Design and Analysis of Health Products and Services: An Example at a Specialized COPD Unit



Christian Domingo1, *, Vicente Ortún Rubio2
1 Servei de Pneumologia Corporació Parc Taulí-Institut Universitari Parc Taulí-FPT Departament de Medicina-Universitat Autònoma de Bellaterra (UAB), (Barcelona)Àrea d’Anatomia i Fisologia, Facultat de Ciències de la Salut, Universitat Internacional de Catalunya (UIC),Barcelona, Spain
2 Departament d’Economia i Empresa Centre de Recerca en Economia i Salut Universitat Pompeu Fabra, Barcelona, Spain


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2008 Bentham Science Publishers Ltd.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Servei de Pneumologia, Corporació Parc Taulí, Parc Taulí s/n, 08 208 Sabadell, Barcelona, Spain; Tel: 34 93 723 10 10, Ext. 21 160; Fax: 34 93 716 06 46; E-mail: cdomingo@tauli.cat


Abstract

Health care demands have increased dramatically in recent decades. With the introduction of major changes in the management of health problems, health care costs have spiralled. Today, in the interests of cost control, medicine is geared towards outpatient care whenever possible.

In this process, the medical community has been obliged to adapt its traditional criteria to the dictates of national economies. Today the criteria for the organization and evaluation of the health services are based on the concepts of efficacy, effectiveness and efficiency. This has led to the emergence of a new discipline for the design and evaluation of medical service production, known as servuction, an amalgam of “service” and “production”. The organigram of a new health product should include the problems the program faces and the steps proposed to overcome these problems.

The concept of evaluation can be divided into two categories: administrative evaluation, and evaluative research. Avedis Donabedian was one of the founders of evaluative research, based on an easy-to-remember triad: structure-process-results. In the final evaluation of a new health care model, the innovations it provides must be considered.

In this article we describe the stages involved in the design of a new health product and correlate them with the types of evaluation that should be applied at each point in the process. Our discussion addresses general aspects of servuction, but also focuses on the design of a particular service, created to care for patients with severe COPD.