Download or read book Characterising Needs in Health Care Priority Setting written by Erik Gustavsson and published by Linköping University Electronic Press. This book was released on 2018-01-10 with total page 93 pages. Available in PDF, EPUB and Kindle. Book excerpt: The focus of this thesis is needs in the context of health care priority setting. The notion of needs has a strong standing in health care policy; however, how the idea should be understood more specifically and how it should guide decisions about priority setting remain contentious issues. The aim of this thesis is to explore how needs should be characterised in health care priority setting. This matter is approached by, first, exploring and developing the conceptual structure of health care needs, and second, discussing and suggesting solutions to normative questions that arise when needs are characterised as a distributive principle. In the first article, the conceptual structure of needs in general and health care needs in particular is explored, and it is argued that a specific characterisation of health care needs is required. In the second article, the notion of health care needs is explored in relation to preferences for health care within the context of shared decision-making. The paper further discusses a number of queries that arise in the intersection between what the patient needs and what the patient wants. The third article discusses how a principle of need should handle questions about interpersonal aggregation. The paper characterises a principle of need which strikes a reasonable balance between giving priority to the worst off and the distribution of benefits with regard to interpersonal aggregation. The fourth article discusses how a principle of need should account for the fact that patients often are badly off due to several conditions rather than one single condition. It is argued that how badly off patients are should be understood as a function of how badly off these patients are when all of their conditions (for which they need health care) are considered. The frame story provides the terminological, theoretical, contextual, and methodological background for the discussion undertaken in this thesis. The conclusions of the articles are brought together and the discussion extended in the concluding discussion by sketching a number of conditions of adequacy for the concept and principle of need relevant for health care priority setting. Den här avhandlingen fokuserar på behov och behovsprinciper inom hälso- och sjukvården. Behov har länge haft en stark ställning inom hälso- och sjukvården men det är omdiskuterat hur begreppet ska förstås mer specifikt och framförallt hur det ska vara vägledande för prioriteringar inom hälso- och sjukvården. Syftet med den här avhandlingen är att karakterisera behov för sådana prioriteringar. Avhandlingen tar sig an detta syfte utifrån två ansatser. För det första, genom att undersöka och utveckla den begreppsliga strukturen hos vårdbehov och, för det andra, genom att diskutera samt ge förslag på lösningar på ett antal normativa frågor som uppstår när vårdbehov skall karakteriseras som en fördelningsprincip. I den första artikeln undersöks begreppen behov och vårdbehov utifrån den allmänfilosofiska diskussionen om behov. I artikeln karakteriseras begreppet vårdbehov på ett sätt som gör det lämpligt för prioriteringar inom hälsooch sjukvården. I den andra artikeln utforskas begreppet vårdbehov i relation till önskemål om vård inom ramen för delat beslutsfattande. I artikeln diskuteras också ett antal frågeställningar som aktualiseras i relation till den spänning som kan uppstå mellan patientens behov å ena sidan och patientens önskemål å andra sidan. I den tredje artikeln behandlas frågan om hur en behovsprincip bör hantera frågor som rör sammanvägning av olika personers behov. I artikeln karakteriseras och försvaras en behovsprincip som balanserar prioritet till de sämst ställda och hur hälsovinster bör fördelas. I den fjärde artikeln förs en diskussion om hur en behovsprincip bör göra reda för det faktum att patienter ofta lider av samsjuklighet snarare än av ett enskilt tillstånd. I artikeln drivs tesen att hur dåligt ställt en patient har det bör förstås som en funktion av hur dåligt ställt patienten har det när alla patientens tillstånd (för vilka patienten behöver vård) har tagits i beaktande, snarare än hur dåligt ställt patienten har det med avseende på det specifika tillstånd för vilket patienten skall behandlas. I kappan ges den terminologiska, kontextuella, teoretiska och metodologiska bakgrunden för diskussionen i avhandlingen. I en avslutande diskussion förs slutsatserna från artiklarna samman och diskussionen utvidgas genom att skissera ett antal adekvansvillkor för begreppet vårdbehov och behovsprinciper i vården.
Download or read book Setting Priorities for Clinical Practice Guidelines written by Institute of Medicine and published by National Academies Press. This book was released on 1995-03-02 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book examines methods for selecting topics and setting priorities for clinical practice guideline development and implementation. Clinical practice guidelines are "systematically defined statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." In its assessment of processes for setting priorities, the committee considers the principles of consistency with the organization's mission, implementation feasibility, efficiency, utility of the results to the organization, and openness and defensibilityâ€"a principle that is especially important to public agencies. The volume also examines the implications of health care restructuring for priority setting and topic selection, including the link between national and local approaches to guidelines development.
