Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

To tackle the chronic illness and epidemic that threatens human health in this century, public health practice must begin to center on far more than providing basic medical services (Healthy People 2010). In particular, the principles of developing and marketing provide a disciplined, consumer-focused, research-based process to plan, implement, and assess many different types of healthcare change initiatives designed to improve the health of population. This session sheds light on efficiency from the production of healthcare product to final consumption by healthcare consumers in four different aspects: (1) production and government control, (2) direct-to-consumer advertising and health disparity, (3) efficiency of healthcare delivery, and (4) access disparity and health communication.

Anegawa examines the first aspect of pharmaceutical production and government control, specifically pharmaceutical price control under the national healthcare system. In this study, he underlines that an official pharmaceutical price would cause R&D inefficiency. The pharmaceutical price regulation might distort R&D activities, and lower the profitability of R&D activities. In the course of the study price regulation was found to be associated with R&D inefficiency, indicating that the quality of medical service is restrained by lower technological progress in the healthcare service sector.

Lillard et al. analyzed the second aspect of direct-to-consumer advertising and health quality disparity in pharmaceutical products related to exposure on television as well as in printed media. The analysis suggests that pharmaceutical companies effectively deliver their message to traditionally disadvantaged groups, concluding that television advertising could be a valuable asset in reducing health disparities facing disadvantaged groups.

Ogura, Suzuki, and Izumida examined the third aspect, which is the efficiency of healthcare delivery seen in long-term health insurance benefits under the national health insurance program. However, the mismatch between care receivers and care delivery fails to produce efficient benefits. It is their conclusion then that the mismatch reflects structural problems in healthcare delivery, especially on the administration level.

Chen and Yamada exhibit the fourth aspect of access to healthcare regarding access disparity and health communication, especially the provider-patient relation, and focusing on pre - and post-retirement patients. In their analysis, they emphasize the importance of patient trust, communication with healthcare providers, and patients' knowledge as well as self-management skills that would consequently improve the delivery of health care. They conclude that the access disparities which would require policy implication of the health disparity gap that face the healthcare sector in the coming decade.

In sum, this session will demonstrate the increasingly prominent issue in today's society on both a social and policy level of government intervention in health care, i.e. price control, long-term care, Medicare, pharmaceutical marketing regulation, and will present a direction of healthcare structures to audiences.