Abstract
We live in exciting times, when technological achievements are a matter of daily occurrences, and when medical technology, in particular, is reaching new and never before imagined heights of accomplishments. The cumulative effects of advances in medical technology and in their management are felt in almost every aspect of our medical life, from cradle to old age. Successes in combating diseases and prolonging life, as well as the quality of artificially prolonged life are too many to list in this book, but for a glimpse into them which isgiven in the case studies in part III of the book.
It is your great good lucli, Cavaliere, lo see Matteo Barberini Pope, but we are even luckier that the Cavaliere Bernini lives at the time of our pontificate.
Pope Urban VIII to Gianlorenzo Bernini Architect of St. Peter’s Square in Rome (1623)
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Notes To Chapter 10
McKenna, R., Real Time: Preparing for the Age of the Never Satisfied Customer, Boston, MA: Harvard Business School Press, 1997.
Herzlinger, R., Market-Driven Health Care: Who Wins, Who Loses in the Transformation of America’s Largest Service Industry, Reading, Ma: Addison-Wesley, 1997.
See, for example, Tannenbaum, A., Control in Organizations, New York: McGraw Hill, 1968. Also see Perrow, C., “The Analysis of Goals in Complex Organizations,” American Sociological Review, Vol. 26, No. 3, 1961, pp. 688-699; Etzioni, A., Modern Organizations, Englewood Cliffs, NJ: Prentice-Hall, 1964.
See Thompson, J., and W. McEwen, “Organizational Goals and Environment: Goalsetting as an Interaction Process,” American Sociological Review, Vol. 23, No. 1, 1958, pp. 23–31.
Hannan, M., and J. Freeman, “Obstacles to Comparative Studies,” in P. Goodman and J. Pennings (eds.), New Perspectives on Organizational Effectiveness, San Francisco, CA: Jossey-Bass, 1977.
Yuchtman, E., and S. Seashore, “A System-Resource Approach to Organizational Effectiveness,” American Sociological Review, Vol. 32, No. 4, 1967, pp. 891–903.
See, for example, Cameron, K., “Effectiveness as Paradox: Consensus and Conflict in Conceptions of Organizational Effectiveness, Management Science, Vol. 32, No. 3, 1986, pp. 539–553.
See Hammer, M., Beyond Reengineering, New York; Harper Collins, 1996.
See Zammuto, R., Assessing Organizational Effectiveness, Albany, NY: State University of New York Press, 1982.
Some authors advocate a different taxonomy. For example, Shortell and Kaluzny (1987) proposed three domains of activity: clinical care, financial management, and human resources management (Shortell, S., and A. Kaluzny, Essentials of Health Care Management, Albany, NY: Belman Publications, 1997.
Cohen, A., “Whose Ambulance Will Get Here First?”, TIME, July 7, 1997, pp. 64–65.
See, for example, Warner, K., and B. Luce, Cost-Effectiveness and Cost-Benefit Analysis in Health Care, Ann Arbor, MI: Health Administration Press, 1982. Also see Wang-Ombe, J., “Economic Evaluation in Primary Health Care: The Case of Western Kenya Community Health Care Project,” Social Science and Medicine, Vol. 18, No. 5, 1988, pp. 375-385; Birch, S., and C. Donaldson, “Applications of Cost-Benefit Analysis to Health Care: Departures from Welfare Economic Theory,” Journal of Health Economics, Vol. 6, No. 3, 1987, pp. 211-225.
See Weinstein, M., and W. Stason, “Foundation of Cost-Effectiveness Analysis for Health and Medical Practices,” New England Journal of Medicine, Vol. 286, 1977, pp. 716–721.
Birch, S., and A. Gafni, “Cost Effectiveness and Cost Utility Analyses: Methods for the Non-Economic Evaluation of Health Care Programmes and How We Can Do Better,” in E. Geisler and O. Heller (eds.), Managing Technology in Health Care, Boston, MA: Kluwer Academic Publishers, 1996, p. 63. Also see Mehrez, A., and A. Gafni, “Healthy Years Equivalent: How to Measure Them Using the Standard Gamble Approach,” Medical Decision Making,” Medical Decision Making, Vol. 11, No. 3, 1991, pp. 140-146.
See, for example, Hornberger, J., D. Redelmeier, and J. Peterson, “Variability Among Methods to Assess Patients’ Well Being and Consequent Effect on a Cost-Effectiveness Analysis,” Journal of Clinical Epidemiology, Vol. 45, 1992, pp. 505–512.
