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Sample records for health systems development

  1. Development of the Choctaw Health Delivery System.

    ERIC Educational Resources Information Center

    Nguyen, Binh N.

    The Choctaw Tribe is the first and only tribe to develop a health delivery system to take over an existing Indian Health Service inpatient facility. The takeover was accomplished in January 1984 under the Indian Self-Determination Act through a contract with the Indian Health Service. The Choctaw Health Delivery System includes a 35-bed general…

  2. [Development of local health systems in Uruguay].

    PubMed

    Noceti, M C; Gherardi, A; Ríos, A M; Ríos, F

    1990-01-01

    This article summarizes Uruguay's experience in local health systems development and the elements that have contributed to awareness and dissemination of this concept. In 1988 the Ministry of Public Health assumed responsibility as one of the entities charged with strengthening the country's local health systems. A technical group was created to act at the central level. It has proposed and promoted changes directed toward the deconcentration of resource utilization in accordance with a set of general guidelines and, at the local level, has acted as a catalyst in the understanding of health services delivery management as a systemic concept.

  3. [Health and the development of a rural health service system].

    PubMed

    Echeverri, O; de Salazar, L M

    1980-01-01

    The first part of this article reviews the interesting experience of the Center for Multidisciplinary Research in Rural Development (CIMDER) of Cali, Colombia, in the application of a model for the integrated development of health services. The strategies used in the model were: services available to all individuals and families in the community, use of accessible technology, community participation, and cooperation between the health sector and other development sectors. The second part briefly reviews the role of the nurse in health and development and takes issue with the traditional narrow view of the sphere of action of nursing as a profession. It is asserted that, in order to bring about the extension of health services and community development, it is necessary that the nurse serve in a position of leadership on a multidisciplinary team as either coordinator of services, supervisor of personnel, or education, and as liaison for the formal health care system with the community to enlist its active participation.

  4. Health Care System Reforms in Developing Countries

    PubMed Central

    Han, Wei

    2012-01-01

    This article proposes a critical but non-systematic review of recent health care system reforms in developing countries. The literature reports mixed results as to whether reforms improve the financial protection of the poor or not. We discuss the reasons for these differences by comparing three representative countries: Mexico, Vietnam, and China. First, the design of the health care system reform, as well as the summary of its evaluation, is briefly described for each country. Then, the discussion is developed along two lines: policy design and evaluation methodology. The review suggests that i) background differences, such as social development, poverty level, and population health should be considered when taking other countries as a model; ii) although demand-side reforms can be improved, more attention should be paid to supply-side reforms; and iii) the findings of empirical evaluation might be biased due to the evaluation design, the choice of outcome, data quality, and evaluation methodology, which should be borne in mind when designing health care system reforms. PMID:25170464

  5. Integrated System Health Management Development Toolkit

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  6. Oral health care systems in developing and developed countries.

    PubMed

    Kandelman, Daniel; Arpin, Sophie; Baez, Ramon J; Baehni, Pierre C; Petersen, Poul E

    2012-10-01

    Health care systems are essential for promoting, improving and maintaining health of the population. Through an efficient health service, patients can be advised of disease that may be present and so facilitate treatment; risks factors whose modification could reduce the incidence of disease and illness in the future can be identified, and further, how controlling such factors can contribute to maintain a good quality of life. In developed countries, clinics or hospitals may be supported by health professionals from various specialties that allow their cooperation to benefit the patient; these institutions or clinics may be equipped with the latest technical facilities. In developing countries, health services are mostly directed to provide emergency care only or interventions towards certain age group population. The most common diseases are dental caries and periodontal disease and frequently intervention procedures aim, at treating existing problems and restore teeth and related structure to normal function. It is unfortunate that the low priority given to oral health hinders acquisition of data and establishment of effective periodontal care programmes in developing countries but also in some developed countries where the periodontal profile is also less than satisfactory. Despite the fact that in several developed countries there are advanced programmes oriented to periodontal disease treatments, the concern is related to the lack of preventive oriented treatments. According to data available on periodontal status of populations from developed countries, despite the number of dentists and trained specialists, dental health professionals do not presently meet adequately the need for prevention, focusing mainly on curative care. The need for strengthening disease prevention and health promotion programmes in order to improve oral health conditions and particularly periodontal status in the majority of countries around the world is evident. Unfortunately, in many

  7. Reviewing Health Manpower Development. A Method of Improving National Health Systems. Public Health Papers No. 83.

    ERIC Educational Resources Information Center

    Fulop, Tamas; Roemer, Milton I.

    This guide is intended to assist countries contemplating a comprehensive, action-oriented review of health labor force development to improve their national health systems. Various aspects of the health system infrastructure are examined (major components, organizational structure, coordinating mechanisms, sources of information, and…

  8. A vision for child health information systems: developing child health information systems to meet medical care and public health needs.

    PubMed

    Hinman, Alan R; Saarlas, Kristin N; Ross, David A

    2004-11-01

    In both the medical care and public health arenas, a variety of information systems have been developed to serve providers and program managers. In general, these systems have not been designed to share information with other information systems and provide comprehensive information about a child's health status to the information user. A number of initiatives are underway to develop integrated information systems. In December 2003, All Kids Count hosted an invitational conference "Developing Child Health Information Systems to Meet Medical Care and Public Health Needs." Through a series of plenary presentations and breakout discussion groups, participants developed a series of recommendations about governance, economic issues, information infrastructure, and uses of information from integrated child health information systems (CHIS). Common threads in the recommendations were: (1) development of a national coalition of stakeholders to promote integration of separate child health information systems within the context of ongoing national initiatives such as the National Health Information Infrastructure and the Public Health Information Network, (2) the need to develop the business and policy cases for integrated CHIS, (3) the need to develop agreement on standards for collecting and transferring information, and (4) the need to get the word out about the importance of integrating separate CHIS to improve health and health services.

  9. Development of an occupational health data base system.

    PubMed

    Dye, B J; Lombard, R A; Worthy, C D

    1983-06-01

    Operational concerns, coupled with rising workers' compensation costs and the proliferation of regulatory requirements, call for a new approach to occupational health data base management. To meet this challenge, an automated system to store and manage worker and workplace exposure data is being developed. The system will include individual minicomputers at local Air Force bases and a central host computer for long-term storage and retrieval. The first step in establishing this data base is the standardization of data entry and storage at base level. This manual system, known as the Standardized Occupational Health Program (SOHP), serves as the basic building block for the Computerized Occupational Health Program (COHP). Standardization and automation of all relevant industrial hygiene, occupational medicine, and environmental data will significantly enhance the flow of information needed by those charged with providing a healthful work environment for Air Force personnel.

  10. Development and Application of a Portable Health Algorithms Test System

    NASA Technical Reports Server (NTRS)

    Melcher, Kevin J.; Fulton, Christopher E.; Maul, William A.; Sowers, T. Shane

    2007-01-01

    This paper describes the development and initial demonstration of a Portable Health Algorithms Test (PHALT) System that is being developed by researchers at the NASA Glenn Research Center (GRC). The PHALT System was conceived as a means of evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT System allows systems health management algorithms to be developed in a graphical programming environment; to be tested and refined using system simulation or test data playback; and finally, to be evaluated in a real-time hardware-in-the-loop mode with a live test article. In this paper, PHALT System development is described through the presentation of a functional architecture, followed by the selection and integration of hardware and software. Also described is an initial real-time hardware-in-the-loop demonstration that used sensor data qualification algorithms to diagnose and isolate simulated sensor failures in a prototype Power Distribution Unit test-bed. Success of the initial demonstration is highlighted by the correct detection of all sensor failures and the absence of any real-time constraint violations.

  11. Afghanistan's basic package of health services: its development and effects on rebuilding the health system.

    PubMed

    Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah

    2014-01-01

    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404

  12. Afghanistan's Basic Package of Health Services: Its development and effects on rebuilding the health system

    PubMed Central

    Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah

    2014-01-01

    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404

  13. Strategic business planning and development for competitive health care systems.

    PubMed

    Nauert, Roger C

    2005-01-01

    The health care industry has undergone enormous evolutionary changes in recent years. Competitive transitions have accelerated the compelling need for aggressive strategic business planning and dynamic system development. Success is driven by organizational commitments to farsighted market analyses, timely action, and effective management. PMID:18975726

  14. Development of a metabolic syndrome personal health record system.

    PubMed

    López, Diego M; Álvarez-Rosero, Rosa E; Sierra-Torres, Carlos H

    2015-01-01

    According to the International Diabetes Federation (IDF), a quarter of the world population is affected with metabolic syndrome (MS). The paper describes the development process of a Personal Health Record System (PHR) for the management of MS. Following the recommendations of ISO 9241-210:2010, a PHR for the promotion of physical activity and healthy nutrition was implemented. PMID:25980887

  15. The Centre for International Mental Health Approach to Mental Health System Development

    PubMed Central

    Minas, Harry

    2012-01-01

    Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. (harv rev psychiatry 2012;20:37–46.) PMID:22335181

  16. Ten years development of human resources in Serbian health system.

    PubMed

    Krstic, Maja; Grozdanov, Jasmina; Ivanovic, Ivan; Korac, Vesna; Vasic, Milena

    2010-01-01

    A key component of any healthcare reform process is to ensure that the services are delivered by the right numbers of staff with appropriate skills and training. In 2007, public health institutions in Serbia had 2% more employees than before the economic transition. Nevertheless, the trend of the total number of employees in the Serbian health care system still preserved a mild rising trend. The most prominent changes in the structure of human resources were effectuated in the total numbers of physicians, nurses and administrative and technical staff. Development of medical science and practice in Serbia is characterized by more intensive processes of specializations, resulting in increased number of specialists among medical doctors. Health care provided in in-patient institutions still employs most of the doctors. The number of unemployed physicians, dentists and pharmacists has been rising since 2000. Another aspect that explains the rise of unemployed, university educated human resources is the rising number of graduated physicians, dentist and pharmacists. Health care policy makers may recognize the need for more integrated planning of human resources in health care, in particular, making management of human resources responsive to system needs and design, instead of vice versa.

  17. A Taxonomy of the Health System Appropriate for Plan Development. Health Planning Methods and Technology Series.

    ERIC Educational Resources Information Center

    Government Studies & Systems, Philadelphia, PA.

    This report presents a two-dimensional framework for classifying the health system which is recommended for use by health planning agencies during plan development activities. The content is in six sections: The first section discusses the need for a consistent planning framework. Section 2 presents the rationale for the selection of health…

  18. Understanding global health and development partnerships: Perspectives from African and global health system professionals.

    PubMed

    Barnes, Amy; Brown, Garrett W; Harman, Sophie

    2016-06-01

    Partnership is a key idea in current debates about global health and development assistance, yet little is known about what partnership means to those who are responsible for operationalising it or how it is experienced in practice. This is particularly the case in the context of African health systems. This paper explores how health professionals working in global health hubs and the health systems of South Africa, Tanzania and Zambia understand and experience partnership. Drawing on semi-structured interviews with 101 professionals based in each country, Washington DC and Geneva between October 2012 and June 2013, the paper makes four key arguments. First, partnership has a legitimating function in global health policy processes for international development institutions, government agencies and civil society organisations alike. Second, the practice of partnership generates idiosyncratic and complicated relationships that health professionals have to manage and navigate, often informally. Third, partnership is shaped by historical legacies, critical events, and independent consultants. Fourth, despite being an accepted part of global health policy, there is little shared understanding of what good partnership is meant to include or resemble in practice. Knowing more about the specific socio-cultural and political dynamics of partnership in different health system contexts is critical to equip health professionals with the skills to build the informal relations that are essential to effective partnership engagement. PMID:27155226

  19. Health care data recording system for developing countries.

    PubMed

    Brolly, E H

    1982-07-01

    Developed countries have an established pattern for recording clinical data. The unit medical record allows statistics to be extrapolated, as well as disease patterns, births, and causes of deaths. In technologically advanced countries, medical records serve the health needs of clinic and hospital patients. However, it is now becoming clear that the emphasis on hospitalization in patient care is no longer appropriate; the emphasis must be switched from curative services to preventive and basic curative services at the primary health care level. A similar alteration will be necessary in the recordkeeping system. As progress towards literacy occurs, the aim will be to expand and improve the recording of basic data. In the next highest level, the district health center, records can be very simple. Increasing sophistication can be instituted at the higher levels of district hospital and central referral hospital. Obviously there must be adequate medical records to directly support clinical care. This paper goes on to outline the structure of such a system geared to the needs of a developing country. It is basically a model for a pilot project. The various problems which might arise before the system is implemented and can be viable include: 1) precise identification of medical records, 2) the need for standardization and definition of diagnoses, and 3) lack of coordination and/or inappropriate utilization of medical records, procedures, or personnel. Concerning procedures, there could be problems with incorrect data production, erroneous channelling of information, or improper feedback. At the lowest level of the chain would be the rural or urban health unit or the mobile health visitor with the primary health worker (PHW). Forms to be used include an attendance card, an infant weight chart, temperature chart, and referral form. The PHW must be appropriately trained in the recognition of signs and symptoms of diseases most likely to be encountered, basic drug therapy

  20. Mental Health in Developing Countries: Challenges and Opportunities in Introducing Western Mental Health System in Uganda

    PubMed Central

    Kopinak, Janice Katherine

    2015-01-01

    Background: Despite decades of disagreement among mental health practitioners and researchers in the Western world pertaining to the causation, classification and treatment of mental disorders there is an ongoing push to implement western mental health models in developing countries. Little information exists on the adaptability of western mental health models in developing countries. Method: This paper presents a review of the attempt to implement a western-oriented mental health system into a different culture, specifically a developing country such as Uganda. It draws upon an extensive literature review and the author’s work in Uganda to identify the lessons learned as well as the challenges of introducing a western-oriented mental health system in a totally new cultural milieu. Results: There is recognition by the national government that the challenges faced in mental health services poses serious public health and development concerns. Efforts have and are being made to improve services using the Western model to diagnose and treat, frequently with practitioners who are unfamiliar with the language, values and culture. Conclusions and Global Health Implications: Uganda can continue to implement the Western mental health practice model which emanates from a different cultural base, based on the medical model and whose tenets are currently being questioned, or establish a model based on their needs with small baseline in-country surveys that focus on values, beliefs, resiliency, health promotion and recovery. The latter approach will lead to a more efficient mental health system with improved care, better outcomes and overall mental health services to Ugandan individuals and communities. PMID:27621983

  1. Mental Health in Developing Countries: Challenges and Opportunities in Introducing Western Mental Health System in Uganda

    PubMed Central

    Kopinak, Janice Katherine

    2015-01-01

    Background: Despite decades of disagreement among mental health practitioners and researchers in the Western world pertaining to the causation, classification and treatment of mental disorders there is an ongoing push to implement western mental health models in developing countries. Little information exists on the adaptability of western mental health models in developing countries. Method: This paper presents a review of the attempt to implement a western-oriented mental health system into a different culture, specifically a developing country such as Uganda. It draws upon an extensive literature review and the author’s work in Uganda to identify the lessons learned as well as the challenges of introducing a western-oriented mental health system in a totally new cultural milieu. Results: There is recognition by the national government that the challenges faced in mental health services poses serious public health and development concerns. Efforts have and are being made to improve services using the Western model to diagnose and treat, frequently with practitioners who are unfamiliar with the language, values and culture. Conclusions and Global Health Implications: Uganda can continue to implement the Western mental health practice model which emanates from a different cultural base, based on the medical model and whose tenets are currently being questioned, or establish a model based on their needs with small baseline in-country surveys that focus on values, beliefs, resiliency, health promotion and recovery. The latter approach will lead to a more efficient mental health system with improved care, better outcomes and overall mental health services to Ugandan individuals and communities.

  2. Developing of National Accreditation Model for Rural Health Centers in Iran Health System

    PubMed Central

    TABRIZI, Jafar Sadegh; GHARIBI, Farid; PIRAHARY, Samereh

    2013-01-01

    Abstract Background The primary health care has notable effects on community health and accreditation is one of the appropriate evaluation methods that led to health system performance improvement, therefore, this study aims to developing of national accreditation model for rural health centers in Iran Health System. Methods Firstly the suitable accreditation models selected to benchmarking worldwide via systematic review, the related books and medical university’s web site surveyed and some interviews hold with experts. Then the obtain standards surveyed from the experts’ perspectives via Delphi technique. Finally, the obtainedmodel assessedvia the experts’ perspective and pilot study. Results The researchers identified JCAHO and CCHSA as the most excellent models. The obtained standards and their quality accepted from experts’ perspective and pilot study, and finally the number of 55 standards acquired. Conclusion The designed model has standards with acceptable quality and quantity, and researchers’ hopeful that its application in rural health centers led to continues quality improvement. PMID:26060646

  3. Health policy and systems research agendas in developing countries

    PubMed Central

    Gonzalez-Block, Miguel A

    2004-01-01

    Background Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. Objective The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. Methods HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. Results The highest ranking topic at the aggregate level is "Sector analysis", followed by

  4. Health policy and systems research agendas in developing countries.

    PubMed

    Gonzalez-Block, Miguel A

    2004-08-01

    BACKGROUND: Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. OBJECTIVE: The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. METHODS: HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. RESULTS: The highest ranking topic at the aggregate level is "Sector analysis", followed

  5. Leadership and governance in seven developed health systems.

    PubMed

    Smith, Peter C; Anell, Anders; Busse, Reinhard; Crivelli, Luca; Healy, Judith; Lindahl, Anne Karin; Westert, Gert; Kene, Tobechukwu

    2012-06-01

    This paper explores leadership and governance arrangements in seven developed health systems: Australia, England, Germany, the Netherlands, Norway, Sweden and Switzerland. It presents a cybernetic model of leadership and governance comprising three fundamental functions: priority setting, performance monitoring and accountability arrangements. The paper uses a structured survey to examine critically current arrangements in the seven countries. Approaches to leadership and governance vary substantially, and have to date been developed piecemeal and somewhat arbitrarily. Although there seems to be reasonable consensus on broad goals of the health system there is variation in approaches to setting priorities. Cost-effectiveness analysis is in widespread use as a basis for operational priority setting, but rarely plays a central role. Performance monitoring may be the domain where there is most convergence of thinking, although countries are at different stages of development. The third domain of accountability is where the greatest variation occurs, and where there is greatest uncertainty about the optimal approach. We conclude that a judicious mix of accountability mechanisms is likely to be appropriate in most settings, including market mechanisms, electoral processes, direct financial incentives, and professional oversight and control. The mechanisms should be aligned with the priority setting and monitoring processes. PMID:22265340

  6. Leadership and governance in seven developed health systems.

    PubMed

    Smith, Peter C; Anell, Anders; Busse, Reinhard; Crivelli, Luca; Healy, Judith; Lindahl, Anne Karin; Westert, Gert; Kene, Tobechukwu

    2012-06-01

    This paper explores leadership and governance arrangements in seven developed health systems: Australia, England, Germany, the Netherlands, Norway, Sweden and Switzerland. It presents a cybernetic model of leadership and governance comprising three fundamental functions: priority setting, performance monitoring and accountability arrangements. The paper uses a structured survey to examine critically current arrangements in the seven countries. Approaches to leadership and governance vary substantially, and have to date been developed piecemeal and somewhat arbitrarily. Although there seems to be reasonable consensus on broad goals of the health system there is variation in approaches to setting priorities. Cost-effectiveness analysis is in widespread use as a basis for operational priority setting, but rarely plays a central role. Performance monitoring may be the domain where there is most convergence of thinking, although countries are at different stages of development. The third domain of accountability is where the greatest variation occurs, and where there is greatest uncertainty about the optimal approach. We conclude that a judicious mix of accountability mechanisms is likely to be appropriate in most settings, including market mechanisms, electoral processes, direct financial incentives, and professional oversight and control. The mechanisms should be aligned with the priority setting and monitoring processes.

  7. Development of the Space Station Freedom Environmental Health System

    NASA Technical Reports Server (NTRS)

    Richard, Elizabeth E.; Russo, Dane

    1990-01-01

    The Environmental Health System (EHS), a subsystem of the Space Station Freedom (SSF) Crew Health Care System, was established to ensure that crewmembers will have a safe and healthy environment in which to live and work. EHS is comprised of six subsystems: Microbiology, Toxicology, Water Quality, Radiological Health, Vibroacoustics, and Barothermal Physiology. Each subsystem contributes to the overall functions of the EHS including environmental planning, environmental monitoring, environmental monitoring, environmental health assessments, and operations support. The EHS will provide hardware for monitoring the air, water, and internal surfaces of Freedom, including capabilities for inflight sample collection, processing, and analysis. The closed environment of SSF, and its dependence on recycled air and water, will necessitate a reliable monitoring system to alert crewmembers if contamination levels exceed the maximum allowable limits established to ensure crew health and safety. This paper describes the functions and hardware design status of the EHS.

  8. Clinical engineering development in the Uruguayan public health system.

    PubMed

    Di Virgilio, Valerio; Ambrois, Gonzalo

    2010-01-01

    Establishment of the clinical engineering department with a network of 5 operational centers to strengthen public medical equipment management and maintenance, in the context of the Health System reform with the purpose of ensuring universal access to the health services in the Republic of Uruguay. PMID:21097119

  9. What can developing economies learn from health system reforms of developed countries?

    PubMed

    Chernichovsky, D

    1995-01-01

    This paper outlines some general lessons developing nations can draw from the health system reform experiences of developed nations. Using the experiences of developed countries, developing countries should be better able to anticipate socio-economic changes and choose an optimal path for their health systems development to accompany those changes. Most developed countries have adopted rather common objectives and principles in their health systems because of market failure in health care; developing countries may start adopting those principles because they do not have market conditions in the first place. It is suggested that developing countries strengthen what is probably the most fundamental initial systemic asset they have: public finance. They should do so by attracting democratically, possibly through earmarked taxes, resources otherwise channelled through the private sector, competing with public finance for limited real resources. This effort can be promoted by giving consumers, mainly of high income groups and in urban areas, more say (through institutions performing the OMCC function) in the nature of care these groups have access to under auspices of public finance. Where feasible, private insurance as a major source of finance should be seen as a transitional phenomenon, giving way to the emergence of OMCC institutions which require similar financial and managerial market infrastructure. Private and competitive provision of care may be unrealistic in many developing areas because of both scarcity of real resources, mainly manpower, and health needs. The challenge of government is, as resources grow, to divest itself from the provision of care and stay involved in activities and facilities that are of 'public nature'--under specific circumstances--that foster private competitive provision. In general, the government should play an enabling role also by investing in health promotions and management skills for health systems.

  10. What can developing economies learn from health system reforms of developed countries?

    PubMed

    Chernichovsky, D

    1995-01-01

    This paper outlines some general lessons developing nations can draw from the health system reform experiences of developed nations. Using the experiences of developed countries, developing countries should be better able to anticipate socio-economic changes and choose an optimal path for their health systems development to accompany those changes. Most developed countries have adopted rather common objectives and principles in their health systems because of market failure in health care; developing countries may start adopting those principles because they do not have market conditions in the first place. It is suggested that developing countries strengthen what is probably the most fundamental initial systemic asset they have: public finance. They should do so by attracting democratically, possibly through earmarked taxes, resources otherwise channelled through the private sector, competing with public finance for limited real resources. This effort can be promoted by giving consumers, mainly of high income groups and in urban areas, more say (through institutions performing the OMCC function) in the nature of care these groups have access to under auspices of public finance. Where feasible, private insurance as a major source of finance should be seen as a transitional phenomenon, giving way to the emergence of OMCC institutions which require similar financial and managerial market infrastructure. Private and competitive provision of care may be unrealistic in many developing areas because of both scarcity of real resources, mainly manpower, and health needs. The challenge of government is, as resources grow, to divest itself from the provision of care and stay involved in activities and facilities that are of 'public nature'--under specific circumstances--that foster private competitive provision. In general, the government should play an enabling role also by investing in health promotions and management skills for health systems. PMID:10156647

  11. Linking public health training and health systems development in sub-Saharan Africa: opportunities for improvement and collaboration.

    PubMed

    Fonn, Sharon

    2011-01-01

    In sub-Saharan Africa previous health gains have been reversed and many countries are not on track to achieving the Millennium Development Goals. The reasons are multifaceted but relate fundamentally to poorly functioning health systems and the HIV, AIDS, and tuberculosis epidemics. Although population health can be improved through specific health interventions that target high burden diseases, these interventions must be offered within a functional health system for optimal effectiveness. Schools of Public Health in Africa should respond to the many systemic issues that confound improvements in population level health through reviewing approaches to health professional training that incorporates a public health approach, focusing on health systems research; collaboration, advocacy and networking; and strengthening health systems management. Institutional mechanisms to define joint research agendas and two-way exchanges between universities and national health systems are required. PMID:21730993

  12. [E-health developments in the system of health services in Hungary and the European Union].

    PubMed

    Váradi, Ágnes

    2014-05-25

    The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which - if accepted - would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems. PMID:24836317

  13. [E-health developments in the system of health services in Hungary and the European Union].

    PubMed

    Váradi, Ágnes

    2014-05-25

    The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which - if accepted - would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems.

  14. Development of lightweight structural health monitoring systems for aerospace applications

    NASA Astrophysics Data System (ADS)

    Pearson, Matthew

    This thesis investigates the development of structural health monitoring systems (SHM) for aerospace applications. The work focuses on each aspect of a SHM system covering novel transducer technologies and damage detection techniques to detect and locate damage in metallic and composite structures. Secondly the potential of energy harvesting and power arrangement methodologies to provide a stable power source is assessed. Finally culminating in the realisation of smart SHM structures. 1. Transducer Technology A thorough experimental study of low profile, low weight novel transducers not normally used for acoustic emission (AE) and acousto-ultrasonics (AU) damage detection was conducted. This included assessment of their performance when exposed to aircraft environments and feasibility of embedding these transducers in composites specimens in order to realise smart structures. 2. Damage Detection An extensive experimental programme into damage detection utilising AE and AU were conducted in both composites and metallic structures. These techniques were used to assess different damage mechanism within these materials. The same transducers were used for novel AE location techniques coupled with AU similarity assessment to successfully detect and locate damage in a variety of structures. 3. Energy Harvesting and Power Management Experimental investigations and numerical simulations were undertaken to assess the power generation levels of piezoelectric and thermoelectric generators for typical vibration and temperature differentials which exist in the aerospace environment. Furthermore a power management system was assessed to demonstrate the ability of the system to take the varying nature of the input power and condition it to a stable power source for a system. 4. Smart Structures The research conducted is brought together into a smart carbon fibre wing showcasing the novel embedded transducers for AE and AU damage detection and location, as well as vibration energy

  15. Propulsion Health Management System Development for Affordable and Reliable Operation of Space Exploration Systems

    NASA Technical Reports Server (NTRS)

    Melcher, Kevin J.; Maul, William A.; Garg, Sanjay

    2007-01-01

    The constraints of future Exploration Missions will require unique integrated system health management capabilities throughout the mission. An ambitious launch schedule, human-rating requirements, long quiescent periods, limited human access for repair or replacement, and long communication delays, all require an integrated approach to health management that can span distinct, yet interdependent vehicle subsystems, anticipate failure states, provide autonomous remediation and support the Exploration Mission from beginning to end. Propulsion is a critical part of any space exploration mission, and monitoring the health of the propulsion system is an integral part of assuring mission safety and success. Health management is a somewhat ubiquitous technology that encompasses a large spectrum of physical components and logical processes. For this reason, it is essential to develop a systematic plan for propulsion health management system development. This paper provides a high-level perspective of propulsion health management systems, and describes a logical approach for the future planning and early development that are crucial to planned space exploration programs. It also presents an overall approach, or roadmap, for propulsion health management system development and a discussion of the associated roadblocks and challenges.

  16. Development of structural health monitoring systems for railroad bridge testbeds

    NASA Astrophysics Data System (ADS)

    Park, Hyun-Jun; Min, Jiyoung; Yun, Chung-Bang; Shin, Min-Ho; Kim, Yong-Su; Park, Su-Yeol

    2011-04-01

    Recently a challenging project has been carried out for construction of a national network for safety management and monitoring of civil infrastructures in Korea. As a part of the project, structural health monitoring (SHM) systems have been established on railroad bridges employing various types of sensors such as accelerometers, optical fiber sensors, and piezoelectric sensors. This paper presents the current status of railroad bridge health monitoring testbeds. Emerging sensors and monitoring technologies are under investigation. They are local damage detection using PZT-based electro-mechanical impedances; vibration-based global monitoring using accelerations, FBG-based dynamic strains; and wireless sensor data acquisition systems. The monitoring systems provide real-time measurements under train-transit and environmental loadings, and can be remotely accessible and controllable via the web. Long-term behaviors of the railroad bridge testbeds are investigated, and guidelines for safety management are to be established by combining numerical analysis and signal processing of the measured data.

  17. Knowledge management systems for oral health in developing and developed countries.

    PubMed

    Nattestad, Anders

    2012-10-01

    Knowledge management systems utilize information technology to manage knowledge in organizations with the purpose of creating, supporting, storing and disseminating information. These systems have been around for decades, but have significantly changed over time in complexity and features with the evolution of information technology and the Internet. With the development of these new technologies, the concept of knowledge management has thrived and has had significant impact on the way in which knowledge is accumulated, stored and accessed. This article will describe the historical development of knowledge management systems in oral health, illustrate the technology using examples and explore the future use of these systems with emerging technologies such as Google Wave®. One example of how knowledge management systems may affect the quality of dental education is the DentEd project, where a collaborative website was developed to coordinate dental school visitations and collection of reports from working groups, leading to several important publications. MEDLINE is another example of an effective knowledge management system in health care, providing access to health care-related scientific literature, which is highly organized under the auspices of the United States National Library of Medicine. Another and very differently organized example of an effective knowledge management system is Wikipedia, which is a free, web-based, collaborative, multilingual encyclopedia project supported by a nonprofit foundation. The final example of an effective knowledge management system is all of the social media, including Facebook and Twitter. These tools have proven very powerful in organizing and collaborating. In conclusion, the development of new technologies and the Internet have changed the way in which information is developed and accessed. This development is still ongoing and only the future will reveal how this will continue to change.

  18. Knowledge management systems for oral health in developing and developed countries.

    PubMed

    Nattestad, Anders

    2012-10-01

    Knowledge management systems utilize information technology to manage knowledge in organizations with the purpose of creating, supporting, storing and disseminating information. These systems have been around for decades, but have significantly changed over time in complexity and features with the evolution of information technology and the Internet. With the development of these new technologies, the concept of knowledge management has thrived and has had significant impact on the way in which knowledge is accumulated, stored and accessed. This article will describe the historical development of knowledge management systems in oral health, illustrate the technology using examples and explore the future use of these systems with emerging technologies such as Google Wave®. One example of how knowledge management systems may affect the quality of dental education is the DentEd project, where a collaborative website was developed to coordinate dental school visitations and collection of reports from working groups, leading to several important publications. MEDLINE is another example of an effective knowledge management system in health care, providing access to health care-related scientific literature, which is highly organized under the auspices of the United States National Library of Medicine. Another and very differently organized example of an effective knowledge management system is Wikipedia, which is a free, web-based, collaborative, multilingual encyclopedia project supported by a nonprofit foundation. The final example of an effective knowledge management system is all of the social media, including Facebook and Twitter. These tools have proven very powerful in organizing and collaborating. In conclusion, the development of new technologies and the Internet have changed the way in which information is developed and accessed. This development is still ongoing and only the future will reveal how this will continue to change. PMID:22909113

  19. SAMS--a systems architecture for developing intelligent health information systems.

    PubMed

    Yılmaz, Özgün; Erdur, Rıza Cenk; Türksever, Mustafa

    2013-12-01

    In this paper, SAMS, a novel health information system architecture for developing intelligent health information systems is proposed and also some strategies for developing such systems are discussed. The systems fulfilling this architecture will be able to store electronic health records of the patients using OWL ontologies, share patient records among different hospitals and provide physicians expertise to assist them in making decisions. The system is intelligent because it is rule-based, makes use of rule-based reasoning and has the ability to learn and evolve itself. The learning capability is provided by extracting rules from previously given decisions by the physicians and then adding the extracted rules to the system. The proposed system is novel and original in all of these aspects. As a case study, a system is implemented conforming to SAMS architecture for use by dentists in the dental domain. The use of the developed system is described with a scenario. For evaluation, the developed dental information system will be used and tried by a group of dentists. The development of this system proves the applicability of SAMS architecture. By getting decision support from a system derived from this architecture, the cognitive gap between experienced and inexperienced physicians can be compensated. Thus, patient satisfaction can be achieved, inexperienced physicians are supported in decision making and the personnel can improve their knowledge. A physician can diagnose a case, which he/she has never diagnosed before, using this system. With the help of this system, it will be possible to store general domain knowledge in this system and the personnel's need to medical guideline documents will be reduced.

  20. School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

    ERIC Educational Resources Information Center

    Rastorfer, Darl

    2011-01-01

    From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

  1. Development of the National Health Information Systems in Botswana: Pitfalls, prospects and lessons

    PubMed Central

    Seitio-Kgokgwe, Onalenna; Gauld, Robin D. C.; Hill, Philip C.; Barnett, Pauline

    2015-01-01

    Background: Studies evaluating development of health information systems in developing countries are limited. Most of the available studies are based on pilot projects or cross-sectional studies. We took a longitudinal approach to analysing the development of Botswana’s health information systems. Objectives: We aimed to: (i) trace the development of the national health information systems in Botswana (ii) identify pitfalls during development and prospects that could be maximized to strengthen the system; and (iii) draw lessons for Botswana and other countries working on establishing or improving their health information systems. Methods: This article is based on data collected through document analysis and key informant interviews with policy makers, senior managers and staff of the Ministry of Health and senior officers from various stakeholder organizations. Results: Lack of central coordination, weak leadership, weak policy and regulatory frameworks, and inadequate resources limited development of the national health information systems in Botswana. Lack of attention to issues of organizational structure is one of the major pitfalls. Conclusion: The ongoing reorganization of the Ministry of Health provides opportunity to reposition the health information system function. The current efforts including development of the health information management policy and plan could enhance the health information management system. PMID:26392841

  2. Applications of Community Psychology in Fostering the Development of Health Systems Agencies.

    ERIC Educational Resources Information Center

    Bunker, Douglas R.

    The Health Systems Agencies created to plan and coordinate the development of health care systems in 205 health service areas across the states have a need to be legitimized and operationalized in community contexts in order to achieve their purpose. Community psychologists have both research and consultation roles to play in contributing to…

  3. Health and development of mothers through system of ICDS.

    PubMed

    Yajnik, N D

    1993-01-01

    In order to accelerate welfare and nutrition programs for women and children in tribal, hilly, and backward areas of India, the government of India has accepted the National Program of Integrated Services. Delivery of these services is coordinated by the Integrated Child Development Services (ICDS). The package of services for prenatal women include physical and obstetrical exams; serial recording of weight, blood pressure, hemoglobin, and urinalysis; tetanus immunization; iron (60 mg) and folic acid (.5 mg) tablets; food supplements; identification and referral of high-risk mothers; and health education on antenatal care, breast feeding, child rearing, and family planning. Postnatal women received 2 home visits within 10 days of delivery and make 1 visit after 1 month of delivery. These visits cover general health, breast feeding, delivery records, infant health, and birth control measures. Food supplementation continues for nursing mothers. All women 15-44 years of age receive health and nutrition education. Specially organized courses, campaigns, home visits by anganwadi workers, cooking demonstrations, and mass media emphasize simple messages regarding health and nutrition. Areas that are covered include family welfare; antenatal, intranatal, and postnatal care; breast feeding; immunization; prevention of such common communicable diseases as malaria, tuberculosis, and leprosy; weaning and supplementary feeding; improvement of children's nutritional status; balanced diet; food storage, preparation, cooking, and serving; eye and ear care; personal and environmental hygiene; sanitation; management of acute respiratory infections; management of diarrhea; and control and treatment of internal parasites. The mobile food and extension units of the Department of Food are utilized. Pregnant and nursing mothers belonging to families of landless agricultural laborers, of marginal farmers, of the scheduled caste, of the scheduled tribe, and of poorer sections of the

  4. [Health promotion effectiveness: developing and testing a system for routine evaluation in health education, workplace health promotion and setting approach supplied by the German statutory health insurance agencies].

    PubMed

    Kliche, T; Riemann, K; Bockermann, C; Niederbühl, K; Wanek, V; Koch, U

    2011-04-01

    The aim of the study was to develop and test a routine evaluation system for all health promotion and education activities funded by the German statutory health insurance companies. The system aims at measuring both individual health effects and the complex organisational effects of setting projects. Measurement instruments were developed synoptically and tested in three field tests (2003-2008). In order to assess the impact of individual health training, 212 courses of the health insurance companies were evaluated. To assess the setting approach, 56 schools participating in a health-promotion project were included, and for workplace health-promotion 6 projects of different health insurance companies were included. The research design was an observational study. Instead of control groups, individual data were compared to reference values for gender- and age-matched groups from national health surveys. The studies consisted of baseline and final assessment (T1/T2), complemented by a follow-up (T3), all adapted to the time of intervention (i. e., 3-24 months for T1/T2 and 3-18 months for T2/T3). The evaluation system provides multilevel-measurement based upon validated questionnaires for health-related structures and processes in institutions, and for the participating individual's subjective health, health problems, health-related quality of life, workplace and institutional satisfaction. Controlling for central confounders is also possible (input and dosage, age, gender, educational background). Thus, short but valid measurement instruments of high usability are available to evaluate the effectiveness of prevention, health promotion and education. PMID:20486081

  5. Tunable Laser Development for In-flight Fiber Optic Based Structural Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Richards, Lance; Parker, Allen; Chan, Patrick

    2014-01-01

    The objective of this task is to investigate, develop, and demonstrate a low-cost swept lasing light source for NASA DFRC's fiber optics sensing system (FOSS) to perform structural health monitoring on current and future aerospace vehicles. This is the regular update of the Tunable Laser Development for In-flight Fiber Optic Based Structural Health Monitoring Systems website.

  6. Developing an Index to Measure Health System Performance: Measurement for Districts of Nepal.

    PubMed

    Kandel, N; Fric, A; Lamichhane, J

    2014-01-01

    Various frameworks for measuring health system performance have been proposed and discussed. The scope of using performance indicators are broad, ranging from examining national health system to individual patients at various levels of health system. Development of innovative and easy index is essential to measure multidimensionality of health systems. We used indicators, which also serve as proxy to the set of activities, whose primary goal is to maintain and improve health. We used eleven indicators of MDGs, which represent all dimensions of health to develop index. These indicators are computed with similar methodology that of human development index. We used published data of Nepal for computation of the index for districts of Nepal as an illustration. To validate our finding, we compared the indices of these districts with other development indices of Nepal. An index for each district has been computed from eleven indicators. Then indices are compared with that of human development index, socio-economic and infrastructure development indices and findings has shown the similarity on distribution of districts. Categories of low and high performing districts on health system performance are also having low and high human development, socio-economic, and infrastructure indices respectively. This methodology of computing index from various indicators could assist policy makers and program managers to prioritize activities based on their performance. Validation of the findings with that of other development indicators show that this can be one of the tools, which can assist on assessing health system performance for policy makers, program managers and others.

  7. Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

    PubMed Central

    Berman, P.

    2000-01-01

    Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision

  8. Space Flight Software Development Software for Intelligent System Health Management

    NASA Technical Reports Server (NTRS)

    Trevino, Luis C.; Crumbley, Tim

    2004-01-01

    The slide presentation examines the Marshall Space Flight Center Flight Software Branch, including software development projects, mission critical space flight software development, software technical insight, advanced software development technologies, and continuous improvement in the software development processes and methods.

  9. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    PubMed Central

    Odeyemi, Isaac AO; Nixon, John

    2013-01-01

    Background Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI). This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity. Methods A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia) that illustrates the principal forms and roles of PHI. Literature describing each country’s health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity. Results In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system. Conclusion PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications and the factors that affect its uptake and equity in different health care systems. The results are anticipated to be helpful in informing how developing countries may utilize PHI to meet the aim of achieving universal health care. PMID:23494071

  10. Health region development from the perspective of system theory - an empirical cross-regional case study.

    PubMed

    Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

    2015-01-01

    Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions.

  11. Health region development from the perspective of system theory - an empirical cross-regional case study.

    PubMed

    Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

    2015-01-01

    Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. PMID:24923839

  12. Medical Education Capacity-Building Partnerships for Health Care Systems Development.

    PubMed

    Rabin, Tracy L; Mayanja-Kizza, Harriet; Rastegar, Asghar

    2016-01-01

    Health care workforce development is a key pillar of global health systems strengthening that requires investment in health care worker training institutions. This can be achieved by developing partnerships between training institutions in resource-limited and resource-rich areas and leveraging the unique expertise and opportunities both have to offer. To realize their full potential, however, these relationships must be equitable. In this article, we use a previously described global health ethics framework and our ten-year experience with the Makerere University-Yale University (MUYU) Collaboration to provide an example of an equity-focused global health education partnership. PMID:27437821

  13. Public health laboratory systems development in East Africa through training in laboratory management and field epidemiology

    PubMed Central

    Mosha, Fausta; Oundo, Joseph; Mukanga, David; Njenga, Kariuki; Nsubuga, Peter

    2011-01-01

    Laboratories are integral to the delivery of quality health care and for public health functions; however laboratory systems and services are often neglected in resource-poor settings such as the East African region. In order to sustainably strengthen national laboratory systems in resource-poor countries, there is a need to train laboratory personnel to work in clinical as well as public health laboratories. In 2004,Kenya, Uganda, Tanzania, and South Sudan began training public health laboratory workers jointly with field epidemiologists in the Kenya Field Epidemiology and Laboratory Training Program (FELTP), and later through the Tanzania FELTP, as a strategy to strengthen public health laboratories. These programs train laboratory epidemiologists through a two-year public health leadership development course, and also offer various types of short course training for frontline staff. The FELTP laboratory graduates in Kenya, Tanzania, Uganda, and South Sudan are working in their respective countries to strengthen public health laboratory systems while the short course participants provide a pool of frontline implementers with the capacity to support the lower tiers of health systems, as well as serve as surge capacity for the regions and the national level. Through training competent public health laboratory workers, the East African ministries of health, in collaboration with other regional partners and stakeholders are now engaged in developing and implementing a holistic approach that will guarantee an overall strengthening of the health system by using well-trained public health laboratory leaders to drive the process. Strengthening public health laboratory medicine in East Africa is critical to improve health-care systems. The experience with the FELTP model in East Africa is a step in the right direction towards ensuring a stronger role for the laboratory in public health. PMID:22359702

  14. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.

    PubMed

    Bosch-Capblanch, Xavier; Lavis, John N; Lewin, Simon; Atun, Rifat; Røttingen, John-Arne; Dröschel, Daniel; Beck, Lise; Abalos, Edgardo; El-Jardali, Fadi; Gilson, Lucy; Oliver, Sandy; Wyss, Kaspar; Tugwell, Peter; Kulier, Regina; Pang, Tikki; Haines, Andy

    2012-01-01

    In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.

  15. Development of structural health monitoring and early warning system for reinforced concrete system

    SciTech Connect

    Iranata, Data E-mail: data@ce.its.ac.id; Wahyuni, Endah; Murtiadi, Suryawan; Widodo, Amien; Riksakomara, Edwin; Sani, Nisfu Asrul

    2015-04-24

    Many buildings have been damaged due to earthquakes that occurred recently in Indonesia. The main cause of the damage is the large deformation of the building structural component cannot accommodate properly. Therefore, it is necessary to develop the Structural Health Monitoring System (SHMS) to measure precisely the deformation of the building structural component in the real time conditions. This paper presents the development of SHMS for reinforced concrete structural system. This monitoring system is based on deformation component such as strain of reinforcement bar, concrete strain, and displacement of reinforced concrete component. Since the deformation component has exceeded the limit value, the warning message can be sent to the building occupies. This warning message has also can be performed as early warning system of the reinforced concrete structural system. The warning message can also be sent via Short Message Service (SMS) through the Global System for Mobile Communications (GSM) network. Hence, the SHMS should be integrated with internet modem to connect with GSM network. Additionally, the SHMS program is verified with experimental study of simply supported reinforced concrete beam. Verification results show that the SHMS has good agreement with experimental results.

