The journal of the Royal Society for the Promotion of Health
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J R Soc Promot Health · Mar 2007
Comparative StudyHealth, spending and the effort to improve quality in OECD countries: a review of the data.
The performance of health systems is of concern to both policy-makers and academics and a large body of recent literature has advanced the debate significantly on methods and results of health system performance assessments. In this article, I attempt to summarize what is known about a range of areas of health system performance, specifically in the areas of spending and outcomes, using data from the Organization for Economic Cooperation and Development (OECD) in the areas of health, spending, risk factors and quality of care. In so doing, we use new data from the OECD's Health Care Quality Indicators (HCQI) to examine a factor that is frequently cited at the national level but rarely compared at the international level, namely the quality of the healthcare provided. ⋯ In other areas such as breast cancer survival, the HCQI data show that most countries are making progress somewhat universally, but that all countries still have progress to be made. Finally, in other areas, such as inpatient care for acute myocardial infarction (AMI), there is wide variation in quality. Future work will need to be undertaken in order to examine possible best practices at the policy and operational level of health care delivery, their impact on spending and, most importantly, on health outcomes.
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J R Soc Promot Health · Mar 2007
The problem of engaging hospital doctors in promoting safety and quality in clinical care.
There is widespread agreement that the medical profession has much to learn about addressing adverse events in clinical practice and participating in clinical governance. In England and Wales centrally driven initiatives such as medical audit, clinical governance and the National Reporting and Learning System have failed to transform the management of iatrogenic adverse events. In this article we explore the historical and cultural background of these issues with respect to hospital medicine and suggest means of tackling the challenges ahead.