Science.gov

Sample records for national health system

  1. [System approach to national health security problems].

    PubMed

    Venediktov, D D

    1998-01-01

    P. K. Anokhin's basic works on functional systems, on space-time continuum and advanced reflection of the reality, on the physiological structure of a behavior act, as well as his fundamental philosophical and scientific postulated are most fruitful for analyzing and solving a number of biomedical, societal, and political problems, among them there are problems of national security in general and its demographic and health aspects. Individual and public health as a measure of balance between the organism (population) and its biosocial environment depends on the efficiency of relevant physiological and societal functional systems is one of the basic prerequisites of national security and timely recognition, avoiding and overcoming numerous challenges, dangers, and threats to the nation. General political and socioeconomic crisis in Russia adversely affects the population's dynamics and public health and it is manifested by depopulatory processes, low birth and high mortality and morbidity rates, growing violence and crime, psychoemotional stress, decreased immunity level of vast majority of population, especially that of children, elderly and other vulnerable groups. Environmental pollution and degradation have reached dangerous proportions. The national health system is unable to meet basic needs of the population. To overcome the crisis, systemic measures should be in the foundation of all health reform concepts and strategies. Monitoring national health, including modelling its future status, as well as progress in health system reforms should be another basic condition for overcoming the national health crisis. PMID:9567717

  2. PEDSnet: a National Pediatric Learning Health System.

    PubMed

    Forrest, Christopher B; Margolis, Peter A; Bailey, L Charles; Marsolo, Keith; Del Beccaro, Mark A; Finkelstein, Jonathan A; Milov, David E; Vieland, Veronica J; Wolf, Bryan A; Yu, Feliciano B; Kahn, Michael G

    2014-01-01

    A learning health system (LHS) integrates research done in routine care settings, structured data capture during every encounter, and quality improvement processes to rapidly implement advances in new knowledge, all with active and meaningful patient participation. While disease-specific pediatric LHSs have shown tremendous impact on improved clinical outcomes, a national digital architecture to rapidly implement LHSs across multiple pediatric conditions does not exist. PEDSnet is a clinical data research network that provides the infrastructure to support a national pediatric LHS. A consortium consisting of PEDSnet, which includes eight academic medical centers, two existing disease-specific pediatric networks, and two national data partners form the initial partners in the National Pediatric Learning Health System (NPLHS). PEDSnet is implementing a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning.

  3. PEDSnet: a National Pediatric Learning Health System

    PubMed Central

    Forrest, Christopher B; Margolis, Peter A; Bailey, L Charles; Marsolo, Keith; Del Beccaro, Mark A; Finkelstein, Jonathan A; Milov, David E; Vieland, Veronica J; Wolf, Bryan A; Yu, Feliciano B; Kahn, Michael G

    2014-01-01

    A learning health system (LHS) integrates research done in routine care settings, structured data capture during every encounter, and quality improvement processes to rapidly implement advances in new knowledge, all with active and meaningful patient participation. While disease-specific pediatric LHSs have shown tremendous impact on improved clinical outcomes, a national digital architecture to rapidly implement LHSs across multiple pediatric conditions does not exist. PEDSnet is a clinical data research network that provides the infrastructure to support a national pediatric LHS. A consortium consisting of PEDSnet, which includes eight academic medical centers, two existing disease-specific pediatric networks, and two national data partners form the initial partners in the National Pediatric Learning Health System (NPLHS). PEDSnet is implementing a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning. PMID:24821737

  4. Canada deserves a national health system.

    PubMed

    Noseworthy, T W

    1997-01-01

    A defining--some would say peculiar--feature about Canada and Canadians is the strong position that we give social programs within our national identity. FORUM presents an essay by Dr. Thomas Noseworthy based on an address to the annual meeting of the Association of Canadian Medical Colleges in April 1996. In it, Dr. Noseworthy calls for a national health system. He sees the federal government retaining an important role in preserving medicare and, in fact, strengthening its powers in maintaining national consistency and standards. Dr. Noseworthy's views are contrary to the governmental decentralization and devolution of powers occurring across the country. In a "point/counterpoint" exchange on this issue, we have invited commentaries from three experts. Raisa Deber leads off by noting that while a national health system may be desirable, constitutional provisions would be an obstacle. Governments, says Deber, have an inherent conflict of interest between their responsibility for maintaining the health care system and their desire to shift costs. Michael Rachlis reminds us that medicare fulfills important economic as well as social objectives. It helps to support Canada's business competitiveness among other nations. The problem, say Rachlis, is that public financing of health care does not ensure an efficient delivery system. Michael Walker offers some reality orientation. He observes that Canada's health care system is based upon ten public insurance schemes with widely different attributes. While he supports a minimum standard of health care across the country, citizens should be able to purchase private medical insurance and have access to a parallel private health care delivery system. Ultimately, this debate is about who should control social programs: the provinces or the federal government? We'll let you, the readers, decide. PMID:10167074

  5. Stewardship of the Spanish national health system.

    PubMed

    Bankauskaite, Vaida; Novinskey, Christina M

    2010-01-01

    Along with resource generation, financing, and health service delivery, stewardship is a key health system function. However, very little empirical analysis has been carried out on it. This paper aims to fill this gap in the literature by assessing the Ministry of Health's (MoHs) role as a steward of the Spanish National Health System (NHS) after the 2001 decentralization reform of health care management to the Autonomous Communities. We use the following stewardship framework with six sub-functions for the analysis, looking at the MoH's ability to: (1) formulate strategic policy framework; 2) ensure a fit between policy objectives and organizational structure and culture; (3) ensure tools for implementation; (4) build coalitions and partnerships; (5) generate intelligence, and (6) ensure accountability. We describe the stewardship function, identify existing challenges and issues in the Spanish case, and reflect upon methodological aspects of this exercise. We use reports, documents, articles, and official statistics to complete the analysis. Overall, we find the MoH to give an average performance in its role as the steward of the health system. The MoH has progressed particularly well in generating intelligence as well as formulating a strategic policy framework over recent years. However, it lacks the appropriate authority to efficiently coordinate the health system and to ensure that the Autonomous Communities implement policies that are in-line with overall NHS objectives.

  6. Stewardship of the Spanish national health system.

    PubMed

    Bankauskaite, Vaida; Novinskey, Christina M

    2010-01-01

    Along with resource generation, financing, and health service delivery, stewardship is a key health system function. However, very little empirical analysis has been carried out on it. This paper aims to fill this gap in the literature by assessing the Ministry of Health's (MoHs) role as a steward of the Spanish National Health System (NHS) after the 2001 decentralization reform of health care management to the Autonomous Communities. We use the following stewardship framework with six sub-functions for the analysis, looking at the MoH's ability to: (1) formulate strategic policy framework; 2) ensure a fit between policy objectives and organizational structure and culture; (3) ensure tools for implementation; (4) build coalitions and partnerships; (5) generate intelligence, and (6) ensure accountability. We describe the stewardship function, identify existing challenges and issues in the Spanish case, and reflect upon methodological aspects of this exercise. We use reports, documents, articles, and official statistics to complete the analysis. Overall, we find the MoH to give an average performance in its role as the steward of the health system. The MoH has progressed particularly well in generating intelligence as well as formulating a strategic policy framework over recent years. However, it lacks the appropriate authority to efficiently coordinate the health system and to ensure that the Autonomous Communities implement policies that are in-line with overall NHS objectives. PMID:21069771

  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. Public health systems research: setting a national agenda.

    PubMed

    Lenaway, Dennis; Halverson, Paul; Sotnikov, Sergey; Tilson, Hugh; Corso, Liza; Millington, Wayne

    2006-03-01

    The Institute of Medicine has recommended that policy decisions about improvement of national public health systems be guided by sound scientific evidence. However, to date there is no national research agenda to help guide public health systems. The Centers for Disease Control and Prevention was called upon to lead a collaborative consensus-based process to define key research questions and establish a framework to create opportunities to better coordinate, leverage, and identify public health resources, which are increasingly scarce. The public health systems research agenda that emerged from this process has 14 over-arching priority research themes. This national agenda should stimulate and guide research to meet the urgent need to improve the nation's public health systems.

  9. 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.

  10. The Chinese health care system: lessons for other nations.

    PubMed

    Hsiao, W C

    1995-10-01

    This paper examines China's health care from a system perspective and draws some lessons for less developed nations. A decade ago, Chinese macro-health policy shifted its health care financing and delivery toward a free market system. It encouraged all levels of health facilities to rely on user fees to support their operations. However, China continued its administered prices and hospitals continued to be operated by the government. These financing, pricing and organizational policies were not coordinated. The author found these uncoordinated policies created serious dissonance in the system. Irrational prices distorted medical practices which resulted in overuse of drugs and high technology tests. Market-based financing created more unequal access to health care between the rich and poor. Public control of hospitals and poor management caused inefficiency, waste and poor quality of care. The disarray of the Chinese health system, however, had not caused a measurable decline in health status of the Chinese people. One explanation was that the government had maintained its level of funding (per capita) for public health and prevention. Another possible explanation was that rapid rising income in China had improved nutrition, clean water and education which offset any adverse impacts of poorer medical services to the low-income populations. Nonetheless, the Chinese experience showed that its increasing expenditure per person for health care through user fees and insurance had not produced commensurate improvement in health status. China'a experience holds several lessons for less developed nations. First, there is a close linkage between financing, price and organization of health care. Uncoordinated policies could exacerbate inequity and inefficiency in health care.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Comparisons among national health care systems in the European marketplace.

    PubMed

    Normand, C

    1993-01-01

    Most European countries have adopted either a Bismarckian system of compulsory health care insurance or a national health care system funded by taxation. For both systems, a basic level of health care is free at the point of use for all citizens. Health care has been undergoing reforms in most European countries. In the western nations, the autonomy of providers of services has increased, elements of competition and cost control have been introduced, and incentives to provide more cost-effective care have been initiated. Most central and eastern European countries have begun to return to the social insurance model for funding services. The ownership of some hospitals in these countries has been transferred to the private sector or to not-for-profit organizations. The European countries vary widely in their standards of facilities and professional staffing, and these generally reflect the prosperity of the country. During the 1980s, western countries implemented measures to limit the growth of health care expenditure, resulting in some reduction in the proportion of the gross domestic product spent on health care. Cost controls may not be as effective in the 1990s, as a result of demographic changes. More modern health care systems will likely develop in some of the central and eastern European countries, although this change will probably be slow.

  12. Working towards a national health information system in Australia.

    PubMed

    Bomba, B; Cooper, J; Miller, M

    1995-01-01

    One of the major administrative dilemmas facing the Australian national health care system is the need to reform practices associated with massive data-information overload. The current system is burdened with paper-based administrative forms, patient record files, referral notes and other manual methods of data organisation. An integrated computer-based information system may be perceived as an attractive solution to such burdens. However, computerisation must not be seen as a panacea with the possibility of exacerbating information overload and accentuating privacy concerns. Recent surveys in Australia [1] and the US [2] indicate a perceived causal link between computers and privacy invasion. Any moves toward a national health information system must counter this perception through macro-level education schemes of affected parties and micro-level mechanisms such as the establishment of hospital privacy officers. Such concerns may be viewed as a subset of the wider privacy debate, and information policy development should address such considerations to develop policies to prevent unauthorized access to personal information and to avoid the extraction and sale of sensitive health data. Conservative in nature and slow to change the health care sector may be forced to adopt more efficient work practices through the increasing proliferation of information technology (IT) in health care delivery and an escalating emphasis upon accountability and efficiency of the public health care dollar. The economic rationalist stance taken by governments in Australia and other nations generally will also force health care workers to adopt and develop more efficient information management practices, health indicators and best practice care methods than presently employed by this sector The benefits of a national health information system are far reaching, particularly in developing a more effective health care system through better identifying and understanding community health care

  13. Pathway to Support the Sustainable National Health Information System

    NASA Astrophysics Data System (ADS)

    Sahavechaphan, Naiyana; Phengsuwan, Jedsada; U-Ruekolan, Suriya; Aroonrua, Kamron; Ponhan, Jukrapong; Harnsamut, Nattapon; Vannarat, Sornthep

    Heath information across geographically distributed healthcare centers has been recognized as an essential resource that drives an efficient national health-care plan. There is thus a need for the National Health Information System (NHIS) that provides the transparent and secure access to health information from different healthcare centers both on demand and in a time efficient manner. As healthiness is the ultimate goal of people and nation, we believe that the NHIS should be sustainable by taking the healthcare center and information consumer perspectives into account. Several issues in particular must be resolved altogether: (i) the diversity of health information structures among healthcare centers; (ii) the availability of health information sharing from healthcare centers; (iii) the efficient information access to various healthcare centers; and (iv) the privacy and privilege of heath information. To achieve the sustainable NHIS, this paper details our work which is divided into 3 main phases. Essentially, the first phase focuses on the application of metadata standard to enable the interoperability and usability of health information across healthcare centers. The second phase moves forward to make information sharing possible and to provide an efficient information access to a large number of healthcare centers. Finally, in the third phase, the privacy and privilege of health information is promoted with respect to access rights of information consumers.

  14. Ethical assessment of national health insurance system of Korea.

    PubMed

    Lee, Yuri; Kim, Soyoon; Kim, Ganglip

    2012-09-01

    The current adverse effects of the health insurance system in Korea are considered to be problems that arise from an insufficient reflection of the notion of respecting human rights. The ethical principles most commonly suggested and used in public health are the 4 principles suggested by Beauchamp and Childress in 1994. From the perspective of the community, these 4 principles of medical ethics can be expanded to resolve problems surrounding existing social systems from a socialistic standpoint. This article describes a flexible, easy-to-use model for incorporating the 4 medical ethics principles into the National Health Insurance System (NHIS). First, the principle of respect for autonomy involves respecting the decision-making capacities of autonomous medical consumers and providers and enabling individuals to make reasoned and informed choices. Second is the principle of good practice. The government and medical institutions should act in a way that benefits the health care consumers. The principle of prohibiting bad practice involves avoiding causing health problems. The National Health Insurance Corporation and health care providers should not harm the health care consumers. Finally, the principle of justice is concerned with distributing benefits, risks, and costs fairly-that is, the notion that patients in similar positions should be treated in a similar manner. If these problems are solved, health system quality could be better and more accessible and sustainable. The ethical assessment of the NHIS could be a trial to match the 4 medical ethics principles and the NHIS. It can be applied internationally to relevant policy makers in different settings.

  15. [The researchers of the National Institutes of Health. Their vicissitudes in the National System of Health].

    PubMed

    Alcocer-Varela, Jorge

    2004-01-01

    Medical researchers that work at the National Institutes of Health have a preponderant role in the scientific production of Mexico. This article focuses their behavior during the last 12 years, within the National System of Investigators (SNI). According to the citation and publication indices, the medical researchers are of greater productivity and quality. The number of investigators of the Institutes that have obtained their entrance to the SNI has grown in 129.8%, during the period of study and has been constant in each one of the Institutes of Health, with the exception of the INPer, that besides to have smaller number of researchers within the SNI, shows a tendency to low. The investigators level 1 have stayed between 10 to 12 per year in most of the Institutes, with exception of Nutrition, Cardiology and Public Health that have managed to maintain effective to more than 20 investigators of this level during the last 5 years; in the case of Nutrition over 30. These three Institutes also have maintained the greater number of investigators level 2 and 3; it emphasizes Nutrition that is counted with the average of publications by researcher in the institutes is of 4.9 +/- 3 papers. The researchers of Nutrition, Pediatría, the INPer and Neurology contribute with more than 4 publications by each year. Nevertheless, when we only included the publications of groups III-V, only the researchers of Nutrition publish annually 6 to 7 high quality research paper. All the professionals of the Institutes that have an appointment of Investigator in Medical Sciences do not belong to the SNI. In the case of the Institute of Medical Sciences and Nutrition, of 131 workers with this appointment (Julio 2003), only 47 (35.9%) belong to the NSI. When analyzing the participation of the professionals that do not belong to the SNI in the mentioned published papers from 1999 to 2002 it was found that of 484 publications of group III, in 108 (22%) nonmembers of the SNI and without

  16. [Proposal for an structural reform for the national health system].

    PubMed

    Ares-Parga, Rodrigo

    2011-01-01

    Since the forties, the National Health System has been organized based on a segmented and shortly linked model by the different service providers. This segmentation is because the population has always been the criterion that differentiates the provision among institutions. Additionally, these institutions have followed strategies conditioned by their own development and in accordance with the needs of population segments that they care (vertical system: each institution is responsible for stewardship, financing and service delivery). According to the Organization for Economic Cooperation and Development (OECD), the fragmentation of the National Health System (NHS) in various organizations that vertically integrate the functions of financing, security and provision, generates inefficiencies and inequities that affect the Federal government's efforts to achieve universal coverage, and impacting on its financial viability. One of the first challenges facing the NHS is associated with the financing; therefore, this paper aims to develop a proposal for structural change in the way of financing the system and changes in management and delivery of health services Mexico.

  17. [The sustainability of the Spanish National Health System].

    PubMed

    Martín, José Jesús Martín; González, Maria del Puerto López del Amo

    2011-06-01

    The Spanish National Health System (SNHS) has sustainability problems resulting from weaknesses in institutional design and governance compounded by the economic crisis it faces. The global economic crisis has had a particularly virulent impact in Spain, characterized by high levels of unemployment and public and private debt. Fiscal adjustment policies implemented may significantly compromise the SNHS. Along with general funding problems, the strong territorial decentralization of health jurisdictions in the Autonomous Communities has not been backed up by efficient State-level health coordination. The SNHS suffers from problems in its rules of governance, its autonomous financing system, human resource policies and diversity of direct and indirect management models in different Autonomous Communities. A reform strategy in Spanish healthcare governancemust be articulated within the context of a broader review of public policies to stabilize the lines of defense of the welfare state. Within the scope of the health sector, the financing system must be improved and institutional changes to increase efficiency must be implemented.

  18. National Center for Health Statistics

    MedlinePlus

    ... Topics Data and Tools Publications News and Events Population Surveys National Health and Nutrition Examination Survey National Health Interview Survey National Survey of Family Growth Vital Records National Vital Statistics System National Death ...

  19. 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

  20. [The strategic purchasing of health services: a big opportunity for the National Universal Health System].

    PubMed

    González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

    2015-01-01

    proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

  1. [The strategic purchasing of health services: a big opportunity for the National Universal Health System].

    PubMed

    González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

    2015-01-01

    proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

  2. The Brazilian national health system: an unfulfilled promise?

    PubMed

    Ocké-Reis, Carlos Octávio; Marmor, Theodore R

    2010-01-01

    In 1988, Brazil became one of the first countries in Latin America to frame access to health care as a constitutional right. However, it would be misleading to call Brazil's Unified Health System (Sistema Único de Saúde, or SUS) a public health system that provides universal access and comprehensive care. This paper reveals a strong contradiction between the re-distribution model set out in the Brazilian Constitution and the inadequate level of public spending on health care. The law states that health care is a basic social right, allocated by need rather than means. Meanwhile, in 2003, Brazil spent US$ 597 per capita on health, or 7.6 per cent of its gross domestic product (GDP), while the average country from the Organization for Economic Cooperation and Development (OECD) spent US$ 3145, or 10.8 per cent, and Argentina spent US$ 1067, or 8.9 per cent of its GDP. PMID:20066670

  3. [Democracy without equity: analysis of health reform and nineteen years of National Health System in Brazil].

    PubMed

    Coelho, Ivan Batista

    2010-01-01

    This paper aims to evaluate the nineteen years of the National Health System in Brazil, under the prism of equity. It takes into account the current political context in Brazil in the 80s, that the democratization of the country and the health sector could, per se, lead to a more equitable situation regarding the access to health services. Democracy and equity concepts are here discussed; analyzing which situations may facilitate or make it difficult its association in a theoretical plan, applying them to the Brazilian context in a more general form and, to emphasizing practical implications to the National Health System and to groups of activism related to health reforms. It also seeks to show the limits and possibilities of these groups with regards to the reduction of inequality, in relation to the access to health services, which still remain. To conclude, the author points out the need for other movements to be established which seek the reduction of such and other inequalities, such as access to education, housing, etc, drawing special attention to the role played by the State, which is questioned regarding its incapacity of promoting equity, once it presents itself as being powerful when approaching other matters.

  4. France tries to save its ailing national health insurance system.

    PubMed

    Sorum, Paul Clay

    2005-07-01

    France has provided universal health care through employment-based health insurance funds. As its governments have increasingly used tax revenues to supplement payroll levies, they have assumed a larger role. Faced with widening deficits in the funds' accounts, the National Assembly adopted in August 2004 legislation designed to decrease health expenses, increase revenues to the funds, and improve quality of care. The apparent impacts of the so-called Douste-Blazy law are to reaffirm social solidarity and equality of access; to reinforce central control rather than relying more on decentralized and market forces; to give the now-unified funds a stronger director, shielded not only from labor and business but also, possibly, from the central government; to allow French private physicians to retain their unrivaled freedom of prescription; and to continue France's reliance on taxes as well as payroll levies to finance its health care. PMID:16022215

  5. National Health Information Center

    MedlinePlus

    ... About ODPHP Dietary Guidelines Physical Activity Guidelines Health Literacy and Communication Health Care Quality and Patient Safety Healthy People healthfinder health.gov About ODPHP National Health Information Center National Health Information Center The National Health ...

  6. The occupational health and safety services of the national health system in Italy.

    PubMed

    Bodini, Laura

    2005-01-01

    Working conditions have been addressed by laws in Italy since the 1950s, but the revision of the penal sanction laws in 1994 gave greater responsibility to those who had for many years been the de facto "police" of occupational health and safety services, allowing them to carry out inspections and to formulate rules for safety. Current preventive services for OHS within the Italian National Health Service are described, and their main features and developments and perspectives for the near future are situated in relation to EU legislation. There is a growing dichotomy in services between Northern and Southern Italy. The shift towards deregulation and decentralization of the current Government jeopardizes the prevention system. An efficient service will require a strong information system based on reliable notification; communication, training and assistance; and control and surveillance.

  7. An innovative national health care waste management system in Kyrgyzstan.

    PubMed

    Toktobaev, Nurjan; Emmanuel, Jorge; Djumalieva, Gulmira; Kravtsov, Alexei; Schüth, Tobias

    2015-02-01

    A novel low-cost health care waste management system was implemented in all rural hospitals in Kyrgyzstan. The components of the Kyrgyz model include mechanical needle removers, segregation using autoclavable containers, safe transport and storage, autoclave treatment, documentation, recycling of sterilized plastic and metal parts, cement pits for anatomical waste, composting of garden wastes, training, equipment maintenance, and management by safety and quality committees. The gravity-displacement autoclaves were fitted with filters to remove pathogens from the air exhaust. Operating parameters for the autoclaves were determined by thermal and biological tests. A hospital survey showed an average 33% annual cost savings compared to previous costs for waste management. All general hospitals with >25 beds except in the capital Bishkek use the new system, corresponding to 67.3% of all hospital beds. The investment amounted to US$0.61 per capita covered. Acceptance of the new system by the staff, cost savings, revenues from recycled materials, documented improvements in occupational safety, capacity building, and institutionalization enhance the sustainability of the Kyrgyz health care waste management system. PMID:25649402

  8. Transitioning to a national health system in Cyprus: a stakeholder analysis of pharmaceutical policy reform

    PubMed Central

    Kanavos, Panos G

    2015-01-01

    Abstract Objective To review the pharmaceutical sector in Cyprus in terms of the availability and affordability of medicines and to explore pharmaceutical policy options for the national health system finance reform expected to be introduced in 2016. Methods We conducted semi-structured interviews in April 2014 with senior representatives from seven key national organizations involved in pharmaceutical care. The captured data were coded and analysed using the predetermined themes of pricing, reimbursement, prescribing, dispensing and cost sharing. We also examined secondary data provided by the Cypriot Ministry of Health; these data included the prices and volumes of prescription medicines in 2013. Findings We identified several key issues, including high medicine prices, underuse of generic medicines and high out-of-pocket drug spending. Most stakeholders recommended that the national government review existing pricing policies to ensure medicines within the forthcoming national health system are affordable and available, introduce a national reimbursement system and incentivize the prescribing and dispensing of generic medicines. There were disagreements over how to (i) allocate responsibilities to governmental agencies in the national health system, (ii) reconcile differences in opinion between stakeholders and (iii) raise awareness among patients, physicians and pharmacists about the benefits of greater generic drug use. Conclusion In Cyprus, if the national health system is going to provide universal health coverage in a sustainable fashion, then the national government must address the current issues in the pharmaceutical sector. Importantly, the country will need to increase the market share of generic medicines to contain drug spending. PMID:26478624

  9. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  10. Balancing economic freedom against social policy principles: EC competition law and national health systems.

    PubMed

    Mossialos, Elias; Lear, Julia

    2012-07-01

    EU Health policy exemplifies the philosophical tension between EC economic freedoms and social policy. EC competition law, like other internal market rules, could restrict national health policy options despite the subsidiarity principle. In particular, European health system reforms that incorporate elements of market competition may trigger the application of competition rules if non-economic gains in consumer welfare are not adequately accounted for. This article defines the policy and legal parameters of the debate between competition law and health policy. Using a sample of cases it analyses how the ECJ, national courts, and National Competition Authorities have applied competition laws to the health services sector in different circumstances and in different ways. It concludes by considering the implications of the convergence of recent trends in competition law enforcement and health system market reforms.

  11. 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

  12. Engaging sub-national governments in addressing health equities: challenges and opportunities in China's health system reform.

    PubMed

    Brixi, Hana; Mu, Yan; Targa, Beatrice; Hipgrave, David

    2013-12-01

    China's current health system reform (HSR) is striving to resolve deep inequities in health outcomes. Achieving this goal is difficult not only because of continuously increasing income disparities in China but also because of weaknesses in healthcare financing and delivery at the local level. We explore to what extent sub-national governments, which are largely responsible for health financing in China, are addressing health inequities. We describe the recent trend in health inequalities in China, and analyse government expenditure on health in the context of China's decentralization and intergovernmental model to assess whether national, provincial and sub-provincial public resource allocations and local government accountability relationships are aligned with this goal. Our analysis reveals that government expenditure on health at sub-national levels, which accounts for ∼90% of total government expenditure on health, is increasingly regressive across provinces, and across prefectures within provinces. Increasing inequity in public expenditure at sub-national levels indicates that resources and responsibilities at sub-national levels in China are not well aligned with national priorities. China's HSR would benefit from complementary measures to improve the governance and financing of public service delivery. We discuss the existing weaknesses in local governance and suggest possible approaches to better align the responsibilities and capacity of sub-national governments with national policies, standards, laws and regulations, therefore ensuring local-level implementation and enforcement. Drawing on China's institutional framework and ongoing reform pilots, we present possible approaches to: (1) consolidate key health financing responsibilities at the provincial level and strengthen the accountability of provincial governments, (2) define targets for expenditure on primary health care, outputs and outcomes for each province and (3) use independent sources to

  13. Design and implementation of a national public health surveillance system in Jordan.

    PubMed

    Sheikhali, Sami Adel; Abdallat, Mohammed; Mabdalla, Sultan; Al Qaseer, Bashir; Khorma, Rania; Malik, Mamunur; Profili, Maria Cristina; Rø, Gunnar; Haskew, John

    2016-04-01

    Understanding and improving the health status of communities depend on effective public health surveillance. Adoption of new technologies, standardised case definitions and clinical guidelines for accurate diagnosis, and access to timely and reliable data, remains a challenge for public health surveillance systems however and existing public health surveillance systems are often fragmented, disease specific, inconsistent and of poor quality. We describe the application of an enterprise architecture approach to the design, planning and implementation of a national public health surveillance system in Jordan. This enabled a well planned and collaboratively supported system to be built and implemented using consistent standards for data collection, management, reporting and use. The system is case-based and integrated and employs mobile information technology to aid collection of real-time, standardised data to inform and improve decision-making at different levels of the health system.

  14. Design and implementation of a national public health surveillance system in Jordan

    PubMed Central

    Sheikhali, Sami Adel; Abdallat, Mohammed; Mabdalla, Sultan; Qaseer, Bashir Al; Khorma, Rania; Malik, Mamunur; Profili, Maria Cristina; Rø, Gunnar; Haskew, John

    2016-01-01

    Understanding and improving the health status of communities depend on effective public health surveillance. Adoption of new technologies, standardised case definitions and clinical guidelines for accurate diagnosis, and access to timely and reliable data, remains a challenge for public health surveillance systems however and existing public health surveillance systems are often fragmented, disease specific, inconsistent and of poor quality. We describe the application of an enterprise architecture approach to the design, planning and implementation of a national public health surveillance system in Jordan. This enabled a well planned and collaboratively supported system to be built and implemented using consistent standards for data collection, management, reporting and use. The system is case-based and integrated and employs mobile information technology to aid collection of real-time, standardised data to inform and improve decision-making at different levels of the health system. PMID:26878763

  15. 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

  16. Assessment of national systems for the surveillance and monitoring of animal health.

    PubMed

    Hueston, W D

    1993-12-01

    Continued growth in international trade and the developing concepts of zoning and risk assessment demand effective assessment of national surveillance and monitoring systems for animal health. The ideal national epidemiological delivery system incorporates surveillance for disease agents, host monitoring and environmental assessment. An extensive veterinary infrastructure is necessary to support the ideal epidemiological delivery system. While the full spectrum of epidemiological services is represented worldwide, a standardized approach to assessing national surveillance and monitoring systems is proposed, in order to meet the emerging demand for scientifically-based import regulations.

  17. Clinical Data Systems to Support Public Health Practice: A National Survey of Software and Storage Systems Among Local Health Departments

    PubMed Central

    Goodin, Kate

    2016-01-01

    Context: Numerous software and data storage systems are employed by local health departments (LHDs) to manage clinical and nonclinical data needs. Leveraging electronic systems may yield improvements in public health practice. However, information is lacking regarding current usage patterns among LHDs. Objective: To analyze clinical and nonclinical data storage and software types by LHDs. Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials. Participants: A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). Main Outcome Measures: Outcome measures included LHD's primary clinical service data system, nonclinical data system(s) used, and plans to adopt electronic clinical data system (if not already in use). Predictors of interest included jurisdiction size and governance type, and other informatics capacities within the LHD. Bivariate analyses were performed using χ2 and t tests. Results: Up to 38.4% of LHDs reported using an electronic health record (EHR). Usage was common especially among LHDs that provide primary care and/or dental services. LHDs serving smaller populations and those with state-level governance were both less likely to use an EHR. Paper records were a common data storage approach for both clinical data (28.9%) and nonclinical data (59.4%). Among LHDs without an EHR, 84.7% reported implementation plans. Conclusions: Our findings suggest that LHDs are increasingly using EHRs as a clinical data storage solution and that more LHDs are likely to adopt EHRs in the foreseeable future. Yet use of paper records remains common. Correlates of electronic system usage emerged across a range of factors. Program- or system-specific needs may be barriers or facilitators to EHR adoption. Policy makers can tailor resources to address barriers specific to LHD size, governance, service

  18. An informatics system to support knowledge management in the health sector--the South African National Health Knowledge Network.

    PubMed

    Louw, J A; Seebregts, C J; Makgoba, W M; Fouché, B

    2001-01-01

    This paper discusses the planning and development of a South African national health knowledge network. The methodology is in essence based on the principles of knowledge management and the drivers of a system of innovation. The knowledge network, SA HealthInfo, aims to provide a one-stop interactive forum/resource, for quality-controlled and evidence-based health research information, to a wide spectrum of users, at various levels of aggregation, with the necessary security arrangements and facilities for interaction among users to promote explicit (codified) and tacit knowledge flow. It will therefore stimulate the process of innovation within the South African health system.

  19. Leveraging the nation's anti-bioterrorism investments: foundation efforts to ensure a revitalized public health system.

    PubMed

    Hearne, Shelley A; Segal, Laura M

    2003-01-01

    The emerging potential threats of bioterrorism combined with critical existing epidemics facing the United States call for immediate and urgent attention to the U.S. public health system. The foundation world is helping to answer that call and is sounding the alarm that our health defenses must be able to do "double duty" to protect us from the full spectrum of modern health threats. This Special Report presents a selective sample of recent and ongoing grant activities designed to revitalize and modernize the public health infrastructure, which is vital to protecting the nation's health and ensuring its safety. PMID:12889772

  20. [The Public Health Services Port-folio in the National Health System: the contribution of the Central Government of Spain].

    PubMed

    Villalbí, Joan R; Carreras, Fernando; Martín-Moreno, José M; Hernández-Aguado, Ildefonso

    2010-01-01

    This paper concentrates on the port folio of public health services in the National Health System, with an inventory of those provided by the central level of government in the currently decentralized context of Spain. There is an important activity in public health, with some dispersion among different bodies and organisations. Most of the current activities of the central level of government concentrate in monitoring health levels and their determinants, managing information systems and health alerts and warnings, but with an involvement in policy development, both as a counterpart of the European Union and as an active agent with both regional levels of government and other organisations influencing public health. Besides, this level of government assures some essential services with little visibility for the general population as they are mostly delivered to other public administrations or to professional groups.

  1. [Information system of the national network of public health laboratories in Peru (Netlab)].

    PubMed

    Vargas-Herrera, Javier; Segovia-Juarez, José; Garro Nuñez, Gladys María

    2015-01-01

    Clinical laboratory information systems produce improvements in the quality of information, reduce service costs, and diminish wait times for results, among other things. In the construction process of this information system, the National Institute of Health (NIH) of Peru has developed and implemented a web-based application to communicate to health personnel (laboratory workers, epidemiologists, health strategy managers, physicians, etc.) the results of laboratory tests performed at the Peruvian NIH or in the laboratories of the National Network of Public Health Laboratories which is called NETLAB. This article presents the experience of implementing NETLAB, its current situation, perspectives of its use, and its contribution to the prevention and control of diseases in Peru.

