Technical Report

El impacto de los servicios sanitarios sobre la salud

Report number: Working Paper No. 752., Affiliation: Universitat Pompeu Fabra Economics and Business
Source: OAI

ABSTRACT This paper reviews what has increased medical-care spending bought in terms of health benefits with longitudinal data from the U.S and, more limited, from Spain. Health services contribution to health has been positive in average, especially during the last 50 years for the U.S and the last 30 years for Spain. This contribution differs among countries and is much greater for some diseases (cardiovascular) than for others (cancer). Benefits from health care interventions can be valued on basis on the social willin gness to pay, observed or declared on the process of establishing health policy priorities. 30.000 euros per Quality Adjusted Life Year could provide an efficiency threshold for financing publicly health services in Spain: Consensus and legitimacy of the political process of establishing health priorities becomes, however, more important than any approximate number. Attention is paid finally to bridging the gap between efficacy (the possibilities given by innovation and resources devoted to health care) and effectiveness (the distance to the frontier) of the everyday working of a health system with its inappropriate care and limited application of the existing knowledge.

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    ABSTRACT: The populations of New Haven and Boston are demographically similar and receive most of their hospital care in university hospitals, but in 1982 their expenditures per head for inpatient care were $451 and $889, respectively. The 685,400 residents of Boston incurred about $300 million more in hospital expenditures and used 739 more beds than they would have if the use rates for New Haven residents had applied. Most of the extra beds were invested in higher admission rates for medical conditions in which the decision to admit can be discretionary. The overall rates for major surgery were equal, but rates for some individual operations varied widely. These findings indicate that academic standards of care are compatible with widely varying patterns of practice and that medical care costs are not necessarily high in communities served largely by university hospitals. They also emphasise the need for increased attention to the outcome and cost implications of differences in practice styles.
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May 26, 2014