Browsing by Author "Benatar, S R"

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    Open Access
    New treatments: Costs, benefits and decision-making procedures
    (Health and Medical Publishing Group, 2003) Benatar, S R; Fleischer, T E
    One hallmark of modern medicine is the ever-rising cost of providing life-saving or life-extending treatments. Advances in medical care and the ability to improve the duration and quality of life, combined with the expectations of both doctors and patients that all new modalities of treatment developed will be implemented in everyday practice, are the major reasons for modern medicine’s becoming so expensive. In these circumstances resource allocation decisions need to be made and appropriate priority-setting processes developed. This challenge faces all societies but most agonisingly middle income countries like South Africa where the expectations of physicians and patients are geared to the best that can be achieved in any country — even the wealthiest. Expensive, new or established standard treatments that may benefit patients may be considered in at least two categories. The first is when each individual patient will be a direct beneficiary. This applies, for example, when a pacemaker or orthopaedic prosthesis is installed, when an organ such as a kidney, heart or liver is transplanted, or when chronic renal dialysis is initiated. While such treatments have some mortality and a measure of sub-optimal results, good outcomes are the rule
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    Rational planning for health care based on observed needs
    (2006) Burch, V C; Benatar, S R
    A major challenge facing health care services worldwide is the need to deliver services appropriate to local community needs. In South Africa, the Department of Health has adopted the District Health System1 as the vehicle to deliver comprehensive health care to an estimated 84%2 of South Africans who do not have private health insurance. Within each health care district, community-based and hospital-based services are to be provided. District hospitals are to play a pivotal role in supporting ambulatory primary care services as well as providing a gateway to specialist health care at regional hospitals and highly specialised care (sub-specialist level) at tertiary hospitals. Documents outlining district and regional hospital service packages1,3 emphasise the need for appropriate packages of care, informed by feedback from service providers at the various levels of service delivery. To date, feedback based on systematic evaluation of service provision is limited.