  16. The Outcome of Breast Cancer Is Associated with National Human Development Index and Health System Attainment

    PubMed Central

    Tian, Wei; Pan, Tao; Ye, Juan; Zhang, Suzhan

    2016-01-01

    Breast cancer is a worldwide threat to female health with patient outcomes varying widely. The exact correlation between global outcomes of breast cancer and the national socioeconomic status is still undetermined. Mortality-to-incidence ratio (MIR) of breast cancer was calculated with the contemporary age standardized incidence and mortality rates for countries with data available at GLOBOCAN 2012 database. The MIR matched national human development indexes (HDIs) and health system attainments were respectively obtained from Human Development Report and World Health Report. Correlation analysis, regression analysis, and Tukey-Kramer post hoc test were used to explore the effects of HDI and health system attainment on breast cancer MIR. Our results demonstrated that breast cancer MIR was inversely correlated with national HDI (r = -.950; P < .001) and health system attainment (r = -.898; P < .001). Countries with very high HDI had significantly lower MIRs than those with high, medium and low HDI (P < .001). Liner regression model by ordinary least squares also indicated negative effects of both HDI (adjusted R2 = .903, standardize β = -.699, P < .001) and health system attainment (adjusted R2 =. 805, standardized β = -.009; P < .001), with greater effects in developing countries identified by quantile regression analysis. It is noteworthy that significant health care disparities exist among countries in accordance with the discrepancy of HDI. Policies should be made in less developed countries, which are more likely to obtain worse outcomes in female breast cancer, that in order to improve their comprehensive economic strength and optimize their health system performance. PMID:27391077

  17. Development and Implementation of a Clinical and Business Intelligence System for the Florida Health Data Warehouse

    PubMed Central

    AlHazme, Raed H.; Rana, Arif M.; De Lucca, Michael

    2014-01-01

    Objective To develop and implement a Clinical and Business Intelligence (CBI) system for the Florida Health Data Warehouse (FHDW) in order to bridge the gap between Florida’s healthcare stakeholders and the health data archived in FHWD. Materials and Methods A gap analysis study has been conducted to evaluate the technological divide between the relevant users and FHWD health data, which is maintained by the Broward Regional Health Planning Council (BRHPC). The study revealed a gap between the health care data and the decision makers that utilize the FHDW data. To bridge the gap, a CBI system was proposed, developed and implemented by BRHPC as a viable solution to address this issue, using the System Development Life Cycle methodology. Results The CBI system was successfully implemented and yielded a number of positive outcomes. In addition to significantly shortening the time required to analyze the health data for decision-making processes, the solution also provided end-users with the ability to automatically track public health parameters. Discussion A large amount of data is collected and stored by various health care organizations at the local, state, and national levels. If utilized properly, such data can go a long way in optimizing health care services. CBI systems provide health care organizations with valuable insights for improving patient care, tracking trends for medical research, and for controlling costs. Conclusion The CBI system has been found quite effective in bridging the gap between Florida’s healthcare stake holders and FHDW health data. Consequently, the solution has improved in the planning and coordination of health care services for the state of Florida. PMID:25379128

  18. Developing New Systems of Data to Advance a Culture of Health

    PubMed Central

    Plough, Alonzo

    2014-01-01

    Introduction: The system dynamics that are driving changes in health and health care in the United States are not well captured by standard data-collection activities. We need data systems that can inform policy and program development and can reflect the increasing recognition that all aspects of people’s lives—their work, families, and communities and not just formal health and health care services—support active and healthy living. Culture of Health Action Areas: Within the Culture of Health (COH) framework, four action areas are further upstream in the sequence of change and point to additional need for more nuanced approaches to data collection: building a shared value of health; fostering collaborations to improve well-being; creating health in more equitable community environments; and transforming health and health care systems. These action areas define the COH framework that we hope will spur research and strategies across sectors to improve health. Conclusion: The action framework for advancing a COH will guide the Robert Wood Johnson Foundation’s (RWJF) grant making and strategic collaborations. It is hoped that the framework will also catalyze changes in how researchers and organizations collect health-related data at all levels. PMID:25995991

  19. Developing Crew Health Care and Habitability Systems for the Exploration Vision

    NASA Technical Reports Server (NTRS)

    Laurini, Kathy; Sawin, Charles F.

    2006-01-01

    This paper will discuss the specific mission architectures associated with the NASA Exploration Vision and review the challenges and drivers associated with developing crew health care and habitability systems to manage human system risks. Crew health care systems must be provided to manage crew health within acceptable limits, as well as respond to medical contingencies that may occur during exploration missions. Habitability systems must enable crew performance for the tasks necessary to support the missions. During the summer of 2005, NASA defined its exploration architecture including blueprints for missions to the moon and to Mars. These mission architectures require research and technology development to focus on the operational risks associated with each mission, as well as the risks to long term astronaut health. This paper will review the highest priority risks associated with the various missions and discuss NASA s strategies and plans for performing the research and technology development necessary to manage the risks to acceptable levels.

  20. Towards responsible system development in health services: a discourse analysis study of design conflict resolution tactics.

    PubMed

    Irestig, Magnus; Timpka, Toomas

    2010-02-01

    We set out to examine design conflict resolution tactics used in development of large information systems for health services and to outline the design consequences for these tactics. Discourse analysis methods were applied to data collected from meetings conducted during the development of a web-based system in a public health context. We found that low risk tactics were characterized by design issues being managed within the formal mandate and competences of the design group. In comparison, high risk tactics were associated with irresponsible compromises, i.e. decisions being passed on to others or to later phases of the design process. The consequence of this collective disregard of issues such as responsibility and legitimacy is that the system design will be impossible to implement in factual health service contexts. The results imply that downstream responsibility issues have to be continuously dealt with in system development in health services.

  1. [The health of developed countries: which is the most cost effective delivery system?].

    PubMed

    Lambert, D C

    2001-01-01

    Several attempts have been undertaken to classify national health care systems according to their merits. The best known is the one published recently by the World Health Organization. The works conducted by the author have produced an other one. Among developed countries, it appears that the model they have adopted--that of Chancelor Bismarck (health services financed by contributions from employers and employees) or that of Lord Beveridge (health services financed by taxes)--does not play a crucial role. Universal access to health services and their provision free of charge do not automatically guarantee equity and efficiency. Equity means that the same treatment is applied to everybody. Efficiency means that health expenditures are kept under control, taking into account the health results obtained. In this respect, the USA are ranked at the lowest level, whatever the classification system used. PMID:11433959

  2. Human rights and health systems development: confronting the politics of exclusion and the economics of inequality.

    PubMed

    Maru, Duncan; Farmer, Paul

    2012-12-15

    The social movements of the last two decades have fostered a rights-based approach to health systems development within the global discourse on national and international health governance. In this piece, we discuss ongoing challenges in the cavernous "implementation gap": translating legislative human rights victories into actual practice and delivery. Using accompaniment as an underlying principle, we focus primarily on constructing effective, equitable, and accountable public sector health systems. Public sector health care delivery is challenged by increasingly exclusive politics and inequitable economic policies that fundamentally limit the participatory power of marginalized citizens. Finally, we discuss the role of implementation science in closing the delivery gap in human rights practice.

  3. A developing country's university oriented toward strengthening health systems: challenges and results.

    PubMed Central

    Bryant, J H; Marsh, D R; Khan, K S; D'Souza, R; Husein, K; Aslam, A; Qureshi, A F; deWit, V; Harnar, R M

    1993-01-01

    OBJECTIVES. The Aga Khan University in Karachi has a mission to educate leaders and to contribute to the development of health systems for Pakistan amid challenges of scarcity and complexity. METHODS. Its key activities are (1) to design and test urban and rural health system prototypes, (2) to develop faculty in medical and nursing postgraduate community health sciences programs, and (3) to design and implement community-based undergraduate medical and nursing curricula. RESULTS. The university has developed equity-based, cost-effective primary health care prototypes in Karachi slums. With government counterparts it has tested village-, facility-, and district-level interventions in a poor rural district. Federal policymakers have taken models from each for widespread replication. The university is training 49 medical and 19 nursing faculty for postgraduate programs in community health sciences. Most faculty retain institutional leadership positions, including teaching community-based, problem-solving, community health sciences as 20% of the medical and nursing undergraduate curriculum. CONCLUSIONS. The mission and experience of the Aga Khan University in population-based health systems design and health sciences education can guide universities in both developing and developed countries. PMID:8238674

  4. [Contributions to the development of a public health information system. SESPAS Report 2010].

    PubMed

    García León, Francisco Javier; Fernández Merino, Juan Carlos

    2010-12-01

    New public health laws are a conceptual and methodological adaptation of public health to current social needs, their common link being the incorporation of health in all policies. This represents a new strategic approach that will require different information systems, which should incorporate the rapid advances made in the field of information technology and communication. The aim of this article was to identify the most important aspects to be taken into account in information systems in public health from a technological perspective, both in their development and in the elements that compose them. To overcome the fragmentation of information systems in public health, these systems must be successfully integrated among themselves and with other health and non-health systems. To achieve this task, technical, semantic and organizational interoperability must be ensured. Emerging technologies should be considered to support these new strategies, especially Web 2.0 tools. This new strategic development will pose additional challenges because of its size and the diversity of the departments involved. It is proposed that information systems will include the elements of Web 2.0 and support systems for decision-making technologies in addition to the traditional operational systems.

  5. Health System Development and Performance in Korea and Japan: A Comparative Study of 2000–2013

    PubMed Central

    Dronina, Yuliya; Yoon, Young Min; Sakamaki, Hiroyuki; Nam, Eun Woo

    2016-01-01

    Background The Japanese and Korean healthcare systems are very similar and thus, they have the same problems and weaknesses. This study discusses the problems and proposes complementary solutions based on the results of a comparative analysis of conditions in the healthcare systems of the two countries. Methods This article presents a comparative analysis of the healthcare status of the two countries based on certain health criteria used worldwide, a literature review, and data from the Korean Ministry of Health and Welfare, Japanese Ministry of Health, Labour and Welfare, World Health Organization (WHO), World Bank, and Organization for Economic Cooperation and Development (OECD). Results The scores of the healthcare systems were calculated for quantitative comparison. The performance of the Japanese health system was the best, followed by the Korean health system. Both countries observed an increased life expectancy and decreased infant and under-five mortality rates during the last 14 years. However, lower fertility rates were found, which could lead to a decreased working population and a subsequent increase in the economic burden of governments and households. A higher alcohol consumption rate was found in Korea, which was related to the establishment of interpersonal relationships. Conclusion The reform of the healthcare systems in Korea and Japan led to an increased life expectancy; concurrently, reduced fertility rates led to an increasing aging population. As a result, increasing health costs require additional measures to improve health equity and strengthen health promotion. PMID:27358836

  6. Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System.

    PubMed

    Dobmeyer, Anne C; Hunter, Christopher L; Corso, Meghan L; Nielsen, Matthew K; Corso, Kent A; Polizzi, Nicholas C; Earles, Jay E

    2016-09-01

    The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed. PMID:27484777

  7. Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System.

    PubMed

    Dobmeyer, Anne C; Hunter, Christopher L; Corso, Meghan L; Nielsen, Matthew K; Corso, Kent A; Polizzi, Nicholas C; Earles, Jay E

    2016-09-01

    The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.

  8. Assessing health system performance in developing countries: a review of the literature.

    PubMed

    Kruk, Margaret Elizabeth; Freedman, Lynn P

    2008-03-01

    With the setting of ambitious international health goals and an influx of additional development assistance for health, there is growing interest in assessing the performance of health systems in developing countries. This paper proposes a framework for the assessment of health system performance and reviews the literature on indicators currently in use to measure performance using online medical and public health databases. This was complemented by a review of relevant books and reports in the grey literature. The indicators were organized into three categories: effectiveness, equity, and efficiency. Measures of health system effectiveness were improvement in health status, access to and quality of care and, increasingly, patient satisfaction. Measures of equity included access and quality of care for disadvantaged groups together with fair financing, risk protection and accountability. Measures of efficiency were appropriate levels of funding, the cost-effectiveness of interventions, and effective administration. This framework and review of indicators may be helpful to health policy makers interested in assessing the effects of different policies, expenditures, and organizational structures on health outputs and outcomes in developing countries.

  9. Early-age mortality, socio-economic development and the health system in Mongolia.

    PubMed

    Neupert, R F

    1995-04-01

    Since the 1920s Mongolia has developed an extensive and well-staffed health care system that has made modern health technologies accessible to most of its population. In addition, the country experienced rapid economic and social development whose benefits were equitably distributed among the population. In spite of this progress, infant and child mortality levels are high by contemporary standards and during the past 20 years these rates have remained virtually constant. The modern health care delivery system, externally imposed, failed to take into account the specific characteristics of the Mongolian culture; this fact is identified as one of the major determinants of the unexpected levels of early-age mortality. The excessive orientation toward curative medicine, the lack of health prevention and promotion activities and the lack of community participation have resulted in the people continuing to believe in traditional therapeutic patterns and self-care. They perceive the modern system exclusively in curative terms and not with regard to health preservation and disease prevention. Most Mongolians do not fully understand the health care system, and use its services mainly because they have no alternative, or because of coercion rather than conviction based on the learning and internalization of its basic principles. In practices and ideas of child care, preservation of health and disease prevention, people seem to identify more with the traditional health care system. Like other former socialist countries, Mongolia is experiencing deep economic and social transformations, whose implications for the health care system are discussed. An economic crisis whose end is nowhere in sight, emergent social inequalities, a vague health insurance model with unclear financing sources, and lack of concern by most policy-makers in strengthening the preventive component of the health system, are not positive factors for substantial infant and child mortality decline in the

  10. [Assessment system for watershed ecological health in the United States: development and application].

    PubMed

    Zhang, Hua; Luo, Yong-Ming

    2013-07-01

    To meet the water quality goals of the Clean Water Act, the environmental agencies in the United States (U.S.) have developed a comprehensive ecological assessment system of watershed health in the last two decades. The system employs a watershed approach, and includes a large set of hydrological, chemical, and biological indices, having become an essential part of the watershed water quality management system in the U.S. and provided strong support for the protection of water environment and the restoration of aquatic system. In this paper, the development and application of the ecological assessment system of watershed health by the U.S. environmental regulators, especially the U.S. Environmental Protection Agency (US EPA), were overviewed from the aspects of related laws and regulations, ecosystem function analysis, ecological health indicators, comprehensive assessment system, and monitoring and data management systems, and the health assessment systems for the rivers, lakes, estuaries, coasts, and wetlands adopted by the National$t1-1-1 Aquatic Resource Surveys (NARS) were introduced. Some suggestions for the future development of the scientific ecological assessment system of watershed health in China were put forward based on the understanding of the protection and remediation practices of our water environment. PMID:24175541

  11. [Assessment system for watershed ecological health in the United States: development and application].

    PubMed

    Zhang, Hua; Luo, Yong-Ming

    2013-07-01

    To meet the water quality goals of the Clean Water Act, the environmental agencies in the United States (U.S.) have developed a comprehensive ecological assessment system of watershed health in the last two decades. The system employs a watershed approach, and includes a large set of hydrological, chemical, and biological indices, having become an essential part of the watershed water quality management system in the U.S. and provided strong support for the protection of water environment and the restoration of aquatic system. In this paper, the development and application of the ecological assessment system of watershed health by the U.S. environmental regulators, especially the U.S. Environmental Protection Agency (US EPA), were overviewed from the aspects of related laws and regulations, ecosystem function analysis, ecological health indicators, comprehensive assessment system, and monitoring and data management systems, and the health assessment systems for the rivers, lakes, estuaries, coasts, and wetlands adopted by the National$t1-1-1 Aquatic Resource Surveys (NARS) were introduced. Some suggestions for the future development of the scientific ecological assessment system of watershed health in China were put forward based on the understanding of the protection and remediation practices of our water environment.

  12. Developing Data Elements for Research Information System in Health; a Starting Point for Systems Integration

    PubMed Central

    Ghorbani, NR; Ahmadi, M; Sadoughi, F; Ghanei, M

    2012-01-01

    Background: This study defines necessary data elements required for the research information system in the domain of health, and its level of accountability to national health research indicators from the experts’ perspective is being explored. Methods: This qualitative study was conducted based on comparative approach using the focus group method. Data were collected through 6 semi-structured group discussions held at the Undersecretary for Research and Technology, Ministry of Health and Medical Education, Tehran, Iran. For this study, 48 researchers were selected for the group discussions. All interviews and group discussions were recorded and transcribed. The Data analysis was performed simultaneously using Strauss and Corbin method. Results: Based on content analysis, the necessary data elements identified for the National Health Research Information System designed for all databases were the following: organizations, researchers, journals, articles, research projects and dissertations. Also, extracted from the focus group discussion were three main themes regarding data elements of these databases for the National Health Research Information System: 1) essential elements for each database 2) the system’s data elements accountability to the national indicators in the domain of health research and 3) recommendations in the direction of optimizing the data. Conclusions: The results obtained from this study can serve as a valuable source in designing research information system in the domain of health within the country and in the region as well. PMID:23641388

  13. Developing the Malaysian health system to meet the challenges of the future.

    PubMed

    Merican, M I; Rohaizat, Y; Haniza, S

    2004-03-01

    The Malaysian health care system is a success story among countries of equivalent socio-economic status. However there are numerous challenges faced by the nation, which create the need for changes and reform. There is rising consumer demands and expectations for high technology and high cost medical care due to improved standards of living, changing disease patterns and demographic changes, inadequate integration of health services, maldistribution of resources and the threats as well as opportunities of globalisation and liberalisation. The changes in health policy, priorities and planning for the country are guided by the country's development policies, objectives and the challenges of Vision 2020, Vision for Health and the goals of the health system in ensuring universal access, improving equity and efficiency and the quality of life of the population. The essential services in the health system of the future are information and education of individuals to empower support for the wellness paradigm. There is also a need to restructure the national health care financing and the health care delivery system. The present roles and responsibilities of MOH also need to be reviewed. PMID:15535341

  14. Developing the Malaysian health system to meet the challenges of the future.

    PubMed

    Merican, M I; Rohaizat, Y; Haniza, S

    2004-03-01

    The Malaysian health care system is a success story among countries of equivalent socio-economic status. However there are numerous challenges faced by the nation, which create the need for changes and reform. There is rising consumer demands and expectations for high technology and high cost medical care due to improved standards of living, changing disease patterns and demographic changes, inadequate integration of health services, maldistribution of resources and the threats as well as opportunities of globalisation and liberalisation. The changes in health policy, priorities and planning for the country are guided by the country's development policies, objectives and the challenges of Vision 2020, Vision for Health and the goals of the health system in ensuring universal access, improving equity and efficiency and the quality of life of the population. The essential services in the health system of the future are information and education of individuals to empower support for the wellness paradigm. There is also a need to restructure the national health care financing and the health care delivery system. The present roles and responsibilities of MOH also need to be reviewed.

  15. Framework for assessing governance of the health system in developing countries: gateway to good governance.

    PubMed

    Siddiqi, Sameen; Masud, Tayyeb I; Nishtar, Sania; Peters, David H; Sabri, Belgacem; Bile, Khalif M; Jama, Mohamed A

    2009-04-01

    Governance is thought to be a key determinant of economic growth, social advancement and overall development, as well as for the attainment of the MDGs in low- and middle-income countries. Governance of the health system is the least well-understood aspect of health systems. A framework for assessing health system governance (HSG) at national and sub-national levels is presented, which has been applied in countries of the Eastern Mediterranean. In developing the HSG framework key issues considered included the role of the state vs. the market; role of the ministries of health vs. other state ministries; role of actors in governance; static vs. dynamic health systems; and health reform vs. human rights-based approach to health. Four existing frameworks were considered: World Health Organization's (WHO) domains of stewardship; Pan American Health Organization's (PAHO) essential public health functions; World Bank's six basic aspects of governance; and United Nations Development Programme (UNDP) principles of good governance. The proposed HSG assessment framework includes the following 10 principles-strategic vision, participation and consensus orientation, rule of law, transparency, responsiveness, equity and inclusiveness, effectiveness and efficiency, accountability, intelligence and information, and ethics. The framework permits 'diagnoses of the ills' in HSG at the policy and operational levels and points to interventions for its improvement. In the case of Pakistan, where the framework was applied, a positive aspect was the growing participation and consensus orientation among stakeholders, while weaknesses were identified in relation to strategic vision, accountability, transparency, effectiveness and efficiency and rule of law. In using the HSG framework it needs to be recognized that the principles are value driven and not normative and are to be seen in the social and political context; and the framework relies on a qualitative approach and does not follow a

  16. Aligning new interventions with developing country health systems: Target product profiles, presentation, and clinical trial design

    PubMed Central

    Brooks, Alan; Nunes, Julia K.; Garnett, Andrew; Biellik, Robin; Leboulleux, Didier; Birkett, Ashley J.; Loucq, Christian

    2012-01-01

    Many new interventions are being created to address health problems of the developing world. However, many developing countries have fragile health systems and find it difficult to accommodate change. Consequently, it is essential that new interventions are well aligned with health systems and their users. Establishing target product profiles (TPPs) is a critical, early step towards tailoring interventions to suit both of these constituencies. Specific analyses can help identify and establish relevant TPP criteria such as optimal formulation, presentation and packaging. Clinical trials for a new intervention should be designed to address both TPP-specific questions and anticipated use of the intervention in target countries. Examples are provided from research on malaria vaccines that are also applicable to other new public health interventions. PMID:22783872

  17. Integrating Continuing Professional Development With Health System Reform: Building Pillars of Support.

    PubMed

    Davis, David A; Rayburn, William F

    2016-01-01

    Clinical failures sparked a widespread desire for health system reform at the beginning of the 21st century, but related efforts have resulted in changes that are either slow or nonexistent. In response, academic medicine has moved in two directions: (1) system-wide reform using electronic health records, practice networks, and widespread data applications (a macro pathway); and (2) professional development of individual clinicians through continuous performance improvement (a micro pathway). Both pathways exist to improve patient care and population health, yet each suffers from limitations in widespread implementation. The authors call for a better union between these two parallel pathways through four pillars of support: (1) an acknowledgment that both pathways are essential to each other and to the final outcome they intend to achieve, (2) a strong faculty commitment to educate about quality improvement and patient safety at all education levels, (3) a reengineering of tools for professional development to serve as effective change agents, and (4) the development of standards to sustain this alignment of pathways. With these pillars of support integrating continuing professional development with health system reform, the authors envision a better functioning system, with improved metrics and value to enhance patient care and population health. PMID:26556296

  18. Integrating Continuing Professional Development With Health System Reform: Building Pillars of Support.

    PubMed

    Davis, David A; Rayburn, William F

    2016-01-01

    Clinical failures sparked a widespread desire for health system reform at the beginning of the 21st century, but related efforts have resulted in changes that are either slow or nonexistent. In response, academic medicine has moved in two directions: (1) system-wide reform using electronic health records, practice networks, and widespread data applications (a macro pathway); and (2) professional development of individual clinicians through continuous performance improvement (a micro pathway). Both pathways exist to improve patient care and population health, yet each suffers from limitations in widespread implementation. The authors call for a better union between these two parallel pathways through four pillars of support: (1) an acknowledgment that both pathways are essential to each other and to the final outcome they intend to achieve, (2) a strong faculty commitment to educate about quality improvement and patient safety at all education levels, (3) a reengineering of tools for professional development to serve as effective change agents, and (4) the development of standards to sustain this alignment of pathways. With these pillars of support integrating continuing professional development with health system reform, the authors envision a better functioning system, with improved metrics and value to enhance patient care and population health.

  19. Armenia: health system review.

    PubMed

    Richardson, Erica

    2013-01-01

    This analysis of the Armenian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2006. Armenia inherited a Semashko style health system on independence from the Soviet Union in 1991. Initial severe economic and sociopolitical difficulties during the 1990s affected the population health, though strong economic growth from 2000 benefited the populations health. Nevertheless, the Armenian health system remains unduly tilted towards inpatient care concentrated in the capital city despite overall reductions in hospital beds and concerted efforts to reform primary care provision. Changes in health system financing since independence have been more profound, as out-of-pocket (OOP) payments now account for over half of total health expenditure. This reduces access to essential services for the poorest households - particularly for inpatient care and pharmaceuticals - and many households face catastrophic health expenditure. Improving health system performance and financial equity are therefore the key challenges for health system reform. The scaling up of some successful recent programmes for maternal and child health may offer solutions, but require sustained financial resources that will be challenging in the context of financial austerity and the low base of public financing.

  20. Slovenia: Health System Review.

    PubMed

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. PMID:27467813

  1. Politics and technology in health information systems development: a discourse analysis of conflicts addressed in a systems design group.

    PubMed

    Irestig, Magnus; Timpka, Toomas

    2008-02-01

    Different types of disagreements must be managed during the development of health information systems. This study examines the antagonisms discussed during the design of an information system for 175,000 users in a public health context. Discourse analysis methods were used for data collection and analysis. Three hundred and twenty-six conflict events were identified from four design meetings and divided into 16 categories. There were no differences regarding the types of conflicts that the different participants brought into the design discussions. Instead, conflict occurrence was primarily affected by the agendas that set the stage for examinations and debates. The results indicate that the selection of design method and the structure used for the meetings are important factors for the manner in which conflicts are brought into consideration during health information system design. Further studies comparing participatory and non-participatory information system design practices in health service settings are warranted.

  2. Critical Issues in the Development of Health Information Systems in Supporting Environmental Health: A Case Study of Ciguatera

    PubMed Central

    Goater, Sarah; Derne, Bonnie; Weinstein, Philip

    2011-01-01

    Background Emerging environmental pressures resulting from climate change and globalization challenge the capacity of health information systems (HIS) in the Pacific to inform future policy and public health interventions. Ciguatera, a globally common marine food-borne illness, is used here to illustrate specific HIS challenges in the Pacific and how these might be overcome proactively to meet the changing surveillance needs resulting from environmental change. Objectives We review and highlight inefficiencies in the reactive nature of existing HIS in the Pacific to collect, collate, and communicate ciguatera fish poisoning data currently used to inform public health intervention. Further, we review the capacity of existing HIS to respond to new data needs associated with shifts in ciguatera disease burden likely to result from coral reef habitat disruption. Discussion Improved knowledge on the ecological drivers of ciguatera prevalence at local and regional levels is needed, combined with enhanced surveillance techniques and data management systems, to capture environmental drivers as well as health outcomes data. Conclusions The capacity of public HIS to detect and prevent future outbreaks is largely dependent on the future development of governance strategies that promote proactive surveillance and health action. Accordingly, we present an innovative framework from which to stimulate scientific debate on how this might be achieved by using existing larger scale data sets and multidisciplinary collaborations. PMID:21163721

  3. Developing and Implementing Major League Baseball's Health and Injury Tracking System.

    PubMed

    Pollack, Keshia M; D'Angelo, John; Green, Gary; Conte, Stan; Fealy, Stephen; Marinak, Chris; McFarland, Edward; Curriero, Frank C

    2016-03-01

    In 2010, Major League Baseball and the Major League Baseball Players Association reached an agreement regarding the development and implementation of an electronic medical record system and a new league-wide injury surveillance system. The systems were developed to create a more efficient method to track medical histories of players longitudinally as they move across Major and Minor league affiliates, as well as to identify and monitor injury trends in the sport, identify areas of specific concern, and conduct epidemiologic research to better optimize player health and safety. The resulting injury surveillance system, the Health and Injury Tracking System (HITS), is a robust system that includes all players from the both the Major and Minor Leagues. HITS also allows for data linkage with other player- and game-level data to inform the development of injury prevention policies and programs. In the present article, we document the development and implementation of HITS; describe its utility for epidemiologic research; illustrate the potential analytic strength of the surveillance system and its ability to inform policy change; and note the potential for this new surveillance system to advance the field of sports injury epidemiology.

  4. Developing and Implementing Major League Baseball's Health and Injury Tracking System.

    PubMed

    Pollack, Keshia M; D'Angelo, John; Green, Gary; Conte, Stan; Fealy, Stephen; Marinak, Chris; McFarland, Edward; Curriero, Frank C

    2016-03-01

    In 2010, Major League Baseball and the Major League Baseball Players Association reached an agreement regarding the development and implementation of an electronic medical record system and a new league-wide injury surveillance system. The systems were developed to create a more efficient method to track medical histories of players longitudinally as they move across Major and Minor league affiliates, as well as to identify and monitor injury trends in the sport, identify areas of specific concern, and conduct epidemiologic research to better optimize player health and safety. The resulting injury surveillance system, the Health and Injury Tracking System (HITS), is a robust system that includes all players from the both the Major and Minor Leagues. HITS also allows for data linkage with other player- and game-level data to inform the development of injury prevention policies and programs. In the present article, we document the development and implementation of HITS; describe its utility for epidemiologic research; illustrate the potential analytic strength of the surveillance system and its ability to inform policy change; and note the potential for this new surveillance system to advance the field of sports injury epidemiology. PMID:26874305

  5. [Development of a distance education program in the public health system in Chile, 2004-2009].

    PubMed

    Carabantes C, Jorge; Guerra U, Manuel; Guillou, Michèle

    2010-09-01

    This paper reports the gradual development and results achieved in the distance education program set up in the Public Health System in Chile in 2004. Up to date, more than 22,000 students from 29 different health divisions have been trained. This strategy was designed to provide more flexibility and diversity to the training programs of the Health System within the framework of a deep and complex organizational change promoted by Health Reform. The main results show that the integration of organizational, teaching, logistic and budgetary aspects has turned out to be a key element in its success, validating the relevance of the provided solutions. The access to training by means of e-learning or blended learning (electronic education that includes traditional and distance learning activities) allowed employees to choose more independently what, where and when to study. This fact accounts for the high demand for this program. Through this initiative, the National Health System, introduced a wider scope of responses to training needs, which will mean a better adaptation to the challenges associated to health care.

  6. [Development of a distance education program in the public health system in Chile, 2004-2009].

    PubMed

    Carabantes C, Jorge; Guerra U, Manuel; Guillou, Michèle

    2010-09-01

    This paper reports the gradual development and results achieved in the distance education program set up in the Public Health System in Chile in 2004. Up to date, more than 22,000 students from 29 different health divisions have been trained. This strategy was designed to provide more flexibility and diversity to the training programs of the Health System within the framework of a deep and complex organizational change promoted by Health Reform. The main results show that the integration of organizational, teaching, logistic and budgetary aspects has turned out to be a key element in its success, validating the relevance of the provided solutions. The access to training by means of e-learning or blended learning (electronic education that includes traditional and distance learning activities) allowed employees to choose more independently what, where and when to study. This fact accounts for the high demand for this program. Through this initiative, the National Health System, introduced a wider scope of responses to training needs, which will mean a better adaptation to the challenges associated to health care. PMID:21249285

  7. The Irish health system: developments in strategy, structure, funding and delivery since 1980.

    PubMed

    Wiley, Miriam M

    2005-09-01

    As the Irish health system embarks upon its first major structural reorganisation in over 30 years, developments within this system over the past two decades are assessed. Real cuts in health expenditure achieved in the 1980s contrast sharply with the unprecedented increase in resources devoted to the health system in the 1990s. While successive statements of health strategy have prioritised the objectives of equity, efficiency and quality of care, questions arise regarding the return achieved with the increased investment. With higher levels of economic growth, more people have been buying private health insurance such that almost half the population are now privately insured. At the same time, the numbers with eligibility for health services without charge have decreased while those from lower socio-economic groups continue to have higher levels of utilisation. Equity issues arise, however, with regard to access to public hospitals as the rate of growth in admissions for private patients outstrips that for public patients. The establishment of a National Treatment Purchase Fund to purchase treatment in private facilities for public patients on waiting lists raises efficiency and equity questions as the treatment of private patients in public hospitals is heavily subsidised while the State pays full cost for the treatment of public patients in private facilities.

  8. A Taxonomy of E-Health Standards to Assist System Developers

    NASA Astrophysics Data System (ADS)

    Chávez, Emma; Krishnan, Padmanabhan; Finnie, Gavin

    Building e-health systems requires a good understanding of the range and characteristics of many relevant standards. These standards play an important role in the promotion of coordination amongst the key players in the technical and administrative areas of the e-health arena. Many entities including government, information technology professional bodies and medical organizations have developed a large number of e-health standards initiatives. Because of this broad range of initiatives, we propose a classification of standards to simplify the process to find out relevant information. The main objective is to facilitate the retrieval of e-health standards information by limiting the searching of classes or categories based on the applicability that the standards have in particular domains. Thus, we offer a framework to classify documents “standards” by assigning them to a predetermined set of categories and domains.

  9. Knowledge-based changes to health systems: the Thai experience in policy development.

    PubMed Central

    Tangcharoensathien, Viroj; Wibulpholprasert, Suwit; Nitayaramphong, Sanguan

    2004-01-01

    Over the past two decades the government in Thailand has adopted an incremental approach to extending health-care coverage to the population. It first offered coverage to government employees and their dependents, and then introduced a scheme under which low-income people were exempt from charges for health care. This scheme was later extended to include elderly people, children younger than 12 years of age and disabled people. A voluntary public insurance scheme was implemented to cover those who could afford to pay for their own care. Private sector employees were covered by the Social Health Insurance scheme, which was implemented in 1991. Despite these efforts, 30% of the population remained uninsured in 2001. In October of that year, the new government decided to embark on a programme to provide universal health-care coverage. This paper describes how research into health systems and health policy contributed to the move towards universal coverage. Data on health systems financing and functioning had been gathered before and after the founding of the Health Systems Research Institute in early 1990. In 1991, a contract capitation model had been used to launch the Social Health Insurance scheme. The advantages of using a capitation model are that it contains costs and provides an acceptable quality of service as opposed to the cost escalation and inefficiency that occur under fee-for-service reimbursement models, such as the one used to provide medical benefits to civil servants. An analysis of the implementation of universal coverage found that politics moved universal coverage onto the policy agenda during the general election campaign in January 2001. The capacity for research on health systems and policy to generate evidence guided the development of the policy and the design of the system at a later stage. Because the reformists who sought to bring about universal coverage (who were mostly civil servants in the Ministry of Public Health and members of

  10. Latvia: Health system review.

    PubMed

    Mitenbergs, Uldis; Taube, Maris; Misins, Janis; Mikitis, Eriks; Martinsons, Atis; Rurane, Aiga; Quentin, Wilm

    2012-01-01

    This analysis of the Latvian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health-system performance. Latvia has been constantly reforming its health system for over two decades. After independence in 1991, Latvia initially moved to create a social health insurance type system. However, problems with decentralized planning and fragmented and inefficient financing led to this being gradually reversed, and ultimately the establishment in 2011 of a National Health Service type system. These constant changes have taken place against a backdrop of relatively poor health and limited funding, with a heavy burden for individuals; Latvia has one of the highest rates of out-of-pocket expenditure on health in the European Union (EU). The lack of financial resources resulting from the financial crisis has posed an enormous challenge to the government, which struggled to ensure the availability of necessary health care services for the population and to prevent deterioration of health status. Yet this also provided momentum for reforms: previous efforts to centralise the system and to shift from hospital to outpatient care were drastically accelerated, while at the same time a social safety net strategy was implemented (with financial support from the World Bank) to protect the poor from the negative consequences of user charges. However, as in any health system, a number of challenges remain. They include: reducing smoking and cardiovascular deaths; increasing coverage of prescription pharmaceuticals; reducing the excessive reliance on out-of-pocket payments for financing the health system; reducing inequities in access and health status; improving efficiency of hospitals through implementation of DRG-based financing; and monitoring and improving quality. In the face of these challenges at a time of financial crisis, one further challenge emerges: ensuring adequate funding for the health

  11. Latvia: Health system review.

    PubMed

    Mitenbergs, Uldis; Taube, Maris; Misins, Janis; Mikitis, Eriks; Martinsons, Atis; Rurane, Aiga; Quentin, Wilm

    2012-01-01

    This analysis of the Latvian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health-system performance. Latvia has been constantly reforming its health system for over two decades. After independence in 1991, Latvia initially moved to create a social health insurance type system. However, problems with decentralized planning and fragmented and inefficient financing led to this being gradually reversed, and ultimately the establishment in 2011 of a National Health Service type system. These constant changes have taken place against a backdrop of relatively poor health and limited funding, with a heavy burden for individuals; Latvia has one of the highest rates of out-of-pocket expenditure on health in the European Union (EU). The lack of financial resources resulting from the financial crisis has posed an enormous challenge to the government, which struggled to ensure the availability of necessary health care services for the population and to prevent deterioration of health status. Yet this also provided momentum for reforms: previous efforts to centralise the system and to shift from hospital to outpatient care were drastically accelerated, while at the same time a social safety net strategy was implemented (with financial support from the World Bank) to protect the poor from the negative consequences of user charges. However, as in any health system, a number of challenges remain. They include: reducing smoking and cardiovascular deaths; increasing coverage of prescription pharmaceuticals; reducing the excessive reliance on out-of-pocket payments for financing the health system; reducing inequities in access and health status; improving efficiency of hospitals through implementation of DRG-based financing; and monitoring and improving quality. In the face of these challenges at a time of financial crisis, one further challenge emerges: ensuring adequate funding for the health

  12. Application of ICT in strengthening health information systems in developing countries in the wake of globalisation.

    PubMed

    Simba, Daudi O; Mwangu, Mughwira

    2004-12-01

    Information Communication Technology (ICT) revolution brought opportunities and challenges to developing countries in their efforts to strengthen the Health Management Information Systems (HMIS). In the wake of globalisation, developing countries have no choice but to take advantage of the opportunities and face the challenges. The last decades saw developing countries taking action to strengthen and modernise their HMIS using the existing ICT. Due to poor economic and communication infrastructure, the process has been limited to national and provincial/region levels leaving behind majority of health workers living in remote/rural areas. Even those with access do not get maximum benefit from ICT advancements due to inadequacies in data quality and lack of data utilisation. Therefore, developing countries need to make deliberate efforts to address constraints threatening to increase technology gap between urban minority and rural majority by setting up favourable policies and appropriate strategies. Concurrently, strategies to improve data quality and utilisation should be instituted to ensure that HMIS has positive impact on people's health. Potential strength from private sector and opportunities for sharing experiences among developing countries should be utilised. Short of this, advancement in ICT will continue to marginalise health workers in developing countries especially those living in remote areas. PMID:15687075

  13. Application of ICT in strengthening health information systems in developing countries in the wake of globalisation.

    PubMed

    Simba, Daudi O; Mwangu, Mughwira

    2004-12-01

    Information Communication Technology (ICT) revolution brought opportunities and challenges to developing countries in their efforts to strengthen the Health Management Information Systems (HMIS). In the wake of globalisation, developing countries have no choice but to take advantage of the opportunities and face the challenges. The last decades saw developing countries taking action to strengthen and modernise their HMIS using the existing ICT. Due to poor economic and communication infrastructure, the process has been limited to national and provincial/region levels leaving behind majority of health workers living in remote/rural areas. Even those with access do not get maximum benefit from ICT advancements due to inadequacies in data quality and lack of data utilisation. Therefore, developing countries need to make deliberate efforts to address constraints threatening to increase technology gap between urban minority and rural majority by setting up favourable policies and appropriate strategies. Concurrently, strategies to improve data quality and utilisation should be instituted to ensure that HMIS has positive impact on people's health. Potential strength from private sector and opportunities for sharing experiences among developing countries should be utilised. Short of this, advancement in ICT will continue to marginalise health workers in developing countries especially those living in remote areas.

  14. Developing Governance Structures in Health Care System Consolidation: A Framework for Nurse Leaders.

    PubMed

    Swartz, Colleen H; Bentley, Sarah

    2016-01-01

    Given the acceleration and increasing complexity of integrative care models across health systems, the question how governance and management structure(s) should be operationalized and evolved to achieve peak system performance is paramount. In a recent evaluation of partnerships with the University of Kentucky HealthCare (UK HealthCare), the conceptualization of the integration management model was explored. It was recognized that nursing leadership, governance structure, and relationships are vital for successful movement and migration of appropriate care models. In this case, the evolving governance models and the forecasted impact on models of care delivery were carefully considered. This included the potential impact on nursing practice. As the model was developed, a conceptual framework was utilized to examine potential variant relationship arrangements and to provide organization to key constructs. Utilization of a blueprint to optimize decision making and provide a replicable approach was essential to management of the integration philosophy.

  15. Developing Governance Structures in Health Care System Consolidation: A Framework for Nurse Leaders.

    PubMed

    Swartz, Colleen H; Bentley, Sarah

    2016-01-01

    Given the acceleration and increasing complexity of integrative care models across health systems, the question how governance and management structure(s) should be operationalized and evolved to achieve peak system performance is paramount. In a recent evaluation of partnerships with the University of Kentucky HealthCare (UK HealthCare), the conceptualization of the integration management model was explored. It was recognized that nursing leadership, governance structure, and relationships are vital for successful movement and migration of appropriate care models. In this case, the evolving governance models and the forecasted impact on models of care delivery were carefully considered. This included the potential impact on nursing practice. As the model was developed, a conceptual framework was utilized to examine potential variant relationship arrangements and to provide organization to key constructs. Utilization of a blueprint to optimize decision making and provide a replicable approach was essential to management of the integration philosophy. PMID:27584887

  16. DEVELOPMENT OF A RURAL COMMUNITY HEALTH CARE MODEL BASED ON INDIAN INDIGENOUS SYSTEM OF MEDICINE

    PubMed Central

    Hyma, B.; Ramesh, A.; Subhadra, N.L.

    1988-01-01

    Based on the principles of primary health care as outlined by WHO at the Alma Ata Conference in 1978, many voluntary organizations in India have been formulating, organizing and experimenting with the comprehensive rural community health Schemes. The goal is to indentify the felt needs at both individual and community levels and facilitate direct participation in decision making, develop suitable alternative, ecologically Sound indigenous models for socioeconomic well-being. In this context the Indian system of medicine has a useful and complementary role to play in the preventive and curative aspects of primary health care programmes. With the above objectives in mind the investigators undertook a brief survey of a “comprehensive rural health” project. The primary aim of this project is to develop a community health care model using innovative alternative methods using Indian indigenous system of medicine and participatory research techniques to improve rural health services of the surrounding under privileged villages. Many gaps exist in the assessment, however, a birds eye-view is presented here. PMID:22557645

  17. Development of an electronic breast pathology database in a community health system

    PubMed Central

    Nelson, Heidi D.; Weerasinghe, Roshanthi; Martel, Maritza; Bifulco, Carlo; Assur, Ted; Elmore, Joann G.; Weaver, Donald L.

