The accessibility paradox in health services: global and individual costs

The Accessibility Paradox in Health Services: Global and Individual Costs

Prof. Luiz Antonio Titton, Universidade de São Paulo, Brasil Prof. Julio Araujo Carneiro da Cunha, Universidade de São Paulo, Brasil Prof. Dr. Marilson Alves Gonçalves, Universidade de São Paulo, Brasil Prof. Dr. Hamilton Luiz Correa, Universidade de São Paulo, Brasil

The health organizations management has three important cornerstones that are fundamental for organizational performance: quality; accessibility and costs (AL-ASSAF, 1997). They are, hence, fundamental for its evaluation, resulting in a perspective for healthcare organizations more incisive based in performance (SHORTELL; KALUZNY, 2000). These issues related to healthcare organizations management are shown necessary before the perception that great part of healthcare professionals point out that management where they work is inefficient (VLASTARAKOS; NIKOLOPOULOS, 2007).

COSTS

The intense control over little resources on hospital-physician context demands an adequate medical service that involves decision makings based on planning and resources management (HARPER, 2002), Hospital financing limitations bring along the need to find efficient ways to manage (utilize and allocate) lack of resources (AKTAS et al., 2007). This consideration has direct effects on hospital management, since studies from several different countries (developed nations and not-developed ones) have already denoted the challenge in managing costs from lack of resources and contentions, e.g. United Kingdom (FITZGERALD, 1994; FITZGERALD; DUFOUR, 1998), Sweden (QUAYE, 1997), Canada (LOO, 1997; FITZGERALD; DUFOUR, 1998), Netherlands (SCHOLTEN; VAN DER GRINTEN, 1998), United States (GOSS; VOZIKIS, 2002; SLOAN, 2007), Oman (ABRI et al., 2006), Spain (SÁNCHEZ-MARTÍNEZ et al., 2006), France (BELLANGER; TARDIF,
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2006), Poland (KOZIERKIEWICZ et al., 2006), Turkey ( KTAS et al., 2007), Tanzand A (GILSON, 1995). This worries with researches based on