With the healthcare sector accounting for a sizeable proportion of national expenditures, the pursuit of efficiency has become a central objective of policymakers within most health systems. However, ...the analysis and measurement of efficiency is a complex undertaking, not least due to the multiple objectives of health care organizations and the many gaps in information systems. In response to this complexity, research in organizational efficiency analysis has flourished. This 2006 book examines some of the most important techniques currently available to measure the efficiency of systems and organizations, including data envelopment analysis and stochastic frontier analysis, and also presents some promising new methodological approaches. Such techniques offer the prospect of many new and fruitful insights into health care performance. Nevertheless, they also pose many practical and methodological challenges. This is an important critical assessment of the strengths and limitations of efficiency analysis applied to health and health care.
The United States spends greatly more per person on health care than any other country but the evidence shows that care is often poor and inappropriate. Despite expenditures of 1.7 trillion dollars ...in 2003, and growing substantially each year, services remain fragmented and poorly coordinated, and more than 46 million people are uninsured. Why can't America, with its vast array of resources, sophisticated technologies, superior medical research and educational institutions, and talented health care professionals, produce higher quality care and better outcomes?In The Truth about Health Care, David Mechanic explains how health care in America has evolved in ways that favor a myriad of economic, professional, and political interests over those of patients. While money has always had a place in medical care, "big money" and the quest for profits has become dominant, making meaningful reforms difficult to achieve. Mechanic acknowledges that railing against these influences, which are here to stay, can achieve only so much. Instead, he asks whether it is possible to convert what is best about health care in America into a well functioning system that better serves the entire population.Bringing decades of experience as an active health policy participant, researcher, teacher, and consultant to the public and private sectors, Mechanic examines the strengths and weaknesses of our system and how it has evolved. He pays special attention to areas often neglected in policy discussions, such as the loss of public trust in medicine, the tragic state of long-term care, and the relationship of mental health to health care.For anyone who has been frustrated by uncoordinated health networks, insurance denials, and other obstacles to obtaining appropriate care, this book will provide a refreshing and frank look at the system's current and future dilemmas. Mechanic's thoughtful roadmap describes how health plans, healthcare professionals, policymakers, and consumer groups can work together to improve access, quality, fairness, and health outcomes in America.About the Author:
It has been more than 20 years since Brazil's 1988 Constitution formally established the Unified Health System (Sistema Unico de Saude, SUS). Building on reforms that started in the 1980s, the SUS ...represented a significant break with the past, establishing health care as a fundamental right and duty of the state and initiating a process of fundamentally transforming Brazil's health system to achieve this goal. This report aims to answer two main questions. First is have the SUS reforms transformed the health system as envisaged 20 years ago? Second, have the reforms led to improvements with regard to access to services, financial protection, and health outcomes? In addressing these questions, the report revisits ground covered in previous assessments, but also brings to bear additional or more recent data and places Brazil's health system in an international context. The report shows that the health system reforms can be credited with significant achievements. The report points to some promising directions for health system reforms that will allow Brazil to continue building on the achievements made to date. Although it is possible to reach some broad conclusions, there are many gaps and caveats in the story. A secondary aim of the report is to consider how some of these gaps can be filled through improved monitoring of health system performance and future research. The introduction presents a short review of the history of the SUS, describes the core principles that underpinned the reform, and offers a brief description of the evaluation framework used in the report. Chapter two presents findings on the extent to which the SUS reforms have transformed the health system, focusing on delivery, financing, and governance. Chapter three asks whether the reforms have resulted in improved outcomes with regard to access to services, financial protection, quality, health outcomes, and efficiency. The concluding chapter presents the main findings of the study, discusses some policy directions for addressing the current shortcomings, and identifies areas for further research.
In Eliminating Healthcare Disparities in America, Dr. Richard Allen Williams assembles the very best scholars on healthcare disparities to raise the public consciousness of this issue. These experts ...provide the benefits of their experience and expertise as a resource for helping others to make judicious determinations about how to proceed in efforts to improve the disparities in American healthcare. Arranged into discrete categories, this volume contains comprehensive coverage, both historical and current, of the healthcare disparity crisis currently plaguing our country in hopes of leading us all to a brighter future. The volume includes chapters of examples that are currently working and concludes with recommendations on how to move forward. The text is not intended to be one in which all of the answers are given to the multitude of problems. Instead, Eliminating Healthcare Disparities in America is intended to raise the readers level of consciousness and concern and to increase the knowledge base about the issues. This groundbreaking text will be an initial spark that ignites the fire that may one day eliminate healthcare disparities in communities around the country.
