WAYS OF SEEING - EXPLAINING VARIATIONS IN USE OF ACUTE HOSPITAL SERVICES

Authors
Citation
G. Bevan, WAYS OF SEEING - EXPLAINING VARIATIONS IN USE OF ACUTE HOSPITAL SERVICES, International journal of epidemiology, 24, 1995, pp. 103-108
Citations number
51
Categorie Soggetti
Public, Environmental & Occupation Heath
ISSN journal
03005771
Volume
24
Year of publication
1995
Supplement
1
Pages
103 - 108
Database
ISI
SICI code
0300-5771(1995)24:<103:WOS-EV>2.0.ZU;2-O
Abstract
Background. in the US Medicare programme, hospitals are paid directly by activity. To provide incentives for efficiency, the US Federal Gove rnment has sought objective measures of inpatients' need for resources . In the UK National Health Service, resources are allocated for acute hospital services as part of a global budget to purchasers, who then contract with hospitals. To provide equity in resource allocation, the Department of Health in England, has sought objective measures of pop ulations' need for resources. Methods. Examination of policy and techn ology that has used variations in utilization of resources to derive o bjective measures of efficiency and equity. Results. The technology of developing empirical measures of resources needed by patients has lac ked information on outcomes, which is vital for measures of efficiency . The technology of developing empirical measures of resources needed by populations has relied on aggregate data. Analyses of specific proc edures and conditions consistently find that these variations are expl ained by differences in medical practice and not by need. Conclusions. There is scope for multidisciplinary research to explain small area v ariations for specific procedures and conditions in resources used by populations. It seems unlikely, however, that governments will be inte rested in findings from this research.