See Spilker, B., et al., “Quality of Life Bibliography and Indexes,” Medical Care, Vol. 28 (Supplement), 1990, pp. 1–77.
For example, see Dexter, F., “Application of Cost-Utility and Quality-Adjusted Life Years Analyses to Monitored Anesthesia Care for Sedation Only,” Journal of Clinical Anesthesia, Vol. 8, No. 4, 1996, pp. 286–288. Also see Brenner, M., B. Curbow, and M. Legoro, “The Proximal-Distal Continuum of Multiple Health Outcomes Measures: The Case of Cataract Surgery,” Medical Care, Vol. 33, No. 4 (Supplement), 1995, pp. AS 236-244. These examples show the application of the outcome measures to specific treatments and areas of medical care, down to the individual illness and corresponding mode of treatment. Patient-centered outcomes allow for such a broad range of applications, from the specific ailment to DRGs (Diagnostic Related Groups), to overall social impacts.
Shortell, S. et al., Remaking Health Care in America, 1996, op. cit.
Ibid., p. 251.
See, for example, Smith, C., D. Hailey, and M. Drummond, “The Role of Economic Appraisal in Health Technology Assessment: The Australian Case,” Social Science & Medicine, Vol. 38, No. 12, 1994, pp. 1653–1662. Also see Coons, S., “Disease Management: Definitions and Exploration of Issues,” Clinical Therapeutics, Vol. 18, No. 6, 1996, pp. 1321-1326.
JCAHO, National Library of Health Care Indicators, Oak Brook Terrace, IL, 1997.
The commission’s task is also to ensure that indicators are evaluated for validity, reliability, and risk adjustment. In this context, see for example, Haug, M., “Elderly Patients, Caregivers, and Physicians: Theory and Research on Health Care Triads,” Journal of Health & Social Behavior, Vol. 35, No. 1, 1994, pp. 1–12. Also see MacArio, A., “Defining Value in Health Care: Outcomes,” International Anesthesiology Clinics, Vol. 33, No. 4, 1995, pp. 15-21; Patterson, L., H. Weiss, and P,. Schano, “Combining Multiple Data Bases for Outcomes Assessment,” American Journal of Medical Quality, Vol. 11, No. 1, 1996, pp. 573-577.
Geisler, E., “Measuring the Unquantifiable: Issues in the Use of Indicators in Unstructured Phenomena,” International Journal of Operations and Quantitative Management, Vol. 1, No. 2, 1995, pp.145-161.
See, for example, Blalock, H., Theory Construction: From Verbal to Mathematical Formulations, Prentice-Hall, Englewood Cliffs, NJ: 1969; and Blalock, H., and A. Blalock (eds.), Methodology as Social Research, McGraw Hill, NY, 1968.
For example, Hammermeister, K., et al., “Why It Is Important to Demonstrate Linkages Between Outcome of Care and Processes and Structures of Care,” Medical Care, Vol. 33, No. 10, Supplement OS 5-16, 1996. Also see Hadorn, D., et al., “Making Judgments About Treatment Effectiveness Based on Health Outcomes: Theoretical and Practical Issues,” Joint Commission Journal on Quality Improvement, Vol. 20, No. 10, 1994, pp. 547-554. These articles are pioneering some headway into the effort to establish a theoretical base for health outcomes and to move forward from simply using a “laundry list” of indicators.
See, for example, Popper, Sir K., The Logic of Scientific Discovery, Basic Books, NY, 1989.
See, for example, Schriesheim, C., et al., “Improving Construct Measurement in Management Research: Comments and a Quantitative Approach for Assessing the Theoretical Content Adequacy for Paper-and-Pencil Survey-Type Instruments,” Journal of Management, Vol. 19, No. 2, 1993, pp. 385–417.
This phenomenon has had wide discussion in the literature. See Cook, T., and D. Campbell, Quasi-Experimentation: Design and Analysis Issues for Field Setting, Rand McNally, Chicago, IL, 1979. Also see Webb, E., et al., Unobtrusive Measures: Nonreactive Research in Social Sciences, Rand McNally, Chicago, IL, 1966.
See, National Library of Health Care Indicators, Joint Commission, op. cit., p. 193-194.
For example Hughes, M., L. Price, and D. Marrs, “Linking Theory Construction and Theory Testing: Models with Multiple Indicators and Latent Variables,” Academy of Management Review, Vol. 11, No. 1, 1986,m pp. 128–144. Also see Horn, S., “Measuring Severity: How Sick is Sick? How Well is Well?”, Health Care Financial Management, Vol. 40, No. 10, 1986, pp. 20-32.