    2014-01-01

    Background: Health care systems rely on electronic patient data, yet access to breast tissue pathology results continues to depend on interpreting dictated free-text reports. Objective: The objective was to develop a method to electronically search and categorize pathologic diagnoses of patients’ breast tissue specimens from dictated free-text pathology reports in a large health system for multiple users including clinicians. Design: A database integrating existing patient-level administrative and clinical information for breast cancer screening and diagnostic services and a web-based application for comprehensive searching of pathology reports were developed by a health system team led by pathologists. The Breast Pathology Assessment Tool and Hierarchy for Diagnosis (BPATH-Dx) provided search terms and guided electronic transcription of diagnoses from text fields on breast pathology clinical reports to standardized categories. Approach: Breast pathology encounters in the pathology database were matched with administrative data for 7332 women with breast tissue specimens obtained from an initial procedure in the health system from January 1, 2008 to December 31, 2011. Sequential queries of the pathology text based on BPATH-Dx categorized biopsies according to their worst pathological diagnosis, as is standard practice. Diagnoses ranged from invasive breast cancer (23.3%), carcinoma in situ (7.8%), atypical lesions (6.39%), proliferative lesions without atypia (27.9%), and nonproliferative lesions (34.7%), and were further classified into subcategories. A random sample of 5% of reports that were manually reviewed indicated 97.5% agreement. Conclusions: Sequential queries of free-text pathology reports guided by a standardized assessment tool in conjunction with a web-based search application provide an efficient and reproducible approach to accessing nonmalignant breast pathology diagnoses. This method advances the use of pathology data and electronic health

  18. Germany: Health system review.

    PubMed

    Busse, Reinhard; Blümel, Miriam

    2014-01-01

    This analysis of the German health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. In the German health care system, decision-making powers are traditionally shared between national (federal) and state (Land) levels, with much power delegated to self-governing bodies. It provides universal coverage for a wide range of benefits. Since 2009, health insurance has been mandatory for all citizens and permanent residents, through either statutory or private health insurance. A total of 70 million people or 85% of the population are covered by statutory health insurance in one of 132 sickness funds in early 2014. Another 11% are covered by substitutive private health insurance. Characteristics of the system are free choice of providers and unrestricted access to all care levels. A key feature of the health care delivery system in Germany is the clear institutional separation between public health services, ambulatory care and hospital (inpatient) care. This has increasingly been perceived as a barrier to change and so provisions for integrated care are being introduced with the aim of improving cooperation between ambulatory physicians and hospitals. Germany invests a substantial amount of its resources on health care: 11.4% of gross domestic product in 2012, which is one of the highest levels in the European Union. In international terms, the German health care system has a generous benefit basket, one of the highest levels of capacity as well as relatively low cost-sharing. However, the German health care system still needs improvement in some areas, such as the quality of care. In addition, the division into statutory and private health insurance remains one of the largest challenges for the German health care system, as it leads to inequalities. PMID:25115137

  19. Origins and development of the National Laboratory System for public health testing.

    PubMed

    Astles, J Rex; White, Vanessa A; Williams, Laurina O

    2010-01-01

    Although not recognized as such, a National Laboratory System (NLS) has existed since the inception of public health laboratory (PHL) testing more than a century ago. The NLS has always relied upon the participation of clinical laboratories, both to report test results that represent public health threats and to submit specimens and isolates to PHLs for additional or confirmatory testing. Historically, a number of factors have hindered the strengthening of the relationships between clinical laboratories and PHLs, but the reality of bioterrorism and subsequent focus on strengthening public-private relationships has stimulated the development of a more robust NLS. Since 2002, there has been substantial strengthening of the NLS through the sharing of lessons learned from several demonstration projects. There is a growing emphasis on defining critical elements of the NLS, including the State Public Health Laboratory System (SPH Laboratory System) and the functions of the Laboratory Program Advisor, a position that every state should have at the center of its laboratory system's capacity-building. Additional strengthening of the NLS is occurring through (1) national biennial measurement of state PHLs' abilities to meet the Core Functions and Capabilities of State PHLs, (2) the new Laboratory System Improvement Program (L-SIP) for the SPH Laboratory System, and (3) sharing ideas to integrate and improve the SPH Laboratory System (e.g., using the L-SIP Online Resource Center). Public health emergencies, such as the recent H1N1 epidemic, illustrate and reinforce the need for a strong NLS within which federal, public health, and clinical (i.e., hospital and private reference) laboratories function in close collaboration. PMID:20518442

  20. Health information system reform in South Africa: developing an essential data set.

    PubMed Central

    Shaw, Vincent

    2005-01-01

    Health services are increasingly under pressure to develop information systems that are responsive to changing health needs and appropriate to service objectives. Developing an essential data set provides managers with a clearly defined set of indicators for monitoring and evaluating services. This article describes a process that resulted in the creation of an essential data set at district level. This had a significant impact on neighbouring districts and resulted in the development of a regional essential data set, which in turn helped to influence the creation of a provincial and then national essential data set. Four key lessons may be drawn from the process. The development of an essential data set both requires and can contribute to a process that allows the reporting requirements to be adjusted over time in response to changing circumstances. In addition, it contributes to (and requires) the integration of programme reporting requirements into a coherent information system. While the case study describes a bottom-up approach, a top-down consultative process is advocated because it establishes a framework within which information needs can be reviewed. Lastly, the use of surveys can aid efforts to keep the essential elements to a minimum. In conclusion, the development of an essential data set contributes to strengthening health services because it necessitates dialogue between programme managers and defines indicators to be monitored by them. PMID:16184283

  1. Ukraine: health system review.

    PubMed

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. PMID:26106880

  2. Professionals with Delivery Skills: Backbone of the Health System and Key to Reaching the Maternal Health Millennium Development Goal

    PubMed Central

    Wirth, Meg

    2008-01-01

    The attainment of the fifth Millennium Development Goal requires adequate national reserves of skilled birth attendants. Nurses, midwives, and their equivalents form the frontline of the formal health system are a critical element of global efforts to reduce ill-health and poverty in the poorest areas of the world. Planning and policies supporting these cadres of workers must be placed high on the development agenda and championed by key international and national players. This article first sets forth an argument for the equity and efficiency of nurses, midwives, and their equivalents as the cadre largely responsible for maternal health. Second, it traces the root causes of neglect of this critical cadre, including a vacuum in political will in the context of poverty, lack of protections for frontline workers, the historical political position of the field of midwifery, lack of a pipeline of secondary school graduates, and gender inequity. Investment in the largely female cadre that cares for the majority of the world’s poorer women has simply not been a high enough priority. Key policy recommendations include harnessing political will and adequate metrics, protection of frontline workers’ safety and livelihoods, ensuring an adequate pipeline with a focus on girls’ education and donor support for training and professional organizations. The fifth and final policy recommendation is a call for unified international support of rapid scale-up of cadres of delivery care workers. PMID:18581610

  3. [The development of the public health system between an increasing market orientation (commercialisation) and social responsibility].

    PubMed

    Trabert, G

    2008-02-01

    The development of the public health system between an increasing market orientation (commercialisation) and social responsibility is critically reflected by examining the medical care of those who are deprived. Poverty in Germany is dramatically increasing. There are confirmed findings on the correlation of being poor and being ill. Poverty leads to an increased number of cases of illness and a higher mortality rate. And vice versa, chronic illnesses very often cause impoverishment. This correlation has largely been ignored not only by the public but also by experts, especially when public health-care issues are on the political agenda. With reference to the current discussion about public health-care and the widespread disregard of the living conditions of the poor, the categories of "reasonable behaviour" (Kant) and "communicative behaviour" (Habermas) are reflected on in a philosophical excursion. Further interest groups affecting the political sphere, such as the pharmaceutical industry, the medical profession, patients and scientists are also examined with regard to public health-care. What are the premises of a health-care discussion that is controlled by economic considerations, particularly when keeping in mind the humanistic and Christian ethics of our society? And what does this mean for our responsibility for those who are handicapped and are in need of our help? Do decision makers and participants of the health-care discussion satisfy these ethical challenges? And what are the effects of the so-called "social peace" on social cooperation and economic power of a country? The increasing market orientation (commercialisation) of the public health sector can only be accepted on the basis of practiced humanity and social responsibility. In the light of a human public health-care, deprived people are in need of our solidarity.

  4. Real-Time Rocket/Vehicle System Integrated Health Management Laboratory For Development and Testing of Health Monitoring/Management Systems

    NASA Technical Reports Server (NTRS)

    Aguilar, R.

    2006-01-01

    Pratt & Whitney Rocketdyne has developed a real-time engine/vehicle system integrated health management laboratory, or testbed, for developing and testing health management system concepts. This laboratory simulates components of an integrated system such as the rocket engine, rocket engine controller, vehicle or test controller, as well as a health management computer on separate general purpose computers. These general purpose computers can be replaced with more realistic components such as actual electronic controllers and valve actuators for hardware-in-the-loop simulation. Various engine configurations and propellant combinations are available. Fault or failure insertion capability on-the-fly using direct memory insertion from a user console is used to test system detection and response. The laboratory is currently capable of simulating the flow-path of a single rocket engine but work is underway to include structural and multiengine simulation capability as well as a dedicated data acquisition system. The ultimate goal is to simulate as accurately and realistically as possible the environment in which the health management system will operate including noise, dynamic response of the engine/engine controller, sensor time delays, and asynchronous operation of the various components. The rationale for the laboratory is also discussed including limited alternatives for demonstrating the effectiveness and safety of a flight system.

  5. Development of a web database portfolio system with PACS connectivity for undergraduate health education and continuing professional development.

    PubMed

    Ng, Curtise K C; White, Peter; McKay, Janice C

    2009-04-01

    Increasingly, the use of web database portfolio systems is noted in medical and health education, and for continuing professional development (CPD). However, the functions of existing systems are not always aligned with the corresponding pedagogy and hence reflection is often lost. This paper presents the development of a tailored web database portfolio system with Picture Archiving and Communication System (PACS) connectivity, which is based on the portfolio pedagogy. Following a pre-determined portfolio framework, a system model with the components of web, database and mail servers, server side scripts, and a Query/Retrieve (Q/R) broker for conversion between Hypertext Transfer Protocol (HTTP) requests and Q/R service class of Digital Imaging and Communication in Medicine (DICOM) standard, is proposed. The system was piloted with seventy-seven volunteers. A tailored web database portfolio system (http://radep.hti.polyu.edu.hk) was developed. Technological arrangements for reinforcing portfolio pedagogy include popup windows (reminders) with guidelines and probing questions of 'collect', 'select' and 'reflect' on evidence of development/experience, limitation in the number of files (evidence) to be uploaded, the 'Evidence Insertion' functionality to link the individual uploaded artifacts with reflective writing, capability to accommodate diversity of contents and convenient interfaces for reviewing portfolios and communication. Evidence to date suggests the system supports users to build their portfolios with sound hypertext reflection under a facilitator's guidance, and with reviewers to monitor students' progress providing feedback and comments online in a programme-wide situation.

  6. The Canadian health care system: development, reform, and opportunities for nurses.

    PubMed

    Attenborough, R

    1997-01-01

    The Canadian health care system is a public insurance model built on the four fundamental principles of comprehensiveness, universality, portability, and public administration. Canadians are infinitely proud of the system and value it highly. Widespread fiscal concerns have placed all publicly financed programs under scrutiny, including health care. The challenge for health care planners and providers will be to improve the health status of Canadians, keep costs under control, and maintain the four principles on which the Canadian health care system was built. Nurses have many of the skills required to make a significant contribution to a reformed system. Working together and with other members of the health care team, nurses can play a pivotal role in shaping the future of health care and ensuring the health of Canadians.

  7. C-PHIS: a concept map-based knowledge base framework to develop personal health information systems.

    PubMed

    Karla, Pramukh R; Gurupur, Varadraj P

    2013-10-01

    In this paper we describe the development of a Personal Health Information System using a knowledge base developed using concept maps. Here we describe a solution for providing the critical need to develop an information capturing system that helps domain experts in developing a graphical representation of the aforementioned knowledge base which can then be converted to a machine-actable form of information. A prototype application has been developed using this information capturing system that clearly demonstrates the use of the knowledge base framework using concept maps to develop Personal Health Information System for lung cancer patients.

  8. An Evaluation Framework for EU Research and Development e-Health Projects' Systems

    NASA Astrophysics Data System (ADS)

    Mavridis, Androklis; Katriou, Stamatia-Ann; Koumpis, Adamantios

    Over the past years it has become evident that an evaluation system was necessary for the European Research and Competitive funded projects which are large and complex structures needing constant monitoring. This is especially so for e-Health projects. The race to complete assignments means that this area is usually neglected. A proposed framework for the evaluation of R & D project systems using ATAM, ISO 14598 and ISO 9126 standards is presented. The evaluation framework covers a series of steps which ensures that the offered system satisfies quality, attributes such as operability, usability and maintainability imposed by the end users. The main advantage of this step by step procedure is that faults in the architecture, software or prototype can be recognised early in the development phase and corrected more rapidly. The system has a common set of attributes against which the various project’s deliverables are assessed.

  9. Pluralist social constraints on the development of a health care system: the case of Israel.

    PubMed

    Palley, H A; Yishai, Y; Ever-Hadani, P

    1983-01-01

    The effectiveness of Israel's health care system is hindered by pluralism, in terms both of its many separate health service institutions and of the particularism of those institutions. Although the health care system provides modern health care to a widely insured population, it does so inefficiently and at unnecessary expense. The lack of vertical and horizontal integration of the health care system has led to problems of fragmentation, duplication, and lack of coordination of services. Because of its limited resources, Israel must work to surmount this pluralism and achieve integrated planning if it is to succeed in providing the efficient and cost-effective care its population needs.

  10. Strengthening health systems by health sector reforms

    PubMed Central

    Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech

    2014-01-01

    Background The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses. Methods A review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health. Findings Health sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms. Conclusions The process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems. PMID:24560261

  11. France: Health System Review.

    PubMed

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. PMID:26766545

  12. France: Health System Review.

    PubMed

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending.

  13. Austria: health system review.

    PubMed

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  14. Malta: Health system review.

    PubMed

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community.

  15. Developing a structural health monitoring system for nuclear dry cask storage canister

    NASA Astrophysics Data System (ADS)

    Sun, Xiaoyi; Lin, Bin; Bao, Jingjing; Giurgiutiu, Victor; Knight, Travis; Lam, Poh-Sang; Yu, Lingyu

    2015-03-01

    Interim storage of spent nuclear fuel from reactor sites has gained additional importance and urgency for resolving waste-management-related technical issues. In total, there are over 1482 dry cask storage system (DCSS) in use at US plants, storing 57,807 fuel assemblies. Nondestructive material condition monitoring is in urgent need and must be integrated into the fuel cycle to quantify the "state of health", and more importantly, to guarantee the safe operation of radioactive waste storage systems (RWSS) during their extended usage period. A state-of-the-art nuclear structural health monitoring (N-SHM) system based on in-situ sensing technologies that monitor material degradation and aging for nuclear spent fuel DCSS and similar structures is being developed. The N-SHM technology uses permanently installed low-profile piezoelectric wafer sensors to perform long-term health monitoring by strategically using a combined impedance (EMIS), acoustic emission (AE), and guided ultrasonic wave (GUW) approach, called "multimode sensing", which is conducted by the same network of installed sensors activated in a variety of ways. The system will detect AE events resulting from crack (case for study in this project) and evaluate the damage evolution; when significant AE is detected, the sensor network will switch to the GUW mode to perform damage localization, and quantification as well as probe "hot spots" that are prone to damage for material degradation evaluation using EMIS approach. The N-SHM is expected to eventually provide a systematic methodology for assessing and monitoring nuclear waste storage systems without incurring human radiation exposure.

  16. Evaluation of State Linkage Systems for Health Manpower Planning and Educational Resource Development. Final Report.

    ERIC Educational Resources Information Center

    Cohen, Perry D.; And Others

    This report presents the analysis and recommendations of a study which evaluated the federal demonstration program to institute linkage systems for health manpower planning in states. Following an introduction to the report, chapter 2 presents the basic concepts to define the health manpower decision system and to describe general characteristics…

  17. NASA Stennis Space Center Integrated System Health Management Test Bed and Development Capabilities

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Holland, Randy; Coote, David

    2006-01-01

    Integrated System Health Management (ISHM) is a capability that focuses on determining the condition (health) of every element in a complex System (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK)-not just data-to control systems for safe and effective operation. This capability is currently done by large teams of people, primarily from ground, but needs to be embedded on-board systems to a higher degree to enable NASA's new Exploration Mission (long term travel and stay in space), while increasing safety and decreasing life cycle costs of spacecraft (vehicles; platforms; bases or outposts; and ground test, launch, and processing operations). The topics related to this capability include: 1) ISHM Related News Articles; 2) ISHM Vision For Exploration; 3) Layers Representing How ISHM is Currently Performed; 4) ISHM Testbeds & Prototypes at NASA SSC; 5) ISHM Functional Capability Level (FCL); 6) ISHM Functional Capability Level (FCL) and Technology Readiness Level (TRL); 7) Core Elements: Capabilities Needed; 8) Core Elements; 9) Open Systems Architecture for Condition-Based Maintenance (OSA-CBM); 10) Core Elements: Architecture, taxonomy, and ontology (ATO) for DIaK management; 11) Core Elements: ATO for DIaK Management; 12) ISHM Architecture Physical Implementation; 13) Core Elements: Standards; 14) Systematic Implementation; 15) Sketch of Work Phasing; 16) Interrelationship Between Traditional Avionics Systems, Time Critical ISHM and Advanced ISHM; 17) Testbeds and On-Board ISHM; 18) Testbed Requirements: RETS AND ISS; 19) Sustainable Development and Validation Process; 20) Development of on-board ISHM; 21) Taxonomy/Ontology of Object Oriented Implementation; 22) ISHM Capability on the E1 Test Stand Hydraulic System; 23) Define Relationships to Embed Intelligence; 24) Intelligent Elements Physical and Virtual; 25) ISHM Testbeds and Prototypes at SSC Current Implementations; 26) Trailer

  18. Poland health system review.

    PubMed

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    , particularly in areas such as pharmaceuticals, are highly regressive. The health status of the Polish population has improved substantially, with average life expectancy at birth reaching 80.2 years for women and 71.6 years for men in 2009. However, there is still a vast gap in life expectancy between Poland and the western European Union (EU) countries and between life expectancy overall and the expected number of years without illness or disability. Given its modest financial, human and material health care resources and the corresponding outcomes, the overall financial efficiency of the Polish system is satisfactory. Both allocative and technical efficiency leave room for improvement. Several measures, such as prioritizing primary care and adopting new payment mechanisms such as diagnosis-related groups (DRGs), have been introduced in recent years but need to be expanded to other areas and intensified. Additionally, numerous initiatives to enhance quality control and build the required expertise and evidence base for the system are also in place. These could improve general satisfaction with the system, which is not particularly high. Limited resources, a general aversion to cost-sharing stemming from a long experience with broad public coverage and shortages in health workforce need to be addressed before better outcomes can be achieved by the system. Increased cooperation between various bodies within the health and social care sectors would also contribute in this direction. The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; they describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.

  19. Estonia: health system review.

    PubMed

    Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

    2013-01-01

    This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. PMID:24334730

  20. Switzerland: Health System Review.

    PubMed

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  1. Switzerland: Health System Review.

    PubMed

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  2. Bulgaria health system review.

    PubMed

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  3. Bulgaria health system review.

    PubMed

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  4. Psychiatric agriculture: systemic nutritional modification and mental health in the developing world.

    PubMed

    London, Douglas S; Stoll, Andrew L; Manning, Bruce B

    2006-01-01

    Modernization of agricultural systems to increase output causes changes to the nutritional content of food entire populations consume. Human nutritional needs differ from their "food", thus producing healthy agricultural products is not equivalent to providing agricultural products that are healthy for humans. Inclusion of the food production system as a factor in the increase of neuropsychiatric disorders and other chronic diseases helps explain negative trends in modern chronic diseases that remain unchecked despite stunning advances in modern medicine. Diseases in which our own technology plays a significant role include obesity and resulting disorders, such as diabetes, heart disease, hypertension, stroke and arthritis. Modernization's lure leads to importation of modern agricultural practices into a nutritionally vulnerable, malnourished and sometimes starving developing world. Wealthier nations hedge their food portfolio by having access to a wider variety of foods. The developing world's reliance on staple foods means even a minor widespread nutritional modification of one key food can have profound effects. New agricultural techniques may improve or exacerbate neuropsychiatric disorders through nutritional modification in regions where populations walk a nutritional tightrope with little margin for error. In most of the developing world western psychiatric interventions have failed to make inroads. People's consumption of fish has a demonstrated beneficial effect on their mental health and the omega-3 fatty acid content is a significant factor. Epidemiological, biological and agricultural studies implicate a lack of dietary omega-3s as a factor in certain mental disorders. Replenishing omega-3s has improved mental illnesses in controlled clinical trials. This article's detailed tilapia fish-farming model demonstrates how aquaculture/agriculture techniques can function as a public health intervention by increasing dietary omega-3s through creation of

  5. Evaluation of an Android-based mHealth system for population surveillance in developing countries

    PubMed Central

    Mbugua, Samuel; Amadi, David; Chepnǵeno, Viola; Saleem, Jason J; Anokwa, Yaw; Hartung, Carl; Borriello, Gaetano; Mamlin, Burke W; Ndege, Samson K; Were, Martin C

    2012-01-01

    Objective In parts of the developing world traditionally modeled healthcare systems do not adequately meet the needs of the populace. This can be due to imbalances in both supply and demand—there may be a lack of sufficient healthcare and the population most at need may be unable or unwilling to take advantage of it. Home-based care has emerged as a possible mechanism to bring healthcare to the populace in a cost-effective, useful manner. This study describes the development, implementation, and evaluation of a mobile device-based system to support such services. Materials and Methods Mobile phones were utilized and a structured survey was implemented to be administered by community health workers using Open Data Kit. This system was used to support screening efforts for a population of two million persons in western Kenya. Results Users of the system felt it was easy to use and facilitated their work. The system was also more cost effective than pen and paper alternatives. Discussion This implementation is one of the largest applications of a system utilizing handheld devices for performing clinical care during home visits in a resource-constrained environment. Because the data were immediately available electronically, initial reports could be performed and important trends in data could thus be detected. This allowed adjustments to the programme to be made sooner than might have otherwise been possible. Conclusion A viable, cost-effective solution at scale has been developed and implemented for collecting electronic data during household visits in a resource-constrained setting. PMID:22366295

  6. Belarus: health system review.

    PubMed

    Richardson, Erica; Malakhova, Irina; Novik, Irina; Famenka, Andrei

    2013-01-01

    This analysis of the Belarusian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2008. Despite considerable change since independence, Belarus retains a commitment to the principle of universal access to health care, provided free at the point of use through predominantly state-owned facilities, organized hierarchically on a territorial basis. Incremental change, rather than radical reform, has also been the hallmark of health-care policy, although capitation funding has been introduced in some areas and there have been consistent efforts to strengthen the role of primary care. Issues of high costs in the hospital sector and of weaknesses in public health demonstrate the necessity of moving forward with the reform programme. The focus for future reform is on strengthening preventive services and improving the quality and efficiency of specialist services. The key challenges in achieving this involve reducing excess hospital capacity, strengthening health-care management, use of evidence-based treatment and diagnostic procedures, and the development of more efficient financing mechanisms. Involving all stakeholders in the development of further reform planning and achieving consensus among them will be key to its success.

  7. [Centralized purchasing of essential drugs, a priority for the health care systems of developing countries].

    PubMed

    Blaise, P; Dujardin, B; de Béthune, X; Vandenbergh, D

    1998-01-01

    Health sector reform is a key priority of many governments throughout the world. Drug supply systems are a major element of public health policy design in Africa, where 90% of drugs are imported. The WHO Essential Drugs Program and the UNICEF sponsored Bamako Initiative have, since the late 1980s, promoted the rational use of essential drugs and attempted to ensure a sustainable drug supply through the implementation of cost recovery schemes and quality assurance mechanisms in public health services. A new market for drugs is emerging within this framework and there is growing competition for its control. Government medical stores are all too often bankrupt and the private sector is expensive, catering mainly for the middle to upper classes of urban areas. An intermediate alternative. Essential Drugs Purchasing Offices (EDPOs), has been proposed to balance social objectives and economic constraints. Some of the experimental strategies have given promising results. However, their implementation raises a number of questions: What is the role of the EDPO? Should it promote public health issues in general or focus purely on drug availability? What is the most appropriate legal status? Public or private? For profit or not? How should the investment capital be structured? In drugs or in funds? With ample provision or a tight budget? How should drug purchases be managed? Where should drugs be purchased? How much? How often? According to which procedures? How should the distribution of drugs be organized? Supplying everyone? Pushing supplies or pulling purchasers in? The answers to these questions, analysis of the reasons for success and failure and the dissemination of the information gathered should identify priorities for action and future research and define a framework for expansion. These are the objectives of the "Concerted Action for the Development of EDPO in Sub-Saharan African Countries" which is supported by the European Union (DG XII).

  8. Development and Flight Testing of an Autonomous Landing Gear Health-Monitoring System

    NASA Technical Reports Server (NTRS)

    Woodard, Stanley E.; Coffey, Neil C.; Gonzalez, Guillermo A.; Taylor, B. Douglas; Brett, Rube R.; Woodman, Keith L.; Weathered, Brenton W.; Rollins, Courtney H.

    2003-01-01

    Development and testing of an adaptable vehicle health-monitoring architecture is presented. The architecture is being developed for a fleet of vehicles. It has three operational levels: one or more remote data acquisition units located throughout the vehicle; a command and control unit located within the vehicle; and, a terminal collection unit to collect analysis results from all vehicles. Each level is capable of performing autonomous analysis with a trained expert system. Communication between all levels is done with wireless radio frequency interfaces. The remote data acquisition unit has an eight channel programmable digital interface that allows the user discretion for choosing type of sensors; number of sensors, sensor sampling rate and sampling duration for each sensor. The architecture provides framework for a tributary analysis. All measurements at the lowest operational level are reduced to provide analysis results necessary to gauge changes from established baselines. These are then collected at the next level to identify any global trends or common features from the prior level. This process is repeated until the results are reduced at the highest operational level. In the framework, only analysis results are forwarded to the next level to reduce telemetry congestion. The system's remote data acquisition hardware and non-analysis software have been flight tested on the NASA Langley B757's main landing gear. The flight tests were performed to validate the following: the wireless radio frequency communication capabilities of the system, the hardware design, command and control; software operation; and, data acquisition, storage and retrieval.

  9. Romania: Health System Review.

    PubMed

    Vladescu, Cristian; Scintee, Silvia Gabriela; Olsavszky, Victor; Hernandez-Quevedo, Cristina; Sagan, Anna

    2016-08-01

    This analysis of the Romanian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Romanian health care system is a social health insurance system that has remained highly centralized despite recent efforts to decentralize some regulatory functions. It provides a comprehensive benefits package to the 85% of the population that is covered, with the remaining population having access to a minimum package of benefits. While every insured person has access to the same health care benefits regardless of their socioeconomic situation, there are inequities in access to health care across many dimensions, such as rural versus urban, and health outcomes also differ across these dimensions. The Romanian population has seen increasing life expectancy and declining mortality rates but both remain among the worst in the European Union. Some unfavourable trends have been observed, including increasing numbers of new HIV/AIDS diagnoses and falling immunization rates. Public sources account for over 80% of total health financing. However, that leaves considerable out-of-pocket payments covering almost a fifth of total expenditure. The share of informal payments also seems to be substantial, but precise figures are unknown. In 2014, Romania had the lowest health expenditure as a share of gross domestic product (GDP) among the EU Member States. In line with the government's objective of strengthening the role of primary care, the total number of hospital beds has been decreasing. However, health care provision remains characterized by underprovision of primary and community care and inappropriate use of inpatient and specialized outpatient care, including care in hospital emergency departments. The numbers of physicians and nurses are relatively low in Romania compared to EU averages. This has mainly been attributed to the high rates of workers emigrating abroad over the

  10. Netherlands: Health System Review.

    PubMed

    Kroneman, Madelon; Boerma, Wienke; van den Berg, Michael; Groenewegen, Peter; de Jong, Judith; van Ginneken, Ewout

    2016-03-01

    This analysis of the Dutch health system reviews recent developments in organization and governance, health financing, healthcare provision, health reforms and health system performance. Without doubt, two major reforms implemented since the mid-2000s are among the main issues today. The newly implemented long-term care reform will have to realize a transition from publicly provided care to more self-reliance on the part of the citizens and a larger role for municipalities in its organization. A particular point of attention is how the new governance arrangements and responsibilities in long-term care will work together. The 2006 reform replaced the division between public and private insurance by one universal social health insurance and introduced managed competition as a driving mechanism in the healthcare system. Although the reform was initiated almost a decade ago, its stepwise implementation continues to bring changes in the healthcare system in general and in the role of actors in particular. In terms of performance, essential healthcare services are within easy reach and waiting times have been decreasing. The basic health insurance package and compensations for lower incomes protect citizens against catastrophic spending. Out-of-pocket payments are low from an international perspective. Moreover, the Dutch rate the quality of the health system and their health as good. International comparisons show that the Netherlands has low antibiotic use, a low number of avoidable hospitalizations and a relatively low avoidable mortality. National studies show that healthcare has made major contributions to the health of the Dutch population as reflected in increasing life expectancy. Furthermore, some indicators such as the prescription of generics and length of stay reveal improvements in efficiency over the past years. Nevertheless, the Netherlands still has one of the highest per capita health expenditures in Europe, although growth has slowed considerably after

  11. France: Health system review.

    PubMed

    Chevreul, Karine; Durand-Zaleski, Isabelle; Bahrami, Stéphane Bahrami; Hernández-Quevedo, Cristina; Mladovsky, Philipa

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The French health care system is a mix of public and private providers and insurers. Public insurance, financed by both employees and employer contributions and earmarked taxes, is compulsory and covers almost the whole population, while private insurance is of a complementary type and voluntary. Providers of outpatient care are largely private. Hospital beds are predominantly public or private non-profit-making. The French population enjoys good health and a high level of choice of providers. It is relatively satisfied with the health care system. However, as in many other countries, the rising cost of health care is of concern with regards to the objectives of the health care system. Many measures were or are being implemented in order to contain costs and increase efficiency. These include, for example, developing pay-for-performance for both hospitals and self-employed providers and increasing quality of professional practice; refining patient pathways; raising additional revenue for statutory health insurance (SHI); and increasing the role of voluntary health insurance (VHI). Meanwhile, socioeconomic disparities and geographic inequality in the density of health care professionals remain considerable challenges to providing a good level of equity in access to health care. Organizational changes at the regional level are important in attempting to tackle both equity and efficiency-related challenges. While the organizational structure of the system

  12. France: Health system review.

    PubMed

    Chevreul, Karine; Durand-Zaleski, Isabelle; Bahrami, Stéphane Bahrami; Hernández-Quevedo, Cristina; Mladovsky, Philipa

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The French health care system is a mix of public and private providers and insurers. Public insurance, financed by both employees and employer contributions and earmarked taxes, is compulsory and covers almost the whole population, while private insurance is of a complementary type and voluntary. Providers of outpatient care are largely private. Hospital beds are predominantly public or private non-profit-making. The French population enjoys good health and a high level of choice of providers. It is relatively satisfied with the health care system. However, as in many other countries, the rising cost of health care is of concern with regards to the objectives of the health care system. Many measures were or are being implemented in order to contain costs and increase efficiency. These include, for example, developing pay-for-performance for both hospitals and self-employed providers and increasing quality of professional practice; refining patient pathways; raising additional revenue for statutory health insurance (SHI); and increasing the role of voluntary health insurance (VHI). Meanwhile, socioeconomic disparities and geographic inequality in the density of health care professionals remain considerable challenges to providing a good level of equity in access to health care. Organizational changes at the regional level are important in attempting to tackle both equity and efficiency-related challenges. While the organizational structure of the system

  13. Hungary health system review.

    PubMed

    Gaal, Peter; Szigeti, Szabolcs; Csere, Marton; Gaskins, Matthew; Panteli, Dimitra

    2011-01-01

    diversified over the past 15 years, but the current mix has yet to be tested for sustainability. The fit between existing capacities and the health care needs of the population remains less than ideal, but improvements have been made over the past 15 years. In general, the average length of stay and hospital admission rates have decreased since 1990, as have bed occupancy rates. However, capacity for long-term nursing care in both the inpatient and outpatient setting is still considered insufficient. Hungary is currently also facing a health workforce crisis, explained by the fact that it is a net donor country with regard to health care worker migration, and health care professionals on the whole are ageing. Although the overall technical efficiency of the system has increased considerably, mainly due to the introduction of output-based payment systems, allocative efficiency remains a problem. Considerable variations exist in service delivery both geographically and by specialization, and equity of access is far from being realized, a fact which is mirrored in differing health outcomes for different population groups. A key problem is the continuing lack of an overarching, evidence-based strategy for mobilizing resources for health, which leaves the health system vulnerable to broader economic policy objectives and makes good governance hard to achieve. On the other hand, Hungary is a target country for cross-border health care, mainly for dental care but also for rehabilitative services, such as medical spa treatment. The health industry can thus be a potential strategic area for economic development and growth. PMID:22394651

  14. Hungary health system review.

    PubMed

    Gaal, Peter; Szigeti, Szabolcs; Csere, Marton; Gaskins, Matthew; Panteli, Dimitra

    2011-01-01

    diversified over the past 15 years, but the current mix has yet to be tested for sustainability. The fit between existing capacities and the health care needs of the population remains less than ideal, but improvements have been made over the past 15 years. In general, the average length of stay and hospital admission rates have decreased since 1990, as have bed occupancy rates. However, capacity for long-term nursing care in both the inpatient and outpatient setting is still considered insufficient. Hungary is currently also facing a health workforce crisis, explained by the fact that it is a net donor country with regard to health care worker migration, and health care professionals on the whole are ageing. Although the overall technical efficiency of the system has increased considerably, mainly due to the introduction of output-based payment systems, allocative efficiency remains a problem. Considerable variations exist in service delivery both geographically and by specialization, and equity of access is far from being realized, a fact which is mirrored in differing health outcomes for different population groups. A key problem is the continuing lack of an overarching, evidence-based strategy for mobilizing resources for health, which leaves the health system vulnerable to broader economic policy objectives and makes good governance hard to achieve. On the other hand, Hungary is a target country for cross-border health care, mainly for dental care but also for rehabilitative services, such as medical spa treatment. The health industry can thus be a potential strategic area for economic development and growth.

  15. [Health system of Vietnam].

    PubMed

    Matsuda, S

    1994-01-01

    Vietnam's health system consists of four levels: national, provincial/special city, prefecture/ward, and basic unit of town or village. Health care is managed by the Health Department at the national level and by the health and welfare section of the People's Committee at all other levels. Actual medical services are provided by the National Central Hospital at the national level, by general hospitals at the provincial/special city level, by general hospitals and multi-purpose health clinics at the prefecture/ward level, and by health stations at the basic unit level. Health services provide not only doctors, nurses, and pharmacists, but also paramedical staff, especially at the basic unit level. Just as with other developing countries, infectious diseases are the most important priorities in health/medical care policies; especially malaria, which is the number one priority followed by diarrhea. Because of well-established health stations at the basic unit level throughout the country and a relatively sufficient supply of medication, the mortality rate due to the above is low. The maternal/infant health care index of 1988 shows the following: low birth weight (14%); maternal mortality (1.4/1000); neonatal mortality (33.5/1000); and perinatal mortality (22.5/1000). Malnutrition of children under 3 years of age in farming areas, insufficient supply of drinking water, and lack of industrial health insurance are some of the problems yet to be solved. It is hoped that medical services can be a significant part of the comprehensive economic development program within the framework of Japan's international cooperation/assistance.

  16. Spain: Health system review.

    PubMed

    García-Armesto, Sandra; Begoña Abadía-Taira, María; Durán, Antonio; Hernández-Quevedo, Cristina; Bernal-Delgado, Enrique

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. This edition of the Spanish HiT focuses on the consequences of the totally devolved status, consolidated in 2002, and the implementation of the road map established by the 2003 SNS Cohesion and Quality Act. Many of the steps already taken underline the improvement path chosen: the SNS Inter-territorial Council (CISNS) comprising the national and regional health ministries was upgraded to the highest SNS authority, paving the way for a brand new consensus-based policy-making process grounded in knowledge management; its effects are progressively starting to be evident. It led the way to the SNS common benefits basket or the SNS human resources policy framework, laying the cornerstones for coordination and the enactment of the SNS Quality Plan. The Plan includes the work in progress to implement the national health information system, the development of a single electronic clinical record (eCR) containing relevant clinical information guaranteeing to patients continuity of care outside their Autonomous Community (AC) of residence or a single patient ID to be used across the country, thus creating the basis for the SNS functional single insurer. It has also become one of the main drivers for the design, implementation and monitoring of quality standards across the SNS, developing national health strategies to tackle both most prevalent chronic diseases (e.g. cancer, cardiovascular diseases, diabetes) and rare diseases, as well as the National Strategy on

  17. Greece: Health system review.

    PubMed

    Economou, Charalambos

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

  18. Environmental assessment for the Satellite Power System concept development and evaluation program: Nonmicrowave health and ecological effects

    NASA Astrophysics Data System (ADS)

    White, M. R.

    1980-11-01

    A preliminary reference system was developed. The assessment is summarized as to scope, methodology, impacts of terrestrial development, launch and recovery of spacecraft, space activities (including health effects of the space environment, ionizing radiation, electromagnetic exposure, spacecraft charging and environmental interactions, occupational hazards, etc.) and construction and operation of rectenna (ground receiving station).

  19. [Mystic, science, and politics in the development of health systems. The experience of Chile].

    PubMed

    Jiménez de la Jara, J

    2001-01-01

    The combination of inspiration, science, and politics is a cornerstone precept for the common good of humanity, towards the fulfillment of social objectives. Based on this precept, this paper reviews core experiences of the Chilean Health Sector. Health sector key events taking place during the first half of the 20th century were the creation of the National Health Service and the development of mother and child healthcare policies. After the earthquake of 1939, the future President of Chile, Doctor Salvador Allende, set up the Special Sanitation Council, to balance policies. Also, he launched the Social Security reform process, which endured financing restrictions and the animosity of physicians opposing the socialization of medical care. In 1951 the reform was approved, to extend coverage to blue collar workers and their families; separate health provision from healthcare security; emphasize preventive pediatric care in mother's health, and reproductive health. The basic tenets of healthcare reform were the right to health, solidarity, and equity, as the pillars of policy-making and healthcare programming. The question of whether the evolution of social security in Chile has been consistent with the original healthcare reform tenets is raised by the author.

  20. [Mystic, science, and politics in the development of health systems. The experience of Chile].

    PubMed

    Jiménez de la Jara, J

    2001-01-01

    The combination of inspiration, science, and politics is a cornerstone precept for the common good of humanity, towards the fulfillment of social objectives. Based on this precept, this paper reviews core experiences of the Chilean Health Sector. Health sector key events taking place during the first half of the 20th century were the creation of the National Health Service and the development of mother and child healthcare policies. After the earthquake of 1939, the future President of Chile, Doctor Salvador Allende, set up the Special Sanitation Council, to balance policies. Also, he launched the Social Security reform process, which endured financing restrictions and the animosity of physicians opposing the socialization of medical care. In 1951 the reform was approved, to extend coverage to blue collar workers and their families; separate health provision from healthcare security; emphasize preventive pediatric care in mother's health, and reproductive health. The basic tenets of healthcare reform were the right to health, solidarity, and equity, as the pillars of policy-making and healthcare programming. The question of whether the evolution of social security in Chile has been consistent with the original healthcare reform tenets is raised by the author. PMID:11763696

  1. Environmental assessment for the satellite power system concept development and evaluation program: nonmicrowave health and ecological effects

    SciTech Connect

    White, M R

    1980-11-01

    A Concept Development and Evaluation Program is being carried out for a proposed Satellite Power System (SPS). For purposes of this evaluation, a preliminary reference system has been developed. SPS, as described in the reference system, would collect solar energy on satellites in geosychronous orbit in space. The energy would be converted to microwaves and beamed to an earth-receiving antenna (rectenna). One task in the environmental part of the program is the assessment of the nonmicrowave effects on health and the environment. These effects would result from all phases of SPS development and operation. This report covers the current knowledge regarding these effects, and is based on the reference system. The assessment is summarized as to scope, methodology, impacts of terrestrial development, launch and recovery of spacecraft, space activities (including health effects of the space environment, ionizing radiation, electromagnetic exposure, spacecraft charging and environmental interactions, occupational hazards, etc.) and construction and operation of rectenna (ground receiving station).

  2. Wearable Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Bell, John

    2015-01-01

    The shrinking size and weight of electronic circuitry has given rise to a new generation of smart clothing that enables biological data to be measured and transmitted. As the variation in the number and type of deployable devices and sensors increases, technology must allow their seamless integration so they can be electrically powered, operated, and recharged over a digital pathway. Nyx Illuminated Clothing Company has developed a lightweight health monitoring system that integrates medical sensors, electrodes, electrical connections, circuits, and a power supply into a single wearable assembly. The system is comfortable, bendable in three dimensions, durable, waterproof, and washable. The innovation will allow astronaut health monitoring in a variety of real-time scenarios, with data stored in digital memory for later use in a medical database. Potential commercial uses are numerous, as the technology enables medical personnel to noninvasively monitor patient vital signs in a multitude of health care settings and applications.

  3. A data capture system for outcomes studies that integrates with electronic health records: development and potential uses.

    PubMed

    Yamamoto, Keiichi; Matsumoto, Shigemi; Tada, Harue; Yanagihara, Kazuhiro; Teramukai, Satoshi; Takemura, Tadamasa; Fukushima, Masanori

    2008-10-01

    In conventional clinical studies, the costs of data management for quality control tend to be high and collecting paper-based case report forms (CRFs) tends to be burdensome, because paper-based CRFs must be developed and filled out for each clinical study protocol. Use of electronic health records for this purpose could result in reductions in cost and improvements in data quality in clinical studies. The purpose of this study was to develop a data capture system for observational cancer clinical studies (i.e. outcomes studies) that would integrate with an electronic health records system, to enable evaluation of patient prognosis, prognostic factors, outcomes and drug safety. At the Outpatient Oncology Unit of Kyoto University Hospital, we developed a data capture system that includes a cancer clinical database system and a data warehouse for outcomes studies. We expect that our new system will reduce the costs of data management and analysis and improve the quality of data in clinical studies.

  4. Design and Development of a Linked Open Data-Based Health Information Representation and Visualization System: Potentials and Preliminary Evaluation

    PubMed Central

    Kauppinen, Tomi; Keßler, Carsten; Fritz, Fleur

    2014-01-01

    Background Healthcare organizations around the world are challenged by pressures to reduce cost, improve coordination and outcome, and provide more with less. This requires effective planning and evidence-based practice by generating important information from available data. Thus, flexible and user-friendly ways to represent, query, and visualize health data becomes increasingly important. International organizations such as the World Health Organization (WHO) regularly publish vital data on priority health topics that can be utilized for public health policy and health service development. However, the data in most portals is displayed in either Excel or PDF formats, which makes information discovery and reuse difficult. Linked Open Data (LOD)—a new Semantic Web set of best practice of standards to publish and link heterogeneous data—can be applied to the representation and management of public level health data to alleviate such challenges. However, the technologies behind building LOD systems and their effectiveness for health data are yet to be assessed. Objective The objective of this study is to evaluate whether Linked Data technologies are potential options for health information representation, visualization, and retrieval systems development and to identify the available tools and methodologies to build Linked Data-based health information systems. Methods We used the Resource Description Framework (RDF) for data representation, Fuseki triple store for data storage, and Sgvizler for information visualization. Additionally, we integrated SPARQL query interface for interacting with the data. We primarily use the WHO health observatory dataset to test the system. All the data were represented using RDF and interlinked with other related datasets on the Web of Data using Silk—a link discovery framework for Web of Data. A preliminary usability assessment was conducted following the System Usability Scale (SUS) method. Results We developed an LOD

  5. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems

    PubMed Central

    Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher B.; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; Neale, Donna

    2015-01-01

    Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings. PMID:25992387

  6. Development of a structural health monitoring system for the life assessment of critical transportation infrastructure.

    SciTech Connect

    Roach, Dennis Patrick; Jauregui, David Villegas; Daumueller, Andrew Nicholas

    2012-02-01

    Recent structural failures such as the I-35W Mississippi River Bridge in Minnesota have underscored the urgent need for improved methods and procedures for evaluating our aging transportation infrastructure. This research seeks to develop a basis for a Structural Health Monitoring (SHM) system to provide quantitative information related to the structural integrity of metallic structures to make appropriate management decisions and ensuring public safety. This research employs advanced structural analysis and nondestructive testing (NDT) methods for an accurate fatigue analysis. Metal railroad bridges in New Mexico will be the focus since many of these structures are over 100 years old and classified as fracture-critical. The term fracture-critical indicates that failure of a single component may result in complete collapse of the structure such as the one experienced by the I-35W Bridge. Failure may originate from sources such as loss of section due to corrosion or cracking caused by fatigue loading. Because standard inspection practice is primarily visual, these types of defects can go undetected due to oversight, lack of access to critical areas, or, in riveted members, hidden defects that are beneath fasteners or connection angles. Another issue is that it is difficult to determine the fatigue damage that a structure has experienced and the rate at which damage is accumulating due to uncertain history and load distribution in supporting members. A SHM system has several advantages that can overcome these limitations. SHM allows critical areas of the structure to be monitored more quantitatively under actual loading. The research needed to apply SHM to metallic structures was performed and a case study was carried out to show the potential of SHM-driven fatigue evaluation to assess the condition of critical transportation infrastructure and to guide inspectors to potential problem areas. This project combines the expertise in transportation infrastructure at New

  7. Systems identification and application systems development for monitoring the physiological and health status of crewmen in space

    NASA Technical Reports Server (NTRS)

    Leonard, J. I.; Furukawa, S.; Vannordstrand, P. C.

    1975-01-01

    The use of automated, analytical techniques to aid medical support teams is suggested. Recommendations are presented for characterizing crew health in terms of: (1) wholebody function including physiological, psychological and performance factors; (2) a combination of critical performance indexes which consist of multiple factors of measurable parameters; (3) specific responses to low noise level stress tests; and (4) probabilities of future performance based on present and periodic examination of past performance. A concept is proposed for a computerized real time biomedical monitoring and health care system that would have the capability to integrate monitored data, detect off-nominal conditions based on current knowledge of spaceflight responses, predict future health status, and assist in diagnosis and alternative therapies. Mathematical models could play an important role in this approach, especially when operating in a real time mode. Recommendations are presented to update the present health monitoring systems in terms of recent advances in computer technology and biomedical monitoring systems.

  8. Henry Ford Health Systems

    Cancer.gov

    Henry Ford Health Systems evolved from a hospital into a system delivering care to 2.5 million patients and includes the Cancer Epidemiology, Prevention and Control Program, which focuses on epidemiologic and public health aspects of cancer.

  9. Health information technology and sociotechnical systems: a progress report on recent developments within the UK National Health Service (NHS).

