RAND Review | Spring 2008 | Baby Steps
RAND Review Spring 2008 Baby Steps
Noe-Natal Mortality has been the yard stick or proxy by which to judge the quality of medical care in a region. Here the Rand Corporation publishes an analysis of neonatal mortality in several Western Nations with modern health care delivery systems. We, that is the US, trails embarrassingly in the mantra of Neonatal Mortality. Despite outstanding centers of excellence, pediatric care is unevenly distributed in the US. The Rand Analysis is 157 pages long. With its European origin, it is surprisingly generous with its assessment of the US's difficulties. The article wrestles with the contrast between regional organization of health care, especially Peri-Natal (premi) care, and centralized structure. There are compelling persuasions for both regional and national (one party) systems.
I have taken the position that regional diversity is the only way to go: because of highly varying regional differences in pathology, the need for competition in evolving management systems and because of the rapidly evolving science and technology of medicine. (None of which can be managed well on a national basis) I would center the Health Care System on state supported medical schools as the most likely institutions to both keep pace with the changes in medicine and to have some understanding of the regional problems. The universities, with which the medical schools are associated, are more than capable of providing the statistics, the business management and the public health expertise required to manage a regional system. These many centers of academic excellence may have better: understanding of the providers they have trained, control over the culture and standard of care and most importantly the ability to adjust pre and post-graduate training on the basis of monitored need.
Noe-Natal Mortality has been the yard stick or proxy by which to judge the quality of medical care in a region. Here the Rand Corporation publishes an analysis of neonatal mortality in several Western Nations with modern health care delivery systems. We, that is the US, trails embarrassingly in the mantra of Neonatal Mortality. Despite outstanding centers of excellence, pediatric care is unevenly distributed in the US. The Rand Analysis is 157 pages long. With its European origin, it is surprisingly generous with its assessment of the US's difficulties. The article wrestles with the contrast between regional organization of health care, especially Peri-Natal (premi) care, and centralized structure. There are compelling persuasions for both regional and national (one party) systems.
I have taken the position that regional diversity is the only way to go: because of highly varying regional differences in pathology, the need for competition in evolving management systems and because of the rapidly evolving science and technology of medicine. (None of which can be managed well on a national basis) I would center the Health Care System on state supported medical schools as the most likely institutions to both keep pace with the changes in medicine and to have some understanding of the regional problems. The universities, with which the medical schools are associated, are more than capable of providing the statistics, the business management and the public health expertise required to manage a regional system. These many centers of academic excellence may have better: understanding of the providers they have trained, control over the culture and standard of care and most importantly the ability to adjust pre and post-graduate training on the basis of monitored need.
posted by Clancy Hughes | 5/05/2008 04:43:00 PM
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