International comparison of health care systems using resource profiles
01 Jan 2000-Bulletin of The World Health Organization (World Health Organization)-Vol. 78, Iss: 6, pp 770-778
TL;DR: A simple framework for comparing data underlying health care systems is presented, which distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures.
Abstract: The most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despite important criticisms of this method, relatively few alternatives have been used in practice. A simple framework for comparing data underlying health care systems is presented in this article. It distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures. Measures of real resources are further subdivided according to whether their factor prices are determined primarily in national or global markets. The approach is illustrated using a simple analysis of health care resource profiles for Denmark, France, Germany, Sweden, the United Kingdom, and the USA. Comparisons based on measures of both real resources and expenditures can be more useful than conventional comparisons of expenditures alone and can lead to important insights for the future management of health care systems.
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Dissertation•
13 Jul 2015
1 citations
Cites background from "International comparison of health ..."
...and Willis M.(55) mentions 10 indicators, some of them shared with this work....
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TL;DR: This edition of Health Expectations shows that indepth exploration of service users’ experience is fundamental in shaping health services to be more accessible and acceptable for service users, hence increasing their effectiveness.
Abstract: The UK has recently celebrated the 70th birthday of the National Health Service, and there has been much reflection on changes in health care since 1948, and focus on how the NHS is currently performing in relation to the health services of other countries. Comparing across health systems is notoriously difficult, even from the perspective of deciding which indicators to measure.1 Simply comparing health care expenditure does not suffice to represent the quality of a health system,2 although this measure continues to be widely reported. In order to make comparison across health systems the WHO has considered the following: overall level of population health, health inequalities, health system responsiveness (and how this is distributed across the population) and how the financial burden is spread. These give a highlevel picture of the health service delivered in each participating country, with clear recognition of public health values. However, for those who use health services the focus is often not on the quality of the health service overall, but on their own personal experience of the care received. If we think of our own experience as service users, what matters most is often the way things are done, how we are treated by those providing care, the extent to which our autonomy is preserved and the relationships we form with service providers. By virtue of its commitment to illuminating the service user’s voice, Health Expectations is uniquely well placed to attract and publish highquality research which explores the experience of care at a granular level. Seeking complementary and alternative care outside the health system is increasingly common (see Chou et al.), but at some points of life people inevitably become mainstream health system service users. One possibly unexpected consequence of becoming a service user may be becoming the focus of professional assessment and judgment. Lauridsen et al. tracked the experiences of women who were categorized as being overweight or obese in pregnancy and assessed the impact over time. Understanding more of what it is like to experience treatment and care is important for those who commission and deliver health services, in order to improve the effectiveness of interventions. Sudden illness also precipitates health service use, and Perry et al. assessed the impact of newly introduced centralized stroke care pathways from the perspective of patients. Mortality from ischaemic stroke is higher in the UK than in comparable countries,3 and care in a specialist stroke unit has been recommended as the biggest single factor to improve clinical outcomes. When stroke services were redesigned in two cities in the England, Perry et al. explored the experiences of patients (and their relatives) who followed the new centralized pathways. They found that the disadvantages of travelling further for care were outweighed for most by the opportunity to receive the best quality care. Additionally, receiving clear and accessible information from service providers was key in maximizing patients’ experience of care. Exploring views is recognized as important in improving the quality of health services, but there can be uncertainty about how best to respond to such feedback. Based on patients’ stories about care received from adult mental health services, Baines et al. have developed a conceptual framework to guide effective responses to service user feedback. Good communication (even down to the level of the words used to speak to service users) is not just the “icing on the cake” but affects health outcomes at a profound level (Stans et al., Reilly et al.). Health inequalities have a profound effect upon experiences of using health services and people who are less advantaged for physical, psychological or social reasons have an even greater need for thoughtful and appropriate care. How to ensure protection for vulnerable groups was one of the knotty problems Swiss citizens considered when asked to reach a consensus on health care allocation decisions (Schindler et al.). The extent to which personal responsibility plays a part in coverage for all was a contentious issue, but the authors conclude that participants were able to set priorities for complex health issues, making “tradeoffs” in the process. This edition of Health Expectations shows that indepth exploration of service users’ experience is fundamental in shaping health services to be more accessible and acceptable for service users, hence increasing their effectiveness. Improving the experience of service use for the most vulnerable has a major part to play in reducing inequalities in health. Louise Condon
1 citations
TL;DR: In this article, the authors present, from a transaction cost approach, the economic reasons why pharmaceutical transactions need to be under public control in order to harmonize regulation for new drugs.
