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Purchasing is championed as key to improving health systems performance. However, despite the central role the purchasing function plays in many health system reforms, there is very little evidence about its development or its real impact on societal objectives. This book addresses this gap and provides: ·A comprehensive account of the theory and practice of purchasing for health services across Europe ·An up-to-date analysis of the evidence on different approaches to purchasing ·Support for policy-makers and practitioners as they formulate purchasing strategies so that they can increase effectiveness and improve performance in their own national context ·An assessment of the intersecting roles of citizens, the government and the providers Written by leading health policy analysts, this book is essential reading for health policy makers, planners and managers as well as researchers and students in the field of health studies. Contributors: Toni Ashton, Philip Berman, Michael Borowitz, Helmut Brand, Reinhard Busse, Andrea Donatini, Martin Dlouhy, Antonio Duran, Tamás Evetovits, André P. van den Exter, Josep Figueras, Nick Freemantle, Julian Forder, Péter Gaál, Chris Ham, Brian Hardy, Petr Hava, David Hunter, Danguole Jankauskiene, Maris Jesse, Ninel Kadyrova, Joe Kutzin, John Langenbrunner, Donald W. Light, Hans Maarse, Nicholas Mays, Martin McKee, Eva Orosz, John Øvretveit, Dominique Polton, Alexander S. Preker, Thomas A. Rathwell, Sabine Richard, Ray Robinson, Andrei Rys, Constantino Sakellarides, Sergey Shishkin, Peter C. Smith, Markus Schneider, Francesco Taroni, Marcial Velasco-Garrido, Miriam Wiley
Health spending continues to grow faster than the economy in most OECD countries. In 2010, the OECD published a study of strategies to increase value for money in health care, in which pay for performance (P4P) was identified as an innovative tool to improve health system efficiency in several OECD countries. However, evidence that P4P increases value for money, boosts quality of processes in health care, or improves health outcomes is limited.This book explores the many questions surrounding P4P such as whether the potential power of P4P has been over-sold, or whether the disappointing results to date are more likely rooted in problems of design and implementation or inadequate monitoring and evaluation. The book also examines the supporting systems and process, in addition to incentives, that are necessary for P4P to improve provider performance and to drive and sustain improvement. The book utilises a substantial set of case studies from 12 OECD countries to shed light on P4P programs in practice.Featuring both high and middle income countries, cases from primary and acute care settings, and a range of both national and pilot programmes, each case study features: Analysis of the design and implementationdecisions, including the role of stakeholders Critical assessment of objectives versus results Examination of the of 'net' impacts, includingpositive spillover effects and unintended consequences The detailed analysis of these 12 case studies together with the rest of this critical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. As a result, this book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability. This title is in the European Observatory on Health Systems and Policies Series.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Healthcare Organizations offer significant opportunities for change and improvement in their overall performance. Hospitals and clinics are generally large, complex, and inefficient, and need serious development in process workflow and management systems, which will ultimately lead to better patient and financial outcomes. The National Academy of Medicine has stated that hospital systems are broken, and that they must begin by "... improving hospital efficiency and patient flow, and using operational management methods and information technologies." In fact, costs and quality are two of the important aspects of the "triple aim" in healthcare. One area that offers significant potential for improvement is through the application of performance improvement methods to patient and process flows. Performance improvement has a significant impact on a hospital’s over financial and strategic performance. Performance improvement involves the deployment of quantitative and scientific methods to model and influence the functioning of organizations. Performance improvement professionals are tasked with managing a variety of activities, such as deploying new information technologies, serving as project managers for construction events, re-engineering departmental process workflow, eliminating bottlenecks, and improving the flow and movement of patients between resource-intensive clinical areas. All of these are high risk, and require use of advanced, sophisticated methods to improve efficiency and quality, while minimizing disruptions from change. This updated edition is a comprehensive and concise guide to performance improvement in healthcare. It describes the management engineering principles focused on designing optimal management and information systems and processes. Case studies and examples are integrated throughout all chapters.
In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.
"Innovation in medical technology drives improvement in the quality of health care but also the unsustainable increase in costs. This book analyzes methods of technology regulation, insurance, payment, pricing, and use, and highlights ways in which they should be reformed. The goal is to improve the value of drugs, devices, and other innovative technologies to achieve better performance at lower cost."--Provided by publisher.
Great progress has been made in recent years in securing better access and financial protection against the cost of illness through collective financing of health care. Managing scarce resources effectively and efficiently is an important part of this story. Experience has shown that, without strategic policies and focused spending, the poor are likely to get left out. The use of purchasing to enhance public sector performance is well-documented in other sectors. Extension to the health sector of lessons from this experience is now successfully implemented in many developing countries. Public.
In a world where there is increasing demand for the performance of health providers to be measured, there is a need for a more strategic vision of the role that performance measurement can play in securing health system improvement. This volume meets this need by presenting the opportunities and challenges associated with performance measurement in a framework that is clear and easy to understand. It examines the various levels at which health system performance is undertaken, the technical instruments and tools available, and the implications using these may have for those charged with the governance of the health system. Technical material is presented in an accessible way and is illustrated with examples from all over the world. Performance Measurement for Health System Improvement is an authoritative and practical guide for policy makers, regulators, patient groups and researchers.
This publication examines how public spending on health care can be made more efficient and equitable in developing countries, focusing on strategic purchasing and contracting of services from non-governmental providers. It is divided into six sections under the headings of: the conceptual framework; how to make strategic purchasing pro-poor; purchasing health services; purchasing inputs; supply, demand and markets; legal and regulatory issues.
The World Health Report 2000 has generated considerable media attention, controversy in some countries, and debate in academic journals. This volume brings together in one place the substance of many of these key debates and reports, methodological advances, and new empiricism reflecting the evolution of the WHO approach since the year 2000. Specifically, the volume presents many differing regional and technical perspectives on key issues, major new methodological developments, and a quantum increase in the empirical basis for cross-country performance assessment. It also gives the full report of the Scientific Peer Review Group's exhaustive assessment of these new approaches.