Lecture 2 - 9/2/99

Alternative Strategies for Cost Containment

• Increase resource supply
• Improve health of population
• Implement administration controls and planning
• Increase patient cost-sharing
• Implement capitation
• Regulate pace of technological change

Quality Measures

• Structure (inputs)
• Process (how care delivered--review of medical records)
• Outcome (satisfaction, health and functional status, survival, quality of life measures)

Quality Assurance Mechanisms

• Licensure: facility and personnel
• Certification
• Drug and device regulation
• Hospital staff privileges and credentialing
• Certificate of need
• Peer review: external and internal
• Litigation
• Information dissemination (report cards)

Distinguishing Characteristics of Health Care

• Asymmetric information
• Externalities
• Uncertainty
• Public goods

Asymmetric Information

• Definition
• Examples
• Responses
• Role of professional norms