Miriam Blümel - Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany
Julia Röttger - Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany
Julia Köppen - Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany
Katharina Achstetter - Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany
Reinhard Busse - Department of Health Care Management, Berlin Centre for Health Economics Research, Technische Universität Berlin, Berlin, Germany

Background Health system performance assessment (HSPA) is a major tool for evidence-based governance in health systems and patient/population-orientation is increasingly considered as an important aspect. The IPHA study aims (۱) to undertake a comprehensive performance assessment of the German health system from a population perspective based on the intermediate and final dimensions defined by the World Health Organization (WHO) and (۲) to identify differences in HSPA between (a) common user characteristics and (b) user types, which differ in their interactions and patterns of action within the health system.   Methods and Analysis A cross-sectional survey was conducted between October and December ۲۰۱۸ with statutorily and privately health insured to assess the German health system from a population perspective related to the past ۱۲ months. The random sample consists of ۳۲ ۰۰۰ persons insured by AOK Nordost and ۲۰ ۰۰۰ persons insured by Debeka. Data from the survey will subsequently be linked with health insurance claims data at the individual level for each respondent who has given consent for data linkage. Claims data covers the time period January ۱, ۲۰۱۷ to June ۳۰, ۲۰۱۸. The combination of the ۲ data sources allows to identify associations between insured patient characteristics and differences in the assessment of health system performance. The survey consists of ۷۱ items measuring all final and intermediate health system goals defined by the WHO and user characteristics like health literacy, self-efficacy, the attention an individual pays to his or her health or disease, the personal network, autonomy, compliance and sociodemographics. The claims data contains information on morbidity, care delivery, service utilization, (co)payments and sociodemography.   Discussion The study represents a promising attempt to perform a holistic HSPA using a population perspective. For this purpose, a questionnaire was designed that contains both validated and new items in order to collect data on all relevant health system dimensions. In particular, linking survey data on HSPA with claims data is of high potential for assessing and analysing determinants of health system performance from the population perspective.

Health System Performance Assessment, Population Perspective, Germany, Data Linkage, Claims Data