PubMed · 16649489
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John Erich. 2006. The sci-fi life.. https://pubmed.ncbi.nlm.nih.gov/16649489/
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Over the last 20 years, governments all around the world have attempted to boost the role of market and competition in health care industries in order to increase efficiency and reduce costs. The increased competition and the significant implications on costs and prices of health care services resulted in health care industries being transformed. Large firms are merging and acquiring other firms. If this trend continues, few firms will dominate the health care markets. In this study, I use the simple concentration ratio (CR) for the largest 4, 8 and 20 companies to measure the concentration of Greek private hospitals during the period 1997-2004. Also, the Gini coefficient for inequality is used. For the two different categories of hospitals used (a) general and neuropsychiatric and (b) obstetric/gynaecological it is evident that the top four firms of the first category accounted for 43% of sales in 1997, and 52% in 2004, while the four largest firms of the second category accounted for almost 83% in 1997, and 81% in 2004. Also, the Gini coefficient increases over the 8-year period examined from 0.69 in 1997 to 0.82 in 2004. It explains that the market of the private health care services becomes less equal in the sense that fewer private hospitals and clinics hold more and more of the share of the total sales. From a cross-industry analysis it is clear that the private hospital sector has the highest concentration rate. Finally, it appears that the market structure of the private hospitals in Greece resembles more closely to an oligopoly rather than a monopolistic competition, since very few firms dominate the market.
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Despite the great promise that telehealth holds for improving cost, quality and access, there is currently a disjunction between what we know about telehealth and system growth and performance. To better understand the relationship between these two facets of telehealth development, this paper examines trends in telehealth, both as an intellectual endeavor and as a practical means of providing health services. Although there are promising avenues for government intervention in the way of coordination, funding, and regulatory practice, lack of knowledge regarding what works and what does not work has served as a major impediment to further progress in this area. In the absence of solid empirical evidence, key decision makers entertain doubts about telehealth's effectiveness, which, in turn, limits public leadership, private investment, and the long-term integration of telehealth into the health and technological mainstream. Solving the disjuncture between research and practice will require additional clinical trials and evaluation studies that examine the efficacy of various technologies, both relative to each other and to conventional in person medical encounters. At the same time, it will require more even distribution of research across applications, service locations, regions, and nations. But the generation of additional high-quality empirical data on process, benefits, costs, and effects is only the beginning. That data must in turn be used to effectuate change. This will require researchers to take a more proactive stance in promoting use of their findings, both instrumentally, to adjust, modify or improve particular programs or policies, and conceptually, to influence how key stakeholders think about telehealth more generally.