Health policy
-
Problems with waiting lists have long affected the National Health Service. The priority given by clinicians to the elective surgery conditions usually found on waiting lists is low, but the publicity surrounding the waiting lists ensures that the priority accorded elective surgery in the political arena is much higher. Waiting list initiatives have provided additional resources for the purpose of reducing the number of patients waiting for elective surgery. It is suggested that economic evaluation should form one of a package of tools used by those setting priorities within elective surgery, but that the evidence provided by previously conducted economic evaluations of elective surgery is not of sufficient quality for purchasing authorities to use as a basis for priority setting.
-
Review Historical Article
WHO under stress: implications for health policy.
A crisis is increasingly challenging the authority and prestige of the United Nations' specialized agencies. Although the World Health Organization is still held in great repute, it has not escaped criticism. Member countries have expressed concern about WHO's bureaucratic procedures, costs, proliferation of meetings, reports, lack of budget transparency. ⋯ Policy is also being decided within an increasingly political milieu. These changes put significant pressure on the Organization in a number of ways, and it is essential to generate a public debate about WHO's future role if the Organization is to retain the esteem within which it is generally held. This paper makes an initial contribution to that debate.
-
The interrelationships between sectors in an economy (especially between the health sector, on one hand, and the rest of the economy, on the other hand) are often ignored when many developing countries strive to achieve some general socioeconomic as well as specific sectoral goals. Macroeconomic policies adopted in developing countries, especially in Sub-Sahara Africa, to deal with the economic crisis failed to take adequate measures to protect the health of the people. Policy makers and the planners have contributed to the problems of the health sector by not devising necessary built-in measures to mitigate the negative impact of macroeconomic and sectoral policies on health. The paper attempts to bring into focus the linkages between the economy and the health sector and to proffer to policy makers and planners, especially in Sub-Sahara Africa, what should be done in future to minimize the negative impact of macro and sectoral policies on health.
-
We discuss some of the challenges facing hospitals in developed nations, with special attention to the need to monitor and evaluate hospital performance. In particular, there is a need for quality indicators that measure the effects of treatment, and are risk-adjusted, so that valid comparisons of outcomes can be made across hospitals that treat different types of patients. ⋯ We discuss the uses of these tools for identifying problems and for monitoring outcomes of care within a hospital, including screening medical records for peer review, identifying variations in outcomes across various subgroups of physicians, and comparing changes in outcomes following various changes in the delivery system. Possible applications at the regional, national and international levels are then discussed, with special emphasis on the use of these tools for measuring the size of the gap between the efficacy of a technology, as determined through randomized controlled trials under stringent protocols, and the effectiveness of the same technology once it is exported, and then used under true practice conditions in another country.