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Monitoring health reform: a report card approach

Author

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  • Brownell, Marni D.
  • Roos, Noralou P.
  • Roos, Leslie L.

Abstract

During the past several years, budget cuts have forced hospitals in several countries to change the way they deliver care. Gilson (Gilson, L. (1998). Discussion: In defence and pursuit of equity. Social Science & Medicine, 47(12), 1891-1896) has argued that, while health reforms are designed to improve efficiency, they have considerable potential to harm equity in the delivery of health care services. It is essential to monitor the impact of health reforms, not only to ensure the balance between equity and efficiency, but also to determine the effect of reforms on such things as access to care and the quality of care delivered. This paper proposes a framework for monitoring these and other indicators that may be affected by health care reform. Application of this framework is illustrated with data from Winnipeg, Manitoba, Canada. Despite the closure of almost 24% of the hospital beds in Winnipeg between 1992 and 1996, access to care and quality of care remained generally unchanged. Improvements in efficiency occurred without harming the equitable delivery of health care services. Given our increasing understanding of the weak links between health care and health, improving efficiency within the health care system may actually be a prerequisite for addressing equity issues in health.

Suggested Citation

  • Brownell, Marni D. & Roos, Noralou P. & Roos, Leslie L., 2001. "Monitoring health reform: a report card approach," Social Science & Medicine, Elsevier, vol. 52(5), pages 657-670, March.
    • Handle: RePEc:eee:socmed:v:52:y:2001:i:5:p:657-670
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    Cited by:

    1. Azharuddin Akhtar & Indrani Roy Chowdhury, 2023. "The socioeconomic inequity in healthcare utilization among individuals with cardiovascular diseases in India," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1000-1018, May.
    2. Davis, Peter & Milne, Barry & Parker, Karl & Hider, Phil & Lay-Yee, Roy & Cumming, Jackie & Graham, Patrick, 2013. "Efficiency, effectiveness, equity (E3). Evaluating hospital performance in three dimensions," Health Policy, Elsevier, vol. 112(1), pages 19-27.
    3. Mary Ann McColl & Alice Aiken & Michael Schaub, 2015. "Do People with Disabilities Have Difficulty Finding a Family Physician?," IJERPH, MDPI, vol. 12(5), pages 1-14, April.
    4. Gross, Revital, 2004. "A consumer-based tool for evaluating the quality of health services in the Israeli health care system following reform," Health Policy, Elsevier, vol. 68(2), pages 143-158, May.
    5. Kruk, Margaret Elizabeth & Freedman, Lynn P., 2008. "Assessing health system performance in developing countries: A review of the literature," Health Policy, Elsevier, vol. 85(3), pages 263-276, March.

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