Snippets Oct 30 2005
Building a Better Delivery System: A New Engineering/Health Care Partnership
Proctor P. Reid, W. Dale Compton, Jerome H. Grossman and Gary Fanjiang, Editors
National Academies Press, 2005
Available online at: http://www.nap.edu/books/030909643X/html/
.The report describes the opportunities and challenges to harnessing the power of systems-engineering tools, information technologies, and complementary knowledge in social sciences, cognitive sciences, and business/management to advance the six IOM quality aims for a twenty-first century health care system.
Commonwealth Fund High Performance Health System Sign-up
The Commonwealth Fund has established the Commission on a High Performance Health System to help move the U.S. toward a health care system that achieves better access, improved quality, and greater efficiency, particularly for those who are vulnerable due to income, race/ethnicity, health, or age.
At a recent Washington, DC briefing cosponsored by the Fund and the Alliance for Health Reform, commission chair James J. Mongan, M.D., president and chief executive officer of Partners HealthCare, called for health system change and the commission released its first chartbook, A Need to Transform the U.S. Health Care System: Improving Access, Quality, and Efficiency.
If you'd like to stay up to date on the commission's activities and publications by receiving e-mail alerts, we invite you to join our new commission mailing list by clicking on the following link to send an e-mail to email@example.com or visiting our e-mail alert sign-up page.
Getting better value for money from Sweden's healthcare system
ECONOMICS DEPARTMENT WORKING PAPERS No. 443
Organisation for Economic Co-operation and Development - OECD, September 20, 2005
Available online as PDF file [39p.] at:
This paper reviews the strengths and weaknesses of the Swedish healthcare system and the challenges that it will face in the future.
It discusses ways to improve access to primary care, including different methods for paying GPs, whether access is less equitable
than in other countries and the role of patient fees. The maximum waiting time guarantee for elective surgery is reviewed, along with
ways of reducing regional variations in quality. The extent of decentralisation is questioned, as that may be affecting the quality of care
and value for money in some areas, including elderly and psychiatric care. Mechanisms for improving the hospital sector are also
examined including fee‑for‑service (DRG) payment mechanisms and whether for‑profit hospitals would help.
Finally, it considers ways to make financing more stable and sustainable.
Bridging the Gap: The Use of Research Evidence in Policy Development
Jon D. Brehaut, Don Juzwishin
Health Technology Assessment Unit Alberta Heritage Foundation for Medical Research
Alberta Heritage Foundation for Medical research, Alberta, Canada September 2005
Available online at: http://www.ahfmr.ab.ca/download.php/603bfe472b366f45f74232a52d798039
.Public policy can be a messy business. Bismarck.s famous observation about legislation.and what is legislation but public policy writ large.and sausage making is often quoted (one translation of Bismarck.s observation: ..People who love the law or good sausage should never watch either being made.) because it resonates with our beliefs and experiences.
Policy decisions are difficult to evaluate at the best of times. Is a given decision good or bad? Is it effective or ineffective?
What about unintended consequences? .
Item from Bobby Milstein : $500,000 MacArthur 'Genius' Grant Awarded to Sue Goldie, Physician and Researcher Who Applies Decision Science to Global Women's Health
One of this year's MacArthur "Genius" Fellowships was awarded to Sue Goldie, a public health researcher at Harvard for her innovative use of computer models in studying policy scenarios. Below is a brief profile of her work. Note the rationale given for why her modeling approach is so worthwhile, and its similarities to the sort of models that many of us have been constructing these past few years at CDC and elsewhere.
"The mathematical models she constructs differ from many models used for cost-effectiveness analysis in that they are "biologically-based," hewing closely to the underlying disease process as it unfolds, while remaining consistent with observed epidemiological data. They extend information available from observational studies by extrapolating patterns beyond the time horizon of a single study, and can be used to evaluate strategies in a wide range of settings. In addition to relating biological and clinical information, they can provide quantitative insight into the relative importance of different components of the prevention or treatment process and allow investigation of how results will change if values of key parameters are varied. By identifying the most influential parameters she can identify key information gaps and prioritize and guide data collection efforts." Said HSPH Dean Barry Bloom of Dr. Goldie: "She has a rare ability to go from the most theoretical analysis of decision-making in health care to translating that into the real world of both rich and poor countries in a way that has already made an enormous difference in women's health."
