Sample records for national health systems

  1. 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.

  2. Public Health Systems Research: Setting a National Agenda

    PubMed Central

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

    2006-01-01

    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 overarching priority research themes. This national agenda should stimulate and guide research to meet the urgent need to improve the nation’s public health systems. PMID:16449601

  3. NATIONAL ORAL HEALTH SURVEILLANCE SYSTEM (NOHSS)

    EPA Science Inventory

    National Oral Health Surveillance System (NOHSS) is a collaborative effort between CDC's Division of Oral Health and The Association of State and Territorial Dental Directors (ASTDD). NOHSS is designed to help public health programs monitor the burden of oral disease, use of the ...

  4. Assessing health information technology in a national health care system--an example from Taiwan.

    PubMed

    Chi, Chunhuei; Lee, Jwo-Leun; Schoon, Rebecca

    2012-01-01

    The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context? We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal. to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services, (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy. The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT. There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system

  5. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    PubMed

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2017-09-01

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  6. 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

  7. Nursing and the national policy of education for health care professionals for the Brazilian national Health System.

    PubMed

    Haddad, Ana Estela

    2011-12-01

    The objective of the present article is to identify the aspects and characteristic of creating and implementing the national policy for the administration of health education, over the last six years, with particular emphasis on the central role of nursing undergraduate studied and the profession as a field of knowledge that structures the management of care and the working process in health. The advancements and the current challenges that are posed to implement the National Health System and the role of connecting health care and education administrators and establishing an interfederal network to assure the success of the ongoing initiatives.

  8. Evaluating the sub-national fidelity of national Initiatives in decentralized health systems: Integrated Primary Health Care Governance in Nigeria.

    PubMed

    Eboreime, Ejemai Amaize; Abimbola, Seye; Obi, Felix Abrahams; Ebirim, Obinna; Olubajo, Olalekan; Eyles, John; Nxumalo, Nonhlanhla Lynette; Mambulu, Faith Nankasa

    2017-03-21

    Policy making, translation and implementation in politically and administratively decentralized systems can be challenging. Beyond the mere sub-national acceptance of national initiatives, adherence to policy implementation processes is often poor, particularly in low and middle-income countries. In this study, we explore the implementation fidelity of integrated PHC governance policy in Nigeria's decentralized governance system and its implications on closing implementation gaps with respect to other top-down health policies and initiatives. Having engaged policy makers, we identified 9 core components of the policy (Governance, Legislation, Minimum Service Package, Repositioning, Systems Development, Operational Guidelines, Human Resources, Funding Structure, and Office Establishment). We evaluated the level and pattern of implementation at state level as compared to the national guidelines using a scorecard approach. Contrary to national government's assessment of level of compliance, we found that sub-national governments exercised significant discretion with respect to the implementation of core components of the policy. Whereas 35 and 32% of states fully met national criteria for the structural domains of "Office Establishment" and Legislation" respectively, no state was fully compliant to "Human Resource Management" and "Funding" requirements, which are more indicative of functionality. The pattern of implementation suggests that, rather than implementing to improve outcomes, state governments may be more interested in executing low hanging fruits in order to access national incentives. Our study highlights the importance of evaluating implementation fidelity in providing evidence of implementation gaps towards improving policy execution, particularly in decentralized health systems. This approach will help national policy makers identify more effective ways of supporting lower tiers of governance towards improvement of health systems and outcomes.

  9. An integrated and sustainable EU health information system: national public health institutes' needs and possible benefits.

    PubMed

    Bogaert, Petronille; Van Oyen, Herman

    2017-01-01

    Although sound data and health information are at the basis of evidence-based policy-making and research, still no single, integrated and sustainable EU-wide public health monitoring system or health information system exists. BRIDGE Health is working towards an EU health information and data generation network covering major EU health policy areas. A stakeholder consultation with national public health institutes was organised to identify the needs to strengthen the current EU health information system and to identify its possible benefits. Five key issues for improvement were identified: (1) coherence, coordination and sustainability; (2) data harmonization, collection, processing and reporting; (3) comparison and benchmarking; (4) knowledge sharing and capacity building; and (5) transferability of health information into evidence-based policy making. The vision of an improved EU health information system was formulated and the possible benefits in relation to six target groups. Through this consultation, BRIDGE Health has identified the continuous need to strengthen the EU health information system. A better system is about sustainability, better coordination, governance and collaboration among national health information systems and stakeholders to jointly improve, harmonise, standardise and analyse health information. More and better sharing of this comparable health data allows for more and better comparative health research, international benchmarking, national and EU-wide public health monitoring. This should be developed with the view to provide the tools to fight both common and individual challenges faced by the Members States and their politicians.

  10. Innovation within a national health care system.

    PubMed

    Young, Antony

    2017-05-01

    Tony is a practicing frontline National Health Service surgeon and director of medical innovation at Anglia Ruskin University and has founded 4 medical-technology start-ups. He has also cofounded the £500 million Anglia Ruskin MedTech Campus, which will become one of the world's largest health innovation spaces. In 2014, he was appointed as national clinical director for innovation at National Health Service England and in February 2016 became the first national clinical lead for innovation. In this role, he provides clinical leadership and support in delivering improved health outcomes in England, drives the uptake of proven innovations across the National Health Service, promotes economic growth through innovation, and helps make the National Health Service the go-to place on the planet for medical innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Implementing National System of Health Research Ethics Regulations: The Nigerian Experience

    PubMed Central

    Adebamowo, Clement A.

    2013-01-01

    Efforts by Nigerian authorities to institutionalize health research dates back to the early 70's with the establishment of the Medical Research Council. Subsequently efforts to strengthen a national health research system in line with the concept of Essential National Health Research (ENHR) were made but albeit un-successfully. This may have been as a result of poor political support, and lack of regulations to promote health research in the country. However little is known about health research regulations and their implementation in Nigeria. Health and health research in Nigeria is not regulated via a set of clearly defined legislation. While the country has developed a regulation document for health research ethics, compliance to this document is likely to be affected by the lack of legislation in for the health system as an entity. In this paper we narrate the developments in health, health research, and health regulations; we describe process for, and extent of implementation of the National Code of Health Research Ethics. We conclude that several factors affect the extent of implementation of the ethics code amongst which legislation is an important one. PMID:24324978

  12. Implementing National System of Health Research Ethics Regulations: The Nigerian Experience.

    PubMed

    Yakubu, Aminu; Adebamowo, Clement A

    2012-01-01

    Efforts by Nigerian authorities to institutionalize health research dates back to the early 70's with the establishment of the Medical Research Council. Subsequently efforts to strengthen a national health research system in line with the concept of Essential National Health Research (ENHR) were made but albeit un-successfully. This may have been as a result of poor political support, and lack of regulations to promote health research in the country. However little is known about health research regulations and their implementation in Nigeria. Health and health research in Nigeria is not regulated via a set of clearly defined legislation. While the country has developed a regulation document for health research ethics, compliance to this document is likely to be affected by the lack of legislation in for the health system as an entity. In this paper we narrate the developments in health, health research, and health regulations; we describe process for, and extent of implementation of the National Code of Health Research Ethics. We conclude that several factors affect the extent of implementation of the ethics code amongst which legislation is an important one.

  13. Reforming the reform: the Greek National Health System in transition.

    PubMed

    Tountas, Yannis; Karnaki, Panagiota; Pavi, Elpida

    2002-10-01

    The National Health System (ESY) in Greece, which was established in 1983, is in a state of continuous crisis. This situation is caused mainly by the system's problematic administration, low productivity and inadequate Primary Health Care. These have led the re-elected PASOK government to introduce by the end of 2000 a radical reform of the health system. The 200 reform measures announced by the new Minister of Health and Welfare include changes aiming at: the decentralization of the ESY, the creation of a unified financing system for the social insurance funds, a new management structure in public hospitals, the organization of a Primary Health System in urban areas, and the strengthening of Public Health and Health Promotion. These changes are presented and discussed in this paper.