    PubMed

    Waterson, Patrick

    2014-03-01

    This paper summarises some of the research that Ken Eason and colleagues at Loughborough University have carried out in the last few years on the introduction of Health Information Technologies (HIT) within the UK National Health Service (NHS). In particular, the paper focuses on three examples which illustrate aspects of the introduction of HIT within the NHS and the role played by the UK National Programme for Information Technology (NPfIT). The studies focus on stages of planning and preparation, implementation and use, adaptation and evolution of HIT (e.g., electronic patient records, virtual wards) within primary, secondary and community care settings. Our findings point to a number of common themes which characterise the use of these systems. These include tensions between national and local strategies for implementing HIT and poor fit between healthcare work systems and the design of HIT. The findings are discussed in the light of other large-scale, national attempts to introduce similar technologies, as well as drawing out a set of wider lessons learnt from the NPfIT programme based on Ken Eason's earlier work and other research on the implementation of large-scale HIT.

  10. Enhancing leadership and governance competencies to strengthen health systems in Nigeria: assessment of organizational human resources development.

    PubMed

    Uneke, Chigozie J; Ezeoha, Abel E; Ndukwe, Chinwendu D; Oyibo, Patrick G; Onwe, Fri Day

    2012-02-01

    The lack of effective leadership and governance in the health sector has remained a major challenge in Nigeria and contributes to the failure of health systems and poor development of human resources. In this cross-sectional intervention study, leadership and governance competencies of policy makers were enhanced through a training workshop, and an assessment was conducted of organizational activities designed to promote evidence-informed leadership and governance to improve human resources for health (HRH). The training workshop increased the understanding of policy makers with regard to leadership and governance factors that ensure the functionality of health systems and improve human resources development, including policy guidance, intelligence and oversight, collaboration and coalition building, regulation, system design and accountability. Findings indicated that systems for human resources development exist in all participants' organizations, but the functionality of these systems was suboptimal. More systematic and standardized processes are required to improve competencies of leadership and governance for better human resources development in low-income settings.

  11. Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies

    PubMed Central

    Sahar, Liora; Faler, Guy; Hristov, Emil; Hughes, Susan; Lee, Leslie; Westnedge, Caroline; Erickson, Benjamin; Nichols, Barbara

    2015-01-01

    Objective To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). Materials and Methods The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a “user-centered design approach.” A survey was completed to assess functionality and user satisfaction. Results IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. Discussion A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. Conclusion IMATS satisfies the need for a system for monitoring and reporting health departments’ countermeasure quantities so that decision makers are better informed. The “user-centered design approach” was successful, as evident by the many public health departments that adopted IMATS. PMID:26392843

  12. Development of portable health monitoring system for automatic self-blood glucose measurement

    NASA Astrophysics Data System (ADS)

    Kim, Huijun; Mizuno, Yoshihumi; Nakamachi, Eiji; Morita, Yusuke

    2010-02-01

    In this study, a new HMS (Health Monitoring System) device is developed for diabetic patient. This device mainly consists of I) 3D blood vessel searching unit and II) automatic blood glucose measurement (ABGM) unit. This device has features such as 1)3D blood vessel location search 2) laptop type, 3) puncturing a blood vessel by using a minimally invasive micro-needle, 4) very little blood sampling (10μl), and 5) automatic blood extraction and blood glucose measurement. In this study, ABGM unit is described in detail. It employs a syringe type's blood extraction mechanism because of its high accuracy. And it consists of the syringe component and the driving component. The syringe component consists of a syringe itself, a piston, a magnet, a ratchet and a micro-needle whose inner diameter is about 80μm. And the syringe component is disposable. The driving component consists of body parts, a linear stepping motor, a glucose enzyme sensor and a slider for accurate positioning control. The driving component has the all-in-one mechanism with a glucose enzyme sensor for compact size and stable blood transfer. On designing, required thrust force to drive the slider is designed to be greater than the value of the blood extraction force. Further, only one linear stepping motor is employed for blood extraction and transportation processes. The experimental result showed more than 80% of volume ratio under the piston speed 2.4mm/s. Further, the blood glucose was measured successfully by using the prototype unit. Finally, the availability of our ABGM unit was confirmed.

  13. Inductive System Health Monitoring

    NASA Technical Reports Server (NTRS)

    Iverson, David L.

    2004-01-01

    The Inductive Monitoring System (IMS) software was developed to provide a technique to automatically produce health monitoring knowledge bases for systems that are either difficult to model (simulate) with a computer or which require computer models that are too complex to use for real time monitoring. IMS uses nominal data sets collected either directly from the system or from simulations to build a knowledge base that can be used to detect anomalous behavior in the system. Machine learning and data mining techniques are used to characterize typical system behavior by extracting general classes of nominal data from archived data sets. IMS is able to monitor the system by comparing real time operational data with these classes. We present a description of learning and monitoring method used by IMS and summarize some recent IMS results.

  14. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems

    PubMed Central

    Blanchet, Karl

    2015-01-01

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. PMID:25905481

  15. Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

    PubMed

    Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

    2016-04-01

    Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs. PMID:27011157

  16. [Health promotion. Concept development].

    PubMed

    Sito, A; Berkowska, M

    2000-01-01

    The development of health promotion in theory and practice is presented-from the Ottawa Charter in 1986, to the community based health promotion programmes, as the vision for the 21 Century. The historical mile stones in the process of change and the conceptualisation of health promotion are discussed with reference to the World WHO Conferences and documents from these conferences. These events and documents have been vital as guidelines for member countries, both for implementation of community based programmes, as well as for healthy public policy and for training, especially concerning evaluation. The paper also discusses the main trends in research; definitions of principal concepts are highlighted, concerning planning, implementation and evaluation of health promotion programmes.

  17. Developing a service platform definition to promote evidence-based planning and funding of the mental health service system.

    PubMed

    Lee, Yong Yi; Meurk, Carla S; Harris, Meredith G; Diminic, Sandra; Scheurer, Roman W; Whiteford, Harvey A

    2014-11-26

    Ensuring that a mental health system provides 'value for money' requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The 'service platform' is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required.

  18. Development of an Information Fusion System for Engine Diagnostics and Health Management

    NASA Technical Reports Server (NTRS)

    Volponi, Allan J.; Brotherton, Tom; Luppold, Robert; Simon, Donald L.

    2004-01-01

    Aircraft gas-turbine engine data are available from a variety of sources including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data Fusion is the integration of data or information from multiple sources, to achieve improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This paper describes a basic PHM Data Fusion architecture being developed in alignment with the NASA C17 Propulsion Health Management (PHM) Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center (GRC), NASA Dryden Flight Research Center (DFRC) and Pratt & Whitney (P&W) have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion as applied to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This paper will provide a broad overview of this work, discuss some of the methodologies employed and give some illustrative examples.

  19. Simulation tools for developing policies for complex systems: modeling the health and safety of refugee communities.

    PubMed

    Anderson, James; Chaturvedi, Alok; Cibulskis, Mike

    2007-12-01

    The U.S. Committee for Refugees and Immigrants estimated that there were over 33 million refugees and internally displaced persons (IDPs) in the world at the beginning of 2005. IDP/Refugee communities behave in complex ways making it difficult to make policy decisions regarding the provision of humanitarian aid and health and safety. This paper reports the construction of an agent-based model that has been used to study humanitarian assistance policies executed by governments and NGOs that provide for the health and safety of refugee communities. Agent-based modeling (ABM) was chosen because the more widely used alternatives impose unrealistic restrictions and assumptions on the system being modeled and primarily apply to aggregate data. We created intelligent agents representing institutions, organizations, individuals, infrastructure, and governments and analyzed the resulting interactions and emergent behavior using a Central Composite Design of Experiments with five factors. The resulting model allows policy makers and analysts to create scenarios, to make rapid changes in parameters, and provides a test bed for concepts and strategies. Policies can be examined to see how refugee communities might respond to alternative courses of action and how these actions are likely to affect the health and well-being of the community.

  20. Croatia: health system review.

    PubMed

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    of the MHI scheme are broad, patients must pay towards the costs of many goods and services, and the right to free health care services has been systematically reduced since 2003, although with exemptions for vulnerable population groups. Configuration of capital and human resources in the health care sector could be improved: for example, homes for the elderly and infirm persons operate close to maximum capacity; psychiatric care in the community is not well developed; and there are shortages of certain categories of medical professionals, including geographical imbalances. Little research is available on the policy process of health care reforms in Croatia. However, it seems that reforms often lack strategic foundations and or projections that could be analysed and scrutinized by the public, and evaluation of reform outcomes is lacking. The overall performance of the health care system seems to be good, given the amount of resources available. However, there is a lack of data to assess it properly. PMID:25115139

  1. Croatia: health system review.

    PubMed

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    of the MHI scheme are broad, patients must pay towards the costs of many goods and services, and the right to free health care services has been systematically reduced since 2003, although with exemptions for vulnerable population groups. Configuration of capital and human resources in the health care sector could be improved: for example, homes for the elderly and infirm persons operate close to maximum capacity; psychiatric care in the community is not well developed; and there are shortages of certain categories of medical professionals, including geographical imbalances. Little research is available on the policy process of health care reforms in Croatia. However, it seems that reforms often lack strategic foundations and or projections that could be analysed and scrutinized by the public, and evaluation of reform outcomes is lacking. The overall performance of the health care system seems to be good, given the amount of resources available. However, there is a lack of data to assess it properly.

  2. A Web-Based, Hospital-Wide Health Care-Associated Bloodstream Infection Surveillance and Classification System: Development and Evaluation

    PubMed Central

    Tseng, Yi-Ju; Wu, Jung-Hsuan; Lin, Hui-Chi; Chen, Ming-Yuan; Ping, Xiao-Ou; Sun, Chun-Chuan; Shang, Rung-Ji; Sheng, Wang-Huei; Lai, Feipei; Chang, Shan-Chwen

    2015-01-01

    Background Surveillance of health care-associated infections is an essential component of infection prevention programs, but conventional systems are labor intensive and performance dependent. Objective To develop an automatic surveillance and classification system for health care-associated bloodstream infection (HABSI), and to evaluate its performance by comparing it with a conventional infection control personnel (ICP)-based surveillance system. Methods We developed a Web-based system that was integrated into the medical information system of a 2200-bed teaching hospital in Taiwan. The system automatically detects and classifies HABSIs. Results In this study, the number of computer-detected HABSIs correlated closely with the number of HABSIs detected by ICP by department (n=20; r=.999 P<.001) and by time (n=14; r=.941; P<.001). Compared with reference standards, this system performed excellently with regard to sensitivity (98.16%), specificity (99.96%), positive predictive value (95.81%), and negative predictive value (99.98%). The system enabled decreasing the delay in confirmation of HABSI cases, on average, by 29 days. Conclusions This system provides reliable and objective HABSI data for quality indicators, improving the delay caused by a conventional surveillance system. PMID:26392229

  3. United Kingdom: Health System Review.

    PubMed

    Cylus, Jonathan; Richardson, Erica; Findley, Lisa; Longley, Marcus; O'Neill, Ciaran; Steel, David

    2015-01-01

    This analysis of the United Kingdom health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. It provides an overview of how the national health services operate in the four nations that make up the United Kingdom, as responsibility for organizing health financing and services was devolved from 1997. With devolution, the health systems in the United Kingdom have diverged in the details of how services are organized and paid for, but all have maintained national health services which provide universal access to a comprehensive package of services that are mostly free at the point of use. These health services are predominantly financed from general taxation and 83.5% of total health expenditure in the United Kingdom came from public sources in 2013. Life expectancy has increased steadily across the United Kingdom, but health inequalities have proved stubbornly resistant to improvement, and the gap between the most deprived and the most privileged continues to widen, rather than close. The United Kingdom faces challenges going forward, including how to cope with the needs of an ageing population, how to manage populations with poor health behaviours and associated chronic conditions, how to meet patient expectations of access to the latest available medicines and technologies, and how to adapt a system that has limited resources to expand its workforce and infrastructural capacity so it can rise to these challenges.

  4. Fetal Health and Development

    MedlinePlus

    ... specific prenatal tests to monitor both the mother's health and fetal health during each trimester. With modern technology, health professionals can Detect birth defects Identify problems that ...

  5. Development and Deployment of the Computer Assisted Neighborhood Visual Assessment System (CANVAS) to Measure Health-Related Neighborhood Conditions

    PubMed Central

    Bader, Michael D. M.; Mooney, Stephen J.; Lee, Yeon Jin; Sheehan, Daniel; Neckerman, Kathryn M.; Rundle, Andrew G.; Teitler, Julien O.

    2014-01-01

    Public health research has shown that neighborhood conditions are associated with health behaviors and outcomes. Systematic neighborhood audits have helped researchers measure neighborhood conditions that they deem theoretically relevant but not available in existing administrative data. Systematic audits, however, are expensive to conduct and rarely comparable across geographic regions. We describe the development of an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of neighborhood environments. We use this system to assess the inter-rater reliability of 187 items related to walkability and physical disorder on a national sample of 150 street segments in the United States. We find that many items are reliably measured across auditors using CANVAS and that agreement between auditors appears to be uncorrelated with neighborhood demographic characteristics. Based on our results we conclude that Google Street View and CANVAS offer opportunities to develop greater comparability across neighborhood audit studies. PMID:25545769

  6. Development and deployment of the Computer Assisted Neighborhood Visual Assessment System (CANVAS) to measure health-related neighborhood conditions.

    PubMed

    Bader, Michael D M; Mooney, Stephen J; Lee, Yeon Jin; Sheehan, Daniel; Neckerman, Kathryn M; Rundle, Andrew G; Teitler, Julien O

    2015-01-01

    Public health research has shown that neighborhood conditions are associated with health behaviors and outcomes. Systematic neighborhood audits have helped researchers measure neighborhood conditions that they deem theoretically relevant but not available in existing administrative data. Systematic audits, however, are expensive to conduct and rarely comparable across geographic regions. We describe the development of an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of neighborhood environments. We use this system to assess the inter-rater reliability of 187 items related to walkability and physical disorder on a national sample of 150 street segments in the United States. We find that many items are reliably measured across auditors using CANVAS and that agreement between auditors appears to be uncorrelated with neighborhood demographic characteristics. Based on our results we conclude that Google Street View and CANVAS offer opportunities to develop greater comparability across neighborhood audit studies. PMID:25545769

  7. Development of a Corrosion Sensor for AN Aircraft Vehicle Health Monitoring System

    NASA Astrophysics Data System (ADS)

    Scott, D. A.; Price, D. C.; Edwards, G. C.; Batten, A. B.; Kolmeder, J.; Muster, T. H.; Corrigan, P.; Cole, I. S.

    2010-02-01

    A Rayleigh-wave-based sensor has been developed to measure corrosion damage in aircraft. This sensor forms an important part of a corrosion monitoring system being developed for a major aircraft manufacturer. This system measures the corrosion rate at the location of its sensors, and through a model predicts the corrosion rates in nearby places on an aircraft into which no sensors can be placed. In order to calibrate this model, which yields corrosion rates rather than the accumulated effect, an absolute measure of the damage is required. In this paper the development of a surface wave sensor capable of measuring accumulated damage will be described in detail. This sensor allows the system to measure material loss due to corrosion regardless of the possible loss of historical corrosion rate data, and can provide, at any stage, a benchmark for the predictive model that would allow a good estimate of the accumulated corrosion damage in similar locations on an aircraft. This system may obviate the need for costly inspection of difficult-to-access places in aircraft, where presently the only way to check for corrosion is by periodic dismantling and reassembly.

  8. Tajikistan: Health System Review.

    PubMed

    Khodjamurodov, Ghafur; Sodiqova, Dilorom; Akkazieva, Baktygul; Rechel, Bernd

    2016-01-01

    The pace of health reforms in Tajikistan has been slow and in many aspects the health system is still shaped by the countrys Soviet legacy. The country has the lowest total health expenditure per capita in the WHO European Region, much of it financed privately through out-of-pocket payments. Public financing depends principally on regional and local authorities, thus compounding regional inequalities across the country. The high share of private out-of-pocket payments undermines a range of health system goals, including financial protection, equity, efficiency and quality. The efficiency of the health system is also undermined by outdated provider payment mechanisms and lack of pooling of funds. Quality of care is another major concern, due to factors such as insufficient training, lack of evidence-based clinical guidelines, underuse of generic drugs, poor infrastructure and equipment (particularly at the regional level) and perverse financial incentives for physicians in the form of out-of-pocket payments. Health reforms have aimed to strengthen primary health care, but it still suffers from underinvestment and low prestige. A basic benefit package and capitation-based financing of primary health care have been introduced as pilots but have not yet been rolled out to the rest of the country. The National Health Strategy envisages substantial reforms in health financing, including nationwide introduction of capitation-based payments for primary health care and more than doubling public expenditure on health by 2020; it remains to be seen whether this will be achieved. PMID:27172509

  9. Health, globalization and developing countries.

    PubMed

    Cilingiroglu, Nesrin

    2005-02-01

    In health care today, scientific and technological frontiers are expanding at unprecedented rates, even as economic and financial pressures shrink profit margins, intensify competition, and constrain the funds available for investment. Therefore, the world today has more economic, and social opportunities for people than 10 or 100 years since globalization has created a new ground somewhat characterized by rapid economic transformation, deregulation of national markets by new trade regimes, amazing transport, electronic communication possibilities and high turnover of foreign investment and capital flow as well as skilled labor. These trends can easily mask great inequalities in developing countries such as importation and spreading of infectious and non-communicable diseases; miniaturization of movement of medical technology; health sector trades management driven by economics without consideration to the social and health aspects and its effects, increasing health inequalities and their economic and social burden creation; multinational companies' cheap labor employment promotion in widening income differentials; and others. As a matter of fact, all these factors are major determinants of ill health. Health authorities of developing countries have to strengthen their regulatory framework in order to ensure that national health systems derive maximum benefit in terms of equity, quality and efficiency, while reducing potential social cost to a minimum generated risky side of globalization. PMID:15770290

  10. Health, globalization and developing countries.

    PubMed

    Cilingiroglu, Nesrin

    2005-02-01

    In health care today, scientific and technological frontiers are expanding at unprecedented rates, even as economic and financial pressures shrink profit margins, intensify competition, and constrain the funds available for investment. Therefore, the world today has more economic, and social opportunities for people than 10 or 100 years since globalization has created a new ground somewhat characterized by rapid economic transformation, deregulation of national markets by new trade regimes, amazing transport, electronic communication possibilities and high turnover of foreign investment and capital flow as well as skilled labor. These trends can easily mask great inequalities in developing countries such as importation and spreading of infectious and non-communicable diseases; miniaturization of movement of medical technology; health sector trades management driven by economics without consideration to the social and health aspects and its effects, increasing health inequalities and their economic and social burden creation; multinational companies' cheap labor employment promotion in widening income differentials; and others. As a matter of fact, all these factors are major determinants of ill health. Health authorities of developing countries have to strengthen their regulatory framework in order to ensure that national health systems derive maximum benefit in terms of equity, quality and efficiency, while reducing potential social cost to a minimum generated risky side of globalization.

  11. [Development of a Conceptual Framework for the Assessment of Chronic Care in the Spanish National Health System].

    PubMed

    Espallargues, Mireia; Serra-Sutton, Vicky; Solans-Domènech, Maite; Torrente, Elena; Moharra, Montse; Benítez, Dolors; Robles, Noemí; Domíngo, Laia; Escarrabill Sanglas, Joan

    2016-07-07

    The aim was to develop a conceptual framework for the assessment of new healthcare initiatives on chronic diseases within the Spanish National Health System. A comprehensive literature review between 2002 and 2013, including systematic reviews, meta-analysis, and reports with evaluation frameworks and/or assessment of initiatives was carried out; integrated care initiatives established in Catalonia were studied and described; and semistructured interviews with key stakeholders were performed. The scope and conceptual framework were defined by using the brainstorming approach.Of 910 abstracts identified, a total of 116 studies were included. They referred to several conceptual frameworks and/or assessment indicators at a national and international level. An overall of 24 established chronic care initiatives were identified (9 integrated care initiatives); 10 in-depth interviews were carried out. The proposed conceptual framework envisages: 1)the target population according to complexity levels; 2)an evaluation approach of the structure, processes, and outcomes considering the health status achieved, the recovery process and the maintenance of health; and 3)the dimensions or attributes to be assessed. The proposed conceptual framework will be helpful has been useful to develop indicators and implement them with a community-based and result-oriented approach and a territorial or population-based perspective within the Spanish Health System. This will be essential to know which are the most effective strategies, what are the key elements that determine greater success and what are the groups of patients who can most benefit.

  12. Developing an Action Model for Integration of Health System Response to HIV/AIDS and Noncommunicable Diseases (NCDs) in Developing Countries

    PubMed Central

    Haregu, Tilahun Nigatu; Setswe, Geoffrey; Elliott, Julian; Oldenburg, Brian

    2014-01-01

    Introduction: Although there are several models of integrated architecture, we still lack models and theories about the integration process of health system responses to HIV/AIDS and NCDs. Objective: The overall purpose of this study is to design an action model, a systematic approach, for the integration of health system responses to HIV/AIDS and NCDs in developing countries. Methods: An iterative and progressive approach of model development using inductive qualitative evidence synthesis techniques was applied. As evidence about integration is spread across different fields, synthesis of evidence from a broad range of disciplines was conducted. Results: An action model of integration having 5 underlying principles, 4 action fields, and a 9-step action cycle is developed. The INTEGRATE model is an acronym of the 9 steps of the integration process: 1) Interrelate the magnitude and distribution of the problems, 2) Navigate the linkage between the problems, 3) Testify individual level co-occurrence of the problems, 4) Examine the similarities and understand the differences between the response functions, 5) Glance over the health system’s environment for integration, 6) Repackage and share evidence in a useable form, 7) Ascertain the plan for integration, 8) Translate the plan in to action, 9) Evaluate and Monitor the integration. Conclusion: Our model provides a basis for integration of health system responses to HIV/AIDS and NCDs in the context of developing countries. We propose that future empirical work is needed to refine the validity and applicability of the model. PMID:24373260

  13. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    PubMed Central

    2013-01-01

    Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation. PMID:23347433

  14. Czech Republic: health system review.

    PubMed

    Alexa, Jan; Recka, Lukas; Votapkova, Jana; van Ginneken, Ewout; Spranger, Anne; Wittenbecher, Friedrich

    2015-01-01

    This analysis of the Czech health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The Czech health-care system is based on compulsory statutory health insurance providing virtually universal coverage and a broad range of benefits, and doing so at 7.7 % of GDP in 2012 - well below the EU average - of which a comparatively high 85 % was publicly funded. Some important health indicators are better than the EU averages (such as mortality due to respiratory disease) or even among the best in the world (in terms of infant mortality, for example). On the other hand, mortality rates for diseases of the circulatory system and malignant neoplasms are well above the EU average, as are a range of health-care utilization rates, such as outpatient contacts and average length of stay in acute care hospitals. In short, there is substantial potential in the Czech Republic for efficiency gains and to improve health outcomes. Furthermore, the need for reform in order to financially sustain the system became evident again after the global financial crisis, but there is as yet no consensus about how to achieve this. PMID:26106825

  15. Development of a cost-effective and flexible vibration DAQ system for long-term continuous structural health monitoring

    NASA Astrophysics Data System (ADS)

    Nguyen, Theanh; Chan, Tommy H. T.; Thambiratnam, David P.; King, Les

    2015-12-01

    In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental-numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues.

  16. Accountable priority setting for trust in health systems - the need for research into a new approach for strengthening sustainable health action in developing countries

    PubMed Central

    Byskov, Jens; Bloch, Paul; Blystad, Astrid; Hurtig, Anna-Karin; Fylkesnes, Knut; Kamuzora, Peter; Kombe, Yeri; Kvåle, Gunnar; Marchal, Bruno; Martin, Douglas K; Michelo, Charles; Ndawi, Benedict; Ngulube, Thabale J; Nyamongo, Isaac; Olsen, Øystein E; Onyango-Ouma, Washington; Sandøy, Ingvild F; Shayo, Elizabeth H; Silwamba, Gavin; Songstad, Nils Gunnar; Tuba, Mary

    2009-01-01

    Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed. Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i) relevance to the local setting, decided by agreed criteria; ii) publicizing priority-setting decisions and the reasons behind them; iii) the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv) the provision of leadership to ensure that the first three conditions are met. REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being applied in an action research

  17. The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

    PubMed

    Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

    2016-09-01

    To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. PMID:25814483

  18. Developing a health system approach to disaster management: A qualitative analysis of the core literature to complement the WHO Toolkit for assessing health-system capacity for crisis management

    PubMed Central

    Bayntun, Claire; Rockenschaub, Gerald; Murray, Virginia

    2012-01-01

    BACKGROUND The World Health Organisation's (WHO) sixty-fourth World Health Assembly in May 2011 adopted a resolution on ‘strengthening national health emergency and disaster management capacities and resilience of health systems’. Disaster management is a topical issue globally and countries are being encouraged to improve their disaster preparedness, along with growing international commitment to strengthening health systems. Lessons identified from disasters have not been effectively collated; essential experience is forgotten. METHODS This paper describes the analysis of the worldwide experience of disasters through a health systems approach. A systematic search of the core literature from January 2000 to November 2011 was conducted. Components drawn from the WHO’s Global assessment of national health sector emergency preparedness and response baseline survey were combined with WHO’s six health system building blocks (or levers) to act as the initial analysis anchors, with a further grounded theory qualitative analysis of the literature allowing the identification of emerging themes and insights. The priority areas identified by this literature review were then compared with the topics covered by the new expert-consensus-derived Toolkit for assessing health-system capacity for crisis management developed by the WHO Regional Office for Europe. FINDINGS 143 publications identified from a literature search were analysed and appraised. Themes and examples from the literature demonstrate how health system strengthening should contribute to disaster management. Priority areas under-represented in the WHO Toolkit and identified by the qualitative analysis are discussed. INTERPRETATION Collation and analysis of the disaster management literature identifies how health system strengthening can promote resilience and efficient recovery in the face of disasters. These findings support and complement the WHO Toolkit. Countries can use the literature evidence with the

  19. Agricultural biodiversity as a link between traditional food systems and contemporary development, social integrity and ecological health.

    PubMed

    Johns, Timothy; Powell, Bronwen; Maundu, Patrick; Eyzaguirre, Pablo B

    2013-11-01

    Traditional food systems offer a key link between the social and economic resilience of smallholder farmers and pastoralists and the sustainable food and nutrition security of global populations. This paper addresses issues related to socio-cultural diversity and the continuing complex engagement of traditional and modern communities with the plants and animals that sustain them. In light of some of the unhealthful consequences of the 'nutrition transition' to globalized modern diets, the authors define and propose a process for a more successful food system transition that balances agro-biodiversity and processed commodities to support diet diversity, health and social equity alongside sustainable economic growth. We review empirical research in support of practice and policy changes in agriculture, economic development and health domains as well as cross-sectoral and community-based innovation. High-value food crops within domestic and global value chains can be an entry point for smallholders' participation as contributors and beneficiaries of development, while sustainable small farms, as purveyors of environmental and public health services, diversify global options for long-term adaptation in the face of environmental uncertainty. PMID:23963831

  20. Agricultural biodiversity as a link between traditional food systems and contemporary development, social integrity and ecological health.

    PubMed

    Johns, Timothy; Powell, Bronwen; Maundu, Patrick; Eyzaguirre, Pablo B

    2013-11-01

    Traditional food systems offer a key link between the social and economic resilience of smallholder farmers and pastoralists and the sustainable food and nutrition security of global populations. This paper addresses issues related to socio-cultural diversity and the continuing complex engagement of traditional and modern communities with the plants and animals that sustain them. In light of some of the unhealthful consequences of the 'nutrition transition' to globalized modern diets, the authors define and propose a process for a more successful food system transition that balances agro-biodiversity and processed commodities to support diet diversity, health and social equity alongside sustainable economic growth. We review empirical research in support of practice and policy changes in agriculture, economic development and health domains as well as cross-sectoral and community-based innovation. High-value food crops within domestic and global value chains can be an entry point for smallholders' participation as contributors and beneficiaries of development, while sustainable small farms, as purveyors of environmental and public health services, diversify global options for long-term adaptation in the face of environmental uncertainty.

  1. [The health system of Guatemala].

    PubMed

    Becerril-Montekio, Víctor; López-Dávila, Luis

    2011-01-01

    This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas.The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings.

  2. Turkey. Health system review.

    PubMed

    Tatar, Mehtap; Mollahaliloğlu, Salih; Sahin, Bayram; Aydin, Sabahattin; Maresso, Anna; Hernández-Quevedo, Cristina

    2011-01-01

    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy reached 71.8 for men and 76.8 for women in 2010. The infant mortality rate (IMR) decreased to 10.1 per 1000 live births in 2010, down from 117.5 in 1980. Despite these achievements, there are still discrepancies in terms of infant mortality between rural and urban areas and different parts of the country, although these have been diminishing over the years. The higher infant mortality rates in rural areas can be attributed to low socioeconomic conditions, low female education levels and the prevalence of infectious diseases. The main causes of death are diseases of the circulatory system followed by malignant neoplasms. Turkeys health care system has been undergoing a far-reaching reform process (HTP) since 2003 and radical changes have occurred both in the provision and the financing of health care services. Health services are now financed through a social security scheme covering the majority of the population, the General Health Insurance Scheme (GHIS (Genel Saglik Sigortasi)), and services are provided both by public and private sector facilities. The Social Security Institution (SSI (Sosyal Guvenlik Kurumu)), financed through payments by employers and employees and government contributions in cases of budget deficit, has become a monopsonic (single buyer) power on the purchasing side of health care services. On the provision side, the Ministry of Health (Saglik Bakenligi) is the main actor and provides primary, secondary and tertiary care through its facilities across the country. Universities are also major providers of tertiary care. The private sector has increased its range over recent years, particularly after arrangements paved the way for private sector provision of services to the SSI. The most important reforms since

  3. Health educaton in developing countries.

    PubMed

    Kanaaneh, H A

    1977-01-01

    Health education is of great relevance in developing communities as it is a means of improving the health level which is an integral part of the overall socioeconomic development. It must be undertaken in conjunction with health services which should involve consumer participation at an early stage. Its focus is on changing behavior in respect to healthful living both at the individual and community levels. Health education subjects in developing communities include maternal and child health (MCH), nutrition, family planning and infectious diseases. Every member in the health team must be a health educator. Personal methods, especially when used by indigenous community health workers, are best suited to induce health behavior change in developing communities. Mass media as a rule is less suited for this, although radio can inform large segments of the population.

  4. [Human resources for local health systems].

    PubMed

    Linger, C

    1989-01-01

    The economic and social crises affecting Latin America have had a profound social and political effect on its structures. This paper analyzes this impact from 2 perspectives: 1) the impact on the apparatus of the state, in particular on its health infra-structures; and 2) the direction of the democratic process in the continent and the participatory processes of civil societies. The institutionalization of the Local Health Systems (SILOS) is an effort to analyze the problem from within the health sector and propose solutions. This paper discusses the issues of human resource development in health systems; training in human resource development and human resource development in local health care systems. There are 3 strategies used to change health systems: 1) The judicial-political system: The state's apparatus 2) The political-administrative system: the national health care system; and 3) the political-operative system: local health care systems. To assure implementation of SILOS there are 4 steps to be followed: 1) create political conditions that allow the transformation and development of local health systems; 2) development of high-level institutional and political initiatives to develop health care networks; 3) offer key players institutional space and social action to develop the SILOS process; 4) rapidly develop SILOS in regions to assure its integration with other development efforts. The labor force in the health sector and organized communities play critical roles in proposing and institutionalizing health programs.

  5. [Human resources for local health systems].

    PubMed

    Linger, C

    1989-01-01

    The economic and social crises affecting Latin America have had a profound social and political effect on its structures. This paper analyzes this impact from 2 perspectives: 1) the impact on the apparatus of the state, in particular on its health infra-structures; and 2) the direction of the democratic process in the continent and the participatory processes of civil societies. The institutionalization of the Local Health Systems (SILOS) is an effort to analyze the problem from within the health sector and propose solutions. This paper discusses the issues of human resource development in health systems; training in human resource development and human resource development in local health care systems. There are 3 strategies used to change health systems: 1) The judicial-political system: The state's apparatus 2) The political-administrative system: the national health care system; and 3) the political-operative system: local health care systems. To assure implementation of SILOS there are 4 steps to be followed: 1) create political conditions that allow the transformation and development of local health systems; 2) development of high-level institutional and political initiatives to develop health care networks; 3) offer key players institutional space and social action to develop the SILOS process; 4) rapidly develop SILOS in regions to assure its integration with other development efforts. The labor force in the health sector and organized communities play critical roles in proposing and institutionalizing health programs. PMID:2766984

  6. [Development and validation of a social vulnerability index applied to public policies of the Unified Health System (SUS)].

    PubMed

    Drachler, Maria de Lourdes; Lobato, Marcos Antônio de Oliveira; Lermen, José Inácio; Fagundes, Sandra; Ferla, Alcindo Antonio; Drachler, Carlos Wietzke; Teixeira, Luciana Barcellos; Leite, José Carlos de Carvalho

    2014-09-01

    The article outlines the development and initial validation of a Social Vulnerability Index (SVI) including five social determinants of risk to health and demonstrates its application in the financing of primary care by the Unified Health System (SUS) in the State of Rio Grande do Sul. Municipal indicators of vulnerability relating to poverty and population dispersion were obtained from the 2010 population census of the Brazilian Institute of Geography and Statistics. Both exploratory and confirmatory factor analysis suggests that the five items can constitute a reliable and acceptable measurement scale. The SVI-5 was then generated based on the first main component, measuring municipal inequalities in social vulnerability relating to poverty and population in the territory in Z-scores. The external validity of SVI-5 was examined in relation to health outcomes using DATASUS 2007-2011 data, revealing that infant mortality and hospitalizations for conditions treatable by primary care are greater in more vulnerable municipalities The results suggest that the SVI-5 is a valid measure of inequalities in social vulnerability between municipalities, applicable to socially equitable policies in health.

  7. Development of a fully automated network system for long-term health-care monitoring at home.

    PubMed

    Motoi, K; Kubota, S; Ikarashi, A; Nogawa, M; Tanaka, S; Nemoto, T; Yamakoshi, K

    2007-01-01

    Daily monitoring of health condition at home is very important not only as an effective scheme for early diagnosis and treatment of cardiovascular and other diseases, but also for prevention and control of such diseases. From this point of view, we have developed a prototype room for fully automated monitoring of various vital signs. From the results of preliminary experiments using this room, it was confirmed that (1) ECG and respiration during bathing, (2) excretion weight and blood pressure, and (3) respiration and cardiac beat during sleep could be monitored with reasonable accuracy by the sensor system installed in bathtub, toilet and bed, respectively.

  8. Development and Evaluation of Sensor Concepts for Ageless Aerospace Vehicles: Report 6 - Development and Demonstration of a Self-Organizing Diagnostic System for Structural Health Monitoring

    NASA Technical Reports Server (NTRS)

    Batten, Adam; Edwards, Graeme; Gerasimov, Vadim; Hoschke, Nigel; Isaacs, Peter; Lewis, Chris; Moore, Richard; Oppolzer, Florien; Price, Don; Prokopenko, Mikhail; Scott, Andrew; Wang, Peter

    2010-01-01

    This report describes a significant advance in the capability of the CSIRO/NASA structural health monitoring Concept Demonstrator (CD). The main thrust of the work has been the development of a mobile robotic agent, and the hardware and software modifications and developments required to enable the demonstrator to operate as a single, self-organizing, multi-agent system. This single-robot system is seen as the forerunner of a system in which larger numbers of small robots perform inspection and repair tasks cooperatively, by self-organization. While the goal of demonstrating self-organized damage diagnosis was not fully achieved in the time available, much of the work required for the final element that enables the robot to point the video camera and transmit an image has been completed. A demonstration video of the CD and robotic systems operating will be made and forwarded to NASA.

  9. Health Occupations. Instructional System Development Model for Vermont Area Vocational Centers.

    ERIC Educational Resources Information Center

    The curriculum guide presents a suggested outline for teaching health occupations in secondary schools in Vermont. It consists of a student/teacher curriculum outline for each of the 20 units. It includes a concept statement, the behavioral objective, suggested learning activities, suggested teacher resource needs, and suggested evaluation…

  10. Intelligent Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  11. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  12. Design and development of an automated and non-contact sensing system for continuous monitoring of plant health and growth.

    PubMed

    Kacira, M; Ling, P P

    2001-01-01

    An automated system was designed and built to continuously monitor plant health and growth in a controlled environment using a distributed system approach for operational control and data collection. The computer-controlled system consisted of a motorized turntable to present the plants to the stationary sensors and reduce microclimate variability among the plants. Major sensing capabilities of the system included machine vision, infrared thermometry, time domain reflectometry, and micro-lysimeters. The system also maintained precise growth-medium moisture levels through a computer-controlled drip irrigation system. The system was capable of collecting required data continuously to monitor and to evaluate the plant health and growth. PMID:12026934

  13. Portable Health Algorithms Test System

    NASA Technical Reports Server (NTRS)

    Melcher, Kevin J.; Wong, Edmond; Fulton, Christopher E.; Sowers, Thomas S.; Maul, William A.

    2010-01-01

    A document discusses the Portable Health Algorithms Test (PHALT) System, which has been designed as a means for evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT system allows systems health management algorithms to be developed in a graphical programming environment, to be tested and refined using system simulation or test data playback, and to be evaluated in a real-time hardware-in-the-loop mode with a live test article. The integrated hardware and software development environment provides a seamless transition from algorithm development to real-time implementation. The portability of the hardware makes it quick and easy to transport between test facilities. This hard ware/software architecture is flexible enough to support a variety of diagnostic applications and test hardware, and the GUI-based rapid prototyping capability is sufficient to support development execution, and testing of custom diagnostic algorithms. The PHALT operating system supports execution of diagnostic algorithms under real-time constraints. PHALT can perform real-time capture and playback of test rig data with the ability to augment/ modify the data stream (e.g. inject simulated faults). It performs algorithm testing using a variety of data input sources, including real-time data acquisition, test data playback, and system simulations, and also provides system feedback to evaluate closed-loop diagnostic response and mitigation control.

  14. Norway: health system review.

    PubMed

    Ringard, Ånen; Sagan, Anna; Sperre Saunes, Ingrid; Lindahl, Anne Karin

    2013-01-01

    Norways five million inhabitants are spread over nearly four hundred thousand square kilometres, making it one of the most sparsely populated countries in Europe. It has enjoyed several decades of high growth, following the start of oil production in early 1970s, and is now one of the richest countries per head in the world. Overall, Norways population enjoys good health status; life expectancy of 81.53 years is above the EU average of 80.14, and the gap between overall life expectancy and healthy life years is around half the of EU average. The health care system is semi decentralized. The responsibility for specialist care lies with the state (administered by four Regional Health Authorities) and the municipalities are responsible for primary care. Although health care expenditure is only 9.4% of Norways GDP (placing it on the 16th place in the WHO European region), given Norways very high value of GDP per capita, its health expenditure per head is higher than in most countries. Public sources account for over 85% of total health expenditure; the majority of private health financing comes from households out-of-pocket payments.The number of practitioners in most health personnel groups, including physicians and nurses, has been increasing in the last few decades and the number of health care personnel per 100 000 inhabitants is high compared to other EU countries. However, long waiting times for elective care continue to be a problem and are cause of dissatisfaction among the patients. The focus of health care reforms has seen shifts over the past four decades. During the 1970s the focus was on equality and increasing geographical access to health care services; during the 1980s reforms aimed at achieving cost containment and decentralizing health care services; during the 1990s the focus was on efficiency. Since the beginning of the millennium the emphasis has been given to structural changes in the delivery and organization of health care and to policies

  15. The Netherlands: health system review.

    PubMed

    Schäfer, Willemijn; Kroneman, Madelon; Boerma, Wienke; van den Berg, Michael; Westert, Gert; Devillé, Walter; van Ginneken, Ewout

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems. They also describe the institutional framework, process, content, and implementation of health and health care policies, highlighting challenges and areas that require more in-depth analysis. Undoubtedly the dominant issue in the Dutch health care system at present is the fundamental reform that came into effect in 2006. With the introduction of a single compulsory health insurance scheme, the dual system of public and private insurance for curative care became history. Managed competition for providers and insurers became a major driver in the health care system. This has meant fundamental changes in the roles of patients, insurers, providers and the government. Insurers now negotiate with providers on price and quality and patients choose the provider they prefer and join a health insurance policy which best fits their situation. To allow patients to make these choices, much effort has been made to make information on price and quality available to the public. The role of the national government has changed from directly steering the system to safeguarding the proper functioning of the health markets. With the introduction of market mechanisms in the health care sector and the privatization of former sickness funds, the Dutch system presents an innovative and unique variant of a social health insurance system. Since the stepwise realization of the blueprint of the system has not yet been completed, the health care system in The Netherlands should be characterized as being in transition. Many measures have been taken to move from the old to the new system as smoothly as possible. Financial measures intended to prevent sudden budgetary

  16. Developing Occupation-Based Preventive Programs for Late-Middle-Aged Latino Patients in Safety-Net Health Systems

    PubMed Central

    Carlson, Mike; Martínez, Jenny; Guzmán, Laura; Mahajan, Anish; Clark, Florence

    2015-01-01

    Latino adults between ages 50 and 60 yr are at high risk for developing chronic conditions that can lead to early disability. We conducted a qualitative pilot study with 11 Latinos in this demographic group to develop a foundational schema for the design of health promotion programs that could be implemented by occupational therapy practitioners in primary care settings for this population. One-on-one interviews addressing routines and activities, health management, and health care utilization were conducted, audiotaped, and transcribed. Results of a content analysis of the qualitative data revealed the following six domains of most concern: Weight Management; Disease Management; Mental Health and Well-Being; Personal Finances; Family, Friends, and Community; and Stress Management. A typology of perceived health-actualizing strategies was derived for each domain. This schema can be used by occupational therapy practitioners to inform the development of health-promotion lifestyle interventions designed specifically for late-middle-aged Latinos. PMID:26565102

  17. Developing Occupation-Based Preventive Programs for Late-Middle-Aged Latino Patients in Safety-Net Health Systems.

    PubMed

    Schepens Niemiec, Stacey L; Carlson, Mike; Martínez, Jenny; Guzmán, Laura; Mahajan, Anish; Clark, Florence

    2015-01-01

    Latino adults between ages 50 and 60 yr are at high risk for developing chronic conditions that can lead to early disability. We conducted a qualitative pilot study with 11 Latinos in this demographic group to develop a foundational schema for the design of health promotion programs that could be implemented by occupational therapy practitioners in primary care settings for this population. One-on-one interviews addressing routines and activities, health management, and health care utilization were conducted, audiotaped, and transcribed. Results of a content analysis of the qualitative data revealed the following six domains of most concern: Weight Management; Disease Management; Mental Health and Well-Being; Personal Finances; Family, Friends, and Community; and Stress Management. A typology of perceived health-actualizing strategies was derived for each domain. This schema can be used by occupational therapy practitioners to inform the development of health-promotion lifestyle interventions designed specifically for late-middle-aged Latinos.

  18. Development of a belt-type wearable sensor system with multi-function for home health care

    NASA Astrophysics Data System (ADS)

    Ban, Yunho; Choi, Samjin; Jiang, Zhongwei; Park, Chanwon

    2005-12-01

    Some reports show that the physiological information measured in hospital is not enough without the one measured in home. The physiological information monitored in home, therefore, is strongly required recently. The goal of this research is to develop a wearable and tractable sensor system for detecting biomedical signals such as cardiac rhythm, respiration, body movement, and percentage of body fat (%BF) and for home health care. A belt type sensor for this purpose is developed, which consists of sensing materials of PVDF film and conductive fabrics. Also several data processing techniques, such as the discrete wavelet transform, cross correlation and adaptive filtering method, were introduced to eliminate noises and base wandering and to extract the specified components. The ECG and respiration signals obtained by the proposed belt type sensor system gave good agreements with commercial medical system. Furthermore, the body fat (%BF) measurement based on the four-electrode BIA was also built in the belt sensor. The body fat was calculated by measuring the body impedance from the belt type sensor and compared with the predicted %BF measured by the commercial adipometer (TBF-607). The results validated also the efficiency of the belt type sensor system.

  19. M-Health: Emerging Mobile Health Systems

    NASA Astrophysics Data System (ADS)

    Istepanian, Robert; Laxminarayan, Swamy; Pattichis, Constantinos S.

    M-health can be defined as the "emerging mobile communications and network technologies for healthcare systems.' This book paves the path toward understanding the future of m-health technologies and services and also introducing the impact of mobility on existing e-health and commercial telemedical systems. M-Health: Emerging Mobile Health Systems presents a new and forward-looking source of information that explores the present and future trends in the applications of current and emerging wireless communication and network technologies for different healthcare scenaria.