Full text
Available for:
FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
`This is an excellent textbook for which there is currently a niche in the market. It will be invaluable to students of health policy, health studies and health service research′ - Professor Michael ...Calnan, University of Bristol Written by leading academics in their field this book provides a clear and considered overview of the politics of health care in Britain. Bringing together a wide range of material on both past events and recent developments, the chapters cover issues such as the politics of health professionalism, clinical knowledge and organisation and management. Each chapter offers a a unique combination of theory, historical detail and analysis of contemporary events. It features case studies to illustrate how policy has evolved and developed in recent years, and the implications these changes have for practice. Written in an accessible style the chapters also include comprehensive introductions, summaries and further reading sections.
Seeking Value Sowers, Wesley E; Ranz, Jules M; Psychiatry, Group for the Advancement of
2020, 2020-11-13
eBook
This comprehensive volume examines the myriad factors that have led to the current state of health care in the United States -- starting with an analysis of the meaning and history of value ...measurement -- but it does not stop there. It offers a holistic vision for health care reform, one in which psychiatric professionals play a pivotal role.
Over the period 1987–1991 an inter-disciplinary five-country group developed the EuroQol instrument, a five-dimensional three-level generic measure subsequently termed the ‘EQ-5D’. It was designed to ...measure and value health status. The salient features of its development and its consolidation and expansion are discussed. Initial expansion came, in particular, in the form of new language versions. Their development raised translation and semantic issues, experience with which helped feed into the design of two further instruments, the EQ-5D-5L and the youth version EQ-5D-Y. The expanded usage across clinical programmes, disease and condition areas, population surveys, patient-reported outcomes, and value sets is outlined. Valuation has been of continued relevance for the Group as this has allowed its instruments to be utilised as part of the economic appraisal of health programmes and their incorporation into health technology assessments. The future of the Group is considered in the context of: (1) its scientific strategy, (2) changes in the external environment affecting the demand for EQ-5D, and (3) a variety of issues it is facing in the context of the design of the instrument, its use in health technology assessment, and potential new uses for EQ-5D outside of clinical trials and technology appraisal.
Full text
Available for:
CEKLJ, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
How good is the quality of health care in the United States? Is quality improving? Or is it suffering? While the average person on the street can follow the state of the economy with economic ...indicators, we do not have a tool that allows us to track trends in health care quality. Beginning in 2003, the Agency for Healthcare Research and Quality (AHRQ) will produce an annual report on the national trends in the quality of health care delivery in the United States. AHRQ commissioned the Institute of Medicine (IOM) to help develop a vision for this report that will allow national and state policy makers, providers, consumers, and the public at large to track trends in health care quality. Envisioning the National Health Care Quality Report offers a framework for health care quality, specific examples of the types of measures that should be included in the report, suggestions on the criteria for selecting measures, as well as advice on reaching the intended audiences. Its recommendations could help the national health care quality report to become a mainstay of our nation's effort to improve health care.
For decades, the nations of the European Union wrote the book on universal health coverage. Recent economic developments, however, have created problems ranging from widening inequities of care to ...growing numbers of uninsured - a progression expertly described by Win de Gooijer in Trends in EU Health Care Systems. De Gooijers dual background as an economist and the CEO of Dutch health care corporations, together with his broad international experience, give him a unique understanding of his subject. He traces world economic currents that have affected quality of and access to health care throughout the EU - trends that took years to develop, but are coming to rapid fruition. Comparative illustrations from Europe and the US show national interests at odds with global ones, as governments transfer social responsibilities to market-driven agencies. Included in his discussion: - Expansion versus reform: a forty-year analysis of Europes health care systems - Why governments cannot completely control the always-evolving dynamics of health care - Ethical and medical issues arising from the continents changing politics - Predictions on future directions in EU health carehow much change is possible, how much is necessary. Some may find De Gooijers ideas startling, and the book is bound to be the subject of controversy. But it is critical reading for health care managers and policymakers, politicians and insurers, advanced students of public health - in short, anyone looking to Europe for the next phase of this far-reaching evolution. 'This book is a very important contribution to the debate about the future direction of health policy in Europe. It captures the economic and social trends that underpin health systems with a keen and objective eye and poses some very challenging questions about the future. It will not be a comfortable read for politicians but it is a book that must be read.' Brian Edwards, Presiden
Full text
Available for:
FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Taking a political economic approach, Schneider examines the conditions under which community-based health groups are emerging and explores the ways different constituencies address health dilemmas. ...She delineates future roles for new participants in health care, new models of community health, and a new medical pluralism.
PDF