  14. [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

  15. National healthcare systems and the need for health information governance.

    PubMed

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

  16. Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries.

    PubMed

    Sun, Daxin; Ahn, Haksoon; Lievens, Tomas; Zeng, Wu

    2017-01-01

    In an effort to improve health service delivery and achieve better health outcomes, the World Health Organization (WHO) has called for improved efficiency of health care systems to better use the available funding. This study aims to examine the efficiency of national health systems using longitudinal country-level data. Data on health spending per capita, infant mortality rate (IMR), under 5 mortality rate (U5MR), and life expectancy (LE) were collected from or imputed for 173 countries from 2004 through 2011. Data envelopment analyses were used to evaluate the efficiency and regression models were constructed to examine the determinants of efficiency. The average efficiency of the national health system, when examined yearly, was 78.9%, indicating a potential saving of 21.1% of health spending per capita to achieve the same level of health status for children and the entire population, if all countries performed as well as their peers. Additionally, the efficiency of the national health system varied widely among countries. On average, Africa had the lowest efficiency of 67%, while West Pacific countries had the highest efficiency of 86%. National economic status, HIV/AIDS prevalence, health financing mechanisms and governance were found to be statistically associated with the efficiency of national health systems. Taking health financing as an example, a 1% point increase of social security expenses as a percentage of total health expenditure correlated to a 1.9% increase in national health system efficiency. The study underscores the need to enhance efficiency of national health systems to meet population health needs, and highlights the importance of health financing and governance in improving the efficiency of health systems, to ultimately improve health outcomes.

  17. 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.

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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. 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.

  19. Immigrant Health Inequalities in the United States: Use of Eight Major National Data Systems

    PubMed Central

    Kogan, Michael D.

    2013-01-01

    Eight major federal data systems, including the National Vital Statistics System (NVSS), National Health Interview Survey (NHIS), National Survey of Children's Health, National Longitudinal Mortality Study, and American Community Survey, were used to examine health differentials between immigrants and the US-born across the life course. Survival and logistic regression, prevalence, and age-adjusted death rates were used to examine differentials. Although these data systems vary considerably in their coverage of health and behavioral characteristics, ethnic-immigrant groups, and time periods, they all serve as important research databases for understanding the health of US immigrants. The NVSS and NHIS, the two most important data systems, include a wide range of health variables and many racial/ethnic and immigrant groups. Immigrants live 3.4 years longer than the US-born, with a life expectancy ranging from 83.0 years for Asian/Pacific Islander immigrants to 69.2 years for US-born blacks. Overall, immigrants have better infant, child, and adult health and lower disability and mortality rates than the US-born, with immigrant health patterns varying across racial/ethnic groups. Immigrant children and adults, however, fare substantially worse than the US-born in health insurance coverage and access to preventive health services. Suggestions and new directions are offered for improvements in health monitoring and for strengthening and developing databases for immigrant health assessment in the USA. PMID:24288488

  20. Chile's National Center for Health Information Systems: A Public-Private Partnership to Foster Health Care Information Interoperability.

    PubMed

    Capurro, Daniel; Echeverry, Aisen; Figueroa, Rosa; Guiñez, Sergio; Taramasco, Carla; Galindo, César; Avendaño, Angélica; García, Alejandra; Härtel, Steffen

    2017-01-01

    Despite the continuous technical advancements around health information standards, a critical component to their widespread adoption involves political agreement between a diverse set of stakeholders. Countries that have addressed this issue have used diverse strategies. In this vision paper we present the path that Chile is taking to establish a national program to implement health information standards and achieve interoperability. The Chilean government established an inter-agency program to define the current interoperability situation, existing gaps, barriers, and facilitators for interoperable health information systems. As an answer to the identified issues, the government decided to fund a consortium of Chilean universities to create the National Center for Health Information Systems. This consortium should encourage the interaction between all health care stakeholders, both public and private, to advance the selection of national standards and define certification procedures for software and human resources in health information technologies.

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

    PubMed

    Wouters, Olivier J; Kanavos, Panos G

    2015-09-01

    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. 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. 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. 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.

  2. [Change and revolution: the rise of the National Health System in Cuba, 1959-1970].

    PubMed

    Chaple, Enrique Beldarraín

    2005-01-01

    This article studies the impact on the Cuban public health system of the political, economical and social changes that occurred after the 1959 Revolution, and the main transformations that occurred in the Cuban public health system during the 1960s, such as the creation of a new public health ministry, the nationalization of the pharmaceutical industry, the massive emigration of health professionals, a reform of medical studies, the creation of a Medical Rural Service, the incorporation of socialist principles in public health and the development of primary health care. As this article intends to demonstrate, these measures guided Cuban public health reform towards the construction of a state monopolized National Health System in 1970.

  3. A comparative study of the proposed models for the components of the national health information system.

    PubMed

    Ahmadi, Maryam; Damanabi, Shahla; Sadoughi, Farahnaz

    2014-04-01

    National Health Information System plays an important role in ensuring timely and reliable access to Health information, which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system - for better planning and management influential factors of performanceseems necessary, therefore, in this study different attitudes towards components of this system are explored comparatively. This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process and output. In this context, search for information using library resources and internet search were conducted, and data analysis was expressed using comparative tables and qualitative data. The findings showed that there are three different perspectives presenting the components of national health information system Lippeveld and Sauerborn and Bodart model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008, and Gattini's 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities and equipment. Plus, in the "process" section from three models, we pointed up the actions ensuring the quality of health information system, and in output section, except for Lippeveld Model, two other models consider information products and use and distribution of information as components of the national health information system. the results showed that all the three models have had a brief discussion about the

  4. 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

  5. A study on the equality and benefit of China's national health care system.

    PubMed

    Zhai, Shaoguo; Wang, Pei; Dong, Quanfang; Ren, Xing; Cai, Jiaoli; Coyte, Peter C

    2017-08-29

    This study is designed to evaluate whether the benefit which the residents received from the national health care system is equal in China. The perceived equality and benefit are used to measure the personal status of health care system, health status. This study examines variations in perceived equality and benefit of the national health care system between urban and rural residents from five cities of China and assessed their determinants. One thousand one hundred ninty eight residents were selected from a random survey among five nationally representative cities. The research characterizes perceptions into four population groupings based on a binary assessment of survey scores: high equality & high benefit; low equality & low benefit; high equality & low benefit; and low equality & high benefit. The distribution of the four groups above is 30.4%, 43.0%, 4.6% and 22.0%, respectively. Meanwhile, the type of health insurance, educational background, occupation, geographic regions, changes in health status and other factors have significant impacts on perceived equality and benefit derived from the health care system. The findings demonstrate wide variations in perceptions of equality and benefit between urban and rural residents and across population characteristics, leading to a perceived lack of fairness in benefits and accessibility. Opportunities exist for policy interventions that are targeted to eliminate perceived differences and promote greater equality in access to health care.

  6. Status of national health research systems in ten countries of the WHO African Region.

    PubMed

    Kirigia, Joses M; Wambebe, Charles

    2006-10-19

    The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that

  7. Status of national health research systems in ten countries of the WHO African Region

    PubMed Central

    Kirigia, Joses M; Wambebe, Charles

    2006-01-01

    Background The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten

  8. A Comparative Study of the Proposed Models for the Components of the National Health Information System

    PubMed Central

    Ahmadi, Maryam; Damanabi, Shahla; Sadoughi, Farahnaz

    2014-01-01

    Introduction: National Health Information System plays an important role in ensuring timely and reliable access to Health information, which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system – for better planning and management influential factors of performanceseems necessary, therefore, in this study different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process and output. In this context, search for information using library resources and internet search were conducted, and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system Lippeveld and Sauerborn and Bodart model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008, and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities and equipment. Plus, in the “process” section from three models, we pointed up the actions ensuring the quality of health information system, and in output section, except for Lippeveld Model, two other models consider information products and use and distribution of information as components of the national health information system. Conclusion: the results showed that all the

  9. Measurement of Sexual Health in the U.S.: An Inventory of Nationally Representative Surveys and Surveillance Systems

    PubMed Central

    Ivankovich, Megan B.; Leichliter, Jami S.; Douglas, John M.