  20. Uzbekistan: health system review.

    PubMed

    Ahmedov, Mohir; Azimov, Ravshan; Mutalova, Zulkhumor; Huseynov, Shahin; Tsoyi, Elena; Rechel, Bernd

    2014-01-01

    Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly self-financing through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern. Quality of care is another area that is receiving increasing attention.

  1. Uzbekistan: health system review.

    PubMed

    Ahmedov, Mohir; Azimov, Ravshan; Mutalova, Zulkhumor; Huseynov, Shahin; Tsoyi, Elena; Rechel, Bernd

    2014-01-01

    Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly self-financing through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern. Quality of care is another area that is receiving increasing attention. PMID:25689490

  2. [Approaches for developing a system model for health evaluation based on body constitutions of traditional Chinese medicine and order parameters].

    PubMed

    Huang, Chong; Zhu, Yan-bo; Liu, Zhuo-jun

    2012-04-01

    From the point of view of systems science, human body can be considered as a complex system, and the human health system is a subsystem of it. Systems science conducts investigation in a holistic manner. As a theoretical method, it deals with the operation and evolution of systems from the macroscopic perspective, so this theory is similar to phenomenological theory of traditional Chinese medicine (TCM) in methodology. Naturally, numerous theories of systems science can be used in research of the human health systems of TCM. In this paper, the authors introduced synergetic, a theory of modern systems science, and its slaving principle, and in particular, analyzed the concept of order parameters related to the slaving principle and the relationship between body constitutions of TCM and order parameters. The body constitution of TCM can be treated as a slow variable in the human health systems. By using synergetic, the authors established a model of the human health system based on body constitutions of TCM. As an application of the model, the authors illustrated the argumentation in the theory of constitution being separable, the theory of a relationship between constitution and disease, and the theory of a recuperable constitution. To some extent, this work has made links between the TCM theory of body constitution and modern systems science, and it will offer a new thought for modeling the human health system.

  3. Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development?

    PubMed Central

    2012-01-01

    Background During the last decade, donor governments and international agencies have increasingly emphasized the importance of building the capacity of indigenous health care organizations as part of strengthening health systems and ensuring sustainability. In 2009, the U.S. Global Health Initiative made country ownership and capacity building keystones of U.S. health development assistance, and yet there is still a lack of consensus on how to define either of these terms, or how to implement “country owned capacity building”. Discussion Concepts around capacity building have been well developed in the for-profit business sector, but remain less well defined in the non-profit and social sectors in low and middle-income countries. Historically, capacity building in developing countries has been externally driven, related to project implementation, and often resulted in disempowerment of local organizations rather than local ownership. Despite the expenditure of millions of dollars, there is no consensus on how to conduct capacity building, nor have there been rigorous evaluations of capacity building efforts. To shift to a new paradigm of country owned capacity building, donor assistance needs to be inclusive in the planning process and create true partnerships to conduct organizational assessments, analyze challenges to organizational success, prioritize addressing challenges, and implement appropriate activities to build new capacity in overcoming challenges. Before further investments are made, a solid evidence base should be established concerning what works and what doesn’t work to build capacity. Summary Country-owned capacity building is a relatively new concept that requires further theoretical exploration. Documents such as The Paris Declaration on Aid Effectiveness detail the principles of country ownership to which partner and donor countries should commit, but do not identify the specific mechanisms to carry out these principles. More evidence as

  4. Development and Management of a Geographic Information System for Health Research in a Developing-country Setting: A Case Study from Bangladesh

    PubMed Central

    Sugimoto, Jonathan D.; Labrique, Alain B.; Salahuddin, Ahmad; Rashid, Mahbubur; Klemm, Rolf D.W.; Christian, Parul; West, Keith P.

    2007-01-01

    In the last decade, geographic information systems (GIS) have become accessible to researchers in developing countries, yet guidance remains sparse for developing a GIS. Drawing on experience in developing a GIS for a large community trial in rural Bangladesh, six stages for constructing, maintaining, and using a GIS for health research purposes were outlined. The system contains 0.25 million landmarks, including 150,000 houses, in an area of 435 sq km with over 650,000 people. Assuming access to reasonably accurate paper boundary maps of the intended working area and the absence of pre-existing digital local-area maps, the six stages are: to (a) digitize and update existing paper maps, (b) join the digitized maps into a large-area map, (c) reference this large-area map to a geographic coordinate system, (d) insert location landmarks of interest, (e) maintain the GIS, and (f) link it to other research databases. These basic steps can produce a household-level, updated, scaleable GIS that can both enhance field efficiency and support epidemiologic analyses of demographic patterns, diseases, and health outcomes. PMID:18402187

  5. Engineering a learning healthcare system: using health information technology to develop an objective nurse staffing tool.

    PubMed

    Harper, Ellen M

    2012-01-01

    Nurses represent the largest proportion of direct healthcare providers. Overstaffed or understaffed units will have implications for the quality, cost, patient, and nurse satisfaction. It is vital that nurses are armed with appropriate instruments and data to help them plan and implement efficient and effective nursing teams. A compelling case is made for the association between nursing care and clinical, quality, and financial outcomes. Even though there is a great body of work on the correlation, there is little agreement on the best approach to determine the correct balance between the patient-to-nurse ratios. The sheer number of variables depicted in the literature suggests why precise evidenced based formulas are difficult to achieve. This paper will describe a practice based knowledge generation mixed methods study using detailed observation and electronic health record abstraction to generate a structural equation for use in predicting staffing needs.

  6. Challenges for health care development in Croatia.

    PubMed

    Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

    2012-09-01

    The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.

  7. Responsibilising managers and clinicians, neglecting system health? What kind of healthcare leadership development do we want?

    PubMed Central

    Martin, Graham P.

    2015-01-01

    Responding to Ruth McDonald’s editorial on the rise of leadership and leadership development programmes in healthcare, this paper offers three arguments. Firstly, care is needed in evaluating impact of leadership development, since achievement of organisational goals is not necessarily an appropriate measure of good leadership. Secondly, the proliferation of styles of leadership might be understood in part as a means of retaining control over public services while distributing responsibility for their success and failure. Thirdly, it makes a plea for the continued utility of good administrative skills for clinicians and managers, which are likely to become all-the-more important given recent developments in healthcare policy and governance. PMID:25584352

  8. Canada: Health system review.

    PubMed

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas.

  9. Canada: Health system review.

    PubMed

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. PMID:23628429

  10. Modeling of Global BEAM Structure for Evaluation of MMOD Impacts to Support Development of a Health Monitoring System

    NASA Technical Reports Server (NTRS)

    Lyle, Karen H.; Vassilakos, Gregory J.

    2015-01-01

    This report summarizes the initial modeling of the global response of the Bigelow Expandable Activity Module (BEAM) to micrometeorite and orbital debris(MMOD) impacts using a structural, nonlinear, transient dynamic, finite element code. These models complement the on-orbit deployment of the Distributed Impact Detection System (DIDS) to support structural health monitoring studies. Two global models were developed. The first focused exclusively on impacts on the soft-goods (fabric-envelop) portion of BEAM. The second incorporates the bulkhead to support understanding of bulkhead impacts. These models were exercised for random impact locations and responses monitored at the on-orbit sensor locations. The report concludes with areas for future study.

  11. Design and development of a meal system for the elderly. [public health - nutrition/diet

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Food preference surveys (taste tests) were performed for 95 food items (which were selected from an original list of 150 items), and 21 menus were developed from the survey results. Each menu contains an entree, two side dishes, dessert, and a beverage. Food manufacturing specifications for freeze dried foods, frozen foods, and beverages are examined, and product labeling and packaging requirements are discussed. The nutritional value of the various foods is listed in tabular form, and sample product labels are shown. Cost estimates per serving are also included.

  12. Challenges for health systems in member countries of the Organisation for Economic Co-operation and Development.

    PubMed Central

    Hurst, J.

    2000-01-01

    For reasons of equity most OECD countries have chosen to base their funding of health care mainly on public sources. There is an almost universal problem of affordability in the health systems of these countries, arising from the tension between the willingness of populations to pay taxes and the eagerness of patients to use health services where these are free or heavily subsidized at the point of use. These tensions are likely to be exacerbated by a surge of new medical technologies adding to demands for health care. Some observers have predicted the breakdown of publicly funded systems of health care under new spending pressures. However, governments can deploy a range of policies for handling new demands. They can also take comfort from the fact that many of them have already coped with successive waves of technological change in health care without abandoning their core commitment to the public funding of health systems. Furthermore, if standards of living continue to rise, public and private insurers should find it easier to obtain the revenues needed to pay for the improved health care expected by consumers. PMID:10916912

  13. Health and development: some concerns about South Africa's health policy.

    PubMed

    Head, J

    1996-09-01

    This critique of South Africa's health policy opens by noting that the World Health Organization's definition of health as "a state of complete physical mental and social well-being" recognizes that health is synonymous with development. Specific areas of concern are then identified as 1) the consequences for health and development of South Africa's emphasis on reducing the budget deficit, 2) the implications of maintaining a private health sector, and 3) the absence of health policy implementation planning. The analysis opens with a look at Mozambique's experience in setting up a health service after independence (between 1976 and 1980). Next, the unique features of South Africa's transition from apartheid to democracy are identified as the rapid migration of people to industrial centers for work, the continuing residence of the powerful European population, and an international context that limits opportunities to promote growth through social democratic policies. The implications of these factors to the health policy are that social inequalities will continue to exist because the health policy fails to delineate how health services will be provided to large urban areas and maintains a two-tier system. It is critical to nationalize the public sector and to involve health workers in the reform process.

  14. Developing a system of multi-evaluation of the impact of global climate change on human health in Russia

    NASA Astrophysics Data System (ADS)

    Granberg, I.; Golitsyn, G.; Istoshin, N.; Efimenko, N.; Alekhin, A.; Rogoza, A.; Povolotskaya, N.; Artamonova, M.; Pogarski, F.

    2009-04-01

    High people sensitivity to weather and space factors, particularly encumbered by various illnesses, was from time immemorial. Now, in terms of global climate change, accompanied by frequent and severe restructuring of atmospheric processes, thermal anomalies, droughts, environmental change through meteorological and heliogeophysical factors affect the human body particularly intense, causing adverse effects to health. There are currently beginning to develop methods for evaluating multifactor of the external environment and prevention of their negative influence on people. For those sensitive to such influences, with adverse weather in response to sudden changes in weather factors pathological of meteopathic reactions may arise. In doing so, even among healthy individuals it is up to 35-45% of meteosensitive. Meteopathic reactions lead to the appearance and progression of pathological disorders, and the associated increase in chronic diseases. In this connection the tasks solution related to assessing the impact of meteorological and climatic variations of different space-time scale on the health of the population of Russia becomes extremely important, especially for the people with cardiovascular disease. This is confirmed by as clinical observations, and the state of vital systems of meteosensitive people. Based on the results of comprehensive research of Pyatigorsk State Research Institute of Curortology (PSRIC), the A. M. Obukhov Institute of Atmospheric Physics of the Russian Academy of Sciences (IAP), and Hydrometeocenter of Russia in the region of Caucasian Mineral Waters (CMW) by scientists of IAP and PSRIC there was established a system of Operational Medical Weather Forecast (OMWF), which aims to have possibility on time to host events for the prevention of meteopathic reactions of people with high meteodependence. Also, we have introduced improved definition of Weather Pathogenicity Index (WPI) for medical weather forecast. As a basis of medical weather

  15. Definition, technology readiness, and development cost of the orbit transfer vehicle engine integrated control and health monitoring system elements

    NASA Technical Reports Server (NTRS)

    Cannon, I.; Balcer, S.; Cochran, M.; Klop, J.; Peterson, S.

    1991-01-01

    An Integrated Control and Health Monitoring (ICHM) system was conceived for use on a 20 Klb thrust baseline Orbit Transfer Vehicle (OTV) engine. Considered for space used, the ICHM was defined for reusability requirements for an OTV engine service free life of 20 missions, with 100 starts and a total engine operational time of 4 hours. Functions were derived by flowing down requirements from NASA guidelines, previous OTV engine or ICHM documents, and related contracts. The elements of an ICHM were identified and listed, and these elements were described in sufficient detail to allow estimation of their technology readiness levels. These elements were assessed in terms of technology readiness level, and supporting rationale for these assessments presented. The remaining cost for development of a minimal ICHM system to technology readiness level 6 was estimated. The estimates are within an accuracy range of minus/plus 20 percent. The cost estimates cover what is needed to prepare an ICHM system for use on a focussed testbed for an expander cycle engine, excluding support to the actual test firings.

  16. Development of a wireless, self-sustaining damage detection sensor system based on chemiluminescence for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Kuang, K. S. C.

    2014-03-01

    A novel application of chemiluminescence resulting from the chemical reaction in a glow-stick as sensors for structural health monitoring is demonstrated here. By detecting the presence of light emitting from these glow-sticks, it is possible to develop a low-cost sensing device with the potential to provide early warning of damage in a variety of engineering applications such as monitoring of cracks or damage in concrete shear walls, detecting of ground settlement, soil liquefaction, slope instability, liquefaction-related damage of underground structure and others. In addition, this paper demonstrates the ease of incorporating wireless capability to the sensor device and the possibility of making the sensor system self-sustaining by means of a renewable power source for the wireless module. A significant advantage of the system compared to previous work on the use of plastic optical fibre (POF) for damage detection is that here the system does not require an electrically-powered light source. Here, the sensing device, embedded in a cement host, is shown to be capable of detecting damage. A series of specimens with embedded glow-sticks have been investigated and an assessment of their damage detection capability will be reported. The specimens were loaded under flexure and the sensor responses were transmitted via a wireless connection.

  17. Developing a system of multi-evaluation of the impact of global climate change on human health in Russia

    NASA Astrophysics Data System (ADS)

    Granberg, I.; Golitsyn, G.; Istoshin, N.; Efimenko, N.; Alekhin, A.; Rogoza, A.; Povolotskaya, N.; Artamonova, M.; Pogarski, F.

    2009-04-01

    High people sensitivity to weather and space factors, particularly encumbered by various illnesses, was from time immemorial. Now, in terms of global climate change, accompanied by frequent and severe restructuring of atmospheric processes, thermal anomalies, droughts, environmental change through meteorological and heliogeophysical factors affect the human body particularly intense, causing adverse effects to health. There are currently beginning to develop methods for evaluating multifactor of the external environment and prevention of their negative influence on people. For those sensitive to such influences, with adverse weather in response to sudden changes in weather factors pathological of meteopathic reactions may arise. In doing so, even among healthy individuals it is up to 35-45% of meteosensitive. Meteopathic reactions lead to the appearance and progression of pathological disorders, and the associated increase in chronic diseases. In this connection the tasks solution related to assessing the impact of meteorological and climatic variations of different space-time scale on the health of the population of Russia becomes extremely important, especially for the people with cardiovascular disease. This is confirmed by as clinical observations, and the state of vital systems of meteosensitive people. Based on the results of comprehensive research of Pyatigorsk State Research Institute of Curortology (PSRIC), the A. M. Obukhov Institute of Atmospheric Physics of the Russian Academy of Sciences (IAP), and Hydrometeocenter of Russia in the region of Caucasian Mineral Waters (CMW) by scientists of IAP and PSRIC there was established a system of Operational Medical Weather Forecast (OMWF), which aims to have possibility on time to host events for the prevention of meteopathic reactions of people with high meteodependence. Also, we have introduced improved definition of Weather Pathogenicity Index (WPI) for medical weather forecast. As a basis of medical weather

  18. Health Information Systems.

    PubMed

    Sirintrapun, S Joseph; Artz, David R

    2015-06-01

    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care.

  19. Mobile health monitoring systems.

    PubMed

    Walker, William; Aroul, A L Praveen; Bhatia, Dinesh

    2009-01-01

    Advancements are being made towards a cheap and effective means for health monitoring. A mobile monitoring system is proposed for monitoring a bicycle rider using light weight, low power wireless sensors. Biometric and environmental information pertaining to the bicycle rider is captured, transmitted to, and stored in a remote database with little user interaction required. Remote users have real time access to the captured information through a web application. Possible applications for this system include the monitoring of a soldier in the battlefield and the monitoring of a patient during an ambulance ride. PMID:19965041

  20. Private health insurance: implications for developing countries.

    PubMed Central

    Sekhri, Neelam; Savedoff, William

    2005-01-01

    Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage. PMID:15744405

  1. Private health insurance: a role model for European health systems.

    PubMed

    Arentz, Christine; Eekhoff, Johann; Kochskämper, Susanna

    2012-10-01

    European health care systems will face major challenges in the near future. Demographic change and technological progress induce rising costs. In order to deal with these developments and to preserve the current level of health care provision, health care systems need to be highly efficient. Yet existing health care systems show a lot of inefficiencies that result in waste of scarce resources. Therefore, improvements in performance are necessary. In this article, we argue that a change in financing health care accompanied by the liberalisation of the market for health care service providers offers a promising solution. We develop a market-based model for financing health care and show how it can be put into practice without generating additional costs for society while meeting social equity criteria.

  2. Poverty, health and development in dermatology.

    PubMed

    Morrone, Aldo

    2007-10-01

    The WHO Constitution states that "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political, economic or social condition." The right to health means that governments must generate conditions in which everyone can be as healthy as possible. Such conditions range from ensuring availability of health services, healthy and safe working conditions, adequate housing and nutritious food. In this report the author analyzes the relationship among health, dermatology and development and tries to find out what the scientific world, including dermatologists, could do for the improvement of health systems.

  3. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    PubMed

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data.

  4. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    PubMed

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. PMID:22887590

  5. Developing national health information in Australia.

    PubMed

    Moss, E A

    1995-01-01

    National Health Data Dictionary (NHDD) as the authoritative set of national definitions and is a significant initiative aimed at improving Australia's health information. The dictionary is the repository of the agreed common language, use of the definitions facilities the description and comparison of health and health services nationally [2]. The National Health Data Dictionary currently covers institutionally provided health care, the national health labor force, and is expanding to cover other major areas, including outpatient services, community care, and mental health. The NHDD is reviewed and maintained by the National Health Data Committee and the overall coordination of definition development projects and publication is undertaken by the Institute. The placement of an agreed definition in the NHDD does not automatically mean that it has a place in a national data collection. The use of the dictionary definition will allow comparison by and between service providers. In order for a data item to be eligible for inclusion in a national minimum data set, the definition of that item must be contained in the NHDD. During the first three months of 1995, the Australian Institute of Health and Welfare will conduct a national project to develop a model for the health system in Australia. The model will provide a common vocabulary and information architecture in order to facilitate better quality health information, and consequently better health for Australians. It is expected that the development of the model will bring several benefits including facilitating the more rapid and accurate assembly of appropriate clinical information to support improved customer service and outcomes, provide a mechanism for achieving better quality information, reduce the costs of data collection; provide enabling mechanisms for the integration of systems via data standards and reduce the costs of acquiring information systems through reduced development and tailoring costs for suppliers

  6. Environmental assessment for the satellite power system-concept development and evaluation program-microwave health and ecological effects

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Potential health and ecological effects of the microwave beam from the microwave power transmission system (MPTS) of the satellite power system (SPS) are discussed. A detailed critical review of selected scientific articles from the published literature on the biological effects of nonionizing electromagnetic radiation is provided followed by an assessment of the possible effects of the SPS, based on exposure values for the reference system.

  7. Environmental assessment for the satellite power system-concept development and evaluation program-microwave health and ecological effects

    SciTech Connect

    Not Available

    1980-11-01

    This report is concerned with the potential health and ecological effects of the microwave beam from the microwave power transmission system (MPTS) of the satellite power system (SPS). The report is written in the form of a detailed critical review of selected scientific articles from the published literature on the biological effects of nonionizing electromagnetic radiation, followed by an assessment of the possible effects of the SPS, based on exposure values for the reference system (US DOE and NASA, 1978).

  8. Development and experimental validation of a numerical tool for structural health and usage monitoring systems based on chirped grating sensors.

    PubMed

    Bettini, Paolo; Guerreschi, Erika; Sala, Giuseppe

    2015-01-01

    The interest of the aerospace industries in structural health and usage monitoring systems is continuously increasing. Among the techniques available in literature those based on Fibre Bragg Grating sensors are much promising thanks to their peculiarities. Different Chirped Bragg Grating sensor configurations have been investigated in this paper. Starting from a numerical model capable of simulating the spectral response of a grating subjected to a generic strain profile (direct problem), a new code has been developed, allowing strain reconstruction from the experimental validation of the program, carried out through different loading cases applied on a chirped grating. The wavelength of the reflection spectrum for a chirped FBG has a one-to-one correspondence to the position along the gauge section, thus allowing strain reconstruction over the entire sensor length. Tests conducted on chirped FBGs also evidenced their potential for SHM applications, if coupled with appropriate numerical strain reconstructions tools. Finally, a new class of sensors-Draw Tower Grating arrays-has been studied. These sensors are applicable to distributed sensing and load reconstruction over large structures, thanks to their greater length. Three configurations have been evaluated, having different spatial and spectral characteristics, in order to explore possible applications of such sensors to SHM systems.

  9. Development and Experimental Validation of a Numerical Tool for Structural Health and Usage Monitoring Systems Based on Chirped Grating Sensors

    PubMed Central

    Bettini, Paolo; Guerreschi, Erika; Sala, Giuseppe

    2015-01-01

    The interest of the aerospace industries in structural health and usage monitoring systems is continuously increasing. Among the techniques available in literature those based on Fibre Bragg Grating sensors are much promising thanks to their peculiarities. Different Chirped Bragg Grating sensor configurations have been investigated in this paper. Starting from a numerical model capable of simulating the spectral response of a grating subjected to a generic strain profile (direct problem), a new code has been developed, allowing strain reconstruction from the experimental validation of the program, carried out through different loading cases applied on a chirped grating. The wavelength of the reflection spectrum for a chirped FBG has a one-to-one correspondence to the position along the gauge section, thus allowing strain reconstruction over the entire sensor length. Tests conducted on chirped FBGs also evidenced their potential for SHM applications, if coupled with appropriate numerical strain reconstructions tools. Finally, a new class of sensors—Draw Tower Grating arrays—has been studied. These sensors are applicable to distributed sensing and load reconstruction over large structures, thanks to their greater length. Three configurations have been evaluated, having different spatial and spectral characteristics, in order to explore possible applications of such sensors to SHM systems. PMID:25587979

  10. Development and experimental validation of a numerical tool for structural health and usage monitoring systems based on chirped grating sensors.

    PubMed

    Bettini, Paolo; Guerreschi, Erika; Sala, Giuseppe

    2015-01-01

    The interest of the aerospace industries in structural health and usage monitoring systems is continuously increasing. Among the techniques available in literature those based on Fibre Bragg Grating sensors are much promising thanks to their peculiarities. Different Chirped Bragg Grating sensor configurations have been investigated in this paper. Starting from a numerical model capable of simulating the spectral response of a grating subjected to a generic strain profile (direct problem), a new code has been developed, allowing strain reconstruction from the experimental validation of the program, carried out through different loading cases applied on a chirped grating. The wavelength of the reflection spectrum for a chirped FBG has a one-to-one correspondence to the position along the gauge section, thus allowing strain reconstruction over the entire sensor length. Tests conducted on chirped FBGs also evidenced their potential for SHM applications, if coupled with appropriate numerical strain reconstructions tools. Finally, a new class of sensors-Draw Tower Grating arrays-has been studied. These sensors are applicable to distributed sensing and load reconstruction over large structures, thanks to their greater length. Three configurations have been evaluated, having different spatial and spectral characteristics, in order to explore possible applications of such sensors to SHM systems. PMID:25587979

  11. Integrating homoeopathy in health systems.

    PubMed Central

    Poitevin, B.

    1999-01-01

    Homoeopathy is a therapy which involves many components and three main agents: the patient, with his or her condition and personal characteristics; the medication used, with its composition and manufacturing procedure; and the physician, with his or her approach to treatment and concepts of health. The development of research and evaluation structures, combined with a critical education in the discipline, would help to improve practices and define homoeopathy's potential role in relation to the other therapies, both conventional and unconventional, used in Western health systems. PMID:10083716

  12. [The health system of Brazil].

    PubMed

    Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

    2011-01-01

    This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

  13. Development and evaluation of a comprehensive clinical decision support taxonomy: comparison of front-end tools in commercial and internally developed electronic health record systems

    PubMed Central

    Sittig, Dean F; Ash, Joan S; Feblowitz, Joshua; Meltzer, Seth; McMullen, Carmit; Guappone, Ken; Carpenter, Jim; Richardson, Joshua; Simonaitis, Linas; Evans, R Scott; Nichol, W Paul; Middleton, Blackford

    2011-01-01

    Background Clinical decision support (CDS) is a valuable tool for improving healthcare quality and lowering costs. However, there is no comprehensive taxonomy of types of CDS and there has been limited research on the availability of various CDS tools across current electronic health record (EHR) systems. Objective To develop and validate a taxonomy of front-end CDS tools and to assess support for these tools in major commercial and internally developed EHRs. Study design and methods We used a modified Delphi approach with a panel of 11 decision support experts to develop a taxonomy of 53 front-end CDS tools. Based on this taxonomy, a survey on CDS tools was sent to a purposive sample of commercial EHR vendors (n=9) and leading healthcare institutions with internally developed state-of-the-art EHRs (n=4). Results Responses were received from all healthcare institutions and 7 of 9 EHR vendors (response rate: 85%). All 53 types of CDS tools identified in the taxonomy were found in at least one surveyed EHR system, but only 8 functions were present in all EHRs. Medication dosing support and order facilitators were the most commonly available classes of decision support, while expert systems (eg, diagnostic decision support, ventilator management suggestions) were the least common. Conclusion We developed and validated a comprehensive taxonomy of front-end CDS tools. A subsequent survey of commercial EHR vendors and leading healthcare institutions revealed a small core set of common CDS tools, but identified significant variability in the remainder of clinical decision support content. PMID:21415065

  14. Dietary Approaches to Stop Hypertension: Lessons Learned From a Case Study on the Development of an mHealth Behavior Change System

    PubMed Central

    2014-01-01

    Background Evidence-based solutions for changing health behaviors exist but problems with feasibility, sustainability, and dissemination limit their impact on population-based behavior change and maintenance. Objective Our goal was to overcome the limitations of an established behavior change program by using the inherent capabilities of smartphones and wireless sensors to develop a next generation mobile health (mHealth) intervention that has the potential to be more feasible. Methods In response to the clinical need and the growing capabilities of smartphones, our study team decided to develop a behavioral hypertension reduction mHealth system inspired by Dietary Approaches to Stop Hypertension (DASH), a lifestyle modification program. We outline the key design and development decisions that molded the project including decisions about behavior change best practices, coaching features, platform, multimedia content, wireless devices, data security, integration of systems, rapid prototyping, usability, funding mechanisms, and how all of these issues intersect with clinical research and behavioral trials. Results Over the 12 months, our study team faced many challenges to developing our prototype intervention. We describe 10 lessons learned that will ultimately stimulate more effective and sustainable approaches. Conclusions The experiences presented in this case study can be used as a reference for others developing mHealth behavioral intervention development projects by highlighting the benefits and challenges facing mHealth research. PMID:25340979

  15. [Perspectives of the Tunisian health system reform].

    PubMed

    Achouri, H

    2001-05-01

    Perspectives of development of the Tunisian health system are presented, in reference to the conceptual framework recommended by the World Health Organization, while a project of health insurance reform of the social security regimes is submitted to a dialogue with the different concerned parts. Recommended orientations articulate around five axes: 1. The promotion of care provision by improving the accessibility to services, notably in zones under served, by introducing new modes of dispensation, organization and management of care provision in the framework of a continuous quality assurance strategy. 2. The financing of health care, with the implementation of the health insurance reform, has to allow an improvement of the financial accessibility of the population to health care, while supervising the evolution of total health expenditures and by developing the system's management capacities. 3. Proposals relative to the mobilization of resources are advanced in areas of medicine, training of health professionals and research on the health system. 4. Adaptation of the health system governance to the new context is necessary and would have to be developed around evolving standards for the health system, on evaluation of its performances and on information and communication with its users. 5. The health system responsiveness, new motion whose contours are again blurred, would have to be analysed and adapted to the specific context of the country. PMID:11515474

  16. [The Brazilian Unified Health System (SUS), State Public Policy: its institutionalized and future development and the search for solutions].

    PubMed

    Santos, Nelson Rodrigues Dos

    2013-01-01

    This paper redeems the significance of the health reform movement and the municipal healthcare movement in the context of the 1970s and 1980s, and its social, politic and innovative power in the democratic reconstruction of the day. It then notes that the implementation of the constitutional guidelines, regulated in 1990 by Laws 8080/90 and 8142/90, has been characterized in the last 22 years by four major and mounting obstacles imposed by State policy on all governments: federal underfunding; federal subsidies to the private health plan market; resistance to reform of the State management structure of service provision; and the handing over of administration of public facilities to private entities. The Brazilian Unified Health System (SUS) included half the population that was once excluded in the public health system, though these obstacles keep the coverage of primary care focused below the poverty line and with poor resolution. The conclusion drawn is that the real policy of the state for healthcare in the past 22 years has prioritized the creation and expansion of the private health plan market for consumer rights, and relegated the effectiveness of constitutional guidelines for civic human rights to second place. PMID:23338517

  17. Ethical issues in health workforce development.

    PubMed Central

    Cash, Richard

    2005-01-01

    Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed. PMID:15868019

  18. A systems approach to understanding and improving health systems.

    PubMed

    Erazo, Álvaro

    2015-09-01

    Health systems face the challenge of helping to improve health conditions. They occupy a priority place in middle- and lower-income countries, since the absence or fragility of health systems adversely impacts expected health outcomes. Thus, due to the direct relationship between programs and systems, the absence or weakness of either will result in a consequent deficiency in public health and the very execution of the programs. In the same vein, weakened health systems are one of the main bottlenecks to attaining the Millennium Development Goals. Systems thinking is one of the "four revolutions in progress" that are helping to transform health and health care systems. Within that framework, this article identifies conceptual and operational elements of systems applicable to health systems that contribute to overcoming the obstacles and inertia that hinder health activities and outcomes. It discusses relevant concepts characteristic of systems thinking, such as structural variables and dynamic complexity, the relationship between programs and health systems, and the monitoring and evaluation function, together with the role of innovation and systems integration as high-priority elements. This will aid in the development of designs that also stress the context of the components that guide management, identifying processes and outcomes in a health management continuum. PMID:26758004

  19. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  20. A Review and Framework for Categorizing Current Research and Development in Health Related Geographical Information Systems (GIS) Studies

    PubMed Central

    Nøhr, C.; Sørensen, E. M.; Gudes, O.; Geraghty, E. M.; Shaw, N. T.; Bivona-Tellez, C.

    2014-01-01

    Summary Objectives The application of GIS in health science has increased over the last decade and new innovative application areas have emerged. This study reviews the literature and builds a framework to provide a conceptual overview of the domain, and to promote strategic planning for further research of GIS in health. Method The framework is based on literature from the library databases Scopus and Web of Science. The articles were identified based on keywords and initially selected for further study based on titles and abstracts. A grounded theory-inspired method was applied to categorize the selected articles in main focus areas. Subsequent frequency analysis was performed on the identified articles in areas of infectious and non-infectious diseases and continent of origin. Results A total of 865 articles were included. Four conceptual domains within GIS in health sciences comprise the framework: spatial analysis of disease, spatial analysis of health service planning, public health, health technologies and tools. Frequency analysis by disease status and location show that malaria and schistosomiasis are the most commonly analyzed infectious diseases where cancer and asthma are the most frequently analyzed non-infectious diseases. Across categories, articles from North America predominate, and in the category of spatial analysis of diseases an equal number of studies concern Asia. Conclusion Spatial analysis of diseases and health service planning are well-established research areas. The development of future technologies and new application areas for GIS and data-gathering technologies such as GPS, smartphones, remote sensing etc. will be nudging the research in GIS and health. PMID:25123730

  1. Developing Clinical Decision Support within a Commercial Electronic Health Record System to Improve Antimicrobial Prescribing in the Neonatal ICU

    PubMed Central

    Cato, K.; Sheehan, B.; Patel, S.; Duchon, J.; DeLaMora, P.; Ferng, Y.H.; Graham, P.; Vawdrey, D.K.; Perlman, J.; Larson, E.; Saiman, L.

    2014-01-01

    Summary Objective To develop and implement a clinical decision support (CDS) tool to improve antibiotic prescribing in neonatal intensive care units (NICUs) and to evaluate user acceptance of the CDS tool. Methods Following sociotechnical analysis of NICU prescribing processes, a CDS tool for empiric and targeted antimicrobial therapy for healthcare-associated infections (HAIs) was developed and incorporated into a commercial electronic health record (EHR) in two NICUs. User logs were reviewed and NICU prescribers were surveyed for their perceptions of the CDS tool. Results The CDS tool aggregated selected laboratory results, including culture results, to make treatment recommendations for common clinical scenarios. From July 2010 to May 2012, 1,303 CDS activations for 452 patients occurred representing 22% of patients prescribed antibiotics during this period. While NICU clinicians viewed two culture results per tool activation, prescribing recommendations were viewed during only 15% of activations. Most (63%) survey respondents were aware of the CDS tool, but fewer (37%) used it during their most recent NICU rotation. Respondents considered the most useful features to be summarized culture results (43%) and antibiotic recommendations (48%). Discussion During the study period, the CDS tool functionality was hindered by EHR upgrades, implementation of a new laboratory information system, and changes to antimicrobial testing methodologies. Loss of functionality may have reduced viewing antibiotic recommendations. In contrast, viewing culture results was frequently performed, likely because this feature was perceived as useful and functionality was preserved. Conclusion To improve CDS tool visibility and usefulness, we recommend early user and information technology team involvement which would facilitate use and mitigate implementation challenges. PMID:25024755

  2. Accounting for health spending in developing countries.

    PubMed

    Raciborska, Dorota A; Hernández, Patricia; Glassman, Amanda

    2008-01-01

    Data on health system financing and spending, together with information on the disease prevalence and cost-effectiveness of interventions, constitute essential input into health policy. It is particularly critical in developing countries, where resources are scarce and the marginal dollar has a major impact. Yet regular monitoring of health spending tends to be absent from those countries, and the results of international efforts to stimulate estimation activities have been mixed. This paper offers a history of health spending measurement, describes alternative sources of data, and recommends improving international collaboration and advocacy with the private sector for the way forward.

  3. Energy Systems and Population Health

    SciTech Connect

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    It is well-documented that energy and energy systems have a central role in social and economic development and human welfare at all scales, from household and community to regional and national (41). Among its various welfare effects, energy is closely linked with people s health. Some of the effects of energy on health and welfare are direct. With abundant energy, more food or more frequent meals can be prepared; food can be refrigerated, increasing the types of food items that are consumed and reducing food contamination; water pumps can provide more water and eliminate the need for water storage leading to contamination or increased exposure to disease vectors such as mosquitoes or snails; water can be disinfected by boiling or using other technologies such as radiation. Other effects of energy on public health are mediated through more proximal determinants of health and disease. Abundant energy can lead to increased irrigation, agricultural productivity, and access to food and nutrition; access to energy can also increase small-scale income generation such as processing of agricultural commodities (e.g., producing refined oil from oil seeds, roasting coffee, drying and preserving fruits and meats) and production of crafts; ability to control lighting and heating allows education or economic activities to be shielded from daily or seasonal environmental constraints such as light, temperature, rainfall, or wind; time and other economic resources spent on collecting and/or transporting fuels can be used for other household needs if access to energy is facilitated; energy availability for transportation increases access to health and education facilities and allow increased economic activity by facilitating the transportation of goods and services to and from markets; energy for telecommunication technology (radio, television, telephone, or internet) provides increased access to information useful for health, education, or economic purposes; provision of energy

  4. SARS: a health system's perspective.

    PubMed

    Beard, Leslie; Clark, Caroline

    2003-01-01

    Effective communications with different stakeholders was critical for health systems everywhere during the worldwide SARS outbreak earlier this year. For Capital Health in Edmonton, Alberta, the health system was able to build on its past experiences in dealing with meningococcal outbreaks and its planning for a pandemic flu. PMID:14628532

  5. Health information systems: the foundations of public health.

    PubMed Central

    AbouZahr, Carla; Boerma, Ties

    2005-01-01

    Public health decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. The products of historical, social and economic forces, they are complex, fragmented and unresponsive to needs. International donors in health are largely responsible for the problem, having prioritized urgent needs for data over longer-term country capacity-building. The result is painfully apparent in the inability of most countries to generate the data needed to monitor progress towards the Millennium Development Goals. Solutions to the problem must be comprehensive; money alone is likely to be insufficient unless accompanied by sustained support to country systems development coupled with greater donor accountability and allocation of responsibilities. The Health Metrics Network, a global collaboration in the making, is intended to help bring such solutions to the countries most in need. PMID:16184276

  6. [The health system of Colombia].

    PubMed

    Guerrero, Ramiro; Gallego, Ana Isabel; Becerril-Montekio, Victor; Vásquez, Johanna

    2011-01-01

    This document briefly describes the health conditions of the Colombian population and, in more detail, the characteristics of the Colombian health system. The description of the system includes its structure and coverage; financing sources; expenditure in health; physical material and human resources available; monitoring and evaluation procedures; and mechanisms through which the population participates in the evaluation of the system. Salient among the most recent innovations implemented in the Colombian health system are the modification of the Compulsory Health Plan and the capitation payment unit, the vertical integration of the health promotion enterprises and the institutions in charge of the provision of services and the mobilization of additional resources to meet the objectives of universal coverage and the homologation of health benefits among health regimes. PMID:21877080

  7. [Wawared Peru: reducing health inequities and improving maternal health by improving information systems in health].

    PubMed

    Pérez-Lu, José E; Iguiñiz Romero, Ruth; Bayer, Angela M; García, Patricia J

    2015-01-01

    In developing countries, there are no high quality data to support decision-making and governance due to inadequate information collection and transmission processes. Our project WawaRed-Peru: "Reducing health inequities and improving maternal health by improving health information systems" aims to improve maternal health processes and indicators through the implementation of interoperability standards for maternal health information systems in order for decision makers to have timely, high quality information. Through this project, we hope to support the development of better health policies and to also contribute to reducing problems of health equity among Peruvian women and potentially women in other developing countries. The aim of this article is to present the current state of information systems for maternal health in Peru. PMID:26338401

  8. [The health system of Mexico].

    PubMed

    Gómez Dantés, Octavio; Sesma, Sergio; Becerril, Victor M; Knaul, Felicia M; Arreola, Héctor; Frenk, Julio

    2011-01-01

    This paper describes the Mexican health system. In part one, the health conditions of the Mexican population are discussed, with emphasis in those emerging diseases that are now the main causes of death, both in men and women: diabetes, ischaemic heart disease, cerebrovascular diseases and cancer. Part two is devoted to the description of the basic structure of the system: its main institutions, the population coverage, the health benefits of those affiliated to the different heath institutions, its financial sources, the levels of financial protection in health, the availability of physical, material and human resources for health, and the stewardship functions displayed by the Ministry of Health and other actors. This part also discusses the role of citizens in the monitorization and evaluation of the health system, as well as the levels of satisfaction with the rendered health services. In part three the most recent innovations and its impact on the performance of the health system are discussed. Salient among them are the System of Social Protection in Health and the Popular Health Insurance. The paper concludes with a brief analysis of the short- and middle-term challenges faced by the Mexican health system.

  9. Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?

    PubMed

    Perry, Lora; Malkin, Robert

    2011-07-01

    It is often said that most of the medical equipment in the developing world is broken with estimates ranging up to 96% out of service. But there is little documented evidence to support these statements. We wanted to quantify the amount of medical equipment that was out of service in resource poor health settings and identify possible causes. Inventory reports were analyzed from 1986 to 2010, from hospitals in sixteen countries across four continents. The UN Human Development Index was used to determine which countries should be considered developing nations. Non-medical hospital equipment was excluded. This study examined 112,040 pieces of equipment. An average of 38.3% (42,925, range across countries: 0.83-47%) in developing countries was out of service. The three main causes were lack of training, health technology management, and infrastructure. We hope that the findings will help biomedical engineers with their efforts toward effective designs for the developing world and NGO's with efforts to design effective healthcare interventions.

  10. Health governance: principal-agent linkages and health system strengthening.

    PubMed

    Brinkerhoff, Derick W; Bossert, Thomas J

    2014-09-01

    Governance is increasingly recognized as an important factor in health system performance, yet conceptually and practically it remains poorly understood and subject to often vague and competing notions of both what its role is and how to address its weaknesses. This overview article for the symposium on health governance presents a model of health governance that focuses on the multiplicity of societal actors in health systems, the distribution of roles and responsibilities among them and their ability and willingness to fulfil these roles and responsibilities. This focus highlights the principal-agent linkages among actors and the resulting incentives for good governance and health system performance. The discussion identifies three disconnects that constitute challenges for health system strengthening interventions that target improving governance: (1) the gap between the good governance agenda and existing capacities, (2) the discrepancy between formal and informal governance and (3) the inattention to sociopolitical power dynamics. The article summarizes the three country cases in the symposium and highlights their governance findings: health sector reform in China, financial management of health resources in Brazilian municipalities and budget reform in hospitals in Lesotho. The concluding sections clarify how the three cases apply the model's principal-agent linkages and highlight the importance of filling the gaps remaining between problem diagnosis and the development of practical guidance that supports 'best fit' solutions and accommodates political realities in health systems strengthening.

  11. Health economics in developing countries.

    PubMed

    Abel-Smith, B

    1989-08-01

    The interpretation of health economics chosen for this paper is broad. It includes the relation between economic and other factors in health development. This interpretation has been chosen lest the acceptance of a disciplinary approach in the commissioning of papers should have the unintended effect of excluding some key areas of research which require the consideration of crucial interrelationships between disciplines. The only justification for covering this area in a paper on economics rather than, for example, epidemiology is that increasingly there is and indeed has to be a heavy focus on costs in considering alternative paths to health development. The word 'research' is loosely interpreted and not restricted to the type of activity which could lead to the award of a PhD. The compilation of experience in many areas is, in the view of the author, a priority need, to plan where further research and experiment is needed.

  12. Investing in health systems for universal health coverage in Africa

    PubMed Central

    2014-01-01

    Background This study focused on the 47 Member States of the World Health Organization (WHO) African Region. The specific objectives were to prepare a synthesis on the situation of health systems¿ components, to analyse the correlation between the interventions related to the health Millennium Development Goals (MDGs) and some health systems¿ components and to provide overview of four major thrusts for progress towards universal health coverage (UHC). Methods The WHO health systems framework and the health-related MDGs were the frame of reference. The data for selected indicators were obtained from the WHO World Health Statistics 2014 and the Global Health Observatory. Results African Region¿s average densities of physicians, nursing and midwifery personnel, dentistry personnel, pharmaceutical personnel, and psychiatrists of 2.6, 12, 0.5, 0.9 and 0.05 per 10 000 population were about five-fold, two-fold, five-fold, five-fold and six-fold lower than global averages. Fifty-six percent of the reporting countries had fewer than 11 health posts per 100 000 population, 88% had fewer than 11 health centres per 100 000 population, 82% had fewer than one district hospital per 100 000 population, 74% had fewer than 0.2 provincial hospitals per 100 000 population, and 79% had fewer than 0.2 tertiary hospitals per 100 000 population. Some 83% of the countries had less than one MRI per one million people and 95% had fewer than one radiotherapy unit per million population. Forty-six percent of the countries had not adopted the recommendation of the International Taskforce on Innovative Financing to spend at least US$ 44 per person per year on health. Some of these gaps in health system components were found to be correlated to coverage gaps in interventions for maternal health (MDG 5), child health (MDG 4) and HIV/AIDS, TB and malaria (MDG 6). Conclusions Substantial gaps exist in health systems and access to MDG-related health interventions. It is imperative that countries

  13. Breast health in developing countries.

    PubMed

    Yip, C H; Taib, N A

    2014-12-01

    Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.