  2. [Information system of the national network of public health laboratories in Peru (Netlab)].

    PubMed

    Vargas-Herrera, Javier; Segovia-Juarez, José; Garro Nuñez, Gladys María

    2015-01-01

    Clinical laboratory information systems produce improvements in the quality of information, reduce service costs, and diminish wait times for results, among other things. In the construction process of this information system, the National Institute of Health (NIH) of Peru has developed and implemented a web-based application to communicate to health personnel (laboratory workers, epidemiologists, health strategy managers, physicians, etc.) the results of laboratory tests performed at the Peruvian NIH or in the laboratories of the National Network of Public Health Laboratories which is called NETLAB. This article presents the experience of implementing NETLAB, its current situation, perspectives of its use, and its contribution to the prevention and control of diseases in Peru. PMID:26338402

  3. [Nutritional challenges in the Brazilian Unified National Health System for building the interface between health and food and nutritional security].

    PubMed

    Rigon, Silvia do Amaral; Schmidt, Suely Teresinha; Bógus, Cláudia Maria

    2016-03-01

    This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the government's agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the field's nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority.

  4. A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England

    PubMed Central

    2011-01-01

    Background The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR. Method Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR's strategic goals, which could be reported to NIHR's leadership team on a quarterly basis via an oversight dashboard. Results Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting. Conclusions The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives. PMID:21435265

  5. National research for health systems in Latin America and the Caribbean: moving towards the right direction?

    PubMed Central

    2014-01-01

    Background National Research for Health Systems (NRfHS) in Latin America and the Caribbean (LAC) have shown growth and consolidation in the last few years. A structured, organized system will facilitate the development and implementation of strategies for research for health to grow and contribute towards people’s health and equity. Methods We conducted a survey with the health managers from LAC countries that form part of the Ibero-American Ministerial Network for Health Education and Research. Results From 13 of 18 questionnaires delivered, we obtained information on the NRfHS governance and management structures, the legal and political framework, the research priorities, existing financing schemes, and the main institutional actors. Data on investment in science and technology, scientific production, and on the socio-economic reality of countries were obtained through desk review focused on regional/global data sources to increase comparability. Conclusions By comparing the data gathered with a review carried out in 2008, we were able to document the advances in research for health system development in the region, mostly in setting governance, coordination, policies, and regulations, key for better functionality of research for health systems. However, in spite of these advances, growth and consolidation of research for health systems in the region is still uneven. PMID:24602201

  6. [Legislation on primary care in Brazilian Unified National Health System: document analysis].

    PubMed

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas

    2016-03-01

    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs.

  7. [Legislation on primary care in Brazilian Unified National Health System: document analysis].

    PubMed

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas

    2016-03-01

    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs. PMID:27027459

  8. [National health research systems in Latin America: a 14-country review].

    PubMed

    Alger, Jackeline; Becerra-Posada, Francisco; Kennedy, Andrew; Martinelli, Elena; Cuervo, Luis Gabriel

    2009-11-01

    This article discusses the main features of the national health research systems (NHRS) of Argentina, Bolivia, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Honduras, Panama, Paraguay, Peru, Uruguay, and Venezuela, based on documents prepared by their country experts who participated in the First Latin American Conference on Research and Innovation for Health held in April 2008, in Rio de Janeiro, Brazil. The review also includes sources cited in the reports, published scientific papers, and expert opinion, as well as regional secondary sources. Six countries reported having formal entities for health research governance and management: Brazil and Costa Rica's entities are led by their ministries of health; while Argentina, Cuba, Ecuador, and Venezuela have entities shared by their ministries of health and ministries of science and technology. Brazil and Ecuador each reported having a comprehensive national policy devoted specifically to health science, technology, and innovation. Argentina, Brazil, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru, and Venezuela reported having established health research priorities. In conclusion, encouraging progress has been made, despite the structural and functional heterogeneity of the study countries' NHRS and their disparate levels of development. Instituting good NHRS governance/management is of utmost importance to how efficiently ministries of health, other government players, and society-at-large can tackle health research.

  9. A multistate examination of partnership activity among local public health systems using the National Public Health Performance Standards.

    PubMed

    Barnes, Priscilla A; Curtis, Amy B; Hall-Downey, Laura; Moonesinghe, Ramal

    2012-01-01

    This study examines whether partnership-related measures in the second version of the National Public Health Performance Standards (NPHPS) are useful in evaluating level of activity as well as identifying latent constructs that exist among local public health systems (LPHSs). In a sample of 110 LPHSs, descriptive analysis was conducted to determine frequency and percentage of 18 partnership-related NPHPS measures. Principal components factor analysis was conducted to identify unobserved characteristics that promote effective partnerships among LPHSs. Results revealed that 13 of the 18 measures were most frequently reported at the minimal-moderate level (conducted 1%-49% of the time). Coordination of personal health and social services to optimize access (74.6%) was the most frequently reported measure at minimal-moderate levels. Optimal levels (conducted >75% of the time) were reported most frequently in 2 activities: participation in emergency preparedness coalitions and local health departments ensuring service provision by working with state health departments (67% and 61% of respondents, respectively) and the least optimally reported activity was review partnership effectiveness (4% of respondents). Factor analysis revealed categories of partnership-related measures in 4 domains: resources and activities contributing to relationship building, evaluating community leadership activities, research, and state and local linkages to support public health activities. System-oriented public health assessments may have questions that serve as proxy measures to examine levels of interorganizational partnerships. Several measures from the NPHPS were useful in establishing a national baseline of minimal and optimal activity levels as well as identifying factors to enhance the delivery of the 10 essential public health services among organizations and individuals in public health systems.

  10. New Zealand's health system: national policy goals and decentralized service planning and delivery.

    PubMed

    Gauld, Robin

    2007-01-01

    To inaugurate the fifth year of its publication, The American Heart Hospital Journal (AHHJ) focused its Winter 2007 issue on health care systems from around the world, with 8 articles contributed by national leaders in their respective countries. Due to the interest and wide range of expertise in the international cardiac community, we will continue to publish Special Reports throughout 2007 on this topic. We invite members of the international community to share with readers of the AHHJ, their insights on the strengths and weaknesses of their respective health care and cardiac care systems, as well as their ideas and aspirations for future change.

  11. [The British Health Services System--major changes once again. The White Paper and commercialization of the National Health Service].

    PubMed

    Kolflaath, J

    1989-08-20

    In February 1989 Prime Minister Margaret Thatcher presented her Proposals in a White Paper. These proposals imply essential changes in the National Health Service (NHS) in Great Britain. The changes will result in a more commercial way of managing both the hospitals and the offices of general practitioners. Among other things, they will imply buying and selling health services. Important objectives in the proposals are cost control, quality assurance and a greater choice for patients. During a visit to London this winter, the author studied the main topics of the proposals. This article discusses the content and aims of the White Paper, also with relevance to Norwegian health policy. Some aspects of the British health system today are also considered, with special reference to the development of the NHS during last 10 to 15 years.

  12. National health expenditures, 1983

    PubMed Central

    Gibson, Robert M.; Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.

    1984-01-01

    Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here. PMID:10310949

  13. [The Citizen Constitution and the 25th anniversary of the Brazilian Unified National Health System (SUS)].

    PubMed

    Paim, Jairnilson Silva

    2013-10-01

    This article, celebrating the 25th anniversary of Brazil's 1988 Constitution, aims to review the country's social policy development, discuss political projects, and analyze challenges for the sustainability of the Unified National Health System (SUS). Based on public policymaking studies, the article revisits the origins of liberal social policy, focused on social assistance, and analyzes the hegemony of U.S. policies targeting poverty and their repercussions for universal policies. After identifying the formulation of political projects in Brazil's democratic transition, it discusses their implications during the various Administrations since 1988, along with the difficulties faced by the National Health System. The article concludes that the political forces occupying government in the last two decades have failed to present a project for the country on the same level as those who drafted the Citizen Constitution. PMID:24127081

  14. [The Citizen Constitution and the 25th anniversary of the Brazilian Unified National Health System (SUS)].

    PubMed

    Paim, Jairnilson Silva

    2013-10-01

    This article, celebrating the 25th anniversary of Brazil's 1988 Constitution, aims to review the country's social policy development, discuss political projects, and analyze challenges for the sustainability of the Unified National Health System (SUS). Based on public policymaking studies, the article revisits the origins of liberal social policy, focused on social assistance, and analyzes the hegemony of U.S. policies targeting poverty and their repercussions for universal policies. After identifying the formulation of political projects in Brazil's democratic transition, it discusses their implications during the various Administrations since 1988, along with the difficulties faced by the National Health System. The article concludes that the political forces occupying government in the last two decades have failed to present a project for the country on the same level as those who drafted the Citizen Constitution.

  15. 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

  16. Information sharing between the National Health Service and criminal justice system in the United Kingdom.

    PubMed

    Lennox, Charlotte; Mason, Julie; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

    2012-09-01

    Offenders with mental health problems often have complex and interrelated needs which separately challenge the criminal justice system (CJS) and National Health Service (NHS) in the United Kingdom (U.K.). Consequently, interagency collaboration and timely information sharing are essential. This study focused on the sharing of information about people with mental health problems in contact with the CJS. Questionnaires were distributed to a range of health and criminal justice personnel. The results showed that there was a mismatch between what service user information criminal justice agencies felt they needed and what was routinely received. Prison Service staff received more information (between 15% and 37%) from health agencies than the police (between 6% and 22%). Health professionals received most of the information they needed from criminal justice agencies (between 55% and 85%). Sharing service user information was impeded by incompatible computer systems and restrictions due to data protection/confidentiality requirements. In the U.K., recent governmental publications have highlighted the importance of information sharing; however there remains a clear mismatch between what health related information about service users criminal justice agencies need, and what is actually received. Better guidance is required to encourage and empower people to share.

  17. 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.

  18. National Health Expenditures, 1982

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.; Levit, Katharine R.

    1983-01-01

    Rapid growth in the share of the nation's gross national product devoted to health expenditure has heightened concern over the survival of government entitlement programs and has led to debate of the desirability of current methods of financing health care. In this article, the authors present the data at the heart of the issue, quantifying spending for various types of health care in 1982 and discussing the sources of funds for that spending. PMID:10310273

  19. [Support for and resistance to homeopathy among managers of the Unified National Health System].

    PubMed

    Salles, Sandra Abrahão Chaim; Schraiber, Lilia Blima

    2009-01-01

    This article presents partial findings from a study on trends towards greater or lesser proximity between homeopathic and allopathic physicians, from the perspective of the latter. Forty-eight health professionals were interviewed (faculty, managers, and physicians working in the public health system). This specific article focused only on the interviews with health system managers. The following concepts were used as references: social and scientific field (Bourdieu); medical rationalities (Madel Luz); technological arrangements in health work (Mendes-Gonçalves); and physician's professional identity (Donnangelo & Schraiber). According to the findings, support by managers for the presence of Homeopathy in the Unified National Health System is related to their perception of social demand, defense of patients' right to choose, and the observation that it is a medical practice that reclaims the humanist dimension of medicine, thus contributing to user satisfaction. The difficulties and resistances identified by managers highlight that the lack of information on homeopathic procedures limits the possibilities for use of Homeopathy because it leads to insecurity towards this area of medicine. PMID:19180302

  20. The laboratory efficiencies initiative: partnership for building a sustainable national public health laboratory system.

    PubMed

    Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles

    2013-01-01

    Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.

  1. The Laboratory Efficiencies Initiative: Partnership for Building a Sustainable National Public Health Laboratory System

    PubMed Central

    Moulton, Anthony D.; Ned, Renée M.; Nicholson, Janet K.A.; Chu, May C.; Becker, Scott J.; Blank, Eric C.; Breckenridge, Karen J.; Waddell, Victor; Brokopp, Charles

    2013-01-01

    Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners. PMID:23997300

  2. [Nutritional challenges in the Brazilian Unified National Health System for building the interface between health and food and nutritional security].

    PubMed

    Rigon, Silvia do Amaral; Schmidt, Suely Teresinha; Bógus, Cláudia Maria

    2016-03-01

    This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the government's agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the field's nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority. PMID:27049315

  3. Equity in paying for health care services under a national insurance system.

    PubMed

    Boaz, R F

    1975-01-01

    The debate over the future of the health care delivery system evolves around the policy issue of what constitutes a fair distribution of the medical services which are considered essential to prolonging life, curing disease, and relieving pain. A case can be made that a socially equitable distribution implies that consumption of medical services is independent of the consumer's income and payment for them unrelated to utilization. The present paper examines to what extent the provisions for financing a national health insurance system are likely to advance or hinder the fair distribution of health care services. Almost all bills specify a mix of direct (cost-shared) and indirect (prepaid) financing. When cost-sharing is based on the quantity of services or on the level of medical expenditure, it helps divert medical care and health insurance benefits to high-income persons at the expense of their low-or moderate-income counterparts. When indirect payments or premium levels are determined by insurance risks rather than by income, they may be too high for persons with moderate means, and are likely to exclude such persons from the national insurance program. When health insurance is tied to salaried employment, it discriminates against the unemployed and the self-employed. To rectify such inequities, some NHI proposals specify separate insurance plans for the disadvantaged. Such programs, which require income-testing to determine eligibility, are likely to be plagued by administrative complications currently engulfing other means-tested social welfare programs. The present paper makes some recommendations for the purpose of avoiding these difficulties and fostering equity in health care.

  4. Does household enrolment reduce adverse selection in a voluntary health insurance system? Evidence from the Ghanaian National Health Insurance System.

    PubMed

    Rajkotia, Yogesh; Frick, Kevin

    2012-08-01

    In August 2003, the Ghanaian Government made history by implementing the first National Health Insurance System (NHIS) in sub-Saharan Africa. Within 2 years, over one-third of the country had voluntarily enrolled in the NHIS. To discourage households from selectively enrolling their sickest (high-risk) members, the NHIS in the Nkoranza district offered premium waivers for all children under 18 in exchange for full household enrolment. This study aimed to test whether, despite this incentive, there is evidence suggestive of adverse selection. To accomplish this, we examined how the observed pay-off from insurance (odds and intensity of medical consumption) responds to changes in the family enrolment cost. If adverse selection were present, we would expect the odds and intensity of medical consumption to increase with family enrolment cost. A number of econometric tests were conducted using the claims database of the NHIS in Nkoranza. Households with full enrolment were analysed, for a total of 58 516 individuals from 12 515 households. Our results show that household enrolment cost is not correlated with (1) odds or intensity of inpatient use or (2) odds of adult outpatient use, and is weakly correlated with the intensity of outpatient use. We also find that household enrolment costs are positively correlated with the number of children in the household and the odds and intensity of outpatient use by children. Thus, we conclude that the child-premium waiver is an important incentive for household enrolment. This evidence suggests that adverse selection has effectively been contained, but not eliminated. We argue that since one of the main objectives of the NHIS was to increase use of necessary care, especially by children, our findings indicate a largely favourable policy outcome, but one that may carry negative financial consequences. Policy makers must balance the fiscal need to contain costs with the societal objective to cover vulnerable populations. PMID

  5. The Evaluation of SEPAS National Project Based on Electronic Health Record System (EHRS) Coordinates in Iran

    PubMed Central

    Asadi, Farkhondeh; Moghaddasi, Hamid; Rabiei, Reza; Rahimi, Forough; Mirshekarlou, Soheila Jahangiri

    2015-01-01

    systems in the case of Maksa approval (The reference health coding of Iran). ISO13606 was used as the main standard in this project. Regarding the telecommunication-communication facilities of the project, the findings showed that its link is restricted to health care centers which does not cover other institutions and organizations involved in public health. The final result showed that SEPAS is in the early stages of execution. And the full implementation of EHR needs the provision of the infrastructure of the National Health Information Network that is the same as EHR system. PMID:26862248

  6. Linking the National Health Interview Survey with the Florida Cancer Data System: A Pilot Study.

    PubMed

    McClure, Laura A; Miller, Eric A; Tannenbaum, Stacey L; Hernandez, Monique N; MacKinnon, Jill A; He, Yulei; LeBlanc, William G; Lee, David J

    2016-01-01

    Cancer registry data are vital for the surveillance of cancer trends, but registries are limited in the number of data items that can be collected for hypothesis-driven research. Linkage with other databases can add valuable information and is a potentially effective tool for increasing our understanding of and identifying the causes of cancer and health disparities along the cancer continuum. We conducted a pilot study to link data from the 1981-2010 Florida Cancer Data System (FCDS) with data from the 1986-2009 National Health Interview Survey (NHIS). The NHIS data contain important information on sociodemographics, screening behaviors, comorbidities, risk factors, health care access, and quality of life, which are not available from FCDS. The linkage resulted in a total of 6,281 linked cases. After removing cases with a first cancer diagnosis before 1981 (prior to FCDS creation) or missing date of diagnosis information, there were 1,908 cases diagnosed with cancer prior to their NHIS interview and 4,367 cases diagnosed after their NHIS interview. The enriched data set resulting from the linkage allows us to evaluate risk factors associated with developing cancer as well as conduct analyses on cancer survivorship issues and mortality. This pilot study demonstrates the feasibility and utility of a linkage between cancer registries and national health surveys, while also acknowledging the cost and challenges associated with such linkages. PMID:27195994

  7. Public health expenditure and spatial interactions in a decentralized national health system.

    PubMed

    Costa-Font, Joan; Pons-Novell, Jordi

    2007-03-01

    One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a way through is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents and institutional factors on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions.

  8. How does private finance affect public health care systems? Marshaling the evidence from OECD nations.

    PubMed

    Tuohy, Carolyn Hughes; Flood, Colleen M; Stabile, Mark

    2004-06-01

    The impact of private finance on publicly funded health care systems depends on how the relationship between public and private finance is structured. This essay first reviews the experience in five nations that exemplify different ways of drawing the public/private boundary to address the particular questions raised by each model. This review is then used to interpret aggregate empirical analyses of the dynamic effects between public and private finance in OECD nations over time. Our findings suggest that while increases in the private share of health spending substitute in part for public finance (and vice versa), this is the result of a complex mix of factors having as much to do with cross-sectoral shifts as with deliberate policy decisions within sectors and that these effects are mediated by the different dynamics of distinctive national models. On balance, we argue that a resort to private finance is more likely to harm than to help publicly financed systems, although the effects will vary depending on the form of private finance.

  9. Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

    PubMed

    Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

    2015-09-01

    Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

  10. The financing of the health system in the Islamic Republic of Iran: A National Health Account (NHA) approach

    PubMed Central

    Zakeri, Mohammadreza; Olyaeemanesh, Alireza; Zanganeh, Marziee; Kazemian, Mahmoud; Rashidian, Arash; Abouhalaj, Masoud; Tofighi, Shahram

    2015-01-01

    Background: The National Health Accounts keep track of all healthcare related activities from the beginning (i.e. resource provision), to the end (i.e. service provision). This study was conducted to address following questions: How is the Iranian health system funded? Who distribute the funds? For what services are the funds spent on?, What service providers receive the funds? Methods: The required study data were collected through a number of methods. The family health expenditure data was obtained through a cross sectional multistage (seasonal) survey; while library and field study was used to collect the registered data. The collected data fell into the following three categories: the household health expenditure (the sample size: 10200 urban households and 6800 rural households-four rounds of questioning), financial agents data, the medical universities financial performance data. Results: The total health expenditure of the Iranian households was 201,496,172 million Rials in 2008, which showed a 34.4% increase when compared to 2007. The share of the total health expenditure was 6.2% of the GDP. The share of the public sector showed a decreasing trend between 2003-2008 while the share of the private sector, of which 95.77% was paid by households, had an increasing trend within the same period. The percent of out of pocket expenditure was 53.79% of the total health expenditure. The total health expenditure per capita was US$ 284.00 based on the official US$ exchange rate and US$ 683.1 based on the international US$ exchange rate.( exchange rate: 1$=9988 Rial). Conclusion: The share of the public and private sectors in financing the health system was imbalanced and did not meet the international standards. The public share of the total health expenditures has increased in the recent years despite the 4th and 5th Development Plans. The inclusion of household health insurance fees and other service related expenses increases the public contribution to 73% of the

  11. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    PubMed

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

  12. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    PubMed

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease. PMID:24443075

  13. [International trade in health services and the medical industrial complex: implications for national health systems].

    PubMed

    Santos, Maria Angelica Borges dos; Passos, Sonia Regina Lambert

    2010-08-01

    Health services have increasingly proven to be an innovative sector, gaining prominence in the medical industrial complex through expansion to public and international markets. International trade can foster economic development and redirect the resources and infrastructure available for healthcare in different countries in favorable or unfavorable directions. Wherever private providers play a significant role in government-funded healthcare, GATS commitments may restrict health policy options in subscribing countries. Systematic information on the impacts of electronic health services, medical tourism, health workers' migration, and foreign direct investment is needed on a case-by-case basis to build evidence for informed decision-making, so as to maximize opportunities and minimize risks of GATS commitments. PMID:21229208

  14. [International trade in health services and the medical industrial complex: implications for national health systems].

    PubMed

    Santos, Maria Angelica Borges dos; Passos, Sonia Regina Lambert

    2010-08-01

    Health services have increasingly proven to be an innovative sector, gaining prominence in the medical industrial complex through expansion to public and international markets. International trade can foster economic development and redirect the resources and infrastructure available for healthcare in different countries in favorable or unfavorable directions. Wherever private providers play a significant role in government-funded healthcare, GATS commitments may restrict health policy options in subscribing countries. Systematic information on the impacts of electronic health services, medical tourism, health workers' migration, and foreign direct investment is needed on a case-by-case basis to build evidence for informed decision-making, so as to maximize opportunities and minimize risks of GATS commitments.

  15. National Jewish Health

    MedlinePlus

    ... Support Makes a Difference Make a Donation Articles & Press Releases View All Finding Relief from Fall Allergies Fall ... Español Follow Us Sign-up for Health-e-News Go © 2016 National Jewish Health 1400 Jackson Street ...

  16. National health expenditures, 1988

    PubMed Central

    1990-01-01

    Every year, analysts in the Health Care Financing Administration present figures on what our Nation spends for health. As the result of a comprehensive re-examination of the definitions, concepts, methods, and data sources used to prepare those figures, this year's report contains new estimates of national health expenditures for calendar years 1960 through 1988. Significant changes have been made to estimates of spending for professional services and to estimates of what consumers pay out of pocket for health care. In the first article, trends in use of and expenditure for various types of goods and services are discussed, as well as trends in the sources of funds used to finance health care. In a companion article, the benchmark process is described in more detail, as are the data sources and methods used to prepare annual estimates of health expenditures. PMID:10113395

  17. A thematic review and a policy-analysis agenda of Electronic Health Records in the Greek National Health System.

    PubMed

    Emmanouilidou, Maria; Burke, Maria

    2013-01-01

    The increasing pressure to improve healthcare outcomes and reduce costs is driving the current agenda of governments at worldwide level and calls for a fundamental reform of the status quo of health systems. This is especially the case with the Greek NHS (National Health System), a system in continuous crisis, and with the recent ongoing financial turbulence under intensive scrutiny. Technological innovations and Electronic Health Records (EHR) in particular, are recognised as key enablers in mitigating the existing burdens of healthcare. As a result, EHR is considered a core component in technology-driven reform processes. Nonetheless, the successful implementation and adoption of EHR proves to be a challenging task due to a mixture of technological, organisational and political issues. Drawing upon experiences within the European Union (EU) healthcare setting and the Greek NHS the paper proposes a conceptual framework as a policy-analysis agenda for EHR interventions in Greece. While the context of discussion is Greece, the paper aims to also derive useful insights to healthcare policy-makers around the globe.

  18. Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission

    PubMed Central

    Prasad, Amit Mohan; Chakraborty, Gautam; Yadav, Sajjan Singh; Bhatia, Salima

    2013-01-01

    Background At the turn of the 21st century, India was plagued by significant rural–urban, inter-state and inter-district inequities in health. For example, in 2004, the infant mortality rate (IMR) was 24 points higher in rural areas compared to urban areas. To address these inequities, to strengthen the rural health system (a major determinant of health in itself) and to facilitate action on other determinants of health, India launched the National Rural Health Mission (NRHM) in April 2005. Methods Under the NRHM, Rs. 666 billion (US$12.1 billion) was invested in rural areas from April 2005 to March 2012. There was also a substantially higher allocation for 18 high-focus states and 264 high-focus districts, identified on the basis of poor health and demographic indicators. Other determinants of health, especially nutrition and decentralized action, were addressed through mechanisms like State/District Health Missions, Village Health, Sanitation and Nutrition Committees, and Village Health and Nutrition Days. Results Consequently, in bigger high-focus states, rural IMR fell by 15.6 points between 2004 and 2011, as compared to 9 points in urban areas. Similarly, the maternal mortality rate in high-focus states declined by 17.9% between 2004–2006 and 2007–2009 compared to 14.6% in other states. Conclusion The article, on the basis of the above approaches employed under NRHM, proposes the NRHM model to ‘reduce health inequities and initiate action on SDH’. PMID:23458089

  19. Internet Infrastructures and Health Care Systems: a Qualitative Comparative Analysis on Networks and Markets in the British National Health Service and Kaiser Permanente

    PubMed Central

    2002-01-01

    Background The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. Objective To identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. Methods A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. Results The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. Conclusions The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management. PMID:12554552

  20. National health expenditures, 1985

    PubMed Central

    Waldo, Daniel R.; Levit, Katharine R.; Lazenby, Helen

    1986-01-01

    Slower price inflation in 1985 translated into slower growth of national health expenditures, but underlying growth in the use of goods and services continued along historic trends. Coupled with somewhat sluggish growth of the gross national product, this adherence to trends pushed the share of our Nation's output accounted for by health spending to 10.7 percent. Some aspects of health spending changed: Falling use of hospital services was offset by rising hospital profits and increased use of other health care services. Other aspects remained the same: Both the public sector and the private sector continued efforts to contain costs, efforts that have affected and will continue to affect not only the providers of care but the users of care as well. PMID:10311775

  1. EHR systems in the Spanish Public Health National System: the lack of interoperability between primary and specialty care.

    PubMed

    de la Torre-Díez, Isabel; González, Sandra; López-Coronado, Miguel

    2013-02-01

    One of the problems of the Spanish Public Health National System is the lack of interoperability in the implemented Electronic Health Records (EHRs) systems in primary and specialty care. There is a deficiency in the electronic health systems that store the data of primary care patients, so one of the basic problems that prevent that every hospital and health center working on the same method is that deficiency. In this paper we research on this problem and to give expression to a series of solutions to it. Bibliographic material in this work has been obtained mainly from MEDLINE source. Additionally, due to the lack of information and privacy about the different EHRs systems, we have resorted to making direct contact with the organizations that have implemented those systems and technological providers. Two solutions have been propounded given several aspects for a feasibility study. The first solution is based upon in the execution of backups in different EHRs databases, which implies a huge economical and infrastructure development. The second of these solutions so that due to the creation of protocols by means of Cloud Computing Technologies. It is crucial the need to reach a homogeneity concerning to the storage of patients clinical data. On the results achieved we can emphasize that maybe the main problems are not the economical handicaps or the large technological development needed, but, as for Health each Region manages its own competences, each one governs with independent policies and decisions. PMID:23321962

  2. National Health Expenditures, 1996

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Braden, Bradley R.; Cowan, Cathy A.; Sensenig, Arthur L.; McDonnell, Patricia A.; Stiller, Jean M.; Won, Darleen K.; Martin, Anne B.; Sivarajan, Lekha; Donham, Carolyn S.; Long, Anna M.; Stewart, Madie W.

    1997-01-01

    The national health expenditures (NHE) series presented in this report for 1960-96 provides a view of the economic history of health care in the United States through spending for health care services and the sources financing that care. In 1996 NHE topped $1 trillion. At the same time, spending grew at the slowest rate, 4.4 percent, ever recorded in the current series. For the first time, this article presents estimates of Medicare managed care payments by type of service, as well as nursing home and home health spending in hospital-based facilities. PMID:10179997

  3. Agency problems of global budget system in Taiwan's National Health Insurance.

    PubMed

    Yan, Yu-Hua; Yang, Chen-Wei; Fang, Shih-Chieh

    2014-05-01

    The main purpose of this study was to investigate the agency problem presented by the global budget system followed by hospitals in Taiwan. In this study, we examine empirically the interaction between the principal: Bureau of National Health Insurance (BNHI) and agency: medical service providers (hospitals); we also describe actual medical service provider and hospital governance conditions from a agency theory perspective. This study identified a positive correlation between aversion to agency hazard (self-interest behavior, asymmetric information, and risk hedging) and agency problem risks (disregard of medical ethics, pursuit of extra-contract profit, disregard of professionalism, and cost orientation). Agency costs refer to BNHI auditing and monitoring expenditures used to prevent hospitals from deviating from NHI policy goals. This study also found agency costs negatively moderate the relationship between agency hazards and agency problems The main contribution of this study is its use of agency theory to clarify agency problems and several potential factors caused by the NHI system. This study also contributes to the field of health policy study by clarifying the nature and importance of agency problems in the health care sector. PMID:24598279

  4. Agency problems of global budget system in Taiwan's National Health Insurance.

    PubMed

    Yan, Yu-Hua; Yang, Chen-Wei; Fang, Shih-Chieh

    2014-05-01

    The main purpose of this study was to investigate the agency problem presented by the global budget system followed by hospitals in Taiwan. In this study, we examine empirically the interaction between the principal: Bureau of National Health Insurance (BNHI) and agency: medical service providers (hospitals); we also describe actual medical service provider and hospital governance conditions from a agency theory perspective. This study identified a positive correlation between aversion to agency hazard (self-interest behavior, asymmetric information, and risk hedging) and agency problem risks (disregard of medical ethics, pursuit of extra-contract profit, disregard of professionalism, and cost orientation). Agency costs refer to BNHI auditing and monitoring expenditures used to prevent hospitals from deviating from NHI policy goals. This study also found agency costs negatively moderate the relationship between agency hazards and agency problems The main contribution of this study is its use of agency theory to clarify agency problems and several potential factors caused by the NHI system. This study also contributes to the field of health policy study by clarifying the nature and importance of agency problems in the health care sector.

  5. Who needs what from a national health research system: lessons from reforms to the English Department of Health's R&D system

    PubMed Central

    2010-01-01

    medical academics, patients and industry, and has been remarkably successful in increasing the funding for health research. There are still areas that might benefit from further recognition and resourcing, but the lessons identified, and progress made by the reforms are relevant for the design and coordination of national health research systems beyond England. PMID:20465789

  6. Single-payer health insurance systems: national myths and immovable mountains.

    PubMed Central

    Lightfoote, J. B.; Ragland, K. D.

    1996-01-01

    Leaders in both government and the health-care industry have strong and varied opinions regarding the present US health-care system, but concur that health-care financing and organization need restructuring. The single-payer system offers the best framework for improving health-care universality, delivery, quality, access, choice, and cost effectiveness. However, the single-payer alternative often is dismissed early in debates on health-care reform. Popular aversion to collective governmental funding of health-care costs and the economic interests of the management, insurance, information, and profit sectors of the health-care industry are the critical impediments to adoption of single-payer insurance systems. This article examines the psychosocial and economic obstacles that prevent development of an efficient and effective health-care system and preclude recognition of the single-payer system as the best answer to health-care reform. PMID:8648657

  7. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  8. Performance Analysis of Hospital Information System of the National Health Insurance Corporation Ilsan Hospital

    PubMed Central

    Han, Jung Mi; Boo, Eun Hee; Kim, Jung A; Yoon, Soo Jin; Kim, Seong Woo

    2012-01-01

    Objectives This study evaluated the qualitative and quantitative performances of the newly developed information system which was implemented on November 4, 2011 at the National Health Insurance Corporation Ilsan Hospital. Methods Registration waiting time and changes in the satisfaction scores for the key performance indicators (KPI) before and after the introduction of the system were compared; and the economic effects of the system were analyzed by using the information economics approach. Results After the introduction of the system, the waiting time for registration was reduced by 20%, and the waiting time at the internal medicine department was reduced by 15%. The benefit-to-cost ratio was increased to 1.34 when all intangible benefits were included in the economic analysis. Conclusions The economic impact and target satisfaction rates increased due to the introduction of the new system. The results were proven by the quantitative and qualitative analyses carried out in this study. This study was conducted only seven months after the introduction of the system. As such, a follow-up study should be carried out in the future when the system stabilizes. PMID:23115744

  9. National Initiatives to Improve Healthcare Outcomes: A Comparative Study of Health Delivery Systems in Slovakia and the United States.