    2013-01-01

    Objectives To identify opportunities within nationally representative surveys and surveillance systems to measure indicators of sexual health, we reviewed and inventoried existing data systems that include variables relevant to sexual health. Methods We searched for U.S. nationally representative surveys and surveillance systems that provided individual-level sexual health data. We assessed the methods of each data system and catalogued them by their measurement of the following domains of sexual health: knowledge, communication, attitudes, service access and utilization, sexual behaviors, relationships, and adverse health outcomes. Results We identified 18 U.S.-focused, nationally representative data systems: six assessing the general population, seven focused on special populations, and five addressing health outcomes. While these data systems provide a rich repository of information from which to assess national measures of sexual health, they present several limitations. Most importantly, apart from data on service utilization, routinely gathered, national data are currently focused primarily on negative aspects of sexual health (e.g., risk behaviors and adverse health outcomes) rather than more positive attributes (e.g., healthy communication and attitudes, and relationship quality). Conclusion Nationally representative data systems provide opportunities to measure a broad array of domains of sexual health. However, current measurement gaps indicate the need to modify existing surveys, where feasible and appropriate, and develop new tools to include additional indicators that address positive domains of sexual health of the U.S. population across the life span. Such data can inform the development of effective policy actions, services, prevention programs, and resource allocation to advance sexual health. PMID:23450886

  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. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. 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

  12. [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.

  13. 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

  14. Building health research systems: WHO is generating global perspectives, and who's celebrating national successes?

    PubMed

    Hanney, Stephen R; González-Block, Miguel A

    2016-12-28

    In 2016, England's National Institute for Health Research (NIHR) celebrated its tenth anniversary as an innovative national health research system with a focus on meeting patients' needs. This provides a good opportunity to reflect on how the creation of the NIHR has greatly enhanced important work, started in 1991, to develop a health research system in England that is embedded in the National Health Service.In 2004, WHO identified a range of functions that a national health research system should undertake to improve the health of populations. Health Research Policy and Systems (HRPS) has taken particular interest in the pioneering developments in the English health research system, where the comprehensive approach has covered most, if not all, of the functions identified by WHO. Furthermore, several significant recent developments in thinking about health research are relevant for the NIHR and have informed accounts of its achievements. These include recognition of the need to combat waste in health research, which had been identified as a global problem in successive papers in the Lancet, and an increasing emphasis on demonstrating impact. Here, pioneering evaluation of United Kingdom research, conducted through the impact case studies of the Research Excellence Framework, is particularly important. Analyses informed by these and other approaches identified many aspects of NIHR's progress in combating waste, building and sustaining research capacity, creating centres of research excellence linked to leading healthcare institutions, developing research networks, involving patients and others in identifying research needs, and producing and adopting research findings that are improving health outcomes.The NIHR's overall success, and an analysis of the remaining problems, might have lessons for other systems, notwithstanding important advances in many countries, as described in papers in HRPS and elsewhere. WHO's recently established Global Observatory for Health

  15. Health equity in the New Zealand health care system: a national survey.

    PubMed

    Sheridan, Nicolette F; Kenealy, Timothy W; Connolly, Martin J; Mahony, Faith; Barber, P Alan; Boyd, Mary Anne; Carswell, Peter; Clinton, Janet; Devlin, Gerard; Doughty, Robert; Dyall, Lorna; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan

    2011-10-20

    In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations

  16. National health research system in Malawi: dead, moribund, tepid or flourishing?

    PubMed

    Kirigia, Joses Muthuri; Kathyola, Damson D; Muula, Adamson S; Ota, Martin Matthew Okechukwu

    2015-03-31

    Several instruments at both the global and regional levels to which countries in the WHO African Region are party call for action by governments to strengthen national health research systems (NHRS). This paper debates the extent to which Malawi has fulfilled this commitment. Some research literature has characterized African research - and by implication NHRS - as moribund. In our view, the Malawi government, with partner support, has made effort to strengthen the capacities of individuals and institutions that generate scientific knowledge. This is reflected in the Malawi national NHRS index (MNSR4HI) of 51%, which is within the 50%-69% range, and thus, it should be characterized as tepid with significant potential to flourish. Governance of research for health (R4H) has improved with the promulgation of the Malawi Science and Technology Act in 2003. However, lack of an explicit R4H policy, a strategic plan and a national R4H management forum undermines the government's effectiveness in overseeing the operation of the NHRS. The mean index of 'governance of R4H' sub-functions was 67%, implying that research governance is tepid. Malawi has a national health research focal point, an R4H program, and four public and 11 private universities. The average index of 'creating and sustaining resources' sub-functions was 48.6%, meaning that R4H human and infrastructural resources can be considered to be in a moribund state. The average index of 'producing and using research' sub-functions of 50.4% implies that production and utilization of research findings in policy development and public health practice can best be described as tepid. Efforts need to be intensified to boost national research productivity. Over the five financial years 2011-2016 the government plans to spend 0.26% of its total health budget on R4H. The mean index of 'financing' sub-functions of 23.6% is within the range of 1-49%, which is considered moribund. A functional NHRS is a prerequisite for the

  17. [Experience of the Mexican National Health System in the development of clinical practice guidelines].

    PubMed

    Sosa-García, Jesús Ojino; Nieves-Hernández, Pedro; Puentes-Rosas, Esteban; Pineda-Pérez, Dayana; Viniegra-Osorio, Arturo; Torres-Arreola, Laura del Pilar; Valenzuela-Flores, Adriana Abigail; Barragán-Padilla, Sergio Baltazar; Díaz-González, Ruth; Chávez-Valdez, Lizbeth; Ramírez-López, Juan Carlos

    2016-01-01

    Clinical practice guidelines are tools that have been able to streamline decisions made in health issues and to decrease the gap between clinical action and scientific evidence. The objective of the study is to share the experience in the development and to update the guidelines by the National Health System of Mexico. The methodology in the development of the guidelines consists of 5 phases: prioritisation, establishment of work groups, development by adoption of international guidelines of de novo, validation and integration in the Master catalogue of clinical practice guidelines for its dissemination. The Master catalogue of clinical practice guidelines contains 664 guidelines, distributed in 42% Internal Medicine, 22% Surgery, 24% Pediatrics and 12% Gynecology. From the total of guidelines coverage is granted at an 85% of the Universal catalogue of health services, an 84% of the Catastrophic expenses protection fund and a 61% of the XXI Century Medical Insurance of the National Commission of Social Protection in Health. The result is the sum of a great effort of coordination and cooperation between the institutions of the National Health System, political wills and a commitment of 3,477 health professionals that participate in guidelines' development and update. Master catalogue guidelines' integration, diffusion and implantation improve quality of attention and security of the users of the National Health System. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  18. 75 FR 50987 - Privacy Act System of Records; National Animal Health Laboratory Network (NAHLN)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-18

    ...] Privacy Act System of Records; National Animal Health Laboratory Network (NAHLN) AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice of a proposed new system of records; request for comment. SUMMARY: The U.S. Department of Agriculture (USDA) proposes to add a new Privacy Act system of records to...