  14. A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: learning from failure.

    PubMed

    El-Jardali, Fadi; Bou-Karroum, Lama; Ataya, Nour; El-Ghali, Hana Addam; Hammoud, Rawan

    2014-12-01

    Public policymaking is complex and suffers from limited uptake of research evidence, particularly in the Eastern Mediterranean Region (EMR). In-depth case studies examining health policymaking in the EMR are lacking. This retrospective policy analysis aims at generating insights about how policies are being made, identifying factors influencing policymaking and assessing to what extent evidence is used in this process by using the Lebanese Voluntary Health Insurance policy as a case study. The study examined the policymaking process through a policy tracing technique that covered a period of 12 years. The study employed a qualitative research design using a case study approach and was conducted in two phases over the course of two years. Data was collected using multiple sources including: 1) a comprehensive and chronological media review; 2) twenty-two key informant interviews with policymakers, stakeholders, and journalists; and 3) a document review of legislations, minutes of meetings, actuarial studies, and official documents. Data was analyzed and validated using thematic analysis. Findings showed that the voluntary health insurance policy was a political decision taken by the government to tackle an urgent political problem. Evidence was not used to guide policy development and implementation and policy implementers and other stakeholders were not involved in policy development. Factors influencing policymaking were political interests, sectarianism, urgency, and values of policymakers. Barriers to the use of evidence were lack of policy-relevant research evidence, political context, personal interests, and resource constraints. Findings suggest that policymakers should be made more aware of the important role of evidence in informing public policymaking and the need for building capacity to develop, implement and evaluate policies. Study findings are likely to matter in light of the changes that are unfolding in some Arab countries and the looming

  15. [Economics of health system transformation].

    PubMed

    González Pier, Eduardo

    2012-01-01

    Health conditions in Mexico have evolved along with socioeconomic conditions. As a result, today's health system faces several problems characterized by four overlapping transitions: demand, expectations, funding and health resources. These transitions engender significant pressures on the system itself. Additionally, fragmentation of the health system creates disparities in access to services and generates problems in terms of efficiency and use of available resources. To address these complications and to improve equity in access and efficiency, thorough analysis is required in how the right to access health care should be established at a constitutional level without differentiating across population groups. This should be followed by careful discussion about what rules of health care financing should exist, which set of interventions ought to be covered and how services must be organized to meet the health needs of the population.

  16. [Economics of health system transformation].

    PubMed

    González Pier, Eduardo

    2012-01-01

    Health conditions in Mexico have evolved along with socioeconomic conditions. As a result, today's health system faces several problems characterized by four overlapping transitions: demand, expectations, funding and health resources. These transitions engender significant pressures on the system itself. Additionally, fragmentation of the health system creates disparities in access to services and generates problems in terms of efficiency and use of available resources. To address these complications and to improve equity in access and efficiency, thorough analysis is required in how the right to access health care should be established at a constitutional level without differentiating across population groups. This should be followed by careful discussion about what rules of health care financing should exist, which set of interventions ought to be covered and how services must be organized to meet the health needs of the population. PMID:23254712

  17. [The design and development of a quality system for the diagnosis of exotic animal diseases at the National Centre for Animal and Plant Health in Cuba].

    PubMed

    de Oca, N Montes; Villoch, A; Pérez Ruano, M

    2004-12-01

    A quality system for the diagnosis of exotic animal diseases was developed at the national centre for animal and plant health (CENSA), responsible for coordinating the clinical, epizootiological and laboratory diagnosis of causal agents of exotic animal diseases in Cuba. A model was designed on the basis of standard ISO 9001:2000 of the International Organization for Standardization (ISO), standard ISO/IEC 17025:1999 of ISO and the International Electrotechnical Commission, recommendations of the World Organisation for Animal Health (OIE) and other regulatory documents from international and national organisations that deal specifically with the treatment of emerging diseases. Twenty-nine standardised operating procedures were developed, plus 13 registers and a checklist to facilitate the evaluation of the system. The effectiveness of the quality system was confirmed in the differential diagnosis of classical swine fever at an animal virology laboratory in Cuba.

  18. [The design and development of a quality system for the diagnosis of exotic animal diseases at the National Centre for Animal and Plant Health in Cuba].

    PubMed

    de Oca, N Montes; Villoch, A; Pérez Ruano, M

    2004-12-01

    A quality system for the diagnosis of exotic animal diseases was developed at the national centre for animal and plant health (CENSA), responsible for coordinating the clinical, epizootiological and laboratory diagnosis of causal agents of exotic animal diseases in Cuba. A model was designed on the basis of standard ISO 9001:2000 of the International Organization for Standardization (ISO), standard ISO/IEC 17025:1999 of ISO and the International Electrotechnical Commission, recommendations of the World Organisation for Animal Health (OIE) and other regulatory documents from international and national organisations that deal specifically with the treatment of emerging diseases. Twenty-nine standardised operating procedures were developed, plus 13 registers and a checklist to facilitate the evaluation of the system. The effectiveness of the quality system was confirmed in the differential diagnosis of classical swine fever at an animal virology laboratory in Cuba. PMID:15861883

  19. The concept of "intercultural opening": the development of an assessment tool for the appraisal of its current implementation in the mental health care system.

    PubMed

    Penka, S; Kluge, U; Vardar, A; Borde, T; Ingleby, D

    2012-06-01

    The German concept of "intercultural opening" is an approach to facilitating migrants' access to the health care system and improving the care they receive. No data exist concerning the current status of the implementation of this approach in Germany, and the concept has never been analysed in practice. To assess the status of "intercultural opening" in the German mental health care system and to further analyse the concept, we developed a tool by combining pre-existing instruments. In order to review the preliminary tool we combined experts' knowledge by carrying out a consensusoriented, expert-based Delphi process with actual practice by piloting the instrument in each type of institution to be assessed. The assessment tool thus developed(1) is the first one to evaluate the current status of "intercultural opening" in the community mental health care system in Germany from a broad perspective. This paper is intended to present the development process of our assessment tool for demonstrating the benefits of this approach and as a model for future studies, as well as to increase transparency in relation to the current German approach to health care structures in dealing with migrants. PMID:22863253

  20. The concept of "intercultural opening": the development of an assessment tool for the appraisal of its current implementation in the mental health care system.

    PubMed

    Penka, S; Kluge, U; Vardar, A; Borde, T; Ingleby, D

    2012-06-01

    The German concept of "intercultural opening" is an approach to facilitating migrants' access to the health care system and improving the care they receive. No data exist concerning the current status of the implementation of this approach in Germany, and the concept has never been analysed in practice. To assess the status of "intercultural opening" in the German mental health care system and to further analyse the concept, we developed a tool by combining pre-existing instruments. In order to review the preliminary tool we combined experts' knowledge by carrying out a consensusoriented, expert-based Delphi process with actual practice by piloting the instrument in each type of institution to be assessed. The assessment tool thus developed(1) is the first one to evaluate the current status of "intercultural opening" in the community mental health care system in Germany from a broad perspective. This paper is intended to present the development process of our assessment tool for demonstrating the benefits of this approach and as a model for future studies, as well as to increase transparency in relation to the current German approach to health care structures in dealing with migrants.

  1. Health, Human Capital, and Development*

    PubMed Central

    Bleakley, Hoyt

    2013-01-01

    How much does disease depress development in human capital and income around the world? I discuss a range of micro evidence, which finds that health is both human capital itself and an input to producing other forms of human capital. I use a standard model to integrate these results, and suggest a re-interpretation of much of the micro literature. I then discuss the aggregate implications of micro estimates, but note the complications in extrapolating to general equilibrium, especially because of health’s effect on population size. I also review the macro evidence on this topic, which consists of either cross-country comparisons or measuring responses to health shocks. Micro estimates are 1–2 orders of magnitude smaller than the cross-country relationship, but nevertheless imply high benefit-to-cost ratios from improving certain forms of health. PMID:24147187

  2. Building health research systems to achieve better health

    PubMed Central

    Hanney, Stephen R; González Block, Miguel A

    2006-01-01

    Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above

  3. Building health research systems to achieve better health.

    PubMed

    Hanney, Stephen R; González Block, Miguel A

    2006-01-01

    Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above

  4. Climbing the Ladder: Experience with Developing a Large Group Genetic Counselor Career Ladder at Children's National Health System.

    PubMed

    Kofman, Laura; Seprish, Mary Beth; Summar, Marshall

    2016-08-01

    Children's National Health System (CNHS) is a not-for-profit pediatric hospital that employs around twenty genetic counselors in a range of specialties, including clinical pediatric, neurology, fetal medicine, research, and laboratory. CNHS lacked a structured system of advancement for their genetic counselors; therefore, a formal career ladder was proposed by the genetic counselors based on years of experience, responsibility, and job performance. This career ladder utilized monetary, academic, and seniority incentives to encourage advancement and continue employment at CNHS. The creation and ultimate approval of the career ladder required direct input from genetic counselors, Department Chairs, and Human Resource personnel. The establishment of a genetic counselor career ladder at CNHS will hopefully benefit the profession of genetic counselors as a whole and allow other facilities to create and maintain their own career ladder to meet the needs of the growing, competitive, field of genetic counseling. PMID:27215631

  5. Leadership development for rural health.

    PubMed

    Size, Tim

    2006-01-01

    Leadership is the capacity to help transform a vision of the future into reality. Individuals who can and will exercise leadership are like a river's current--a part past where we now stand, a part yet to come. We have an ongoing need to remember and to look toward the next "generation." A key responsibility of those here now, is to mentor and to create structures for mentoring, in order to maximize the flow and effectiveness of tomorrow's leaders. When recruiting organizational leaders, the recruitment and interview process must seek individuals who in addition to technical competence, also have demonstrated leadership in their prior work and activities. To exercise effective leadership, we must work to know who we are, how we relate to others, and the environment around us. "Servant leadership" is a perspective held by many throughout the rural health community and offers a key set attributes of leadership useful to rural health. To implement the Institute of Medicine's recommendations in Through Collaboration: the Future of Rural Health, we must develop leaders skilled in collaboration, both internal to their organization and across organizations. The National Advisory Committee on Rural Health and Human Services had it right when they said to the Secretary and to the rest of us, "the best way to honor Jim is to consciously work to help develop the next generation of rural health leaders." There are, of course, a multitude of leadership institutes, programs, and courses throughout America; this is not a call for yet another separate entity. But it is a call to each of us in rural health to assure that we are deliberate in how we identify "emerging leaders from and for rural communities and provide them with the training and resources to play a lead role in ensuring access to quality healthcare in their states and communities." Let's get started.

  6. [Informatics in the Croatian health care system].

    PubMed

    Kern, Josipa; Strnad, Marija

    2005-01-01

    Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA

  7. Developing School Health Services in Massachusetts: A Public Health Model

    ERIC Educational Resources Information Center

    Sheetz, Anne H.

    2003-01-01

    In 1993 the Massachusetts Department of Public Health (MDPH) began defining essential components of school health service programs, consistent with the public health model. The MDPH designed and funded the Enhanced School Health Service Programs to develop 4 core components of local school health services: (a) strengthening the administrative…

  8. Health Coaching: A Developing Field within Health Education

    ERIC Educational Resources Information Center

    Palmer, Stephen

    2004-01-01

    The health promotion and health education literature has references to health counselling. Yet, beyond the field of health, coaching has become a popular method to enhance and facilitate individual and group performance in business, sports, and personal areas of life. This paper focuses on the recent development of health coaching by practitioners…

  9. TRICARE, Military Health System

    MedlinePlus

    ... a Phone Call Away The Importance of Health Literacy Be Aware of Bullying This Month TRICARE Expands ... Cards Dental Providers Provider Resources For Staff For Media Vendors FAQs Publications Resources Filing Claims Disaster Information ...

  10. Ontology-driven health information systems architectures.

    PubMed

    Blobel, Bernd; Oemig, Frank

    2009-01-01

    Following an architecture vision such as the Generic Component Model (GCM) architecture framework, health information systems for supporting personalized care have to be based on a component-oriented architecture. Representing concepts and their interrelations, the GCM perspectives system architecture, domains, and development process can be described by the domains' ontologies. The paper introduces ontology principles, ontology references to the GCM as well as some practical aspects of ontology-driven approaches to semantically interoperable and sustainable health information systems.

  11. Breast health in developing countries.

    PubMed

    Yip, C H; Taib, N A

    2014-12-01

    Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources. PMID:25131779

  12. The Contribution of Primary Care Systems to Health Outcomes within Organization for Economic Cooperation and Development (OECD) Countries, 1970–1998

    PubMed Central

    Macinko, James; Starfield, Barbara; Shi, Leiyu

    2003-01-01

    Objective To assess the contribution of primary care systems to a variety of health outcomes in 18 wealthy Organization for Economic Cooperation and Development (OECD) countries over three decades. Data Sources/Study Setting Data were primarily derived from OECD Health Data 2001 and from published literature. The unit of analysis is each of 18 wealthy OECD countries from 1970 to 1998 (total n=504). Study Design Pooled, cross-sectional, time-series analysis of secondary data using fixed effects regression. Data Collection/Extraction Methods Secondary analysis of public-use datasets. Primary care system characteristics were assessed using a common set of indicators derived from secondary datasets, published literature, technical documents, and consultation with in-country experts. Principal Findings The strength of a country's primary care system was negatively associated with (a) all-cause mortality, (b) all-cause premature mortality, and (c) cause-specific premature mortality from asthma and bronchitis, emphysema and pneumonia, cardiovascular disease, and heart disease (p<0.05 in fixed effects, multivariate regression analyses). This relationship was significant, albeit reduced in magnitude, even while controlling for macro-level (GDP per capita, total physicians per one thousand population, percent of elderly) and micro-level (average number of ambulatory care visits, per capita income, alcohol and tobacco consumption) determinants of population health. Conclusions (1) Strong primary care system and practice characteristics such as geographic regulation, longitudinality, coordination, and community orientation were associated with improved population health. (2) Despite health reform efforts, few OECD countries have improved essential features of their primary care systems as assessed by the scale used here. (3) The proposed scale can also be used to monitor health reform efforts intended to improve primary care. PMID:12822915

  13. Welcome to health information science and systems.

    PubMed

    Zhang, Yanchun

    2013-01-01

    Health Information Science and Systems is an exciting, new, multidisciplinary journal that aims to use technologies in computer science to assist in disease diagnoses, treatment, prediction and monitoring through the modeling, design, development, visualization, integration and management of health related information. These computer-science technologies include such as information systems, web technologies, data mining, image processing, user interaction and interface, sensors and wireless networking and are applicable to a wide range of health related information including medical data, biomedical data, bioinformatics data, public health data.

  14. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development.

    PubMed

    Gray, Kathleen

    2016-04-26

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector.

  15. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development

    PubMed Central

    Gray, Kathleen

    2016-01-01

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public health The landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

  16. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development.

    PubMed

    Gray, Kathleen

    2016-04-26

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

  17. Enhancing oral and systemic health.

    PubMed

    Warren, R C

    2001-07-01

    Much published research documents continuing racial and ethnic disparities in health, particularly for African Americans, which apply to both oral and systemic diseases. Current research suggests biologically plausible associations between oral and systemic diseases; however, clear cause-and-effect relationships have not been substantiated. Some researchers and health care providers have noted anecdotal associations between oral and systemic health, as well as compounding adverse effects of oral and systemic diseases and dysfunctions. Historically, African American physicians, dentists, and pharmacists have bonded together under one organizational umbrella to combat discrimination, prejudice, and racism directed at them and their patient populations. This coming together has resulted in a more comprehensive clinical, behavioral, economic, and public health decision-making process related to the general health and well-being of their patient populations, such as maximizing health care visits, treatment plans, reimbursements, and oral and systemic health care follow-ups. According to the 1985 Secretary's Task Force Report, the six causes of excess deaths among African Americans were: cardiovascular disease and stroke; cancer; diabetes; cirrhosis; homicide and accidents; and infant mortality. In 1991, HIV/AIDS became the seventh cause of excess deaths. This article summarizes salient information about cardiovascular diseases, diabetes, cancer, and the social and behavioral factors related to oral and systemic health.

  18. The engine or the caboose: health policy in developing countries.

    PubMed

    Goldsteen, R L; Pereira, J C; Goldsteen, K

    1990-12-01

    A discussion of health policy in developing countries is presented. It argues that developing countries must adopt a progressive approach to health policy which rejects the two-tiered system of public and private health care. However, it also points out that ideology is not sufficient to maintain support. A progressive health system must utilize administrative and social and behavioral sciences to achieve effectiveness and efficiency in health care delivery. It cannot ignore these goals any more than a private health care system can.

  19. ["Hannibal ante portas" -- technical development and health care reorganization].

    PubMed

    Fülesdi, Béla; Velkey, György

    2011-11-20

    Authors intend to analyze the impact of medical technical development on the Hungarian health care system and try to draw attention to potentially necessary measures for professional and structural health care reorganization.

  20. [The development of the medical information system for the improvement of the quality of work of the Crimean spa and health resorts].

    PubMed

    Ezhov, V V; Grigor'ev, P E; Mizin, V I; Andriyashek, Yu I; Gol'dberg, D L; Olenchuk, A V

    2016-01-01

    The Crimea has the enormous potential for the health promotion activities. However, neither the profile of these activities nor the demand for the socio-medical services is clearly defined for the majority of the local spa and health resort facilities. The possibilities of modern information technology are not used in the full measure either. The objective of the present work was to elaborate the new medical information system and demonstrate its effectiveness. In addition, the article describes the main advantages of the system for the optimization of healthcare in the Crimean spa and health resort facilities. We reviewed and analyzed various literature publications, legal framework, standards, regulations, guidelines, and questionnaire survey data obtain at 50 spa and health resort facilities of the Crimea. The results of the assessment indicate the necessity of the systematic approach to the analysis of the quality of medical care and the process of its further development. Statistical and mathematical methods were used to elaborate the medical information system for the optimization of the activities of the Crimean spa and health resorts. The distinctive features of the proposed information system are modularity and the possibility of flexible adjustment to the conditions of individual settings, one-step data loading with the subsequent multiple application for the formulation of documents, automated filling of records in compliance with the medical standards, and taking into consideration the possible changes in or amendments to the form of the documents. The data obtained in the course of project implementation were used for the first time in the Republic of Crimea to design, substantiate, and recommend for the practical application the algorithm for the comprehensive estimation of the results of treatment of the patients based at the spa and health resort facilities with due regard for the specific regional conditions.

  1. [The development of the medical information system for the improvement of the quality of work of the Crimean spa and health resorts].

    PubMed

    Ezhov, V V; Grigor'ev, P E; Mizin, V I; Andriyashek, Yu I; Gol'dberg, D L; Olenchuk, A V

    2016-01-01

    The Crimea has the enormous potential for the health promotion activities. However, neither the profile of these activities nor the demand for the socio-medical services is clearly defined for the majority of the local spa and health resort facilities. The possibilities of modern information technology are not used in the full measure either. The objective of the present work was to elaborate the new medical information system and demonstrate its effectiveness. In addition, the article describes the main advantages of the system for the optimization of healthcare in the Crimean spa and health resort facilities. We reviewed and analyzed various literature publications, legal framework, standards, regulations, guidelines, and questionnaire survey data obtain at 50 spa and health resort facilities of the Crimea. The results of the assessment indicate the necessity of the systematic approach to the analysis of the quality of medical care and the process of its further development. Statistical and mathematical methods were used to elaborate the medical information system for the optimization of the activities of the Crimean spa and health resorts. The distinctive features of the proposed information system are modularity and the possibility of flexible adjustment to the conditions of individual settings, one-step data loading with the subsequent multiple application for the formulation of documents, automated filling of records in compliance with the medical standards, and taking into consideration the possible changes in or amendments to the form of the documents. The data obtained in the course of project implementation were used for the first time in the Republic of Crimea to design, substantiate, and recommend for the practical application the algorithm for the comprehensive estimation of the results of treatment of the patients based at the spa and health resort facilities with due regard for the specific regional conditions. PMID:27030569

  2. Republic of Moldova health system review.

    PubMed

    Turcanu, Ghenadie; Domente, Silviu; Buga, Mircea; Richardson, Erica

    2012-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The reform of health financing in the Republic of Moldova began in earnest in 2004 with the introduction of a mandatory health insurance (MHI) system. Since then, MHI has become a sustainable financing mechanism that has improved the technical and allocative efficiency of the system as well as overall transparency. This has helped to further consolidate the prioritization of primary care in the system, which has been bas ed on a family medicine model since the 1990s. Hospital stock in the country has been reduced since independence as the country inherited a Semashko health system with excessive infrastructure, but there is still room for efficiency gains, particularly through the consolidation of specialist services in the capital city. The rationalization of duplicated specialized services, therefore, remains a key challenge facing the Moldovan health system. Other challenges include health workforce shortages (particularly in rural areas) and improving equity in financing and access to care by reducing out of pocket (OOP) payments. OOP spending on health is dominated by the cost of pharmaceuticals and this is currently a core focus of reform efforts.

  3. [E-health--challenge for health care system].

    PubMed

    Buczak-Stec, Elzbieta; Lemanowicz, Katarzyna; Mazurek, Marcin

    2011-01-01

    E-health and systems related to the electronic patient record (EPR) are seen as important factors in the development of the health care System. In 2004 European Commission had adopted e-Health Action Plan, which indicated the development directions of European e-Health. In Poland, the main development trends and Government course of actions in this regard, are contained in the document Computerization plan "e-Health Poland" 2009-2015. The European Commission defines e-Health as an application of tools and services, information and communication technologies in healthcare. EPR is a collection of patient data that are stored in a certain place and it is possible to access them. E-health and EPR are closely related to the concept of interoperability. Denmark is one of the countries in which the information services and information technology in healthcare is mostly used. The introduction of ERP involves a lot of positive effects. Using the ERP, stored data can be optimally used by both physicians and patients. However, also risks associated with data security need to be considered. Furthermore, the Polish law defines in great detail the issues associated with creating, storing and sharing medical records (1). According to the Act from 17 February 2005, concerning the computerization of public service activities, it possible to keep medical documentation in electronically form.

  4. Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana

    PubMed Central

    2014-01-01

    Background Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP ‘works’ when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. Methods We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. Results The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP’s underlying goal of organisational control. Conclusions Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that

  5. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    PubMed

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it.

  6. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    PubMed

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it. PMID:25738387

  7. Development and trialling of a tool to support a systems approach to improve social determinants of health in rural and remote Australian communities: the healthy community assessment tool

    PubMed Central

    2013-01-01

    Introduction The residents of many Australian rural and remote communities do not have the essential infrastructure and services required to support healthy living conditions and community members choosing healthy lifestyle options. Improving these social determinants of health is seen to offer real opportunities to improve health among such disadvantaged populations. In this paper, we describe the development and trialling of a tool to measure, monitor and evaluate key social determinants of health at community level. Methods The tool was developed and piloted through a multi-phase and iterative process that involved a series of consultations with community members and key stakeholders and trialling the tool in remote Indigenous communities in the Northern Territory of Australia. Results The indicators were found to be robust, and by testing the tool on a number of different levels, face validity was confirmed. The scoring system was well understood and easily followed by Indigenous and non-Indigenous study participants. A facilitated small group process was found to reduce bias in scoring of indicators. Conclusion The Healthy Community Assessment Tool offers a useful vehicle and process to help those involved in planning, service provision and more generally promoting improvements in community social determinants of health. The tool offers many potential uses and benefits for those seeking to address inequities in the social determinants of health in remote communities. Maximum benefits in using the tool are likely to be gained with cross-sector involvement and when assessments are part of a continuous quality improvement program. PMID:23442804

  8. Strengthening health information systems to address health equity challenges.

    PubMed Central

    Nolen, Lexi Bambas; Braveman, Paula; Dachs, J. Norberto W.; Delgado, Iris; Gakidou, Emmanuela; Moser, Kath; Rolfe, Liz; Vega, Jeanette; Zarowsky, Christina

    2005-01-01

    Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development. PMID:16184279

  9. Health Monitoring System for Composite Structures

    NASA Technical Reports Server (NTRS)

    Tang, S. S.; Riccardella, P. C.; Andrews, R. J.; Grady, J. E.; Mucciaradi, A. N.

    1996-01-01

    An automated system was developed to monitor the health status of composites. It uses the vibration characteristics of composites to identify a component's damage condition. The vibration responses are characterized by a set of signal features defined in the time, frequency and spatial domains. The identification of these changes in the vibration characteristics corresponding to different health conditions was performed using pattern recognition principles. This allows efficient data reduction and interpretation of vast amounts of information. Test components were manufactured from isogrid panels to evaluate performance of the monitoring system. The components were damaged by impact to simulate different health conditions. Free vibration response was induced by a tap test on the test components. The monitoring system was trained using these free vibration responses to identify three different health conditions. They are undamaged vs. damaged, damage location and damage zone size. High reliability in identifying the correct component health condition was achieved by the monitoring system.

  10. International Youth Justice Systems: Promoting Youth Development and Alternative Approaches: A Position Paper of the Society for Adolescent Health and Medicine.

    PubMed

    2016-10-01

    Youth incarceration is an international public health concern among developed and developing countries. Worldwide, youth are held in incarceration, detention, and other secure settings that are inappropriate for their age and developmental stages, jeopardizing their prosocial development, and reintegration into society. Youth incarceration lacks evidence and cost-effectiveness. The well-being of youth is a key indicator of the welfare of families, communities, and society at large; therefore, the Society for Adolescent Health and Medicine (SAHM) supports a paradigm shift in the role of the justice system as it relates to treatment of youth. SAHM recommends justice systems focus greater attention and resources on identifying and reducing the antecedents of high-risk and criminal behaviors, recognizing the rights and freedom of young persons, and prioritizing the well-being of youth over punitive measures that may harm and disrupt healthy adolescent development. SAHM supports the following positions: (1) incarceration is a last option for selected offenders who have committed the most serious violent crimes and are unable to remain safely in the community; (2) youth justice policies, programs, and practices affecting youth be evidence based and trauma informed; (3) youth justice policies, programs, and practices must incorporate research and ongoing program evaluation; (4) youth justice policies shall protect the privacy and dignity of children younger than 18 years; and (5) health care professionals and media will promote positive portrayals of youth in healthy relationships within their communities and reduce representations and images of youth that are negative, violent, deviant, and threatening.

  11. International Youth Justice Systems: Promoting Youth Development and Alternative Approaches: A Position Paper of the Society for Adolescent Health and Medicine.

    PubMed

    2016-10-01

    Youth incarceration is an international public health concern among developed and developing countries. Worldwide, youth are held in incarceration, detention, and other secure settings that are inappropriate for their age and developmental stages, jeopardizing their prosocial development, and reintegration into society. Youth incarceration lacks evidence and cost-effectiveness. The well-being of youth is a key indicator of the welfare of families, communities, and society at large; therefore, the Society for Adolescent Health and Medicine (SAHM) supports a paradigm shift in the role of the justice system as it relates to treatment of youth. SAHM recommends justice systems focus greater attention and resources on identifying and reducing the antecedents of high-risk and criminal behaviors, recognizing the rights and freedom of young persons, and prioritizing the well-being of youth over punitive measures that may harm and disrupt healthy adolescent development. SAHM supports the following positions: (1) incarceration is a last option for selected offenders who have committed the most serious violent crimes and are unable to remain safely in the community; (2) youth justice policies, programs, and practices affecting youth be evidence based and trauma informed; (3) youth justice policies, programs, and practices must incorporate research and ongoing program evaluation; (4) youth justice policies shall protect the privacy and dignity of children younger than 18 years; and (5) health care professionals and media will promote positive portrayals of youth in healthy relationships within their communities and reduce representations and images of youth that are negative, violent, deviant, and threatening. PMID:27664466

  12. Community exposures to chemical incidents: development and evaluation of the first environmental public health surveillance system in Europe

    PubMed Central

    Bowen, H; Palmer, S; Fielder, H; Coleman, G; Routledge, P; Fone, D

    2000-01-01

    OBJECTIVE—To describe the frequency, nature and location of acute chemical incidents in Wales, and the morbidity in employees, emergency responders and the general public who were exposed.
DESIGN—Active multi-agency community-based surveillance system.
SETTING—Wales, 1993-5.
MAIN OUTCOME MEASURES—Frequency, nature and location of incidents, populations potentially exposed and with symptoms.
RESULTS—Most of the 402 incidents identified were not associated with sites governed by the Control of Industrial Major Accident Hazard Regulations but with smaller industrial sites and commercial premises. About two in every thousand of the estimated 236 000 members of the public considered to be at risk from exposure reported symptoms, which were mainly nausea, headaches, and irritation of the eye, skin and respiratory tract. The most commonly reported chemicals that members of the public were exposed to were smoke toxins, miscellaneous organics, toxic gases and flammable gases. A health authority was reported to be involved in only 34 (8%) of the incidents and in only 3 of the 29 incidents where more than 100 members of the public were exposed.
CONCLUSION—A geographically defined, multi-agency surveillance system can identify high risk locations and types of incidents, together with the chemicals most likely to be involved. Such ongoing surveillance information is essential for appropriate policy making, emergency planning, operational management and training.


Keywords: surveillance; pollution; chemical PMID:11027203

  13. Developing a strategic plan for school health services in Massachusetts.

    PubMed

    Sheetz, Anne H

    2002-09-01

    School health service programs underwent rapid changes to meet the health needs of today's students. These needs stem largely from: a) increased number of students with special health care needs attending school, b) increased stress and time pressure on families, c) rapid restructuring of the health care system serving children, and d) recognition that schools provide opportunities to identify students with health risks. This paper describes seven components of a statewide Massachusetts plan to develop school health services by: a) setting standards, b) reviewing and revising statutes and regulations, c) promoting credentialing of school health personnel, d) providing continuing education on subjects pertinent to school health, e) exploring reimbursement systems and new funding sources, including funds from the tobacco settlement, f) exploring new models of care, and g) implementing data systems. The plan focuses on developing school nurse-managed school health services within a public health model.

  14. [The health system of Cuba].

    PubMed

    Domínguez-Alonso, Emma; Zacea, Eduardo

    2011-01-01

    This paper describes the health conditions in Cuba and the general characteristics of the Cuban health system, including its structure and coverage, its financial sources, its health expenditure, its physical, material and human resources, and its stewardship functions. It also discusses the increasing importance of its research institutions and the role played by its users in the operation and evaluation of the system. Salient among the social actors involved in the health sector are the Cuban Women Federation and the Committees for the Defense of the Revolution. The paper concludes with the discussion of the most recent innovations implemented in the Cuban health system, including the cardiology networks, the Miracle Mission (Misión Milagro) and the Battle of Ideas (Batalla de Ideas).

  15. Health System Measurement Project

    MedlinePlus

    ... string(86) "Dollars Invested in Pharmaceutical and Medicine Manufacturing Research and Development" ["field_data_field_order_field_ ... string(86) "Dollars Invested in Pharmaceutical and Medicine Manufacturing Research and Development" ["log"]=> string(0) "" ["status"]=> string( ...

  16. Integrated Systems Health Management (ISHM) Toolkit

    NASA Technical Reports Server (NTRS)

    Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim

    2013-01-01

    A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

  17. [The health system of Venezuela].

    PubMed

    Bonvecchio, Anabelle; Becerril-Montekio, Victor; Carriedo-Lutzenkirchen, Angela; Landaeta-Jiménez, Maritza

    2011-01-01

    This paper describes the Venezuelan health system, including its structure and coverage, financial sources, human and material resources and its stewardship functions. This system comprises a public and a private sector. The public sector includes the Ministry of Popular Power for Health (MS) and several social security institutions, salient among them the Venezuelan Institute for Social Security (IVSS). The MH is financed with federal, state and county contributions. The IVSS is financed with employer, employee and government contributions. These two agencies provide services in their own facilities. The private sector includes providers offering services on an out-of-pocket basis and private insurance companies. The Venezuelan health system is undergoing a process of reform since the adoption of the 1999 Constitution which calls for the establishment of a national public health system. The reform process is now headed by the Barrio Adentro program. PMID:21877092

  18. [The health system of Venezuela].

    PubMed

    Bonvecchio, Anabelle; Becerril-Montekio, Victor; Carriedo-Lutzenkirchen, Angela; Landaeta-Jiménez, Maritza

    2011-01-01

    This paper describes the Venezuelan health system, including its structure and coverage, financial sources, human and material resources and its stewardship functions. This system comprises a public and a private sector. The public sector includes the Ministry of Popular Power for Health (MS) and several social security institutions, salient among them the Venezuelan Institute for Social Security (IVSS). The MH is financed with federal, state and county contributions. The IVSS is financed with employer, employee and government contributions. These two agencies provide services in their own facilities. The private sector includes providers offering services on an out-of-pocket basis and private insurance companies. The Venezuelan health system is undergoing a process of reform since the adoption of the 1999 Constitution which calls for the establishment of a national public health system. The reform process is now headed by the Barrio Adentro program.

  19. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  20. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions. PMID:26016214

  1. Health care financing and the sustainability of health systems.

    PubMed

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-01-01

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability. PMID:26369417

  2. Health care financing and the sustainability of health systems.

    PubMed

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-09-15

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

  3. Health impacts of urban development: key considerations.

    PubMed

    Capon, Anthony G

    2007-01-01

    The urban environment is an important determinant of health. Health impact assessment is a tool for systematic analysis of the health consequences of urban development and management. This paper identifies key considerations, including opportunities for physical activity, food access and local economic development. Time use by urban residents has health implications. The schedule for infrastructure development in new release areas (in particular transport, education and health infrastructure) also has health implications. Health impacts should be considered a primary outcome of urban development and management.

  4. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".

    PubMed

    Blanchet, Karl

    2015-05-01

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. PMID:25905481

  5. Unemployment and health: the healthcare system's role.

    PubMed

    Harris, E; Webster, I W; Harris, M F; Lee, P J

    1998-03-16

    Experts from the South Western Sydney Area Health Service and the University of New South Wales say there are few reports of healthcare interventions to address the impact of unemployment on health. They outline possible strategies, which include providing accessible and appropriate healthcare; developing the healthcare system's capacity to deal with the health problems of unemployed people; collaborating with other agencies and sectors working on this issue; acting as an advocate for unemployed people; undertaking research; and providing training, work experience and employment opportunities within the healthcare system. Long term solutions lie in increasing employment and training opportunities. Nevertheless, there is a clear role for the healthcare system in reducing the health impacts of unemployment and ensuring that poor health does not act as a barrier to returning to work. PMID:9549538

  6. Ensuring public health's future in a national-scale learning health system.

    PubMed

    Bernstein, Jennifer A; Friedman, Charles; Jacobson, Peter; Rubin, Joshua C

    2015-04-01

    Data and information are fundamental to every function of public health and crucial to public health agencies, from outbreak investigations to environmental surveillance. Information allows for timely, relevant, and high-quality decision making by public health agencies. Evidence-based practice is an important, grounding principle within public health practice, but resources to handle and analyze public health data in a meaningful way are limited. The Learning Health System is a platform that seeks to leverage health data to allow evidence-based real-time analysis of data for a broad range of uses, including primary care decision making, public health activities, consumer education, and academic research. The Learning Health System is an emerging endeavor that is gaining support throughout the health sector and presents an important opportunity for collaboration between primary care and public health. Public health should be a key stakeholder in the development of a national-scale Learning Health System because participation presents many potential benefits, including increased workforce capacity, enhanced resources, and greater opportunities to use health information for the improvement of the public's health. This article describes the framework and progression of a national-scale Learning Health System, considers the advantages of and challenges to public health involvement in the Learning Health System, including the public health workforce, gives examples of small-scale Learning Health System projects involving public health, and discusses how public health practitioners can better engage in the Learning Health Community.

  7. Improving the use of health data for health system strengthening

    PubMed Central

    Nutley, Tara; Reynolds, Heidi W.

    2013-01-01

    Background Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated. PMID:23406921

  8. Evaluation of population health short courses: implications for developing and evaluating population health professional development initiatives.

    PubMed

    Naccarella, Lucio; Greenstock, Louise; Butterworth, Iain

    2016-01-01

    Population health as an approach to planning is key to improving the health and well-being of whole populations and to reduce inequities within and between population groups. The Victorian Department of Health North and West Metropolitan Region, in collaboration with The University of Melbourne (School of Population Health), have delivered four annual population health short courses. The short courses were designed to equip participants with knowledge and skills to implement population health approaches upon their return to their workplaces. For three consecutive years, online surveys (n=41) and semi-structured interviews (n=35), underpinned by participatory and realist evaluation approaches, were conducted to obtain the perceptions and experiences of the population health short course participants. Evaluation findings indicate that participants' understanding of population health concepts increased; however, there were mixed outcomes in assisting participants' implementation of population health approaches upon their return to their workplaces. A core list of perceived requirements, enablers and barriers emerged at an individual, organisational and system level as influencing the capability of participants to implement population health approaches. Evaluation recommendations and actions taken to revise short course iterations are presented, providing evidence that the evaluation approaches were appropriate and increased the use of evaluation learnings. Implications of evaluation findings for professional development practice (i.e. shift from a 'Course' as a one-off event to a Population Health 'Program' of inter-dependent components) and evaluation (i.e. participatory realist evaluation approaches) are presented.

  9. Structural Health System for Crew Habitats

    NASA Technical Reports Server (NTRS)

    Brandon, Erik

    2005-01-01

    This viewgraph presentation reviews the history of JPL, and its affilation with CalTech and NASA. It continues by examining some of the sensors, and systems to ensure structural health that JPL has developed. It also reviews some of the habitat designs that are being developed for the lunar base. With these crew habitats, there is a requirement to have embedded systems health monitoring, to alert the crew in time about adverse structural conditions. The use of sensing technologies and smart materials are being developed to assure mechanical flexibility, minimumally invasive, autonomous, and enhanced reliability.

  10. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India

    PubMed Central

    Maulik, Pallab K; Tewari, Abha; Devarapalli, Siddhardha; Kallakuri, Sudha; Patel, Anushka

    2016-01-01

    Introduction Common mental disorders (CMD) such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India’s vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS) to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign. Materials and Methods The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre. Results The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers. Discussion A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen’s behavioural model of health services use. Conclusion The findings assisted with refining the intervention prior to large-scale implementation and evaluation. PMID:27732652

  11. Reusable Rocket Engine Turbopump Health Management System

    NASA Technical Reports Server (NTRS)

    Surko, Pamela

    1994-01-01

    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  12. Examining the social determinants of children's developmental health: protocol for building a pan-Canadian population-based monitoring system for early childhood development

    PubMed Central

    Guhn, Martin; Janus, Magdalena; Enns, Jennifer; Brownell, Marni; Forer, Barry; Duku, Eric; Muhajarine, Nazeem; Raos, Rob

    2016-01-01

    Introduction Early childhood is a key period to establish policies and practices that optimise children's health and development, but Canada lacks nationally representative data on social indicators of children's well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in children's developmental health and to advance research examining the social determinants of health. Methods and analysis Canada-wide EDI records from 2004 to 2014 (representing over 700 000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics and dissemination Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood

  13. United Kingdom (Scotland): Health system review.

    PubMed

    Steel, David; Cylus, Jonathan

    2012-01-01

    Over the last decade, Scotland's health system has increasingly diverged from the health system in England. Scotland has pursued an approach stressing integration and partnership among all parts of its NHS as opposed to an English approach in part driven by market forces. Comparatively fewer organizational and structural changes, in addition to consistent policy objectives, have provided a strong launching pad for achieving improvement. Substantial increases in funding have led to significant growth in the clinical workforce and numerous performance targets have been set to improve population health, the quality and outcomes of health care, and the efficiency of the health system. As a result, Scotland has made well-documented progress in terms of population health and the quality and effectiveness of care. However, a number of challenges remain. More progress is needed to close the gap in health status between Scotland and other developed countries, and to address persistent inequalities in health within Scotland. As in many other countries, increased fiscal pressures may make it difficult to maintain current levels of health care quantity and quality in future. PMID:23579054

  14. Social capital to strengthen health policy and health systems.

    PubMed

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

    This article recounts the development of a model for social capital building developed over the course of interventions focused on HIV-related stigma and discrimination, safe motherhood and reproductive health. Through further engagement with relevant literature, it explores the nature of social capital and suggests why undertaking such a process can enhance health policy and programmes, advocacy and governance for improved health systems strengthening (HSS) outcomes. The social capital process proposed facilitates the systematic and effective inclusion of community voices in the health policy process-strengthening programme effectiveness as well as health system accountability and governance. Because social capital building facilitates communication and the uptake of new ideas, norms and standards within and between professional communities of practice, it can provide an important mechanism for integration both within and between sectors-a process long considered a 'wicked problem' for health policy-makers. The article argues that the systematic application of social capital building, from bonding through bridging into linking social capital, can greatly enhance the ability of governments and their partners to achieve their HSS goals. PMID:24277736

  15. Social capital to strengthen health policy and health systems.

    PubMed

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

    This article recounts the development of a model for social capital building developed over the course of interventions focused on HIV-related stigma and discrimination, safe motherhood and reproductive health. Through further engagement with relevant literature, it explores the nature of social capital and suggests why undertaking such a process can enhance health policy and programmes, advocacy and governance for improved health systems strengthening (HSS) outcomes. The social capital process proposed facilitates the systematic and effective inclusion of community voices in the health policy process-strengthening programme effectiveness as well as health system accountability and governance. Because social capital building facilitates communication and the uptake of new ideas, norms and standards within and between professional communities of practice, it can provide an important mechanism for integration both within and between sectors-a process long considered a 'wicked problem' for health policy-makers. The article argues that the systematic application of social capital building, from bonding through bridging into linking social capital, can greatly enhance the ability of governments and their partners to achieve their HSS goals.

  16. Introduction on health recommender systems.

    PubMed

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described. PMID:25417084

  17. Introduction on health recommender systems.

    PubMed

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  18. Putting Integrated Systems Health Management Capabilities to Work: Development of an Advanced Caution and Warning System for Next-Generation Crewed Spacecraft Missions

    NASA Technical Reports Server (NTRS)

    Mccann, Robert S.; Spirkovska, Lilly; Smith, Irene

    2013-01-01

    Integrated System Health Management (ISHM) technologies have advanced to the point where they can provide significant automated assistance with real-time fault detection, diagnosis, guided troubleshooting, and failure consequence assessment. To exploit these capabilities in actual operational environments, however, ISHM information must be integrated into operational concepts and associated information displays in ways that enable human operators to process and understand the ISHM system information rapidly and effectively. In this paper, we explore these design issues in the context of an advanced caution and warning system (ACAWS) for next-generation crewed spacecraft missions. User interface concepts for depicting failure diagnoses, failure effects, redundancy loss, "what-if" failure analysis scenarios, and resolution of ambiguity groups are discussed and illustrated.

  19. Big Data: Implications for Health System Pharmacy.

    PubMed

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.

  20. Big Data: Implications for Health System Pharmacy.

    PubMed

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services. PMID:27559194

  1. The 'cube' meta-model for the information system of large health sector organizations--a (platform neutral) mapping tool to integrate information system development with changing business functions and organizational development.

    PubMed

    Balkányi, László

    2002-01-01

    To develop information systems (IS) in the changing environment of the health sector, a simple but throughout model, avoiding the techno-jargon of informatics, might be useful for the top management. A platform neutral, extensible, transparent conceptual model should be established. Limitations of current methods lead to a simple, but comprehensive mapping, in the form of a three-dimensional cube. The three 'orthogonal' views are (a) organization functionality, (b) organizational structures and (c) information technology. Each of the cube-sides is described according to its nature. This approach enables to define any kind of an IS component as a certain point/layer/domain of the cube and enables also the management to label all IS components independently form any supplier(s) and/or any specific platform. The model handles changes in organization structure, business functionality and the serving info-system independently form each other. Practical application extends to (a) planning complex, new ISs, (b) guiding development of multi-vendor, multi-site ISs, (c) supporting large-scale public procurement procedures and the contracting, implementation phase by establishing a platform neutral reference, (d) keeping an exhaustive inventory of an existing large-scale system, that handles non-tangible aspects of the IS. PMID:15460745

  2. [The health system of Chile].

    PubMed

    Becerril-Montekio, Víctor; Reyes, Juan de Dios; Manuel, Annick

    2011-01-01

    This paper describes the Chilean health system, including its structure, financing, beneficiaries, and its physical, material and human resources. This system has two sectors, public and private. The public sector comprises all the organisms that constitute the National System of Health Services, which covers 70% of the population, including the rural and urban poor, the low middle-class, the retired, and the self-employed professionals and technicians.The private sector covers 17.5% of the population, mostly the upper middle-class and the high-income population. A small proportion of the population uses private health services and pays for them out-of-pocket. Around l0% of the population is covered by other public agencies, basically the Health Services for the Armed Forces. The system was recently reformed with the establishment of a Universal System of Explicit Entitlements, which operates through a Universal Plan of Explicit Entitlements (AUGE), which guarantees timely access to treatment for 56 health problems, including cancer in children, breast cancer, ischaemic heart disease, HIV/AIDS and diabetes.