Download or read book Evidence Based Medicine and the Changing Nature of Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2008-09-06 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Download or read book The Future of the Public s Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Download or read book Improving Healthcare Quality in Europe Characteristics Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Download or read book Health Care Comes Home written by National Research Council and published by National Academies Press. This book was released on 2011-06-22 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, health care devices, technologies, and practices are rapidly moving into the home. The factors driving this migration include the costs of health care, the growing numbers of older adults, the increasing prevalence of chronic conditions and diseases and improved survival rates for people with those conditions and diseases, and a wide range of technological innovations. The health care that results varies considerably in its safety, effectiveness, and efficiency, as well as in its quality and cost. Health Care Comes Home reviews the state of current knowledge and practice about many aspects of health care in residential settings and explores the short- and long-term effects of emerging trends and technologies. By evaluating existing systems, the book identifies design problems and imbalances between technological system demands and the capabilities of users. Health Care Comes Home recommends critical steps to improve health care in the home. The book's recommendations cover the regulation of health care technologies, proper training and preparation for people who provide in-home care, and how existing housing can be modified and new accessible housing can be better designed for residential health care. The book also identifies knowledge gaps in the field and how these can be addressed through research and development initiatives. Health Care Comes Home lays the foundation for the integration of human health factors with the design and implementation of home health care devices, technologies, and practices. The book describes ways in which the Agency for Healthcare Research and Quality (AHRQ), the U.S. Food and Drug Administration (FDA), and federal housing agencies can collaborate to improve the quality of health care at home. It is also a valuable resource for residential health care providers and caregivers.
Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
Download or read book Improving Health in the Community written by Institute of Medicine and published by National Academies Press. This book was released on 1997-05-21 with total page 497 pages. Available in PDF, EPUB and Kindle. Book excerpt: How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.
Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
Download or read book Priorities in Health written by and published by World Bank Publications. This book was released on 2006-01-01 with total page 242 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This companion guide to Disease Control Priorities in Developing Countries, 2nd edition speeds the diffusion of life-saving knowledge by distilling the contents of the larger volume into an easily read format. Policy makers, practitioners, academics, and other interested readers will get an overview of the messages and analysis in Disease Control Priorities in Developing Countries, 2nd edition; be alerted to the scope of major diseases; learn strategies to improve policies and choices to implement cost-effective interventions; and locate chapters of immediate interest."
Download or read book The Future of the Nursing Workforce in the United States written by Peter Buerhaus and published by Jones & Bartlett Publishers. This book was released on 2009-10-06 with total page 329 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US. Using plain, jargon free language, the book identifies and describes the key changes in the current nursing workforce and provide insights about what is likely to develop in the future. The Future of the Nursing Workforce offers an in-depth discussion of specific policy options to help employers, educators, and policymakers design and implement actions aimed at strengthening the current and future RN workforce. The only book of its kind, this renowned author team presents extensive data, exhibits and tables on the nurse labor market, how the composition of the workforce is evolving, changes occurring in the work environment where nurses practice their profession, and on the publics opinion of the nursing profession.
Download or read book Medicine and Social Justice written by Rosamond Rhodes Ph.D and published by Oxford University Press. This book was released on 2002-08-29 with total page 489 pages. Available in PDF, EPUB and Kindle. Book excerpt: Because medicine can preserve and restore health and function, it has been widely acknowledged as a basic good that a just society should provide its members. Yet there is wide disagreement over the scope of what is to be provided, to whom, how, when and why. In this uniquely comprehensive book some of the best-known philosophers, doctors, lawyers, political scientists, and economists writing on the subject discuss the concerns and deepen our understanding of the theoretical and practical issues that run through the contemporary debate. The first section lays a broad theoretical basis for understanding the concept of justice, particularly as it relates to the distribution of health care. The second section critically examines how medical care is distributed in different countries around the world and the particular advantages and injustices associated with those systems. The third section draws attention to the special needs of different social groups and the specific issues of justice that are raised by the impact of various policies on health care distribution. The concluding section delves intothe dilemmas that confront those designing health care systems--the politics, the priorities, and the place of desires as opposed to needs in a socially just scheme.
Download or read book Priority Areas for National Action written by Institute of Medicine and published by National Academies Press. This book was released on 2003-04-10 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas.
Download or read book Health System Efficiency written by Jonathan Cylus and published by Health Policy. This book was released on 2016-12-15 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Implementation Research in Health written by David H. Peters and published by World Health Organization. This book was released on 2013 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt: Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.