  19. A novel system architecture for the national integration of electronic health records: a semi-centralized approach.

    PubMed

    AlJarullah, Asma; El-Masri, Samir

    2013-08-01

    The goal of a national electronic health records integration system is to aggregate electronic health records concerning a particular patient at different healthcare providers' systems to provide a complete medical history of the patient. It holds the promise to address the two most crucial challenges to the healthcare systems: improving healthcare quality and controlling costs. Typical approaches for the national integration of electronic health records are a centralized architecture and a distributed architecture. This paper proposes a new approach for the national integration of electronic health records, the semi-centralized approach, an intermediate solution between the centralized architecture and the distributed architecture that has the benefits of both approaches. The semi-centralized approach is provided with a clearly defined architecture. The main data elements needed by the system are defined and the main system modules that are necessary to achieve an effective and efficient functionality of the system are designed. Best practices and essential requirements are central to the evolution of the proposed architecture. The proposed architecture will provide the basis for designing the simplest and the most effective systems to integrate electronic health records on a nation-wide basis that maintain integrity and consistency across locations, time and systems, and that meet the challenges of interoperability, security, privacy, maintainability, mobility, availability, scalability, and load balancing.

  20. Developing and validating a new national remote health advice syndromic surveillance system in England.

    PubMed

    Harcourt, S E; Morbey, R A; Loveridge, P; Carrilho, L; Baynham, D; Povey, E; Fox, P; Rutter, J; Moores, P; Tiffen, J; Bellerby, S; McIntosh, P; Large, S; McMenamin, J; Reynolds, A; Ibbotson, S; Smith, G E; Elliot, A J

    2017-03-01

    Public Health England (PHE) coordinates a suite of real-time national syndromic surveillance systems monitoring general practice, emergency department and remote health advice data. We describe the development and informal evaluation of a new syndromic surveillance system using NHS 111 remote health advice data. NHS 111 syndromic indicators were monitored daily at national and local level. Statistical models were applied to daily data to identify significant exceedances; statistical baselines were developed for each syndrome and area using a multi-level hierarchical mixed effects model. Between November 2013 and October 2014, there were on average 19 095 NHS 111 calls each weekday and 43 084 each weekend day in the PHE dataset. There was a predominance of females using the service (57%); highest percentage of calls received was in the age group 1-4 years (14%). This system was used to monitor respiratory and gastrointestinal infections over the winter of 2013-14, the potential public health impact of severe flooding across parts of southern England and poor air quality episodes across England in April 2014. This new system complements and supplements the existing PHE syndromic surveillance systems and is now integrated into the routine daily processes that form this national syndromic surveillance service. © Crown copyright 2016.

  1. National health inequality monitoring: current challenges and opportunities.

    PubMed

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

    National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

  2. A national research agenda for public health services and systems.

    PubMed

    2012-05-01

    The field of public health services and systems research (PHSSR) has emerged over the past decade to produce the evidence needed to address critical uncertainties about how best to organize, finance, and deliver effective public health strategies to all Americans. To advance these efforts, a national PHSSR research agenda-setting process was used to identify a broad inventory of information needs and uncertainties that public health stakeholders face in the domains of public health workforce, public health system structure and performance, public health financing, and public health information and technology. This paper presents the results of an expert review process used to transform the identified information needs into a concise set of research questions that can be pursued through new scientific inquiry in PHSSR. Established research frameworks were used to specify the contexts, mechanisms of action, and outcomes within the public health system that require further study. A total of 72 research questions were developed from the 113 original items in the PHSSR inventory of information needs. The questions include both persistent problems and newly emerging needs in public health practice and policy. The resulting research agenda provides a starting point for mobilizing the public health scientific enterprise around contemporary, high-priority uncertainties identified by broad cross sections of public health stakeholders. Regular updates to this agenda will be required to achieve continuous improvements in both the science and practice of public health. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.

  3. Health equity in the New Zealand health care system: a national survey

    PubMed Central

    2011-01-01

    Introduction In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. Methods A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Results Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or

  4. The National Health Insurance system as one type of new typology: the case of South Korea and Taiwan.

    PubMed

    Lee, Sang-Yi; Chun, Chang-Bae; Lee, Yong-Gab; Seo, Nam Kyu

    2008-01-01

    A typology is the useful way of understanding the key frameworks of health care system. With many different criteria of health care system, several typologies have been introduced and applied to each country's health care system. Among those, National Health Service (NHS), Social Health Insurance (SHI), and Private Health Insurance (PHI) are three most well-known types of health care system in the 3-model typology. Differentiated from the existing 3-model typology of health care system, South Korea and Taiwan implemented new concept of National Health Insurance (NHI) system. Since none of previous typologies can be applied to these countries' NHI to explain its unique features in a proper manner, a new typology needs to be introduced. Therefore, this paper introduces a new typology with two crucial variables that are 'state administration for health care financing' and 'main body for health care provision'. With these two variables, the world's national health care systems can be divided into four types of model: NHS, SHI, NHI, and PHI (Liberal model). This research outlines the rationale of developing new typology and introduces main features and frameworks of the NHI that South Korea and Taiwan implemented in the 1990 s.

  5. [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.

  6. The Impact of Health System Changes on the Nation's Requirements for Registered Nurses in 1985. Health Manpower References.

    ERIC Educational Resources Information Center

    Doyle, Timothy C.; And Others

    A study was conducted to assess the impact of three anticipated changes in the health care system on the future requirements for registered nurses. The changes investigated were the introduction of national health insurance (NHI), the increased enrollment in health maintenance organizations (HMOs), and the reformulation of nursing roles. Following…

  7. [The cost of tobacco-related diseases for Brazil's Unified National Health System].

    PubMed

    Pinto, Márcia; Ugá, Maria Alicia Domínguez

    2010-06-01

    This study aimed to identify the direct costs of hospitalizations due to three smoking-related groups of diseases - cancer and circulatory and respiratory diseases - in Brazil's Unified National Health System (SUS) in 2005. For cancer, the cost of chemotherapy was also included. The study derived cost estimates using administrative databases, relative risks, smoking prevalence, and smoking-attributable fraction. According to the estimates, smoking- attributable medical expenditures for the three disease groups amounted to R$338,692,516.02 (approximately U$185 million), accounting for 27.6% of total medical expenditures. Considering all hospitalizations and chemotherapy provided by the National Health System, tobacco-related diseases accounted for 7.7% of total medical expenditures. These costs also represented 0.9% of expenditures by federally funded public health services. This study provides a conservative estimate of smoking-related costs and suggests the need for continued research on comprehensive approaches to measure the total burden of smoking for society.

  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. Internet infrastructures and health care systems: a qualitative comparative analysis on networks and markets in the British National Health Service and Kaiser Permanente.

    PubMed

    Séror, Ann C

    2002-12-01

    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. 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. 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. The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. 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.

  10. 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)

  11. 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

  12. Women's health nursing in the context of the National Health Information Infrastructure.

    PubMed

    Jenkins, Melinda L; Hewitt, Caroline; Bakken, Suzanne

    2006-01-01

    Nurses must be prepared to participate in the evolving National Health Information Infrastructure and the changes that will consequently occur in health care practice and documentation. Informatics technologies will be used to develop electronic health records with integrated decision support features that will likely lead to enhanced health care quality and safety. This paper provides a summary of the National Health Information Infrastructure and highlights electronic health records and decision support systems within the context of evidence-based practice. Activities at the Columbia University School of Nursing designed to prepare nurses with the necessary informatics competencies to practice in a National Health Information Infrastructure-enabled health care system are described. Data are presented from electronic (personal digital assistant) encounter logs used in our Women's Health Nurse Practitioner program to support evidence-based advanced practice nursing care. Implications for nursing practice, education, and research in the evolving National Health Information Infrastructure are discussed.

  13. [Public health research in obstetrics coordinated by the Italian National Health Institute.

    PubMed

    Donati, Serena

    2017-10-01

    The Italian National Institute of Health (ISS) has set up a population-based surveillance system for maternal mortality and severe morbidity that covers 75% of total births and promotes the prevention of avoidable outcomes through knowledge-based action. The surveillance system promotes the continuous training of health professionals by distance learning, provides recommendations for clinical practice under the auspices of the ISS - National Guidelines System and strengthens a "no blame" culture among health professionals.

