This part of our course included two parts: 1. Quality and Outcomes in Cardiovascular Sciences 2. Economic Analysis for Health Policy
During the first one we discussed the quality of medical care and its assessment, outcomes measurement, learning healthcare systems and the role of research, models, indicators and data for study improvement and Design Principles for Studying Quality Improvement and others. The importance of continuous quality monitoring is obvious. But studding the association between access, quality of care and costs in the practical way was very important part of the course. A particularly interesting for me was the description of the possible designs of the studies which will allow evaluate the quality and outcomes dynamics during big federal or regional programs, for example «interrupted times series». Below are links to a couple of open assessing literature sources on the topic.
Quality of Care - What is It? - David Blumenthal 19/09/1996
Centers for Disease Controls and Prevention. Evaluation Guide - Developing and Using a Logic Model
The second part included studding on the health care services markets, basic principles of health care financing, health care needs, insurance, consumers behavior and etc. There was interesting discussion on the healthcare financing and its association with life expectancy or quality indicators. Up to a certain level of financing (in terms of expenditures on healthcare per 1 inhabitant or as% of GDP on health care), there is a linear association more money on healthcare - more life expectancy and better quality. But after reaching some threshold this association comes to a plateau as it were, when further funding is not associated with increase in life expectancy and quality improvement.
Here are also a couple of references to the open-assess sources of literature. Financing Health Care in the European Union: Challenges and policy responses - Thomson Sarah, Foubister Thomas, Mossialos Elias 2009 Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment - Manning, Willard G.Newhouse, Joseph P.Duan, NaihuaKeeler, Emmett B.Lelbowitz, ArleenMarquis.
Conclusion This concludes the description of my first visit in the framework of training in LSE. I have not written so much about the content of training (in the future I will try to write more), but try to inspire interest and insure in the possibility of training. My nest trip will be in June. But before that I have a lot of homework: to write two essays (I never wrote an essay! I wrote reports, articles, dissertation, but this is different!) And prepare for two exams. If you have any questions, write, try to answer. Yours, Anna Kontsevaya
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