Welfare Reform on the Web (January 2006): Healthcare - overseas

The $800 million pill: the truth behind the cost of new drugs

M. Goozner
London: University of California Press, 2005

The book describes the arcane process of drug development from the beginning in academic and government labs to the final approval by the US Food and Drug Administration. The book asks two questions. Where do new drugs come from? What do they really cost to invent?  It challenges the assertion that new drugs have to be expensive in order to finance future innovation.

Commercialization of health care: global and local dynamics and policy responses

M Mackintosh and M. Koivusalo (editors)
Basingstoke: Palgrave Macmillan, 2005

Health care is increasingly a market sector, but the process of commercialization is widely contested. It poses enormous challenges for health planners and activists who aim to ensure decent health care for all. The book analyzes the causes and consequences of global and local commercialization and argues for the necessity and possibility of effective policy responses to develop good quality, inclusive health systems worldwide.

Deregulating the pharmacy market:  the case of Iceland and Norway

A. Anell
Health Policy, vol.75, 2005, p.9-17

The community pharmacy market in many European countries has traditionally consisted of individually owned small firms operating under tight government control.  Norway and Iceland have been in the forefront of a new move to deregulate pharmacies and introduce competition based on price.  In both countries the new policies quickly led to horizontal integration and concentration of the market, and in Norway emerging pharmacy groups also integrated with wholesalers.  By 2004, two pharmacy groups in Iceland and three in Norway controlled 85% and 97% of the markets respectively.

Feasibility first:  developing public performance indicators on patient safety and clinical effectiveness for Dutch hospitals

M. Berg and others
Health Policy, vol.75, 2005, p.59-73

Until now Dutch hospitals have been regulated through a system of surveys and inspection visits.  However, the Dutch Health Care Inspectorate has developed a set of performance indicators to provide data on patient safety and clinical effectiveness in all hospitals.  The Inspectorate’s vision was to quickly produce a set of indicators that would improve monitoring of the quality of care, enhance transparency and motivate hospitals to improve , while at the same time avoiding unintended consequences such as misinterpretations or defensive reactions

Health operations management: patient flow logistics in health care

J. Vissers and R. Beech (editors)
London: Routledge, 2005

As governments and other health care financing agencies are increasingly requiring health care providers to ‘modernise’ their services in order to make more intensive and efficient use of existing health care resources, health care providers are facing growing pressures to change the ways in which they deliver services. These pressures have meant that health operations management has become an increasingly important aspect of managing health services. The case studies cover: analysis of hospital care processes; scheduling outpatient appointments; admission planning; master scheduling of medical specialists; aggregate production and capacity planning services for older people

Healthcare reform involving the introduction of user fees and drug revolving funds:  influence of health workers’ behavior in Southeast Nigeria

B. Uzochukwu and O. Onwujekwe
Health Policy, vol.75, 2005, p.1-8

In 1988 local government areas in Nigeria were given the equivalent of $10,000 to buy a supply of drugs.  Health centres were expected to sell these to patients at more than cost to provide funds to replenish the supply.  In general, the system improved the motivation of health workers because they had basic drugs to work with.  However, as time went on some became more focused on revenue generation and profit making through sale of their own drugs, as no incentives were offered and their salaries were delayed.  Drugs came to be prescribed irrationally and patients showed widespread dissatisfaction with fees charged, waiting times to be seen, and treatment instructions given to them.

Medicine, the market and the mass media: producing health in the twentieth century

V. Berridge and K. Loughlin (editors)
London: Routledge, 2005

The book examines the development of a new view of the ‘health of the public’ and the influences that shaped it in the post-World War II years. It looks at the dual legacy of social medicine through health services and health promotion, and analyses the role of the mass media along with the connections between public health and industry.

Narrativizing errors of care:  critical incident reporting in clinical practice

R. Iedema and others
Social Science and Medicine, vol.62, 2006, p.134-144

This paper considers the rise across the industrialised world of techniques that encourage clinicians to share their personal experiences of errors and mishaps.  It suggests that this critical incident reporting achieves three objectives.  Firstly, it gives clinicians a channel for bringing problems to light in a non-blaming way.  Secondly, incident reporting, enables clinicians to demonstrate concern about what happened.  Thirdly, incident reporting becomes the basis for radically altering the clinician-organisation relationship.

Strategic management of health care organizations. Fifth edition.

L. Swayne, W. Duncan, and P. Ginter
Oxford: Blackwell, 2005

The book is a classic introduction to strategic thinking, strategic planning and strategic momentum. It demonstrates how strategic managers can become strategic thinkers with the crucial skills to evaluate the changing environment, analyze data, question assumptions, and develop new ideas.

Strategic opportunities in the oversight of the US hospital accreditation system

M.L. Moffett and others
Health Policy, vol.75, 2005, p.109-115

Hospital accreditation and state certification are the means that Centers for Medicare and Medicaid Services employ to meet quality of care requirements for medical care reimbursement.  Hospitals can choose to use either a national accreditation agency or a State certification inspection in order to qualify for Medicare/Medicaid payments.  About 80% of hospitals choose the national scheme.  This paper analyses and proposes improvements to the structure of the national scheme in a Principal-Agent-Supervisor framework.