Evaluating the Healthcare System: Effectiveness, Efficiency, and Equity, Fourth Edition

Now in its fourth edition, this book defines and illustrates the application of effectiveness, efficiency, and equity criteria for evaluating health services system performance. It integrates the theories, issues, approaches, and methods of health services research, providing an excellent framework for understanding health services systems and change. The authors take a broad and integrative look at the role of public health and personal care services in enhancing community well-being. This edition has been revised and updated throughout and includes the following new features: Two new discussions have been added on the nature of the health policymaking process and problems in health policy research. The section on populations at risk has been expanded to reflect recent literature on equity disparities related to predisposing, enabling, and need-related characteristics. The discussion of realized access has been revised to emphasize the mutable factors shown to contribute to disparities in health and in access to health services (such as insurance and education). Information about the Patient Protection and Affordable Care Act has been incorporated throughout the text Pay for performance, accountable care organizations, and medical homes are introduced as newer payment and care delivery models designed to improve the efficiency and quality of health services in the United States. The book concludes with a comprehensive new case study illustrating the application and integration of the three perspectives of health services research in evaluating a recent policy change.

About the Authors

Charles E. Begley, PhD, is professor of management, policy, and community health at the School of Public Health, University of Texas Health Science Center at Houston, where he has taught courses in health policy, health services research, and health economics at the master’s and doctoral levels since 1984. He also is codirector of the Center for Health Services Research, director of the Houston Health Services Research Collaborative, and an adjunct faculty member of economics at Rice University. His current research interests include disparities in healthcare, performance of healthcare safety net systems, and healthcare reform.

David R. Lairson, PhD, is professor of health economics and codirector of the Center for Health Services Research at the University of Texas School of Public Health and a member of the adjunct faculty in the Department of Economics at Rice University. He was a doctoral fellow at the Kaiser Permanente Center for Health Research in Portland, Oregon, and received his PhD from the University of Kentucky. Dr. Lairson’s main research and teaching interests include health services research, health economics, and the economic evaluation of healthcare programs.

Robert O. Morgan, PhD, is professor of management, policy, and community health at the School of Public Health, University of Texas Health Science Center at Houston and is an adjunct faculty member at Baylor College of Medicine in the health services research section of the Department of Medicine. Dr. Morgan teaches courses at the master’s and doctoral levels in health survey methodology, advanced health services research methods, and healthcare payment system policy in the United States. His research interests include measurement in health services research, access to care by the elderly, and the examination of financing systems in relation to healthcare delivery and outcomes.

Paul J. Rowan, PhD, is an assistant professor of management and policy sciences at the University of Texas School of Public Health. He received his PhD in clinical psychology, with a focus in health psychology, from the University of Alabama in 2002. Dr. Rowan completed post-doctoral fellowships at the Michael E. DeBakey VA Medical Center and at the University of Texas MD Anderson Cancer Center, both in Houston. He teaches graduate-level courses concerning the outcomes, quality, performance, and delivery of healthcare, including policy aspects.

Rajesh Balkrishnan, PhD, is a tenured associate professor in the Department of Clinical, Social and Administrative Sciences, College of Pharmacy, and in the Department of Health Policy and Management, School of Public Health, at the University of Michigan.