Breaking Gridlock in Health Policy?; Comment on “A New Synthesis”

Document Type : Commentary

Author

Canadian Medical Association, Ottawa, Ontario, Canada

Abstract

Pierre-Gerlier Forest has put forward the case that we are on the brink of a revolution in health policy that will be the result of the interplay of five factors. I would not challenge any of them but would emphasize the need to address socio-economic health inequalities, which have the potential to become a major cost driver in a time of growing economic inequality. To Dr. Forest’s list, I would add two important shifts that are taking shape. The first is the development of an outcome focus in healthcare that seeks to measure improvements in individual and population health status. The second is a Copernican revolution in which healthcare providers revolve around the patient. These developments will enable us to answer many questions about resource allocation and return on investment in healthcare, although I still think there will be an outstanding question of how many resources society is willing and able to allocate to healthcare.

Keywords

Main Subjects

References

1.  Forest PG. A new synthesis. Int J Health Policy Manag 2014; 2: 55–7. doi:       10.15171/ijhpm.2014.13
2.  Mackenbach JP, Meerding WJ, Kunst AE. Economic costs of health inequalities in the European Union. J Epidemiol Community Health 2011; 65: 412–9. doi: 10.1136/jech.2010.112680
3.  Organization for Economic Cooperation and Development (OECD). Crisis squeezes income and puts pressure on inequality and poverty [internet]. 2013 [cited 2014 March 15]. Available from: http://www.oecd.org/els/soc/OECD2013-Inequality-and-Poverty-8p.pdf
4.  Neuhauser D. Florence Nightingale gets no respect: as a statistician that is. Qual Saf Health Care 2003; 12: 317. doi: 10.1136/qhc.12.4.317
5.  Neuhauser D. Ernest Amory Codman, M.D., and end results in medical care. Int J Technol Assess Health Care 1990; 6: 307–25. doi: http://dx.doi.org/10.1017/S0266462300000842
6.  Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q1966; 44: 166–203. doi: 10.2307/3348969
7.  Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992; 30: 473–83.
8.  Kind P, Brooks R, Rabin R. EQ-5D concepts and methods: a developmental history. ordrecht: Springer; 2005. doi: 10.1007/1-4020-3712-0
9.  Health & Social Care Information Centre. Provisional monthly patient reported outcome measures (PROMs) in England - April 2013 to August 2014 [internet]. 2013 [cited 2014 March 12]. Available from: http://www.hscic.gov.uk/catalogue/PUB13246
10.  Peters M, Crocker H, Jenkinson C, Doll H, Fitzpatrick R. The routine collection of patient-reported outcome measures (PROMs) for long-term conditions in primary care: a cohort survey. BMJ Open 2014; 4: e003968. doi: 10.1136/bmjopen-2013-003968
11.  World Development Bank. World development report 1993. Investing in health. New York: Oxford University Press; 1993.
12.  Stine N, Stevens D, Braithwhite RS, Gourevitch MN, Wilson RM. HALE and hearty: toward more meaningful health measurement in the clinical setting. Healthcare 2013; 1: 86–90. doi: http://dx.doi.org/10.1016/j.hjdsi.2013.07.003
13.  Kindig DA. Purchasing population health: paying for results. Ann Arbor, Michigan: University of Michigan Press; 1997.
14.  Secretaries of State for Health, Wales, Northern Ireland and Scotland. Working for Patients. London: Her Majesty’s Stationery Office; 1989.
15.  Warden J. Patients first. BMJ1991; 303: 1153.
16.  Department of Health. The NHS improvement plan: putting people at the heart of public services. London: Her Majesty’s Stationery Office; 2004.
17.  National Health Service (NHS) The NHS Constitution [internet]. 2013 [cited 2014 March 12]. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170656/NHS_Constitution.pdf
18.  National Health Service (NHS). The handbook to the NHS Constitution [internet]. 2013 [cited 2014 March 12]. Available from: http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Documents/2013/handbook-to-the-nhs-constitution.pdf
19.  Morgan B, Wright K. Hospital waiting lists and waiting times. Research paper 99/60. London: House of Commons Library; 1999.
20.  National Health Service (NHS). Referral to treatment (RTT) waiting times, England [internet]. April 2007 to December 2013 [cited 2014 March 12]. Available from: http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2013-14/
21.  See www.choosingwisely.org
22.  Brody H. Medicine’s ethical responsibility for health care reformthe Top Five list. N Engl J Med 2010; 362: 283–5. doi: 10.1056/NEJMp0911423
23.  Organization for Economic Cooperation and Development. Health at a glance 2013: OECD indicators. Paris: OECD Publishing; 2013.
24.  Saltman RB, Cahn Z. Restructuring health systems for an era of prolonged austerity: an essay by Richard B Saltman and Zachary Cahn. BMJ2013; 346: f3972. doi: http://dx.doi.org/10.1136/bmj.f3972
25.  Polak J. Regenerative medicine. Opportunities and challenges: a brief overview. Journal of the Royal Society Interface 2010; 7: S777–81. doi: 10.1098/​rsif.2010.0362.focus

Files

History

  • Receive Date: 02 March 2014
  • Revise Date: 19 March 2014
  • Accept Date: 18 March 2014
  • First Publish Date: 01 April 2014

Share

How to cite

Statistics