  3. National Health Accounts development: lessons from Thailand.

    PubMed

    Tangcharoensathien, V; Laixuthai, A; Vasavit, J; Tantigate, N A; Prajuabmoh-Ruffolo, W; Vimolkit, D; Lertiendumrong, J

    1999-12-01

    National Health Accounts (NHA) are an important tool to demonstrate how a country's health resources are spent, on what services, and who pays for them. NHA are used by policy-makers for monitoring health expenditure patterns; policy instruments to re-orientate the pattern can then be further introduced. The National Economic and Social Development Board (NESDB) of Thailand produces aggregate health expenditure data but its estimation methods have several limitations. This has led to the research and development of an NHA prototype in 1994, through an agreed definition of health expenditure and methodology, in consultation with peer and other stakeholders. This is an initiative by local researchers without external support, with an emphasis on putting the system into place. It involves two steps: firstly, the flow of funds from ultimate sources of finance to financing agencies; and secondly, the use of funds by financing agencies. Five ultimate sources and 12 financing agencies (seven public and five private) were identified. Use of consumption expenditures was listed under four main categories and 32 sub-categories. Using 1994 figures, we estimated a total health expenditure of 128,305.11 million Baht; 84.07% consumption and 15.93% capital formation. Of total consumption expenditure, 36.14% was spent on purchasing care from public providers, with 32.35% on private providers, 5.93% on administration and 9.65% on all other public health programmes. Public sources of finance were responsible for 48.79% and private 51.21% of the total 1994 health expenditure. Total health expenditure accounted for 3.56% of GDP (consumption expenditure at 3.00% of GDP and capital formation at 0.57% of GDP). The NESDB consumption expenditure estimate in 1994 was 180,516 million Baht or 5.01% of GDP, of which private sources were dominant (82.17%) and public sources played a minor role (17.83%). The discrepancy of consumption expenditure between the two estimates is 2.01% of GDP. There

  4. Health Service Delivery in Developing Countries

    ERIC Educational Resources Information Center

    Benyoussef, Amor

    1977-01-01

    Reviews recent work dealing with methodological and technical issues in health and development; presents examples of the application of social sciences, including health demography and economics, in questions of health services delivery; and analyzes delivery of health services to rural and nomadic populations in Africa, Asia, and Latin America.…

  5. The Human Health, Growth, and Development Curriculum.

    ERIC Educational Resources Information Center

    Boyles, Linda R.; And Others

    This health and human development curriculum for grades 1-6 contains tips for teachers and overviews of the philosophy behind teaching these topics to elementary school students. The section on health education is structured around ten content strands: (1) health knowledge, attitudes, decisions, and behavior; (2) emotional and social health; (3)…

  6. Engine health monitoring: An advanced system

    NASA Technical Reports Server (NTRS)

    Dyson, R. J. E.

    1981-01-01

    The advanced propulsion monitoring system is described. The system was developed in order to fulfill a growing need for effective engine health monitoring. This need is generated by military requirements for increased performance and efficiency in more complex propulsion systems, while maintaining or improving the cost to operate. This program represents a vital technological step in the advancement of the state of the art for monitoring systems in terms of reliability, flexibility, accuracy, and provision of user oriented results. It draws heavily on the technology and control theory developed for modern, complex, electronically controlled engines and utilizes engine information which is a by-product of such a system.

  7. Development of a Medicaid Behavioral Health Case-Mix Model

    ERIC Educational Resources Information Center

    Robst, John

    2009-01-01

    Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several…

  8. Health-system strengthening and tuberculosis control.

    PubMed

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. PMID:20488514

  9. Health-system strengthening and tuberculosis control.

    PubMed

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice.

  10. Health risks of energy systems.

    PubMed

    Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

    1998-08-01

    Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed. PMID:9775447

  11. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    NASA Astrophysics Data System (ADS)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  12. The School Health Portfolio System: A New Tool for Planning and Evaluating Coordinated School Health Programs.

    ERIC Educational Resources Information Center

    Weiler, Robert M.; Pigg, R. Morgan, Jr.

    2004-01-01

    The School Health Portfolio System (SHPS), developed originally to evaluate the Florida Coordinated School Health Program Pilot Schools Project, offers a new and innovative system for planning and evaluating a coordinated school health program at the individual school level. The SHPS provides practitioners a detailed but easy-to-use system that…

  13. Oral health information systems--towards measuring progress in oral health promotion and disease prevention.

    PubMed Central

    Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas; Ogawa, Hiroshi

    2005-01-01

    This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of oral disease which primarily reflect changing risk profiles and the implementation of oral health programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers and the general public. WHO has developed global and regional oral health databanks for surveillance, and international projects have designed oral health indicators for use in oral health information systems for assessing the quality of oral health care and surveillance systems. Modern oral health information systems are being developed within the framework of the WHO STEPwise approach to surveillance of noncommunicable, chronic disease, and data stored in the WHO Global InfoBase may allow advanced health systems research. Sound knowledge about progress made in prevention of oral and chronic disease and in health promotion may assist countries to implement effective public health programmes to the benefit of the poor and disadvantaged population groups worldwide. PMID:16211160

  14. Allied health: untapped potential in the Australian health system.

    PubMed

    Philip, Kathleen

    2015-06-01

    Although comprising around 20 per cent ofAustralia's health care workforce, allied health and its contribution to improving health outcomes remains poorly understood and largely invisible in the Australian health policy and reform environment. There is strong evidence demonstrating the benefits of allied health in improving patient outcomes, minimising risk and harm from illness and improving health system efficiency and capacity to meet increased demand cost effectively. Despite this, the existing health model, funding and culture prevent us from effectively accessing these benefits at a system level. The untapped potential of allied health represents a major underutilised resource to address many of the challenges facing Australia's health system today. A transformational change in the Australian health system in how, where and by whom care is provided is necessary. Australia's health model and culture needs to shift, to genuinely involve the consumer and make fill use of all three pillars of the patient care workforce. PMID:26629583

  15. Experience Placements. Mental Health Career Development Programs.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHEW), Bethesda, MD.

    The purpose of the Mental Health Career Development Program (MHCD) is to recruit and develop talented professionals for major roles in the multidisciplinary Federal mental health effort at the National Institute of Mental Health and other agencies. This booklet is intended to assist MHCD members and their advisors in planning for the transition…

  16. Four centuries on from Bacon: progress in building health research systems to improve health systems?

    PubMed

    Hanney, Stephen R; González-Block, Miguel A

    2014-01-01

    In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment. PMID:25249030

  17. Four centuries on from Bacon: progress in building health research systems to improve health systems?

    PubMed

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

    In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment.

  18. Health and economic development: the example of China and Cuba.

    PubMed

    Challenor, B D

    1975-01-01

    The unprecedented accomplishments reported from China and Cuba in providing health care to their populations question the assumption that economic development along the model of Western nations is a sine qua non for developing effective health care systems among nonaffluent developing nations. Equal distribution of resources, emphasis on preventive public health measures, and attention to improving overall quality of life have been concepts employed to great advantage by both countries. When it is realized that improved standards of living have far overshadowed modern medical technology in upgrading the health of populations, the policies employed in China and Cuba become especially relevant to other nations, both developed and developing.

  19. Making Technology Ready: Integrated Systems Health Management

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

    This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

  20. Optimal Sensor Selection for Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Santi, L. Michael; Sowers, T. Shane; Aguilar, Robert B.

    2005-01-01

    Sensor data are the basis for performance and health assessment of most complex systems. Careful selection and implementation of sensors is critical to enable high fidelity system health assessment. A model-based procedure that systematically selects an optimal sensor suite for overall health assessment of a designated host system is described. This procedure, termed the Systematic Sensor Selection Strategy (S4), was developed at NASA John H. Glenn Research Center in order to enhance design phase planning and preparations for in-space propulsion health management systems (HMS). Information and capabilities required to utilize the S4 approach in support of design phase development of robust health diagnostics are outlined. A merit metric that quantifies diagnostic performance and overall risk reduction potential of individual sensor suites is introduced. The conceptual foundation for this merit metric is presented and the algorithmic organization of the S4 optimization process is described. Representative results from S4 analyses of a boost stage rocket engine previously under development as part of NASA's Next Generation Launch Technology (NGLT) program are presented.

  1. Review of Developments in Electronic, Clinical Data Collection, and Documentation Systems over the Last Decade - Are We Ready for Big Data in Routine Health Care?

    PubMed

    Kessel, Kerstin A; Combs, Stephanie E

    2016-01-01

    Recently, information availability has become more elaborate and widespread, and treatment decisions are based on a multitude of factors, including imaging, molecular or pathological markers, surgical results, and patient's preference. In this context, the term "Big Data" evolved also in health care. The "hype" is heavily discussed in literature. In interdisciplinary medical specialties, such as radiation oncology, not only heterogeneous and voluminous amount of data must be evaluated but also spread in different styles across various information systems. Exactly this problem is also referred to in many ongoing discussions about Big Data - the "three V's": volume, velocity, and variety. We reviewed 895 articles extracted from the NCBI databases about current developments in electronic clinical data management systems and their further analysis or postprocessing procedures. Few articles show first ideas and ways to immediately make use of collected data, particularly imaging data. Many developments can be noticed in the field of clinical trial or analysis documentation, mobile devices for documentation, and genomics research. Using Big Data to advance medical research is definitely on the rise. Health care is perhaps the most comprehensive, important, and economically viable field of application.

  2. Review of Developments in Electronic, Clinical Data Collection, and Documentation Systems over the Last Decade – Are We Ready for Big Data in Routine Health Care?

    PubMed Central

    Kessel, Kerstin A.; Combs, Stephanie E.

    2016-01-01

    Recently, information availability has become more elaborate and widespread, and treatment decisions are based on a multitude of factors, including imaging, molecular or pathological markers, surgical results, and patient’s preference. In this context, the term “Big Data” evolved also in health care. The “hype” is heavily discussed in literature. In interdisciplinary medical specialties, such as radiation oncology, not only heterogeneous and voluminous amount of data must be evaluated but also spread in different styles across various information systems. Exactly this problem is also referred to in many ongoing discussions about Big Data – the “three V’s”: volume, velocity, and variety. We reviewed 895 articles extracted from the NCBI databases about current developments in electronic clinical data management systems and their further analysis or postprocessing procedures. Few articles show first ideas and ways to immediately make use of collected data, particularly imaging data. Many developments can be noticed in the field of clinical trial or analysis documentation, mobile devices for documentation, and genomics research. Using Big Data to advance medical research is definitely on the rise. Health care is perhaps the most comprehensive, important, and economically viable field of application. PMID:27066456

  3. United Kingdom (England): Health system review.

    PubMed

    Boyle, Seán

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

  4. Developing a complex approach to health phenomena (step 1)

    NASA Astrophysics Data System (ADS)

    Cifuentes, Myriam Patricia

    Health is a complex object for science and operative levels, partly because there are many approaches defining it but not scientifically sufficient or operatively accepted. This is relevant for health understanding but also for decision making on health related problems. "Determinants of Health" as a widely accepted theoretical proposal, identifies as problematic the reductionist view of health as the disease opposite, attempting to develop it positively according to WHO's definition, proposing a set of factors determining health outcomes. Though this allows a larger comprehension of health causes and effects, still has insufficiently defined theoretical statements and unproved assumptions which difficult understanding and effective actions orientation. Complexity deductive modeling since the insufficiently formalized frameworks, implies incorporating unmanageable object assumptions or reducing health broadness. Taking profit of Bogotá government adherence to DH proposal leading a health information system development, was possible inductive modeling since a systemic massive database (690.000 registries). In this way, DH theoretical statements about health components connectedness were explored by classic statistic approach, and by learning Bayesian networks from data (data mining). First approach showed understanding difficulties. Second was advantageous in approximating within and between determinants relationship structure. However, though DH introduces a systemic approach in considering diverse interacting elements is not empirically satisfactory to exhibit all the meaning of health complexity, because just matches analytic fashioned constructs depending on data expression. A strong networked model developing health complexity, needs the orientation by theoretical constructs as human agency and organization, to explore and understand emergent patterns of health.

  5. X-33/RLV System Health Management/Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Mouyos, William; Wangu, Srimal

    1998-01-01

    To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

  6. Inadequacies of present health services and strategies to improve maternal and child health in developing countries.

    PubMed

    Ratnam, S S; Prasad, R N

    1984-12-01

    The lack of health care to the majority of population in the developing world is a reason for major concern. The present system of health care in developing countries has failed to meet the needs of the people. Examples of innovative health delivery systems that have been introduced in some countries in recent years are given. All existing health personnel, conventional and non-conventional, and traditional should be maximally utilized, and, if necessary, additional minimal training be introduced to meet the objectives of "health for all by the year 2000".

  7. X-33/RLV System Health Management/ Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Garbos, Raymond J.; Mouyos, William

    1998-01-01

    To reduce operations cost, the RLV must include the following elements: highly reliable, robust subsystems designed for simple repair access with a simplified servicing infrastructure and incorporating expedited decision making about faults and anomalies. A key component for the Single Stage to Orbit (SSTO) RLV System used to meet these objectives is System Health Management (SHM). SHM deals with the vehicle component- Vehicle Health Management (VHM), the ground processing associated with the fleet (GVHM) and the Ground Infrastructure Health Management (GIHM). The objective is to provide an automated collection and paperless health decision, maintenance and logistics system. Many critical technologies are necessary to make the SHM (and more specifically VHM) practical, reliable and cost effective. Sanders is leading the design, development and integration of the SHM system for RLV and X-33 SHM (a sub-scale, sub-orbit Advanced Technology Demonstrator). This paper will present the X-33 SHM design which forms the baseline for RLV SHM. This paper will also discuss other applications of these technologies.

  8. Local public health system partnerships.

    PubMed Central

    Zahner, Susan J.

    2005-01-01

    OBJECTIVES: Interorganizational collaboration aimed at community health improvement is an expectation of local public health systems. This study assessed the extent to which such collaboration occurred within one state (Wisconsin), described the characteristics of existing partnerships, and identified factors associated with partnership effectiveness. METHODS: In Stage 1, local health department (LHD) directors in Wisconsin were surveyed (93% response rate). In Stage 2, LHDs completed self-administered mailed surveys for each partnership identified in Stage 1 (85% response rate). Two-level hierarchical logit regression methods were used to model relationships between partnership and LHD variables and partnership outcomes. Data from 924 partnerships associated with 74 LHDs were included in the analysis. RESULTS: Partnerships most frequently addressed tobacco prevention and control, maternal and child health, emergency planning, community assessment and planning, and immunizations. Partnering was most frequent with other government agencies, hospitals, medical practices or clinics, community-based organizations, and schools. Partnership effectiveness was predicted by having a budget, having more partners contributing financially, having a broader array of organizations involved, and having been in existence for a longer period of time. A government mandate to start the partnership was inversely related to successful outcomes. Characteristics of LHDs did not predict partnership effectiveness. CONCLUSIONS: Financial support, having a broader array of partners, and allowing sufficient time for partnerships to succeed contribute to partnership effectiveness. Further study-using objective outcome measures-is needed to examine the effects of organizational and community characteristics on the effectiveness of local public health system partnerships. PMID:15736335

  9. [The health system of Costa Rica].

    PubMed

    Sáenz, María del Rocío; Acosta, Mónica; Muiser, Jorine; Bermúdez, Juan Luis

    2011-01-01

    This paper describes the Costa Rican health system which provides health, water and sanitation services. The health component of the system includes a public and a private sector. The public sector is dominated by the Caja Costarricense de Seguro Social (CCSS), an autonomous institution in charge of financing, purchasing and delivering most of the personal health services in Costa Rica. CCSS is financed with contributions of the affiliates, employers and the state, and manages three regimes: maternity and illness insurance, disability, old age and death insurance, and a non-contributive regime. CCSS provides services in its own facilities but also contracts with private providers. The private sector includes a broad set of services offering ambulatory and hospital care. These services are financed mostly out-of-pocket, but also with private insurance premiums. The Ministry of Health is the steward of the system, in charge of strategic planning, sanitary regulation, and research and technology development. Among the recent policy innovations we can mention the establishment of the basic teams for comprehensive health care (EBAIS), the de-concentration of hospitals and public clinics, the introduction of management agreements and the creation of the Health Boards.

  10. Evaluate, assess, treat: development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues.

    PubMed

    DeBate, R D; Cragun, D; Gallentine, A A; Severson, H H; Shaw, T; Cantwell, C; Christiansen, S; Koerber, A; Hendricson, W; Tomar, S L; McCormack Brown, K; Tedesco, L A

    2012-11-01

    Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues whilst interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e. early detection of oral manifestations of disordered eating behaviours, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviours. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and seven dental (D) classes from eight institutions were randomized to either the intervention or control conditions. Both groups completed pre- and post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention whilst controlling for baseline levels. Statistically significant improvements from pre- to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all P < 0.01). Effect sizes ranged from 0.57 to 0.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication.

  11. An activist looks at nursing's role in health policy development.

    PubMed

    Ferguson, S L

    2001-01-01

    Health care delivery systems are evolving and transforming rapidly. Nurses will need new leadership and policy skills to meet the challenge of ensuring patient care safety and quality health care delivery. Nurses bring a unique perspective to health care policy development because of their educational training, professional values and ethics, advocacy skills, and experiential background. Significant progress has occurred over the years toward advancing nursing's presence, role, and influence in the development of health care policy. However, more nurses need to learn how to identify issues strategically; work with decision makers; understand who holds the power in the workplace, communities, state and federal level organizations; and understand who controls the resources for health care services. In health care policy development, nurses are essential in ensuring quality health care that is accessible and affordable for all women and their infants. More nurses need to actively work as leaders in the health policy arena. PMID:11572536

  12. [Health, equity, and the Millennium Development Goals].

    PubMed

    Torres, Cristina; Mújica, Oscar J

    2004-06-01

    In September 2000 representatives of 189 countries met for the Millennium Summit, which the United Nations convened in New York City, and adopted the declaration that provided the basis for formulating the Millennium Development Goals (MDGs). The eight goals are part of a long series of initiatives that governments, the United Nations system, and international financial institutions have undertaken to reduce world poverty. Three of the eight goals deal with health, so the health sector will be responsible for implementing, monitoring, and evaluating measures proposed to meet targets that have been formulated: to reduce by two-thirds the mortality rate in children under 5 years of age between 1990 and 2015; to reduce by three-quarters the maternal mortality rate between 1990 and 2015; and to halt and begin to reverse the spread of HIV/AIDS by the year 2015, as well as to halt and begin to reverse the incidence of malaria, tuberculosis, and other major diseases. The health sector must also work with other parties to achieve targets connected with two other of the goals: to improve access to affordable essential drugs, and to reduce the proportion of persons who do not have safe drinking water. Adopting a strategy focused on the most vulnerable groups-ones concentrated in locations and populations with the greatest social exclusion-would make possible the largest total reduction in deaths among children, thus reaching the proposed target as well as producing greater equity. In the Region of the Americas the principal challenges in meeting the MDGs are: improving and harmonizing health information systems; designing health programs related to the MDGs that bring together the set of services and interventions that have the greatest impact, according to the special characteristics of the populations who are intended to be the beneficiaries; strengthening the political will to support the MDGs; and guaranteeing funding for the measures undertaken to attain the MDGs.

  13. Child Poverty and the Health Care System.

    PubMed

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty. PMID:27044708

  14. Child Poverty and the Health Care System.

    PubMed

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty.

  15. Information Systems; Modern Health Care and Medical Information.

    ERIC Educational Resources Information Center

    Brandejs, J. F., And Others

    1975-01-01

    To effectively handle changes in health policy and health information, new designs and applications of automation are explored. Increased use of computer-based information systems in health care could serve as a means of control over the costs of developing more comprehensive health service, with applications increasing not only the automation of…

  16. Systemic diseases and oral health.

    PubMed

    Tavares, Mary; Lindefjeld Calabi, Kari A; San Martin, Laura

    2014-10-01

    The US population is at the beginning of a significant demographic shift; the American geriatric population is burgeoning, and average longevity is projected to increase in the coming years. Elder adults are affected by numerous chronic conditions, such as diabetes, hypertension, osteoarthritis, osteoporosis, cardiovascular diseases, and cerebrovascular diseases. These older adults need special dental care and an improved understanding of the complex interactions of oral disease and systemic chronic diseases that can complicate their treatment. Oral diseases have strong associations with systemic diseases, and poor oral health can worsen the impact of systemic diseases.

  17. Development of a Student Health Assessment System: Health Knowledge, Attitudes, and Behaviors in Middle-School Students. Research Report. ETS RR-10-04

    ERIC Educational Resources Information Center

    MacCann, Carolyn; Roberts, Richard D.

    2010-01-01

    Newly developed assessments of nutrition and exercise knowledge, attitudes, and behavior were administered to 383 eighth-graders. Evidence for the validity of assessment scores was evaluated with five findings. First, parent- and self-reported behaviors were similar and congruent for healthy eating and exercising but not for sedentary behaviors or…

  18. Training of Health Workers for Developing Countries.

    ERIC Educational Resources Information Center

    Scrimshaw, Nevin S.

    1985-01-01

    The author argues that the achievement of health in developing countries requires that health workers be trained to prevent disease in addition to any training they receive in the identification and management of disease. This preventive role includes communication of health promotion concepts to people and gaining the confidence of communities.…

  19. Data Liquidity in Health Information Systems

    PubMed Central

    Courtney, Paul K.

    2011-01-01

    In 2001 the IOM report "Crossing the Quality Chasm" and the NCVHS report "Information for Health" were released and they provided the context for the development of information systems used to support health-supporting processes. Both had as their goals, implicit or explicit, to ensure the right data is provided to the right person at the right time, which is one definition of "Data Liquidity". This concept has had some traction in recent years as a shorthand way to express a system property for Health IT, but there is not a well-defined characterization of what properties of a system or of its components give it better or worse data liquidity. This paper looks at some recent work that help to identify those properties and perhaps can help to ground the concept with metrics that are assessable. PMID:21799328

  20. The health and health system of South Africa: historical roots of current public health challenges.

    PubMed

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-01

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  1. The health and health system of South Africa: historical roots of current public health challenges.

    PubMed

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-01

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa. PMID:19709728

  2. [The health system of Argentina].

    PubMed

    Belló, Mariana; Becerril-Montekio, Victor M

    2011-01-01

    This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar.

  3. [The health system of Argentina].

    PubMed

    Belló, Mariana; Becerril-Montekio, Victor M

    2011-01-01

    This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar. PMID:21877098

  4. Development and Validation of a Clinical and Computerised Decision Support System for Management of Hypertension (DSS-HTN) at a Primary Health Care (PHC) Setting

    PubMed Central

    Anchala, Raghupathy; Di Angelantonio, Emanuele; Prabhakaran, Dorairaj; Franco, Oscar H.

    2013-01-01

    Background Hypertension remains the top global cause of disease burden. Decision support systems (DSS) could provide an adequate and cost-effective means to improve the management of hypertension at a primary health care (PHC) level in a developing country, nevertheless evidence on this regard is rather limited. Methods Development of DSS software was based on an algorithmic approach for (a) evaluation of a hypertensive patient, (b) risk stratification (c) drug management and (d) lifestyle interventions, based on Indian guidelines for hypertension II (2007). The beta testing of DSS software involved a feedback from the end users of the system on the contents of the user interface. Software validation and piloting was done in field, wherein the virtual recommendations and advice given by the DSS were compared with two independent experts (government doctors from the non-participating PHC centers). Results The overall percent agreement between the DSS and independent experts among 60 hypertensives on drug management was 85% (95% CI: 83.61 - 85.25). The kappa statistic for overall agreement for drug management was 0.659 (95% CI: 0.457 - 0.862) indicating a substantial degree of agreement beyond chance at an alpha fixed at 0.05 with 80% power. Receiver operator curve (ROC) showed a good accuracy for the DSS, wherein, the area under curve (AUC) was 0.848 (95% CI: 0.741 - 0.948). Sensitivity and specificity of the DSS were 83.33 and 85.71% respectively when compared with independent experts. Conclusion A point of care, pilot tested and validated DSS for management of hypertension has been developed in a resource constrained low and middle income setting and could contribute to improved management of hypertension at a primary health care level. PMID:24223984

  5. Towards a Healthy District: Organizing and Managing District Health Systems Based on Primary Health Care.

    ERIC Educational Resources Information Center

    Tarimo, E.

    This book is concerned with orienting health care workers in district health systems in developing countries to ways and means of overcoming problems, and describes briefly how district health systems can be improved. The book is organized around nine issues in nine chapters, each of which is an integral part of a district planning cycle. The…

  6. National Research Council Dialogue to Assess Progress on NASA's Human Health & Support Systems Capability Roadmap Development: General Background and Introduction

    NASA Technical Reports Server (NTRS)

    Aikins, Jan

    2005-01-01

    Contents include the following: General Background and Introduction of Capability Roadmaps. Agency Objective. Strategic Planning Transformation. Advanced Planning Organizational Roles. Public Involvement in Strategic Planning. Strategic Roadmaps and Schedule. Capability Roadmaps and Schedule. Purpose of NRC Review. Capability Roadmap Development (Progress to Date).

  7. Mental health policy developments in Latin America.

    PubMed Central

    Alarcón, R. D.; Aguilar-Gaxiola, S. A.

    2000-01-01

    New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, scarce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people's mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice. PMID:10885167

  8. Health Update: Development of New National Child Care Health Standards.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    1988-01-01

    Discusses the absence of national standards which are uniformly applicable to health, safety, sanitation, and nutrition aspects of child care programs. Explains the responsive collaborative project of the American Academy of Pediatrics and American Public Health Association to develop national reference standards for out-of-home child care…

  9. Principles and Framework for eHealth Strategy Development

    PubMed Central

    Mars, Maurice

    2013-01-01

    Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs- and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth. PMID:23900066

  10. Precision Pointing System Development

    SciTech Connect

    BUGOS, ROBERT M.

    2003-03-01

    The development of precision pointing systems has been underway in Sandia's Electronic Systems Center for over thirty years. Important areas of emphasis are synthetic aperture radars and optical reconnaissance systems. Most applications are in the aerospace arena, with host vehicles including rockets, satellites, and manned and unmanned aircraft. Systems have been used on defense-related missions throughout the world. Presently in development are pointing systems with accuracy goals in the nanoradian regime. Future activity will include efforts to dramatically reduce system size and weight through measures such as the incorporation of advanced materials and MEMS inertial sensors.

  11. Modeling of Local BEAM Structure for Evaluation of MMOD Impacts to Support Development of a Health Monitoring System

    NASA Technical Reports Server (NTRS)

    Lyle, Karen H.; Vassilakos, Gregory J.

    2015-01-01

    This report summarizes initial modeling of the local response of the Bigelow Expandable Activity Module (BEAM) to micrometeorite and orbital debris (MMOD) impacts using a structural, non-linear, transient dynamic finite element code. Complementary test results for a local BEAM structure are presented for both hammer and projectile impacts. Review of these data provided guidance for the transient dynamic model development. The local model is intended to support predictions using the global BEAM model, described in a companion report. Two types of local models were developed. One mimics the simplified Soft-Goods (fabric envelop) part of the BEAM NASTRAN model delivered by the project. The second investigates through-the-thickness modeling challenges for MMOD-type impacts. Both the testing and the analysis summaries contain lessons learned and areas for future efforts.

  12. Establishing a health promotion and development foundation in South Africa.

    PubMed

    Perez, A M; Ayo-Yusuf, O A; Hofman, K; Kalideen, S; Maker, A; Mokonoto, D; Morojele, N; Naidoo, P; Parry, C D H; Rendall-Mkosi, K; Saloojee, Y

    2013-01-14

    South Africa has a 'quadruple burden of disease'. One way to reduce this burden, and address the social determinants of health and social inequity, could be through health promotion interventions driven by an independent Health Promotion and Development Foundation (HPDF). This could provide a framework to integrate health promotion and social development into all government and civil society programmes. On priority issues, the HPDF would mobilise resources, allocate funding, develop capacity, and monitor and evaluate health promotion and development work. Emphasis would be on reducing the effects of poverty, inequity and unequal development on disease rates and wellbeing. The HPDF could also decrease the burden on the proposed National Health Insurance (NHI) system. We reflect on such foundations in other countries, and propose a structure for South Africa's HPDF and a dedicated funding stream to support its activities. In particular, an additional 2% levy on alcohol and tobacco products is proposed to be utilised to fund the HPDF.

  13. Different approaches to contracting in health systems.

    PubMed Central

    Perrot, Jean

    2006-01-01

    Contracting is one of the tools increasingly being used to enhance the performance of health systems in both developed and developing countries; it takes different forms and cannot be limited to the mere purchase of services. Actors adopt contracting to formalize all kinds of relations established between them. A typology for this approach will demonstrate its diversity and provide a better understanding of the various issues raised by contracting. In recent years the way health systems are organized has changed significantly. To remedy the under-performance of their health systems, most countries have undertaken reforms that have resulted in major institutional overhaul, including decentralization of health and administrative services, autonomy for public service providers, separation of funding bodies and service providers, expansion of health financing options and the development of the profit or nonprofit private sector. These institutional reshuffles lead not only to multiplication and diversification of the actors involved, but also to greater separation of the service provision and administrative functions. Health systems are becoming more complex and can no longer operate in isolation. Actors are gradually realizing that they need to forge relations. The simplest way to do that is through dialogue, although some prefer a more formal commitment. Interaction between actors may take various forms and be on different scales. There are several types of contractual relations: some are based on the nature of the contract (public or private), others on the parties involved and yet others on the scope of the contract. Here they are classified into three categories according to the object of the contract: delegation of responsibility, act of purchase of services, or cooperation. PMID:17143459

  14. Different approaches to contracting in health systems.

    PubMed

    Perrot, Jean

    2006-11-01

    Contracting is one of the tools increasingly being used to enhance the performance of health systems in both developed and developing countries; it takes different forms and cannot be limited to the mere purchase of services. Actors adopt contracting to formalize all kinds of relations established between them. A typology for this approach will demonstrate its diversity and provide a better understanding of the various issues raised by contracting. In recent years the way health systems are organized has changed significantly. To remedy the under-performance of their health systems, most countries have undertaken reforms that have resulted in major institutional overhaul, including decentralization of health and administrative services, autonomy for public service providers, separation of funding bodies and service providers, expansion of health financing options and the development of the profit or nonprofit private sector. These institutional reshuffles lead not only to multiplication and diversification of the actors involved, but also to greater separation of the service provision and administrative functions. Health systems are becoming more complex and can no longer operate in isolation. Actors are gradually realizing that they need to forge relations. The simplest way to do that is through dialogue, although some prefer a more formal commitment. Interaction between actors may take various forms and be on different scales. There are several types of contractual relations: some are based on the nature of the contract (public or private), others on the parties involved and yet others on the scope of the contract. Here they are classified into three categories according to the object of the contract: delegation of responsibility, act of purchase of services, or cooperation.

  15. Mental health in schools and system restructuring.

    PubMed

    Adelman, H S; Taylor, L

    1999-03-01

    Because health is not the primary business of schools, a school's response to mental health and psychosocial concerns usually is limited to targeted problems seen as direct barriers to learning. And because resources are sparse, priority is given to problems defined in legislative mandates. As a result, school-based mental health services are available only to a small proportion of the many students who require assistance, and interventions generally are narrowly focused and short-term. To better meet the needs of those served and to serve greater numbers, emerging trends are pushing for restructuring of school-owned services and greater linkage with community resources to develop multifaceted, comprehensive, integrated approaches. This review (a) provides an overview of what schools currently do related to mental health and psychosocial concerns, (b) clarifies key emerging trends, and (c) explores implications for major systemic changes.

  16. Developing effective policy and practice for health promotion in Scotland.

    PubMed

    Wimbush, Erica; Young, Ian; Robertson, Graham

    2007-01-01

    Scotland has recently embarked on a new phase of policy and infrastructure development for improving population health and reducing health inequalities that broadly conforms to the Ottawa Charter and WHO's strategic framework for the prevention and control of non-communicable diseases. The new phase is characterised by an integrated, cross-government approach to improving health with strengthened political and Scottish Executive leadership and investment since devolution. A comprehensive policy framework for improving young people's health and reducing inequalities has been developed across education, health, environment and social justice. It builds on an earlier phase of relative stability and continuity in the health promotion infrastructure with policy focused on CVD and cancer prevention and tackling the behavioural risk factors (smoking, alcohol, diet, physical activity) as well as sexual health and mental health and wellbeing. These national strategies are currently being implemented across Scotland. They combine promotion, prevention, treatment and protection goals and target both population-level and high-risk groups. Crosscutting government objectives and headline targets for addressing poverty, disadvantage and health inequalities now supplement the NHS health improvement targets on smoking, alcohol, physical activity, teenage pregnancy and child immunization. Within the health service, prevention efforts are largely concerned with primary care development (anticipatory care) and health system reform to maximize their impact on reducing health inequalities. Efforts to tackle the social determinants of health and reduce inequalities in health outcomes are beginning to be connected and mainstreamed across local government with Community Planning Partnerships as the main vehicle. National level mechanisms for integrated funding, planning and performance reporting to deliver shared priority outcomes have yet to be developed. The development of health

  17. FAILSAFE Health Management for Embedded Systems

    NASA Technical Reports Server (NTRS)

    Horvath, Gregory A.; Wagner, David A.; Wen, Hui Ying; Barry, Matthew

    2010-01-01

    The FAILSAFE project is developing concepts and prototype implementations for software health management in mission- critical, real-time embedded systems. The project unites features of the industry-standard ARINC 653 Avionics Application Software Standard Interface and JPL s Mission Data System (MDS) technology (see figure). The ARINC 653 standard establishes requirements for the services provided by partitioned, real-time operating systems. The MDS technology provides a state analysis method, canonical architecture, and software framework that facilitates the design and implementation of software-intensive complex systems. The MDS technology has been used to provide the health management function for an ARINC 653 application implementation. In particular, the focus is on showing how this combination enables reasoning about, and recovering from, application software problems.

  18. Cascade Distillation System Development

    NASA Technical Reports Server (NTRS)

    Callahan, Michael R.; Sargushingh, Miriam; Shull, Sarah

    2014-01-01

    NASA's Advanced Exploration Systems (AES) Life Support System (LSS) Project is chartered with de-veloping advanced life support systems that will ena-ble NASA human exploration beyond low Earth orbit (LEO). The goal of AES is to increase the affordabil-ity of long-duration life support missions, and to re-duce the risk associated with integrating and infusing new enabling technologies required to ensure mission success. Because of the robust nature of distillation systems, the AES LSS Project is pursuing develop-ment of the Cascade Distillation Subsystem (CDS) as part of its technology portfolio. Currently, the system is being developed into a flight forward Generation 2.0 design.

  19. Health and health systems performance in the United Arab Emirates.

    PubMed

    Blair, Iain; Sharif, Amer

    2013-01-01

    In the early 2000s, the United Arab Emirates (UAE) had good levels of health and its health system was ranked twenty-seventh in the world by the World Health Organization. Since that time, to further improve the situation and to address cost and quality challenges, the UAE has embarked on an ambitious programme of health system reform. These reforms have focused on the introduction of private health insurance and encouraging the growth of private health provision. In these areas there have been impressive achievements but while it is too early to say whether these reforms are succeeding some anxieties are emerging. These include the rising cost of services with no obvious improvement in outcomes, a growth in hospital provision that may not best meet the needs of the population, rising levels of chronic disease risk factors and an insuffcient focus on public health services, public health leadership, health work-force planning and research. PMID:24683809

  20. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies.

  1. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. PMID:25458716

  2. Public health crises of cities in developing countries.

    PubMed

    Wang'ombe, J K

    1995-09-01

    During the decade and a half after Alma Ata hundreds of projects were started in developing countries to implement the principles of PHC and start community based health care programs in the rural areas of developing countries. Until the past five years urban health was not seen as a special health problem. Population pressure in the rural areas has created shortages of land, food and employment opportunities. These forces have generated major population movements to the urban centres. The population movements have encouraged unprecedented expansion of urban centres. This sudden concentration of large populations in small geographical areas has resulted in the urban health crises of the developing world. The poor who live in the slum areas have no access to adequate health services, they experience frequent epidemics of communicable diseases like cholera, they live within a heavily polluted environment, and their children have very poor health because they are not immunized and are malnourished. The paper agrees with approaches which have been championed by development agencies to address the urban health crises. These approaches propose the reorientation of urban health systems to include adoption of PHC for urban health programs, intersectoral collaboration and extra budgetary support. The paper argues for further strengthening of the reorientation approach by adjusting the development planning model. It is proposed that the urban plan be integrated into the national development plan so that emerging urban health crises can receive special attention in resource allocation.

  3. Innovations in public health education: promoting professional development and a culture of health.

    PubMed

    Levy, Marian; Gentry, Daniel; Klesges, Lisa M

    2015-03-01

    As the field of public health advances toward addressing complex, systemic problems, future public health professionals must be equipped with leadership and interprofessional skills that support collaboration and a culture of health. The University of Memphis School of Public Health has infused innovative strategies into graduate education via experiential learning opportunities to enhance leadership, collaboration, and professional development. Novel training programs such as Day One, Public Health Interdisciplinary Case Competition, and Memphis Healthy U support Association of Schools and Programs of Public Health cross-cutting competencies and prepare Master of Public Health and Master of Health Administration graduates to function effectively at the outset of their careers and become catalysts for creating a culture of health. PMID:25706016

  4. Innovations in public health education: promoting professional development and a culture of health.

    PubMed

    Levy, Marian; Gentry, Daniel; Klesges, Lisa M

    2015-03-01

    As the field of public health advances toward addressing complex, systemic problems, future public health professionals must be equipped with leadership and interprofessional skills that support collaboration and a culture of health. The University of Memphis School of Public Health has infused innovative strategies into graduate education via experiential learning opportunities to enhance leadership, collaboration, and professional development. Novel training programs such as Day One, Public Health Interdisciplinary Case Competition, and Memphis Healthy U support Association of Schools and Programs of Public Health cross-cutting competencies and prepare Master of Public Health and Master of Health Administration graduates to function effectively at the outset of their careers and become catalysts for creating a culture of health.

  5. Reproductive health and health sector reform in developing countries: establishing a framework for dialogue.

    PubMed Central

    Lubben, Marianne; Mayhew, Susannah H.; Collins, Charles; Green, Andrew

    2002-01-01

    It is not clear how policy-making in the field of reproductive health relates to changes associated with programmes for the reform of the health sector in developing countries. There has been little communication between these two areas, yet policy on reproductive health has to be implemented in the context of structural change. This paper examines factors that limit dialogue between the two areas and proposes the following framework for encouraging it: the identification of policy groups and the development of bases for collaborative links between them; the introduction of a common understanding around relevant policy contexts; reaching agreement on compatible aims relating to reproductive health and health sector change; developing causal links between policy content in reproductive health and health sector change as a basis for evidence-based policy-making; and strengthening policy-making structures, systems, skills, and values. PMID:12219159

  6. Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development.

    PubMed

    Estupiñán-Day, Saskia; Lafontant, Christina; Acuña, Maria Cecilia

    2011-11-01

    In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO) reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH) Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development.

  7. A telemedicine health care delivery system

    NASA Technical Reports Server (NTRS)

    Sanders, Jay H.

    1991-01-01

    The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

  8. Aren't technological choices central to designing health systems?

    PubMed

    Priya, Ritu

    2013-01-01

    This paper argues that delivery of technology-based preventive, promotive and curative care is one of the central tasks of any health-care system and therefore it forms one of the central pivots for rational structuring/re-structuring of a health-care system. The development of our public health system has, historically, adopted health technologies (HT) uncritically and thereby not explicitly developed institutional mechanisms to assess them for rational choice. Determinants of HT policy choices and structuring of a service delivery system based on that are discussed with examples of modern low cost HT, technologies of codified health knowledge systems other than the modern and local health traditions. Various forms of institutional structures for HT assessment and R and D using a comprehensive primary health-care approach are suggested. PMID:24351381

  9. Aren't technological choices central to designing health systems?

    PubMed

    Priya, Ritu

    2013-01-01

    This paper argues that delivery of technology-based preventive, promotive and curative care is one of the central tasks of any health-care system and therefore it forms one of the central pivots for rational structuring/re-structuring of a health-care system. The development of our public health system has, historically, adopted health technologies (HT) uncritically and thereby not explicitly developed institutional mechanisms to assess them for rational choice. Determinants of HT policy choices and structuring of a service delivery system based on that are discussed with examples of modern low cost HT, technologies of codified health knowledge systems other than the modern and local health traditions. Various forms of institutional structures for HT assessment and R and D using a comprehensive primary health-care approach are suggested.

  10. Health systems research in the time of health system reform in India: a review

    PubMed Central

    2014-01-01

    Background Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period. Methods We reviewed 9,477 publications between 2005 and 2013 in two online databases, PubMed and IndMED. Articles were classified according to the WHO classification of health systems building blocks. Results Our findings indicate the number of publications on health systems progressively increased every year from 92 in 2006 to 314 in 2012. The majority of papers were on service delivery (40%), with fewer on information (16%), medical technology and vaccines (15%), human resources (11%), governance (5%), and financing (8%). Around 70% of articles were lead by an author based in India, the majority by authors located in only four states. Several states, particularly in eastern and northeastern India, did not have a single paper published by a lead author located in a local institution. Moreover, many of these states were not the subject of a single published paper. Further, a few select institutions produced the bulk of research. Of the foreign author lead papers, 77% came from five countries (USA, UK, Canada, Australia, and Switzerland). Conclusions The growth of published research during the reform period in India is a positive development. However, bulk of this research is produced in a few states and by a few select institutions Further strengthening health systems research requires attention to neglected health systems domains like human resources, financing, and governance. Importantly

  11. Enabling Better Interoperability for HealthCare: Lessons in Developing a Standards Based Application Programing Interface for Electronic Medical Record Systems.

    PubMed

    Kasthurirathne, Suranga N; Mamlin, Burke; Kumara, Harsha; Grieve, Grahame; Biondich, Paul

    2015-11-01

    We sought to enable better interoperability and easy adoption of healthcare applications by developing a standardized domain independent Application Programming Interface (API) for an Electronic Medical Record (EMR) system. We leveraged the modular architecture of the Open Medical Record System (OpenMRS) to build a Fast Healthcare Interoperability Resources (FHIR) based add-on module that could consume FHIR resources and requests made on OpenMRS. The OpenMRS FHIR module supports a subset of FHIR resources that could be used to interact with clinical data persisted in OpenMRS. We demonstrate the ease of connecting healthcare applications using the FHIR API by integrating a third party Substitutable Medical Apps & Reusable Technology (SMART) application with OpenMRS via FHIR. The OpenMRS FHIR module is an optional component of the OpenMRS platform. The FHIR API significantly reduces the effort required to implement OpenMRS by preventing developers from having to learn or work with a domain specific OpenMRS API. We propose an integration pathway where the domain specific legacy OpenMRS API is gradually retired in favor of the new FHIR API, which would be integrated into the core OpenMRS platform. Our efforts indicate that a domain independent API is a reality for any EMR system. These efforts demonstrate the adoption of an emerging FHIR standard that is seen as a replacement for both Health Level 7 (HL7) Version 2 and Version 3. We propose a gradual integration approach where our FHIR API becomes the preferred method for communicating with the OpenMRS platform. PMID:26446013

  12. Sustainable Health Development Goals (SHDG): breaking down the walls.

    PubMed

    Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

    2015-01-01

    The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world.

  13. Sustainable Health Development Goals (SHDG): breaking down the walls

    PubMed Central

    Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

    2015-01-01

    The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world. PMID:26966502

  14. Building capacity in health research in the developing world.

    PubMed

    Lansang, Mary Ann; Dennis, Rodolfo

    2004-10-01

    Strong national health research systems are needed to improve health systems and attain better health. For developing countries to indigenize health research systems, it is essential to build research capacity. We review the positive features and weaknesses of various approaches to capacity building, emphasizing that complementary approaches to human resource development work best in the context of a systems and long-term perspective. As a key element of capacity building, countries must also address issues related to the enabling environment, in particular: leadership, career structure, critical mass, infrastructure, information access and interfaces between research producers and users. The success of efforts to build capacity in developing countries will ultimately depend on political will and credibility, adequate financing, and a responsive capacity-building plan that is based on a thorough situational analysis of the resources needed for health research and the inequities and gaps in health care. Greater national and international investment in capacity building in developing countries has the greatest potential for securing dynamic and agile knowledge systems that can deliver better health and equity, now and in the future. PMID:15643798

  15. Building capacity in health research in the developing world.

    PubMed

    Lansang, Mary Ann; Dennis, Rodolfo

    2004-10-01

    Strong national health research systems are needed to improve health systems and attain better health. For developing countries to indigenize health research systems, it is essential to build research capacity. We review the positive features and weaknesses of various approaches to capacity building, emphasizing that complementary approaches to human resource development work best in the context of a systems and long-term perspective. As a key element of capacity building, countries must also address issues related to the enabling environment, in particular: leadership, career structure, critical mass, infrastructure, information access and interfaces between research producers and users. The success of efforts to build capacity in developing countries will ultimately depend on political will and credibility, adequate financing, and a responsive capacity-building plan that is based on a thorough situational analysis of the resources needed for health research and the inequities and gaps in health care. Greater national and international investment in capacity building in developing countries has the greatest potential for securing dynamic and agile knowledge systems that can deliver better health and equity, now and in the future.