See, for example, Van de Ven, A., and D. Ferry, Measuring and Assessing Organizations, John Wiley and Sons, NY, 19
See in particular, Mansfield, E., “Academic Research and Industrial Innovation,” Research Policy, Vol. 20, No. 1, 1991, pp. 1–12. Also see Mansfield, E., “Academic Research and Industrial Innovation: A Further Note,” Research Policy, Vol. 21, No. 3, 1992, pp. 295-296.
Griliches, Z., (eds.), R&D, Patents, and Productivity, The University of Chicago Press, Chicago, IL, 1984.
See Birch and Gafni, op. cit.
See, for example, Pavitt, K., “Science and Technology Indicators: Eight Conclusions,” Science and Public Policy, Vol. 11, No. 1, 1984, pp. 21–24.
Robb, W., “How Good is Our Research?”, Research-Technology Management, Vol. 3, No. 2, 1991, pp. 16–21.
See, for example, Marsh, H., and D. Hocevar, “A New More Powerful Approach to Multitrait-Multimethod Analysis: Application o Second Order Confirmatory Factor Analysis,” Journal of Applied Psychology, Vol. 73, No. 1, 1988, pp. 107–117.
See Martin, I., and S. Eroglu, “Measuring a Multidimensional Construct: Country Image,” Journal of Business Research, Vol. 28, No. 3, 1993, pp. 191–210; Chandhuri, S., and M. Ravallion, “How Well Do Static Indicators Identify the Chronically Poor?”, Journal of Public Economics, Vol. 53, No. 3, 1994, pp. 367-394.
Frattali, C., “Ins and Outs of Outcomes,” Advances for Health Information Executives, Vol. 1, No. 1, 1997, pp. 61–62.
Donabedian, A., The Definition of Quality and Approaches to Its Assessment, Ann Arbor, Ml: Health Administration Press, 1980, p. xi.
See, for example, Dayton, D., Information Technology Audit Handbook, New York, Simon and Schuster, 1995. Also see Kaplan, R., and D. Norton, “The Balanced Scorecard—Measures That Drive Performance,” Harvard Business Review, Vol. 70, No. 1, 1992, pp. 71-79. Also see Kaplan, R., and D. Norton, “Using the Balanced Scoreboard as a Strategic Management System,” Harvard Business Review, Vol. 79, No. 1, 1990, pp. 75-87.
See Geisler, E., and A. Rubenstein, “Methodology Issues as Conducting Evaluation Studies of R&D/lnnovation,” Proceedings of the Symposium on Management of Technological Innovation, Worcester Polytechnic Institute, Washington DC, 1983. Also see Geisler, E., and A. Rubenstein, “The Use of Indicators and Measures of the R&D Process in Evaluating Science and Technology Programs,” in D. Roessner (ed.), Government Innovation Policy, St. Martin Press, New York, 1988, pp. 185–204.
See a description of the model for use in evaluating R&D organizations in Geisler, E., “Key Output Indicators in Performance Evaluation of Research and Development Organizations,” Technological Forecasting and Social Change, Vol. 47, No. 2, 1994, pp. 189–203. Also see Geisler, E., “An Integrated Cost-Performance Model of Research and Development Evaluation,” Omega, Vol. 23, No. 3, 1995, pp. 281-294.
See an example of public sector evaluation in Geisler, E., “Integrated Figure of Merit of Public Sector Research Evaluation,” Scientometrics, Vol. 30, No. 3, 1996, pp. 379–395.
Hall, R., Organizations: Structures, Processes, and Outcomes, 6th Edition, Englewood Cliffs, NJ: Prentice Hall, 1996, p. 260.
See, for example: Trajtenberg, M., “A Penny for Your Quotes: Patient Citations and the Value of Innovations,” Rand Journal of Economics, Vol. 21, No. 2, 1990, pp. 172–187.
The test includes such clinical performance indicators as mortality, surgical site infection, and pregnancy/maternal care among other indicators. Administrative indicators include degree of utilization, system integration, and financial stability, as well as satisfaction of various stakeholders.
Joint Commission on Accreditation of Health Care Organizations, Doing the Right Things—Case Studies on Strategies for Maintaining Survey Readiness, Oak Brook Terrace, IL, 1997.
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Geisler, E., Heller, O. (1998). Maximizing Effectiveness and Patient Value. In: Management of Medical Technology. Management of Medical Technology, vol 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5519-3_10
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