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Concepts of acceptability that have been widely studied include acceptable risk in situations affecting human health, and acceptable loss in particularly dire situations. The idea of not increasing lifetime risk by more than one in a million has become commonplace in public health discourse and policy. [7] It is a heuristic measure.
The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, the usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing factors, enabling factors, and need.
Increasing or decreasing one results in changes to one or both of the other two. For example, a policy that increases access to health services would lower quality of health care and/or increase cost. The desired state of the triangle, high access and quality with low cost represents value in a health care system. [3]
The MSF was first proposed by John W. Kingdon to describe the agenda setting stage of the policy making process. [1] In developing his framework Kingdon took inspiration from the garbage can model of organizational choice, [2] which views organizations as anarchical processes resulting from the interaction of four streams: 1) choices, 2) problems, 3) solutions, and 4) energy from participants.
Feasible policies must be politically acceptable or at least not unacceptable. Political unacceptability is a combination of two conditions too much opposition or too little support. One common mistake is widespread in practice that feasibility becomes a dominant criterion of preferable alternative.
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Unwarranted variations in medical practice refer to the differences in care that cannot be explained by the illness/medical need or by patient preferences. The term “unwarranted variations” was first coined by Dr. John Wennberg when he observed small area (geographic) and practice style variations, which were not based on clinical rationale. [5]
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