Health Management

Time to Consider the Risks of Caesarean Delivery for Long Term Child Health

Time to Consider the Risks of Caesarean Delivery for Long Term Child Health
BMJ [British Medical Journal] 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h2410

Jan Blustein and Jianmeng Liu
06/10/2015

Jan Blustein and Jianmeng Liu examine the evidence linking caesarean delivery with childhood chronic disease and say that guidelines on delivery should be reviewed with these risks in mind.

Understanding Pay Differentials Among Health Professionals, Nonprofessionals, And Their Counterparts In Other Sectors

Understanding Pay Differentials Among Health Professionals, Nonprofessionals, And Their Counterparts In Other Sectors
Health Affairs, 34, no.6 (2015):929-935

Sherry Glied, Stephanie Ma and Ivanna Pearlstein
06/09/2015

About half of the $2.1 trillion of US health services spending constitutes compensation to employees. We examined how the wages paid to health-sector employees compared to those paid to workers with similar qualifications in other sectors. Overall, we found that health care workers are paid only slightly more than workers elsewhere in the US economy, but the patterns are starkly different for nonprofessional and professional employees. Nonprofessional health care workers earn slightly less than their counterparts elsewhere in the economy. By contrast, the average nurse earns about 40 percent more than the median comparable worker in a different sector. The average physician earns about 50 percent more than a comparable worker in another sector of the economy, and this differential has increased sharply since 1993. Cost containment is likely to lead to reductions in the earnings of health care professionals, but it will also require using fewer or less skilled employees to produce a given service.

Vital Signs: Core Metrics for Health and Health Care Progress

Vital Signs: Core Metrics for Health and Health Care Progress
Committee on Core Metrics for Better Health at Lower Cost; Institute of Medicine. Washington, DC: The National Academies Press, 2015.

David Blumenthal, Elizabeth Malphrus, and J. Michael McGinnis (Eds.)
04/28/2015

Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their sheer number, as well as their lack of focus, consistency, and organization, limits their overall effectiveness in improving performance of the health system. To achieve better health at lower cost, all stakeholders—including health profes­sionals, payers, policy makers, and members of the public—must be alert to the measures that matter most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans?

With support from the Blue Shield of California Foundation, the California Healthcare Foundation, and the Robert Wood Johnson Foundation, the Institute of Medicine (IOM) convened a committee to identify core measures for health and health care. In VITAL SIGNS: Core Metrics for Health and Health Care Progress, the committee proposes a streamlined set of 15 standardized mea­sures, with recommendations for their application at every level and across sec­tors. Ultimately, the committee concludes that this streamlined set of measures could provide consistent benchmarks for health progress across the nation and improve system performance in the highest-priority areas.

Supplying Health to the World

Supplying Health to the World
The Medicine Maker, 0315, Article #302.

Privett, N.
04/07/2015

New and improved drugs are released every year to tackle global health needs – and many pharma companies have initiatives to supply those drugs to the developing world. Unfortunately, efforts are wasted without proper supply chain management. Here, we prioritize the top ten challenges.

The Top Ten Global Health Supply Chain Issues: Perspectives from the Field

The Top Ten Global Health Supply Chain Issues: Perspectives from the Field
Operations Research for Health Care. 3(4) 226-230.

Privett, N. and D. Gonsalves
12/01/2014

In the battle for global health, supply chains are often found wanting. Yet most of what is known about in-country pharmaceutical supply chains resides in the experiences of individual stakeholders, with limited amounts of this knowledge captured in technical reports and papers. This short communication taps into the collective experience and wisdom of global health supply chain professionals through interviews and surveys to identify and prioritize the top 10 global health pharmaceutical supply chain challenges: (1) lack of coordination, (2) inventory management, (3) absent demand information, (4) human resource dependency, (5) order management, (6) shortage avoidance, (7) expiration, (8) warehouse management, (9) temperature control, and (10) shipment visibility. As such, this work contributes to the foundational knowledge of global health pharmaceutical supply chains. These challenges must be addressed by researchers, policy makers, and practitioners alike if global pharmaceutical supply chains are to be developed and improved in emerging regions of the world.

Connecting the Dots: Interprofessional Health Education and Delivery System Redesign at the Veterans Health Administration

Connecting the Dots: Interprofessional Health Education and Delivery System Redesign at the Veterans Health Administration
Academic Medicine, Vol. 89, no. 8, pp. 1113-1116. DOI: 10.1097/ACM.0000000000000312

Gilman, S.C., D. Chokshi, J.L. Bowen, K.W. Rugen, and M. Cox
08/01/2014

Health systems around the United States are embracing new models of primary care using interprofessional team-based approaches in pursuit of better patient outcomes, higher levels of satisfaction among patients and providers, and improved overall value. Less often discussed are the implications of new models of care for health professions education, including education for physicians, nurse practitioners, physician assistants, and other professions engaged in primary care. Described here is the interaction between care transformation and redesign of health professions education at the largest integrated delivery system in the United States: the Veterans Health Administration (VA). Challenges and lessons learned are discussed in the context of a demonstration initiative, the VA Centers of Excellence in Primary Care Education. Five sites, involving VA medical centers and their academic affiliates in Boise, Cleveland, San Francisco, Seattle, and West Haven, introduced interprofessional primary care curricula for resident physicians and nurse practitioner students beginning in 2011. Implementation struggles largely revolved around the operational logistics and cultural disruption of integrating educational redesign for medicine and nursing and facilitating the interface between educational and clinical activities. To realize new models for interprofessional teaching, faculty, staff, and trainees must understand the histories, traditions, and program requirements across professions and experiment with new approaches to achieving a common goal. Key recommendations for redesign of health professions education revolve around strengthening the union between interprofessional learning, team-based practice, and high-value care.

What Passes and Fails as Health Policy and Management

What Passes and Fails as Health Policy and Management
Journal of Health Politics, Policy and Law; 39 (5): 1113-1126. doi: 10.1215/03616878-2813719

Rodwin, VG. and Chinitz, DP.
07/18/2014

The field of health policy and management (HPAM) faces a gap between theory, policy and practice. Despite decades of efforts at reforming health policy and health care systems, prominent analysts state that the health system is ‘‘stuck’’ and that models for change remain ‘‘aspirational.’’ We discuss four reasons for the failure of current ideas and models for redesigning health care: (1) the dominance of microeconomic thinking; (2) the lack of comparative studies of health care organizations and the limits of health management theory in recognizing the importance of local contexts; (3) the separation of HPAM from the rank and file of health care, particularly physicians; and (4) the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking how the field of HPAM might generate more promising policies for health care providers and managers by abandoning the illusion of context-free theories and, instead, seeking to facilitate the processes by which organizations can learn to improve their own performance.

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