Expenditure on health care services and population health

In public debate, and even in the literature on health policy, there is frequent confusion about the relationship among expenditure on health care services and population health. Between those who emphasize the decisive impact of social determinants of health and those who focus on access to health care, there is a middle groundattention not only to the consequences of poor social conditions, but also to the barriers in accessing health care services that are known to prevent disease, reduce avoidable hospitalizations, and decrease premature mortality. Based on a new book, Health Care in World Cities (Gusmano, Rodwin and Weisz), this article calls attention to the importance of two indicators which reveal something about the health care system's contributions to population health: hospital discharges for "avoidable hospital conditions" and revascularizations adjusted for the burden of disease.