Dr. Goldie's faculty research page is available at: http://www.hsph.harvard.edu/faculty/SueGoldie.html
A feature profile of Dr. Goldie from the Summer 2002 issue of Harvard Public Health Review is available at: http://www.hsph.harvard.edu/review/review_summer_02/goldie.html
(please note, Dr. Goldie is now an associate professor)
Nanny or Steward? The role of government in public health
The King's Fund, London, UK October 2005
Available online at: http://www.kingsfund.org.uk/resources/publications/nanny_or.html
..The past year has seen some contentious debates about public health in the United Kingdom, focusing on a ban on smoking in public places, food labelling and food advertising to children. Some people have argued that any government intervention in these areas is nanny statist an unnecessary intrusion into peoples lives and what they do, eat and drink. Others have argued that only the state can effectively reduce the poverty that is so often the root cause of ill health .
.This paper suggests that there is a strong argument to be made for government intervention to safeguard public health. Legislation brings about changes that individuals on their own cannot, and sets new standards for the public good. Rather than condemning such activity as nanny statist, it might be more appropriate to view it as a form of stewardship.
Health Systems Action Network (HSAN)
Concept Note: http://www.hsanet.org/pubs/Proposal-HSAN.pdf
The development of a Health Systems Action Network (HSAN) was first proposed at a World Health Organization meeting on The Montreux Challenge: Making Health Systems Work in April 2005. It was thought that HSAN could serve as a means to build
· build on the growing interest and momentum around creating stronger health systems by providing a vehicle through which diverse partners could help maintain attention on health systems
· improve communication and the flow of credible information about how health system strengthening could be done, and
· help promote greater coordination and collaboration
The "Montreux Challenge": Making Health Systems Work
Glion sur Montreux, Switzerland, 4-6, April 2005
Background Materials of the meeting available at: http://www.hsanet.org/montreux.html
From Knowledge@Wharton Health Economics
After Decades of Malaise, the Vaccine Industry Is Getting an Injection
After decades of decline, the vaccine industry is gaining new interest from drug makers and the federal government in response to last year's flu-shot shortage, concerns about an avian flu pandemic, and the development of potential vaccines targeted at new markets, including cancer. Still, vaccines remain a small piece of the overall drug market -- less than 3% of the global pharmaceutical industry -- and vaccine manufacturers continue to face liability problems and low payments from public-health customers, according to Wharton faculty and other experts. In the face of these obstacles, what will it take to inject some life into the ailing industry?
Implementation Research: A Synthesis of the Literature
National Implementation Research Network (NIRN), University of South Florida, 2005
.In this report, researchers from the National Implementation Research Network provide a comprehensive view of the current science of implementation and offer practical advice for getting evidence-based practices and programs off the ground successfully. Recommendations gleaned from the authors' analysis of the current literature will help planners make decisions based on the best available knowledge from fields as diverse as medicine and manufacturing . Sebastien Levesque
Download the entire document [5.2mb pdf]
From OECD What is new October 2005 : HEALTH
In Search of Efficiency: Improving Health Care in Hungary: Working Paper
A Series of OECD Policy Briefs on Health: Listing
UK Health Watch Report: The Experience of Health in an unequal society
Available online as PDF file [164p.] at: http://www.pohg.org.uk/support/downloads/ukhealthwatch-2005.pdf
On the day that the UK government, as part of its EU Presidency, hosts a two day Health Inequalities Summit conference in London, a new report claims that health inequalities have deteriorated as a direct result of government policies.
Doing better but feeling worse is how UK Health Watch 2005 - an 'alternative UK health report' from the Politics of Health Group - describes health in the UK in 2005. Although average life expectancy in the UK continues to increase, the inequalities between rich and poor people, and the problems faced by socially excluded groups, have got steadily worse under New Labour. This is confirmed by the Governments own statistics, says Dr Alex Scott-Samuel, joint editor of the report and Joint Chair of the Politics of Health Group.
In Case you missed it (Includes Health Stream Session Reports):
The October 2005 issue of the System Dynamics Newsletter is available at
take a look! This issue of the newsletter contains a full report on the
Boston Conference, including the President's Address and many articles
submitted by volunteer conference session reporters.
SDList : SD for Malaria Prevention and Control
Posted by "Jack Homer" <firstname.lastname@example.org>
See: James Ritchie Dunham and Jorge Mendez Galvan, "Evalating Epidemic
Intervention Policies with Systems Thinking: A Case Study of Dengue Fever in
Mexico, System Dynamics Review, 15(2), Summer 1999.
Also, pp. 300-323 on modeling disease epidemics, in Sterman's Business
Posted by "Leslie A. Martin" <email@example.com>
Please see http://www.uneval.org/docs/John%20Newman.doc
The paper describes a system dynamics approach taken to evaluate
malaria-control programs in Bolivia.