| Tackling wastage and inefficiency in the health sector. | |
| | |
MedLine Citation:
|
PMID: 8018273 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Governments and the public are concerned about waste and inefficiency in the health sector. Although there are likely to be various underlying causes, wastage often results from limited information and from limited accountability for decisions about the use of resources. Corruption and fraud occur where there are conflicting interests in combination with limited accountability. Policy-makers, managers, providers and service users should feel responsible for ensuring that scare health resources are used efficiently. They should actively combat wastage by identifying the causes, and then make corresponding changes in policy, management and technical procedures. While governments and the public worldwide express concern about the best use of scarce resources for health care, reports from developed and developing countries point to examples of the waste of money, health personnel, time, and supplies. Inefficiency occurs when more resources than necessary are used to obtain a result. Wastage occurs when resources are carelessly squandered. Allocative inefficiency occurs when decisions on the use of limited resources fail to yield the greatest possible health gains at the lowest possible cost, and technical inefficiency occurs when the costs of providing specific services or goods are higher than necessary. Decisions made at various levels result in waste. For example, policy makers may overemphasize urban vs. rural services, managers may underutilize health staff, health care workers may prescribe excessively expensive drugs, and users of services may demand inappropriate prescriptions. It is difficult to measure the magnitude of wastage, but estimates are in the billions of dollars annually. Corrective action relies on data obtained from efficiency studies of single elements or subsystems of the health sector. The savings attainable by various actions can be derived by making judgments based on experience and knowledge of the health care system. Combining individual estimates will reveal the cumulative effect of different actions. In addition, cost-effectiveness analysis can be used to determine the magnitude of specific wastage problems. Wastage can be reduced by making changes in policy decisions, management, training, education, and communications. Efforts to reduce waste should concentrate on areas where the greatest savings will result and should take into account the cost of making the necessary changes. Decision-makers can be made aware of the costs and impacts of different health actions through an assessment of available resources and a general understanding of their use. Decentralization of health facilities can also reduce waste by providing improved information and feedback for decision-makers, increasing the control of managers and providers over factors affecting wastage, and increasing the accountability and responsiveness of the health system to its stake-holders. |
| | |
Authors:
|
D Parker; W Newbrander |
Related Documents
:
|
17249853 - Measuring preferences for cost-utility analysis: how choice of method may influence dec... 10162923 - Beyond guidelines: promoting clinical change in the real world. 21946683 - Citizenship, work, welfare, education and health in new zealand. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: World health forum Volume: 15 ISSN: 0251-2432 ISO Abbreviation: World Health Forum Publication Date: 1994 |
Date Detail:
|
Created Date: 1994-08-04 Completed Date: 1994-08-04 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8010746 Medline TA: World Health Forum Country: SWITZERLAND |
Other Details:
|
Languages: eng Pagination: 107-13; discussion 114-31 Citation Subset: IM; J |
Affiliation:
|
Office of Social Policy and Economic Analysis, UNICEF, New York, NY 10017. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Costs and Cost Analysis Decision Making Efficiency* Health Personnel / education Health Resources / economics, utilization* Humans Policy Making Social Responsibility |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Medical school-community dialogue: a survey of current initiatives in Canada and the United States.
Next Document: Traditional herbal eye medicine in Kenya.