beds will close, any bid farewell, no operating rooms will open in the afternoon ... The answers given by hospitals in order to proceed to the internalization of the public budget cuts announced by the government of Catalonia are rather unimaginative and seem more managers only being used to manage incrementalisme year after year than managers who have to account for the results they have achieved in health for its population.
aside if the cut is appropriate care, I suspect that if hospitals will probably undergo an adequate dose of healthy competition, the market response to a narrower and less ability to spend would be radically different.
should not go unnoticed in patients and taxpayers to talk constantly to one side of the balance, the fact that this year we have less money for health, ignoring the other side of the scale, quality of service we offer the patient with the money we had so far and have not again for many years.
rather inclined to think it would be helpful to the defense of quality public health is not contracted with our health centers How many doors closed to patients but will proceed to assess the ability of public money and resources assigned to them to improve the quality of life and save lives if we spend as we have done so far and if we can find ways without do more to achieve better health outcomes activity.
Although it is a marginal pass must pay for more visits to the doctor, specialist or emergency room, or for more x-rays, CT or resonances, or to make more revenue and income re- Hospital to pay, even a small part of the budget, decision-making capacity and health outcomes. In doing so, the current debate is circular and endless, if you give me less, I will do less business. It's common sense, but perhaps worth remembering that our tax money allocated to public health to make more visits to the doctor, by the way already make more than necessary, but to have more health and quality of life.
Most centers announced that eligible after Easter to reduce extra services, operating rooms to close and dismiss staff possible. A reduction in the supply of services should not surprise anyone that affect waiting lists for a specialist visit, a diagnostic test or an intervention. This will so if we continue doing the same and just as far.
Like any patient and physician know, not all views, not all tests nor income and all surgeries have the same contribution to improving the quality of life and survival. The effect on quality of care and patients' health in a shrinking budget will be higher if done in a uniform or nearly so opportunist without using criteria based on knowledge about the clinical benefit or improvement in health can be achieved for each patient.
can not pay for visits but only to resolve satisfactorily episodes and health problems. Can not afford to produce only emergency visits or hospital readmissions of people with asthma or COPD but to have them properly controlled adherence to their treatments and just avoiding suffering exacerbations of their disease.
The urgency may not be the sole criterion for prioritizing waiting lists a greased. Maybe it is easier to apply and even easier to explain. Let us not confuse the simplicity is not always the best indication. I understand the statement that "anyone who might be expected to wait" in the positive sense: to be prioritized and that when there is price, with you need to optimize limited resources, the waiting list is not a test failure but a management tool to achieve the maximum years of life with the budget we have, apart from lower when compared to that of the last year.
A model for managing waiting lists based on the urgency is not only inappropriate as it may take many years, but may end up resulting that even the future costs of the health system for the worsening of the patients who remain on the waiting list until the deterioration of his health is quite clear as to qualify them for pressing.
the end of the year past, AIAQS, and quality evaluation agency of the Government in health, spread an interesting report on criteria for prioritization of thirty with elective surgery waiting lists. The two most important criteria are the impact on quality of life and the risk of waiting, in that order, then the effectiveness of intervention and resource consumption during the wait. Prioritization tools are there, now what is needed is a decision based more on knowledge and less incrementalista captured by the discourse.
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