Guidelines for the Clinical and Economic Assessment of Health Technologies

1985 ◽  
Vol 1 (3) ◽  
pp. 551-566 ◽  
Author(s):  
Gordon Guyatt ◽  
Michael Drummond

That new health technologies often diffuse into the health care systems of developed countries without adequate evaluation has long been a cause of concern (I). In addition, where clinical or economic assessments have been carried out, they often contain methodological weaknesses which reduce their usefulness to health policy makers or clinical practitioners (5,6).

1986 ◽  
Vol 2 (2) ◽  
pp. 285-295
Author(s):  
Thomas P. Hughes

If medicine is becoming mechanized, as many indications suggest, then those interested in policy making for medical matters have much to learn from the history of technology. The mechanization of medicine, as in the case of the mechanization of production, will accelerate the transfer of skill and knowledge from people to machines and the transition of health care to a capital intensive industry (19, 196–226). Furthermore, mechanization and increasing capital intensification may bring the increased systematization of health care. If the development of mechanized medicine follows the precedent of the mechanization of production, then our society must deal with the evolution of another set of extremely large systems, systems that will become virtually impervious to social control. Historians of technology are currently providing a better understanding of the evolution of large systems of production (3;9;10); there are lessons to be learned from this history by policy makers in health care.


Author(s):  
Patricia Illingworth ◽  
Wendy E. Parmet

Immigration and health are two of the most contentious issues facing policy makers today. Policies that relate to both issues—to the health of newcomers—often reflect misimpressions about immigrants, their health, and their impact on health care systems. Although immigrants are typically younger and healthier than natives, and many newcomers play a vital role in providing care in their new lands, natives are often reluctant to extend basic health care to immigrants. Likewise, many nations turn against immigrants when epidemics strike, falsely believing that native populations can be kept well by keeping immigrants out. This book demonstrates how such reactions thwart attempts to create efficient and effective health policies and efforts to promote public health. The book argues that because health is a global public good and people benefit from the health of neighbor and stranger alike, it is in everyone’s interest to ensure the health of all. Reviewing issues as diverse as medical repatriation, epidemic controls, the right to health, the medical brain drain, organ tourism, and global climate change, the book shows why solidarity between natives and newcomers is ethically required and in the service of health for all.


2018 ◽  
Author(s):  
Curtis L Petersen ◽  
William B Weeks ◽  
Olof Norin ◽  
James N Weinstein

BACKGROUND Caring for individuals with chronic conditions is labor intensive, requiring ongoing appointments, treatments, and support. The growing number of individuals with chronic conditions makes this support model unsustainably burdensome on health care systems globally. Mobile health technologies are increasingly being used throughout health care to facilitate communication, track disease, and provide educational support to patients. Such technologies show promise, yet they are not being used to their full extent within US health care systems. OBJECTIVE The purpose of this study was to examine the use of staff and costs of a remote monitoring care model in persons with and without a chronic condition. METHODS At Dartmouth-Hitchcock Health, 2894 employees volunteered to monitor their health, transmit data for analysis, and communicate digitally with a care team. Volunteers received Bluetooth-connected consumer-grade devices that were paired to a mobile phone app that facilitated digital communication with nursing and health behavior change staff. Health data were collected and automatically analyzed, and behavioral support communications were generated based on those analyses. Care support staff were automatically alerted according to purpose-developed algorithms. In a subgroup of participants and matched controls, we used difference-in-difference techniques to examine changes in per capita expenditures. RESULTS Participants averaged 41 years of age; 72.70% (2104/2894) were female and 12.99% (376/2894) had at least one chronic condition. On average each month, participants submitted 23 vital sign measurements, engaged in 1.96 conversations, and received 0.25 automated messages. Persons with chronic conditions accounted for 39.74% (8587/21,607) of all staff conversations, with higher per capita conversation rates for all shifts compared to those without chronic conditions (P<.001). Additionally, persons with chronic conditions engaged nursing staff more than those without chronic conditions (1.40 and 0.19 per capita conversations, respectively, P<.001). When compared to the same period in the prior year, per capita health care expenditures for persons with chronic conditions dropped by 15% (P=.06) more than did those for matched controls. CONCLUSIONS The technology-based chronic condition management care model was frequently used and demonstrated potential for cost savings among participants with chronic conditions. While further studies are necessary, this model appears to be a promising solution to efficiently provide patients with personalized care, when and where they need it.