    PubMed

    Curtis, Robert; Caplanova, Anetta; Novak, Marcel

    2015-01-01

    While the United States and Slovakia offer different healthcare delivery systems, each country faces the same challenges of improving the health status of their populations. The authors explore the impact of their respective systems on the health of their populations and compare the health outcomes of both nations. They point out that socioeconomic factors play a far more important role in determining population health outcomes than do the structures of the systems surrounding the care delivery. The authors illustrate this finding through a comparison of the poverty and education levels of a selected minority group from each country in relation to the health outcomes for each population group. The comparison reveals that education is a more influential determinant in a population's health outcomes, than the improved access to care offered by a universal system. PMID:26684681

  10. The national health care imperative.

    PubMed

    Halamandaris, V J

    1990-03-01

    In summary, the nation's health care system is in serious need of reform. It is expensive and woefully inefficient. Millions of people are excluded from coverage, while others receive limited or second-class care. For those millions who suffer serious chronic problems that require long-term care, there is virtually no help. There is no help for the family whose loved one suffers from Alzheimer's disease. There is no help for the family whose child is born with cerebral palsy or epilepsy. There is no help for the middle-aged father, disabled in an automobile accident. Providing good care to all Americans is not a matter of money. America currently spends some 13% of its gross national product on health care, and yet the health statistics of Americans are the worst in the industrialized world. What America needs is a comprehensive system of health care that includes both acute and long-term care. Congress must take action to restore health care as a basic constitutional right of all Americans. Coverage for long-term care must be included within the context of any new national health care program. Funding for such a program should come from the most progressive tax that the Congress can fashion, which to this point is the federal income tax. Although there is an appropriate role for private insurance, it should function as a supplement to rather than as a substitute for a new national program. There are several other elements that are key to a national health care program: Home care must be the first line of any national long-term care program.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10106451

  11. Integration of a nationally procured electronic health record system into user work practices

    PubMed Central

    2012-01-01

    Background Evidence suggests that many small- and medium-scale Electronic Health Record (EHR) implementations encounter problems, these often stemming from users' difficulties in accommodating the new technology into their work practices. There is the possibility that these challenges may be exacerbated in the context of the larger-scale, more standardised, implementation strategies now being pursued as part of major national modernisation initiatives. We sought to understand how England's centrally procured and delivered EHR software was integrated within the work practices of users in selected secondary and specialist care settings. Methods We conducted a qualitative longitudinal case study-based investigation drawing on sociotechnical theory in three purposefully selected sites implementing early functionality of a nationally procured EHR system. The complete dataset comprised semi-structured interview data from a total of 66 different participants, 38.5 hours of non-participant observation of use of the software in context, accompanying researcher field notes, and hospital documents (including project initiation and lessons learnt reports). Transcribed data were analysed thematically using a combination of deductive and inductive approaches, and drawing on NVivo8 software to facilitate coding. Results The nationally led "top-down" implementation and the associated focus on interoperability limited the opportunity to customise software to local needs. Lack of system usability led users to employ a range of workarounds unanticipated by management to compensate for the perceived shortcomings of the system. These had a number of knock-on effects relating to the nature of collaborative work, patterns of communication, the timeliness and availability of records (including paper) and the ability for hospital management to monitor organisational performance. Conclusions This work has highlighted the importance of addressing potentially adverse unintended consequences

  12. Has cost containment after the National Health Insurance system been successful? Determinants of Taiwan hospital costs.

    PubMed

    Hung, Jung-Hua; Chang, Li

    2008-03-01

    Taiwan implemented the National Health Insurance system (NHI) in 1995. After the NHI, the insurance coverage expanded and the quality of healthcare improved, however, the healthcare costs significantly escalated. The objective of this study is to determine what factors have direct impact on the increased costs after the NHI. Panel data analysis is used to investigate changes and factors affecting cost containment at Taipei municipal hospitals from 1990 to 2001. The results show that the expansion of insured healthcare coverage (especially to the elderly and the treatment of more complicated types of diseases), and the increased competition (requiring the growth of new technology and the longer average length of stay) are important driving forces behind the increase of hospital costs, directly influenced by the advent of the NHI. Therefore, policymakers should emphasize health prevention activities and disease management programs for the elderly to improve cost containment. In addition, hospital managers should find ways to improve the hospital efficiency (shorten the LOS) to reduce excess services and medical waste. They also need to better understand their market position and acquire suitable new-tech equipment earlier, to be a leader, not a follower. Finally, policymakers should establish related benchmark indices for what drivers up hospital costs (micro-aspect) and to control healthcare expenditures (macro-level).

  13. Assessment of patient safety culture in clinical laboratories in the Spanish National Health System

    PubMed Central

    Giménez-Marín, Angeles; Rivas-Ruiz, Francisco; García-Raja, Ana M.; Venta-Obaya, Rafael; Fusté-Ventosa, Margarita; Caballé-Martín, Inmaculada; Benítez-Estevez, Alfonso; Quinteiro-García, Ana I.; Bedini, José Luis; León-Justel, Antonio; Torra-Puig, Montserrat

    2015-01-01

    Introduction There is increasing awareness of the importance of transforming organisational culture in order to raise safety standards. This paper describes the results obtained from an evaluation of patient safety culture in a sample of clinical laboratories in public hospitals in the Spanish National Health System. Material and methods A descriptive cross-sectional study was conducted among health workers employed in the clinical laboratories of 27 public hospitals in 2012. The participants were recruited by the heads of service at each of the participating centers. Stratified analyses were performed to assess the mean score, standardized to a base of 100, of the six survey factors, together with the overall patient safety score. Results 740 completed questionnaires were received (88% of the 840 issued). The highest standardized scores were obtained in Area 1 (individual, social and cultural) with a mean value of 77 (95%CI: 76-78), and the lowest ones, in Area 3 (equipment and resources), with a mean value of 58 (95%CI: 57-59). In all areas, a greater perception of patient safety was reported by the heads of service than by other staff. Conclusions We present the first multicentre study to evaluate the culture of clinical safety in public hospital laboratories in Spain. The results obtained evidence a culture in which high regard is paid to safety, probably due to the pattern of continuous quality improvement. Nevertheless, much remains to be done, as reflected by the weaknesses detected, which identify areas and strategies for improvement. PMID:26525595

  14. Impact of Health System Inputs on Health Outcome: A Multilevel Longitudinal Analysis of Botswana National Antiretroviral Program (2002-2013)

    PubMed Central

    Price, Natalie; El-Halabi, Shenaaz; Mlaudzi, Naledi; Keapoletswe, Koona; Lebelonyane, Refeletswe; Fetogang, Ernest Benny; Chebani, Tony; Kebaabetswe, Poloko; Masupe, Tiny; Gabaake, Keba; Auld, Andrew F.; Nkomazana, Oathokwa; Marlink, Richard

    2016-01-01

    Objective To measure the association between the number of doctors, nurses and hospital beds per 10,000 people and individual HIV-infected patient outcomes in Botswana. Design Analysis of routinely collected longitudinal data from 97,627 patients who received ART through the Botswana National HIV/AIDS Treatment Program across all 24 health districts from 2002 to 2013. Doctors, nurses, and hospital bed density data at district-level were collected from various sources. Methods A multilevel, longitudinal analysis method was used to analyze the data at both patient- and district-level simultaneously to measure the impact of the health system input at district-level on probability of death or loss-to-follow-up (LTFU) at the individual level. A marginal structural model was used to account for LTFU over time. Results Increasing doctor density from one doctor to two doctors per 10,000 population decreased the predicted probability of death for each patient by 27%. Nurse density changes from 20 nurses to 25 nurses decreased the predicted probability of death by 28%. Nine percent decrease was noted in predicted mortality of an individual in the Masa program for every five hospital bed density increase. Conclusion Considerable variation was observed in doctors, nurses, and hospital bed density across health districts. Predictive margins of mortality and LTFU were inversely correlated with doctor, nurse and hospital bed density. The doctor density had much greater impact than nurse or bed density on mortality or LTFU of individual patients. While long-term investment in training more healthcare professionals should be made, redistribution of available doctors and nurses can be a feasible solution in the short term. PMID:27490477

  15. Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh

    PubMed Central

    Ao, Trong T.; Rahman, Mahmudur; Haque, Farhana; Chakraborty, Apurba; Hossain, M. Jahangir; Haider, Sabbir; Alamgir, A.S.M.; Sobel, Jeremy; Luby, Stephen P.

    2016-01-01

    We assessed a media-based public health surveillance system in Bangladesh during 2010–2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005. PMID:26981877

  16. Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh.

    PubMed

    Ao, Trong T; Rahman, Mahmudur; Haque, Farhana; Chakraborty, Apurba; Hossain, M Jahangir; Haider, Sabbir; Alamgir, A S M; Sobel, Jeremy; Luby, Stephen P; Gurley, Emily S

    2016-04-01

    We assessed a media-based public health surveillance system in Bangladesh during 2010-2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005.

  17. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    PubMed Central

    2011-01-01

    Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i) the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii) the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii) a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv) effective strategies for HIV/AIDS care in other settings should be validated in Liberia and

  18. Comparing a paper based monitoring and evaluation system to a mHealth system to support the national community health worker programme, South Africa: an evaluation

    PubMed Central

    2014-01-01

    Background In an attempt to address a complex disease burden, including improving progress towards MDGs 4 and 5, South Africa recently introduced a re-engineered Primary Health Care (PHC) strategy, which has led to the development of a national community health worker (CHW) programme. The present study explored the development of a cell phone-based and paper-based monitoring and evaluation (M&E) system to support the work of the CHWs. Methods One sub-district in the North West province was identified for the evaluation. One outreach team comprising ten CHWs maintained both the paper forms and mHealth system to record household data on community-based services. A comparative analysis was done to calculate the correspondence between the paper and phone records. A focus group discussion was conducted with the CHWs. Clinical referrals, data accuracy and supervised visits were compared and analysed for the paper and phone systems. Results Compared to the mHealth system where data accuracy was assured, 40% of the CHWs showed a consistently high level (>90% correspondence) of data transfer accuracy on paper. Overall, there was an improvement over time, and by the fifth month, all CHWs achieved a correspondence of 90% or above between phone and paper data. The most common error that occurred was summing the total number of visits and/or activities across the five household activity indicators. Few supervised home visits were recorded in either system and there was no evidence of the team leader following up on the automatic notifications received on their cell phones. Conclusions The evaluation emphasizes the need for regular supervision for both systems and rigorous and ongoing assessments of data quality for the paper system. Formalization of a mHealth M&E system for PHC outreach teams delivering community based services could offer greater accuracy of M&E and enhance supervision systems for CHWs. PMID:25106499

  19. IMPLEMENTING LAPAROSCOPY IN BRAZIL'S NATIONAL PUBLIC HEALTH SYSTEM: THE BARIATRIC SURGEONS' POINT OF VIEW

    PubMed Central

    SUSSENBACH, Samanta; SILVA, Everton N; PUFAL, Milene Amarante; ROSSONI, Carina; CASAGRANDE, Daniela Schaan; PADOIN, Alexandre Vontobel; MOTTIN, Cláudio Corá

    2014-01-01

    Background Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. Aim 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. Methods A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. Results From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. Conclusion 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy. PMID:25409964

  20. Diffusion of anti-VEGF injections in the Portuguese National Health System

    PubMed Central

    Marques, Ana Patrícia; Macedo, António Filipe; Perelman, Julian; Aguiar, Pedro; Rocha-Sousa, Amândio; Santana, Rui

    2015-01-01

    Objectives To analyse the temporal and geographical diffusion of antivascular endothelial growth factor (anti-VEGF) interventions, and its determinants in a National Health System (NHS). Setting NHS Portuguese hospitals. Participants All inpatient and day cases related to eye diseases at all Portuguese public hospitals for the period 2002–2012 were selected on the basis of four International Classification of Diseases 9th revision, Clinical Modification (ICD-9-CM) codes for procedures: 1474, 1475, 1479 and 149. Primary and secondary outcome measures We measured anti-VEGF treatment rates by year and county. The determinants of the geographical diffusion were investigated using generalised linear modelling. Results We analysed all hospital discharges from all NHS hospitals in Portugal (98 408 hospital discharges corresponding to 57 984 patients). National rates of hospitals episodes for the codes for procedures used were low before anti-VEGF approval in 2007 (less than 12% of hospital discharges). Between 2007 and 2012, the rates of hospital episodes related to the introduction of anti-VEGF injections increased by 27% per year. Patients from areas without ophthalmology departments received fewer treatments than those from areas with ophthalmology departments. The availability of an ophthalmology department in the county increased the rates of hospital episodes by 243%, and a 100-persons greater density per km2 raised the rates by 11%. Conclusions Our study shows a large but unequal diffusion of anti-VEGF treatments despite the universal coverage and very low copayments. The technological innovation in ophthalmology may thus produce unexpected inequalities related to financial constraints unless the implementation of innovative techniques is planned and regulated. PMID:26597866

  1. The role of pulmonology in the National Health System Chronicity Strategy.

    PubMed

    Soler-Cataluña, Juan José; Sánchez Toril, Fernando; Aguar Benito, M Carmen

    2015-08-01

    Longer life expectancy and the progressive aging of the population is changing the epidemiological pattern of healthcare, with a reduction in the incidence of acute diseases and a marked increase in chronic diseases. This change brings important social, healthcare and economic consequences that call for a reorganization of patient care. In this respect, the Spanish National Health System has developed a Chronicity strategy that proposes a substantial change in focus from traditional rescue medicine to patient- and environment-centered care, with a planned, proactive, participative and multidisciplinary approach. Some of the more common chronic diseases are respiratory. In COPD, this integrated approach has been effective in reducing exacerbations, improving quality of life, and even reducing costs. However, the wide variety of management strategies, not only in COPD but also in asthma and other respiratory diseases, makes it difficult to draw definitive conclusions. Pulmonologists can and must participate in the new chronicity models and contribute their knowledge, experience, innovation, research, and special expertise to the development of these new paradigms.

  2. The role of pulmonology in the National Health System Chronicity Strategy.

    PubMed

    Soler-Cataluña, Juan José; Sánchez Toril, Fernando; Aguar Benito, M Carmen

    2015-08-01

    Longer life expectancy and the progressive aging of the population is changing the epidemiological pattern of healthcare, with a reduction in the incidence of acute diseases and a marked increase in chronic diseases. This change brings important social, healthcare and economic consequences that call for a reorganization of patient care. In this respect, the Spanish National Health System has developed a Chronicity strategy that proposes a substantial change in focus from traditional rescue medicine to patient- and environment-centered care, with a planned, proactive, participative and multidisciplinary approach. Some of the more common chronic diseases are respiratory. In COPD, this integrated approach has been effective in reducing exacerbations, improving quality of life, and even reducing costs. However, the wide variety of management strategies, not only in COPD but also in asthma and other respiratory diseases, makes it difficult to draw definitive conclusions. Pulmonologists can and must participate in the new chronicity models and contribute their knowledge, experience, innovation, research, and special expertise to the development of these new paradigms. PMID:25554457

  3. The Reality of Rhetoric in Information Systems Adoption: A Case Study Investigation of the Uk National Health Service

    NASA Astrophysics Data System (ADS)

    Khan, Imran; Ferneley, Elaine

    The UK National Health Service is undergoing a tremendous IS -led change, the purpose of which is to create a service capable of meeting the demands of the 21st century. The aim of this paper is to examine the extent to which persuasive discourse, or rhetoric, influences and affects the adoption of information systems within the health sector. It seeks to explore the ways in which various actors use rhetoric to advance their own agendas and the impact this has on the system itself. As such, the paper seeks to contribute to diffusion research through the use of a case study analysis of the implementation of an Electronic Single Patient Care Record system within one UK Health Service Trust. The findings of the paper suggest that rhetoric is an important and effective persuasive tool, employed by system trainers to coax users into not only adopting the system but also using the system in a predefined manner.

  4. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

    PubMed Central

    2014-01-01

    Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour. Methods A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. Results There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. Conclusions As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms

  5. The National Institutes of Health's Biomedical Translational Research Information System (BTRIS): Design, Contents, Functionality and Experience to Date

    PubMed Central

    Cimino, James J.; Ayres, Elaine J.; Remennik, Lyubov; Rath, Sachi; Freedman, Robert; Beri, Andrea; Chen, Yang; Huser, Vojtech

    2013-01-01

    The US National Institutes of Health (NIH) has developed the Biomedical Translational Research Information System (BTRIS) to support researchers’ access to translational and clinical data. BTRIS includes a data repository, a set of programs for loading data from NIH electronic health records and research data management systems, an ontology for coding the disparate data with a single terminology, and a set of user interface tools that provide access to identified data from individual research studies and data across all studies from which individually identifiable data have been removed. This paper reports on unique design elements of the system, progress to date and user experience after five years of development and operation. PMID:24262893

  6. Australia's national mental health policy.

    PubMed

    Whiteford, H A

    1993-10-01

    In April 1992 the health ministers of all Australian states, territories, and the federal government endorsed Australia's first National Mental Health Policy. The major principles outlined in the policy include protecting consumers' rights, setting national service standards, mainstreaming mental health services with general health services, better integrating inpatient and community mental health services to ensure continuity of care, and linking mental health services and other social and disability services. A five-year National Mental Health Plan, accompanied by additional federal funding, has also been released, with time frames for implementing the policy in all states and territories and at the federal level. PMID:8225277

  7. National health spending trends in 1996. National Health Accounts Team.

    PubMed

    Levit, K R; Lazenby, H C; Braden, B R

    1998-01-01

    The National Health Accounts, produced annually by the Health Care Financing Administration's Office of the Actuary, present estimates for 1960-1996 of nationwide spending for health care and the sources funding that care. This year's estimates set two records: Spending topped $1 trillion for the first time, and expenditure growth slowed to the lowest rate seen in thirty-seven years of measuring health care spending--4.4 percent. The combination of decelerating health spending and a growing economy has kept national health spending as a share of the nation's gross domestic product unchanged for the fourth consecutive year.

  8. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27175280

  9. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27648258

  10. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

  11. [The trajectory of the national policy for the reorientation of professional training in health in the Unified Health System (SUS)].

    PubMed

    Dias, Henrique Sant'anna; Lima, Luciana Dias de; Teixeira, Márcia

    2013-06-01

    This paper examines the national policy and its antecedents for reorientation of professional health training implemented after 2003. It highlights landmarks and transformations in the course of policies between 1980 and 2010, elements of continuity and change and the connections between past and current policy initiatives. The study involved a review of the literature on the subject and document analysis supported by theoretical analysis of public policies, particularly historical institutionalism. The results point to four different moments during the trajectory of the policy, marked by changes in the initiatives of reorientation of higher education in health: antecedents; initial experiences; university protagonism; broadening and enhancement. As an element of continuity, there is the permanence of objects in the guiding principles advocated in the policies. The evidence of implementation expresses prospects of enhancement, with diversification of mobilized actors and organizations, and more projects implemented. The accumulated experience suggests structural maturity of the structural bases of action and the main changes relate to the enhancement of decision-making bodies of the SUS and the approximation to the process of decentralization and regionalization of national health policy. PMID:23752528

  12. [The trajectory of the national policy for the reorientation of professional training in health in the Unified Health System (SUS)].

    PubMed

    Dias, Henrique Sant'anna; Lima, Luciana Dias de; Teixeira, Márcia

    2013-06-01

    This paper examines the national policy and its antecedents for reorientation of professional health training implemented after 2003. It highlights landmarks and transformations in the course of policies between 1980 and 2010, elements of continuity and change and the connections between past and current policy initiatives. The study involved a review of the literature on the subject and document analysis supported by theoretical analysis of public policies, particularly historical institutionalism. The results point to four different moments during the trajectory of the policy, marked by changes in the initiatives of reorientation of higher education in health: antecedents; initial experiences; university protagonism; broadening and enhancement. As an element of continuity, there is the permanence of objects in the guiding principles advocated in the policies. The evidence of implementation expresses prospects of enhancement, with diversification of mobilized actors and organizations, and more projects implemented. The accumulated experience suggests structural maturity of the structural bases of action and the main changes relate to the enhancement of decision-making bodies of the SUS and the approximation to the process of decentralization and regionalization of national health policy.

  13. National Health Insurance and Health Education: Strategies for Change.

    ERIC Educational Resources Information Center

    Dwore, Richard B.

    1980-01-01

    The concept of National Health Insurance (NHI) as one of several strategies for resolving health problems in the U.S. is discussed. NHI goals include comprehensive health care, quality health care, efficient delivery systems, phased-in benefits, and consumer representation. (JD)

  14. Building the national health information infrastructure for personal health, health care services, public health, and research

    PubMed Central

    Detmer, Don E

    2003-01-01

    Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

  15. Internet-based remote health self-checker symptom data as an adjuvant to a national syndromic surveillance system.

    PubMed

    Elliot, A J; Kara, E O; Loveridge, P; Bawa, Z; Morbey, R A; Moth, M; Large, S; Smith, G E

    2015-12-01

    Syndromic surveillance is an innovative surveillance tool used to support national surveillance programmes. Recent advances in the use of internet-based health data have demonstrated the potential usefulness of these health data; however, there have been limited studies comparing these innovative health data to existing established syndromic surveillance systems. We conducted a retrospective observational study to assess the usefulness of a national internet-based 'symptom checker' service for use as a syndromic surveillance system. NHS Direct online data were extracted for 1 August 2012 to 1 July 2013; a time-series analysis on the symptom categories self-reported by online users was undertaken and compared to existing telehealth syndromic data. There were 3·37 million online users of the internet-based self-checker compared to 1·43 million callers to the telephone triage health service. There was a good correlation between the online and telephone triage data for a number of syndromic indicators including cold/flu, difficulty breathing and eye problems; however, online data appeared to provide additional early warning over telephone triage health data. This assessment has illustrated some potential benefit of using internet-based symptom-checker data and provides the basis for further investigating how these data can be incorporated into national syndromic surveillance programmes.

  16. [The Unified National Health System and public policies: psychological care for menopausal women in the Federal District, Brazil].

    PubMed

    Mori, Maria Elizabeth; Coelho, Vera Lúcia Decnop; Estrella, Renata da Costa Netto

    2006-09-01

    This study focused on psychological care for middle-aged women in public health services in the Federal District (Brasilia), Brazil. The article discusses women's health and more specifically menopause and its place in Brazilian public health policies. The survey confirmed the lack of psychological support for menopausal women. In most cases only outpatient medical care was offered. No psychologist had been designated in any of the units surveyed to assist these women. The study concludes that this period of women's life has failed to receive psychological care in Brazil, thus neglecting the principles of the Unified National Health System. Menopausal women deserve comprehensive health care, including attention to conflicts related to biological, psychological, and socio-cultural dimensions of aging, thus contributing to the process of working through maturity.

  17. Modeling, simulation, and analysis at Sandia National Laboratories for health care systems

    NASA Astrophysics Data System (ADS)

    Polito, Joseph

    1994-12-01

    Modeling, Simulation, and Analysis are special competencies of the Department of Energy (DOE) National Laboratories which have been developed and refined through years of national defense work. Today, many of these skills are being applied to the problem of understanding the performance of medical devices and treatments. At Sandia National Laboratories we are developing models at all three levels of health care delivery: (1) phenomenology models for Observation and Test, (2) model-based outcomes simulations for Diagnosis and Prescription, and (3) model-based design and control simulations for the Administration of Treatment. A sampling of specific applications include non-invasive sensors for blood glucose, ultrasonic scanning for development of prosthetics, automated breast cancer diagnosis, laser burn debridement, surgical staple deformation, minimally invasive control for administration of a photodynamic drug, and human-friendly decision support aids for computer-aided diagnosis. These and other projects are being performed at Sandia with support from the DOE and in cooperation with medical research centers and private companies. Our objective is to leverage government engineering, modeling, and simulation skills with the biotechnical expertise of the health care community to create a more knowledge-rich environment for decision making and treatment.

  18. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    Far West Lab. for Educational Research and Development, San Francisco, CA.

    This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

  19. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    National Consortium on Health Science and Technology Education, Okemos, MI.

    This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

  20. National Dissemination of Cognitive Behavioral Therapy for Depression in the Department of Veterans Affairs Health Care System: Therapist and Patient-Level Outcomes

    ERIC Educational Resources Information Center

    Karlin, Bradley E.; Brown, Gregory K.; Trockel, Mickey; Cunning, Darby; Zeiss, Antonette M.; Taylor, C. Barr

    2012-01-01

    Objective: The Department of Veterans Affairs (VA) health care system is nationally disseminating and implementing cognitive behavioral therapy for depression (CBT-D). The current article evaluates therapist and patient-level outcomes associated with national training in and implementation of CBT-D in the VA health care system. Method: Therapist…

  1. Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System

    PubMed Central

    Song, Sun Ok; Jung, Chang Hee; Song, Young Duk; Park, Cheol-Young; Kwon, Hyuk-Sang; Cha, Bong Soo; Park, Joong-Yeol; Lee, Ki-Up

    2014-01-01

    Background The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers. Methods The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI. Results Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining. Conclusion The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform. PMID:25349827

  2. 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

  3. Securing health through food systems: an initiative of the nutrition consortium of the National Health Research Institutes in Taiwan and Asia Pacific regional partners as a network.

    PubMed

    Wahlqvist, Mark L; Kuo, Ken N

    2009-01-01

    There are growing concerns about the health impacts of climate change with ecosystem degradation and global warming, finite reserves of non-renewable energy, water shortages in food-producing regions, limits to contemporary agriculture with its dependence on exhaustible petrochemical nitrogen and rock phosphate fertilizers, and failure of the global financial system. To date, health security has meant attention to safe environments especially water, sanitation and waste disposal; and access to health care and its affordability. Its dependency on food security (safety, sufficiency, sustainability, and satisfaction which requires diversity and quality) has been under-estimated because the current and imminent risks have increased and extended to more populations, because these may be less tractable and because the nature, extent and dynamics of nutritionally-related health are better appreciated. As a step towards more collaborative food and health systems, the National Health Research Institutes in Taiwan has created an interdisciplinary Nutrition Consortium (NC) with research and policy agendas. The NC held a food in Health Security (FIHS) in the Asia Pacific region roundtable in conjunction with the World Vegetable Center based in Tainan, supported by the National Science Council and Academia Sinica in Taiwan and the Australian Academies of Science and of Science Technology and Engineering, August 2-5th 2009 in Taiwan. A FIHS Network is being established to further the initiative. It should form part of the broader Human Security agenda.

  4. Securing health through food systems: an initiative of the nutrition consortium of the National Health Research Institutes in Taiwan and Asia Pacific regional partners as a network.

    PubMed

    Wahlqvist, Mark L; Kuo, Ken N

    2009-01-01

    There are growing concerns about the health impacts of climate change with ecosystem degradation and global warming, finite reserves of non-renewable energy, water shortages in food-producing regions, limits to contemporary agriculture with its dependence on exhaustible petrochemical nitrogen and rock phosphate fertilizers, and failure of the global financial system. To date, health security has meant attention to safe environments especially water, sanitation and waste disposal; and access to health care and its affordability. Its dependency on food security (safety, sufficiency, sustainability, and satisfaction which requires diversity and quality) has been under-estimated because the current and imminent risks have increased and extended to more populations, because these may be less tractable and because the nature, extent and dynamics of nutritionally-related health are better appreciated. As a step towards more collaborative food and health systems, the National Health Research Institutes in Taiwan has created an interdisciplinary Nutrition Consortium (NC) with research and policy agendas. The NC held a food in Health Security (FIHS) in the Asia Pacific region roundtable in conjunction with the World Vegetable Center based in Tainan, supported by the National Science Council and Academia Sinica in Taiwan and the Australian Academies of Science and of Science Technology and Engineering, August 2-5th 2009 in Taiwan. A FIHS Network is being established to further the initiative. It should form part of the broader Human Security agenda. PMID:19965334

  5. Creating patient safety capacity in a nation's health system: A comparison between Israel and Canada

    PubMed Central

    2012-01-01

    Injuries to patients by the healthcare system (i.e., adverse events) are common and their impact on individuals and systems is considerable. Over the last decade, extensive efforts have been made worldwide to improve patient safety. Given the complexity and extent of the activities required to address the issue, coordinating and organizing them at a national level is likely beneficial. Whereas some capacity and expertise already exist in Israel, there is a considerable gap that needs to be filled. In this paper two countries, Canada and Israel, are examined and some of the essential steps for any country are considered. Possible immediate next steps for Israel are suggested. PMID:22913865

  6. Linking NASA Environmental Data with a National Public Health Cohort Study and a CDC On-Line System to Enhance Public Health Decision Making

    NASA Technical Reports Server (NTRS)

    Al-Hamdan, Mohammad; Crosson, William; Economou, Sigrid; Estes, Maurice, Jr.; Estes, Sue; Hemmings, Sarah; Kent, Shia; Puckett, Mark; Quattrochi, Dale; Wade, Gina; McClure, Leslie

    2012-01-01

    The overall goal of this study is to address issues of environmental health and enhance public health decision making by utilizing NASA remotely-sensed data and products. This study is a collaboration between NASA Marshall Space Flight Center, Universities Space Research Association (USRA), the University of Alabama at Birmingham (UAB) School of Public Health and the Centers for Disease Control and Prevention (CDC) National Center for Public Health Informatics. The objectives of this study are to develop high-quality spatial data sets of environmental variables, link these with public health data from a national cohort study, and deliver the linked data sets and associated analyses to local, state and federal end-user groups. Three daily environmental data sets were developed for the conterminous U.S. on different spatial resolutions for the period 2003-2008: (1) spatial surfaces of estimated fine particulate matter (PM2.5) exposures on a 10-km grid utilizing the US Environmental Protection Agency (EPA) ground observations and NASA s MODerate-resolution Imaging Spectroradiometer (MODIS) data; (2) a 1-km grid of Land Surface Temperature (LST) using MODIS data; and (3) a 12-km grid of daily Solar Insolation (SI) and maximum and minimum air temperature using the North American Land Data Assimilation System (NLDAS) forcing data. These environmental datasets were linked with public health data from the UAB REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study to determine whether exposures to these environmental risk factors are related to cognitive decline and other health outcomes. These environmental national datasets will also be made available to public health professionals, researchers and the general public via the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) system, where they can be aggregated to the county, state or regional level as per users need and downloaded in tabular, graphical, and map formats. The

  7. 76 FR 13969 - Notice of Request for Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ...; National Animal Health Monitoring System; Needs Assessments AGENCY: Animal and Plant Health Inspection... National Animal Health Monitoring System needs assessments. DATES: We will consider all comments that we...-2908. SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring System; Needs...

  8. 75 FR 52711 - Notice of Request for Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ...; National Animal Health Monitoring System; Sheep 2011 Study AGENCY: Animal and Plant Health Inspection... intention to initiate an information collection to support the National Animal Health Monitoring System...-2908. SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring System; Sheep 2011 Study....

  9. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the National Instant Criminal Background Check System (NICS). Final rule.

    PubMed

    2016-01-01

    The Department of Health and Human Services (HHS or "the Department'') is issuing this final rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule to expressly permit certain HIPAA covered entities to disclose to the National Instant Criminal Background Check System (NICS) the identities of individuals who are subject to a Federal "mental health prohibitor'' that disqualifies them from shipping, transporting, possessing, or receiving a firearm. The NICS is a national system maintained by the Federal Bureau of Investigation (FBI) to conduct background checks on persons who may be disqualified from receiving firearms based on Federally prohibited categories or State law. Among the persons subject to the Federal mental health prohibitor established under the Gun Control Act of 1968 and implementing regulations issued by the Department of Justice (DOJ) are individuals who have been involuntarily committed to a mental institution; found incompetent to stand trial or not guilty by reason of insanity; or otherwise have been determined by a court, board, commission, or other lawful authority to be a danger to themselves or others or to lack the mental capacity to contract or manage their own affairs, as a result of marked subnormal intelligence or mental illness, incompetency, condition, or disease. Under this final rule, only covered entities with lawful authority to make the adjudications or commitment decisions that make individuals subject to the Federal mental health prohibitor, or that serve as repositories of information for NICS reporting purposes, are permitted to disclose the information needed for these purposes. The disclosure is restricted to limited demographic and certain other information needed for NICS purposes. The rule specifically prohibits the disclosure of diagnostic or clinical information, from medical records or other sources, and any mental health information beyond the indication that the individual

  10. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the National Instant Criminal Background Check System (NICS). Final rule.

    PubMed

    2016-01-01

    The Department of Health and Human Services (HHS or "the Department'') is issuing this final rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule to expressly permit certain HIPAA covered entities to disclose to the National Instant Criminal Background Check System (NICS) the identities of individuals who are subject to a Federal "mental health prohibitor'' that disqualifies them from shipping, transporting, possessing, or receiving a firearm. The NICS is a national system maintained by the Federal Bureau of Investigation (FBI) to conduct background checks on persons who may be disqualified from receiving firearms based on Federally prohibited categories or State law. Among the persons subject to the Federal mental health prohibitor established under the Gun Control Act of 1968 and implementing regulations issued by the Department of Justice (DOJ) are individuals who have been involuntarily committed to a mental institution; found incompetent to stand trial or not guilty by reason of insanity; or otherwise have been determined by a court, board, commission, or other lawful authority to be a danger to themselves or others or to lack the mental capacity to contract or manage their own affairs, as a result of marked subnormal intelligence or mental illness, incompetency, condition, or disease. Under this final rule, only covered entities with lawful authority to make the adjudications or commitment decisions that make individuals subject to the Federal mental health prohibitor, or that serve as repositories of information for NICS reporting purposes, are permitted to disclose the information needed for these purposes. The disclosure is restricted to limited demographic and certain other information needed for NICS purposes. The rule specifically prohibits the disclosure of diagnostic or clinical information, from medical records or other sources, and any mental health information beyond the indication that the individual

  11. National Health Care Survey

    Cancer.gov

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  12. [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.

  13. [Access to early breast cancer diagnosis in the Brazilian Unified National Health System: an analysis of data from the Health Information System].