  14. Knowledge of medical students on National Health Care System: A French multicentric survey.

    PubMed

    Feral-Pierssens, A-L; Jannot, A-S

    2017-09-01

    Education on national health care policy and costs is part of our medical curriculum explaining how our health care system works. Our aim was to measure French medical students' knowledge about national health care funding, costs and access and explore association with their educational and personal background. We developed a web-based survey exploring knowledge on national health care funding, access and costs through 19 items and measured success score as the number of correct answers. We also collected students' characteristics and public health training. The survey was sent to undergraduate medical students and residents from five medical universities between July and November 2015. A total of 1195 students from 5 medical universities responded to the survey. Most students underestimated the total amount of annual medical expenses, hospitalization costs and the proportion of the general population not benefiting from a complementary insurance. The knowledge score was not associated with medical education level. Three students' characteristics were significantly associated with a better knowledge score: male gender, older age, and underprivileged status. Medical students have important gaps in knowledge regarding national health care funding, coverage and costs. This knowledge was not associated with medical education level but with some of the students' personal characteristics. All these results are of great concern and should lead us to discussion and reflection about medical and public health training. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. [Politics as a tool in National Health System transformation].

    PubMed

    Dávila Torres, Javier

    2012-01-01

    The politics as an activity oriented to the decision making process, seeks to achieve specific objectives, and it is a fundamental tool for the transformation of the National Health System (NHS). It is important to point out that there are different elements, interest and participants that take part in the design and implementation of these policies. Therefore, it should be considered the presence of the health care institutions in the development of the health policies, as well as the participation of the Congress where each political party presents and defends their proposals, negotiate the approval and assignation of the financial budget, among others. Nowadays, there are elements with a relevant presence on these policies and in the transformation process of the NHS such as the media and laboral force represented by the unions. Finally, some general statements are expressed to contribute with the advances in the integration process for a stronger NHS. This should consider the economic, demographic and social changes in the country; furthermore it should focus on universal coverage and provision of a better health care for the Mexican population.

  16. 75 FR 48853 - National Health Center Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Part IV The President Proclamation 8545--National Health Center Week, 2010 #0; #0; #0..., 2010 National Health Center Week, 2010 By the President of the United States of America A Proclamation America's community health centers are a vital component of our health care system, providing underserved...

  17. [The health system of Uruguay].

    PubMed

    Aran, Daniel; Laca, Hernán

    2011-01-01

    This paper describes the Uruguayan health system, including its structure and coverage, its financial sources, the level and distribution of its health expenditure, the physical, material and human resources available, its stewardship functions, the institutions in charge of information and research, and the level and type of citizen's participation in the operation and evaluation of the system. The most recent policy innovations are also discussed, including the creation of the National Comprehensive Health System, the National Health Insurance, the National Health Fund and the Comprehensive Health Care Program. Finally, the impact of these innovations in health expenditure, fairness of health financing, coverage levels and main health indicators is analyzed.

  18. 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.

  19. 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

  20. 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.

  1. DataView: National Health Expenditures, 1998

    PubMed Central

    Cowan, Cathy A.; Lazenby, Helen C.; Martin, Anne B.; McDonnell, Patricia A.; Sensenig, Arthur L.; Stiller, Jean M.; Whittle, Lekha S.; Kotova, Kimberly A.; Zezza, Mark A.; Donham, Carolyn S.; Long, Anna M.; Stewart, Madie W.

    1999-01-01

    In 1998, national health care expenditures reached $1.1 trillion, an increase of 5.6 percent from the previous year. This marked the fifth consecutive year of spending growth under 6 percent. Underlying the stability of the overall growth, major changes began taking place within the Nation's health care system. Public payers felt the initial effects of the Balanced Budget Act of 1997 (BBA), and private payers experienced increased health care costs and increased premium growth. PMID:11481774

  2. Implementing a national early awareness and alert system for new and emerging health technologies in Italy: the COTE Project.

    PubMed

    Migliore, Antonio; Perrini, Maria Rosaria; Jefferson, Tom; Cerbo, Marina

    2012-07-01

    The aim of this study was to establish a national Early Awareness and Alert (EAA) system for the identification and assessment of new and emerging health technologies in Italy. In 2008, Agenas, a public body supporting Regions and the Ministry of Health (MoH) in health services research, started a project named COTE (Observatory of New and Emerging Health Technologies) with the ultimate aim of implementing a national EAA system. The COTE project involved all stakeholders (MoH, Regions, Industry, Universities, technical government bodies, and Scientific Societies), in defining the key characteristics and methods of the EAA system. Agreement with stakeholders was reached using three separate workshops. During the workshops, participants shared and agreed methods for identification of new and emerging health technologies, prioritization, and assessment. The structure of the Horizon Scanning (HS) reports was discussed and defined. The main channels for dissemination of outputs were identified as the EuroScan database, and the stakeholders' Web portals. During the final workshop, Agenas presented the first three HS reports produced at national level and proposed the establishment of a permanent national EAA system. The COTE Project created the basis for a permanent national EAA system in Italy. An infrastructure to enable the stakeholders network to grow was created, methods to submit new and emerging health technologies for possible evaluation were established, methods for assessment of the technologies selected were defined, and the stakeholders involvement was delineated (in the identification, assessment, and dissemination stages).

  3. Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

    PubMed

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-09-22

    Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

  4. National Health Information Center

    MedlinePlus

    ... About ODPHP National Health Information Center National Health Information Center The National Health Information Center (NHIC) is ... of interest View the NHO calendar . Federal Health Information Centers and Clearinghouses Federal Health Information Centers and ...

  5. Forecasting the Future Reimbursement System of Korean National Health Insurance: A Contemplation Focusing on Global Budget and Neo-KDRG-Based Payment Systems

    PubMed Central

    2012-01-01

    With the adoption of national health insurance in 1977, Korea has been utilizing fee-for-service payment with contract-based healthcare reimbursement system in 2000. Under the system, fee-for-service reimbursement has been accused of augmenting national healthcare expenditure by excessively increasing service volume. The researcher examined in this paper two major alternatives including diagnosis related group-based payment and global budget to contemplate the future of reimbursement system of Korean national health insurance. Various literature and preceding studies on pilot project and actual implementation of Neo-KDRG were reviewed. As a result, DRG-based payment was effective for healthcare cost control but low in administrative efficiency. Global budget may be adequate for cost control and improving the quality of healthcare and administrative efficiency. However, many healthcare providers disagree that excess care arising from fee-for-service payment alone has led to financial deterioration of national health insurance and healthcare institutions should take responsibility with global budget payment as an appropriate solution. Dissimilar payment systems may be applied to different types of institutions to reflect their unique attributes, and this process can be achieved step-by-step. Developing public sphere among the stakeholders and striving for consensus shall be kept as collateral to attain the desirable reimbursement system in the future. PMID:22661867

  6. Forecasting the future reimbursement system of Korean National Health Insurance: a contemplation focusing on global budget and Neo-KDRG-based payment systems.

    PubMed

    Kim, Yang-Kyun

    2012-05-01

    With the adoption of national health insurance in 1977, Korea has been utilizing fee-for-service payment with contract-based healthcare reimbursement system in 2000. Under the system, fee-for-service reimbursement has been accused of augmenting national healthcare expenditure by excessively increasing service volume. The researcher examined in this paper two major alternatives including diagnosis related group-based payment and global budget to contemplate the future of reimbursement system of Korean national health insurance. Various literature and preceding studies on pilot project and actual implementation of Neo-KDRG were reviewed. As a result, DRG-based payment was effective for healthcare cost control but low in administrative efficiency. Global budget may be adequate for cost control and improving the quality of healthcare and administrative efficiency. However, many healthcare providers disagree that excess care arising from fee-for-service payment alone has led to financial deterioration of national health insurance and healthcare institutions should take responsibility with global budget payment as an appropriate solution. Dissimilar payment systems may be applied to different types of institutions to reflect their unique attributes, and this process can be achieved step-by-step. Developing public sphere among the stakeholders and striving for consensus shall be kept as collateral to attain the desirable reimbursement system in the future.

