Chapter 7 focuses a lot on how the performance of various health care systems and how they are assessed and evaluated in the industry. There are three different criteria for evaluation of health care systems: (a)quality (b)equity (c)efficiency. Structure and process influence the outcomes of health care. Ultimately, our interest is in outcomes, and we ask: Have the structures and processes of the health care system resulted in the desired outcome: quality, equitable, and efficient health care? I think that every aspect of the assessment process and all three criteria are very important. Each section of the process has important aspects of the health care systems that need to be recognized.
Of the three, we have spent the most time on the quality of health care, mainly because over the past 20 years an increasingly large effort has developed to measure and improve quality at the microlevel. Evaluations of clinical effectiveness and patient safety are based on empirical studies that provide evidence about best practices and are the foundation of clinical practice guidelines. These studies have been well funded, and the practice guidelines that have resulted are increasingly used to evaluate the performance of health care providers—individual providers and organizations. Public as well as private organizations are involved in this effort. Determining the quality of the health care system is very important, arguably the most important, criteria of the three. It is important to know that the care provided form the health care system is working and effective. Making sure you are seeing the results of the quality of care that you are giving is very important for a health care system.
Equity is the second criterion used to evaluate the performance of health care systems. Equity or distributive justice is concerned with the fair allocation of benefits and burdens among those who are deserving of care and those who can pay for it. Disparities in quality of care and access to that care is one of the main things they look at when evaluating this criterion.
Efficiency is the third criterion for judging a health care system. “Efficiency requires that we produce the combination of goods and services with the highest attainable total value, given our limited resources and technology” (Aday et al., 1993, p. 73). Efficiency is allocative or production. Allocative efficiency concerns attaining the most valued mix of health care services. Production efficiency refers to producing a given level of health care services at minimum cost. The main thing about this section is making the system as efficient as possible. Making sure that a health care system has many different options of care available to the consumer as well as producing these care options at minimal cost for maximum overall value.
Lastly, this chapter touches on the importance of health care data information systems and data technology. With the increase dependence on technology in the coming age and moving forward, data technology and dependence of technology systems housing information and records will be increasingly important. Digitizing record keeping and evaluation in data technology makes it easier for the health care system and more efficient. I think in the coming years there will be more advancement and innovation in the data technology of health care systems that will make managing health care systems and information even easier than before.