scholarly journals The Measurement of Health Care System Efficiency: Cross-country Comparison by Geographical Region

2014 ◽  
Vol 29 (1) ◽  
pp. 21-44
Author(s):  
Younhee Kim ◽  
Minah Kang

Performance of health care delivery at the cross-country level has not often been directly evaluated by given inputs and outputs. This study estimates the efficiency of the health care systems of 170 countries by extending recent research using Simar and Wilson’s bootstrap data envelopment analysis with a sensitivity test. The 170 countries are divided into four groups to compute efficiency estimators necessary to attaining a homogeneity requirement. The major finding is that most countries were inefficient to maximize the use of their inputs at the given output level. Countries in the high-income group have a relatively high average efficiency, but only 16.7% of the countries performed efficiently in the management of their health care systems. Notably, Asian countries performed more efficiently among other regions in each group. This study suggests that inefficient countries should pay attention to benchmark health care best practices within their regional peer groups.

2006 ◽  
Vol 5 (3) ◽  
pp. 375-385 ◽  
Author(s):  
Bob Matthews ◽  
Yoonsoon Jung

This paper discusses and compares the origin and development of the health care systems of South Korea and the UK from the end of WW2 and endeavours to compare outcomes. The paper emphasises the importance of war as a stimulus to the development of national health services in both countries and argues that there is convergence between the UK's nationalised NHS and South Korea's US-modelled capitalist system. Overall, we conclude that there is a possibility not only that the financing and nature of the Korean and UK health care delivery systems may show convergence, but it is not impossible that they will ‘change places’ with the UK system dominated by private provision and South Korea's by public provision.


2005 ◽  
Vol 44 (02) ◽  
pp. 273-277
Author(s):  
D. M. Lawrence

Summary Purpose: To compare organized and traditional health care delivery systems and their ability to meet several major challenges facing health care in the next 25 years. Approach: Analysis of traditional and organized health care systems based on a career spent in organized health care systems. Conclusions: The traditional health care system based on independent autonomous physicians is not able to meet the challenges of current healthcare. Stronger integration and coordination, i.e., organized health care delivery systems are required.


Author(s):  
Duncan Wade Unwin ◽  
Louis Sanzogni ◽  
Kuldeep Sandhu

This chapter examines the adoption of information technology and information systems to support the clinical process. It explores popular models of information systems adoption and success, and relates these to the health it context. The end result of successful adoption of technology should be the improvement in performance of health care delivery, yet measurement of performance is complex. The various approaches to performance measurement are discussed. As one of the challenges in predicting the outcomes of adoption is the lack of consistent taxonomy, a solution to which is proposed. The chapter then looks at evaluation of it projects and considers what special factors may affect health it adoption and benefits in developing health care systems.


2019 ◽  
Vol 40 (06) ◽  
pp. 857-868 ◽  
Author(s):  
J. Stuart Elborn

AbstractCystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidity and almost all the mortality of CF occur in adults and will increasingly follow this pattern even with new effective modulator therapies. Maintaining good quality of life including social functioning and maximizing survival for adults are the key priorities. This requires a highly knowledgeable and adaptable multidisciplinary team, which, though focused on maintaining lung health, requires an increasing range of other disciplines and specialties to maximize well-being. Changes in health care systems will require current models of care to adapt to provide care for the large number of adult patients. With increasing survival and age, many are likely to have both CF morbidities and additional diseases of aging. New models are needed for health care delivery for this expanding population with complex medical conditions.


2016 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
H. Leggett ◽  
D. Duijster ◽  
G.V.A. Douglas ◽  
K. Eaton ◽  
G.J.M.G. van der Heijden ◽  
...  

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission’s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.


2016 ◽  
Vol 32 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Jennifer L. Wiler ◽  
Kelly Bookman ◽  
Derek B. Birznieks ◽  
Robert Leeret ◽  
April Koehler ◽  
...  

Health care systems have utilized various process redesign methodologies to improve care delivery. This article describes the creation of a novel process improvement methodology, Rapid Process Optimization (RPO). This system was used to redesign emergency care delivery within a large academic health care system, which resulted in a decrease: (1) door-to-physician time (Department A: 54 minutes pre vs 12 minutes 1 year post; Department B: 20 minutes pre vs 8 minutes 3 months post), (2) overall length of stay (Department A: 228 vs 184; Department B: 202 vs 192), (3) discharge length of stay (Department A: 216 vs 140; Department B: 179 vs 169), and (4) left without being seen rates (Department A: 5.5% vs 0.0%; Department B: 4.1% vs 0.5%) despite a 47% increased census at Department A (34 391 vs 50 691) and a 4% increase at Department B (8404 vs 8753). The novel RPO process improvement methodology can inform and guide successful care redesign.


1989 ◽  
Vol 18 (2) ◽  
pp. 235-251 ◽  
Author(s):  
Cam Donaldson ◽  
Karen Gerard

ABSTRACTWithin both publicly and privately financed health care Systems different funding mechanisms have evolved, or have been proposed, to deal with the problem of ‘moral hazard’. Moral hazard arises when financial incentives within the health care System lead to either inefficient demands for care by consumers or inefficient supply of care by providers. In this paper the problem of moral hazard is outlined in more detail, and different ways of countering moral hazard are reviewed in terms of three criteria: effect on patient utilisation of health services in general; effect on utilisation by different groups of patients; and effect on health status. It is concluded that evidence on different methods of funding health services can only be judged in the context of objectives. If the objectives of health care delivery are ‘maintenance or improvement of health’ and ‘equal access for equal need’ then charges and finance of care through health maintenance organisations both appear to be less favourable than ‘free’ care at the point of delivery whilst the latter is not necessarily more costly as a resuit. Research on other suggested alternatives is required, otherwise radical changes to health care financing in the UK will simply result in movement from one unproven system to another.


Elem Sci Anth ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Katie Cueva ◽  
Christine Ingemann ◽  
Larisa Zaitseva ◽  
Gwen Healey Akearok ◽  
Josée G. Lavoie

Health care delivery in the Circumpolar North is challenged by a scarcity of culturally relevant health care services, few medical providers trained in cross-cultural care, and high costs of transportation. Community health workers (CHWs) are primarily Indigenous individuals who provide on-the-ground health care and health promotion services in their own communities. The CHWs’ scope of work varies from health education to clinical care and often focuses on upstream factors that impact the public’s health. Although often overlooked and underutilized, the CHW role is an innovative approach to promoting more sustainable and culturally relevant care within health systems. Investigating and understanding the potential ways that CHW-integrated health care systems support health and wellness could allow for a clearer understanding of how to translate this approach to other regions seeking a transition to sustainability in health and wellness. Drawing on experiences with CHWs in the Circumpolar North, this article introduces a conceptual model summarizing pathways that describe how integrating CHWs supports wellness in their communities. The proposed model includes five pathways for how CHWs could support wellness: (1) the recruitment of CHWs from within a community promotes community capacity and control; (2) the CHW role allows them to advocate to address structural and systemic inequalities that contribute to ill health, if CHWs are supported to organize their communities around wellness; (3) CHWs have the potential to support and empower community members;  (4) CHWs have the potential to develop culturally relevant, feasible, and effective health promotion strategies; and (5) CHWs have the potential to build on community strengths. This model allows for CHW-integrated health care systems to be critically examined to both test and refine this proposed model, and support and empower community health workers as a transition to a more sustainable health care delivery system that reduces inequities and promotes health.


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