  7. 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.

  8. Guidelines for developing effective health education service in a national health agency.

    PubMed

    Ochor, J O

    1983-01-01

    The constraints facing health education include: the fragmentation and dispersal of health-educational services among different agencies and personnel; lack of policy guidelines; ineffectively organized and inefficiently managed health education systems; poor hierarchical status and inadequacy of resources. To resolve these constraints, national health education systems in health agencies should be developed on the basis of stipulated guidelines that could ensure their viability, efficiency and effectiveness. A study at the African Regional Health Education Centre, Ibadan, Nigeria, has yielded thirty synthesized guidelines. The "guidelines" were empirically tested as an evaluation tool by assessing the operational and organizational status of Oyo State Health Education Unit, Ibadan, Nigeria. These guidelines are adaptable to local conditions to enhance the re-organization, re-orientation and consolidation of health education in national health agencies.

  9. 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. Copyright © 2012 John Wiley & Sons, Ltd.

  10. Circumpolar Inuit health systems.

    PubMed

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic - Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Literature review. It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems' effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of methodology and timing of the available data

  11. Assessing systems quality in a changing health care environment: the 2009-10 national survey of children with special health care needs.

    PubMed

    Strickland, Bonnie B; Jones, Jessica R; Newacheck, Paul W; Bethell, Christina D; Blumberg, Stephen J; Kogan, Michael D

    2015-02-01

    To provide a national, population-based assessment of the quality of the health care system for children and youth with special health care needs using a framework of six health care system quality indicators. 49,242 interviews with parents of children with special health care needs from the 2009-10 National Survey of Children with Special Health Care Needs (NS-CSHCN) were examined to determine the extent to which CSHCN had access to six quality indicators of a well-functioning system of services. Criteria for determining access to each indicator were established and applied to the survey data to estimate the proportion of CSHCN meeting each quality indicator by socio-demographic status and functional limitations. 17.6% of CSHCN received care consistent with all six quality indicators. Results for each component of the system quality framework ranged from a high of 70.3% of parents reporting that they shared decision-making with healthcare providers to a low of 40% of parents reporting receipt of services needed for transition to adult health care. Attainment rates were lower for CSHCN of minority racial and ethnic groups, those residing in households where English was not the primary language, those in lower income households, and those most impacted by their health condition. Only a small proportion of CSHCN receive all identified attributes of a high-quality system of services. Moreover, significant disparities exist whereby those most impacted by their conditions and those in traditionally disadvantaged groups are served least well by the current system. A small proportion of CSHCN appear to remain essentially outside of the system, having met few if any of the elements studied.

  12. Changes in Local Public Health System Performance Before and After Attainment of National Accreditation Standards.

    PubMed

    Ingram, Richard C; Mays, Glen P; Kussainov, Nurlan

    The aim of this study is to investigate the impact of Public Health Accreditation Board (PHAB) accreditation on the delivery of public health services and on participation from other sectors in the delivery of public health services in local public health systems. This study uses a longitudinal repeated measures design to identify differences between a cohort of public health systems containing PHAB-accredited local health departments and a cohort of public health systems containing unaccredited local health departments. It uses data spanning from 2006 to 2016. This study examines a cohort of local public health systems that serves large populations and contains unaccredited and PHAB-accredited local health departments. Data in this study were collected from the directors of health departments that include local public health systems followed in the National Longitudinal Study of Public Health Systems. The intervention examined is PHAB accreditation. The study focuses on 4 areas: the delivery of core public health services, local health department contribution toward these services, participation in the delivery of these services by other members of the public health system, and public health system makeup. Prior to the advent of accreditation, public health systems containing local health departments that were later accredited by PHAB appear quite similar to their unaccredited peers. Substantial differences between the 2 cohorts appear to manifest themselves after the advent of accreditation. Specifically, the accredited cohort seems to offer a broader array of public health services, involve more partners in the delivery of those services, and enjoy a higher percentage of comprehensive public health systems. The results of this study suggest that accreditation may yield significant benefits and may help public health systems develop the public health system capital necessary to protect and promote the public's health.

  13. [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.

  14. The link between health governance models and global health innovation: an exploration of OECD nations.

    PubMed

    Schnarr, Karin; Snowdon, Anne; Cramm, Heidi; Cohen, Jason; Alessi, Charles

    2015-01-01

    While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations. We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, The Netherlands, Switzerland, and the United States). Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition. Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

  15. The israeli virtual national health record: a robust national health information infrastructure based on a firm foundation of trust.

    PubMed

    Saiag, Esther

    2005-01-01

    In many developed countries, a coordinated effort is underway to build national and regional Health Information Infrastructures (HII) for the linking of disparate sites of care, so that an access to a comprehensive Health Record will be feasible when critical medical decisions are made [1]. However, widespread adoption of such national projects is hindered by a series of barriers- regulatory, technical, financial and cultural. Above all, a robust national HII requires a firm foundation of trust: patients must be assured that their confidential health information will not be misused and that there are adequate legal remedies in the event of inappropriate behavior on the part of either authorized or unauthorized parties[2].The Israeli evolving National HII is an innovative state of the art implementation of a wide-range clinical inter-organizational data exchange, based on a unique concept of virtually temporary sharing of information. A logically connection of multiple caregivers and medical organizations creates a patient-centric virtual repository, without centralization. All information remains in its original format, location, system and ownership. On demand, relevant information is instantly integrated and delivered to the point of care. This system, successfully covering more than half of Israel's population, is currently evolving from a voluntary private-public partnership (dbMOTION and CLALIT HMO) to a formal national reality. The governmental leadership, now taking over the process, is essential to achieve a full potential of the health information technology. All partners of the Israeli health system are coordinated in concert with each other, driven with a shared vision - realizing that a secured, private, confidential health information exchange is assured.

  16. National health expenditures, 1990

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Cowan, Cathy A.; Letsch, Suzanne W.

    1991-01-01

    During 1990, health expenditures as a share of gross national product rose to 12.2 percent, up from 11.6 percent in 1989. This dramatic increase is the second largest increase in the past three decades. The national health expenditure estimates presented in this article document rapidly rising health care costs and provide a context for understanding the health care financing crisis facing the Nation today. The 1990 national health expenditures incorporate the most recently available data. They differ from historical estimates presented in the preceding article. The length of time and complicated process of producing projections required use of 1989 national health expenditures—data available prior to the completion of the 1990 estimates presented here. PMID:10114934

  17. [Analysis of the progressivity of Brazilian Unified National Health System (SUS) financing].

    PubMed

    Ugá, Maria Alicia Domínguez; Santos, Isabela Soares

    2006-08-01

    This article analyzes the level of progressivity in taxes financing the Brazilian Unified National Health System (SUS). Distribution of the tax burden financing the SUS was calculated using micro-data from the Household Budgets Survey, 2002-2003. The Kakwani index, which shows a tax system's level of progressivity, was calculated. The Kakwani index of public financing was -0.008, and SUS financing was nearly proportional to income. From a social justice perspective this is highly undesirable in a society like Brazil, with a Gini index of 0.57. The system should be clearly progressive in order to counterbalance the country's extreme income concentration.

  18. Dot-gov: market failure and the creation of a national health information technology system.

    PubMed

    Kleinke, J D

    2005-01-01

    The U.S. health care marketplace's continuing failure to adopt information technology (IT) is the result of economic problems unique to health care, business strategy problems typical of fragmented industries, and technology standardization problems common to infrastructure development in free-market economies. Given the information intensity of medicine, the quality problems associated with inadequate IT, the magnitude of U.S. health spending, and the large federal share of that spending, this market failure requires aggressive governmental intervention. Federal policies to compel the creation of a national health IT system would reduce aggregate health care costs and improve quality, goals that cannot be attained in the health care marketplace.

