First, it identifies that the objective is to improve human welfare. Health status
is an important component of welfare but not the only one.
Second, it recognises that resources are Hmited compared to an unlimited
potential to improve welfare. Therefore, the problem is to maximise welfare
within scarce limited resources. Both outcomes and their opportunity costs are
important.
Third, resources are used as inputs to the production of health care. Health
care, in turn, is an input to the production of health; and therefore health care
is valued for its contribution to health.
Fourth, there are other inputs to the production of health, besides health care.
These include prevention and health promotion as well as education, housing,
nutrition, and the environment.
Fifth, it recognises that there might be other outcomes from health care besides
health gains; for example information and satisfaction with the process of care.
A successful re-orientation of the health care system away from its current
focus on inputs and throughputs towards health outcomes would represent a
radical change in the way health services are perceived by the managers
responsible for their delivery. Though desirable, there is a danger, because of
the size of the task and the confusion about what health outcomes actually are,
that we lose sight of the final objective. Conceptualising health outcomes within
the economic framework described in this paper provides the clarity needed to
promote health outcomes and thus improve the effectiveness of the health
services.
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