    PubMed

    Azevedo E Silva, Gulnar; Bustamante-Teixeira, Maria Teresa; Aquino, Estela M L; Tomazelli, Jeane Glaucia; Dos-Santos-Silva, Isabel

    2014-07-01

    The recent reduction in breast cancer mortality in high-income countries resulted from improvements in early detection and treatment. Breast cancer is the most common cancer in Brazilian women. Since 2004, the government has recommended annual clinical breast examination for women aged ≥ 40 years and biannual mammograms for those aged 50-69. This article investigates the degree of implementation of these guidelines using data from the Brazilian Unified National Health System for 2010 according to major geographic region and age group. The findings showed low national mammogram coverage in the target population (32% in the 50-59-year group; 25% from 60 to 69 years). The percentage of women with abnormal radiological findings who underwent biopsy was also low (27% for 50-59 years; 63% for 60-69 years). The number of breast cancer surgeries exceeded the number of cases detected by mammography but was well below the estimated number of incident breast cancer cases in 2010. There are striking regional inequalities in access to early detection and surgery, being the lowest access in the North Region and the highest in the South Region.

  14. National Institute of Environmental Health Sciences

    MedlinePlus

    ... for New Grants Microphysiological Systems (MPS) for Disease Modeling and Efficacy Testing (UG3/UH3) TR-16-017 ... Health National Toxicology Program Staff Directory Freedom of Information Act Office of Inspector General Web Policies & Notices ...

  15. National health expenditures, 1984

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.; Davidoff, Lawrence M.

    1985-01-01

    Growth in health care expenditures slowed to 9.1 percent in 1984, the smallest increase in expenditures in 19 years. Economic forces and emerging structural changes within the health sector played a role in slowing growth. Of the $1,580 per person spent for health care in 1984, 41 percent was financed by public programs; 31 percent by private health insurance; and the remainder by other private sources. Together, Medicare and Medicaid accounted for 27 percent of all health spending. PMID:10311395

  16. 75 FR 6044 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences,...

  17. 78 FR 64228 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special...

  18. Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems

    PubMed Central

    2012-01-01

    Background A commitment to Electronic Health Record (EHR) systems now constitutes a core part of many governments’ healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively) short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Methods Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England’s National Health Service’s Care Records Service (NHS CRS). Results/discussion We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome). Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. Summary New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT) projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within multiple specific settings and

  19. 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

  20. 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

  1. Health financing in Malawi: Evidence from National Health Accounts

    PubMed Central

    2010-01-01

    Background National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan. Methods Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions. Results The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006. Conclusion There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens. PMID:21062503

  2. National health expenditures, 1999.

    PubMed

    Cowan, C A; Lazenby, H C; Martin, A B; McDonnell, P A; Sensenig, A L; Smith, C E; Whittle, L S; Zezza, M A; Donham, C S; Long, A M; Stewart, M W

    2001-01-01

    The health care spending share of gross domestic product (GDP) remained steady between 1993 and 1999 as moderate-to-strong economic growth coincided with a rapid shift to managed care. This shift, along with decelerating growth in Medicare spending, appears to have generated a mostly one-time saving that lowered aggregate health expenditure growth.

  3. 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

  4. Evaluation of the usefulness at national level of the dairy cattle health and production recording systems in Great Britain.

    PubMed

    Velasova, M; Drewe, J A; Gibbons, J; Green, M; Guitian, J

    2015-09-26

    The aim of this study was to formally evaluate, qualitatively, the ability of existing recording systems to generate accurate and reliable estimates of the frequency of selected health conditions in the dairy herd of Great Britain. Fifty-nine recording systems were identified, of which 36 had their key characteristics defined through a web-based questionnaire. Nineteen of them were further assessed following the SERVAL, a SuRveillance EVALuation framework against a set of 12 attributes: benefit, bias, communication, coverage, data collection, data management, data analysis, data completeness, flexibility, multiple utility, representativeness and stability/sustainability. The evaluated systems showed considerable differences in their coverage, implementation and objectives. There were overlaps in recorded conditions, with Johne's disease, bovine viral diarrhoea, mastitis and lameness being recorded by most of the systems. Selection bias, data ownership and lack of integration of data from different systems appeared to be a key limitation on the future use of existing systems for nationwide monitoring. The results showed that even though the individual systems can provide reliable estimates of dairy health for individual farmers, none of the systems alone could provide accurate and reliable estimates for any of the conditions of interest at national level.

  5. 75 FR 50987 - Privacy Act System of Records; National Animal Health Laboratory Network (NAHLN)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-18

    ... Animal Health Protection Act (7 U.S.C. 8301-8317); Public Health Security and Bioterrorism Preparedness... aid in containing and responding to a foreign animal disease outbreak, bioterrorism, or other animal... Animal Health Protection Act, 7 U.S.C. 8301-8317; the Public Health Security and...

  6. National Institutes of Health

    MedlinePlus

    ... of infant death. Learn more » October Is Health Literacy Month Raise awareness about the importance of clear ... Us Contact Us Bookmark & Share Email Updates Social Media & Outreach Twitter Facebook YouTube Footer NIH Home En ...

  7. [The evolution of the Brazilian National Health System, strategic courses of action and strategies to understand these actions].

    PubMed

    dos Santos, Nelson Rodrigues

    2007-01-01

    The author has the intention to propose to the Brazilian health care management and sanitary reform managers an examination and positioning on the course of action in the implementation of SUS (Brazilian National Health System). The findings underscore two non-convergent set of policies that have affected the course of action in the implementation of the SUS in the 1990s: the first and 'main' course of action derives from policies created in 1988 in the so-called Citizen Constitution, of which the SUS is the most important achievement. The second and "additional" course of action derives from the prevailing macro-economic model and its related policies, implemented since the 1990s, besides advocating a social inclusion measure while leaving out all the related improvements of SUS such as Universality, Integrity and Equity. In addition, the second course of action is in opposition to the model based on social protection, besides raising the importance of market-based individualistic values and actions in general, it carries them into the health care system. The author suggests that a clarification on the desirable and on the deviant courses of action of SUS may be a vital contribution to guaranteeing social rights in health care, while preserving its integrity, equity and universal nature.

  8. [The evolution of the Brazilian National Health System, strategic courses of action and strategies to understand these actions].

    PubMed

    dos Santos, Nelson Rodrigues

    2007-01-01

    The author has the intention to propose to the Brazilian health care management and sanitary reform managers an examination and positioning on the course of action in the implementation of SUS (Brazilian National Health System). The findings underscore two non-convergent set of policies that have affected the course of action in the implementation of the SUS in the 1990s: the first and 'main' course of action derives from policies created in 1988 in the so-called Citizen Constitution, of which the SUS is the most important achievement. The second and "additional" course of action derives from the prevailing macro-economic model and its related policies, implemented since the 1990s, besides advocating a social inclusion measure while leaving out all the related improvements of SUS such as Universality, Integrity and Equity. In addition, the second course of action is in opposition to the model based on social protection, besides raising the importance of market-based individualistic values and actions in general, it carries them into the health care system. The author suggests that a clarification on the desirable and on the deviant courses of action of SUS may be a vital contribution to guaranteeing social rights in health care, while preserving its integrity, equity and universal nature. PMID:17680098

  9. The National Disaster Medical System

    NASA Technical Reports Server (NTRS)

    Reutershan, Thomas P.

    1991-01-01

    The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

  10. Cuba's National eHealth Strategy.

    PubMed

    Delgado, Ariel; Gorry, Conner

    2008-01-01

    Cuba has been building a national strategy using information and communication technologies (ICTs) for health since the establishment of the National Medical Sciences Information Center (CNICM) in 1965. Back then, vital statistics and health data - considered a cornerstone of the country's new universal health system - were transmitted by hand or over the phone. As technology grew more sophisticated over the next 30 years, microprocessors and computers were integrated into the process. In 1992, reeling from economic crisis, Cuba founded the national health telematics network known as INFOMED (www.sld.cu), betting on the strategy that ICTs could be used to improve population health at low cost. From these initial efforts until today, the country has followed a policy to build and strengthen a virtual health information infrastructure.[1].

  11. Mental health for nations.

    PubMed

    Bhugra, Dinesh

    2016-08-01

    Mental ill health is a universal phenomenon: that is, it is seen across all cultures and societies, even though the presentation may be culture-specific and affected by cultural norms and more. Governments have a moral and ethical duty to develop mental health services which are accessible, appropriate, and non-discriminatory. Equity in funding mental health services is critical. As globally services and their quality vary dramatically, one should be proposing and agreeing on minimum standards of care. In this paper the basic components and minimum standards of care are described. It is imperative that services are non-discriminatory. It is important that governments work with psychiatrists, other mental health professionals, and individuals with mental illness, their families, and carers to plan, develop, and deliver services with adequate funding. Employers and psychological first aid must also be remembered. Services must be geographically accessible. In this endeavour primary care services have a major role to play. Training and clinical decision-making must be part of the change in service delivery. It is imperative that every effort is made to keep the population mentally as well as physically healthy, and people who develop mental illness must have access to evidence-based treatment at the earliest possible opportunity. PMID:27686156

  12. 75 FR 71134 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting..., Cancer Control, National Institutes of Health, HHS) Dated: November 16, 2010. Jennifer S....

  13. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

    PubMed Central

    2011-01-01

    Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®). Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain. PMID:21645335

  14. Referring cruise ship patients to specialists in Norway--a welfare state with a national health care system.

    PubMed

    Dahl, Eilif

    2015-01-01

    Northern Europe is a popular cruise destination, but many non-Scandinavian cruise ship's doctors who are used to enthusiastic service from specialists ashore, get frustrated when referring passengers or crew to out-patient medical evaluation. Norway's national health care system is described and used as an example of medical conditions in a welfare state with a relatively well-functioning national health care system: Emergency cases are usually promptly admitted. Out-patient specialist consultations are available in public polyclinics, but waiting time can be considerable, also for patients from ships. Private specialists are fully booked weeks in advance and do not work from Friday to Monday and during holidays. Public and private medical service capacity is significantly reduced during the summer months. Hence, most specialists ashore are not eager to see demanding ship patients. Ship's doctors should limit referral to conditions that require specific procedures that are not available on the vessel but are necessary for the patient to be able to continue cruising or working aboard. Crewmembers who are unfit for work aboard, should instead be signed off and repatriated for diagnostic work-up and follow-up at home. In cases of hospitalisation or necessary referral ashore, the ship's doctor should always confer in advance with the company's ship's port agents and make necessary shore-side arrangements through them. PMID:26119674

  15. Referring cruise ship patients to specialists in Norway--a welfare state with a national health care system.

    PubMed

    Dahl, Eilif

    2015-01-01

    Northern Europe is a popular cruise destination, but many non-Scandinavian cruise ship's doctors who are used to enthusiastic service from specialists ashore, get frustrated when referring passengers or crew to out-patient medical evaluation. Norway's national health care system is described and used as an example of medical conditions in a welfare state with a relatively well-functioning national health care system: Emergency cases are usually promptly admitted. Out-patient specialist consultations are available in public polyclinics, but waiting time can be considerable, also for patients from ships. Private specialists are fully booked weeks in advance and do not work from Friday to Monday and during holidays. Public and private medical service capacity is significantly reduced during the summer months. Hence, most specialists ashore are not eager to see demanding ship patients. Ship's doctors should limit referral to conditions that require specific procedures that are not available on the vessel but are necessary for the patient to be able to continue cruising or working aboard. Crewmembers who are unfit for work aboard, should instead be signed off and repatriated for diagnostic work-up and follow-up at home. In cases of hospitalisation or necessary referral ashore, the ship's doctor should always confer in advance with the company's ship's port agents and make necessary shore-side arrangements through them.

  16. 78 FR 24153 - Notice of Emergency Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ...; National Animal Health Monitoring System; Equine Herpesvirus Myeloencephalopathy Study AGENCY: Animal and... information collection for a National Animal Health Monitoring System Equine Herpesvirus Myeloencephalopathy...: National Animal Health Monitoring System; Equine Herpesvirus Myeloencephalopathy Study. OMB Number:...

  17. The Internet and healthcare in Taiwan: value-added applications on the medical network in the National Health Insurance smart card system.

    PubMed

    Tsai, Wen-Hsien; Kuo, Hsiao-Chiao

    2007-01-01

    The introduction of smart card technology has ushered in a new era of electronic medical information systems. Taiwan's Bureau of National Health Insurance (BNHI) implemented the National Health Insurance (NHI) smart card project in 2004. The purpose of the project was to replace all paper cards with one smart card. The NHI medical network now provides three kinds of services. In this paper, we illustrate the status of the NHI smart card system in Taiwan and propose three kinds of value-added applications for the medical network, which are electronic exchange of medical information, retrieval of personal medical records and medical e-learning for future development of health information systems.

  18. NATIONAL HEALTH & ENVIRONMENTAL EFFECTS RESEARCH LABORATORY BEGINS IMPLEMENTATION OF AN ELECTRONIC SCIENTIFIC DATA MANAGEMENT SYSTEM

    EPA Science Inventory

    Data and records management have changed greatly as a result of progress in computer technology, but many organizations, including the US EPA's National Records Management Program (NRMP) and the U.S. National Archives and Records Administration (NARA), still struggle to escape th...

  19. 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

  20. Financing universal health coverage—effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries

    PubMed Central

    Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

    2015-01-01

    Summary Background How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. Methods We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011. Findings Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9·86 (95% CI 3·92–15·8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16·7, 9·16 to 24·3), but not for consumption taxes on goods and services (−$4·37, −12·9 to 4·11). In countries with low tax revenues (<$1000 per capita per year), an additional $100 tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6·74 percentage points (95% CI 0·87–12·6) and the extent of financial coverage by 11·4 percentage points (5·51–17·2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Interpretation Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for

  1. Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance--a qualitative study of householders' views.

    PubMed

    Mershed, Mania; Busse, Reinhard; van Ginneken, Ewout

    2012-01-01

    This study aims to identify the satisfaction with the current public health system and health benefit schemes, examine willingness to participate in national health insurance and review expectations and preferences of national health insurance. To this end, qualitative semi-structured interviews were carried out with 19 Syrian householders. Our results show that a need for health reform exists and that Syrian people are willing to support a national health insurance scheme if some key issues are properly addressed. Funding of the scheme is a major concern and should take into account the ability to pay and help the poor. In addition, waiting times should be shortened and sufficient coverage guaranteed. On the whole, the people would support a national health insurance with national pooling and purchasing under a public set-up, but important concerns of such a system regarding corruption and inefficiency were voiced too. Installing a quasi non-governmental organisation as manager of the insurance system under the stewardship of the Ministry of Health could provide a compromise acceptable to the people.

  2. 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

  3. A comparison of HAS & NICE guidelines for the economic evaluation of health technologies in the context of their respective national health care systems and cultural environments

    PubMed Central

    Massetti, Marc; Aballéa, Samuel; Videau, Yann; Rémuzat, Cécile; Roïz, Julie; Toumi, Mondher

    2015-01-01

    Background Health technology assessment (HTA) has been reinforced in France, notably with the introduction of economic evaluation in the pricing process for the most innovative and expensive treatments. Similarly to the National Institute for Clinical Excellence (NICE) in England, the National Authority for Health (HAS), which is responsible for economic evaluation of new health technologies in France, has published recommendations on the methods of economic evaluation. Since economic assessment represents a major element of HTA in England, exploring the differences between these methodological guidelines might help to comprehend both the shape and the role economic assessment is intended to have in the French health care system. Methods Methodological guidelines for economic evaluation in France and England have been compared topic-by-topic in order to bring out key differences in the recommended methods for economic evaluation. Results The analysis of both guidelines has revealed multiple similarities between France and England, although a number of differences were also noted regarding the elected methodology of analysis, the comparison of studies’ outcomes with cost-effectiveness thresholds, the study population to consider, the quality of life valuation methods, the perspective on costs, the types of resources considered and their valuation, the discount rates to apply in order to reflect the present value of interventions, etc. To account for these differences, modifications will be required in order to adapt economic models from one country to the other. Conclusions Changes in HTA assessment methods occur in response to different challenges determined by the different philosophical and cultural considerations surrounding health and welfare as well as the political considerations regarding the role of public policies and the importance of their evaluation. PMID:27123190

  4. [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.

  5. [Perception of prenatal care among clients of the Brazilian National Health System (SUS): a comparative study].

    PubMed

    Ribeiro, José Mendes; Costa, Nílson do Rosário; Pinto, Luiz Felipe da Silva; Silva, Pedro Luiz Barros

    2004-01-01

    This was a comparative cross-sectional study among public prenatal care users in conventional outpatient health services and family health services, aimed at assessing perception and quality differences between the two models of health services organization according to Ministry of Health guidelines. A total of 203 pregnant women from 22 municipalities in five regions of the country were interviewed while waiting for prenatal consultation. Besides soliciting the women's opinions, we checked for possible advantages in innovative family care services in issues like access and commitment. Data revealed approval by users for key aspects related to care and consultation in both types of public facilities and suggest consistent primary care policies. Low coverage in dentistry (18.9%), gynecological preventive tests (39.6%), and HIV tests (52.6%) indicates policy obstacles. Comparatively, family health services received significantly greater approval by women on issues like quality of the last visit (p = 0.0432), maternity hospital access (p = 0.0106), vaccination schedules (p = 0.0023), drug delivery (p = 0.0053), blood glucose tests (p = 0.0309), nursing visit (p = 0.0469), and home visits (p < 0.0001).

  6. Human Factors in the Large: Experiences from Denmark, Finland and Canada in Moving Towards Regional and National Evaluations of Health Information System Usability

    PubMed Central

    Kaipio, J.; Nieminen, M.; Hyppönen, H.; Lääveri, T.; Nohr, C.; Kanstrup, A. M.; Berg Christiansen, M.; Kuo, M.-H.; Borycki, E.

    2014-01-01

    Summary Objectives The objective of this paper is to explore approaches to understanding the usability of health information systems at regional and national levels. Methods Several different methods are discussed in case studies from Denmark, Finland and Canada. They range from small scale qualitative studies involving usability testing of systems to larger scale national level questionnaire studies aimed at assessing the use and usability of health information systems by entire groups of health professionals. Results It was found that regional and national usability studies can complement smaller scale usability studies, and that they are needed in order to understand larger trends regarding system usability. Despite adoption of EHRs, many health professionals rate the usability of the systems as low. A range of usability issues have been noted when data is collected on a large scale through use of widely distributed questionnaires and websites designed to monitor user perceptions of usability. Conclusion As health information systems are deployed on a widespread basis, studies that examine systems used regionally or nationally are required. In addition, collection of large scale data on the usability of specific IT products is needed in order to complement smaller scale studies of specific systems. PMID:25123725

  7. The National Institutes of Health Microphysiological Systems Program focuses on a critical challenge in the drug discovery pipeline.

    PubMed

    Sutherland, Margaret L; Fabre, Kristin M; Tagle, Danilo A

    2013-01-01

    The National Institutes of Health has partnered with the US Food and Drug Administration and the Defense Advanced Research Projects Agency to accelerate the development of human microphysiological systems (MPS) that address challenges faced in predictive toxicity assessment and efficacy analysis of new molecular entities during the preclinical phase of drug development. Use of human MPS could provide better models for predicting the efficacy of new molecular entities in clinical trials. It is also anticipated that improvements in predicting drug toxicities early in the drug development process through the use of MPS or human organs-on-a-chip will decrease the need to withdraw new therapies from the market and minimize or eliminate deaths due to unidentified drug toxicities.

  8. [Strategies by civil society organizations for access to breast cancer drugs in the Brazilian Unified National Health System].

    PubMed

    Deprá, Aline Scaramussa; Ribeiro, Carlos Dimas Martins; Maksud, Ivia

    2015-07-01

    This study aims to identify and analyze strategies by civil society organizations working with breast cancer (CSOs) on access to drugs in Brazilian Unified National Health System (SUS) and the main social actors. A qualitative approach used the snowball technique, semi-structured interviews, and participant observation. Thematic analysis was based on the following categories: access to drugs for breast cancer treatment, relationship between CSOs and government, relationship between CSOs and the pharmaceutical industry, and other strategies used by CSOs. The results showed that civil society organizations have influenced access to drugs for breast cancer in the SUS and that their main strategies have focused on pressuring government at all levels. Meanwhile, the pharmaceutical industry sponsors some CSOs in order to strengthen them and expand its own market. The main difficulties in access to such drugs involve insufficient services, unequal treatment, and inclusion of technology in the SUS.

  9. [Strategies by civil society organizations for access to breast cancer drugs in the Brazilian Unified National Health System].

    PubMed

    Deprá, Aline Scaramussa; Ribeiro, Carlos Dimas Martins; Maksud, Ivia

    2015-07-01

    This study aims to identify and analyze strategies by civil society organizations working with breast cancer (CSOs) on access to drugs in Brazilian Unified National Health System (SUS) and the main social actors. A qualitative approach used the snowball technique, semi-structured interviews, and participant observation. Thematic analysis was based on the following categories: access to drugs for breast cancer treatment, relationship between CSOs and government, relationship between CSOs and the pharmaceutical industry, and other strategies used by CSOs. The results showed that civil society organizations have influenced access to drugs for breast cancer in the SUS and that their main strategies have focused on pressuring government at all levels. Meanwhile, the pharmaceutical industry sponsors some CSOs in order to strengthen them and expand its own market. The main difficulties in access to such drugs involve insufficient services, unequal treatment, and inclusion of technology in the SUS. PMID:26248106

  10. 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

  11. 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

  12. 78 FR 55751 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Notice of Meeting Pursuant to... Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard, Rockville, MD 20852....

  13. 78 FR 8153 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request: Recipient... Blood Institute (NHLBI), the National Institutes of Health (NIH) has submitted to the Office...

  14. Health Care Systems and National Policy: Role of Leadership in the Obesity Crisis.

    PubMed

    Jones, Jessica Lynn; Sundwall, David

    2016-03-01

    Obesity, defined as a body mass index (BMI) of 30 or higher in adults and BMI in the 95th percentile or higher for children, is epidemic in the United States. The predominant culture of caloric excess and sedentary behaviors contributes to this problem. Obesity increases the risk of many chronic diseases and premature death. The broad response to this costly disease includes efforts from medical providers, local and federal governments, and nongovernmental agencies. Although obesity can be addressed on an individual basis, it is largely recognized as a public health issue.

  15. Integrated Disease Investigations and Surveillance planning: a systems approach to strengthening national surveillance and detection of events of public health importance in support of the International Health Regulations.

    PubMed

    Taboy, Celine H; Chapman, Will; Albetkova, Adilya; Kennedy, Sarah; Rayfield, Mark A

    2010-12-03

    The international community continues to define common strategic themes of actions to improve global partnership and international collaborations in order to protect our populations. The International Health Regulations (IHR[2005]) offer one of these strategic themes whereby World Health Organization (WHO) Member States and global partners engaged in biosecurity, biosurveillance and public health can define commonalities and leverage their respective missions and resources to optimize interventions. The U.S. Defense Threat Reduction Agency's Cooperative Biological Engagement Program (CBEP) works with partner countries across clinical, veterinary, epidemiological, and laboratory communities to enhance national disease surveillance, detection, diagnostic, and reporting capabilities. CBEP, like many other capacity building programs, has wrestled with ways to improve partner country buy-in and ownership and to develop sustainable solutions that impact integrated disease surveillance outcomes. Designing successful implementation strategies represents a complex and challenging exercise and requires robust and transparent collaboration at the country level. To address this challenge, the Laboratory Systems Development Branch of the U.S. Centers for Disease Control and Prevention (CDC) and CBEP have partnered to create a set of tools that brings together key leadership of the surveillance system into a deliberate system design process. This process takes into account strengths and limitations of the existing system, how the components inter-connect and relate to one another, and how they can be systematically refined within the local context. The planning tools encourage cross-disciplinary thinking, critical evaluation and analysis of existing capabilities, and discussions across organizational and departmental lines toward a shared course of action and purpose. The underlying concepts and methodology of these tools are presented here.

  16. 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

  17. 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

  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

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  19. South African National Cancer Registry: Effect of withheld data from private health systems on cancer incidence estimates

    PubMed Central

    Singh, E; Underwood, J M; Nattey, C; Babb, C; Sengayi, M; Kellett, P

    2015-01-01

    Background The National Cancer Registry (NCR) was established as a pathology-based cancer reporting system. From 2005 to 2007, private health laboratories withheld cancer reports owing to concerns regarding voluntary sharing of patient data. Objectives To estimate the impact of under-reported cancer data from private health laboratories. Methods A linear regression analysis was conducted to project expected cancer cases for 2005 – 2007. Differences between actual and projected figures were calculated to estimate percentage under-reporting. Results The projected NCR case total varied from 53 407 (3.8% net increase from actual cases reported) in 2005 to 54 823 (3.7% net increase) in 2007. The projected number of reported cases from private laboratories in 2005 was 26 359 (19.7% net increase from actual cases reported), 27 012 (18.8% net increase) in 2006 and 27 666 (28.4% net increase) in 2007. Conclusion While private healthcare reporting decreased by 28% from 2005 to 2007, this represented a minimal impact on overall cancer reporting (net decrease of <4%). PMID:26242527

  20. Establishing national health goals and standards.

    PubMed Central

    Zwick, D I

    1983-01-01

    Four statements of national health goals and standards were proclaimed from the U.S. Department of Health and Human Services during the 1970s. Two were based on statutory mandates--the National Guidelines for Health Planning and the Model Standards for Community Preventive Health Services. Two were the results of administrative initiatives--the Forward Plans for Health and the complementary publications "Healthy People" and "Promoting Health/Preventing Disease". These efforts present a variety of approaches and experiences and can provide direction and lessons for future endeavors along these lines. The four issuances include guidance on national priorities, resource standards, and accessibility to care. They also offer goals and objectives for local services and health status. They address a multiplicity of issues, ranging from hospital bed supply and recommended uses of specialized medical equipment to infant mortality and proposed reductions in death and disability. Almost all urge further actions to prevent illness and promote health. The development of statements of national health goals and standards has been advocated by some experts and questioned by others. Advocates believe that these materials can help clarify purposes and priorities for health programs, resulting in more effective and efficient uses of resources and greater accountability. Critics are particularly concerned about deleterious impacts on creativity and local initiatives. Among the major lessons identifiable from these undertakings is the importance of committed leadership, broad-based consultation, and reliable data. Implementation inevitably encounters the complexities of the health system and depends upon available resources. In influencing the agenda of deliberation and debate, the symbolic value of these statements may often be more significant than the specific details. The continuing interest in these approaches suggests that future efforts along these lines are likely. PMID:6414027

  1. Forecasting the stochastic demand for inpatient care: the case of the Greek national health system.

    PubMed

    Boutsioli, Zoe

    2010-08-01

    The aim of this study is to estimate the unexpected demand of Greek public hospitals. A multivariate model with four explanatory variables is used. These are as follows: the weekend effect, the duty effect, the summer holiday and the official holiday. The method of the ordinary least squares is used to estimate the impact of these variables on the daily hospital emergency admissions series. The forecasted residuals of hospital regressions for each year give the estimated stochastic demand. Daily emergency admissions decline during weekends, summer months and official holidays, and increase on duty hospital days. Stochastic hospital demand varies both among hospitals and over the five-year time period under investigation. Variations among hospitals are larger than time variations. Hospital managers and health policy-makers can be availed by forecasting the future flows of emergent patients. The benefit can be both at managerial and economical level. More advanced models including additional daily variables such as the weather forecasts could provide more accurate estimations.

  2. HNET - A National Computerized Health Network

    PubMed Central

    Casey, Mark; Hamilton, Richard

    1988-01-01

    The HNET system demonstrated conceptually and technically a national text (and limited bit mapped graphics) computer network for use between innovative members of the health care industry. The HNET configuration of a leased high speed national packet switching network connecting any number of mainframe, mini, and micro computers was unique in it's relatively low capital costs and freedom from obsolescence. With multiple simultaneous conferences, databases, bulletin boards, calendars, and advanced electronic mail and surveys, it is marketable to innovative hospitals, clinics, physicians, health care associations and societies, nurses, multisite research projects libraries, etc.. Electronic publishing and education capabilities along with integrated voice and video transmission are identified as future enhancements.

  3. 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

  4. 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

  5. National Center for Environmental Health

    MedlinePlus

    ... Health Asthma Carbon Monoxide Clean Water for Health Climate and Public Health Environmental Noise Exposure and Health ... Overviews Asthma Control Built Environment and Health Initiative Climate and Health Environmental Health Laboratory Environmental Health Services ...

  6. 76 FR 9319 - Notice of Request for Reinstatement of an Information Collection; National Animal Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... an Information Collection; National Animal Health Monitoring System; Feedlot 2011 Study AGENCY... information collection to support the National Animal Health Monitoring Feedlot 2011 Study. DATES: We will... Coordinator, at (301) 851-2908. SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring...

  7. Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre

    PubMed Central

    Dhallu, Sandeep K; Maurino, Vincenzo; Wilkins, Mark R

    2016-01-01

    Objectives To describe the initial outcomes following installation of a cataract surgery laser system. Setting National Health Service cataract surgery day care unit in North London, UK. Participants 158 eyes of 150 patients undergoing laser-assisted cataract surgery. Interventions Laser cataract surgery using the AMO Catalys femtosecond laser platform. Primary and secondary outcome measures Primary outcome measure: intraoperative complications including anterior and posterior capsule tears. Secondary outcome measures: docking to the laser platform, successful treatment delivery, postoperative visual acuities. Results Mean case age was 67.7±10.8 years (range 29–88 years). Docking was successful in 94% (148/158 cases), and in 4% (6/148 cases) of these, the laser delivery was aborted part way during delivery due to patient movement. A total of 32 surgeons, of grades from junior trainee to consultant, performed the surgeries. Median case number per surgeon was 3 (range from 1–20). The anterior capsulotomy was complete in 99.3% of cases, there were no anterior capsule tears (0%). There were 3 cases with posterior capsule rupture requiring anterior vitrectomy, and 1 with zonular dialysis requiring anterior vitrectomy (4/148 eyes, 2.7%). These 4 cases were performed by trainee surgeons, and were either their first laser cataract surgery (2 surgeons) or their first and second laser cataract surgeries (1 surgeon). Conclusions Despite the learning curve, docking and laser delivery were successfully performed in almost all cases, and surgical complication rates and visual outcomes were similar to those expected based on national data. Complications were predominately confined to trainee surgeons, and with the exception of intraoperative pupil constriction appeared unrelated to the laser-performed steps. PMID:27466243

  8. Socialism and the British National Health Service.

    PubMed

    Powell, M

    1997-09-01

    This paper examines some of the key characteristics of a socialist health care system using the example of the British National Health Service (NHS). It has been claimed that the NHS has socialist principles, and represents an island of socialism in a capitalist sea. However, using historical analysis, this paper argues that while the NHS claims some socialist ends, they could never be fully achieved because of the lack of socialist means. The socialist mechanisms which were associated with earlier plans for a national health service such as salaried service, health centres, elected health authorities and divorcing private practice from the public service were discarded in negotiation. Moreover, even these would have achieved socialism merely in the sense of distributing health care, without any deeper transformation associated with doctor-patient relationships and prevention. In short, the NHS is more correctly seen as nationalised rather than socialised medicine, achieving the first three levels of a socialist health service identified here. It can be said to have socialist principles in the limited distributional sense and has some socialist means to achieve these. However, it lacks the stronger means to fully achieve its distributional goals, and is very distant from the third level of a radical transformation of health care.

  9. 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.

  10. France: Health system review.

    PubMed

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

    2010-01-01

    remained very stable until the mid 1990s, in the following decade many changes occurred and several new institutions were created. Concurrently, the respective power and involvement of the parliament, government, local authorities and SHI in the policy-making process have evolved. However, the Ministry of Health has retained substantial control over the health system, although ongoing reforms at both the regional and the national levels may challenge its traditional role. This edition of the French HiT was written concurrently with the vote and implementation of the 2009 Hospital, Patients, Health and Territories Act, which dramatically changed again the organizational structure and management of the health care system at the regional and local level. In order to ensure a comprehensive description and understanding of the system, the HiT, therefore, describes both the previous organization and the reorganization following the Act. However, the implementation process of the Act and its formal application was still a work in progress at the time of completing the French HiT.

  11. France: Health system review.

    PubMed

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

    2010-01-01

    remained very stable until the mid 1990s, in the following decade many changes occurred and several new institutions were created. Concurrently, the respective power and involvement of the parliament, government, local authorities and SHI in the policy-making process have evolved. However, the Ministry of Health has retained substantial control over the health system, although ongoing reforms at both the regional and the national levels may challenge its traditional role. This edition of the French HiT was written concurrently with the vote and implementation of the 2009 Hospital, Patients, Health and Territories Act, which dramatically changed again the organizational structure and management of the health care system at the regional and local level. In order to ensure a comprehensive description and understanding of the system, the HiT, therefore, describes both the previous organization and the reorganization following the Act. However, the implementation process of the Act and its formal application was still a work in progress at the time of completing the French HiT. PMID:21406338

  12. 76 FR 71047 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... EPRB, NIAAA, National Institutes of Health, 5365 Fishers Lane, Room 2085, Rockville, MD 20852,...

  13. 76 FR 44597 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed...; 93.839, Blood Diseases and Resources Research, National Institutes of Health, HHS) Dated: July...

  14. 3 CFR 8711 - Proclamation 8711 of September 12, 2011. National Health Information Technology Week, 2011

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Health Information Technology Week, 2011 8711 Proclamation 8711 Presidential Documents Proclamations Proclamation 8711 of September 12, 2011 Proc. 8711 National Health Information Technology Week, 2011By the... health information systems. During National Health Information Technology Week, we highlight the...

  15. [French national health insurance. The current situation].

