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• ACG and capitation: population focus. (2008)

  Different national experiments have pointed towards the consolidation of a new paradigm for health management and financing based on inhabitants. As we have already seen in other environments, the appearance of this paradigm necessarily requires the use of population-based Patient Classification Systems (PCS).

  For the first time in our immediate environment, this study analyses the capacity of these PCS, such as Adjusted Clinical Groups(r) (ACG), to explain the individual total care costs for a geographically defined population.

   

• Evaluation of the efficiency and scientific-technical quality of hospitals in Spain depending on their management model. (2007)

  "This study compares the results obtained by hospitals managed directly by the health authorities and hospitals which have incorporated management formulas which are characterised by taking on staff. For the 75 hospitals included, the indicators assessed were scientific-technical care quality, functional efficiency and adjusted production cost per product line."

   

• 'Ad hoc' studies or standardised hospital databases? Extra information sources, not alternatives. (2007)

  "The analysis of the standardised clinical databases for hospitalisation (the minimum basic data set or MBDS) constitutes a complementary option to the 'ad hoc' studies used by the pharmaceutical industry, offering solid, fast and cost-effective estimations of the clinical conditions of interest, their characteristics and their resource consumption."

   

• From intuitive management to management based on evidence in the health services. (2006)

  One of the pillars of professional health management involves making decisions based on objective and proven data. As it is crucial to explain the management objectives at all levels of health organisation, the skills involved with specifying the monitoring and evaluation parameters for these objectives are particularly relevant in terms of visualising its progress. In order to make decisions with a view to improvements, it is fundamental to compare the results with other similar health service providers in the environment. Management based on evidence strongly encourages comparing results with rigorous methodologies. The formal benchmarking processes constitute a valuable and cost-effective instrument for decision making if the necessary precautions are taken to prevent them from becoming a simple non-critical emulation of other successful experiences.

   

• New era for hospital benchmarking: from average stay to managing the indicator. (2005)

  Monitoring the Average Stay has represented the keystone for hospital benchmarking in the last few decades, permitting substantial gains in productivity. However, the reasons at the time which led it to become the main 'driver' for efficiency have lost ground in an environment which is characterised by care changes, new diagnosis and therapeutic approximations and the growing possibilities offered by information systems. The sector is facing new challenges and requires new benchmarking instruments.

   

• Case-mix and assessment of risk in populations: A substantial advance for knowledge, evaluation and management of health services and health plans. (2005)

  Case-mix assessment systems have represented a fundamental advance in evaluating consumption of health resources. They provide a more equitable measure of the expected differences in use of resources by a determined population, they are useful for patient and process management and they provide a common language for doctors, technicians and administrators when discussing the use of resources. Several case-mix assessment systems have been developed which provide a reasonably good explanation for the variability seen in resource consumption. Selecting one of these systems depends on a critical evaluation of each of them against the targets for its use, implantation feasibility and the health environment where it is going to be applied.

   

• Preventing risks: volume of activity and risk in surgery. (2005)

  In 2004, a first edition was held of the Thoracic Surgery Benchmarking Club working from the interest expressed by different tertiary hospitals to obtain clinically detailed information which would allow them to find out about and compare the quality and efficiency of their work with others.

   

• Hospital clichés and myths: widespread unfounded beliefs. (2005)

  Doctors' common sense is the most usual source of information in health services. But data collected over the last decades gives new perspectives which particularly contest two clichés: outpatient surgery will increase the patient's average stay and reducing the stay will increase the risk of readmission. Mercè Casas questions these ideas and poses new questions.

   

• The Top 20 2000. Targets, advantages and limitations. (2002)

  "By means of this article, IASIST is providing an introduction to the targets, methodological contributions and guidelines for assessing results from the TOP 20 programme. Written after the debate following the publication of the results from the first edition of the Programme."