Editorial: The Relationship Between Cost and Quality, No Free Lunch - March 14, 2012 — JAMA + link to original article

The Relationship Between Cost and Quality, March 14, 2012, Joynt and Jha 307 (10): 1082 — JAMA
 Editorial: The Relationship Between Cost and Quality 

No Free Lunch

Since this article does not have an abstract, we have provided the first 150 words of the full text. (Blogger's Note: subscription required to view $$$)

"For the past 30 years, research from investigators at Dartmouth has demonstrated large and persistent variations in costs and quality across the US health care system. Beyond simply showing that cost and quality vary by geography, the Dartmouth Atlas has demonstrated that in many communities, care is so fragmented and ineffective that greater spending on Medicare beneficiaries often leads to worse outcomes^1,2 because some patients receive services that are redundant and low value and that may even have substantial risks. 

However, some US policy makers have misinterpreted the Dartmouth research and in the troves of data have found what they believe to be a free lunch: given the inverse relationship between costs and quality, it follows that it should be possible to simultaneously reduce spending and improve care. Although this notion is attractive, much of the subtlety of the Dartmouth work has been lost in translation. What ....."

[Full Text of this Article] (subscription required to view)

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open access: Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices

Blogger's Note: note patient numbers per physician; study limitations

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"Primary care providers are increasingly interested in ensuring that preventive health care be part of their work routines.1 This reorientation fits with the evidence that recommendations from family practitioners increase substantially the likelihood of patients undergoing preventive manoeuvres,2 whereas the lack of such recommendations has been linked with patient noncompliance.3^,4

Studies evaluating adherence to recommended preventive care suggest that the most pervasive barriers rest with the organization of the health care system and the practice itself, such as the absence of external financial incentives for the work done and the lack of a reminder system in the office.3^,5^–9

Countries attempting to reform their delivery of primary care and improve the delivery of preventive services have often directed their efforts in finding alternatives to the traditional fee-for-service model, in which providers receive payment for each service provided......."

Canadian Health Reference Guide - Invisible Healthcare System Taking Toll on Canadian Caregivers

Commission on the Future of Health Care in Canada: The Romanow Commission - Health Canada

Blogger's Note: 

the facts: 

With the exception of this blogger, 

 no  public presentations were made on behalf of ovarian cancer by any professional organization nor charity (NP)

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Commission on the Future of Health Care in Canada: The Romanow Commission

Note: This section replaces the former Web site of the Commission on the Future of Health Care in Canada (Romanow Commission) which has been archived in the Government of Canada Web Archive.

In April 2001, the federal government established the Commission on the Future of Health Care in Canada to review Medicare - Canada's universally accessible, publicly funded health care system - and recommend policies and measures to improve the system and its long-term sustainability.

The Commission embarked on an ambitious effort to ensure that the final recommendations were evidence-based and reflected the values Canadians want in the health care system. Headed by Roy J. Romanow, Q.C., former Attorney General and Deputy Premier of Saskatchewan, the Commission carried out its work in two distinct phases:

• fact-finding; and
• consultation and dialogue - engaging Canadians in a national discussion about the future of Canada's health care system.

The fact-finding phase included:

• analyzing existing reports on health care;
• identifying knowledge gaps and commissioning independent research from experts to address those gaps and gain new perspectives;
• soliciting and analyzing submissions concerning health care challenges and opportunities from health care providers, stakeholder groups and concerned Canadians; and
• consulting with key health care stakeholders, provincial and territorial governments, and Aboriginal organizations to refine research and consultation priorities.

During the consultation and dialogue phase, the Commission worked collaboratively with a variety of partners to provide Canadians with opportunities to engage in an informed discussion about the future of health care in Canada. Tens of thousands of Canadians - from ordinary citizens to health experts, health ministers and premiers, researchers and health care workers - participated in the process, which included public hearings, workshops, policy dialogues and other consultations.

Reports

On November 28, 2002, the Commission tabled its final report, Building on Values: The Future of Health Care in Canada, in the House of Commons. The report recommended sweeping changes to ensure the long-term sustainability of Canada's health care system.

Electronic and print copies are available from Government of Canada Publications.

Copies may also be available through associated bookstores and booksellers that carry Government of Canada publications or through Depository Libraries of Canadian government information.

What Information is Available

• Recommendations in Brief
• Key Commission Documents