  19. 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. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  20. Examining national trends in worker health with the National Health Interview Survey.

    PubMed

    Luckhaupt, Sara E; Sestito, John P

    2013-12-01

    To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

  1. A comparison of prevalence estimates for selected health indicators and chronic diseases or conditions from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, 2007-2008.

    PubMed

    Li, Chaoyang; Balluz, Lina S; Ford, Earl S; Okoro, Catherine A; Zhao, Guixiang; Pierannunzi, Carol

    2012-06-01

    To compare the prevalence estimates of selected health indicators and chronic diseases or conditions among three national health surveys in the United States. Data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2007 and 2008 (n=807,524), the National Health Interview Survey (NHIS) in 2007 and 2008 (n=44,262), and the National Health and Nutrition Examination Survey (NHANES) during 2007 and 2008 (n=5871) were analyzed. The prevalence estimates of current smoking, obesity, hypertension, and no health insurance were similar across the three surveys, with absolute differences ranging from 0.7% to 3.9% (relative differences: 2.3% to 20.2%). The prevalence estimate of poor or fair health from BRFSS was similar to that from NHANES, but higher than that from NHIS. The prevalence estimates of diabetes, coronary heart disease, and stroke were similar across the three surveys, with absolute differences ranging from 0.0% to 0.8% (relative differences: 0.2% to 17.1%). While the BRFSS continues to provide invaluable health information at state and local level, it is reassuring to observe consistency in the prevalence estimates of key health indicators of similar caliber between BRFSS and other national surveys. Published by Elsevier Inc.

  2. NATIONAL ELECTRONIC DISEASE SURVEILLANCE SYSTEM (NEDSS)

    EPA Science Inventory

    The National Electronic Disease Surveillance System (NEDSS) project is a public health initiative to provide a standard-based, integrated approach to disease surveillance and to connect public health surveillance to the burgeoning clinical information systems infrastructure. NEDS...

  3. [The Spanish National Health System patient safety strategy, results for the period 2005-2007].

    PubMed

    Terol, E; Agra, Y; Fernández-Maíllo, M M; Casal, J; Sierra, E; Bandrés, B; García, M J; del Peso, P

    2008-12-01

    In 2005 the Spanish National Health System (SNHS) implemented a strategy aimed at improving patient safety in Spanish healthcare centres. Promote and develop knowledge of patient safety and a patient safety culture among health professionals and patients; design and implement adverse event information and reporting systems for learning purposes; introduce recommended safe practices in SNHS centres; promote patient safety research and public and patient involvement in patient safety policies. An Institutional Technical Committee was created with representatives from all the Spanish regions. All national organizations involved in healthcare quality and patient safety took part in the project. The strategy follows the WHO World Alliance for Patient Safety and Council of Europe recommendations. Budget allocated in the period 2005-2007: approximately EUR35 million. Around 5,000 health professionals were educated in PS concepts. Several studies were conducted on: adverse events in Hospitals and Primary Care, as well as studies to obtain information on health professionals' perceptions on safety, the use of medications and the situation regarding hospital-acquired infections. All the regions have introduced safe clinical practices related with the strategy. The strategy has been implemented in all the Spanish regions. Awareness was raised among health professionals and the public. A network of alliances has been set up with the regions, universities, schools, agencies and other organizations supporting the strategy.

  4. [Use of health technology assessment in decision-making processes by the Brazilian Ministry of Health on the incorporation of technologies in the Brazilian Unified National Health System].

    PubMed

    Novaes, Hillegonda Maria Dutilh; Elias, Flávia Tavares Silva

    2013-11-01

    Policies for scientific development and knowledge production in health have increased in recent decades. In Brazil, incentives for research, development, and innovation have been part of the National Health Act since 1990, and science and technology policies for health, including health technology assessment (HTA), have been implemented since 1994, as in many other countries. The emphasis is now on impact evaluation of HTA policies in the incorporation of technologies by health services and systems. The article presents a case study of HTA utilization in decision-making processes in the Brazilian Ministry of Health, analyzing participation by the Department of Science and Technology (DECIT), responsible for the production of assessments used in the Commission on Technology Incorporation (CITEC) of the Ministry of Health from 2008 to 2010. CITEC used 103 assessments in its decisions during this period, of which DECIT produced 80%. Nearly all were literature reviews on therapeutic technologies. An increase in knowledge production was observed. A methodological and political learning process appears to have occurred in the use of HTA, but its impact on Brazilian Unified National Health System remains unclear.

  5. Assessing Systems Quality in a Changing Health Care Environment: The 2009–10 National Survey of Children with Special Health Care Needs

    PubMed Central

    Jones, Jessica R.; Newacheck, Paul W.; Bethell, Christina D.; Blumberg, Stephen J.; Kogan, Michael D.

    2016-01-01

    To provide a national, population-based assessment of the quality of the health care system for children and youth with special health care needs using a framework of six health care system quality indicators. 49,242 interviews with parents of children with special health care needs from the 2009–10 National Survey of Children with Special Health Care Needs (NS-CSHCN) were examined to determine the extent to which CSHCN had access to six quality indicators of a well-functioning system of services. Criteria for determining access to each indicator were established and applied to the survey data to estimate the proportion of CSHCN meeting each quality indicator by socio-demographic status and functional limitations. 17.6 % of CSHCN received care consistent with all six quality indicators. Results for each component of the system quality framework ranged from a high of 70.3 % of parents reporting that they shared decision-making with healthcare providers to a low of 40 % of parents reporting receipt of services needed for transition to adult health care. Attainment rates were lower for CSHCN of minority racial and ethnic groups, those residing in households where English was not the primary language, those in lower income households, and those most impacted by their health condition. Only a small proportion of CSHCN receive all identified attributes of a high-quality system of services. Moreover, significant disparities exist whereby those most impacted by their conditions and those in traditionally disadvantaged groups are served least well by the current system. A small proportion of CSHCN appear to remain essentially outside of the system, having met few if any of the elements studied. PMID:24912943

  6. Health services management modalities in the Brazilian Unified National Health System: a narrative review of research production in Public Health (2005-2016).

    PubMed

    Ravioli, Antonio Franco; Soárez, Patrícia Coelho De; Scheffer, Mário César

    2018-01-01

    The current study aimed to systematically analyze trends and priorities in the theoretical and conceptual approaches and empirical studies on specific health services management modalities in the Brazilian Unified National Health System. A narrative review of the literature identified, in 33 publications, the location and nature of services, management models, methodological procedures, and study outcomes. The research deals mainly with the models' conceptual and legal characteristics and management practices, in addition to addressing contracts, procurement, human resources, financing, and control mechanisms. In conclusion, the literature is limited and concentrated in the State of São Paulo, showing little theoretical diversity and methodological weaknesses, while it is nonconclusive as to the superiority of one management model over another. New evaluation studies are needed that are capable of comparing different models and assessing their performance and their effects on the quality of health services' provision, the population's health, and the health system's organization.

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

    PubMed

    McCullough, J Mac; Goodin, Kate

    2016-01-01

    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. To analyze clinical and nonclinical data storage and software types by LHDs. 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. A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). 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 χ and t tests. 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. 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 portfolio, existing informatics capabilities, and other pertinent characteristics.

  8. National health expenditures, 1989

    PubMed Central

    Lazenby, Helen C.; Letsch, Suzanne W.

    1990-01-01

    Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988. PMID:10113559

  9. 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

  10. Circumpolar Inuit health systems

    PubMed Central

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    Background The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design Literature review. Results It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of

  11. 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

  12. 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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. 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

  14. Health information exchange: national and international approaches.

    PubMed

    Vest, Joshua R

    2012-01-01

    Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

  15. 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.

  16. [Forum: twenty years of experience and the challenge with the Unified National Health System. Introduction].

