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Health system efficiency: how to make measurement matter for policy and management: Health Policy Series no. 46 [Minkštas viršelis]

  • Formatas: Paperback / softback, 264 pages
  • Išleidimo metai: 16-Dec-2016
  • Leidėjas: WHO Regional Office for Europe
  • ISBN-10: 9289050411
  • ISBN-13: 9789289050418
Kitos knygos pagal šią temą:
  • Formatas: Paperback / softback, 264 pages
  • Išleidimo metai: 16-Dec-2016
  • Leidėjas: WHO Regional Office for Europe
  • ISBN-10: 9289050411
  • ISBN-13: 9789289050418
Kitos knygos pagal šią temą:
Efficiency is one of the central preoccupations of health policy-makers and managers, and justifiably so. Inefficient care can lead to unnecessarily poor outcomes for patients, either in terms of their health, or in their experience of the health system. What is more, inefficiency anywhere in the system is likely to deny health improvement to patients who might have been treated if resources had been used better. Improving efficiency is therefore a compelling policy goal, especially in systems facing serious resource constraints.

The desire for greater efficiency motivates a great deal of decision-making, but the routine use of efficiency metrics to guide decisions is severely lacking. To improve efficiency in the health system we must first be able to measure it and must therefore ensure that our metrics are relevant and useful for policy-makers and managers.

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.

The authors use examples from Europe and around the world to explore how policy-makers and managers have used efficiency measurement to support their work in the past, and suggest ways they can make better use of efficiency measurement in the future.

The study came out of the Observatory's LSE hub. It links to a forthcoming study offering further insights into how to develop and interpret policy relevant efficiency metrics and to the earlier volumes on performance measurement. It will be of considerable use to policymakers and their advisors, health care regulators, patient representative groups, managers and researchers.
Acknowledgements viii
List of contributors
ix
List of tables, boxes and figures
x
List of abbreviations
xiii
Glossary xvi
Preface xviii
Chapter 1 A framework for thinking about health system efficiency
1(20)
Jonathan Cylus
Irene Papanicolas
Peter C. Smith
1.1 Why is health sector efficiency important?
1(1)
1.2 What is inefficiency?
2(2)
1.3 Allocative inefficiency
4(2)
1.4 Technical inefficiency
6(4)
1.5 An analytical framework for thinking about efficiency indicators
10(8)
1.6 Concluding comments
18(3)
References
20(1)
Chapter 2 Measuring and comparing health system outputs: using patient classification systems for efficiency analyses
21(32)
Wilm Quentin
Alexander Geissler
Reinhard Busse
2.1 Introduction: what are the benefits of classifying patients into groups?
21(2)
2.2 DRG systems in Europe: background and definitions
23(4)
2.3 Application of DRGs: indicators of efficiency
27(8)
2.4 Patient classification systems for other areas of health care
35(9)
2.5 Conclusion: advantages and limitations of patient classification systems
44(9)
References
48(5)
Chapter 3 Using registry data to compare health care efficiency
53(22)
Reijo Sund
Unto Hakkinen
3.1 Introduction
53(1)
3.2 Using registry data to define episodes of care
54(2)
3.3 Constructing indicators based on episodes of care
56(5)
3.4 Comparing provider performance: the need for risk adjustment
61(3)
3.5 Adjustment techniques
64(1)
3.6 Examples of efficiency considerations
64(2)
3.7 International comparisons
66(1)
3.8 The EuroHOPE project
67(3)
3.9 The EuroREACH diabetes case study
70(2)
4.0 Conclusions
72(3)
References
73(2)
Chapter 4 Management accounting and efficiency in health services: the foundational role of cost analysis
75(24)
Christopher S. Chapman
Anja Kern
Aziza Laguecir
Wilm Quentin
4.1 Introduction
75(3)
4.2 Analysing the challenge of cost system design
78(5)
4.3 Demonstrating cost system design choices with two detailed examples
83(7)
4.4 The role of cost data in delivering efficient health care
90(3)
4.5 Cost data and support of local clinical and managerial decision-making
93(4)
4.6 Conclusions
97(2)
References
98(1)
Chapter 5 Health system efficiency: measurement and policy
99(16)
Bruce Hollingsworth
5.1 Introduction: data envelopment analysis and stochastic frontier analysis
99(1)
5.2 Efficiency measurement methods
100(5)
5.3 The application of DEA
105(4)
5.4 Setting out the protocol
109(4)
5.5 Conclusions
113(2)
References
113(2)
Chapter 6 Cost--effectiveness analysis
115(24)
Ranjeeta Thomas
Kalipso Chalkidou
6.1 Introduction
115(1)
6.2 Cost--effectiveness analysis: an overview of its strengths and weaknesses
116(3)
6.3 Methodological issues in the use of economic evaluations at the micro level
119(4)
6.4 Cost-effectiveness analysis as a measure of organizational and system efficiency
123(1)
6.5 Methodological and informational challenges
124(5)
6.6 Cost-effectiveness analysis in policy: present and future
129(5)
6.7 Conclusion
134(5)
References
135(4)
Chapter 7 Cross-national efficiency comparisons of health systems, subsectors and disease areas
139(28)
Jonathan Cylus
Mark Pearson
7.1 Introduction: the basis for interest in cross-country efficiency comparisons
139(2)
7.2 Cross-country databases containing health system efficiency metrics
141(6)
7.3 Multicountry health care efficiency studies at the system, subsector and treatment levels
147(12)
7.4 Key progress and remaining challenges
159(5)
7.5 Conclusion
164(3)
References
164(3)
Chapter 8 Efficiency measurement for policy formation and evaluation
167(36)
Anita Charlesworth
Zeynep Or
Emma Spencelayh
8.1 Introduction
167(2)
8.2 The definition of public health basket and regulation of reimbursement
169(6)
8.3 Cost sharing arrangements
175(5)
8.4 Hospital organization
180(4)
8.5 Provider payment
184(6)
8.6 Public reporting of health care data
190(4)
8.7 Conclusion
194(9)
References
197(6)
Chapter 9 Efficiency measurement for management
203(22)
Alec Morton
Laura Schang
9.1 Introduction
203(1)
9.2 Who are managers?
204(2)
9.3 Frameworks for analysis
206(2)
9.4 Managerial roles for efficiency analysis in intelligence, design and choice
208(10)
9.5 Recommendations for practice
218(4)
9.6 Conclusion
222(3)
References
223(2)
Chapter 10 Conclusions
225
Jonathan Cylus
Irene Papanicolas
Peter C. Smith
10.1 Introduction
225(1)
10.2 Revisiting the analytical framework: key challenges of efficiency measurement
226(5)
10.3 The role of simple metrics
231(5)
10.4 Promising opportunities for efficiency measurement
236(4)
10.5 Concluding remarks
240
References
242