The International journal of health planning and management
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Int J Health Plann Manage · Apr 1994
Using hospital activity indicators to evaluate performance in Andhra Pradesh, India.
The performance of secondary level public hospitals in Andhra Pradesh. India was evaluated with the help of input-output ratios of hospital activity and service mix. Indicators for emergency, clinical, diagnostic and medico-legal services have been defined. ⋯ Extremes of turnover and occupancy were not associated with any particular case-mix pattern. Thus, neither poor productivity and capacity utilization nor over-crowding can be explained by case-mix differences. Problems of poor performance and inadequate capacity seem to be real.
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Canada's health system is undergoing stocktaking and adjustment. Ontario and Quebec have recently reviewed their goals and strategies; other provinces have been seeking to control established programs. ⋯ Its themes ultimately concern whether equity is compatible with innovation and choice; whether downplaying technology is harmful; and whether restrictions (e.g. on medical manpower supply) can be achieved relatively painlessly. Changing political traditions in the different provinces have an effect upon their health systems, it is concluded.
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Int J Health Plann Manage · Oct 1988
Comparative StudyEffects of different remuneration methods on general medical practice: a comparison of capitation and fee-for-service payment.
There are severe methodological problems to be overcome in comparing the effects of different payment methods on general medical practice, not least because there are many factors which affect the pattern of service delivery. Also, the reliability and comparability of data may be poor. This article emphasises that the effects of capitation and fee-for-service payment methods on general medical practice should be carefully compared with factual information, especially numerical data. ⋯ On the other hand, a capitation system may lead doctors to hastier and less courteous care than a fee-for-service system. The geographical distribution of general practitioners (GPs) may be more even, and continuity of care may be better maintained, under a capitation system; but there may be excessive referrals from GPs to specialists under this system of payment. There is no evidence for the contention that a capitation system encourages preventive medicine, but the financial coverage for preventive procedures does encourage such procedures.
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Int J Health Plann Manage · Oct 1986
Comparative StudyBritish and American health policy: recent lessons from one system to the other.
Arguably, US and British health-care policies have shown some convergence in recent years, despite vast differences in the two health-care systems. In part, this reflects the incentives common to all systems which must be mobilized to improve efficiency and effectiveness; in part, this reflects the (two-way) trans-Atlantic 'trendiness' of ideas. This article seeks to examine the main context of policy affecting the two health-care systems, the means now used to achieve the systems' goals, and the validity of claims of convergence. The focus is conceptual, although a significant aim is to assess recent policies in a comparative framework.