  16. Building capacity in health research in the developing world.

    PubMed Central

    Lansang, Mary Ann; Dennis, Rodolfo

    2004-01-01

    Strong national health research systems are needed to improve health systems and attain better health. For developing countries to indigenize health research systems, it is essential to build research capacity. We review the positive features and weaknesses of various approaches to capacity building, emphasizing that complementary approaches to human resource development work best in the context of a systems and long-term perspective. As a key element of capacity building, countries must also address issues related to the enabling environment, in particular: leadership, career structure, critical mass, infrastructure, information access and interfaces between research producers and users. The success of efforts to build capacity in developing countries will ultimately depend on political will and credibility, adequate financing, and a responsive capacity-building plan that is based on a thorough situational analysis of the resources needed for health research and the inequities and gaps in health care. Greater national and international investment in capacity building in developing countries has the greatest potential for securing dynamic and agile knowledge systems that can deliver better health and equity, now and in the future. PMID:15643798

  17. Health in the developing world: achieving the Millennium Development Goals.

    PubMed Central

    Sachs, Jeffrey D.

    2004-01-01

    The Millennium Development Goals depend critically on scaling up public health investments in developing countries. As a matter of urgency, developing-country governments must present detailed investment plans that are sufficiently ambitious to meet the goals, and the plans must be inserted into existing donor processes. Donor countries must keep the promises they have often reiterated of increased assistance, which they can easily afford, to help improve health in the developing countries and ensure stability for the whole world. PMID:15654410

  18. Health Monitoring of a Satellite System

    NASA Technical Reports Server (NTRS)

    Chen, Robert H.; Ng, Hok K.; Speyer, Jason L.; Guntur, Lokeshkumar S.; Carpenter, Russell

    2004-01-01

    A health monitoring system based on analytical redundancy is developed for satellites on elliptical orbits. First, the dynamics of the satellite including orbital mechanics and attitude dynamics is modelled as a periodic system. Then, periodic fault detection filters are designed to detect and identify the satellite's actuator and sensor faults. In addition, parity equations are constructed using the algebraic redundant relationship among the actuators and sensors. Furthermore, a residual processor is designed to generate the probability of each of the actuator and sensor faults by using a sequential probability test. Finally, the health monitoring system, consisting of periodic fault detection lters, parity equations and residual processor, is evaluated in the simulation in the presence of disturbances and uncertainty.

  19. Sources of project financing in health care systems.

    PubMed

    Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

    2000-01-01

    Through discussions with chief financial officers of leading health care systems, insights are offered on preferences for project financing and development efforts. Data from these same systems provide at least anecdotal evidence in support of pecking-order theory.

  20. Developing Community Health Worker Diabetes Training

    ERIC Educational Resources Information Center

    Ferguson, W. J.; Lemay, C. A.; Hargraves, J. L.; Gorodetsky, T.; Calista, J.

    2012-01-01

    We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included…

  1. Integrated Systems Health Management for Space Exploration

    NASA Technical Reports Server (NTRS)

    Uckun, Serdar

    2005-01-01

    Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.

  2. A Community Health Education System to meet the health needs of Indo-Chinese women.

    PubMed

    Ratnaike, R N; Chinner, T L

    1992-04-01

    This paper presents a Community Health Education System which is cost-effective, sustainable, strongly community-based, and directed at improving the health status of rural women in Indo-china (Kampuchea, Laos and Vietnam). The system is developed through a series of steps which are concerned with the education of Community Health Education Units (in national ministries of health) and, at the village level, among community health workers, women's groups, and other women. The ultimate aim is the establishment of a community health education program in Indochinese villages. PMID:1602046

  3. Child Health, Education and Development.

    ERIC Educational Resources Information Center

    Chandler, William U.

    1986-01-01

    Bristling with facts, this article argues that what is needed today is a strategy of integrated development to meet basic needs all across the Third World. Stop-gap techniques such as oral rehydration programs that prevent death are good, but must be augmented by policies which promote food production, clean water, education, family planning, and…

  4. Evaluating Health Information Systems Using Ontologies

    PubMed Central

    Anderberg, Peter; Larsson, Tobias C; Fricker, Samuel A; Berglund, Johan

    2016-01-01

    Background There are several frameworks that attempt to address the challenges of evaluation of health information systems by offering models, methods, and guidelines about what to evaluate, how to evaluate, and how to report the evaluation results. Model-based evaluation frameworks usually suggest universally applicable evaluation aspects but do not consider case-specific aspects. On the other hand, evaluation frameworks that are case specific, by eliciting user requirements, limit their output to the evaluation aspects suggested by the users in the early phases of system development. In addition, these case-specific approaches extract different sets of evaluation aspects from each case, making it challenging to collectively compare, unify, or aggregate the evaluation of a set of heterogeneous health information systems. Objectives The aim of this paper is to find a method capable of suggesting evaluation aspects for a set of one or more health information systems—whether similar or heterogeneous—by organizing, unifying, and aggregating the quality attributes extracted from those systems and from an external evaluation framework. Methods On the basis of the available literature in semantic networks and ontologies, a method (called Unified eValuation using Ontology; UVON) was developed that can organize, unify, and aggregate the quality attributes of several health information systems into a tree-style ontology structure. The method was extended to integrate its generated ontology with the evaluation aspects suggested by model-based evaluation frameworks. An approach was developed to extract evaluation aspects from the ontology that also considers evaluation case practicalities such as the maximum number of evaluation aspects to be measured or their required degree of specificity. The method was applied and tested in Future Internet Social and Technological Alignment Research (FI-STAR), a project of 7 cloud-based eHealth applications that were developed and

  5. Power Systems Development Facility

    SciTech Connect

    Southern Company Services

    2009-01-31

    In support of technology development to utilize coal for efficient, affordable, and environmentally clean power generation, the Power Systems Development Facility (PSDF), located in Wilsonville, Alabama, has routinely demonstrated gasification technologies using various types of coals. The PSDF is an engineering scale demonstration of key features of advanced coal-fired power systems, including a Transport Gasifier, a hot gas particulate control device, advanced syngas cleanup systems, and high-pressure solids handling systems. This final report summarizes the results of the technology development work conducted at the PSDF through January 31, 2009. Twenty-one major gasification test campaigns were completed, for a total of more than 11,000 hours of gasification operation. This operational experience has led to significant advancements in gasification technologies.

  6. [A Maternal Health Care System Based on Mobile Health Care].

    PubMed

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

  7. Exploring and Developing Consumer Health Vocabularies

    PubMed Central

    Zeng, Qing T.; Tse, Tony

    2006-01-01

    Laypersons (“consumers”) often have difficulty finding, understanding, and acting on health information due to gaps in their domain knowledge. Ideally, consumer health vocabularies (CHVs) would reflect the different ways consumers express and think about health topics, helping to bridge this vocabulary gap. However, despite the recent research on mismatches between consumer and professional language (e.g., lexical, semantic, and explanatory), there have been few systematic efforts to develop and evaluate CHVs. This paper presents the point of view that CHV development is practical and necessary for extending research on informatics-based tools to facilitate consumer health information seeking, retrieval, and understanding. In support of the view, we briefly describe a distributed, bottom-up approach for (1) exploring the relationship between common consumer health expressions and professional concepts and (2) developing an open-access, preliminary (draft) “first-generation” CHV. While recognizing the limitations of the approach (e.g., not addressing psychosocial and cultural factors), we suggest that such exploratory research and development will yield insights into the nature of consumer health expressions and assist developers in creating tools and applications to support consumer health information seeking. PMID:16221948

  8. Integrated Crew Health Care System for Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2007-01-01

    Dr. Davis' presentation includes a brief overview of space flight and the lessons learned for health care in microgravity. He will describe the development of policy for health care for international crews. He will conclude his remarks with a discussion of an integrated health care system.

  9. Human Health and Support Systems Capability Roadmap Progress Review

    NASA Technical Reports Server (NTRS)

    Grounds, Dennis; Boehm, Al

    2005-01-01

    The Human Health and Support Systems Capability Roadmap focuses on research and technology development and demonstration required to ensure the health, habitation, safety, and effectiveness of crews in and beyond low Earth orbit. It contains three distinct sub-capabilities: Human Health and Performance. Life Support and Habitats. Extra-Vehicular Activity.

  10. Sexual and reproductive health and rights in changing health systems

    PubMed Central

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  11. Sexual and reproductive health and rights in changing health systems.

    PubMed

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  12. Developing health promoting practices: a transformative process.

    PubMed

    Hartrick, G

    1998-01-01

    For health care professionals to successfully make the transition from disease care to health promotion requires a reorientation of how such professionals think and behave in their practice. This paper describes a multidisciplinary team's transition from disease care to health promotion. The research was conducted to learn what is involved in developing health promotion practices and the major changes practitioners experience as they shift from disease care to health promotion. A large, acute care institution and public health agency collaborated to address the needs of families and children with asthma, allergies, and eczema, with the goal of changing the focus from inpatient care to ambulatory or community-based care. A team of 5 nurses, 1 physiotherapist, 1 respiratory technologist, and 1 nutritionist was formed to undertake the initiative. PMID:9805341

  13. Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research

    PubMed Central

    Burris, Scott; Mays, Glen P; Douglas Scutchfield, F; Ibrahim, Jennifer K

    2012-01-01

    Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the

  14. Consumer acceptance of accountable-eHealth systems.

    PubMed

    Gajanayake, Randike; Iannella, Renato; Sahama, Tony

    2014-01-01

    In this paper, we present the results of a survey conducted to measure the attitudes of eHealth consumers towards Accountable-eHealth systems, which are designed for information privacy management. We developed a research model that identify the factors contributing to system acceptance from quantitative data of 187 completed survey responses from university students studying non-health-related courses at university (Queensland, Australia). The research model is validated using structural equation modeling and can be used to identify how specific characteristics of Accountable-eHealth systems would affect their overall acceptance by future eHealth consumers. PMID:25160334

  15. Global Health Workforce Alliance: increasing the momentum for health workforce development.

    PubMed

    Afzal, Muhammad; Cometto, Giorgio; Rosskam, Ellen; Sheikh, Mubashar

    2011-06-01

    The Global Health Workforce Alliance was launched in 2006 to provide a joint platform for governments, development partners, international agencies, civil society organizations, academia, private sector, professional associations, and other stakeholders to work together to address a global crisis in human resources for health. Five years later the vision and mandate of the Alliance still remain valid. Despite advances in bringing the health workforce to the fore in international health policy arenas, more available knowledge and tools, and encouraging signs of commitments from many countries, health workforce bottlenecks continue to prevent many health systems from delivering essential and quality health services. Latin America is not spared from the challenges. The 2010 Second Global Forum on Human Resources for Health provided an opportunity to review progress, identify persisting gaps, reach consensus on solutions, and renew the momentum for and commitment to acutely needed investment and actions. PMID:21845311

  16. Developing Responsive Indicators of Indigenous Community Health.

    PubMed

    Donatuto, Jamie; Campbell, Larry; Gregory, Robin

    2016-01-01

    How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is "at risk" is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations. PMID:27618086

  17. Developing Responsive Indicators of Indigenous Community Health

    PubMed Central

    Donatuto, Jamie; Campbell, Larry; Gregory, Robin

    2016-01-01

    How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is “at risk” is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations. PMID:27618086

  18. Valve-"Health"-Monitoring System

    NASA Technical Reports Server (NTRS)

    Jensen, Scott L.; Drouant, George J.

    2009-01-01

    A system that includes sensors and data acquisition, wireless data-communication, and data-processing subsystems has been developed as a means of both real-time and historical tracking of information indicative of deterioration in the mechanical integrity and performance of a highgeared ball valve or a linearly actuated valve that operates at a temperature between cryogenic and ambient.

  19. Remote systems development

    NASA Technical Reports Server (NTRS)

    Olsen, R.; Schaefer, O.; Hussey, J.

    1992-01-01

    Potential space missions of the nineties and the next century require that we look at the broad category of remote systems as an important means to achieve cost-effective operations, exploration and colonization objectives. This paper addresses such missions, which can use remote systems technology as the basis for identifying required capabilities which must be provided. The relationship of the space-based tasks to similar tasks required for terrestrial applications is discussed. The development status of the required technology is assessed and major issues which must be addressed to meet future requirements are identified. This includes the proper mix of humans and machines, from pure teleoperation to full autonomy; the degree of worksite compatibility for a robotic system; and the required design parameters, such as degrees-of-freedom. Methods for resolution are discussed including analysis, graphical simulation and the use of laboratory test beds. Grumman experience in the application of these techniques to a variety of design issues are presented utilizing the Telerobotics Development Laboratory which includes a 17-DOF robot system, a variety of sensing elements, Deneb/IRIS graphics workstations and control stations. The use of task/worksite mockups, remote system development test beds and graphical analysis are discussed with examples of typical results such as estimates of task times, task feasibility and resulting recommendations for design changes. The relationship of this experience and lessons-learned to future development of remote systems is also discussed.

  20. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  1. Autonomous Operations System: Development and Application

    NASA Technical Reports Server (NTRS)

    Toro Medina, Jaime A.; Wilkins, Kim N.; Walker, Mark; Stahl, Gerald M.

    2016-01-01

    Autonomous control systems provides the ability of self-governance beyond the conventional control system. As the complexity of mechanical and electrical systems increases, there develops a natural drive for developing robust control systems to manage complicated operations. By closing the bridge between conventional automated systems to knowledge based self-awareness systems, nominal control of operations can evolve into relying on safe critical mitigation processes to support any off-nominal behavior. Current research and development efforts lead by the Autonomous Propellant Loading (APL) group at NASA Kennedy Space Center aims to improve cryogenic propellant transfer operations by developing an automated control and health monitoring system. As an integrated systems, the center aims to produce an Autonomous Operations System (AOS) capable of integrating health management operations with automated control to produce a fully autonomous system.

  2. [Health, environment and sustainable development in Mexico].

    PubMed

    1998-09-01

    This article is based on "Salud, ambiente y desarrollo humano sostenible: el caso de México," a document prepared in June 1997 by the Comité Técnico Nacional para el Desarrollo Sostenible. It opens with information regarding the epidemiologic and demographic changes that have taken place in Mexico, such as the decrease in communicable diseases, the rise in noncommunicable diseases, and the less conspicuous increase in lesions resulting from accidents or acts of violence. This is followed by a discussion of priority problems and problems of lesser magnitude in environmental health, specifically those relating to water and air quality, as well as disposal of household and dangerous wastes. Finally, it proposes three areas of intervention in light of the structural problems detected: the absence of an integrated information system covering the area of health, environment, and development; the absence of channels of communication within and between institutions and sectors, and the lack of coordination in planning and implementing programs and actions in this field.

  3. Concept Development for Software Health Management

    NASA Technical Reports Server (NTRS)

    Riecks, Jung; Storm, Walter; Hollingsworth, Mark

    2011-01-01

    This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

  4. China's public health-care system: facing the challenges.

    PubMed Central

    Liu, Yuanli

    2004-01-01

    The severe acute respiratory syndrome (SARS) crisis in China revealed not only the failures of the Chinese health-care system but also some fundamental structural deficiencies. A decentralized and fragmented health system, such as the one found in China, is not well-suited to making a rapid and coordinated response to public health emergencies. The commercial orientation of the health sector on the supply-side and lack of health insurance coverage on the demand-side further exacerbate the problems of the under-provision of public services, such as health surveillance and preventive care. For the past 25 years, the Chinese Government has kept economic development at the top of the policy agenda at the expense of public health, especially in terms of access to health care for the 800 million people living in rural areas. A significant increase in government investment in the public health infrastructure, though long overdue, is not sufficient to solve the problems of the health-care system. China needs to reorganize its public health system by strengthening both the vertical and horizontal connections between its various public health organizations. China's recent policy of establishing a matching-fund financed rural health insurance system presents an exciting opportunity to improve people's access to health care. PMID:15500285

  5. Liga developer apparatus system

    DOEpatents

    Boehme, Dale R.; Bankert, Michelle A.; Christenson, Todd R.

    2003-01-01

    A system to fabricate precise, high aspect ratio polymeric molds by photolithograpic process is described. The molds for producing micro-scale parts from engineering materials by the LIGA process. The invention is a developer system for developing a PMMA photoresist having exposed patterns comprising features having both very small sizes, and very high aspect ratios. The developer system of the present invention comprises a developer tank, an intermediate rinse tank and a final rinse tank, each tank having a source of high frequency sonic agitation, temperature control, and continuous filtration. It has been found that by moving a patterned wafer, through a specific sequence of developer/rinse solutions, where an intermediate rinse solution completes development of those portions of the exposed resist left undeveloped after the development solution, by agitating the solutions with a source of high frequency sonic vibration, and by adjusting and closely controlling the temperatures and continuously filtering and recirculating these solutions, it is possible to maintain the kinetic dissolution of the exposed PMMA polymer as the rate limiting step.

  6. Heatpipe power system development

    SciTech Connect

    Houts, M.G.; Poston, D.I.

    1998-12-31

    This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The objective of the project was to develop a design approach that could enable the development of near-term, low-cost, space fission-power systems. Sixteen desired attributes were identified for such systems and detailed analyses were performed to verify that they are feasible. Preliminary design work was performed on one concept, the Heatpipe Power system (HPS). As a direct result of this project, funding was obtained from the National Aeronautics and Space Administration to build and test an HPS module. The module tests went well, and they now have funding to build a bimodal module.

  7. Health systems frameworks in their political context: framing divergent agendas

    PubMed Central

    2012-01-01

    Background Despite the mounting attention for health systems and health systems theories, there is a persisting lack of consensus on their conceptualisation and strengthening. This paper contributes to structuring the debate, presenting landmarks in the development of health systems thinking against the backdrop of the policy context and its dominant actors. We argue that frameworks on health systems are products of their time, emerging from specific discourses. They are purposive, not neutrally descriptive, and are shaped by the agendas of their authors. Discussion The evolution of thinking over time does not reflect a progressive accumulation of insights. Instead, theories and frameworks seem to develop in reaction to one another, partly in line with prevailing paradigms and partly as a response to the very different needs of their developers. The reform perspective considering health systems as projects to be engineered is fundamentally different from the organic view that considers a health system as a mirror of society. The co-existence of health systems and disease-focused approaches indicates that different frameworks are complementary but not synthetic. The contestation of theories and methods for health systems relates almost exclusively to low income countries. At the global level, health system strengthening is largely narrowed down to its instrumental dimension, whereby well-targeted and specific interventions are supposed to strengthen health services and systems or, more selectively, specific core functions essential to programmes. This is in contrast to a broader conceptualization of health systems as social institutions. Summary Health systems theories and frameworks frame health, health systems and policies in particular political and public health paradigms. While there is a clear trend to try to understand the complexity of and dynamic relationships between elements of health systems, there is also a demand to provide frameworks that distinguish

  8. Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

    PubMed

    East, Marlene Lynette; Havard, Byron C

    2015-01-01

    The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

  9. Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System

    PubMed Central

    2015-01-01

    The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

  10. New partnership for health? Business groups on health and health systems agencies.

    PubMed

    Bradbury, R C

    1983-01-01

    The experience of the Central Massachusetts Health Systems Agency (CMHSA) and the Central Massachusetts Business Group on Health (CMBGH) demonstrates the feasibility of cooperation between HSAs and BGHs. Objectives and strategies of the two groups in carrying out community health planning and working for health systems change are compared. Nearly two decades of government-sponsored community health planning programs, first through comprehensive health planning agencies and then through HSAs, have had less impact than many had anticipated because neither the technical nor political basis for such planning was sufficiently established. The CMHSA experience is typical, although it is credited with developing a hospital systems plan that is based on sound planning methods and statistical data. It is in the implementation of plans that the CMHSA has made slow progress, reflecting its inadequate community power base. The CMBGH, 1 of more than 90 groups that have developed recently across the country to attack high health care costs, was formed in 1981 by business leaders to address these rising costs. The principal strategy adopted by the CMBGH involves fostering a competitive health care market by creating a critical number of competing health plans. The providers in each plan will then have incentives to provide effective care in an efficient manner to keep the premium competitive and attract enrollees. Cooperation between the CMBGH and CMHSA is based on each organization's emphasizing its strengths. The CMHSA's data base and analyses have been the primary resources used by the CMBGH to identify problems. Each organization has developed its own set of goals and objectives, while keeping in mind those of the other organization. The CMBGH adopted a subset of theCMHSA's goals-those that focus on hospital capacity and utilization. Although the CMHSA's regulatory strategies differ greatly from the CMBGH's competition strategies, they do not necessarily conflict

  11. The near-term future for child health information systems.

    PubMed

    Ross, David A; Hinman, Alan R; Saarlas, Kristin N; Lloyd-Puryear, Michele A; Downs, Stephen J

    2004-11-01

    The developmental process in children offers an opportunity to influence their health and well-being as adults. The information infrastructure of the future needs to support the multiple partners responsible for providing elements of the health protection and health care of children. In this partnership, public health plays simultaneously a supportive role and a leadership role. Five tasks need to guide near-term information systems thinking with respect to establishing a basis for building electronic linkages among various child health programs. First, the nation's vital records system must be reengineered to ensure that this key information asset can be integrated into other child health information systems. Second, through an appropriate governance structure, the key stakeholders in child health should endorse standards and requirements that define a longitudinal health record for children. Third, public health agencies should develop a thorough business case/value proposition that drives mutually developed and mutually endorsed requirements for the integration of presently fragmented systems. Fourth, public health should take the lead in ensuring that parents have convenient access to information that can support the coordination of their child's care and development. And fifth, provider groups and public health agencies should join research networks to study how information supports positive changes to children's health. PMID:15643367

  12. Rural health network development: public policy issues and state initiatives.

    PubMed

    Casey, M M; Wellever, A; Moscovice, I

    1997-02-01

    Rural health networks are a potential way for rural health care systems to improve access to care, reduce costs, and enhance quality of care. Networks provide a means for rural providers to contract with managed care organizations, develop their own managed care entities, share resources, and structure practice opportunities to support recruitment and retention of rural physicians and other health care professionals. The results of early network development initiatives indicate a need for state officials and others interested in encouraging network development to agree on common rural health network definitions, to identify clearly the goals of network development programs, and to document and analyze program outcomes. Future network development efforts need to be much more comprehensive if they are to have a significant impact on rural health care. This article analyzes public policy issues related to integrated rural health network development, discusses current efforts to encourage network development in rural areas, and suggests actions that states may take if they desire to support rural health network development. These actions include adopting a formal rural health network definition, providing networks with alternatives to certain regulatory requirements, and providing incentives such as matching grants, loans, or technical assistance. Without public sector support for networks, managed care options may continue to be unavailable in many less densely populated rural areas of the country, and locally controlled rural health networks are unlikely to develop as an alternative to the dominant pattern of managed care expansion by large urban entities. Implementation of Medicare reform legislation could provide significant incentives for the development of rural health networks, depending on the reimbursement provisions, financial solvency standards, and antitrust exemptions for provider-sponsored networks in the final legislation and federal regulations. PMID

  13. CORBA security services for health information systems.

    PubMed

    Blobel, B; Holena, M

    1998-01-01

    The structure of healthcare systems in developed countries is changing to 'shared care', enforced by economic constraints and caused by a change in the basic conditions of care. That development results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and, as far as their domains are concerned, heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems require a high level of data protection and data security, both with respect to patient information and with respect to users. This paper, relying on experience gained through our activities in CORBAmed, describes the possibilities the CORBA middleware provides to achieve application and communication security. On the background of the overall CORBA architecture, it outlines the different security services previewed in the adopted CORBA specifications which are discussed in the context of the security requirements of healthcare information systems. Security services required in the healthcare domain but not available at the moment are mentioned. A solution is proposed, which on the one hand allows to make use of the available CORBA security services and additional ones, on the other hand remains open to other middleware approaches, such as DHE or HL7. PMID:9848400

  14. CORBA security services for health information systems.

    PubMed

    Blobel, B; Holena, M

    1998-01-01

    The structure of healthcare systems in developed countries is changing to 'shared care', enforced by economic constraints and caused by a change in the basic conditions of care. That development results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and, as far as their domains are concerned, heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems require a high level of data protection and data security, both with respect to patient information and with respect to users. This paper, relying on experience gained through our activities in CORBAmed, describes the possibilities the CORBA middleware provides to achieve application and communication security. On the background of the overall CORBA architecture, it outlines the different security services previewed in the adopted CORBA specifications which are discussed in the context of the security requirements of healthcare information systems. Security services required in the healthcare domain but not available at the moment are mentioned. A solution is proposed, which on the one hand allows to make use of the available CORBA security services and additional ones, on the other hand remains open to other middleware approaches, such as DHE or HL7.

  15. Development and Testing of Propulsion Health Management

    NASA Technical Reports Server (NTRS)

    Hunter, Gary W.; Lekki, John D.; Simon, Donald L.

    2012-01-01

    An Integrated Vehicle Health Management system aims to maintain vehicle health through detection, diagnostics, state awareness, prognostics, and lastly, mitigation of detrimental situations for each of the vehicle subsystems and throughout the vehicle as a whole. This paper discusses efforts to advance Propulsion Health Management technology for in-flight applications to provide improved propulsion sensors measuring a range of parameters, improve ease of propulsion sensor implementation, and to assess and manage the health of gas turbine engine flow-path components. This combined work is intended to enable real-time propulsion state assessments to accurately determine the vehicle health, reduce loss of control, and to improve operator situational awareness. A unique aspect of this work is demonstration of these maturing technologies on an operational engine.

  16. Fundamental Technology Development for Gas-Turbine Engine Health Management

    NASA Technical Reports Server (NTRS)

    Mercer, Carolyn R.; Simon, Donald L.; Hunter, Gary W.; Arnold, Steven M.; Reveley, Mary S.; Anderson, Lynn M.

    2007-01-01

    Integrated vehicle health management technologies promise to dramatically improve the safety of commercial aircraft by reducing system and component failures as causal and contributing factors in aircraft accidents. To realize this promise, fundamental technology development is needed to produce reliable health management components. These components include diagnostic and prognostic algorithms, physics-based and data-driven lifing and failure models, sensors, and a sensor infrastructure including wireless communications, power scavenging, and electronics. In addition, system assessment methods are needed to effectively prioritize development efforts. Development work is needed throughout the vehicle, but particular challenges are presented by the hot, rotating environment of the propulsion system. This presentation describes current work in the field of health management technologies for propulsion systems for commercial aviation.

  17. Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico

    PubMed Central

    2011-01-01

    Background Health system strengthening is critical to ensure the integration and scaling-up of priority health promotion, disease prevention and control programs. Normative guidelines are available to address health system function imbalances while strategic and analytical frameworks address critical functions in complex systems. Tacit knowledge-based health system constructs can help identify actors' perspectives, contributing to improve strengthening strategies. Using maternal health as an example, this paper maps and analyses the health system functions that critical actors charged with formulating and delivering priority health programs consider important for their success. Methods Using concept mapping qualitative and statistical methods, health system functions were mapped for different categories of actors in high maternal mortality states of Mexico and at the federal level. Functions within and across maps were analyzed for degree of classification, importance, feasibility and coding. Results Hospital infrastructure and human resource training are the most prominent functions in the maternal health system, associated to federal efforts to support emergency obstetric care. Health policy is a highly diffuse function while program development, intercultural and community participation and social networks are clearly stated although less focused and with lower perceived importance. The importance of functions is less correlated between federal and state decision makers, between federal decision makers and reproductive health/local health area program officers and between state decision makers and system-wide support officers. Two sets of oppositions can be observed in coding across functions: health sector vs. social context; and given structures vs. manageable processes. Conclusions Concept mapping enabled the identification of critical functions constituting adaptive maternal health systems, including aspects of actor perspectives that are seldom included in

  18. Interview: Iceland's health care system. Interview by Susan Reeves.

    PubMed

    Magnusson, G

    1985-01-01

    Iceland has a well established system of socialized medicine and national health insurance. Its small homogeneous population has enabled Iceland to computerize and process data concerning quality of patient care, volume and type of drugs prescribed, and pertinent epidemiological information. In the following interview, Dr. Gudjon Magnusson discusses the development, maintenance, and operational costs of such a health care system.

  19. Spatial and non-spatial determinants of successful tuberculosis treatment outcomes: An implication of Geographical Information Systems in health policy-making in a developing country.

    PubMed

    Kolifarhood, Goodarz; Khorasani-Zavareh, Davoud; Salarilak, Shaker; Shoghli, Alireza; Khosravi, Nasim

    2015-09-01

    This retrospective study aimed to address whether or to what extent spatial and non-spatial factors with a focus on a healthcare delivery system would influence successful tuberculosis (TB) treatment outcomes in Urmia, Iran. In this cross-sectional study, data of 452 new TB cases were extracted from Urmia TB Management Center during a 5-year period. Using the Geographical Information System (GIS), health centers and study subjects' locations were geocoded on digital maps. To identify the statistically significant geographical clusters, Average Nearest Neighbor (ANN) index was used. Logistic regression analysis was employed to determine the association of spatial and non-spatial variables on the occurrence of adverse treatment outcomes. The spatial clusters of TB cases were concentrated in older, impoverished and outskirts areas. Although there was a tendency toward higher odds of adverse treatment outcomes among urban TB cases, this finding after adjusting for distance from a given TB healthcare center did not reach statistically significant. This article highlights effects of spatial and non-spatial determinants on the TB adverse treatment outcomes, particularly in what way the policies of healthcare services are made. Accordingly, non-spatial determinants in terms of low socio-economic factors need more attention by public health policy makers, and then more focus should be placed on the health delivery system, in particular men's health.

  20. Open source cardiology electronic health record development for DIGICARDIAC implementation

    NASA Astrophysics Data System (ADS)

    Dugarte, Nelson; Medina, Rubén.; Huiracocha, Lourdes; Rojas, Rubén.

    2015-12-01

    This article presents the development of a Cardiology Electronic Health Record (CEHR) system. Software consists of a structured algorithm designed under Health Level-7 (HL7) international standards. Novelty of the system is the integration of high resolution ECG (HRECG) signal acquisition and processing tools, patient information management tools and telecardiology tools. Acquisition tools are for management and control of the DIGICARDIAC electrocardiograph functions. Processing tools allow management of HRECG signal analysis searching for indicative patterns of cardiovascular pathologies. Telecardiology tools incorporation allows system communication with other health care centers decreasing access time to the patient information. CEHR system was completely developed using open source software. Preliminary results of process validation showed the system efficiency.

  1. [Health and development in Brazil: progress and challenges].

    PubMed

    Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira

    2012-12-01

    The structural sustainability of the Brazilian health system refers to the country's pattern of development according to how this pattern is expressed and reproduced in the Brazilian population. This derives not only from its social dimension, but also from the economic one, as it accounts for a significant part of the gross domestic product and of job creation, and produces a great impact on the generation of innovation and national competitiveness. The federal government has institutionalized the role of health in the national development agenda due to its strategic aspect. Despite this, the fragility of its productive base continues to be a major vulnerability for the National Health System and for Brazil's competitiveness in a global environment. This signals that the virtuous establishment of the relation between health and development involves the rupture of cognitive and political paradigms that separate, in an impermeable way, the economic from the social order.

  2. Globalization of psychiatry - a barrier to mental health development.

    PubMed

    Fernando, Suman

    2014-10-01

    The concept of globalization has been applied recently to ways in which mental health may be developed in low- and middle-income countries (LMICs), sometimes referred to as the 'Third World' or developing countries. This paper (1) describes the roots of psychiatry in western culture and its current domination by pharmacological therapies; (2) considers the history of mental health in LMICs, focusing on many being essentially non-western in cultural background with a tradition of using a plurality of systems of care and help for mental health problems, including religious and indigenous systems of medicine; and (3) concludes that in a post-colonial world, mental health development in LMICs should not be left to market forces, which are inevitably manipulated by the interests of multinational corporations mostly located in ex-colonizing countries, especially the pharmaceutical companies.

  3. Health Code Number (HCN) Development Procedure

    SciTech Connect

    Petrocchi, Rocky; Craig, Douglas K.; Bond, Jayne-Anne; Trott, Donna M.; Yu, Xiao-Ying

    2013-09-01

    This report provides the detailed description of health code numbers (HCNs) and the procedure of how each HCN is assigned. It contains many guidelines and rationales of HCNs. HCNs are used in the chemical mixture methodology (CMM), a method recommended by the department of energy (DOE) for assessing health effects as a result of exposures to airborne aerosols in an emergency. The procedure is a useful tool for proficient HCN code developers. Intense training and quality assurance with qualified HCN developers are required before an individual comprehends the procedure to develop HCNs for DOE.

  4. Racism and children's health: issues in development.

    PubMed

    Williams-Morris, R S

    1996-01-01

    It has been posited by some social scientists that racism has a negative impact on the health of certain minority groups in the United States. How racism affects the development of children and thus their health, has not been addressed by research in developmental psychology, despite a plethora of studies of racial/ethnic identity development. Existing developmental theories may be amenable to describing and possibly predicting the role that racism plays on child and adolescent development. A model is presented that attempts to explain how racism might affect a child's development and consequently his health by incorporating and synthesizing various developmental principles and social cognition theory. The need for empirical inquiry on this topic is indicated; design suggestions are offered.

  5. Health Track System—An Automated Occupational Medical System

    PubMed Central

    Compton, Jack E.; Hartridge, Anne D.; Maluish, Andrew G.

    1980-01-01

    The development of an automated occupational health and hazards system is being undertaken at the Department of Energy by Electronic Data Systems. This system, called the Health Track System (HTS), involves the integration and collection of data from the fields of occupational medicine, industrial hygiene, health physics, safety and personnel. This in itself is an exciting prospect, however, the scope of the system calls for it to be installed throughout DOE and contractor organizations across the country, which is even more exciting. Presented here are the main ideas behind the system, and how state of the art technology can be applied to this task.

  6. Promoting maternal health in developing countries.

    PubMed

    Seipel, M M

    1992-08-01

    Most maternal deaths are preventable, yet more than 500,000 women die annually worldwide. However, the risk of maternal mortality is unevenly distributed; 99 percent of all maternal deaths occur in developing countries. This article examines the causes of this disparity and suggests several recommendations for social workers to promote maternal health in developing countries. PMID:1526599

  7. Geographic information systems (GIS) for Health Promotion and Public Health: a review.

    PubMed

    Nykiforuk, Candace I J; Flaman, Laura M

    2011-01-01

    The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.

  8. INDUCTIVE SYSTEM HEALTH MONITORING WITH STATISTICAL METRICS

    NASA Technical Reports Server (NTRS)

    Iverson, David L.

    2005-01-01

    Model-based reasoning is a powerful method for performing system monitoring and diagnosis. Building models for model-based reasoning is often a difficult and time consuming process. The Inductive Monitoring System (IMS) software was developed to provide a technique to automatically produce health monitoring knowledge bases for systems that are either difficult to model (simulate) with a computer or which require computer models that are too complex to use for real time monitoring. IMS processes nominal data sets collected either directly from the system or from simulations to build a knowledge base that can be used to detect anomalous behavior in the system. Machine learning and data mining techniques are used to characterize typical system behavior by extracting general classes of nominal data from archived data sets. In particular, a clustering algorithm forms groups of nominal values for sets of related parameters. This establishes constraints on those parameter values that should hold during nominal operation. During monitoring, IMS provides a statistically weighted measure of the deviation of current system behavior from the established normal baseline. If the deviation increases beyond the expected level, an anomaly is suspected, prompting further investigation by an operator or automated system. IMS has shown potential to be an effective, low cost technique to produce system monitoring capability for a variety of applications. We describe the training and system health monitoring techniques of IMS. We also present the application of IMS to a data set from the Space Shuttle Columbia STS-107 flight. IMS was able to detect an anomaly in the launch telemetry shortly after a foam impact damaged Columbia's thermal protection system.

  9. [Development, health-industrial complex and industrial policy].

    PubMed

    Gadelha, Carlos Augusto Grabois

    2006-08-01

    This paper puts health questions within the context of national development and industrial policy. It follows the idea of structuralist, Marxist and Schumpeterian approaches, in which industry and innovations form determining factors for the dynamism in capitalist economies and relative positions within the world economy. All countries that have developed and started to compete under better conditions with advanced countries have had an association between strong industry and an endogenous knowledge, learning and innovation base. However, in the field of health, this vision presents problems because business interests move according to the economic logic of profit rather than to meet health needs. The notion of the health-industrial complex is an attempt to provide a theoretical reference that enables linkage between two distinct types of logic: health and economic development. This study has sought to show, on the basis of foreign trade data, how disregard for the logic of health policy development has led to a situation of economic vulnerability in this sector, which may limit the objectives of universality, equality and comprehensiveness. Within this context, a cognitive and political break with these antagonistic visions that put health needs on one side and industrial needs on the other is proposed. A country that aims to reach a condition of development and independence requires strong innovative industries and an inclusive and universal health system, at the same time. PMID:16924298

  10. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

    This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600

  11. Community mental health care worldwide: current status and further developments

    PubMed Central

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness.

  12. Community mental health care worldwide: current status and further developments

    PubMed Central

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness. PMID:27717265

  13. Food Systems and Public Health Disparities

    PubMed Central

    Neff, Roni A.; Palmer, Anne M.; Mckenzie, Shawn E.; Lawrence, Robert S.

    2009-01-01

    The United States has set a national goal to eliminate health disparities. This article emphasizes the importance of food systems in generating and exacerbating health disparities in the United States and suggests avenues for reducing them. It presents a conceptual model showing how broad food system conditions interplay with community food environments—and how these relationships are filtered and refracted through prisms of social disparities to generate and exacerbate health disparities. Interactions with demand factors in the social environment are described. The article also highlights the separate food systems pathway to health disparities via environmental and occupational health effects of agriculture. PMID:23173027

  14. Mental health system in Saudi Arabia: an overview

    PubMed Central

    Qureshi, Naseem Akhtar; Al-Habeeb, Abdulhameed Abdullah; Koenig, Harold G

    2013-01-01

    Background There is evidence that mapping mental health systems (MHSs) helps in planning and developing mental health care services for users, families, and other caregivers. The General Administration of Mental Health and Social Services of the Ministry of Health over the past 4 years has sought to streamline the delivery of mental health care services to health consumers in Saudi Arabia. Objective We overview here the outcome of a survey that assessed the Saudi MHS and suggest strategic steps for its further improvement. Method The World Health Organization Assessment Instrument for Mental Health Systems was used systematically to collect information on the Saudi MHS in 2009–2010, 4 years after a baseline assessment. Results Several mental health care milestones, especially provision of inpatient mental health services supported by a ratified Mental Health Act, were achieved during this period. However, community mental health care services are needed to match international trends evident in developed countries. Similarly, a larger well-trained mental health workforce is needed at all levels to meet the ever-increasing demand of Saudi society. Conclusion This updated MHS information, discussed in light of international data, will help guide further development of the MHS in Saudi Arabia in the future, and other countries in the Eastern Mediterranean region may also benefit from Saudi experience. PMID:23966783

  15. Implementing the learning health system: from concept to action.

    PubMed

    Greene, Sarah M; Reid, Robert J; Larson, Eric B

    2012-08-01

    Clinicians and health systems are facing widespread challenges, including changes in care delivery, escalating health care costs, and the need to keep up with rapid scientific discovery. Reorganizing U.S. health care and changing its practices to render better, more affordable care requires transformation in how health systems generate and apply knowledge. The "rapid-learning health system"-posited as a conceptual strategy to spur such transformation-leverages recent developments in health information technology and a growing health data infrastructure to access and apply evidence in real time, while simultaneously drawing knowledge from real-world care-delivery processes to promote innovation and health system change on the basis of rigorous research. This article describes an evolving learning health system at Group Health Cooperative, the 6 phases characterizing its approach, and examples of organization-wide applications. This practical model promotes bidirectional discovery and an open mind at the system level, resulting in willingness to make changes on the basis of evidence that is both scientifically sound and practice-based. Rapid learning must be valued as a health system property to realize its full potential for knowledge generation and application.

  16. Primary health care and public health: foundations of universal health systems.

    PubMed

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  17. [Health and environmental governance for sustainable development].

    PubMed

    Buss, Paulo Marchiori; Machado, Jorge Mesquita Huet; Gallo, Edmundo; Magalhães, Danielly de Paiva; Setti, Andréia Faraoni Freitas; Franco Netto, Francisco de Abreu; Buss, Daniel Forsin

    2012-06-01

    The United Nations Conference on Sustainable Development, Rio+20, will address the challenges for sustainable development (SD), 'green economy and poverty eradication' and the 'institutional structure of sustainable development'. Therefore it will address the governance needed to achieve such goals. This paper discusses the structure of global, regional and national governance of and for health and environment in the context of SD. Among other global actions, the Millenium Development Goals were a significant recent political effort, but despite its advances, it fails when ignores the structural causes of production and consumption patterns and the unequal distribution of power, which are responsible for inequities and impede true development. To achieve SD, proposals must avoid reductionism, advancing conceptually and methodologically to face the challenges of the socio-environmental determinants of health through intersectoral action, including social participation and all levels of government. It is paramount to continue the implementation of Agenda 21, to meet the MDGs and to create 'Sustainable Development Goals'. Regarding the health field, Rio+20 Summit must reassure the connection between health and sustainability - as a part of the Social pillar of sustainable development - inspiring politics and actions in multiple levels.

  18. Asset health monitors: development, sustainment, advancement

    NASA Astrophysics Data System (ADS)

    Mauss, Fredrick J.

    2011-04-01

    Pacific Northwest National Laboratory (PNNL) has developed the Captive Carry Health Monitor Unit (HMU) and the Humidity Indicator HMU. Each of these devices provides end users information that can be used to ensure the proper maintenance and performance of the missile. These two efforts have led to the ongoing development and evolution of the next generation Captive Carry HMU and the next generation Humidity Indicator HMU. These next generation efforts are in turn, leading to the future of HMUs. This evolutionary development process inherently allows for direct and indirect impact toward new HMU functionality, operability and performance characteristics by influencing their requirements, testing, communications, data archival, and user interaction. Current designs allow systems to operate in environments outside the limits of typical consumer electronics for up to or exceeding 10 years. These designs are battery powered and typically provided in custom mechanical packages that employ sensors for temperature, shock/vibration, and humidity measurements. The data taken from these sensors is then analyzed onboard using unique algorithms. The algorithms are developed from test data and fielded prototypes. Onboard data analysis provides field users with a simple indication of missile exposure. The HMU provides missile readiness information to the user based on storage and use conditions observed. To continually advance current designs PNNL evaluates the potential for enhancing sensor capabilities by improving performance or power saving features, increasing algorithm and processing abilities, and adding new features. Future work at PNNL includes the utilization of power harvesting, using a defined wireless protocol, and defining a data/information structure. These efforts will lead to improved performance allowing the HMUs to benefit users with direct access to HMUs in the field as well as benefiting those with the ability to make strategic and high-level supply and

  19. Health development experience in North and South Korea.

    PubMed

    Kim, H J; Ahn, Y S; Lee, S G

    2001-01-01

    The purpose of this study is to compare the difference in health status between South Koreans and North Koreans and to identify factors responsible for the remarkable improvements in the health status of South Koreans. In order to examine the causes of the difference in health level, the health indices and their determinants of two Koreas were analyzed in time order. As of the year 2000, the average life expectancy at birth is 71.0 years for men and 78.6 years for women in South Korea, which is longer than that of North Korea by 8.1 for men and 11.2 for women. Infant mortality rate in 1998 was 9.0 per 1,000 live births in South Korea and 54.0 in North Korea. Since being liberated from Japanese ruling in 1945, South Korea has achieved remarkable economic growth under democracy and a market economy system. On the other hand, North Korea has maintained a socialistic system. North Korea has suffered from economic crisis since the 1990s. From this point it could be said that economic status is the major factor for the differences in health level between the two Koreas. Economic status not only directly influences health level but also indirectly affects it through influences on nutrition, hygiene, health resources, and other intervening factors. The South Korean government has concentrated its limited resources on public health activities such as tuberculosis control, family planning (FP), and maternal and child health (MCH) programmes whereas the private sector has taken charge of constructing the health delivery system including health facilities and human resources. In order to solve the problem, which might occur in the private-oriented medical care system, the South Korean government has introduced the national health insurance programme and enforced regulation policies. Many developing countries which are suffering from poverty and disease, can learn from the experience of Korea that had suffered from similar problems up to the early 1970s.

  20. Internal insulation system development