    PubMed

    Huguier, Michel; Lagrave, Michel; Marcelli, Aline; Rossignol, Claude; Tillement, Jean-Paul

    2010-06-01

    An audit of the French national health insurance system would be justified by economic considerations alone, but this would risk overlooking the notions of solidarity and freedom to which the French are rightly attached. European comparisons suggest, however, that our system could be made more efficient without undermining public health. The national health insurance system allows each member of the population to receive high-quality medical care. Practitioners have near-total freedom of prescription and practice. Medical care contributes to the ongoing increase in life expectancy, which is currently 73 years and second only to Japan. Healthcare is also a source of a million jobs. Macro-economic spending controls have failed, owing to medical progress and population aging, and also to medical consumerism favored by an unprecedented range of examinations and treatments, the increasing reimbursement of medical care, and the extension of direct payment by the insurer. Many ineffective measures have been implemented, such as tarification according to activity, and hospital certification. Health spending is also increased unnecessarily by bureaucratisation of healthcare spending and the transfer of professionals to posts for which they are not qualified. Some controversial medical prescriptions are not adequately controlled by the health service. Many reforms are based on over-optimistic economic predictions that fail to take related overheads into account. Lobbying by special interests groups undermines reform and the public interest. Too many independent administrative bodies have been created, and many are less efficient than the public structures they replaced. In sum, the French national health insurance system has become less and less efficient over the years. PMID:21513139

  16. Salmonella prevalence and antimicrobial susceptibility from the National Animal Health Monitoring System Swine 2000 and 2006 studies.

    PubMed

    Haley, C A; Dargatz, D A; Bush, E J; Erdman, M M; Fedorka-Cray, P J

    2012-03-01

    Concern about Salmonella contamination of food is compounded by fear that antimicrobials traditionally used to combat the infection will become useless due to rising antibiotic resistance. Livestock, in particular swine, often are blamed for illnesses caused by Salmonella and for increasing antibiotic resistance due to use of antibiotics in pigs. As part of the National Animal Health Monitoring System Swine 2000 and 2006 studies, swine fecal samples were cultured for Salmonella. These samples were collected from 123 operations in 17 states in 2000 and from 135 operations in 17 states in 2006. At each operation, 50 and 60 fecal samples were collected from late finisher pig pens in 2000 and 2006, respectively. Salmonella isolates were characterized to determine serogroup and serotype and were tested for susceptibility to a panel of 17 and 15 antimicrobial drugs in 2000 and 2006, respectively. A total of 5,470 and 7,788 samples were cultured for Salmonella in 2000 and 2006, respectively. Overall, 6.2% of the samples and 34.2% of the farms were positive for Salmonella in 2000. In 2006, 7.2% of the samples and 52.6% of the farms were positive. Salmonella Derby, Salmonella Typhimurium var. 5- (formerly Salmonella Typhimurium var. Copenhagen), and Salmonella Agona were the three serotypes most often recovered in both study years. The most common antimicrobial resistance pattern for Salmonella Derby in the two study years was resistance to streptomycin, sulfisoxazole, and tetracycline. Most isolates were resistant to tetracycline, sulfisoxazole, and streptomycin in both study years. The proportion of Salmonella isolates that were susceptible to all antimicrobials (pansusceptible) was 38.1% in 2000 and 20.4% in 2006. The proportion of Salmonella isolates that were resistant to three or more antimicrobials (multidrug resistant) was similar in 2000 and in 2006 (52.8 and 57.7%, respectively).

  17. Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System?

    PubMed Central

    2011-01-01

    Background This study aims to design an empirical test on the sensitivity of the prescribing doctors to the price afforded for the patient, and to apply it to the population data of primary care dispensations for cardiovascular disease and mental illness in the Spanish National Health System (NHS). Implications for drug policies are discussed. Methods We used population data of 17 therapeutic groups of cardiovascular and mental illness drugs aggregated by health areas to obtain 1424 observations ((8 cardiovascular groups * 70 areas) + (9 psychotropics groups * 96 areas)). All drugs are free for pensioners. For non-pensioner patients 10 of the 17 therapeutic groups have a reduced copayment (RC) status of only 10% of the price with a ceiling of €2.64 per pack, while the remaining 7 groups have a full copayment (FC) rate of 40%. Differences in the average price among dispensations for pensioners and non-pensioners were modelled with multilevel regression models to test the following hypothesis: 1) in FC drugs there is a significant positive difference between the average prices of drugs prescribed to pensioners and non-pensioners; 2) in RC drugs there is no significant price differential between pensioner and non-pensioner patients; 3) the price differential of FC drugs prescribed to pensioners and non-pensioners is greater the higher the price of the drugs. Results The average monthly price of dispensations to pensioners and non-pensioners does not differ for RC drugs, but for FC drugs pensioners get more expensive dispensations than non-pensioners (estimated difference of €9.74 by DDD and month). There is a positive and significant effect of the drug price on the differential price between pensioners and non-pensioners. For FC drugs, each additional euro of the drug price increases the differential by nearly half a euro (0.492). We did not find any significant differences in the intensity of the price effect among FC therapeutic groups. Conclusions Doctors

  18. [Involvement of workers from municipal outpatient services in Uberaba, Minas Gerais State, Brazil, in the reorganization of services under the Unified National Health System].

    PubMed

    Goulart, Bethania Ferreira; Freitas, Maria Imaculada de Fátima

    2008-09-01

    This study was conducted in two specialized municipal outpatient clinics in the city of Uberaba, Minas Gerais State, Brazil. The study analyzes the involvement of professionals in their work and the reorganization of health services from their perspective, considering the participatory management recommended by the Unified National Health System (SUS). The study included nine workers with or without specific health training, all involved in health sector activities. Participants were selected according to profession or job (groups: dentistry, infrastructure, medicine, social work, psychology, coordination, nursing, pharmacy, and biochemistry), with one participant per "category" for each clinic. The content was submitted to structural narrative analysis. Three analytical categories were identified: management, involvement in work, and involvement in the SUS proposals. The study was not intended to generalize results on health workers' involvement, but it does highlight the importance of understanding the interaction between the management model and the reorganization of services as recommended under the SUS.

  19. [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.

  20. [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

  1. An Assessment of the Application of Pharma Cloud System to the National Health Insurance Program of Taiwan and the Result in Hospitals.

    PubMed

    Yan, Yu-Hua; Lu, Chen-Luan

    2016-01-01

    National Health Insurance Administration established Pharma Cloud System in July 2014. The purpose is to decrease therapeutic duplications and enhance public medication safety. Comparison will be made among individual hospitals and the administering branches of National Health Insurance Bureau (NHIB) on the statistical data on the inquiry of the cloud medication history record system to understand the result of the installation and advocacy of this system. The results show (1) there were 2,329,846 entries of data collected from the branches of the NHIB from 2015 on cloud medication history record and 50,224 entries of data from individual hospitals. (2) The inquiry rate at the branches of the NHIB was 43.2% from January to April, 2015 and at individual hospitals was 18.8%. (3) The improvement rate at the branches of the NHIB was 32.5% and at the individual hospitals was 47.0% from January to April, 2015.

  2. [The Brazilian National Health Conference: challenges for the country].

    PubMed

    Gadelha, Paulo

    2015-10-01

    This article was published in the context of the upcoming 15th Brazilian National Health Conference and addresses the country's health challenges based on the history of previous conferences. The authors analyze the evolution of health as a public policy agenda, highlighting the role of such institutions as the Brazilian Center for Health Studies (CEBES), the Brazilian Association of Collective Health (Abrasco), and the National Health Council in advocating and establishing the Brazilian Unified National Health System (SUS). The article also focuses on expectations concerning the 15th National Health Conference within a political and economic scenario that raises questions and challenges both for the future of health policy, exemplified by SUS, and the current capacity to mobilize stakeholders.

  3. Greece: Health system review.

    PubMed

    Economou, Charalambos

    2010-01-01

    financing and equity in access to health care services. Efficiency is in question due to the lack of incentives to improve performance in the public sector. Mechanisms for needs assessment and priority-setting are underdeveloped and, as a consequence, the regional distribution of health resources is unequal. Centralization of the system is coupled with a lack of planning and coordination, and limited managerial and administrative capacity. In addition, the oversupply of physicians, the absence of a referral system, and irrational pricing and reimbursement policies are factors encouraging under-the-table payments and the black economy. These shortcomings result in low satisfaction with the health care system expressed by citizens. The landmark in the development of the Greek health care system was the creation of the national health system (ESY) in 1983. This report describes the development of the ESY at the structural level and generally, the process of implementing reforms. The strategic targets of health reform initiatives have been to structure a unified health care sector along the lines of the original ESY proposal and to cope with current inefficiencies. However, the three reforms attempted in the 1990s were never fully implemented, while the ambitious reform project of the period 2000–2004, which provided for the regionalization of the system, new management structures, prospective reimbursement, new employment conditions for hospital doctors, modernization of public health services and reorganization of primary health care, was abolished after the elections of 2004 and a change in government. While the new strategy, launched in 2005 with the stated aims of securing the financial viability of the health care system in the short term and its sustainability in the long term, addressed specific weaknesses, it has been rather controversial: the introduction of a centralized administrative public procurement system, the development of public–private partnerships

  4. 75 FR 42758 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to... Institutes of Health, 9000 Rockville Pike, Building 31, C Wing, 6th Floor, Conference Room 10, Bethesda,...

  5. 78 FR 42967 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed... Institutes of Health, HHS) Dated: July 12, 2013. Michelle Trout, Program Analyst, Office of Federal...

  6. 76 FR 53685 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review; Comment Request; Partner and... Center for Scientific Review (CSR), National Institutes of Health (NIH), has submitted to the Office...

  7. Issues in national health insurance.

    PubMed Central

    Donabedian, A

    1976-01-01

    Health insurance, by reducing net price to the consumer and increasing the opportunities for revenue to the provider, has profound effects, among other things, on the volume, content and distribution of services, their prices, and the capacity of providers to produce them. The magnitude and nature of these effects depend, partly, on the design of insurance benefits and, partly, on the nature of the health care system, particularly its current and potential capacity and the methods it uses to pay providers. Those who believe that the unique aim of insurance is to protect against unpredictable expenses attempt to suppress these effects, mainly by imposing financial disincentives to utilization which, in turn, reduce protection for those who need it most. Those who wish to reform the system have a broader range of objectives which include protective efficacy, cost control, quantitative adequacy, qualitative adequacy, efficiency of production, efficiency of allocation, equity, and redistribution of capacity. An analysis of the effects of insurance in the light of these objectives reveals favorable as well as unfavorable consequences. The provision of comprehensive benefits generates the necessity for a fundamental change in the organization of health services, if the advantages are to be fully realized and the disadvantages minimized. PMID:817614

  8. Improving quality outcomes in a single-payer system: lessons learned from the UK National Health Service Breast Screening Programme.

    PubMed

    Wallis, Matthew G; Lawrence, Gill; Brenner, R James

    2008-06-01

    The success of pay-for-performance initiatives in the United States as a function of improved quality of care is likely to be conditioned on the participation of all stakeholders. The ability of providers to develop quality improvement programs that receive sufficient resource support from the government represents a dynamic that has proved successful for the Breast Screening Programme, a part of the National Health Service, in the United Kingdom. A review of selected aspects of the program should serve as a template for consideration of how the deliberate coordination of clinical care can be improved under such circumstances.

  9. The reality of virtual learning for nurses in the largest integrated health care system in the nation.

    PubMed

    Rick, Cathy; Kearns, Martha A; Thompson, Nancy A

    2003-01-01

    The health care network and hospital system within the Department of Veterans Affairs (VA), the Veterans Health Administration (VHA), provides employment to more than 56,000 nursing personnel and serves as clinical education site to countless other nursing and health professional students. Nurse administrators and educators are posed with the challenge of providing an environment in which each nurse is able to gain needed knowledge, learn new skills, and share and communicate this knowledge with other colleagues. The education of nurses improves the health status of veterans while also realizing individual professional enhancement. Regional and cultural diversity of the system present challenges to education, in both delivery and content. VHA's learning organizations, the Employee Education System and the Office of Special Projects, have maximized new technologies and information systems to provide innovative, virtual education opportunities, capitalizing on the benefits of informal and formal learning, thus moving VHA to the forefront in knowledge sharing and dissemination. The Virtual Learning Center, VA Knowledge Network, Learning Catalog, and VA Learning Online provide VHA's nurses with interactive, desktop virtual learning opportunities.

  10. Indicator-based systems of performance management in the National Health Service: a comparison of the perceptions of local- and national-level managers.

    PubMed

    Jones, G T

    2000-02-01

    Historically, the UK Government has policed the use of National Health Service (NHS) resources through the centralization of control. With the majority of resource-draining decisions being taken by clinicians, however, professional financial accountability is becoming more important within the NHS management structure. Variations in clinical performance can be monitored through the use of performance indicators, although these are not without their problems. The use of league tables of such indicators in the national press is now infamous and there is much anecdotal evidence about the intraorganizational conflict arising from the use of such tables. A questionnaire survey and interview study of clinical directors, clinical service directors and business managers in several Scottish NHS Trusts was undertaken to ascertain the perceptions of local-level managers on the issue of performance indicators. Interviews were also carried out with a number of personnel in the Scottish Office Department of Economics and Information, the Division of Health Gain and the Finance Directorate. This paper explores the differences between the perceptions of the managers at these two levels of the NHS with regards to issues of performance measurement, intraorganizational conflict and corporate vision. PMID:11184003

  11. Social representations of the Brazilian national health care system in the city of Rio de Janeiro, Brazil, according to the structural approach.

    PubMed

    Gomes, Antonio Marcos Tosoli; de Oliveira, Denize Cristina; de Sá, Celso Pereira

    2008-01-01

    The Brazilian National Health Care System The Single Health System (SHS) [SUS-Sistema Unico de Saúde] faces difficulties for its effective implementation. This paper aims to characterize the contents and the social representation structure of the Brazilian health care system among health care professionals in the city of Rio de Janeiro. The concept of social memory and the theory of social representation were adopted as frameworks. Five health care institutions were included in this research, with 100 professionals altogether. The free-association technique was used to collect data and the EVOC 2003 software was used analyzed for data analysis. The results signal to a central nucleus, characterized by negative attitudes regarding the SUS. In the contrast area, there is a negative attitude towards the effectiveness of the system and a positive attitude towards the care provided to service users, also showing other principles. At its periphery, the implementation of new opinions about the representation could be observed. It is concluded that the professionals present social representations that recognize the SUS as a new system, eliciting negative attitudes among the professionals, and that is in a process of formation or progressive transformation, raising judgments about the pertinence of the system's principles.

  12. Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

    PubMed Central

    Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

    2016-01-01

    Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The

  13. [The Electronic Health Information System (eGIS) of the National Association of Statutory Health Insurance Physicians (KBV): a basis for small-scale analyses of health-care provision].

    PubMed

    Kopetsch, T; John, S

    2014-02-01

    As one of the main players in the German health system, the National Association of Statutory Health Insurance Physicians (KBV) is heavily involved in issues around research and planning for the current and future provision of medical care. The KBV is particularly concerned with tackling the challenge of establishing a uniform source of data and is working to bridge the"data divide" in the research and planning of medical care. To this end, it has developed the Electronic Health Information System (eGIS). The procedure for setting up the EGIS was as follows: (1) Merging externally available data from the relevant sectors of the German health system with the KBV's own data to form a single database. (2) Merging and aggregating the cross-sector data at a single small-scale geographical level. (3) Capturing several years' worth of data in order to be able to carry out time series analyses and identify trends. eGIS provides a single database and uniform evaluation methods, thus ensuring that the principles of homogeneity and comparability are adhered to. The access it gives to the available regionalized data facilitates comprehensive analyses, such as regional, time series and regression analyses, at a small-scale level. The design chosen for the eGIS ensures that its analyses achieve high consistency in answering questions related to the provision of medical care. With the help of the eGIS, an exceptionally broad range of issues in the field of health and medical care can be studied at a regional level.

  14. 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.

  15. Developing National Biosecurity Systems

    SciTech Connect

    Mahy, Heidi A.

    2008-03-05

    Biosecurity literally means ‘safe life’ and encompasses all policies and measures taken to secure humans, animals and plants against biological threats regardless of whether they are naturally-occurring or man-made. This includes the prevention, detection and mitigation of damage by disease, pests and bioterrorism to economies, the environment (including water, agriculture, biodiversity) and human and animal health. Biosecurity cannot be defined singularly; rather it is the sum of government policies and programs; the role of institutions and individuals; the relationship of businesses and bio-responsibility, education and community engagement at the local, national and international levels.

  16. Arbona system reengineered in the Garcia-Ariz Model: a national health reform plan from an orthopedics program perspective.

    PubMed

    García Ariz, Manuel; García-Peña, Enrique; Hernández-Polo, Víctor; Pino-Delgado, Franz; Pérez-Carrillo, Omar

    2010-01-01

    During the 1950's the healthcare system of Puerto Rico was maintained exclusively by the local government. The Arbona system, as it came to be known, although it provided health care professionals on the island with multiple educational experiences, presented substantial costs for the government. In the early 1990's a program of privatization known as "La Reforma" was implemented with the ultimate goal of providing a universal coverage system for the poor and the needy. At present this program has brought other issues regarding the quality of medical services and loss of academic centers. This is a preliminary report that analyzes various aspects of both systems through the search and analysis of background resources and literature, interviews, and physician/patient satisfaction surveys (on working conditions and quality of services). The main purpose of this report is to create a model that proves to be efficient and coherent with the island's idiosyncrasies.

  17. 78 FR 31947 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ... Institute of Mental Health Data Access Request and Use Certification SUMMARY: In compliance with the... comment on proposed data collection projects, the National Institute of Mental Health (NIMH), National... obtain a copy of the data collection plans and instruments, submit comments in writing, or request...

  18. 77 FR 9673 - National Institute on Minority Health and Health Disparities Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ... Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Blvd... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Minority Health and...

  19. Polity and health care expenditures: the association among 159 nations.

    PubMed

    Gregorio, Leah E; Gregorio, David I

    2013-03-01

    This paper hypothesized that democratic nations, as characterized by Polity IV Project regime scores, spend more on health care than autocratic nations and that the association reported here is independent of other demographic, health system or economic characteristics of nations. WHO Global Observatory data on 159 nations with roughly 98% of the world's population were examined. Regime scores had significant, direct and independent associations with each of four measures of health care expenditure. For every unit increment in a nation's regime score toward a more democratic authority structure of governance, we estimated significant (p<0.05) increments in the percent of GDP expended on health care (+0.14%), percent of general government expenditures targeted to health care (+0.25%), total per capita expenditures on health (+34.4Int$) and per capita general government expenditures (+22.4Int$), while controlling for a population's age distribution, life expectancy, health care workforce and system effectiveness and gross national income. Moreover, these relationships were found to persist across socio-economic development levels. The finding that practices of health care expenditure and authority structures of government co-vary is instructive about the politics of health and the challenges of advancing global health objectives. PMID:23856538

  20. Polity and health care expenditures: the association among 159 nations.

    PubMed

    Gregorio, Leah E; Gregorio, David I

    2013-03-01

    This paper hypothesized that democratic nations, as characterized by Polity IV Project regime scores, spend more on health care than autocratic nations and that the association reported here is independent of other demographic, health system or economic characteristics of nations. WHO Global Observatory data on 159 nations with roughly 98% of the world's population were examined. Regime scores had significant, direct and independent associations with each of four measures of health care expenditure. For every unit increment in a nation's regime score toward a more democratic authority structure of governance, we estimated significant (p<0.05) increments in the percent of GDP expended on health care (+0.14%), percent of general government expenditures targeted to health care (+0.25%), total per capita expenditures on health (+34.4Int$) and per capita general government expenditures (+22.4Int$), while controlling for a population's age distribution, life expectancy, health care workforce and system effectiveness and gross national income. Moreover, these relationships were found to persist across socio-economic development levels. The finding that practices of health care expenditure and authority structures of government co-vary is instructive about the politics of health and the challenges of advancing global health objectives.

  1. 78 FR 58269 - Notice of Request for Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ...; National Animal Health Monitoring System; Bison 2014 Study AGENCY: Animal and Plant Health Inspection... intention to request approval of a new information collection for the National Animal Health Monitoring...: National Animal Health Monitoring System; Bison 2014 Study. OMB Number: 0579-XXXX. Type of...

  2. 78 FR 58268 - Notice of Request for Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ...; National Animal Health Monitoring System; Cervid 2014 Study AGENCY: Animal and Plant Health Inspection... intention to request approval of a new information collection for the National Animal Health Monitoring...: National Animal Health Monitoring System; Cervid 2014 Study. OMB Number: 0579-XXXX. Type of...

  3. 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…

  4. National health policy for traditional medicine in India.

    PubMed

    Srinivasan, P

    1995-01-01

    External pressures have combined to erode the practice of India's traditional medical systems to such an extent that they are in danger of becoming extinct. A better balanced national health policy could go a long way towards reversing this trend.

  5. 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.

  6. 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

  7. 76 FR 55930 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center For Scientific Review Notice of Closed Meetings... Health, 6701 Rockledge Drive, Room 6194, MSC 7804, Bethesda, MD 20892, 301-996-6208,...

  8. 76 FR 16798 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review; Notice of Closed Meeting... Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892 (Telephone Conference Call). Contact...

  9. The United Nations and One Health: the International Health Regulations (2005) and global health security.

    PubMed

    Nuttall, I; Miyagishima, K; Roth, C; de La Rocque, S

    2014-08-01

    The One Health approach encompasses multiple themes and can be understood from many different perspectives. This paper expresses the viewpoint of those in charge of responding to public health events of international concern and, in particular, to outbreaks of zoonotic disease. Several international organisations are involved in responding to such outbreaks, including the United Nations (UN) and its technical agencies; principally, the Food and Agriculture Organization of the UN (FAO) and the World Health Organization (WHO); UN funds and programmes, such as the United Nations Development Programme, the World Food Programme, the United Nations Environment Programme, the United Nations Children's Fund; the UN-linked multilateral banking system (the World Bank and regional development banks); and partner organisations, such as the World Organisation for Animal Health (OIE). All of these organisations have benefited from the experiences gained during zoonotic disease outbreaks over the last decade, developing common approaches and mechanisms to foster good governance, promote policies that cut across different sectors, target investment more effectively and strengthen global and national capacities for dealing with emerging crises. Coordination among the various UN agencies and creating partnerships with related organisations have helped to improve disease surveillance in all countries, enabling more efficient detection of disease outbreaks and a faster response, greater transparency and stakeholder engagement and improved public health. The need to build more robust national public human and animal health systems, which are based on good governance and comply with the International Health Regulations (2005) and the international standards set by the OIE, prompted FAO, WHO and the OIE to join forces with the World Bank, to provide practical tools to help countries manage their zoonotic disease risks and develop adequate resources to prevent and control disease

  10. The United Nations and One Health: the International Health Regulations (2005) and global health security.

    PubMed

    Nuttall, I; Miyagishima, K; Roth, C; de La Rocque, S

    2014-08-01

    The One Health approach encompasses multiple themes and can be understood from many different perspectives. This paper expresses the viewpoint of those in charge of responding to public health events of international concern and, in particular, to outbreaks of zoonotic disease. Several international organisations are involved in responding to such outbreaks, including the United Nations (UN) and its technical agencies; principally, the Food and Agriculture Organization of the UN (FAO) and the World Health Organization (WHO); UN funds and programmes, such as the United Nations Development Programme, the World Food Programme, the United Nations Environment Programme, the United Nations Children's Fund; the UN-linked multilateral banking system (the World Bank and regional development banks); and partner organisations, such as the World Organisation for Animal Health (OIE). All of these organisations have benefited from the experiences gained during zoonotic disease outbreaks over the last decade, developing common approaches and mechanisms to foster good governance, promote policies that cut across different sectors, target investment more effectively and strengthen global and national capacities for dealing with emerging crises. Coordination among the various UN agencies and creating partnerships with related organisations have helped to improve disease surveillance in all countries, enabling more efficient detection of disease outbreaks and a faster response, greater transparency and stakeholder engagement and improved public health. The need to build more robust national public human and animal health systems, which are based on good governance and comply with the International Health Regulations (2005) and the international standards set by the OIE, prompted FAO, WHO and the OIE to join forces with the World Bank, to provide practical tools to help countries manage their zoonotic disease risks and develop adequate resources to prevent and control disease

  11. 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

  12. Budget impact analysis of the percutaneous septal occluder for treatment of ostium secundum atrial septal defects in the Brazilian Unified National Health System.

    PubMed

    Senna, Kátia Marie Simões e; Sarti, Flavia Mori; Costa, Márcia Gisele Santos da; Nita, Marcelo Eidi; Santos, Marisa da Silva; Tura, Bernardo Rangel; Correia, Marcelo Goulart

    2015-08-01

    The aim of this study was to perform a budget impact analysis on the adoption of percutaneous occlusion of ostium secundum atrial septal defects in the Brazilian Unified National Health System. Costs were collected using micro-costing technique from medical records for each treatment technique (conventional surgery versus percutaneous septal occluder) at a public federal hospital specialized in high-complexity cardiology. The analysis showed that expenditures associated with percutaneous occlusion were lower than with conventional surgery, and sensitivity analysis confirmed the cost reduction in several scenarios, showing a significant budget impact with a 30% adoption rate for the percutaneous occluder (savings of approximately 1.5 million dollars per year). The study indicates that the adoption of the percutaneous septal occluder would mean cost savings of approximately 3.5 million dollars for the Brazilian public health system. PMID:26375653

  13. Budget impact analysis of the percutaneous septal occluder for treatment of ostium secundum atrial septal defects in the Brazilian Unified National Health System.

    PubMed

    Senna, Kátia Marie Simões e; Sarti, Flavia Mori; Costa, Márcia Gisele Santos da; Nita, Marcelo Eidi; Santos, Marisa da Silva; Tura, Bernardo Rangel; Correia, Marcelo Goulart

    2015-08-01

    The aim of this study was to perform a budget impact analysis on the adoption of percutaneous occlusion of ostium secundum atrial septal defects in the Brazilian Unified National Health System. Costs were collected using micro-costing technique from medical records for each treatment technique (conventional surgery versus percutaneous septal occluder) at a public federal hospital specialized in high-complexity cardiology. The analysis showed that expenditures associated with percutaneous occlusion were lower than with conventional surgery, and sensitivity analysis confirmed the cost reduction in several scenarios, showing a significant budget impact with a 30% adoption rate for the percutaneous occluder (savings of approximately 1.5 million dollars per year). The study indicates that the adoption of the percutaneous septal occluder would mean cost savings of approximately 3.5 million dollars for the Brazilian public health system.

  14. The development of health law as a way to change traditional attitudes in national legal systems. The influence of international human rights law: what is left for the national legislator?

    PubMed

    Birmontiene, Toma

    2010-03-01

    The development of health law as a sovereign subject of law could be seen as a correlative result of the development of international human rights law. From the perspectives of human rights law, health law gives us a unique possibility to change the traditional point of reference - from the regulation of medical procedures, to the protection of human rights as the main objective of law. At the end of the twentieth and the beginning of this century, human rights law and the most influential international instrument--the European Convention on Human Rights (and the jurisprudence of the ECHR) has influenced health care so much that it has became difficult to draw a line between these subjects. Health law sometimes directly influences and even aspires to change the content of Convention rights that are considered to be traditional. However, certain problems of law linked to health law are decided without influencing the essence of rights protected by the Convention, but just by construing the particularities of application of a certain right. In some cases by further developing the requirements of protection of individual rights that are also regulated by the health law, the ECHR even "codifies" some fields of health law (e.g., the rights of persons with mental disorders). The recognition of worthiness and diversity of human rights and the development of their content raise new objectives for national legislators when they regulate the national legal system. Here the national legislator is often put into a quandary whether to implement the standards of human rights that are recognized by the international community, or to refuse to do so, taking account of the interests of a certain group of the electorate.

  15. Disinvestment in the age of cost-cutting sound and fury. Tools for the Spanish National Health System.

    PubMed

    García-Armesto, Sandra; Campillo-Artero, Carlos; Bernal-Delgado, Enrique

    2013-05-01

    This paper proposes the framing of disinvestment strategies as the "value for money" approach suitable for the current situation of acute budget restrictions. Building on the experiences from other countries, it first reviews the instruments already available for implementing this approach within the Spanish National Health Service (SNS) named (A) The mandate to do it: regulatory framework.(B) The capacity to identify “low value” interventions and produce guidance on best practice.(C) The capacity to monitor compliance to and effects of “enforced” guidance.These three elements have been in place in the SNS for some years now. However their effective alignment in supporting a disinvestment strategy has met with several hurdles. Components of organisational incentives as well as the "technological fascination" affecting professionals' and public perceptions have played a role in Spain as elsewhere. In addition, some idiosyncratic political factors lead to weak mechanisms for the channelling of available evidence into decision-making and the existing SNS technical bodies capped to issue only non-binding recommendations. Sadly, the "cuts across the board" strategy adopted in facing the financial crisis might have finally triggered the required political clime to overcome these obstacles to disinvestment. In the current context, the SNS stakeholders (professionals and the public) may regard the disinvestment proposal of informed local decisions about how best to spend the shrinking amount of resources, getting rid of low value care, as a shielding rationale, rather than a thread.

  16. 78 FR 13689 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ..., Chief, Scientific Review Officer, National Institute On Minority Health, and Health Disparities, 6707... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Minority Health and...

  17. Fairness of Financial Contribution in Iranian Health System: Trend Analysis of National Household Income and Expenditure, 2003-2010

    PubMed Central

    Fazaeli, Amir Abbas; Seyedin, Hesam; Moghaddam, Abbas Vosoogh; Delavari, Alireza; Salimzadeh, H.; Varmazyar, Hasan; Fazaeli, Ali Akbar

    2015-01-01

    Background: Social systems are dealing with the challenge of achieving fairness in the distribution of financial burden and protecting the risk of financial loss. The purpose of this paper is to present a trend analysis for the indicators related to fairness in healthcare’s financial burden in rural and urban population of Iran during the eight years period of 2003 to 2010. Methods: We used the information gathered by statistical center of Iran through sampling processes for the household income and expenditures. The indicators of fairness in financial contribution of healthcare were calculated based on the WHO recommended methodology. The indices trend analysis of eight-year period for the rural, urban areas and the country level were computed. Results: This study shows that in Iran the fairness of financial contribution index during the eight-year period has been decreased from 0.841 in 2003 to above 0.827 in 2010 and The percentage of people with catastrophic health expenditures has been increased from 2.3% to above 3.1%. The ratio of total treatment costs to the household overall capacity to pay has been increased from 0.055 to 0.068 and from 0.072 to 0.0818 in urban and rural areas respectively. Conclusion: There is a decline in fairness of financial contribution index during the study period. While, a trend stability of the proportion of households who suffered catastrophic health expenditures was found. PMID:26156920

  18. Preparing national health systems to cope with the impending tsunami of ageing and its associated complexities: Towards more sustainable health care.

    PubMed

    Amalberti, René; Nicklin, Wendy; Braithwaite, Jeffrey

    2016-06-01

    Healthcare systems across the world are experiencing increased financial, organizational and social pressures attributable to a range of critical issues including the challenge of ageing populations. Health systems need to adapt, in order to sustainably provide quality care to the widest range of patients, particularly those with chronic and complex diseases, and especially those in vulnerable and low-income groups. We report on a workshop designed to tackle such issues under the auspices of ISQua, with representatives from Argentina, Australia, Canada, Columbia, Denmark, Emirates, France, Ireland, Jordan, Qatar, Malaysia, Norway, Oman, UK, South Africa and Switzerland. We discuss some of the challenges facing healthcare systems in countries ageing rapidly, to those less so, and touch on current and future reform options. PMID:26980115

  19. Preparing national health systems to cope with the impending tsunami of ageing and its associated complexities: Towards more sustainable health care.

    PubMed

    Amalberti, René; Nicklin, Wendy; Braithwaite, Jeffrey

    2016-06-01

    Healthcare systems across the world are experiencing increased financial, organizational and social pressures attributable to a range of critical issues including the challenge of ageing populations. Health systems need to adapt, in order to sustainably provide quality care to the widest range of patients, particularly those with chronic and complex diseases, and especially those in vulnerable and low-income groups. We report on a workshop designed to tackle such issues under the auspices of ISQua, with representatives from Argentina, Australia, Canada, Columbia, Denmark, Emirates, France, Ireland, Jordan, Qatar, Malaysia, Norway, Oman, UK, South Africa and Switzerland. We discuss some of the challenges facing healthcare systems in countries ageing rapidly, to those less so, and touch on current and future reform options.

  20. Issues concerning Mexican cattle on feedlots in the United States as reported in the United States National Animal Health Monitoring System 1994-1995 Cattle on Feed Evaluation.

    PubMed

    Losinger, W C

    1997-07-01

    Producers participating in the United States National Animal Health Monitoring System 1994-1995 Cattle on Feed Evaluation provided information on cattle of Mexican origin in their feedlot operations. Cattle of Mexican origin accounted for 8.1% of cattle placed on United States feedlots from 1 July 1993 through 30 June 1994. Of operations with a one-time capacity of 1000 or more cattle, 12.8% placed cattle of Mexican origin on their feedlots over this time frame. Very few operations (about 1%) reported cattle of Mexican origin at the same time as cattle to be used for breeding in the United States.

  1. Supporting National Men's Health Week.

    THOMAS, 111th Congress

    Rep. Cummings, Elijah E. [D-MD-7

    2010-06-14

    06/23/2010 Received in the Senate and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  2. Supporting National Men's Health Week.

