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Biomedical subjects

G Mooney

Publications and source records attributed to G Mooney.

At least 91 records · Page 5Linked to original sources
PubMed1984

Medical ethics: an excuse for inefficiency?

There is frequently an appearance of conflict between medicine and economics. This arises first because the nature of health and health care requires the doctor to make decisions on behalf of the patient and thus serves to explain why medical ethics exist. But secondly it is due to the relative lack of acceptance of the ethics of the common good within medical ethics. As a result while economics in the field of health has as an objective the maximisation of the health of the community, subject to resource constraints, medical ethics pushes individual doctors to try to maximise the health of their patients. There is no reason to believe that the latter will sum to the former. To make the maximisation of health of the community the goal of the medical profession requires institutional changes, particularly with regard to budgeting, which will cajole and if necessary coerce doctors to adopt the good of the community as their objective.

Economics, Medical↗
PubMed1984

Programme budgeting: an aid to planning and priority setting in health care.

Programme budgeting can assist in overcoming some of the current problems besetting health care planning and management. In particular, health services suffer from lack of (i) explicit objectives; (ii) comprehensive overviews; (iii) knowledge of production functions; (iv) incentives for efficiency; and (v) inappropriate budgeting structures. Programme budgeting while not in itself capable of overcoming all these problems can create an information framework which first highlights but secondly fosters amelioration of these problems. In essence programme budgeting links outputs and inputs by health care programme. This facilitates monitoring, planning, control and the fostering of evaluation. Two examples of the use of programme budgets are presented.

Budgets↗
PubMed1983

Rational establishment of air quality standards.

This paper attempts to apply two principles of rationality--efficiency and equity--to the establishment of air quality standards for total suspended particulates in the USA. It is argued that standard setting should embrace either the use of some cost-benefit-risk criterion, or some concept of equity whereby risks are not reduced below levels judged to be acceptable elsewhere. There is often a trade-off to be made between these principles of efficiency and equity and that both cannot be pursued in tandem. In other words, the cost of fairness is more deaths in total than there need be at a particular level of expenditure. The concept of the "margin of safety" is also discussed, and we conclude that, as currently defined, it is of doubtful relevance in either the context of efficiency or of equity. Finally, and using evidence from other studies, we conclude that there are much more cost-effective ways of using scarce resources to save lives (e.g., in health care and in road safety) than pursuing the primary standards for TSP laid down by the United States Environmental Protection Agency in light of the U.S. Clean Air Act Amendments of 1970 and 1977.

Air Pollution↗
PubMed1982

Breast cancer screening. A study in cost-effectiveness analysis.

This paper identifies the long run average British National Health Service screening costs in one particular screening clinic for various different regimes: mammography, thermography and clinical examination; thermography and clinical examination; and mammography and clinical examination; each of these having one or two clinical examinations and the option of single or double reporting of mammograms and thermograms. It then compares the cost-effectiveness of these different regimes where 'costs' are defined widely to include not only screening costs but also biopsy costs, anxiety costs for women biopsied, costs of false negatives, etc. By defining costs in this way, it was possible (if somewhat tentatively because of the small numbers involved) to identify mammography with single reporting together with a single clinical examination as 'the best buy'.

Adult↗
PubMedDate not supplied

Coping with regional variations: the case of surgery in Denmark.

This article examines some of the key research and policy issues that are emerging as a result of recent analyses of regional variations in health care. The article presents a historical background to this important new field of health services' research, and indicates, using some Danish examples of research on hysterectomy, cholecystectomy, and prostatectomy, the relevance of this research to management and policy planning. Regional variations are not yet fully explained in terms of what causes them. What is clear and what is the primary focus of this article is that their very existence, whatever their explanation, creates a major challenge for the management and planning of future health services.

Cholecystectomy↗