The impact of vouchers on the use and quality of health care in developing countries: A systematic review

AbstractIntroductionEarthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in “Mega-Mass-Casualty” earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system.MethodsThe systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy was developed to identify all publications relating to earthquakes and the orthopedic treatment in adult patients. The following databases were searched: PubMed (Medline; US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), Ovid (Ovid Technologies; New York, New York USA), Web of Science (Thomson Reuters; New York, New York USA), and The Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom).ResultsThe searches identified 4,704 articles: 4,445 after duplicates were removed. The papers were screened for title and abstract and 65 out of those were selected for full-text analysis. The quality of data does not permit a standard-of-care (SOC) to be defined. Scarcity and poor quality of the data collected also may suggest a low level of accountability of the activity of the international hospital teams. Qualitatively, it is possible to define that there are more open fractures during daytime hours than at night. Excluding data about open and closed fractures, for all types of injuries, the results underline that the higher the impact of the earthquake, as measured by Richter Magnitude Scale (RMS), the higher is the number of injuries.DiscussionRegarding orthopedic injuries during earthquakes, special attention must be paid to the management of the lower limbs most frequently injured. Spinal cord involvement following spine fractures is an important issue: this underlines how a neurosurgeon on a disaster team could be an important asset during the response. Conservative treatment for fractures, when possible, should be encouraged in a disaster setting. Regarding amputation, it is important to underline how the response and the quality of health care delivered is different from one team to another. This study shows how important it is to improve, and to require, the accountability of international disaster teams in terms of type and quality of health care delivered, and to standardize the data collection.BortolinM, MorelliI, VoskanyanA, JoyceNR, CiottoneGR. Earthquake-related orthopedic injuries in adult population: a systematic review. Prehosp Disaster Med. 2017;32(2):201–208.

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Rapid population growth, the quality of health, and the quality of health care in developing countries

Consequences of Rapid Population Growth in Developing Countries ◽

10.4324/9781315058979-12 ◽

1991 ◽

pp. 219-242

Author(s):

J. E. Potter

Keyword(s):

Health Care ◽

Developing Countries ◽

Population Growth ◽

Quality Of Health Care ◽

Rapid Population Growth

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Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service

American Economic Journal Economic Policy ◽

10.1257/pol.5.4.134 ◽

2013 ◽

Vol 5 (4) ◽

pp. 134-166 ◽

Cited By ~ 50

Author(s):

Martin Gaynor ◽

Rodrigo Moreno-Serra ◽

Carol Propper

Keyword(s):

Health Care ◽

National Health Service ◽

Health Service ◽

Patient Outcomes ◽

Quality Of Health Care ◽

Policy Reform ◽

Difference In Differences ◽

Empirical Estimates ◽

The Impact

The effect of competition on the quality of health care remains a contested issue. Most empirical estimates rely on inference from nonexperimental data. In contrast, this paper exploits a procompetitive policy reform to provide estimates of the impact of competition on hospital outcomes. The English government introduced a policy in 2006 to promote competition between hospitals. Using this policy to implement a difference-in-differences research design, we estimate the impact of the introduction of competition on not only clinical outcomes but also productivity and expenditure. We find that the effect of competition is to save lives without raising costs. (JEL H51, I11, I18, L32, L33)

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Effectiveness of UK provider financial incentives on quality of care: a systematic review

British Journal of General Practice ◽

10.3399/bjgp17x693149 ◽

2017 ◽

Vol 67 (664) ◽

pp. e800-e815 ◽

Cited By ~ 10

Author(s):

Rishi Mandavia ◽

Nishchay Mehta ◽

Anne Schilder ◽

Elias Mossialos

Keyword(s):

Systematic Review ◽

Health Care ◽

Quality Of Care ◽

Quality Of Health Care ◽

Financial Incentives ◽

Healthcare Quality ◽

Standards Of Care ◽

Positive Effects ◽

The Uk

BackgroundProvider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency.AimTo review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care.Design and settingSystematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations.MethodMEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as ‘positive’, those that were ‘intermediate’ showed improvement in some measures, and those classified as ‘negative’ showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist.ResultsOf the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points.ConclusionThe effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives — if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK.

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