    THOMAS, 111th Congress

    Rep. Cummings, Elijah E. [D-MD-7

    2009-06-03

    07/09/2009 Received in the Senate and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  3. National Alliance for Hispanic Health

    MedlinePlus

    ... connected to global and international efforts. Capacities and competencies to respond to health emergencies. Services that integrate ... Our People Our Legacy Annual Reports Supporting You Core Programs Demonstration Programs Resources News and Advocacy  News ...

  4. Primary care practitioners’ views on test result management in EHR-enabled health systems: a national survey

    PubMed Central

    Singh, Hardeep; Spitzmueller, Christiane; Petersen, Nancy J; Sawhney, Mona K; Smith, Michael W; Murphy, Daniel R; Espadas, Donna; Laxmisan, Archana; Sittig, Dean F

    2013-01-01

    Context Failure to notify patients of test results is common even when electronic health records (EHRs) are used to report results to practitioners. We sought to understand the broad range of social and technical factors that affect test result management in an integrated EHR-based health system. Methods Between June and November 2010, we conducted a cross-sectional, web-based survey of all primary care practitioners (PCPs) within the Department of Veterans Affairs nationwide. Survey development was guided by a socio-technical model describing multiple inter-related dimensions of EHR use. Findings Of 5001 PCPs invited, 2590 (51.8%) responded. 55.5% believed that the EHRs did not have convenient features for notifying patients of test results. Over a third (37.9%) reported having staff support needed for notifying patients of test results. Many relied on the patient's next visit to notify them for normal (46.1%) and abnormal results (20.1%). Only 45.7% reported receiving adequate training on using the EHR notification system and 35.1% reported having an assigned contact for technical assistance with the EHR; most received help from colleagues (60.4%). A majority (85.6%) stayed after hours or came in on weekends to address notifications; less than a third reported receiving protected time (30.1%). PCPs strongly endorsed several new features to improve test result management, including better tracking and visualization of result notifications. Conclusions Despite an advanced EHR, both social and technical challenges exist in ensuring notification of test results to practitioners and patients. Current EHR technology requires significant improvement in order to avoid similar challenges elsewhere. PMID:23268489

  5. [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

  6. [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.

  7. 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

  8. 78 FR 62638 - National Institute on Minority Health and Health Disparities; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... Disparities Special Emphasis Panel; NIMHD Technologies for Improving Minority Health and Eliminating Health... contract proposals. Place: National Institute on Minority Health and Health Disparities, 6707 Democracy..., National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd., Suite 800, Bethesda,...

  9. National Student Conference on Health Manpower.

    ERIC Educational Resources Information Center

    Student American Pharmaceutical Association, Washington, DC.

    This document summarizes the proceedings of the National Student Conference on Health Manpower, Chicago, March 1972. Following a staff report on the conference proceedings, student research papers on workshop topics are presented. These papers concern health profession recruitment and retention with consideration of general minority and sex-biased…

  10. 78 FR 24427 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... separately through media and social media channels. The surveys will be available on a designated survey Web... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day Comment Request; Genomics...

  11. A National Agenda for Public Health Informatics

    PubMed Central

    Yasnoff, William A.; Overhage, J. Marc; Humphreys, Betsy L.; LaVenture, Martin

    2001-01-01

    The AMIA 2001 Spring Congress brought together members of the the public health and informatics communities to develop a national agenda for public health informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes—that all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health. PMID:11687561

  12. 76 FR 28414 - Notice of Request for Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-17

    ...; National Animal Health Monitoring System; Emergency Epidemiologic Investigations AGENCY: Animal and Plant... to support the National Animal Health Monitoring System. DATES: We will consider all comments that we... Coordinator, at (301) 851-2908. SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring...

  13. 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

  14. 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.

  15. 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

  16. A United Nations Global Health Panel for Global Health Governance.

    PubMed

    Mackey, Tim K; Liang, Bryan A

    2013-01-01

    The World Health Organization now relies upon voluntary contributions tied to specific projects, underwriting 75% of operations. A resulting cacophony of non-governmental, foundation, and private sector actors have emerged overlapping and fractionating WHO programs. In this expanding world of "global health organizations," WHO's role must be redefined. We propose coordination of global health initiatives through a United Nations Global Health Panel with active participation of WHO. Given recent events, the UN is poised to take a greater leadership role in global health.

  17. 75 FR 65365 - National Institute of Environmental Health Sciences;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: Environmental Health Sciences Review Committee; Research Career... applications. Place: Nat. Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T....

  18. National Library of Medicine Web Resources for Student Health Professionals

    SciTech Connect

    Womble, R.

    2010-04-02

    Familiarize students affiliated with the Student National Medical Association with the National Library of Medicine's online resources that address medical conditions, health disparities, and public health preparedness needs.

  19. A National Initiative to Advance School Mental Health Performance Measurement in the US

    ERIC Educational Resources Information Center

    Connors, Elizabeth Halsted; Stephan, Sharon Hoover; Lever, Nancy; Ereshefsky, Sabrina; Mosby, Amanda; Bohnenkamp, Jill

    2016-01-01

    Standardized health performance measurement has increasingly become an imperative for assuring quality standards in national health care systems. As compared to somatic health performance measures, behavioral health performance measures are less developed. There currently is no national standardized performance measurement system for monitoring…

  20. 76 FR 52633 - Notice of Request for Reinstatement of an Information Collection; National Animal Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Animal and Plant Health Inspection Service Notice of Request for Reinstatement of an Information Collection; National Animal Health Monitoring System; Swine 2012 Study AGENCY: Animal and Plant Health... National Animal Health Monitoring System's Swine 2012 Study. DATES: We will consider all comments that...

  1. 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.

  2. A systematic approach to the identification and classification of near-miss events on labor and delivery in a large, national health care system.

    PubMed

    Clark, Steven L; Meyers, Janet A; Frye, Donna R; McManus, Kathryn; Perlin, Jonathan B

    2012-12-01

    We describe a systematic approach to the identification and classification of near-miss events on labor and delivery in a large, national health care system. Voluntary reports of near-miss events were prospectively collected during 2010 in 203,708 deliveries. These reports were analyzed according to frequency and potential severity. Near-miss events were reported in 0.69% of deliveries. Medication and patient identification errors were the most common near-miss events. However, existing barriers were found to be highly effective in preventing such errors from reaching the patient. Errors with the greatest potential for causing harm involved physician response and decision making. Fewer and less effective existing barriers between these errors and potential patient harm were identified. Use of a comprehensive system for identification of near-miss events on labor and delivery units have proven useful in allowing us to focus patient safety efforts on areas of greatest need.

  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. 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

  6. National technical report on forest health, 1996

    SciTech Connect

    Stolte, K.W.

    1997-10-01

    Forest Health Monitoring (FHM) is a national program designed to determine the status, changes, and trends in indicators of forest condition on an annual basis. The FHM program uses data from ground plots and surveys, aerial surveys, and other biotic data sources and develops analytical approaches to address forest health issues that affect the sustainability of forest ecosystems. This report focuses on 18 States that have ground plots. Six forest health issues were identified by the FHM program in 1996 to evaluate forest health; forest ecosystem fragmentation, forest vitality, key ecosystem processes, plant biodiversity, soil conservation, and wildlife habitat.

  7. European Union health policy and its implications for national convergence.

    PubMed

    Cucic, S

    2000-06-01

    This paper explores the relevance for health care of European Union (EU) legislation, regulation and policies. Reports, communications and other materials of the European Commission and other relevant European bodies are screened for their implications for health care, primarily on the national health system level. The paper provides a brief overview of EU history and its main institutions, followed by an analysis of health (care)-related provisions in the EU's main legal documents--its treaties. The impact of the EU actions on health protection is considered with regard to both actions in the field of public health and health protection requirements in its policies. In the public health area, information systems that are now being developed are discussed, followed by an outline of health protection requirements in EU policies that can have an impact on health systems. These policies are then analysed using the political factions model. Finally an attempt is made to predict future developments, stressing the need for a far-reaching synchronization of national systems.

  8. Hospitals, finance, and health system reform in Britain and the United States, c. 1910-1950: historical revisionism and cross-national comparison.

    PubMed

    Gorsky, Martin

    2012-06-01

    Comparative histories of health system development have been variously influenced by the theoretical approaches of historical institutionalism, political pluralism, and labor mobilization. Britain and the United States have figured significantly in this literature because of their very different trajectories. This article explores the implications of recent research on hospital history in the two countries for existing historiographies, particularly the coming of the National Health Service in Britain. It argues that the two hospital systems initially developed in broadly similar ways, despite the very different outcomes in the 1940s. Thus, applying the conceptual tools used to explain the U.S. trajectory can deepen appreciation of events in Britain. Attention focuses particularly on working-class hospital contributory schemes and their implications for finance, governance, and participation; these are then compared with Blue Cross and U.S. hospital prepayment. While acknowledging the importance of path dependence in shaping attitudes of British bureaucrats toward these schemes, analysis emphasizes their failure in pressure group politics, in contrast to the United States. In both countries labor was also crucial, in the United States sustaining employment-based prepayment and in Britain broadly supporting system reform.

  9. Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

    2015-01-01

    Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

  10. 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

  11. Hungary health system review.

    PubMed

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

    2011-01-01

    Hungary has achieved a successful transition from an overly centralized, integrated Semashko-style health care system to a purchaser provider split model with output-based payment methods. Although there have been substantial increases in life expectancy in recent years among both men and women, many health outcomes remain poor, placing Hungary among the countries with the worst health status and highest rate of avoidable mortality in the EU (life expectancy at birth trailed the EU27 average by 5.1 years in 2009). Lifestyle factors especially the traditionally unhealthy Hungarian diet, alcohol consumption and smoking play a very important role in shaping the overall health of the population.In the single-payer system, the recurrent expenditure on health services is funded primarily through compulsory, non-risk-related contributions made by eligible individuals or from the state budget. The central government has almost exclusive power to formulate strategic direction and to issue and enforce regulations regarding health care. In 2009 Hungary spent 7.4% of its gross domestic product (GDP) on health, with public expenditure accounting for 69.7% of total health spending, and with health expenditure per capita ranking slightly above the average for the new EU Member States, but considerably below the average for the EU27 in 2008. Health spending has been unstable over the years, with several waves of increases followed by longer periods of cost-containment and budget cuts. The share of total health expenditure attributable to private sources has been increasing, most of it accounted for by out-of-pocket (OOP) expenses. A substantial share of the latter can be attributed to informal payments, which are a deeply rooted characteristic of the Hungarian health system and a source of inefficiency and inequity. Voluntary health insurance, on the other hand, amounted to only 7.4% of private and 2.7% of total health expenditure in 2009. Revenue sources for health have been

  12. Hungary health system review.

    PubMed

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

    2011-01-01

    Hungary has achieved a successful transition from an overly centralized, integrated Semashko-style health care system to a purchaser provider split model with output-based payment methods. Although there have been substantial increases in life expectancy in recent years among both men and women, many health outcomes remain poor, placing Hungary among the countries with the worst health status and highest rate of avoidable mortality in the EU (life expectancy at birth trailed the EU27 average by 5.1 years in 2009). Lifestyle factors especially the traditionally unhealthy Hungarian diet, alcohol consumption and smoking play a very important role in shaping the overall health of the population.In the single-payer system, the recurrent expenditure on health services is funded primarily through compulsory, non-risk-related contributions made by eligible individuals or from the state budget. The central government has almost exclusive power to formulate strategic direction and to issue and enforce regulations regarding health care. In 2009 Hungary spent 7.4% of its gross domestic product (GDP) on health, with public expenditure accounting for 69.7% of total health spending, and with health expenditure per capita ranking slightly above the average for the new EU Member States, but considerably below the average for the EU27 in 2008. Health spending has been unstable over the years, with several waves of increases followed by longer periods of cost-containment and budget cuts. The share of total health expenditure attributable to private sources has been increasing, most of it accounted for by out-of-pocket (OOP) expenses. A substantial share of the latter can be attributed to informal payments, which are a deeply rooted characteristic of the Hungarian health system and a source of inefficiency and inequity. Voluntary health insurance, on the other hand, amounted to only 7.4% of private and 2.7% of total health expenditure in 2009. Revenue sources for health have been

  13. 75 FR 52504 - Notice of Request for Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ... Information Collection; National Animal Health Monitoring System; Dairy Heifer Raiser 2010 Study AGENCY... National Animal Health Monitoring System Dairy Heifer Raiser 2010 Study. DATES: We will consider all... Health Monitoring System; Dairy Heifer Raiser 2010 Study. OMB Number: 0579-xxxx. Type of...

  14. Customer complaints in the National Health Service.

    PubMed

    Reid, N; Reid, R; Morris, D

    1995-11-01

    This paper addresses the role of consumer complaints in the flourishing quality assurance industry within the National Health Service (NHS), and considers the traditional ethos of complaints within the service. The advent of the internal market is considered as one of a range of factors which may change attitudes of NHS staff to complaints. In evaluating how complaints services might develop relevant literature is reviewed and recent national data on complaints procedures are cited. PMID:8548145

  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. [Transfer and sharing of public health knowledge: reflections on the components of a national information system in France].

    PubMed

    Cambon, Linda; Alla, François

    2013-01-01

    It is becoming increasingly necessary, in France, to develop a more efficient public health policy and define research in terms of the perspective of its use for public decisions and clinical practice. One possible solution consists of knowledge transfer and sharing based on a continuous exchange and interaction process between scientists and potential users of research data - field workers and health policy decision-makers. Such a process would involve collaboration with users to help them apply the evidence produced by research as well as the mobilization of research scientists to develop research more adapted to needs. This article defines the goals of development of knowledge transfer in the French setting. The conceptual bases are defined and four strategic axes and their operational modalities are developed. This proposal also integrates all of the public authorities concerned: promote knowledge transfer; reinforce observation and diffusion of evidence and its usability; promote the development of more adapted public health research by facilitating research scientist /research data user relationships; assist the various parties in the exchange and sharing of knowledge. Apart from improving the efficiency of health policies, the development of knowledge transfer and sharing would also strengthen the credibility of certain intervention strategies, especially in the field of prevention, by designing evidence-based strategies.

  17. 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

  18. 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

  19. Cost-Benefit Performance of Robotic Surgery Compared with Video-Assisted Thoracoscopic Surgery under the Japanese National Health Insurance System

    PubMed Central

    Barron, James Patrick; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2014-01-01

    Background: Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci® Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). Objective: To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. Methods: This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. Results: The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Conclusion: Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure. PMID:24835923

  20. Validation of the French national health insurance information system as a tool in vaccine safety assessment: application to febrile convulsions after pediatric measles/mumps/rubella immunization.

    PubMed

    Hanf, Matthieu; Quantin, Catherine; Farrington, Paddy; Benzenine, Eric; Hocine, N Mounia; Velten, Michel; Tubert-Bitter, Pascale; Escolano, Sylvie

    2013-12-01

    In the French national health insurance information system (SNIIR-AM), routine records of health claimed reimbursements are linked to hospital admissions for the whole French population. The main focus of this work is the usability of this system for vaccine safety assessment programme. Self-controlled case series analyses were performed using an exhaustive SNIIR-AM extraction of French children aged less than 3 years, to investigate the relationship between MMR immunization and children hospitalizations for febrile convulsions, a well-documented rare adverse event, over 2009-2010. The results suggest a significant increase of febrile convulsions during the 6-11 days period following any MMR immunization (IRR=1.49, 95% CI=1.22, 1.83; p=0.0001) and no increase 15-35 days post any MMR immunization (IRR=1.03, 95% CI=0.89, 1.18; p=0.72). These results are in accordance with other results obtained from large epidemiologic studies, which suggest the usability of the SNIIR-AM as a relevant database to study the occurrence of adverse events associated with immunization. For future use, results associated with risk of convulsion during the day of vaccination should nevertheless be considered with particular caution.

  1. National health data warehouse: issues to consider.

    PubMed

    Blewett, Lynn A; Parente, Stephen T; Finch, Michael D; Peterson, Eileen

    2004-01-01

    A national data warehouse that links public and private data could be used to monitor trends in healthcare costs, utilization, quality of care, and adherence to quality guidelines and changes in treatment protocols. The development of the data warehouse, however, would require overcoming a number of political and technical challenges to gain access to private insurance data. This article outlines recommendations from a national conference sponsored by the Agency for Healthcare Research and Quality (AHRQ) on the private sector's role in quality monitoring and provides an operational outline for the development of a national private sector health data warehouse.

  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. First Nations women's encounters with mainstream health care services.

    PubMed

    Browne, A J; Fiske, J A

    2001-03-01

    Health care encounters are important areas for study because they reflect social, political, economic, and ideological relations between patients and the dominant health care system. This study examines mainstream health care encounters from the viewpoint of First Nations women from a reserve community in northwestern Canada. Perspectives from critical medical anthropology and the concept of cultural safety provided the theoretical orientation for the study. Critical and feminist ethnographic approaches were used to guide in-depth interviews conducted with 10 First Nations women. Findings were organized around two broad themes that characterized women's descriptions of "invalidating" and "affirming" encounters. These narratives revealed that women's encounters were shaped by racism, discrimination, and structural inequities that continue to marginalize and disadvantage First Nations women. The women's health care experiences have historical, political, and economic significance and are reflective of wider postcolonial relations that shape their everyday lives.

  4. 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

  5. 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.

  6. Who killed the English National Health Service?

    PubMed

    Powell, Martin

    2015-05-01

    The death of the English National Health Service (NHS) has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.

  7. Who killed the English National Health Service?

    PubMed Central

    Powell, Martin

    2015-01-01

    The death of the English National Health Service (NHS) has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented. PMID:25905477

  8. 75 FR 44967 - National Institute for Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    ... HUMAN SERVICES National Institute for Occupational Safety and Health Designation of a Class of Employees..., Division of Compensation Analysis and Support, National Institute for Occupational Safety and Health (NIOSH... Occupational Safety and Health. BILLING CODE 4163-19-P...

  9. National Library of Medicine Guide to Finding Health Information

    MedlinePlus

    ... I Evaluate Information that I Find? MedlinePlus Evaluating Internet Health Information , National Library of Medicine Using Trusted Resources , NIH National Cancer Institute How to Evaluate Health Information on the Internet , NIH Office of Dietary Supplements Find Good Health ...

  10. 76 FR 11500 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities; Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special..., Scientific Review Officer, National Institute on Minority Health and Health Disparities, National...

  11. The public health infrastructure and our nation's health.

    PubMed

    Baker, Edward L; Potter, Margaret A; Jones, Deborah L; Mercer, Shawna L; Cioffi, Joan P; Green, Lawrence W; Halverson, Paul K; Lichtveld, Maureen Y; Fleming, David W

    2005-01-01

    Threats to Americans' health-including chronic disease, emerging infectious disease, and bioterrorism-are present and growing, and the public health system is responsible for addressing these challenges. Public health systems in the United States are built on an infrastructure of workforce, information systems, and organizational capacity; in each of these areas, however, serious deficits have been well documented. Here we draw on two 2003 Institute of Medicine reports and present evidence for current threats and the weakness of our public health infrastructure. We describe major initiatives to systematically assess, invest in, rebuild, and evaluate workforce competency, information systems, and organizational capacity through public policy making, practical initiatives, and practice-oriented research. These initiatives are based on applied science and a shared federal-state approach to public accountability. We conclude that a newly strengthened public health infrastructure must be sustained in the future through a balancing of the values inherent in the federal system.

  12. 77 FR 50139 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-20

    ... Health and Health Disparities. The meeting will be closed to the public in accordance with the provisions... privacy. Name of Committee: National Advisory Council on Minority Health and Health Disparities. Date...: National Institutes of Health and Health Disparities, National Institutes of Health, 6707 Democracy...

  13. 78 FR 46994 - Proposed Collection; 60-Day Comment Request: National Institute of Mental Health Recruitment and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ... Institute of Mental Health Recruitment and Milestone Reporting System Summary: In compliance with the... consideration. Proposed Collection: National Institute of Mental Health Recruitment Milestone Reporting System... of Information Collection: Recruitment Milestone Reporting (RMR) allows NIMH staff to monitor...

  14. Evidence from the national health account: the case of Dubai

    PubMed Central

    Hamidi, Samer

    2014-01-01

    Introduction National health accounts (NHAs) provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Economic Cooperation and Development (OECD) countries. Methods The author analyzed secondary data published in NHAs for Dubai and Qatar, and data collected by the OECD countries and publicly available from the Statistical Office of the European Union (Eurostat), for 25 OECD countries for comparative analysis. All health financing measures used are as defined in the international System of Health Accounts (SHA). Results In Dubai, only 33% of current health expenditure (CHE) is funded by the government. However, the public sector is the main source of health funding in Qatar and most OECD countries, with an average of 79% and 72%, respectively. Households in Dubai spent about 22% of CHE, equivalent to an average US$187 per capita, ranking the highest among Gulf Cooperation Council (GCC) countries, and compared with 20% of CHE across OECD countries. Hospitals in Dubai accounted for 48% of CHE, which is much higher than Qatar (40%) and the OECD average (36%). Conclusion The Dubai health care financing system differs substantially from that in OECD countries, as it is more private oriented. The findings point to several potential opportunities for growth and improvement. Policy areas that may be addressed using the information presented in this article are broad and include the following: shift from hospital care to ambulatory and day care, sustainability of health finance, shift the cost of health care to the private sector, introduce cost-containment measures, revise payment systems for health providers, and produce subnational accounts for non-communicable diseases. More investment in the translation of

  15. Structural health monitoring activities at National Laboratories

    SciTech Connect

    Farrar, C.R.; Doebling, S.W.; James, G.H.; Simmermacher, T.

    1997-09-01

    Sandia National Laboratories and Los Alamos National Laboratory have on-going programs to assess damage in structures and mechanical systems from changes in their dynamic characteristics. This paper provides a summary of how both institutes became involved with this technology, their experience in this field and the directions that their research in this area will be taking in the future.

  16. [Review: Patient safety as a national health goal: current state and essential fields of action for the German healthcare system].

    PubMed

    Hölscher, Uvo M; Gausmann, Peter; Haindl, Hans; Heidecke, Claus-Dieter; Hübner, Nils-Olaf; Lauer, Wolfgang; Lauterberg, Jörg; Skorning, Max; Thürmann, Petra A

    2014-01-01

    For some years patient safety has been an important topic for the design of the healthcare systems in many countries. In Germany we are still in the starting phase of this development. Here, patient safety is not a main focus for research and there is only little funding for these topics. Thus most findings on patient safety have been derived in foreign studies. Slowly, some find their way into the clinical routine in Germany. This paper summarises the state of development of patient safety from a trans-sectoral point of view and outlines essential fields of action for the German healthcare system. PMID:24602522

  17. Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

    PubMed

    Ballinger, Geoff

    2007-01-01

    The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

  18. 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

  19. 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

  20. Courting the idea of national health.

    PubMed

    Draper, J

    1980-02-22

    Compromise is the name of the game as America works towards a system of health insurance. In the run up to the presidential elections, John Draper looks at the current legislative proposals and their chances of survival in a country which has always shied away from 'socialised' health care. PMID:10245817

  1. [Access to medicines for Alzheimer's disease provided by the Brazilian Unified National Health System in Minas Gerais State, Brazil].

    PubMed

    Almeida-Brasil, Celline Cardoso; Costa, Juliana de Oliveira; Aguiar, Viviane Celestino Ferreira Dos Santos; Moreira, Daniela Pena; Moraes, Edgar Nunes de; Acurcio, Francisco de Assis; Guerra, Augusto Afonso; Álvares, Juliana

    2016-08-01

    This study evaluated barriers to access to treatment for Alzheimer's disease based on administrative cases involving cholinesterase inhibitors (ChEIs) and submitted to the Minas Gerais State Health Secretariat in Brazil in 2012 and 2013. Drawing on data from 165 randomly selected cases, the study addressed the following dimensions of access: geographic accessibility, accommodation, acceptability, availability, and affordability. The administrative processing to supply ChEIs took an average of 39 days and was influenced by characteristics of the path taken by the user. The majority of the prescribers met less than 80% of the required criteria in the Clinical Protocol and Therapeutic Guidelines (CPTG) for Alzheimer's disease. As a result, 38% of requests for medication were denied. Private treatment with ChEIs cost the equivalent of 21 days of the monthly minimum wage. In conclusion, bureaucratic administrative procedures and prescribers' difficulty in following the CPTG hindered access to treatment of Alzheimer's disease and imposed a heavy burden on patients' pockets. PMID:27505179

  2. The National Mental Health Registry (NMHR).

    PubMed

    Aziz, A A; Salina, A A; Abdul Kadir, A B; Badiah, Y; Cheah, Y C; Nor Hayati, A; Ruzanna, Z Z; Sharifah Suziah, S M; Chee, K Y

    2008-09-01

    The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports. PMID:19227671

  3. The National Mental Health Registry (NMHR).

    PubMed

    Aziz, A A; Salina, A A; Abdul Kadir, A B; Badiah, Y; Cheah, Y C; Nor Hayati, A; Ruzanna, Z Z; Sharifah Suziah, S M; Chee, K Y

    2008-09-01

    The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.

  4. [Patterns in the use of outpatient care in Brazil by patients treated through the Brazilian Unified National Health System, private health insurance, and out-of-pocket medical care].

    PubMed

    Dilélio, Alitéia Santiago; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Siqueira, Fernando Carlos Vinholes; Piccini, Roberto Xavier; Silva, Suele Manjourany; Nunes, Bruno Pereira; Facchini, Luiz Augusto

    2014-12-01

    Indicators of supply, access, and use of healthcare are helpful for characterizing services, planning activities, and organizing demand. This study describes patterns of use of outpatient care and the associations with demographic and socioeconomic factors, morbidity, population size of the municipality and region, and administrative and financial classification of the provider. This was a population-based cross-sectional study with a sample of 12,402 Brazilian adults from 20 to 59 years of age living in urban areas of 100 municipalities from five regions. Prevalence of outpatient care in the three months prior to the interview was 34.6%. The Brazilian Unified National Health System (SUS) accounted for more than half (53.6%) of the cases, health insurance was used by 34% of the sample, and out-of-pocket services 12.4%, regardless of region, population size, and morbidity profile. Patterns of use of health services remain socially determined, resulting from the supply, demographic and socioeconomic characteristics, and health profile of users.

  5. [Health on the borders: access to and demands on the Brazilian National Health System by foreigners and non-resident Brazilians in cities along the border with MERCOSUR countries from the perspective of municipal health secretaries].

    PubMed

    Giovanella, Ligia; Guimarães, Luisa; Nogueira, Vera Maria Ribeiro; Lobato, Lenaura de Vasconcelos Costa; Damacena, Giseli Nogueira

    2007-01-01

    In the context of forming common markets, border areas require special attention, since they anticipate the effects of integration processes. Along borders, different political, monetary, security, and social systems coexist; the intensification of flows resulting from integration raises challenges for the health systems, requiring specific policies focused on guaranteeing the right to health. This article presents the results of a study on the conditions for access to (and demands for) health services in the MERCOSUR border cities. A survey was performed with municipal health secretaries in the 69 Brazilian cities in the States of Rio Grande do Sul, Santa Catarina, Paraná, and Mato Grosso do Sul that border on the other MERCOSUR countries. The study attempted to identify the services demanded by the border population, mechanisms used for access, flows between services and systems, response strategies, and local agreements. Initiatives for cooperation between Brazilian and foreign local administrators were identified in nearly half of the municipalities and can orient the formulation of guidelines for border situations, allowing improvement in comprehensive access to health care.

  6. 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.

  7. 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.

  8. 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

  9. National health policy for traditional medicine in India.

    PubMed

    Srinivasan, P

    1995-01-01

    External pressures have combined to erode the practice of India's traditional medical systems to such an extent that they are in danger of becoming extinct. A better balanced national health policy could go a long way towards reversing this trend. PMID:7794464

  10. Consumers' Perspectives on National Health Insurance in South Africa: Using a Mobile Health Approach

    PubMed Central

    Stuttaford, Maria C

    2014-01-01

    Background Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services. Objective This research is based on a survey using Mxit as a mobile phone–based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care. Methods Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes. Results Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system’s governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI. Conclusions The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform. PMID:25351980

  11. National health expenditures projections through 2030

    PubMed Central

    Burner, Sally T.; Waldo, Daniel R.; McKusick, David R.

    1992-01-01

    If current laws and practices continue, health expenditures in the United States will reach $1.7 trillion by the year 2000, an amount equal to 18.1 percent of the Nation's gross domestic product (GDP). By the year 2030, as America's baby boomers enter their seventies and eighties, health spending will top $16 trillion, or 32 percent of GDP. The projections presented here incorporate the assumptions and conclusions of the Medicare trustees in their 1992 report to Congress on the status of Medicare, and the 1992 President's budget estimates of Medicaid outlays. PMID:10124432

  12. National Costs Of The Medical Liability System

    PubMed Central

    Mello, Michelle M.; Chandra, Amitabh; Gawande, Atul A.; Studdert, David M.

    2011-01-01

    Concerns about reducing the rate of growth of health expenditures have reignited interest in medical liability reforms and their potential to save money by reducing the practice of defensive medicine. It is not easy to estimate the costs of the medical liability system, however. This article identifies the various components of liability system costs, generates national estimates for each component, and discusses the level of evidence available to support the estimates. Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending. PMID:20820010

  13. [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.

  14. [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

  15. 75 FR 28262 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... Health Disparities. The meeting will be open to the public as indicated below, with attendance limited to... personal privacy. Name of Committee: National Advisory Council on Minority Health and Health...

  16. 76 FR 31618 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-01

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... Health Disparities. The meeting will be open to the public as indicated below, with attendance limited to... personal privacy. Name of Committee: National Advisory Council on Minority Health and Health...

  17. 75 FR 53975 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-02

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... Health Disparities. The meeting will be open to the public as indicated below, with attendance limited to... personal privacy. Name of Committee: National Advisory Council on Minority Health and Health...

  18. 75 FR 66114 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-27

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special Emphasis Panel; NCMHD Health Disparities Research on Minority and Underserved Population (R01)....

  19. 75 FR 12766 - National Center on Minority Health and Health Disparities; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special Emphasis Panel Loan Repayment Program for Health Disparities Research--Panel 2. Date: April 5, 2010....

  20. 76 FR 55075 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... Health Disparities. The meeting will be open to the public as indicated below, with attendance limited to... personal privacy. Name of Committee: National Advisory Council on Minority Health and Health...

  1. 76 FR 6808 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... Health Disparities. The meeting will be open to the public as indicated below, with attendance limited to... personal privacy. Name of Committee: National Advisory Council on Minority Health and Health...

  2. 75 FR 9421 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special Emphasis Panel; Loan Repayment Program for Health Disparities Research--Panel 1. Date: March 18, 2010....

  3. 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.

  4. Cross-national diffusion of mental health policy

    PubMed Central

    Shen, Gordon C

    2014-01-01

    Background: Following the tenets of world polity and innovation diffusion theories, I focus on the coercive and mimetic forces that influence the diffusion of mental health policy across nations. International organizations’ mandates influence government behavior. Dependency on external resources, namely foreign aid, also affects governments’ formulation of national policy. And finally, mounting adoption in a region alters the risk, benefits, and information associated with a given policy. Methods: I use post-war, discrete time data spanning 1950 to 2011 and describing 193 nations’ mental health systems to test these diffusion mechanisms. Results: I find that the adoption of mental health policy is highly clustered temporally and spatially. Results provide support that membership in the World Health Organization (WHO), interdependence with neighbors and peers in regional blocs, national income status, and migrant sub-population are responsible for isomorphism. Aid, however, is an insufficient determinant of mental health policy adoption. Conclusion: This study examines the extent to which mental, neurological, and substance use disorder are addressed in national and international contexts through the lens of policy diffusion theory. It also adds to policy dialogues about non-communicable diseases as nascent items on the global health agenda. PMID:25337601

  5. 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.

  6. 78 FR 9705 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-11

    ... advisory committees; and therefore, extends particular encouragement to nominations for appropriately... Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration, HHS... nominations to fill five (5) vacancies on the National Advisory Council (NAC) on the National Health...

  7. [Treatment of rheumatoid arthritis in the Brazilian Unified National Health System: expenditures on infliximab compared to synthetic disease-modifying anti-rheumatic drugs, 2003-2006].

    PubMed

    Costa, Juliana de Oliveira; Almeida, Alessandra Maciel; Guerra Jr, Augusto Afonso; Cherchiglia, Mariangela Leal; Andrade, Eli Iola Gurgel; Acurcio, Francisco de Assis

    2014-02-01

    This study aimed to characterize the profile of users and related expenses with infliximab and synthetic disease-modifying anti-rheumatic drugs (DMARD) for rheumatoid arthritis treatment in the Brazilian Unified National Health System (SUS). We constructed a cohort from 2003 to 2006 drawing on databases of the SUS Outpatient Information System. Analyses were stratified by clinical and socio-demographic characteristics. We calculated average monthly expenditure per individual follow-up year and the factors that influenced it. The cohort consisted of 26,228 patients, mostly female, between 40 and 59 years of age, living in the Southeast of Brazil, and diagnosed with Felty's syndrome. Medicines for rheumatoid arthritis totalized BRL 74,306,087.18, of which infliximab accounted for 70%. Median monthly per capita expenditure was BRL 3,466.03 for patients receiving infliximab compared to BRL 143.85 for patients treated with synthetic DMARD. Drug treatment for rheumatoid arthritis was the main expense in SUS, with high economic impact from infliximab. Sex, diagnosis, age, and region of residence were factors that influenced expenditures.

