Tuesday, April 19, 2011

[EQ] Variations in health care: The good, the bad and the inexplicable

Variations in health care:
The good, the bad and the inexplicable

John Appleby, Veena Raleigh, Francesca Frosini, Gwyn Bevan, Haiyan Gao, Tom Lyscom
The King’s Fund 2011

Available online at: http://bit.ly/emTUBU

As this report illustrates with reference to differences in admission rates for many routine surgical procedures, variations in health care are not limited to relatively rare or new interventions. Nor are such variations a new phenomenon or simply concerned with the efficient use of scarce health service resources. The existence of persistent unwarranted variations in health care directly impacts on equity of access to services, the health outcomes of populations and efficient use of resources. But the eradication of all variation is not the task.

 

As Al Mulley has noted:

If all variation were bad, solutions would be easy. The difficulty is in reducing the bad variation, which reflects the limits of professional knowledge and failures in its application, while preserving the good variation that makes care patient centred.

When we fail, we provide services to patients who don’t need or wouldn’t choose them while we withhold the same services from people who do or would, generally making far more costly errors of overuse than of underuse.

(Mulley 2010)

The task, then, is more complicated. However, the NHS is well placed in terms of the data it collects to begin to map out in a systematic way where variations exist and then to move forward with strategies to tackle them. A key focus will need to be to tackle clinical decisions through greater emphasis on shared decision-making…”

Content.

Executive summary

Introduction

1 Variations: what’s good, what’s bad?

   Measuring variation and adjusting for need

2 Variations in elective hospital admissions

    Ubiquity: variation in common, clinically effective procedures

    Persistence: trends in variation

    Efficiency: variation in day case rates

    Effectiveness: variation in low effectiveness procedures

    Equity: variation in pre-operative health

    Choice: preference-sensitive variations

3 Conclusions and recommendations

References

Appendix

 

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[EQ] WHO Global Forum: Addressing the Challenge of Noncommunicable Diseases - Moscow, Russian Federation 27 April 2011

WHO Global Forum: Addressing the Challenge of Noncommunicable Diseases

Moscow, Russian Federation -  27 April 2011

Website: http://bit.ly/dMSspc

“….This forum will bring together a wide group of stakeholders to share views and experiences on the challenges and opportunities in noncommunicable disease prevention, treatment and control. The forum participants will include NGOs, the private sector, academia, countries and UN and specialized agencies.
They will identify and commit to priority actions to strengthen global action to prevent and control noncommunicable diseases.

The forum will also provide direct input into the First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control that takes place 28-29 April in Moscow.

Objectives of the Global Forum:

·         Provide an opportunity for a wide range of stakeholders to discuss and share perspectives on the prevention and control of noncommunicable diseases (NCDs)

·         Understand expectations, roles and contributions of the different stakeholders in support of the September 2011 UN High-level Meeting (HLM) on NCDs and its expected outcomes, as well as activities post the HLM.

·         Update knowledge and share experience on progress in addressing NCDs including through implementing the Action Plan for the Global Strategy for the Prevention and Control of NCDs.

·         Promote ways of accelerating the implementation of actions for international and national partners under each objective of the Action Plan.

·         Mobilize a broader base of stakeholders in support of NCD prevention and control, in particular in developing countries….”

 

Conference concept note http://bit.ly/g2t1e2

Sessions will have live broadcast http://who.telemarker.ru

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
Washington DC USA

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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Thank you.