Letters
Health services administration
Volume 191 - Issue 7

Making cars and making health care: a critical review

Authors:  Sarah Winch and Amanda J Henderson

Med J Aust 2009; 191 (7): 414-415. || doi: 10.5694/j.1326-5377.2009.tb02867.x
Published online: 5 October 2009
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In reply: Our article highlighted issues with the uncritical adoption of car-making processes into health care planning — specifically, the regulation and splintering of the human element of a care pathway.

While day-of-surgery admission speeds patients through the system, the capacity for error remains and relates to our original arguments. For example, one assumption commonly made is that the patient or carer has the literacy level to understand the presurgical procedures, such as fasting, taking particular preparations or completing health history forms.

Yet the Australian Bureau of Statistics reported in 2003 that 37% of the population met only the minimum literacy standard (Level 3) required to function in a complex society such as ours in Australia.1 Forty-six per cent fell below this benchmark. For health literacy specifically, 35% of the population met only Level 3 standard, with about 60% falling below this standard.

This indicates that some of the work we have happily “outsourced” to the patient may be poorly understood and cause problems further down the line. It also highlights another key difference between cars and people: baseline control of the beginning raw material is difficult to achieve.

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