  8. Contribution of Primary Care to Health Systems and Health

    PubMed Central

    Starfield, Barbara; Shi, Leiyu; Macinko, James

    2005-01-01

    Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups. PMID:16202000

  9. Promoting health equity: WHO health inequality monitoring at global and national levels

    PubMed Central

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

    2015-01-01

    Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

  10. 78 FR 54477 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-04

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Initial Review Group Interventions Committee for... Extramural Activities, National Institute of Mental Health National Institutes of Health, 6001 Executive...

  11. 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.

  12. 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

  13. 76 FR 14673 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-17

    ... HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities; Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special... Review Officer, National Institute on Minority Health and Health Disparities, 6707 Democracy...

  14. 76 FR 11499 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities; Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special... Review Officer, National Institute on Minority Health and Health Disparities, 6707 Democracy...

  15. 76 FR 55078 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities; Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special..., Scientific Review Officer, National Institute on Minority Health and Health Disparities, 6707...

  16. 76 FR 57068 - National Center on Minority and Health Disparities Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special... Review Officer, National Institute on Minority Health, and Health Disparities, 6707 Democracy...

  17. National health insurance policy in Nepal: challenges for implementation.

    PubMed

    Mishra, Shiva Raj; Khanal, Pratik; Karki, Deepak Kumar; Kallestrup, Per; Enemark, Ulrika

    2015-01-01

    The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9%) and rural (59%) discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015), the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS) after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal. PMID:26300556

  18. National health insurance policy in Nepal: challenges for implementation.

    PubMed

    Mishra, Shiva Raj; Khanal, Pratik; Karki, Deepak Kumar; Kallestrup, Per; Enemark, Ulrika

    2015-01-01

    The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9%) and rural (59%) discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015), the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS) after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

  19. Croatia: health system review.

    PubMed

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

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  20. Croatia: health system review.

    PubMed

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

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  1. 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.

  2. 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.

  3. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

    PubMed Central

    2012-01-01

    Background While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery (< 2 days from admission) and in-hospital mortality, controlling for several confounding factors. Results Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%). However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not. PMID:22257790

  4. Health leadership and management competencies: a systemic approach.

    PubMed

    Holder, Reynaldo; Ramagem, Caroline

    2012-01-01

    The achievement of national and international health goals requires better-performing health systems. Strengthening leadership and management of health systems thus becomes essential for achieving greater efficiency and responsiveness, ultimately improving health outcomes. Building a global framework of core competencies for leadership and management needs to be approached with systems thinking and methodologies akin to complexity science that takes into account all components and levels of the health system and the possible interactions between them that influence outcomes. The results will have important policy implications for national health authorities seeking to strengthen management capacity and building transformational leadership in health systems.

  5. Prevention of cervical cancer in women with ASCUS in the Brazilian Unified National Health System: cost-effectiveness of the molecular biology method for HPV detection.

    PubMed

    Nomelini, Rosekeila Simões; Guimarães, Patrícia Dias Neto; Candido, Pamela Aparecida; Campos, Ana Cláudia Camargo; Michelin, Márcia Antoniazi; Murta, Eddie Fernando Candido

    2012-11-01

    This study aimed to assess the performance of PCR as a means of detecting HPV 16/18 compared to the single probe-based PCR for detecting high-risk HPV, and evaluate these methods for detecting cervical intraepithelial neoplasia (CIN) in follow-ups for ASCUS testing. It also compares the costs of cytology, PCR methods, colposcopy and biopsy in the Brazilian Unified National Health System. Of the 81 patients with ASCUS, 41 (50.6%) tested positive for HPV 16/18 in PCR testing and 47 (58.02%) tested positive for high-risk HPV with single probe-based PCR testing. The negative predictive value was 93.75% for HPV 16/18 PCR and 100% for single probe-based PCR in cases that progressed to high-grade CIN. The annual costs of patient referral were the following: R$2,144.52 for referral of patients with ASCUS cytology for colposcopy; R$6,307.44 for referral of patients with ASCUS cytology and PCR positive for HPV 16/18 or colposcopy; R$3,691.80 for referral of patients with ASCUS cytology with single probe-based PCR positive for high-risk HPV. Therefore, cost per user can be reduced by performing single probe-based PCR for high-risk HPV on patients with ASCUS.

  6. Prevalence of internal parasites in beef cows in the United States: Results of the National Animal Health Monitoring System's (NAHMS) beef study, 2007-2008.

    PubMed

    Stromberg, Bert E; Gasbarre, Louis C; Ballweber, Lora R; Dargatz, David A; Rodriguez, Judith M; Kopral, Christine A; Zarlenga, Dante S

    2015-10-01

    During the United States Department of Agriculture (USDA) National Animal Health Monitoring System's (NAHMS) 2007-2008 beef study, 567 producers from 24 US States were offered the opportunity to collect fecal samples from weaned beef calves and have them evaluated for the presence of parasite eggs (Phase 1). Participating producers were provided with instructions and materials for sample collection. Up to 20 fresh fecal samples were collected from each of the 99 participating operations. Fresh fecal samples were submitted to one of 3 randomly assigned laboratories for evaluation. Upon arrival at the laboratories, all samples were processed for the enumeration of strongyle, Nematodirus, and Trichuris eggs using the modified Wisconsin technique. The presence or absence of coccidian oocysts and tapeworm eggs was also noted. In submissions where the strongyle eggs per gram exceeded 30, aliquots from 2 to 6 animals were pooled for DNA extraction. Extracted DNA was subjected to genus level polymerase chain reaction (PCR) identification for the presence of Ostertagia, Cooperia, Haemonchus, Oesophagostomum, and Trichostrongylus. In this study, 85.6% of the samples had strongyle type, Nematodirus, and Trichuris eggs. Among the samples evaluated, 91% had Cooperia, 79% Ostertagia, 53% Haemonchus, 38% Oesophagostomum, 18% Nematodirus, 7% Trichuris, and 3% Trichostrongylus. The prevalence of coccidia and tapeworm eggs was 59.9% and 13.7%, respectively.

  7. Growing pains of East Timor: health of an infant nation.

    PubMed

    Morris, K

    2001-03-17

    In August, 1999, three-quarters of East Timorese adults voted to end more than two decades of an Indonesian administration never recognised by the United Nations. The ensuing spree of violence and destruction by militia backed by the Indonesian military meant the birth of the fledgling nation became a complex humanitarian disaster. 1 year on, progress was heartening: a transitional government, a judiciary, and tax systems were in place, and East Timor was a proud competitor in the Sydney Olympic games. Rebuilding a country from ground level has brought a golden opportunity for fresh approaches. However, reconstruction is also a slow, complex, and sometimes controversial process at the mercy of multiple agendas. The health sector has seen basic care restored, establishment of a much-needed public-health service, and planning for the future health system. An innovative partnership between WHO/Roll Back Malaria and Merlin for post-conflict research has provided data to guide malaria control. The story of progress from humanitarian emergency to national health plan epitomises the triumphs and challenges of this newest nations' first 18 months.

  8. Lessons from the first to the latest nation to enact national health insurance.

    PubMed

    Eastaugh, S R

    1992-01-01

    In 1989, South Korea became the latest country to enact a national health insurance plan. In 1989-91, South Korea experienced a 22 percent increase in health care spending despite instituting the world's highest level of cost-sharing and coinsurance. Now, taking a page from the lesson book of Germany--the first country to adopt a national insurance strategy--South Korea is applying a system of global budgeting that should produce an optimal amount of cost control while preserving consumer choice.

  9. 78 FR 55264 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National... Council on the National Health Service Corps (NHSC). DATES: Dates and Times: September 26, 2013, 2:00 p.m... National Health Service Corps role in the Affordable Care Act. The public can join the meeting via......

  10. 78 FR 65345 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Minority Health and Health... unwarranted invasion of personal privacy. Name of Committee: National Institute on Minority Health and...

  11. 77 FR 36564 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ..., National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd., Suite 800, Bethesda, MD... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Minority Health and...

  12. [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.

  13. [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

  14. Implementation and Integration of Regional Health Care Data Networks in the Hellenic National Health Service

    PubMed Central

    Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

    2002-01-01

    Background Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. Objectives To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. Methods The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. Results The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. Conclusions The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications. PMID:12554551

  15. 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.

  16. 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

  17. 78 FR 28711 - National Women's Health Week, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Documents#0;#0; ] Proclamation 8978 of May 10, 2013 National Women's Health Week, 2013 By the President of the United States of America A Proclamation Since our Nation's founding, women have given their all to..., advances in women's health and well-being have lagged behind. During National Women's Health Week,...

  18. Statement of National Environmental Health Assocation on Future National Health Legislation

    ERIC Educational Resources Information Center

    Pohlit, Nicholas; And Others

    1974-01-01

    This article concerns the need for more preventative health legislation to cutback increasing curative medical costs. Preventative action would provide better nutrition, better housing, and more effective controls on food, water, and solid wastes. Environmental health specialists would play a major role in the staffing of the new health systems.…

  19. Why it's time for a national health program in the United States.

    PubMed Central

    Waitzkin, H

    1989-01-01

    The United States lacks a coherent national health program. Current programs leave major gaps in coverage and recently have become more restrictive. Influential policies that have failed to correct crucial problems of the health-care system include competitive strategies, corporate intervention, and public-sector cutbacks with bureaucratic expansion. A national health program that combines elements of national health insurance and a national health service is a policy that would help solve current health-care problems. Previous proposals for national health insurance contained weaknesses that would need correction under a national program. Based on the experiences of other economically advanced countries, a national health program could provide universal entitlement to health care while controlling costs and improving the health-care system through structural reorganization. Current proposals for a national health program contain several basic principles dealing with the scope of services, copayments, financing, cost controls, physician and professional associations, personnel and distribution, prevention, and participation in policy making. Support for a national health program is growing rapidly. Such a program would help protect all people who live in this country from unnecessary illness, suffering, and early death. PMID:2735021

  20. An in-depth, exploratory assessment of the implementation of the National Health Information System at a district level hospital in Tanzania

    PubMed Central

    2014-01-01

    Background A well functioning Health Information System (HIS) is crucial for effective and efficient health service delivery. In Tanzania there is a national HIS called Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA). It comprises a guideline/manual, a series of registers for primary data collection and secondary data books where information from the registers is totalled or used for calculations. Methods A mix of qualitative methods were used. These included key informant interviews; staff interviews; participant observations; and a retrospective analysis of the hospital’s 2010 MTUHA reporting documents and the hospital’s development plan. Results All staff members acknowledged data collection as part of their job responsibilities. However, all had concerns about the accuracy of MTUHA data. Access to training was limited, mathematical capabilities often low, dissemination of MTUHA knowledge within the hospital poor, and a broad understanding of the HIS’s full capabilities lacking. Whilst data collection for routine services functioned reasonably well, filling of the secondary data tools was unsatisfactory. Internal inconsistencies between the different types of data tools were found. These included duplications, and the collection of data that was not further used. Sixteen of the total 72 forms (22.2%) that make up one of the key secondary data books (Hospital data/MTUHA book 2) could not be completed with the information collected in the primary data books. Moreover, the hospital made no use of any of the secondary data. The hospital’s main planning document was its development plan. Only 3 of the 22 indicators in this plan were the same as indicators in MTUHA, the information for 9 more was collected by the MTUHA system but figures had to be extracted and recalculated to fit, while for the remaining 10 indicators no use could be made of MTUHA at all. Conclusion The HIS in Tanzania is very extensive and it could be advisable to simplify it to the

  1. [Health in the post-2015 United Nations Development Agenda].

    PubMed

    Buss, Paulo Marchiori; Magalhães, Danielly de Paiva; Setti, Andréia Faraoni Freitas; Gallo, Edmundo; Franco Netto, Francisco de Abreu; Machado, Jorge Mesquita Huet; Buss, Daniel Forsin

    2014-12-01

    This paper evaluates health as a Sustainable Development Goal (SDG) in the context of the Post-2015 Development Agenda, between 2012 and 2014. Health was part of the debate since the Millennium Summit and the MDGs (2000), and it also appears in the documents discussing the Post-2015 Agenda, from the Rio+20 to the Open Working Group (OWG), whose report was submitted to the General Assembly of the United Nations (UNGA) 2014-2015, and in the Global Consultation on Health and the High-Level Panel of Eminent Persons reports. The Authors concluded that the treatment of health in all these documents is uniform. They point out that the scope of the health-related SDG is very comprehensive, but its targets are conceptually fragmented and reduced. They advocate their change as to include not only the idea of social determinants of health, but also targets in the field of public health, which were not included in the proposal of the OWG. They also warn that the global and national governance systems need to be reformed and advocate more participation of the civil society, which can influence diplomacy, which, in turn, will be responsible for the agreement signed at the UNGA in 2015.

  2. [Health in the post-2015 United Nations Development Agenda].

    PubMed

    Buss, Paulo Marchiori; Magalhães, Danielly de Paiva; Setti, Andréia Faraoni Freitas; Gallo, Edmundo; Franco Netto, Francisco de Abreu; Machado, Jorge Mesquita Huet; Buss, Daniel Forsin

    2014-12-01

    This paper evaluates health as a Sustainable Development Goal (SDG) in the context of the Post-2015 Development Agenda, between 2012 and 2014. Health was part of the debate since the Millennium Summit and the MDGs (2000), and it also appears in the documents discussing the Post-2015 Agenda, from the Rio+20 to the Open Working Group (OWG), whose report was submitted to the General Assembly of the United Nations (UNGA) 2014-2015, and in the Global Consultation on Health and the High-Level Panel of Eminent Persons reports. The Authors concluded that the treatment of health in all these documents is uniform. They point out that the scope of the health-related SDG is very comprehensive, but its targets are conceptually fragmented and reduced. They advocate their change as to include not only the idea of social determinants of health, but also targets in the field of public health, which were not included in the proposal of the OWG. They also warn that the global and national governance systems need to be reformed and advocate more participation of the civil society, which can influence diplomacy, which, in turn, will be responsible for the agreement signed at the UNGA in 2015. PMID:26247985

  3. 76 FR 34717 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel, National Cooperative Drug... Officer, Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience...

  4. 76 FR 82313 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Initial Review Group Interventions Committee for... Officer, Division of Extramural Activities, National Institute of Mental Health, National Institutes...

  5. 78 FR 54478 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-04

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Innovative Treatment... Officer, Division of Extramural Activities, National Institute of Mental Health, National Institutes...

  6. 75 FR 32959 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... Committee: National Institute of Mental Health Special Emphasis Panel, Mental Health Services--Member... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001 Executive...

  7. Ecological health in the Nation's streams

    USGS Publications Warehouse

    Carlisle, Daren M.; Woodside, Michael D.

    2013-01-01

    Aquatic biological communities, which are collections of organisms, are a direct measure of stream health because they indicate the ability of a stream to support life. This fact sheet highlights selected findings of a national assessment of stream health by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The assessment was unique in that it integrated the condition of three biological communities—algae, macroinvertebrates, and fish—as well as measures of streamflow modification, pesticides, nutrients, and other factors. At least one biological community was altered at 83 percent of assessed streams, and the occurrence of altered communities was highest in urban streams. Streamflows were modified at 86 percent of assessed streams, and increasing severity of streamflow modification was associated with increased occurrence of altered biological communities. Agricultural and urban land use in watersheds may contribute pesticides and nutrients to stream waters, and increasing concentrations of these chemicals were associated with increased occurrence of altered biological communities.

  8. Basic patterns in national health expenditure.

    PubMed Central

    Musgrove, Philip; Zeramdini, Riadh; Carrin, Guy

    2002-01-01

    Analysed in this paper are national health accounts estimates for 191 WHO Member States for 1997, using simple comparisons and linear regressions to describe spending on health and how it is financed. The data cover all sources - out-of-pocket spending, social insurance contributions, financing from government general revenues and voluntary and employment-related private insurance - classified according to their completeness and reliability. Total health spending rises from around 2-3% of gross domestic product (GDP) at low incomes (< 1000 US dollars per capita) to typically 8-9% at high incomes (> 7000 US dollars). Surprisingly, there is as much relative variation in the share for poor countries as for rich ones, and even more relative variation in amounts in US dollars. Poor countries and poor people that most need protection from financial catastrophe are the least protected by any form of prepayment or risk-sharing. At low incomes, out-of-pocket spending is high on average and varies from 20-80% of the total; at high incomes that share drops sharply and the variation narrows. Absolute out-of-pocket expenditure nonetheless increases with income. Public financing increases faster, and as a share of GDP, and converges at high incomes. Health takes an increasing share of total public expenditure as income rises, from 5-6% to around 10%. This is arguably the opposite of the relation between total health needs and need for public spending, for any given combination of services. Within public spending, there is no convergence in the type of finance - general revenue versus social insurance. Private insurance is usually insignificant except in some rich countries. PMID:11953792

  9. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    PubMed Central

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  10. 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.

  11. Utilization of health technologies-Do not look where there is a light; shine your light where there is a need to look! Relating national health goals with resource allocation decision-making; illustration through examining the Israeli healthcare system.

    PubMed

    Shavit, Oren

    2009-10-01

    Innovative health technologies are often the focus of attention. However, in the allocation of public resources for improving health, the focus should be on the health needs of the population. It is the need that should be analyzed first, and decision makers should then evaluate the full range of interventions available, whether new or old, to meet this need. This is in contrast to analyzing the technology first and then characterizing the need it meets, which is the current practice in reimbursement decision-making in several countries. The identified health need should define national health goals, and these goals should be proactively assimilated into the reimbursement decision-making process. Differential reimbursement rates could reflect the relative contribution of the technology to the unmet health need.

  12. 78 FR 20646 - National Committee on Vital and Health Statistics, Population Health Subcommittee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... HUMAN SERVICES National Committee on Vital and Health Statistics, Population Health Subcommittee... Statistics (NCVHS), Subcommittees on Population Health and Privacy, Confidentiality & Security. Time and Date... meeting is to provide an opportunity for the Population Health and Privacy, Confidentiality and...

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

    PubMed Central

    2014-01-01

    adopt the 2014 Luanda Commitment on UHC in Africa as their long-term vision and back it with sound policies and plans with clearly engrained road maps for strengthening national health systems and addressing the social determinants of health. PMID:25345988

  14. National health spending by medical condition, 1996-2005.

    PubMed

    Roehrig, Charles; Miller, George; Lake, Craig; Bryant, Jenny

    2009-01-01

    This study responds to recent calls for information about how personal health expenditures from the National Health Expenditure Accounts are distributed across medical conditions. It provides annual estimates from 1996 through 2005 for thirty-two conditions mapped into thirteen all-inclusive diagnostic categories. Circulatory system spending was highest among the diagnostic categories, accounting for 17 percent of spending in 2005. The most costly conditions were mental disorders and heart conditions. Spending growth rates were lowest for lung cancer, chronic obstructive pulmonary disease, pneumonia, coronary heart disease, and stroke, perhaps reflecting benefits of preventive care.

  15. A New Collaborative Tool for Visually Understanding National Health Indicators

    SciTech Connect

    Xu, Songhua; Jewell, Brian C; Steed, Chad A; Schryver, Jack C

    2012-01-01

    The authors propose a new online collaborative tool for visually understanding national health indicators, which facilitates the full spectrum of investigation of indicators, from an overview of all the correlation coefficients between variables, to investigation of subsets of selected variables, and to individual data element analysis. this tool is publicly accessible at http://cda.ornl.gov/heat/heatmap.html. In this paper, they discuss the key issues regarding the interface design and implementation. They also illustrate how to use their interface for analyzing the health indicator dataset by showing some key system views. In the end, they introduce and discuss some ongoing research efforts extending this work.

  16. 76 FR 81515 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Dates and Times: January 19, 2012: 8:30 a.m.-4:30...

  17. 76 FR 29769 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-23

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Dates and Times: June 22, 2011-8:30 a.m.-4:30...

  18. 75 FR 36427 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Date and Time: August 4, 2010, 9 a.m.-4 p.m....

  19. 77 FR 73473 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Dates And Time: January 10, 2013--9:30 a.m.--4:45...

  20. 75 FR 21005 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-22

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Dates and Times: May 20, 2010, 2 p.m.-5:15 p.m.;...

  1. 76 FR 3639 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-20

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Dates and Times: February 10, 2011--1 p.m.-4...

  2. 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

  3. Promotion, Prevention and Early Intervention for Mental Health: National Consultation.

    ERIC Educational Resources Information Center

    2003

    This report provides a description of a national consultation that was undertaken in 2001-2002 to provide feedback on two companion national policy documents: "National Action Plan for Promotion, Prevention and Early Intervention for Mental Health 2000" and "Promotion, Prevention and Early Intervention for Mental Health: A Monograph," and to…

  4. 75 FR 25259 - National Health Care Workforce Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... OFFICE National Health Care Workforce Commission AGENCY: Government Accountability Office (GAO). ACTION... Comptroller General of the United States responsibility for appointing 15 members to the National Health Care...: Nominations can be submitted by either of the following: E- mail: HCWorkforce@gao.gov . Mail: GAO Health...

  5. Evaluation of the National School Health Coordinator Leadership Institute

    ERIC Educational Resources Information Center

    Ottoson, Judith M.; Streib, Greg; Thomas, John Clayton; Rivera, Mark; Stevenson, Beth

    2004-01-01

    In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training…

  6. 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

  7. Mental health surveillance and information systems.

    PubMed

    Gater, R; Chisholm, D; Dowrick, C

    2015-07-01

    Routine information systems for mental health in many Eastern Mediterranean Region countries are rudimentary or absent, making it difficult to understand the needs of local populations and to plan accordingly. Key components for mental health surveillance and information systems are: national commitment and leadership to ensure that relevant high quality information is collected and reported; a minimum data set of key mental health indicators; intersectoral collaboration with appropriate data sharing; routine data collection supplemented with periodic surveys; quality control and confidentiality; and technology and skills to support data collection, sharing and dissemination. Priority strategic interventions include: (1) periodically assessing and reporting the mental health resources and capacities available using standardized methodologies; (2) routine collection of information and reporting on service availability, coverage and continuity, for priority mental disorders disaggregated by age, sex and diagnosis; and (3) mandatory recording and reporting of suicides at the national level (using relevant ICD codes). PMID:26442892

  8. The British National Health Service: a tarnished moral vision?

    PubMed

    Doyal, L; Doyal, L

    1999-01-01

    Last year (1998) saw the celebration of the 50th Anniversary of the British National Health Service (NHS). One of the few completely nationalized systems of health care in the world, the NHS is seen by many as a moral beacon of what it means to provide equitable medical treatment to all citizens on the basis of need and need alone. However, others argue that it has failed to achieve the overall goals for which it was created. Because of scarce resources, some urgently needed care is not available at all, while that which is received is sometimes second class. For these reasons, it is claimed that the NHS should be scrapped and replaced by other systems of health care delivery. This paper outlines the history of the NHS, indicating some of the problems and innovations which have led to its current organization and structure. The philosophical foundations of the NHS are then articulated and defended on the grounds that it still represents a morally coherent and economically efficient approach to the delivery of health care. Scarce resources are the key problem facing the NHS, making rationing inevitable and it is shown that this is not incompatible with the moral foundations of the service. However, there can be little doubt that the NHS is now becoming dangerously under-funded. The paper concludes with arguments about why this is so and what might be done about it.

  9. 76 FR 51380 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... Committee: National Institute of Mental Health Initial Review Group, Interventions Committee for Adult... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Initial Review Group, Interventions Committee...

  10. 76 FR 58285 - National Institute of Mental Health Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-20

    ... Mental Health Special Emphasis Panel; National Research Service Award Institutional Research Training... HUMAN SERVICES National Institutes of Health National Institute of Mental Health Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Conte Centers for Basic...

  11. 78 FR 18359 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis....nih.gov . Name of Committee: National Institute of Environmental Health Sciences Special...

  12. 78 FR 59944 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, National Institute of Environmental Health...

  13. 77 FR 60448 - National Institute of Environmental Health Sciences Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences Notice... and projects conducted by the National Institute of Environmental Health Sciences, including...:50 a.m. Agenda: Scientific Presentations Place: National Institute of Environmental Health...

  14. 78 FR 64221 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. ] Name of Committee: National Institute of Environmental Health Sciences Special Emphasis...: To review and evaluate grant applications. Place: National Institute of Environmental Health...

  15. 77 FR 16844 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... . Name of Committee: National Institute of Environmental Health Sciences Special Emphasis Panel;...

  16. 78 FR 32672 - National Institute of Environmental Health Sciences (NIEHS); Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences (NIEHS... that the National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research... Division. Organizing Institute: National Institute of Environmental Health Sciences. Dates and Times:...

  17. 76 FR 34717 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel, NIH Pathway to Independence..., Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center,...

  18. 75 FR 8372 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-24

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel, HIV AIDS Training. Date... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001...

  19. 75 FR 68612 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Dissertations. Date... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001...

  20. 76 FR 11801 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Behavioral Mechanisms In..., Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center,...

  1. 77 FR 11139 - National Institute of Mental Health Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Fellowships and..., Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center,...

  2. 75 FR 10492 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; HIV/AIDS Interventions... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001...

  3. 76 FR 4122 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Adolescent OCD Treatment... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001 Executive...

  4. 75 FR 40844 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... Committee: National Institute of Mental Health Special Emphasis Panel, HIV/AIDS Intervention Development... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001 Executive...

  5. [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

  6. Health services system for seafarers and fishermen in Iran.

    PubMed

    Ali Hasanzadeh, Mohammad; Azizabadi, Ebrahim; Allah Alipour, Nosrat

    2005-01-01

    The maritime health services system is presented in this review article. The national Iranian shipping line IRISL owns the largest commercial fleet in the Middle East and it operates 137 ships. This company and several other national shipping companies employ over 5900 seafarers. There are 11,000 fishing ships and boats and the number of Iranian fishermen reaches 124,000. Seafarers and fishermen are regularly medically examined and issued health certificates, according to the national regulations. The health services system for them is linked to the port authorities throughout the country. Observations, data and relevant statistics on the health problems of the national maritime workers have been regularly collected. PMID:16532596

  7. [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.

  8. National Retail Data Monitor for public health surveillance.

    PubMed

    Wagner, Michael M; Tsui, F C; Espino, J; Hogan, W; Hutman, J; Hersh, J; Neill, D; Moore, A; Parks, G; Lewis, C; Aller, R

    2004-09-24

    The National Retail Data Monitor (NRDM) is a public health surveillance tool that collects and analyzes daily sales data for over-the-counter (OTC) health-care products. NRDM collects sales data for selected OTC health-care products in near real time from >15,000 retail stores and makes them available to public health officials. NRDM is one of the first examples of a national data utility for public health surveillance that collects, redistributes, and analyzes daily sales-volume data of selected health-care products, thereby reducing the effort for both data providers and health departments.

  9. 75 FR 45133 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Development in the Environmental Health Sciences; 93.113, Biological Response to Environmental Health...

  10. 76 FR 28795 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities; Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities Special... and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, (301)...

  11. 75 FR 67379 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... of Committee: National Institute of Mental Health Special Emphasis Panel, Mental Health Disparities... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of...

  12. Racism, the National Health Service, and the health of black people.

    PubMed

    Kushnick, L

    1988-01-01

    Racism has been and is central to an understanding of the health of black people in Britain. Black people have played and are playing a central role in the National Health Service (NHS). Their role is, however, shaped by racism. Their experiences as consumers of the NHS are also shaped by racism--in terms of their treatment for both physical and mental health problems. In addition, their specific health problems such as sickle cell anemia have not received the attention they deserve. The NHS has become part of the internal control system of the British racist immigration system. The cuts in the NHS, and in other areas of the welfare state, since 1979 have created the conditions for increasing racial conflict on the one hand and for interracial class-based resistance on the other.

  13. Economic growth and health progress in Italy: 30 years of National Health Service.

    PubMed

    Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi

    2012-01-01

    On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations. PMID:23223322

  14. Economic growth and health progress in Italy: 30 years of National Health Service.

    PubMed

    Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi

    2012-01-01

    On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations.

  15. Do interoperable national information systems enhance availability of data to assess the effect of scale-up of HIV services on health workforce deployment in resource-limited countries?

    PubMed

    Oluoch, Tom; Muturi, David; Kiriinya, Rose; Waruru, Anthony; Lanyo, Kevin; Nguni, Robert; Ojwang, James; Waters, Keith P; Richards, Janise

    2015-01-01

    Sub-Saharan Africa (SSA) bears the heaviest burden of the HIV epidemic. Health workers play a critical role in the scale-up of HIV programs. SSA also has the weakest information and communication technology (ICT) infrastructure globally. Implementing interoperable national health information systems (HIS) is a challenge, even in developed countries. Countries in resource-limited settings have yet to demonstrate that interoperable systems can be achieved, and can improve quality of healthcare through enhanced data availability and use in the deployment of the health workforce. We established interoperable HIS integrating a Master Facility List (MFL), District Health Information Software (DHIS2), and Human Resources Information Systems (HRIS) through application programmers interfaces (API). We abstracted data on HIV care, health workers deployment, and health facilities geo-coordinates. Over 95% of data elements were exchanged between the MFL-DHIS and HRIS-DHIS. The correlation between the number of HIV-positive clients and nurses and clinical officers in 2013 was R2=0.251 and R2=0.261 respectively. Wrong MFL codes, data type mis-match and hyphens in legacy data were key causes of data transmission errors. Lack of information exchange standards for aggregate data made programming time-consuming.

  16. Do interoperable national information systems enhance availability of data to assess the effect of scale-up of HIV services on health workforce deployment in resource-limited countries?

    PubMed

    Oluoch, Tom; Muturi, David; Kiriinya, Rose; Waruru, Anthony; Lanyo, Kevin; Nguni, Robert; Ojwang, James; Waters, Keith P; Richards, Janise

    2015-01-01

    Sub-Saharan Africa (SSA) bears the heaviest burden of the HIV epidemic. Health workers play a critical role in the scale-up of HIV programs. SSA also has the weakest information and communication technology (ICT) infrastructure globally. Implementing interoperable national health information systems (HIS) is a challenge, even in developed countries. Countries in resource-limited settings have yet to demonstrate that interoperable systems can be achieved, and can improve quality of healthcare through enhanced data availability and use in the deployment of the health workforce. We established interoperable HIS integrating a Master Facility List (MFL), District Health Information Software (DHIS2), and Human Resources Information Systems (HRIS) through application programmers interfaces (API). We abstracted data on HIV care, health workers deployment, and health facilities geo-coordinates. Over 95% of data elements were exchanged between the MFL-DHIS and HRIS-DHIS. The correlation between the number of HIV-positive clients and nurses and clinical officers in 2013 was R2=0.251 and R2=0.261 respectively. Wrong MFL codes, data type mis-match and hyphens in legacy data were key causes of data transmission errors. Lack of information exchange standards for aggregate data made programming time-consuming. PMID:26262137

  17. Improving Health Care: National Policy and Local Practice

    PubMed Central

    Roper, William L.

    2008-01-01

    1Attention to quality and patient safety in health care has grown substantially over recent years. From 1982, I have been involved in advocating for efforts to improve quality and safety. Four years ago, I was given the opportunity to lead an academic health system - hospitals, doctors, and a medical school. This article recounts the shift in perspective, from a focus solely on national policy, to one now of changing local practice. Both are important and needed. The past 25 years have seen a large scale shift in the way the public at large and especially the medical community view the state of quality and safety in health care. I have been privileged to participate in this transformation at the national level in several roles, and I would like to describe that evolution. Now, however, I have the job of leading an academic medical enterprise, and am challenged by the task of putting lofty national ideas into practice at the local level. I am very committed to this effort, but am sobered by the challenges we face. PMID:18596859

  18. National seismic system science plan

    SciTech Connect

    Heaton, T.H.; Anderson, D.L.; Arabasz, W.J.; Buland, R.; Ellsworth, W.L.; Hartzell, S.H.; Lay, T.; Spudich, P.

    1989-01-01

    Recent developments in digital communication and seismometry enable scientists to propose revolutionary new ways to reduce vulnerability from earthquakes, volcanoes, and tsunamis, to understand such phenomena, and to study the basic structure and dynamics of the Earth. This document briefly describes new ways that critical problems can be addressed using modern digital seismic networks, provides an overview of existing seismic networks, and suggests ways to integrate them into a National Seismic System. Such a system might significantly reduce societal risk from earthquake losses and open new areas of fundamental basic research.

  19. 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

  20. 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.

  1. 77 FR 61611 - National Institute on Minority Health and Health Disparities; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ... Disparities Special Emphasis Panel; NIMHD Social, Behavioral, Health Services, and Policy Research on Minority Health and Health Disparities (R01). Date: November 7-9, 2012. Time: 8 a.m. to 3 p.m. Agenda: To review... Minority Health and Health ] Disparities, National Institutes of Health, 6707 Democracy Blvd., Suite...

  2. 78 FR 10621 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Minority Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act,...

  3. 77 FR 66623 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... and Eliminating Health Disparities: Dissemination Phase (R24). Date: December 17-18, 2012. Time: 8:00... Review Officer, National Institute on Minority Health and Health Disparities, National Institutes of... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

  4. 76 FR 40733 - National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program Science/Technical Advisory Committee...

