Public Health
Volume 122, Issue 1 , Pages 84-91, January 2008

Clinical-outcome-based demand management in health services

  • C. Brogan

      Affiliations

    • Public Health Action Support Team, WeLReN (West London Research Network), Imperial College, London, UK
    • University College London, London, UK
    • ,
  • D. Lawrence

      Affiliations

    • Brent Primary Care Trust, London, UK
    • London School of Hygiene and Tropical Medicine, London, UK
    • Corresponding Author InformationCorresponding author. London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Tel.: +442074365816; fax: +442075808183.
    • ,
  • L. Mayhew

      Affiliations

    • Brent Primary Care Trust, London, UK
    • Cass Business School, City University, London, UK

Received 17 March 2006; received in revised form 31 January 2007; accepted 3 April 2007.

Summary 

The problem of managing demand

Most healthcare systems have ‘third-party payers’ who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system.

Technique for managing demand

The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given.

Conclusion

The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

Keywords: Demand management, Healthcare systems, Treatment thresholds, Clinical outcomes

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PII: S0033-3506(07)00151-5

doi:10.1016/j.puhe.2007.04.013

Public Health
Volume 122, Issue 1 , Pages 84-91, January 2008

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