2019 ◽  
Vol 23 (1) ◽  
pp. 104-114 ◽  
Author(s):  
R. A. Khalfin ◽  
V. V. Madyanova ◽  
O. E. Kachkova ◽  
I. D. Demina ◽  
T. I. Krishtaleva ◽  
...  

Purpose of the study. To analyze the concept of creating patient-oriented medicine, the prerequisites for its emergence, the difficulties of introducing it into existing health systems based on foreign experience. Materials and methods. The main materials of the study were used sources of foreign literature, which presents the concept of patient-oriented medicine, analyzed the prerequisites for changing models of health care in the European Union, USA and Asia in accordance with the principles of patient-oriented medicine, as well as data on the components and levels of patient-oriented medicine in foreign countries Results. The analyzed literature quite fully describes the difficulties of introducing patient-oriented medicine into existing health care systems. Particular attention should be paid to a multidisciplinary approach, continuity at different levels of medical care and effective communication between the physician and the patient towards the integration of this model into clinical practice. The analysis of the availability of medical care in developed countries and its dependence on social status, ethnicity and disease of the patient. Conclusion. Patient-oriented medicine is a new model for planning, implementing and evaluating medical services, which is based on mutually beneficial partnerships between medical workers, patients and their families. Taking into account the current problems of domestic health care, the introduction of the patient-oriented model will significantly improve the quality of medical care provided to the population of our country. Globally, the implementation of the principles of this model is far from complete. In the Russian Federation, targeted work in this direction requires additional scientific research, systematization of available data, and development of new legal documents


2007 ◽  
Vol 23 (suppl 2) ◽  
pp. S133-S142 ◽  
Author(s):  
Thomas Gerlinger ◽  
Hans-Jürgen Urban

In the European Union (EU), health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision.


2020 ◽  
Author(s):  
Francesco Petracca ◽  
Oriana Ciani ◽  
Maria Cucciniello ◽  
Rosanna Tarricone

UNSTRUCTURED A common development observed during the COVID-19 pandemic is the renewed reliance on digital health technologies. Prior to the pandemic, the uptake of digital health technologies to directly strengthen public health systems had been unsatisfactory; however, a relentless acceleration took place within health care systems during the COVID-19 pandemic. Therefore, digital health technologies could not be prescinded from the organizational and institutional merits of the systems in which they were introduced. The Italian National Health Service is strongly decentralized, with the national government exercising general stewardship and regions responsible for the delivery of health care services. Together with the substantial lack of digital efforts previously, these institutional characteristics resulted in delays in the uptake of appropriate solutions, territorial differences, and issues in engaging the appropriate health care professionals during the pandemic. An in-depth analysis of the organizational context is instrumental in fully interpreting the contribution of digital health during the pandemic and providing the foundation for the digital reconstruction of what is to come after.


10.2196/19866 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e19866 ◽  
Author(s):  
Jiancheng Ye

At present, the coronavirus disease (COVID-19) is spreading around the world. It is a critical and important task to take thorough efforts to prevent and control the pandemic. Compared with severe acute respiratory syndrome and Middle East Respiratory Syndrome, COVID-19 spreads more rapidly owing to increased globalization, a longer incubation period, and unobvious symptoms. As the coronavirus has the characteristics of strong transmission and weak lethality, and since the large-scale increase of infected people may overwhelm health care systems, efforts are needed to treat critical patients, track and manage the health status of residents, and isolate suspected patients. The application of emerging health technologies and digital practices in health care, such as artificial intelligence, telemedicine or telehealth, mobile health, big data, 5G, and the Internet of Things, have become powerful “weapons” to fight against the pandemic and provide strong support in pandemic prevention and control. Applications and evaluations of all of these technologies, practices, and health delivery services are highlighted in this study.


Sign in / Sign up

Export Citation Format

Share Document