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Any society and its health care are interrelated systems. As such,
each needs to express concordance with principles of systems science if
long-term evolvability and value creation (system’s emergence) are the
goals.
Quality, as quoted in the Editorial - “clinical effectiveness,
safety, and a good experience for the patient,” cannot be the only goals
of a health care system because quality is merely a component of value.
A system, functioning and operating along systems science principles,
needs to generate value to remain vibrant.
Value thus represents an aggregate of efficiency, effectiveness, risk
management, and cost. Focusing only on some components of this summation
destabilizes the system.
The futility of separating these components and using some as the only
measure of value can be expressed in the following quotes:
• Efficiency:
“An operation not worth doing is not worth doing well!” Collin Thomas
• Effectiveness:
“With so many different things being done, it is not possible that
everyone is doing the right thing.” David M. Eddy
• Risk management:
“The operation was successful but the patient died.” Unknown
• Cost:
“High $ does not = high quality.” Colloquial
For further information on systems and health care, please see
Janecka IP: Is the U.S. Health Care an Appropriate System? A strategic
perspective from systems science. Health Research Policy and Systems 2009,
7:1 (Highly Accessed) http://www.health-policy-systems.com/content/7/1/1
Quality vs. Value
Any society and its health care are interrelated systems. As such,
each needs to express concordance with principles of systems science if
long-term evolvability and value creation (system’s emergence) are the
goals.
Quality, as quoted in the Editorial - “clinical effectiveness,
safety, and a good experience for the patient,” cannot be the only goals
of a health care system because quality is merely a component of value.
A system, functioning and operating along systems science principles,
needs to generate value to remain vibrant.
Value thus represents an aggregate of efficiency, effectiveness, risk
management, and cost. Focusing only on some components of this summation
destabilizes the system.
The futility of separating these components and using some as the only
measure of value can be expressed in the following quotes:
• Efficiency:
“An operation not worth doing is not worth doing well!” Collin Thomas
• Effectiveness:
“With so many different things being done, it is not possible that
everyone is doing the right thing.” David M. Eddy
• Risk management:
“The operation was successful but the patient died.” Unknown
• Cost:
“High $ does not = high quality.” Colloquial
For further information on systems and health care, please see
Janecka IP: Is the U.S. Health Care an Appropriate System? A strategic
perspective from systems science. Health Research Policy and Systems 2009,
7:1 (Highly Accessed) http://www.health-policy-systems.com/content/7/1/1
Competing interests:
None declared
Competing interests: No competing interests