martes, 15 de febrero de 2011

Management in evolutionary process?

Just as health has evolved from the earlier definitions of being defined as the state of being free from diseases to a state of complete physical, social, and mental well-being, management in the health field is also evolving. Many health management systems are moving away from costly treatment options to instead providing proactive preventive programs allowing the creation of strategies that allow for more sustainable health care systems.
New health management strategies focus greater on the responsibility of the population to create an environment that is conductive to promoting health and that incorporates the seven dimensions of wellness including physical, social, emotional, mental, occupational, environmental, and intellectual wellness. 
Health management prevention strategies range from promoting physical well-being by banning junk food in schools and smoking in public areas to promoting social health in the elderly by creating community centers for the aged.

Cohen et al in Does preventative care save money?, after conducting an extensive literature analysis argues that the widespread proclamation that health promotion is the answer to health economics is overreaching and cites the below graphic as an example of the differences in costs between prevention and treatment.

           Cohen, J.T., Neumann, P.J., Weinstein, M.C. Does Preventive Care Save Money? Health Economics and the  Presidential Candidates. N Engl J Med 2008; 358:661-663

 The authors state that vast majority of preventative measures reviewed in health economics do not save money. In a world where success is measured greenly by gross national product, and the gross national happiness indicator is widely unknown, one does have to ask, would you rather be treated for a disease or have a bit higher cost and be spared the disease burden at all? Is it time that  the debate from prevention vs. treatment evolves to a general consensus that preventing disease creates happier (if not richer) populations.

In this blog, we will focus on public health and management designed to keep people healthy. Highlighted will be innovative programs that have been demonstrated to be efficient and cost-effective in preventing diseases which according to Cohen et al, may not reduce the economic burden of health (and disease), but have contributed to our gross national happiness.  Each week, a new dimension of wellness will be explored with best management practices focused on addressing that dimension of wellness through health promotion and prevention. Although the debate of prevention vs. treatment continues, there is no denying what Virgil once stated: "the greatest wealth is health."


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