Constructabetterhealthcaresystem

Introduction

Intoday’scomplexworld,itcanbedif culttosayexactlywhatahealthsystemis,whatitconsistsof,andwhereitbeginsandends.TheWorldHealthReport200de nesahealthsystemtoincludealltheactivitieswhoseprimarypurposeistopromote,restoreormaintainhealth.

Healthsystemshavearesponsibilitynotjusttoimprovepeople’shealthbuttoprotectthemagainstthe nancialcostofillness-andtotreatthemwithdignity.Sohealthsystemsarevaluableandimportant,buttheycouldaccomplishmuchmorewiththeavailableunderstandingofhowtoimprovehealth.Thefailingswhichlimitperformancedonotresultprimarilyfromlackofknowledgebutfromnotfullyapplyingwhatisalreadyknown:thatis,fromsystemicratherthantechnicalfailures.Thisistrueevenofmostmedicalerrors,because´’theproblemisnotbadpeople;theproblemisthatthesystemneedstobemadesafer´’.Somefactorsthatareoftendebatedindeterminingthequalityofcareinclude:coverageforcomplementarycare;whichdiseasesarethemostcriticalinaffectingoverallhealth;percentageofGDPspentonhealthcare;percentageofhealthcarecoststhatgoestowardlabor/administrative/malpracticeinsurance;ratioofpublictoprivatespendingonhealthcare;percapitaspendingonhealthcare;growthofpercapitaspendingonhealthcare;numberofparticipatingphysicians;percapitasickdays;fairnessofcareintermsofage,race,gender,socio-economicclass;andmanymore.

Howtomeasurecurrentperformanceandhowtoachievethepotentialim-provementsinitarethesubjectofthispaper.

Notationsandde nitions

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