- Email: [email protected]
DRG experience in England 1981–1991
334
DRG Experience in England 1981-1991 By T. Newman and L. Jenkins London, CASPE-Research 72 pp., 1991, f7.00. ‘DRG Experience in England 1981-1991’is really a nice publication which tells us the odyssey - I come back to this non-coincidental word - of the DRG’s in England. Five chapters, an extensive list of references and four very useful appendices put it all together in 72 pages. After an overview, the early days 1981-1987 tells us of Fetter aod Thompson’s visits to the King’s Fund. We meet again Hugh Sanderson, Linda Jenkins and Gwyn Bevao, whom we met in 1983 in a seminar on patient classification systems for management, budgeting and planning in Leuveo University as mentioned in the book. The cmsolidatioo period 1987-1989 eods with the White Paper ‘Working for Patients’ and takes ua into the expansion period 1990-l 99 1 govzmed by the Department of Health’s resource management prograoone. The last chapter peeks into the future: where next? Undoubtedly, the DRG experience has opened up the world of patient data in England... “in many cases being seen for the first time by doctors and managers...!” Rightly, the only sentence with an exclamation point in the book. The list of seven requirements for further patient classification effort we strongly recoouneod. Why now odyssey? Though the authors waro against ‘gross averages’ (page 26) and are aware that ‘resource homogeneity is an assmnptioo in any case mix grouping system’ (page 29), they unfortunately do not take os to the next logical step beyond their patient classification efforts: an investigation into the variability in physician practice pattems in England. As for Odysseus, is the homeland of health care management, today just aa 20 years ago, not the consultants, the specialty mix and the orgaoisatioo of services7 To base these on patient characteristics alongside institutional aod health system characteristics is the true leaming experience of the some 20 year voyage through DRG territory. Professor L. Delesie, Ir., Ph.D. School of Public Health University of Leuveo Leuveo, Belgium
*****
The Diffusion of Heart and Liver Transplantation
across Europe
By M. Bos London, King’s Fund Ceotre for Health Services Development 168 pp., 1991, ISBN O-903060-84-1, E9.50.
This book is one part of a threefold study on the diffusion of medical technology in Europe: renal stone treatment, particularly by lithotripsy; prenatal screening, particularly for Down’s syndrome aod open neural tube defects, and organ transplantation with particular emphasis on liver and heart transplantation. The purpose of studying three rather differcot technologies is identifying the similarities and differences in their adoption aod use. With growing numbers of transplant procedurea, legal, financial and ethical issuea have to be solved. An exploration of factors, influencing of organ traosplaotatioo, in different countries should provide health policy makers with basic data. Michael A. Bos in his study includes data of European Community countries as well as data of the Scandinavian countries, Austria, Switzerland and Turkey. Although transplant prognunmes have also been established in Eastern European countries (for example in Krakow, Poland, over 100 heart transplant procedurea have beeo performed; communication XIIIth European Congress of Cardiology, Amsterdam, 1991), Eastem Europe has been omitted because of the extreme difficulty in obtaining reliable and recent data. Because the U.S.A. has played a crucial role in the development of traosplaotatioo medicine, relevant data of this country have been included.
DRG Experience in England 1981-1991 By T. Newman and L. Jenkins London, CASPE-Research 72 pp., 1991, f7.00. ‘DRG Experience in England 1981-1991’is really a nice publication which tells us the odyssey - I come back to this non-coincidental word - of the DRG’s in England. Five chapters, an extensive list of references and four very useful appendices put it all together in 72 pages. After an overview, the early days 1981-1987 tells us of Fetter aod Thompson’s visits to the King’s Fund. We meet again Hugh Sanderson, Linda Jenkins and Gwyn Bevao, whom we met in 1983 in a seminar on patient classification systems for management, budgeting and planning in Leuveo University as mentioned in the book. The cmsolidatioo period 1987-1989 eods with the White Paper ‘Working for Patients’ and takes ua into the expansion period 1990-l 99 1 govzmed by the Department of Health’s resource management prograoone. The last chapter peeks into the future: where next? Undoubtedly, the DRG experience has opened up the world of patient data in England... “in many cases being seen for the first time by doctors and managers...!” Rightly, the only sentence with an exclamation point in the book. The list of seven requirements for further patient classification effort we strongly recoouneod. Why now odyssey? Though the authors waro against ‘gross averages’ (page 26) and are aware that ‘resource homogeneity is an assmnptioo in any case mix grouping system’ (page 29), they unfortunately do not take os to the next logical step beyond their patient classification efforts: an investigation into the variability in physician practice pattems in England. As for Odysseus, is the homeland of health care management, today just aa 20 years ago, not the consultants, the specialty mix and the orgaoisatioo of services7 To base these on patient characteristics alongside institutional aod health system characteristics is the true leaming experience of the some 20 year voyage through DRG territory. Professor L. Delesie, Ir., Ph.D. School of Public Health University of Leuveo Leuveo, Belgium
*****
The Diffusion of Heart and Liver Transplantation
across Europe
By M. Bos London, King’s Fund Ceotre for Health Services Development 168 pp., 1991, ISBN O-903060-84-1, E9.50.
This book is one part of a threefold study on the diffusion of medical technology in Europe: renal stone treatment, particularly by lithotripsy; prenatal screening, particularly for Down’s syndrome aod open neural tube defects, and organ transplantation with particular emphasis on liver and heart transplantation. The purpose of studying three rather differcot technologies is identifying the similarities and differences in their adoption aod use. With growing numbers of transplant procedurea, legal, financial and ethical issuea have to be solved. An exploration of factors, influencing of organ traosplaotatioo, in different countries should provide health policy makers with basic data. Michael A. Bos in his study includes data of European Community countries as well as data of the Scandinavian countries, Austria, Switzerland and Turkey. Although transplant prognunmes have also been established in Eastern European countries (for example in Krakow, Poland, over 100 heart transplant procedurea have beeo performed; communication XIIIth European Congress of Cardiology, Amsterdam, 1991), Eastem Europe has been omitted because of the extreme difficulty in obtaining reliable and recent data. Because the U.S.A. has played a crucial role in the development of traosplaotatioo medicine, relevant data of this country have been included.