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.
`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.
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.
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.
PROMOTING PARTNERSHIP FOR HEALTH This book forms part of a series entitled Promoting Partnership for Health publishedin association with the UK Centre for the Advancement of Interprofessional ...Education (CAIPE). The series explores partnership for health from policy, practice and educational perspectives. Whilst strongly advocating the imperative driving collaboration in healthcare, it adopts a pragmatic approach. Far from accepting established ideas and approaches, the series alerts readers to the pitfalls and ways to avoid them. DESCRIPTION Interprofessional Teamwork for Health and Social Care is an invaluable guide for clinicians, academics, managers and policymakers who need to understand, implement and evaluate interprofessional teamwork. It will give them a fuller understanding of how teams function, of the issues relating to the evaluation of teamwork, and of approaches to creating and implementing interventions (e.g. team training, quality improvement initiatives) within health and social care settings. It will also raise awareness of the wide range of theories that can inform interprofessional teamwork. The book is divided into nine chapters. The first 'sets the scene' by outlining some common issues which underpin interprofessional teamwork, while the second discusses current teamwork developments around the globe. Chapter 3 explores a range of team concepts, and Chapter 4 offers a new framework for understanding interprofessional teamwork. The next three chapters discuss how a range of range of social science theories, interventions and evaluation approaches can be employed to advance this field. Chapter 8 presents a synthesis of research into teams the authors have undertaken in Canada, South Africa and the UK, while the final chapter draws together key threads and offers ideas for future of teamwork. The book also provides a range of resources for designing, implementing and evaluating interprofessional teamwork activities.
Against Health Metzl, Jonathan; Kirkland, Anna
11/2010, Volume:
18
eBook
You see someone smoking a cigarette and say,Smoking is bad for your health, when what you mean is, You are a bad person because you smoke. You encounter someone whose body size you deem excessive, ...and say, Obesity is bad for your health, when what you mean is, You are lazy, unsightly, or weak of will. You see a woman bottle-feeding an infant and say,Breastfeeding is better for that child's health, when what you mean is that the woman must be a bad parent. You see the smokers, the overeaters, the bottle-feeders, and affirm your own health in the process. In these and countless other instances, the perception of your own health depends in part on your value judgments about others, and appealing to health allows for a set of moral assumptions to fly stealthily under the radar.Against Health argues that health is a concept, a norm, and a set of bodily practices whose ideological work is often rendered invisible by the assumption that it is a monolithic, universal good. And, that disparities in the incidence and prevalence of disease are closely linked to disparities in income and social support. To be clear, the book's stand against health is not a stand against the authenticity of people's attempts to ward off suffering. Against Health instead claims that individual strivings for health are, in some instances, rendered more difficult by the ways in which health is culturally configured and socially sustained.The book intervenes into current political debates about health in two ways. First, Against Health compellingly unpacks the divergent cultural meanings of health and explores the ideologies involved in its construction. Second, the authors present strategies for moving forward. They ask, what new possibilities and alliances arise? What new forms of activism or coalition can we create? What are our prospects for well-being? In short, what have we got if we ain't got health? Against Health ultimately argues that the conversations doctors, patients, politicians, activists, consumers, and policymakers have about health are enriched by recognizing that, when talking about health, they are not all talking about the same thing. And, that articulating the disparate valences of health can lead to deeper, more productive, and indeed more healthy interactions about our bodies.
Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early ...2000s, a new policy environment emerged. Methods: This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Findings: Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Conclusions: Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert.
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