Health resource allocation and quality of care measurement in a social policy framework

Abstract

An activity analysis production function, linking the structure, process, and outcome of medical care, is introduced. The model, based on a semi-Markovian conception of the disease process, is designed to determine that allocation of inputs among programs which maximizes expected improvement in population health status. Reflected in such prescriptions are the expected efficacy of alternative treatments and population preferences among program outcomes. Based on the model, two system-oriented indexes of the quality of medical care are defined. This allocation methodology represents a particular application of a more general "social policy model," a potentially useful paradigm for the evaluation of public programs generally.

The deserving sick: Income-maintenance policy towards the ill and disabled

“…Current definitions of disability are based on clinical taxonomies of medical impairments, rather than on scales of functional ability or of economic need (Nagi, 1977;Stone, 1978a). Research on health program evaluation has led to the development of functionally-based health indices, which might fruitfully be applied to disability programs as administrative tools rather than as evaluative tools (Fanshel and Bush, 1970;Patrick et al, 1973;Lipscomb, 1978). If disability determinations could be based on real tests of performance or functional capabilities, the distortion of translating medical impairments into income losses could be reduced.…”