The NMJI

Encyclopedia of Health Care Management. Michael J. Stahl (ed). Sage Publications, New Delhi, 2004. 621 pp, US$ 125. ISBN 0–7619–2674–7.

I love encyclopaedias—they contain nuggets of information on a particular subject that may (or may not) whet your appetite for more. Encyclopaedias are something I have loved since I was a child, whether it was the Pears Cyclopaedia or ‘dipping into’ the Encyclopaedia Britannica in the local library. I am not sure whether this fascination for encyclopaedias is a male thing or not. Certainly the evidence from educational research suggests that boys tend to favour non-fiction reading while girls favour fiction. All this meant that Stahl’s book had a head start in making it into my good books (if you will forgive the pun).

The editor stakes out the need for and role of this book in helping ‘patients, physicians, other providers, employees of healthcare providers, students of healthcare, and consumers of healthcare insurance’ to understand the business and management of healthcare. This need, according to Stahl, has been highlighted by the rapid expansion and development of the healthcare industry in the USA. With that I have no quibble.

There are 600 key words defined in this encyclopaedia, which are classified into 16 general categories, viz. accounting and activity-based accounting, economics, finance, health policy, human resources, information technology, institutions and organizations, international healthcare issues, legal and regulatory issues, managed care, marketing and customer value, operations and decision-making, pharmaceuticals and clinical trials, quality, statistics and data mining, and strategy. The 160+ contributors to this encyclopaedia appear to be a remarkable collection of professionals and include academics, medical practitioners, medical teachers and trainers, and professionals from the pharmaceutical industry, accounting and law.

The focus of this encyclopaedia is firmly on the USA (only three contributors that I could pick out were not based in the USA—from Puerto Rico, the UK and Saudi Arabia) and is evidenced by the large number of entries for, say, ‘Institutions and organizations’ and ‘Legal and regulatory issues’ concentrating almost exclusively on the USA, while ‘International health care issues’ merits 8 entries (including the ‘US health care system’).

Nonetheless, I have learned a lot from this book. I found myself dipping into the encyclopaedia to look up terms that cropped up in my day-to-day work—‘case mix’, ‘alternative medicine’ and ‘Hippocratic oath’. I found the entries eminently readable and informative. I also looked up terms that do not crop up in my day-to-day work including: ‘first-mover advantage (FMA)’ defined as ‘the supposed advantages a company gains by becoming the first significant entrant to a particular market segment’; ‘managing organizational change’; and the ‘Kefauver–Harris amendments’ in the USA (‘these amendments mandate that drug manufacturers adhere to new requirements regarding test products’ purity, safety, and effectiveness’—now taken for granted when drugs are licensed for use). I also now know about the Pareto principle (see under ‘Pareto chart’)—the principle reflecting the practical observation that limited resources must be concentrated on the issues that are likely to have the most impact.

Noticeably, as the book remained on my desk for several days for anyone to pick up and read, I caught more than one of my colleagues skimming through it and nodding their heads. This confirmed the readability of the book but an evidence-based review of how useful this book is will take time. I will keep it prominently displayed in my room for all to see and use—but would I pay US$ 125 for the privilege of its 621 pages? The cost–benefit analysis (entry page 108) suggests that I would prefer to use my resources for some other need. Part of the reason for this is because I hate parochialism. Unfortunately, this book, although useful, is limited by its parochialism—the almost exclusive focus on healthcare in the USA.

Despite my prejudices, this book will be useful for some. I believe that the editor and his contributors have produced an impressive book that will be of relevance to those in the USA, or those who are interested in the US healthcare system. Even if I do not buy this book, I suspect many medical, public health and public policy libraries will feel the need to have it on their shelves.