Strategic Management of Clinical Services

Financial resources alone are insufficient for individuals to benefit from the opportunities presented by modern health care systems. Some countries have achieved much better levels of health than would be expected given their financial resources (Mehotra 2000); many examples of poor-quality care in countries at all levels of development reflect not only scarce resources but also inadequate management of what resources are available (see chapter 70). Many inputs must come together at the appropriate time and in the appropriate place to achieve maximum health gain. These inputs include human resources (in particular, trained staff); physical resources (such as pharmaceuticals and technology); and intellectual resources (in the form of evidence and the ability to apply it appropriately). This congruence requires that the production, distribution, and combination of these resources be actively managed and that the relations among the various elements that contribute to health care be optimized.