2.2 Coverage, quality, effective coverage, and the care cascade

Figure 2.2 Coverage, quality, effective coverage, and the care cascade

A Population in need Population with condition X B Coverage Receives service for condition X C Effective coverage 1 Receives correct interventions for condition X D Effective coverage 2

EC1= = ∙ C B C A AB =Coverage rate ∙ Correct treatment rate (Quality 1)

EC2 D A

= = B AB D ∙ =Coverage rate ∙ Successful treatment rate (Quality 2)

Source: World Bank.

Successful treatment, i.e., maximum health gain achieved

Effective coverage tree Figure 2.3 further illustrates the components of effective coverage by looking at different scenarios at each step of the interactions between patients and health care providers: consultation, diagnosis, and treatment. At the end of each branch of the tree, the green color symbolizes a desirable outcome, while the orange color denotes undesirable outcomes. For any medical condition, the population (A) is divided between those in need of care (B) and those not in need. Among those in need of care, a fraction (C) consults, while the rest does not and thus will not receive care. Among the fraction (C) that consults, some patients will be correctly diagnosed, while others might be incorrectly diagnosed and will thus receive irrelevant care.

Among those correctly diagnosed, relevant care will be provided to a fraction (D), but the rest might receive no care or irrelevant care despite a correct diagnosis. Going one step further than correct diagnosis and aiming at measuring successful treatment, the fraction (D) that received correct treatment can be further divided into a fraction (E ) that was correctly treated and benefited from the maximum health gain, a fraction (F) that received some relevant care but for whom the maximum health gain is not realized, and a fraction (G) that received a mix of relevant and irrelevant care for whom the maximum health gain is not realized.