Geographic Variations in Health Care

Abstract

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Multi-criteria decision analysis for supporting the selection of medical devices under uncertainty

“…The purpose of this article is to provide methodological support and a theoretical justification for that support for selecting MDs in uncertain conditions, using the selection of magnetic resonance imaging (MRI) systems for contributory health organisations administered by regional authorities (hereinafter referred to as "regional hospitals") in the Czech Republic as an example. The regional hospitals in the Czech Republic are owned by the regional government, and this group of hospitals is the largest provider of country's inpatient acute care (Roubal & Sidlo, 2014).…”

Efficiency vs Effectiveness: a Benchmarking Study on European Healthcare Systems

“…Hence, performance evaluation and benchmarking models in the healthcare sector are still far from being developed and capable to provide useful results. Additionally, academic and industry literature reports evidence of diffused inefficiency in healthcare management in Europe that has contributed to health expenditure increase in the last decade (Hollingsworth and Wildman, 2003;OECD, 2014). Furthermore, empirical evidence indicates that high level of efficiency cannot be achieved without reducing quality or effectiveness of healthcare service provision due to potential trade off between them.…”

Medical practice variation: public reporting a first necessary step to spark change

“…The findings from research into practice variation are rich and demonstrative of the challenges facing national healthcare systems [8, 9]. From previous work, we know that unwarranted variation can be harmful to patients and costly to society [1, 7].…”

“…We also know that patients who live in regions with high costs and high utilization rates do not reliably experience better care and outcomes: more is not always better [10, 11]. These findings have been partially replicated in a few countries, but in most countries, geographic data analysis is at the earliest stages, and very few have established systems for monitoring healthcare value metrics [9] with sufficient regional and provider specificity to guide change. There are a few noteworthy exceptions.…”

“…According to the authors, ‘In many localities across England, the NHS Atlas of Variation in Healthcare series has been used as a stimulus to start a search for unwarranted variation, and as a springboard to releasing resources for re-investment in higher-value healthcare for local patients and populations.’ Another example is the Dartmouth Atlas of Health Care [13], which found marked variation in end-of-life care across hospitals in the USA. A few other countries showed progress in variation research in a recent Organisation for Economic Co-operation and Development study [9]. However, in general, most countries do not have clear, valid and reliable insights into the geographic distribution of the use, costs and outcomes of healthcare, or into trends over time.…”