Avarice, Inefficiency, and Inequality: An International Health Care Tale

1977 ◽  
Vol 7 (2) ◽  
pp. 179-190
Author(s):  
Alan Maynard
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Care Delivery ◽  
Medical Profession ◽  
International Health ◽  
West Germany ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Health Care Delivery Systems ◽  
The Cost

The paper is concerned with impact of a medical profession, physicians, on the delivery of health care. The basic economic motivation of self-interest and avarice has led this profession to produce health care outcomes which are inequitable and inefficient. In the first section of the paper the regional geographical distribution of physicians in four disparate health systems—England, Ireland, France, and West Germany-is analyzed and found to be highly unequal. The next section is concerned with the efficacy of therapies and the cost-effectiveness of health care delivery systems in a variety of countries. The final section discusses how health care can be more equitably and more efficiently delivered. It is argued that both markets and bureaucracies are likely to be inadequate unless carefully monitored. In particular, there is a great need to investigate the cost-effectiveness of therapies and then persuade physicians, via pecuniary and nonpecuniary incentives, to behave in a manner which leads to more equitable and efficient health care outcomes.

scholarly journals Telemedicine During the COVID-19 Pandemic: Experiences From Western China (Preprint)

2020 ◽  
Author(s):  
Zhen Hong ◽  
Nian Li ◽  
Dajiang Li ◽  
Junhua Li ◽  
Bing Li ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Western China ◽  
Smartphone App ◽  
Telemedicine System ◽  
Health Care Resources ◽  
Health Care Outcomes ◽  
The World ◽  
Care Outcomes

UNSTRUCTURED Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.

Better Accounting Transforms Health Care Delivery

2014 ◽  
Vol 28 (2) ◽  
pp. 365-383 ◽  
Author(s):  
Robert S. Kaplan ◽  
Mary L. Witkowski
Keyword(s):  
Health Care ◽  
Medical Condition ◽  
Care Delivery ◽  
Value Added ◽  
Activity Based Costing ◽  
Cost Information ◽  
Process Step ◽  
Health Care Outcomes ◽  
Bundled Payments ◽  
Care Outcomes

SYNOPSIS The paper describes the theory and preliminary results for an action research program that explores the implications from better measurements of health care outcomes and costs. After summarizing Porter's outcome taxonomy (Porter 2010), we illustrate how to use process mapping and time-driven activity-based costing to measure the costs of treating patients over a complete cycle of care for a specific medical condition. With valid outcome and cost information, managers and clinicians can standardize clinical and administrative processes, eliminate non-value added and redundant steps, improve resource utilization, and redesign care so that appropriate medical resources perform each process step. These actions enable costs to be reduced while maintaining or improving medical outcomes. Better measurements also allow payers to offer bundled payments, based on the costs of using efficient processes and contingent on achieving superior outcomes. The end result will be a more effective and more productive health care sector. The paper concludes with suggestions for accounting research opportunities in the sector.

scholarly journals The role of accreditation in 21st century health professions education: report of an International Consensus Group

2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Jason R. Frank ◽  
◽  
Sarah Taber ◽  
Marta van Zanten ◽  
Fedde Scheele ◽  
...  
Keyword(s):  
Health Care ◽  
International Health ◽  
Health Professions ◽  
Health Professions Education ◽  
International Consensus ◽  
Health Care Outcomes ◽  
Core Elements ◽  
Care Outcomes ◽  
Education Report ◽  
Google Search

Abstract Background Accreditation is considered an essential ingredient for an effective system of health professions education (HPE) globally. While accreditation systems exist in various forms worldwide, there has been little written about the contemporary enterprise of accreditation and even less about its role in improving health care outcomes. We set out to 1) identify a global, contemporary definition of accreditation in the health professions, 2) describe the relationship of educational accreditation to health care outcomes, 3) identify important questions and recurring issues in twenty-first century HPE accreditation, and 4) propose a framework of essential ingredients in present-day HPE accreditation. Methods We identified health professions accreditation leaders via a literature search and a Google search of HPE institutions, as well as by accessing the networks of other leaders. These leaders were invited to join an international consensus consortium to advance the scholarship and thinking about HPE accreditation. We describe the consensus findings from the International Health Professions Accreditation Outcomes Consortium (IHPAOC). Results We define accreditation as the process of formal evaluation of an educational program, institution, or system against defined standards by an external body for the purposes of quality assurance and enhancement. In the context of HPE, accreditation is distinct from other forms of program evaluation or research. Accreditation can enhance health care outcomes because of its ability to influence and standardize the quality of training programs, continuously enhance curriculum to align with population needs, and improve learning environments. We describe ten fundamental and recurring elements of accreditation systems commonly found in HPE and provide an overview of five emerging developments in accreditation in the health professions based on the consensus findings. Conclusions Accreditation has taken on greater importance in contemporary HPE. These consensus findings provide frameworks of core elements of accreditation systems and both recurring and emerging design issues. HPE scholars, educators, and leaders can build on these frameworks to advance research, development, and operation of high-quality accreditation systems worldwide.

scholarly journals Telemedicine During the COVID-19 Pandemic: Experiences From Western China

10.2196/19577 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e19577 ◽  
Author(s):  
Zhen Hong ◽  
Nian Li ◽  
Dajiang Li ◽  
Junhua Li ◽  
Bing Li ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Western China ◽  
Smartphone App ◽  
Telemedicine System ◽  
Health Care Resources ◽  
Health Care Outcomes ◽  
The World ◽  
Care Outcomes

Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.

Setting priorities in and for end-of-life care: challenges in the application of economic evaluation

2012 ◽  
Vol 7 (4) ◽  
pp. 431-439 ◽  
Author(s):  
CHARLES NORMAND
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Short Time ◽  
Competition For Resources

AbstractHealth technology assessment processes aim to provide evidence on the effectiveness and cost-effectiveness of different elements of health care to assist setting priorities. There is a risk that services that are difficult to evaluate, and for which there is limited evidence on cost-effectiveness, may lose out in the competition for resources to those with better evidence. It is argued here that end-of-life care provides particular challenges for evaluation. Outcomes are difficult to measure, can take place over short time scales, and services can be difficult to characterise as they are tailored to the specific needs of individuals. Tools commonly used to measure health care outcomes do not appear to discriminate well in the end-of-life care context. It is argued that the assumption that units of time of different quality of life can simply be added to assess the overall experience at the end of life may not apply, and that alternative perspectives, such as the Peak and End Rule, might offer useful perspectives.

A Comparison of International Health Outcomes and Health Care Spending

1994 ◽  
Vol 10 (3) ◽  
pp. 376-381 ◽  
Author(s):  
Akira Babazono ◽  
Alan L. Hillman
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
International Health ◽  
Oecd Countries ◽  
Health Care Spending ◽  
Health Care Outcomes ◽  
Inpatient Utilization ◽  
Care Outcomes ◽  
Per Capita ◽  
Improve Health

AbstractDoes increased spending improve health outcomes? We analyzed 1988 data from OECD countries to determine how key health care indexes correlate with health care outcomes. Total health care spending per capita and outpatient and inpatient utilization are not related to health outcomes. How our resources are allocated seems to be more important than how much money is actually spent.

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