Modeling and Evaluation of the Health Care Delivery System

by Marsha A. Dade


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A master's thesis in management, presenting a methodology for evaluating existing and possible future modes of delivery of health care in the United States. A systems approach is taken, in contrast to the usual fragmented studies. Health is defined as "a state of complete physical, mental, and social well-being." The study describes the present health care delivery system, defining the key elements and their interactions and identifying inherent problems; defines a methodology for evaluating alternatives by conceptualizing the objectives and formulating effectiveness criteria; and applies this methodology to evaluate the traditional fee-for-service system and a prepaid Health Maintenance Organization mode. Methods of reducing measurement errors are given. In constructing indices, each alternative is described by a vector of independent measures, and certain techniques of Raiffa are described for reducing this vector and assessing a value index for each alternative. Practical problems of data collection are discussed, with suggestions for future research.

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