em cenários que incluam as consequências individuais e colectivas em períodos de tempo que cursam para lá dos ciclos políticos. link
É necessário fazer o exercício de transferência de impactes estimados na saúde para impactes económicos e societais, para mais directamente se apelar às preocupações e prioridade dos decisores políticos.
A avaliação de impacte e mais concretamente a avaliação de impacte na saúde constitui um poderoso instrumento para elevar a prioridade da saúde na hierarquia dos diferentes sectores.
Esta avaliação, baseada na evidência científica, é essencial para fundamentar a decisão, ter em conta os custos indirectos, no médio e longo prazos, derivados da morbilidade e mortalidade evitáveis, a par do potencial impacte do acréscimo dos anos de vida saudáveis na redução da despesa pública, no aumento da vida activa, na sustentabilidade dos sistemas de saúde e protecção social, na competitividade da O Plano Nacional de Saúde, com um horizonte temporal até 2010, preconiza o diálogo intersectorial de forma a contribuir para objectivos de saúde através de outras políticas, bem como o desenvolvimento de mecanismos destinados a garantir a transversalidade da política de saúde nas outras políticas internas, nomeadamente recorrendo à avaliação de impacte.
CC, Sessão de abertura do Encontro Sobre Avaliação do Impacte na Saúde e nos Sistemas de Saúde.

(...) Grossman distinguishes between health as a consumption good and health as a capital good. As a consumption good, health enters directly into the utility function of the individual, as people enjoy being healthy. As a capital good, health reduces the number of days spent ill, and therefore increases the number of days available for both market and non-market activities. Thus, the production of health affects an individual’s utility not only because of the pleasure of feeling in good health, but also because it increases the number of healthy days available for work (and therefore income) and leisure. link

Health is not only demanded, but also produced by the individual. Individuals inherit an initial stock of health that depreciates with time, but they can invest to maintain and increase this stock. Many inputs contribute to the production of health, as indicated in Figure 1. Healthcare is one among these factors. The demand for healthcare is therefore a derived demand for health. The production of health also requires the use of time by the individual away from market and non-market activities.
While the Grossman model has encountered some criticism (3), it continues to stand — with some extensions — as the key model of the demand for health.

Since human capital matters for economic outcomes and since health is an important component of human capital, health also matters for economic outcomes. At the same time, economic outcomes matter for health.
Health is determined by genetic, economic, social, cultural and environmental factors. But the health of a population may also, in return, influence the economic context. In line with the scheme proposed by Bloom et al. (2001), we suggest in this study that health could contribute to economic outcomes (at both the individual and the country level) in high-income countries mainly through four channels: higher productivity, higher labour supply, higher skills as a result of greater education and training, and more savings available for investment in physical and intellectual capital. These four channels are represented in the right-hand side of Figure 1.
As illustrated in the left-hand side of Figure 1, the health of an individual depends on many factors: genetic endowments, lifestyle, living and working conditions (access and use of healthcare, education, wealth, housing, occupation) and the more general socioeconomic, cultural and environmental conditions (4). Several of these determinants of health can be influenced by public policies.
In assessing the contribution that health can make to growth, it is important to keep in mind the positive feedback from income to health. There are two ways in which income can influence health: through a direct effect on the material conditions that have a positive impact on biological survival and health, and through an effect on social participation, the opportunity to control life circumstances, and the feeling of security. Above a certain threshold of material deprivation, income may be more important because of its link with these social and psychological factors, particularly in societies where social participation depends heavily on individual income (Marmot 2002). (...)
The contribution of health to the economy in the European Union