Abstract: Countries with distinct institutional endowments are trying to reach drug harmonization. The explanation given for the beginning of this process is that the rising health concerns governments have about patients transcend their different visions of social welfare and increasing bureaucratic costs, for both pharmaceutical companies and governments. The underlying reasons are, on the one hand, the high transaction costs between the pharmaceutical companies and the patients of medication and, on the other hand, the differing pharmaceutical regulations increase bureaucratic costs. This situation pushed Europe, Japan and the US into initiating a process of harmonization of regulation for new drugs. Even though harmonization is an on-going process, global and simultaneous medication product approval is not easy (the final objective of harmonization). In this paper we present, from a transaction cost approach, the economic reasons why pharmaceutical transactions need to be under public control. At the s...
1 citations
Cites background from "International comparison of health ..."
...The debate during recent years has focused on control of health care expenditure (Schweitzer 1997, Anell and Willis 2000, Danzon and Pauly 2002)....
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...The general comparison between the EU countries and the US is detailed in the study by Anell and Willis (2000), which specifies the characteristics that make those countries different in their health care systems....
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01 Jan 2014
TL;DR: A set of guidelines and actions that would facilitate interaction between primary health care and wellness organisations in Sweden in a manner conducive to achievement of social sustainability in the area of public health are created.
Abstract: This paper is a conclusion of a four-month-long research project. Aging and lifestyle diseases pose a massive challenge for sustainability of societies of the developed countries. The aim of the study was creation of a set of guidelines and actions that would facilitate interaction between primary health care and wellness organisations in Sweden in a manner conducive to achievement of social sustainability in the area of public health. The theoretical part provides insights into significance of public health for sustainability. It explores systematic barriers for achievement and maintenance of optimal health within health system and social system. Research was conducted through interviews with professionals working at the Blekinge Health Arena, doctors and nurses. The results were framed within FSSD to ensure compliance with Social Sustainability Principles. The guidelines and actions promote health through lifestyle change, community empowerment, holistic perspective of the patient and close collaboration between primary health care and wellness organisations. The authors believe the results may be widely implemented within Sweden, helping transition towards sustainability.
01 Jan 2017
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TL;DR: Part 1: health care and cost containment in the EU - an overview - health care systems, health care spending, cost containment measures,cost containment measures in practice, Eli Mossialos and Julian Le Grand and Panos Kanovos.
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TL;DR: Two of the most seasoned observers of comparative health system research and a colleague provide the latest data and some commentary upon them for the health care enterprises of the twenty-four countries that are members of the Organization for Economic Cooperation and Development (OECD).
Abstract: Prologue: Changes in the way health care systems finance services are often driven by some combination of data, public pressure, payer receptivity, and the expressed views of the medical profession and allied disciplines. In this paper, two of the most seasoned observers of comparative health system research and a colleague provide the latest data and some commentary upon them for the health care enterprises of the twenty-four countries that are members of the Organization for Economic Cooperation and Development (OECD). George Schieber is director of the Office of Research at the U.S. Health Care Financing Administration (HCFA). Jean-Pierre Poullier is principal administrator, Directorate for Social Affairs, Manpower, and Education for the OECD in Paris. Leslie Greenwald is a health policy analyst in the HCFA Office of Research and also a doctoral candidate in public policy at the University of Virginia. The OECD's health database provides the most current road map available to compare the status of the ...
118 citations