  5. Design of the national health security preparedness index.

    PubMed

    Uzun Jacobson, Evin; Inglesby, Tom; Khan, Ali S; Rajotte, James C; Burhans, Robert L; Slemp, Catherine C; Links, Jonathan M

    2014-01-01

    The importance of health security in the United States has been highlighted by recent emergencies such as the H1N1 influenza pandemic, Superstorm Sandy, and the Boston Marathon bombing. The nation's health security remains a high priority today, with federal, state, territorial, tribal, and local governments, as well as nongovernment organizations and the private sector, engaging in activities that prevent, protect, mitigate, respond to, and recover from health threats. The Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (OPHPR), led an effort to create an annual measure of health security preparedness at the national level. The collaborative released the National Health Security Preparedness Index (NHSPI(™)) in December 2013 and provided composite results for the 50 states and for the nation as a whole. The Index results represent current levels of health security preparedness in a consistent format and provide actionable information to drive decision making for continuous improvement of the nation's health security. The overall 2013 National Index result was 7.2 on the reported base-10 scale, with areas of greater strength in the domains of health surveillance, incident and information management, and countermeasure management. The strength of the Index relies on the interdependencies of the many elements in health security preparedness, making the sum greater than its parts. Moving forward, additional health security-related disciplines and measures will be included alongside continued validation efforts.

  6. Informatics at the National Institues of Health

    PubMed Central

    Hendee, William R.

    1999-01-01

    Biomedical informatics, imaging, and engineering are major forces driving the knowledge revolutions that are shaping the agendas for biomedical research and clinical medicine in the 21st century. These disciplines produce the tools and techniques to advance biomedical research, and continually feed new technologies and procedures into clinical medicine. To sustain this force, an increased investment is needed in the physics, biomedical science, engineering, mathematics, information science, and computer science undergirding biomedical informatics, engineering, and imaging. This investment should be made primarily through the National Institutes of Health (NIH). However, the NIH is not structured to support such disciplines as biomedical informatics, engineering, and imaging that cross boundaries between disease- and organ-oriented institutes. The solution to this dilemma is the creation of a new institute or center at the NIH devoted to biomedical imaging, engineering, and informatics. Bills are being introduced into the 106th Congress to authorize such an entity. The pathway is long and arduous, from the introduction of bills in the House and Senate to the realization of new opportunities for biomedical informatics, engineering, and imaging at the NIH. There are many opportunities for medical informaticians to contribute to this realization. PMID:10428000

  7. Coverage of genetic technologies under national health reform.

    PubMed Central

    Mehlman, M. J.; Botkin, J. R.; Scarrow, A.; Woodhall, A.; Kass, J.; Siebenschuh, E.

    1994-01-01

    This article examines the extent to which the technologies expected to emerge from genetic research are likely to be covered under Government-mandated health insurance programs such as those being proposed by advocates of national health reform. Genetic technologies are divided into three broad categories; genetic information services, including screening, testing, and counseling; experimental technologies; and gene therapy. This article concludes that coverage of these technologies under national health reform is uncertain. The basic benefits packages provided for in the major health reform plans are likely to provide partial coverage of experimental technologies; relatively broad coverage of information services; and varying coverage of gene therapies, on the basis of an evaluation of their costs, benefits, and the degree to which they raise objections on political and religious grounds. Genetic services that are not included in the basic benefits package will be available only to those who can purchase supplemental insurance or to those who can purchase the services with personal funds. The resulting multitiered system of access to genetic services raises serious questions of fairness. PMID:7977343

  8. Small Business Grants at the National Cancer Institute and National Institutes of Health

    NASA Astrophysics Data System (ADS)

    Baker, Houston

    2002-10-01

    Ten Federal Agencies set aside 2.5% of their external research budget for US small businesses—mainly for technology research and development, including radiation sensor system developments. Five agencies also set aside another 0.15% for the Small Business Technology Transfer Program, which is intended to facilitate technology transfers from research laboratories to public use through small businesses. The second largest of these agencies is the Department of Health and Human Services, and almost all of its extramural research funds flow through the 28 Institutes and Centers of the National Institutes of Health. For information, instructions, and application forms, visit the NIH website's Omnibus Solicitation for SBIR and STTR applications. The National Cancer Institute is the largest NIH research unit and SBIR/STTR participant. NCI also issues SBIR and STTR Program Announcements of its own that feature details modified to better support its initiatives and objectives in cancer prevention, detection, diagnosis, treatment, and monitoring.

  9. A spatial national health facility database for public health sector planning in Kenya in 2008

    PubMed Central

    Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

    2009-01-01

    Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning

  10. [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.

  11. [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

  12. A Case Analysis of INFOMED: The Cuban National Health Care Telecommunications Network and Portal

    PubMed Central

    2006-01-01

    Background The Internet and telecommunications technologies contribute to national health care system infrastructures and extend global health care services markets. The Cuban national health care system offers a model to show how a national information portal can contribute to system integration, including research, education, and service delivery as well as international trade in products and services. Objective The objectives of this paper are (1) to present the context of the Cuban national health care system since the revolution in 1959, (2) to identify virtual institutional infrastructures of the system associated with the Cuban National Health Care Telecommunications Network and Portal (INFOMED), and (3) to show how they contribute to Cuban trade in international health care service markets. Methods Qualitative case research methods were used to identify the integrated virtual infrastructure of INFOMED and to show how it reflects socialist ideology. Virtual institutional infrastructures include electronic medical and information services and the structure of national networks linking such services. Results Analysis of INFOMED infrastructures shows integration of health care information, research, and education as well as the interface between Cuban national information networks and the global Internet. System control mechanisms include horizontal integration and coordination through virtual institutions linked through INFOMED, and vertical control through the Ministry of Public Health and the government hierarchy. Telecommunications technology serves as a foundation for a dual market structure differentiating domestic services from international trade. Conclusions INFOMED is a model of interest for integrating health care information, research, education, and services. The virtual infrastructures linked through INFOMED support the diffusion of Cuban health care products and services in global markets. Transferability of this model is contingent upon ideology

  13. Mental Health under National Health Care Reform: The Empirical Foundations.

    ERIC Educational Resources Information Center

    Hudson, Christopher G.; DeVito, Jo Anne

    1994-01-01

    Reviews research pertinent to mental health services under health care reform proposals. Examines redistributional impact of inclusion of outpatient mental health benefits, optimal benefit packages, and findings that mental health services lower medical utilization costs. Argues that extending minimalist model of time-limited benefits to national…

  14. 75 FR 48853 - National Health Center Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... of the United States of America the two hundred and thirty-fifth. (Presidential Sig.) [FR Doc. 2010... Proclamation 8545--National Health Center Week, 2010 #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal...;The President ] Proclamation 8545 of August 5, 2010 National Health Center Week, 2010 By the...

  15. 77 FR 58297 - National Farm Safety and Health Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... hundred and thirty- seventh. (Presidential Sig.) [FR Doc. 2012-23299 Filed 9-18-12; 11:15 am] Billing code... Documents#0;#0; ] Proclamation 8865 of September 14, 2012 National Farm Safety and Health Week, 2012 By the.... During National Farm Safety and Health Week, we celebrate agricultural workers' vital contributions...

  16. 75 FR 58281 - National Farm Safety and Health Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ...-fifth. (Presidential Sig.) [FR Doc. 2010-24096 Filed 9-22-10; 11:15 am] Billing code 3195-W0-P ... Documents#0;#0; ] Proclamation 8565 of September 17, 2010 National Farm Safety and Health Week, 2010 By the... around the globe. As we celebrate National Farm Safety and Health Week, we recognize the...

  17. 76 FR 27597 - National Women's Health Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... of America the two hundred and thirty-fifth. (Presidential Sig.) [FR Doc. 2011-11748 Filed 5-10-11... May 11, 2011 Part V The President Proclamation 8670--National Women's Health Week, 2011 Proclamation... ] Proclamation 8670 of May 6, 2011 National Women's Health Week, 2011 By the President of the United States...

  18. 76 FR 57615 - National Health Information Technology Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... the United States of America the two hundred and thirty-sixth. (Presidential Sig.) [FR Doc. 2011-23924... September 15, 2011 Part IV The President Proclamation 8711--National Health Information Technology Week... September 12, 2011 National Health Information Technology Week, 2011 By the President of the United...

  19. 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

  20. 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

  1. 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 ...

  2. Ghana's National Health Insurance Scheme: insights from members, administrators and health care providers.

    PubMed

    Barimah, Kofi Bobi; Mensah, Joseph

    2013-08-01

    The Ghana National Health Insurance Scheme (NHIS) was established as part of a poverty reduction strategy to make health care more affordable to Ghanaians. It is envisaged that it will eventually replace the existing cash-and-carry system. This paper examines the views of NHIS administrators, members/enrollees, and health care providers on how the Scheme operates in practice. It is part of a larger evaluation project on Ghana's NHIS, sponsored by the Bill and Melinda Gates Foundation and the Global Development Network as part of a two-year global research. We rely primarily on qualitative data from focus group discussion in the Brong Ahafo and the Upper East regions respectively. Our findings suggest that the NHIS has improved access to affordable health care services and prescription drugs to many people in Ghana. However, there are concerns about fraud and corruption that must be addressed if the Scheme is to be financially viable.

  3. The military health system's personal health record pilot with Microsoft HealthVault and Google Health

    PubMed Central

    Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

    2011-01-01

    Objective To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. Materials and methods A pilot project was conducted in 2008–2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. Results The pilot project included 250 beneficiary users. Approximately 73.2% of users were <65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n=60) satisfied with convenience of record access and 91.7% (n=55) satisfied with overall functionality of PHR. Discussion Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Conclusion Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability. PMID:21292705

  4. 77 FR 11557 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... adequately represented on advisory committees; and therefore, extends particular encouragement to nominations... Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration... Administration (HRSA) is requesting nominations to fill five vacancies on the National Advisory Council (NAC)...

  5. Objectives for the nation: occupational safety and health

    SciTech Connect

    Not Available

    1980-01-01

    Fifteen priority areas were identified in the 1979 Surgeon General's report pertaining to improving health in America, for which objectives were then established. Specific to the problem of occupational safety and health was modification of working conditions where individuals were exposed to toxic chemicals, harmful fibrous dusts, coal dust, cotton fiber, ionizing radiation, physical hazards, excessive noise and stress, and routinized trivial tasks. Various health problems associated with these tasks included lung cancer and other cancers, heart disease, birth defects, sensory deficits, injuries, and psychological problems. Prevention/promotion measures included potential measures aimed at worker education and development of occupational health and safety systems, service measures for preventive and treatment services, technological measures (engineering, control technology, and measurement methods), legislative and regulatory measures, and economic measures. Use of specific measures differed for different problems. Specific objectives for no later than 1990, including improving health status, reducing risk factors, improving public and professional awareness, improving services and protection, and improving surveillance and evaluation were described. Data sources at national and state or local levels were provided.

  6. National Health Insurance Development in China from 2004 to 2011: Coverage versus Benefits

    PubMed Central

    Zhang, Xiang; Zhang, Yaoguang; Zhang, Liang

    2015-01-01

    Background The simultaneous improvement of the security capability of China Health Insurance System and its development in the last decade remains uncertain. This study measures the status and trends of reimbursement levels of the China Health Insurance System, as well as to offer policy advice to subsequent insurance reforms. Methods The National Reimbursement Ratio was created to determine the reimbursement level of the national health insurance system based on total health expenditure and the covered population. Chinese total health expenditure data from 2004 to 2011 were extracted from China’s Health Statistics according to the standards of the International Classification for Health Accounts by Healthcare Financing. Results In 2011, the medical expenditure per capita in China was USD 130.95 and the National Reimbursement Ratio was 26.39%. The National Reimbursement Ratio showed an intense transition from 2004 to 2011, with a sharp decrease from 98.51% in 2004 to 22.44% in 2009, and then a small increase to 26.39% in 2011. Conclusion The National Reimbursement Ratio was effective in revealing the reimbursement level of the national health insurance system and in predicting its trends. The challenge to China’s healthcare reform is to switch from increasing insurance coverage to guaranteeing a steady increase in government input and building a powerful supervision mechanism. PMID:26020248

  7. The effects of Taiwan's National Health Insurance on access and health status of the elderly.

    PubMed

    Chen, Likwang; Yip, Winnie; Chang, Ming-Cheng; Lin, Hui-Sheng; Lee, Shyh-Dye; Chiu, Ya-Ling; Lin, Yu-Hsuan

    2007-03-01

    The primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference-in-difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low- or middle-income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self-perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self-perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI. PMID:16929478

  8. PERSONAL HEALTH BUDGETS IN ENGLAND: MOOD MUSIC OR DEATH KNELL FOR THE NATIONAL HEALTH SERVICE?

    PubMed

    Scott-Samuel, Alex

    2015-01-01

    Personal health budgets in England are National Health Service (NHS) funds that can be allocated to certain groups of patients to allow them, together with their NHS support staff, to purchase services or equipment that they believe will enhance their health and well-being. Some see this as a welcome personalization of health care that increases people's control over their health. However, personal health budgets are being introduced at a time when rapid privatization of the English NHS is taking place and when restrictions are being placed on people's access to health care. As a result, many view their introduction as a diversionary gimmick designed to help pave the way for the conversion of the NHS into the insurance-based system, which many believe is the intention of the U.K. government. This article describes the research and policy context in which this controversial intervention is being introduced and presents recent expert debate between proponents and opponents of personal health budgets, from e-mail discussion lists. PMID:26460448

  9. Towards best practice in national health workforce planning.

    PubMed

    McCarty, Maureen V; Fenech, Bethany J

    2013-09-01

    Health Workforce Australia (HWA) was established by the Council of Australian Governments through its 2008 National Partnership Agreement on Hospital and Health Workforce Reform, as the national agency to progress health workforce reform and address the challenges of providing a skilled, innovative and flexible health workforce in Australia. The Australian Health Ministers' Conference commissioned HWA to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. Health Workforce 2025 (HW 2025) was conducted in two phases: developing projections for the size and type of the health workforce (doctors, nurses and midwives) needed to meet future service requirements from 2012 to 2025; and modelling the training pipeline necessary to meet the size and type of this health workforce. HWA has used a number of key principles in developing HW 2025 to ensure the projections are robust and able to be applied nationally. HW 2025 is not a one-off project. Projections will be updated as new data become available, and methodology and assumptions underpinning the projections will be periodically reviewed. To also ensure the continued improvement of national health workforce planning, HWA is pursuing other areas for improvement, including better national data collections and improved estimation methodology for demand. Results of HW 2025 were presented to the Australian Health Ministers (through the Standing Council on Health) in April 2012.

  10. THE U.S. EPA NATIONAL HEALTH AND ENVIRONMENTAL EFFECTS RESEARCH LABORATORY'S APPROACH TO AUDITING HEALTH EFFECTS STUDIES

    EPA Science Inventory

    This is an abstract of a proposed presentation and does not necessarily reflect EPA policy.

    The Health Divisions of the US EPA National Health and Environmental Effects Research Laboratory have a guideline for conducting technical systems audits. As part of the guideline ...

  11. ADHD and Health Services Utilization in the National Health Interview Survey

    ERIC Educational Resources Information Center

    Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert

    2009-01-01

    Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…

  12. National Geothermal Data System (NGDS)

    DOE Data Explorer

    The National Geothermal Data System (NGDS) is a DOE-funded distributed network of databases and data sites. Much of the risk of geothermal energy development is associated with exploring for, confirming and characterizing the available geothermal resources. The overriding purpose of the NGDS is to help mitigate this up-front risk by serving as a central gateway for geothermal and relevant related data as well as a link to distributed data sources. Assessing and categorizing the nation's geothermal resources and consolidating all geothermal data through a publicly accessible data system will support research, stimulate public interest, promote market acceptance and investment, and, in turn, the growth of the geothermal industry. Major participants in the NGDS to date include universities, laboratories, the Arizona Geological Survey and Association of American State Geologists (Arizona Geological Survey, lead), the Geothermal Resources Council, and the U.S. Geological Survey. The Geothermal Energy Association is collaborating with the NGDS to insure that it meets the needs of the geothermal industry.

  13. Potential effects of rational prescribing on national health care spending

    PubMed Central

    Littman, Jordan; Halil, Roland

    2016-01-01

    Abstract Objective To estimate the cost savings that could result from implementation of a rational prescribing model for drug classes that are equivalent in terms of efficacy, toxicity, and convenience. Design The top 10 drug classes based on annual spending were gathered from the Canadian Institute for Health Information. They were reviewed for potential inclusion in the study based on the ability to compare intraclass medications. When equivalence in efficacy, toxicity, and convenience was determined from a literature review, annual prescribing data were gathered from the National Prescription Drug Utilization Information Systems Database. The potential cost savings were then calculated by comparing current market shares with potential future market shares. Setting Canada. Main outcome measures Estimated differences in spending produced by a rational prescribing model. Results Statins, proton pump inhibitors, angiotensin-converting enzyme inhibitors, and selective serotonin reuptake inhibitors were determined to have class equivalence for efficacy, toxicity, and convenience. Total current annual spending on these classes is $856 million through public drug programs, and an estimated $1.97 billion nationally. Through rational prescribing, annual savings could reach $222 million for public drug programs, and $521 million nationally. Conclusion Most of the potential savings are derived from deprescribing the newest patent-protected medications in each class. Avoiding prescribing the newest intraclass drug, particularly in the absence of research to support its superiority in relevant clinical outcomes, could lead to considerable savings in health care expenditures and might push the pharmaceutical industry to innovate rather than imitate. PMID:26975917

  14. Vegetation Health and Productivity Indicators for Sustained National Climate Assessments

    NASA Astrophysics Data System (ADS)

    Jones, M. O.; Running, S. W.

    2014-12-01

    The National Climate Assessment process is developing a system of physical, ecological, and societal indicators that communicate key aspects of the physical climate, climate impacts, vulnerabilities, and preparedness for the purpose of informing both decision makers and the public. Implementing a 14 year record of Gross and Net Primary Productivity (GPP/NPP) derived from the NASA EOS MODIS satellite sensor we demonstrate how these products can serve as Ecosystem Productivity and Vegetation Health National Climate Indicators for implementation in sustained National Climate Assessments. The NPP product combines MODIS vegetation data with daily global meteorology to calculate annual growth of all plant material at 1 sq. km resolution. NPP anomalies identify regions with above or below average plant growth that may result from climate fluctuations and can inform carbon source/sink dynamics, agricultural and forestry yield measures, and response to wildfire or drought conditions. The GPP product provides a high temporal resolution (8-day) metric of vegetation growth which can be used to monitor short-term vegetation response to extreme events and implemented to derive vegetation phenology metrics; growing season start, end, and length, which can elucidate land cover and regionally specific vegetation responses to a changing climate. The high spatial resolution GPP and NPP indicators can also inform and clarify responses seen from other proposed Pilot Indicators such as forest growth/productivity, land cover, crop production, and phenology. The GPP and NPP data are in continuous production and will be sustained into the future with the next generation satellite missions. The long-term Ecosystem Productivity and Vegetation Health Indicators are ideal for use in sustained National Climate Assessments, providing regionally specific responses to a changing climate and complete coverage at the national scale.

  15. Systems modeling at the Idaho National Engineering Laboratory

    NASA Astrophysics Data System (ADS)

    Bray, Michael A.

    1994-12-01

    This paper describes two experiences in systems modeling at the Idaho National Engineering Laboratory. These experiences reinforce key points that bear on the use of systems modeling in analyzing health-care issues. The first point is that mental models are a crucial part of systems. The second point is that simulation uncovers long-term consequences of existing assumptions.

  16. Public health research systems in the European union

    PubMed Central

    2011-01-01

    Background Strengthening health research is an important objective for international health organisations, but there has been less attention to support for health research in Europe. We describe the public-health (population and organisational level) research systems in the 27 European Union countries. Methods We developed a typology for describing health research structures based on funding streams and strategies. We drew data from internet sources and asked country informants to review these for consistency and completeness. The structures were described as organograms and narratives in country profiles for each of the 27 EU member states. National public-health research structures included public and independent funding organisations, 'mixed' institutions (which receive funds, and both use and allocate them) and provider institutions. Results Most health research is funded through ministries of science or science councils (and sometimes foundations), while parliaments and regions may also contribute. National institutes of public health are usually funded by ministries of health. Many national research organisations both determine research programmes and undertake health research, but there is a move towards public-health sciences within the universities, and a transition from internal grants to competitive funding. Of 27 national research strategies, 17 referred to health and 11 to public health themes. Although all countries had strategies for public health itself, we found little coherence in public-health research programmes. The European Commission has country contact points for both EU research and health programmes, but they do not coordinate with national health-research programmes. Conclusions Public-health research is broadly distributed across programmes in EU countries. Better understanding of research structures, programmes and results would improve recognition for public health in Europe, and contribute to practice. EU ministries of health should

  17. Powerful connections for public health: the National Library of Medicine and the National Network of Libraries of Medicine.

    PubMed

    Humphreys, B L; Ruffin, A B; Cahn, M A; Rambo, N

    1999-11-01

    As incorporated in Healthy People 2010 objectives, data and information systems and a skilled workforce are 2 of the critical components of the public health infrastructure. The National Library of Medicine (NLM) and the National Network of Libraries of Medicine (NN/LM) are important resources for improving Internet access and providing related training to the public health workforce and to those in training for public health careers. The NLM and the NN/LM have joined forces with the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and the Public Health Foundation. The goal of this collaboration is to improve electronic resources useful in public health practice and increase awareness of them, to train public health professionals to use electronic information services, and to help public health agencies obtain the equipment and Internet connections needed to use these services effectively. The databases, outreach programs, and connection grants available to public health professionals from the NLM, and the training and ongoing support available from the NN/LM for accessing these programs and services, are described.

  18. 78 FR 26793 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... review and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences,...

  19. 75 FR 7487 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Inst. of Environmental Health Sciences, Office of Program Operations, Scientific Review Branch,...

  20. 76 FR 26311 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Manpower Development in the Environmental Health Sciences; 93.113, Biological Response to...

  1. 78 FR 59042 - National Institute of Environmental Health Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES, including... Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander Drive, Research...

  2. 78 FR 7794 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Sciences; 93.113, Biological Response to Environmental Health Hazards; 93.114, Applied...

  3. 77 FR 61613 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute Environmental Health Sciences, P....

  4. 76 FR 27653 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Review Branch, Division of Extramural Research and Training, Nat. Institute Environmental Health...

  5. 77 FR 40076 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute of Environmental Health Sciences,...

  6. 78 FR 42968 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... review and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences, Building...

  7. 77 FR 33472 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Administrator, Nat. Institute of Environmental Health Sciences, Office of Program Operations, Scientific...

  8. 77 FR 22793 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute of Environmental Health Sciences,...

  9. 77 FR 26300 - National Institute of Environmental Health Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences, including.... Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander...

  10. 76 FR 5184 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Agenda: To review and evaluate grant applications. Place: Nat. Inst. of Environmental Health...

  11. 78 FR 18997 - National Institute of Environmental Health Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences, including..., Neuropharmacology and Human Metabolism Groups. Place: Nat. Inst. of Environmental Health Sciences, Building...

  12. 76 FR 52672 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Agenda: To review and evaluate contract proposals. Place: Nat. Inst. of Environmental Health...

  13. 77 FR 12602 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences, Building...

  14. 78 FR 26643 - National Institute of Environmental Health Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES, including... Biomarker-Based Epidemiology Group. Place: Nat. Inst. of Environmental Health Sciences, Building...

  15. 75 FR 10293 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences, Special Emphasis... Education; 93.894, Resources and Manpower Development in the Environmental Health Sciences;...

  16. 75 FR 71133 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Special Emphasis Panel; Competitive Revision for..., Mental Health Research Grants; 93.281, Scientist Development Award, Scientist Development Award...

  17. National Institutes of Health, Office of Research on Women's Health

    MedlinePlus

    ... Report on Research on Women's Health Raising the Bar Clinical Research & Trials Including Women and Minorities in ... Report on Research on Women's Health Raising the Bar Clinical Research & Trials Including Women and Minorities in ...

  18. National Institutes of Health, Office of Research on Women's Health

    MedlinePlus

    ... D. NIH Associate Director for Research on Women's Health Messages Twitter Bio More from our Director Twitter ... list Subscribe NIH Office of Research on Women's Health (ORWH) 6707 Democracy Boulevard Bethesda, MD 20817 Phone: ...

  19. Health information technology: laying the infrastructure for national health reform.

    PubMed

    Buntin, Melinda Beeuwkes; Jain, Sachin H; Blumenthal, David

    2010-06-01

    The enactment of the Patient Protection and Affordable Care Act is a signal achievement on the road to reform, which arguably began with the passage of the American Recovery and Reinvestment Act of 2009. That statute's Health Information Technology for Economic and Clinical Health (HITECH) provisions created an essential foundation for restructuring health care delivery and for achieving the key goals of improving health care quality; reducing costs; and increasing access through better methods of storing, analyzing, and sharing health information. This article discusses the range of initiatives under HITECH to support health reform, including proposed regulations on "meaningful use" and standards; funding of regional extension centers and Beacon communities; and support for the development and use of clinical registries and linked health outcomes research networks, all of which are critical to carrying out the comparative clinical effectiveness research that will be expanded under health reform.

  20. The importance of establishing a national health security preparedness index.

    PubMed

    Lumpkin, John R; Miller, Yoon K; Inglesby, Tom; Links, Jonathan M; Schwartz, Angela T; Slemp, Catherine C; Burhans, Robert L; Blumenstock, James; Khan, Ali S

    2013-03-01

    Natural disasters, infectious disease epidemics, terrorism, and major events like the nuclear incident at Fukushima all pose major potential challenges to public health and security. Events such as the anthrax letters of 2001, Hurricanes Katrina, Irene, and Sandy, severe acute respiratory syndrome (SARS) and West Nile virus outbreaks, and the 2009 H1N1 influenza pandemic have demonstrated that public health, emergency management, and national security efforts are interconnected. These and other events have increased the national resolve and the resources committed to improving the national health security infrastructure. However, as fiscal pressures force federal, state, and local governments to examine spending, there is a growing need to demonstrate both what the investment in public health preparedness has bought and where gaps remain in our nation's health security. To address these needs, the Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (PHPR), is creating an annual measure of health security and preparedness at the national and state levels: the National Health Security Preparedness Index (NHSPI). PMID:23506403

  1. The importance of establishing a national health security preparedness index.

    PubMed

    Lumpkin, John R; Miller, Yoon K; Inglesby, Tom; Links, Jonathan M; Schwartz, Angela T; Slemp, Catherine C; Burhans, Robert L; Blumenstock, James; Khan, Ali S

    2013-03-01

    Natural disasters, infectious disease epidemics, terrorism, and major events like the nuclear incident at Fukushima all pose major potential challenges to public health and security. Events such as the anthrax letters of 2001, Hurricanes Katrina, Irene, and Sandy, severe acute respiratory syndrome (SARS) and West Nile virus outbreaks, and the 2009 H1N1 influenza pandemic have demonstrated that public health, emergency management, and national security efforts are interconnected. These and other events have increased the national resolve and the resources committed to improving the national health security infrastructure. However, as fiscal pressures force federal, state, and local governments to examine spending, there is a growing need to demonstrate both what the investment in public health preparedness has bought and where gaps remain in our nation's health security. To address these needs, the Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (PHPR), is creating an annual measure of health security and preparedness at the national and state levels: the National Health Security Preparedness Index (NHSPI).

  2. Collection of social determinant of health measures in U.S. national surveillance systems for HIV, viral hepatitis, STDs, and TB.

    PubMed

    Beltran, Victoria M; Harrison, Kathleen McDavid; Hall, H Irene; Dean, Hazel D

    2011-01-01

    Challenges exist in the study of social determinants of health (SDH) because of limited comparability of population-based U.S. data on SDH. This limitation is due to differences in disparity or equity measurements, as well as general data quality and availability. We reviewed the current SDH variables collected for HIV, viral hepatitis, sexually transmitted diseases, and tuberculosis at the Centers for Disease Control and Prevention through its population-based surveillance systems and assessed specific system attributes. Results were used to provide recommendations for a core set of SDH variables to collect that are both feasible and useful. We also conducted an environmental literature scan to determine the status of knowledge of SDH as underlying causes of disease and to inform the recommended core set of SDH variables.

  3. 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

  4. 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.

  5. The Italian health-care system.

    PubMed

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist.

  6. 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.

  7. Organisation for Change: The British National Health Service.

    ERIC Educational Resources Information Center

    Chester, T. E.

    Begun in 1948, The National Health Service was organized in a "functional" pattern of three main groups: hospital service, primary health care, and community health services and personal social services. Dissatisfaction led to a reorganization in 1974 along geographical divisions for region, area, and district levels, necessitating a managing…

  8. The National Health Educator Job Analysis 2010: Process and Outcomes

    ERIC Educational Resources Information Center

    Doyle, Eva I.; Caro, Carla M.; Lysoby, Linda; Auld, M. Elaine; Smith, Becky J.; Muenzen, Patricia M.

    2012-01-01

    The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience…

  9. The National Adolescent Student Health Survey. A Report on the Health of America's Youth.

    ERIC Educational Resources Information Center

    American School Health Association, Kent, OH.

    The National Adolescent Student Health Survey (NASHS) was designed to assess students' health-related knowledge, attitudes, and behaviors in eight areas of critical importance to the health of youth. Two grade levels, eighth and tenth, were chosen to be the focus of the study. The survey provides a national profile of students at these two grade…

  10. 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

  11. 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.

  12. National health expenditures: a global analysis.

    PubMed Central

    Murray, C. J.; Govindaraj, R.; Musgrove, P.

    1994-01-01

    As part of the background research to the World development report 1993: investing in health, an effort was made to estimate public, private and total expenditures on health for all countries of the world. Estimates could be found for public spending for most countries, but for private expenditure in many fewer countries. Regressions were used to predict the missing values of regional and global estimates. These econometric exercises were also used to relate expenditure to measures of health status. In 1990 the world spent an estimated US$ 1.7 trillion (1.7 x 10(12) on health, or $1.9 trillion (1.9 x 10(12)) in dollars adjusted for higher purchasing power in poorer countries. This amount was about 60% public and 40% private in origin. However, as incomes rise, public health expenditure tends to displace private spending and to account for the increasing share of incomes devoted to health. PMID:7923542

  13. Health Promotion Dissemination and Systems Thinking: Towards an Integrative Model

    ERIC Educational Resources Information Center

    Best, Allan; Moor, Gregg; Holmes, Bev; Clark, Pamela I.; Bruce, Ted; Leischow, Scott; Buchholz, Kaye; Krajnak, Judith

    2003-01-01

    Objective:: To help close the gap between health promotion research and practice by using systems thinking. Methods: We review 3 national US tobacco control initiatives and a project (ISIS) that has introduced systems thinking to tobacco control, speculating on ways in which systems thinking may add value to health promotion dissemination and…

  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. The Australian health system: continuity and change.

    PubMed

    Harris, M G; Harris, R D

    1998-01-01

    The health of Australians, with the exception of Aboriginals and Torres Strait Islanders, compares favourably with other industrialised nations. Since 1984, universal access for citizens to medical and public hospital services has been achieved under a national Health Insurance Scheme called Medicare, partially funded by a 1.4 percent levy on all taxpayers. Medicare found early widespread support from the electorate but continues to be buffeted by a minority coalition of some medical associations, private health insurers, and conservative "libertarian" politicians. Over the decade since its inception, Medicare has provided stability in maintaining total health costs around 8 percent of GDP. This has been largely due to capping hospital costs via Commonwealth-State agreements. Medicare has failed in the past five years to contain medical costs which have increased proportionally with increases in the medical workforce. This article examines the structure and performance of Medicare and its role within Australia's overall health system. Benefits of a universal access insurance program are outlined together with challenges associated with inequities in health status, geography, aging of the population, burgeoning technology, ideological diversity, and an economic climate requiring cost containment and favouring privatisation and the role of the market. It can be concluded that, despite these challenges, universal access to health care is here to stay. Australia's Medicare program has become popular with the electorate. PMID:10338721

  16. The Mexican national satellite system

    NASA Astrophysics Data System (ADS)

    Sanchez Ruiz, M. E.; Briskman, R. D.

    1983-10-01

    The satellites, tracking, telemetry, command, and monitoring facilities, and the earth station complex for the Mexican national satellite system, Morelos, are described. The spacecraft are intended to provide educational television, rural telephony, data transmission, and business and industrial services. Scheduled for 1985 launch, the satellites will be placed in GEO and use the C and Ku bands with 12 narrow band and six wideband transponders. Spin-stabilized and solar cell powered, the functional mass will be 666 kg, including propellant. The solar panels will provide 940 W of power and 830 W will be available from NiCd batteries during eclipse conditions. The earth station will be located at Iztapalapa, which will have a 12 m antenna, redundant uplink and downlink radios, and command and ranging equipment. Back-up capability will be provided by a station at Tulancingo. Ku band and C band stations are in planning.

  17. [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).

  18. TOXNET and Beyond: Using the National Library of Medicine's Environmental Health and Toxicology Portal

    SciTech Connect

    Templin-Branner, W.

    2010-10-20

    The National Library of Medicine's Environmental Health and Toxicology Portal provides access to numerous databases that can help you explore environmental chemicals and risks. TOXNET and Beyond: Using NLM's Environmental Health and Toxicology Portal conveys the fundamentals of searching the NLM's TOXNET system of databases in chemistry, toxicology, environmental health, and related fields. In addition to TOXNET, the course will highlight various resources available through the Environmental Health and Toxicology Portal.

  19. National Institute for Occupational Safety and Health

    MedlinePlus

    ... and health research training centers, continuing education NIOSH Science Blog A-Z Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Top Resources Pocket Guide to Chemical Hazards Manual of Analytical Methods Health Hazard Evaluations (HHEs) NIOSH en Español Research ...

  20. 78 FR 39738 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National... retention resources, and partnerships. The public can join the meeting via audio conference call on the date... INFORMATION CONTACT: Njeri Jones, Bureau of Clinician Recruitment and Service, Health Resources and...