As the US health care system begins to reengineer itself to address the need for quality improvement, it also is being actively reshaped by the expectations of consumers. The confluence of these forces requires a new approach to setting health care performance standards. The National Quality Forum (NQF) has been established as a private, not-for-profit, open membership, public benefit corporati...

League tables are just one example of the growing importance of "institutional success" in the health service. What are the implications of attaching importance to institutional success, and what impact might this have on professional ethics? This paper considers these issues and argues that public policy processes which centre on institutional performance, and which co-opt professional loyalti...

Governmental authorities of wealthy developed nations differ in their professed commitments and activity related to the provision of the prerequisites of health through public policy action. Part 1 of this article showed how nations identified as social democratic or liberal welfare states were those where such commitments are present. Nations identified as conservative or Latin welfare states ...

In Spain, deskilling (bureaucratization): visits perceived as exogenous and prescription perceived as induced. Lack of response capacity. Inferiority complex versus secondary care. Weak leadership in primary care teams. Micromanagement and renewal of the health care team, organizational redesign, good governance and public policy implication with the maximum achievable effectiveness and efficie...

Evidence suggests that in spite of the value potential of information technology (IT), institutions in the health care sector have been slow to adopt it. To the extent that significant problems in health care such as patient safety, medical errors, and escalating costs can be addressed through IT, accelerating its diffusion throughout the system is an important public policy issue. This researc...

We propose a new approach to the study of comparative public policy that examines how the agenda-setting attributes of an issue combine with problems to drive political attention. Whereas existing comparative policy studies tend to focus on how institutional or programmatic differences affect policy and politics, we begin by asking how the issue itself affects politics across nations. We illust...

Study objective: To explore how the increased supply of coronary bypass operations and angioplasties from 1988 to 1996 influenced socioeconomic and gender equity in their use. Design: Register based linkage study; information on coronary procedures from the Finnish Hospital Discharge Register in 1988 and 1996 was individually linked to national population censuses in 1970–1995 to obtain patient...