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Priorities of health policy: cost shifting or population health.

BACKGROUND: This paper is an edited version of an invited paper submitted to the Australian Health Care Summit on 17-19 August 2003. It comments upon the policies which have dominated recent debate and contrasts their importance with the importance of five issues which have received relatively little attention. METHODS: Policy is usually a response to identified problems and the paper examines the nature and size of the problems which heave led to recent policy initiatives. These are contrasted with the magnitude and potential cost effectiveness policies to address the problems in five areas of comparative neglect. RESULTS: It is argued that recent and proposed changes to the financing and delivery of health services in Australia have focused upon issues of relatively minor significance while failing to address adequately major inequities and system deficiencies. CONCLUSION: There is a need for an independent review of the health system with the terms of reference focusing attention upon large system-wide failures.

Journal Article↗

Health Watch 2000: community health assessment in south central Ohio.

In Ohio, there has been a recent but concerted effort from the state health department down through the local health departments to complete community health assessment studies for the prioritization and delivery of health services in their respective communities. At the same time, the Joint Commission on Accreditation of Health Care Organizations has been actively encouraging hospitals to assess targeted communities prior to the delivery of community-based services. In a changing health care system that demands greater emphasis on health promotion and disease prevention, new alliances are born of necessity, with collaborative products and benefits to all involved. A local health department and a community hospital in south central Ohio that was jointly owned by the city and county, in consultation with a neighboring state university, embarked on a 1 1/2-year study to define, prioritize, and plan service delivery for the community through Health Watch 2000. Six priority health areas based on national health objectives were determined along with subsequent health planning recommendations, leading to the ultimate goal of healthy people in healthy communities.

Adolescent↗

Management. Setting priorities in health: the Oregon experiment (Part 1).

Increasing emphasis on obtaining consumer opinion in relation to needs assessment and decision making has led to interest in this country about the Oregon experiment in the US. Despite controversies over the efficacy of such approaches, it seems likely that future emphasis will be placed on devising systematic means of gathering information about societal preferences for care. In two articles, Ann Bowling reviews the evidence from America and relates it to the ongoing changes in the British health service. Part 1 introduces the ideas behind the Oregon experiment and examines similar initiatives in the UK.

Community Health Services↗

Management. Setting priorities in health: the Oregon experiment (Part 2).

Increasing emphasis on obtaining consumer opinion in relation to needs assessment and decision making has led to interest in this country about the Oregon experiment in the US. In spite of controversies over the efficacy of such approaches, it seems likely that future emphasis will be placed on devising systematic means of gathering information about societal preferences for care. In two articles, Ann Bowling reviews the evidence from America and relates it to the ongoing changes in the British health service. Part 2 examines the methods, results and controversies generated by the Oregon experiment.

Community Health Services↗