Neonatology enters the 21st century for health care oversight: the public reporting of health care outcomes

Objectives This review aimed to present the clinical and health-care outcomes for patients with congenital heart disease (CHD) who use home monitoring technologies. Methods Five databases were systematically searched from inception to November 2020 for quantitative studies in this area. Data were extracted using a pre-formatted data-collection table which included information on participants, interventions, outcome measures and results. Risk of bias was determined using the Cochrane Risk of Bias 2 tool for randomised controlled trials (RCTs), the Newcastle–Ottawa Quality Assessment Scale for cohort studies and the Institute of Health Economics quality appraisal checklist for case-series studies. Data synthesis: Twenty-two studies were included in this systematic review, which included four RCTs, 12 cohort studies and six case-series studies. Seventeen studies reported on mortality rates, with 59% reporting that home monitoring programmes were associated with either a significant reduction or trend for lower mortality and 12% reporting that mortality trended higher. Fourteen studies reported on unplanned readmissions/health-care resource use, with 29% of studies reporting that this outcome was significantly decreased or trended lower with home monitoring and 21% reported an increase. Impact on treatment was reported in 15 studies, with 67% of studies finding that either treatment was undertaken significantly earlier or significantly more interventions were undertaken in the home monitoring groups. Conclusion The use of home monitoring programmes may be beneficial in reducing mortality, enabling earlier and more timely detection and treatment of CHD complication. However, currently, this evidence is limited due to weakness in study designs.

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National Trends in Coronary Artery Disease Imagingassociations with Health Care Outcomes and Costs

SSRN Electronic Journal ◽

10.2139/ssrn.3944594 ◽

2021 ◽

Author(s):

Jonathan Weir-McCall ◽

Michelle C. Williams ◽

Anoop Shah ◽

Giles Roditi ◽

James Rudd ◽

...

Keyword(s):

Coronary Artery Disease ◽

Health Care ◽

Coronary Artery ◽

Health Care Outcomes ◽

Care Outcomes ◽

Artery Disease ◽

National Trends

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Avarice, Inefficiency, and Inequality: An International Health Care Tale

International Journal of Health Services ◽

10.2190/nup7-cbmd-efxl-w6cu ◽

1977 ◽

Vol 7 (2) ◽

pp. 179-190

Author(s):

Alan Maynard

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Care Delivery ◽

Medical Profession ◽

International Health ◽

West Germany ◽

Health Care Outcomes ◽

Care Outcomes ◽

Health Care Delivery Systems ◽

The Cost

The paper is concerned with impact of a medical profession, physicians, on the delivery of health care. The basic economic motivation of self-interest and avarice has led this profession to produce health care outcomes which are inequitable and inefficient. In the first section of the paper the regional geographical distribution of physicians in four disparate health systems—England, Ireland, France, and West Germany-is analyzed and found to be highly unequal. The next section is concerned with the efficacy of therapies and the cost-effectiveness of health care delivery systems in a variety of countries. The final section discusses how health care can be more equitably and more efficiently delivered. It is argued that both markets and bureaucracies are likely to be inadequate unless carefully monitored. In particular, there is a great need to investigate the cost-effectiveness of therapies and then persuade physicians, via pecuniary and nonpecuniary incentives, to behave in a manner which leads to more equitable and efficient health care outcomes.

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