chapter  1
9 Pages

Our global health crisis

WithTimothy A. Carey

Globally, our health systems are in an enduring and escalating crisis. The inefficiencies in our systems, brought about by the provision of inappropriate care, are devouring enormous amounts of financial resources. In this chapter, the characteristics of inappropriate care are discussed. Also, definitions of “overuse”, “underuse”, and “misuse” are provided, and the difficulties in applying these definitions are considered. In particular, the problems of an ambiguous “grey zone” are introduced. No doubt numerous factors contribute to the existence of the grey zone. Whatever the factors are that led to its manifestation, however, it is the outcomes within the grey zone that are so problematic for the provision of appropriate care. The chapter suggests that the primacy of the patient’s perspective is inescapable when concepts such as “appropriate care”, “inappropriate care”, and “right care” are discussed. Accepting the centrality of patients’ preferences and values also has implications for the concept of the grey zone. The chapter offers the conclusion that the patient’s perspective is pivotal to the provision of appropriate care or the right health care.