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The vast literature on what public finances devoted to health should purchase has conspicuously avoided an explicit discussion of “how” these interventions should be delivered, and the effect of health care context on the effectiveness and cost-effectiveness of the intervention. DCP3 has explicitly taken on the challenge of providing policymakers with greater analytical insight into questions of how the access, uptake, and quality of interventions can be improved through policy.
The primary objective of this meeting was to discuss the availability and effectiveness of policy instruments to improve access, uptake, and quality of interventions. It addressed the twin challenge of expanding access to health services while ensuring a high quality of services. The second objective was to discuss how instruments of policy that improve access, quality, and uptake should be incorporated into the economic analyses of interventions. For instance, how should a policy intervention involving the use of mobile technologies to improve adherence to diabetes treatment be considered in an economic analysis of diabetes treatment?
A third purpose was to explore how the available evidence on policy instruments can be incorporated into DCP3 analyses and volumes. Specifically, volumes on maternal and child health, child development, surgery, and vascular disease are each considering including a chapter on quality. Tying these messages into a single quality chapter in volume 1 is also under consideration. Within DCP3, we will rely on published evidence and expert opinion on the determinants of provider skill, provider compliance with explicit standards of practice (guidelines, checklists, algorithms, etc), patient demand for diagnosis, patient adherence specific to each health intervention, and the costs of poor quality, for which a broader economic assessment is being carried out.
We commissioned review papers on major categories of instruments, both within the health sector as well as on cross-sectoral efforts – to assess the available evidence on their effectiveness and influence on major categories of technical interventions. Early drafts of these papers were discussed at this meeting.
Other materials:
- The Meeting Agenda
- Dr. Thomas Weiser's Presentation on Measuring Quality
- Dr. Carol Levin's Presentation on the Cost of Quality
- Dr. Lisa Hirschhorn's Presentation on Bridging the Quality Gap
- Dr. Olusoji Adeyi's Presentation on Improving Quality in the Context of Universal Health Coverage
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DCP3 editors and contributors review draft chapters from the maternal and child health volume. |
Dr. John Peabody of the University of California, San Francisco discusses how quality should inform priority setting. |
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DCP3 Surgery editor Margaret Kruk shares early economic analyses from the surgery volume. |
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