    PubMed

    Maio, Marcos Chor; Lima, Nísia Trindade

    2009-07-01

    This Introduction presents the Forum on the 20 years of experience with the Unified National Health System (SUS), consisting of 3 articles and a postscript. The first article provides a historical overview of the implementation of the SUS, in light of the Constitutional provisions pertaining to health. It discusses the context and main issues underlying the creation of the SUS in Brazil and proposes a renewed linkage between health sector policies and an expanded project for Brazilian society. The second article analyzes the SUS' dynamics; strides in access to and comprehensiveness of care; and challenges for the achievement of its objectives, in light of factors that are external to the system, involving the need for greater politicization of analyses on the issue. The third article approaches social and political processes that developed from 1988 to 2008. It mainly analyzes the history of two collegiate bodies under the SUS at the Federal level: the National Health Council and the Tripartite Inter-Managers' Commission. Despite the complexity identified by the authors and the important obstacles they identify, the reflections indicate that the SUS has been a successful social policy, besides contributing to the consolidation of democracy in Brazil.

  17. 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

  18. Surveying perceptions of the progress of national mental health reform.

    PubMed

    Hickie, Ian; Groom, Grace

    2004-06-01

    To provide comment on the latest Australian government commitment to a 5 year plan under the National Mental Health Strategy. In the absence of a credible system of accountability for the implementation of mental health reform, the Mental Health Council of Australia, in association with the Brain and Mind Research Institute, has taken up the task of auditing. A national, government-supported system needs to be developed in order to monitor progress of genuine mental health reform in Australia.

  19. The prospects for national health insurance reform.

    PubMed

    Belcher, J R; Palley, H A

    1991-01-01

    This article explores the unequal access to health care in the context of efforts by the American Medical Association (AMA) and its allies to maintain a market-maximizing health care system. The coalition between the AMA and its traditional allies is breaking down, in part, because of converging developments creating an atmosphere which may be more conducive to national health care reform and the development of a reformed health care delivery system that will be accessible, adequate, and equitable in meeting the health care and related social service needs of the American people.

  20. Systems of evidence-based healthcare and personalised health information: some international and national trends.

    PubMed

    Gordon, C; Gray, J A; Toth, B; Veloso, M

    2000-01-01

    In Europe, North America and elsewhere, growing interest has focussed on evidence-based healthcare systems, incorporating the deployment of practice guidelines, as a field of application for health telematics. The clinical benefit and technical feasibility of common European approaches to this task has recently been demonstrated. In Europe it is likely that, building on recent progress in electronic health record architecture (EHRA) standards, a sufficient state of maturity can be reached to justify initiation within CEN TC251 of a prestandards process on guideline content formats during the current 5th Framework of EC RT&D activity. There is now a similar impetus to agree standards for this field in North America. Thanks to fruitful EC-USA contacts during the 4th Framework programme, there is now a chance, given well-planned coordination, to establish a global consensus optimally suited to serve the world-wide delivery and application of evidence-based medicine. This review notes three factors which may accelerate progress to convergence: (1) revolutionary changes in the knowledge basis of professional/patient/public healthcare partnerships, involving the key role of the Web as a health knowledge resource for citizens, and a rapidly growing market for personalised health information and advice; (2) the emergence at national levels of digital warehouses of clinical guidelines and EBM knowledge resources, agencies which are capable of brokering common mark-up and interchange media definitions between knowledge providers, industry and healthcare organizations; (3) the closing gap in knowledge management technology, with the advent of XML and RDF, between approaches and services based respectively on text mark-up and knowledge-base paradigms. A current project in the UK National Health Service (the National electronic Library of Health) is cited as an example of a national initiative designed to harness these trends.

  1. The role of Brazilian National Health Information Systems in assessing the impact of Zika virus outbreak.

    PubMed

    Pavão, Ana Luiza Braz; Barcellos, Christovam; Pedroso, Marcel; Boccolini, Cristiano; Romero, Dália

    2017-01-01

    The Zika virus (ZIKV) epidemic has become a public health emergency following its association with severe neurological complications. We aim to discuss how the Brazilian National Health Information Systems can help to assess the impact of the ZIKV epidemic on health outcomes potentially related to ZIKV. Health outcomes potentially related to ZIKV infection were described based on a literature review of published studies on ZIKV infection outcomes and on recent protocols developed and published by the Brazilian Ministry of Health for different stages of the life cycle. These outcomes were correlated with the International Classification of Diseases 10th Revision (ICD-10) classification system, as this is the diagnostic classification registered in the Health Information System. A suggested list of 50 clinical manifestations, dispersed into 4 ICD chapters, and their information sources was created to help monitor the ZIKV epidemics and trends. Correlation of these selected ICD-10 codes and the HIS, as well as, a review of the potentialities and limitations of health information systems were performed. The potential of the Health Information System and its underutilization by stakeholders and researchers have been a barrier in diagnosing and reporting ZIKV infection and its complications. The ZIKV outbreak is still a challenge for health practice and the Brazilian Health Information System.

  2. The Italian National Health Service expenditure on workplace prevention and safety (2006-2013): a national-level analysis.

    PubMed

    Signorelli, C; Riccò, M; Odone, A

    2016-01-01

    The World Health Organization (WHO) stated that countries' health policies should give high priority to primary prevention of occupational health hazards. Scant data are available on health expenditure on workplace prevention and safety services and on its impact on occupational health outcomes in Italy and in other European countries. objective of the present study was to systematically retrieve, analyse and critically appraise the available national-level data on public health expenditure on workplace prevention and safety services as well as to correlate them with occupational health outcomes. National-level data on total public health expenditure on prevention services, its share spent on workplace prevention and safety services as well as on number of workers receiving appropriate health surveillance were derived from the national public health expenditure monitoring system over a 8-year study period (2006-2013). An analytic approach was adopted to explore the association between health expenditure and occupational health services supply. The Italian National Health Service spends almost € 5 billion per year on preventive care, of which 13.3% are spent on workplace prevention and safety programmes (€ 645 million, € 10.6 per capita). There is wide heterogeneity between Italian regions. Our findings are useful for health systems and policies analysis, national and international comparisons as well as for health policy makers to plan, implement and monitor occupational health prevention programmes.

  3. Understanding factors that influence the integration of acute malnutrition interventions into the national health system in Niger.

    PubMed

    Deconinck, Hedwig; Hallarou, Mahaman Elh; Pesonen, Anais; Gérard, Jean Christophe; Criel, Bart; Donnen, Philippe; Macq, Jean

    2016-12-01

    Since 2007 to address a high burden, integration of acute malnutrition has been promoted in Niger. This paper studies factors that influenced the integration process of acute malnutrition into the Niger national health system.We used qualitative methods of observation, key informant interviews and focus group discussions at national level, two districts and nine communities selected through convenience sampling, as well as document review. A framework approach constructed around the problem, intervention, adoption system, health system characteristics and broad context guided the analysis. Data were recorded on paper, transcribed in a descriptive record, coded by themes deduced by building on the framework and triangulated for comprehensiveness.Key facilitating factors identified were knowledge and recognition of the problem helped by accurate information; effectiveness of decentralized continuity of care; compatibility with goals, support and involvement of health actors; and leadership for aligning policies and partnerships and mobilizing resources within a favourable political context driven by multisectoral development goals. Key hindering factors identified were not fully understanding severity, causes and consequences of the problem; limited utilization and trust in health interventions; high workload, and health worker turnover and attrition; and high dependence on financial and technical support based on short-term emergency funding within a context of high demographic pressure.The study uncovered influencing factors of integrating acute malnutrition into the national health system and their complex dynamics and relationships. It elicited the need for goal-oriented strategies and alignment of health actors to achieve sustainability, and systems thinking to understand pathways that foster integration. We recommend that context-specific learning of integrating acute malnutrition may expand to include causal modelling and scenario testing to inform strategy

  4. 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; hide

    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

  5. 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

  6. [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.

  7. Veneto Region, Italy. Health system review.

    PubMed

    Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

    2012-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

  8. 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.

  9. 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…

  10. Health financing options for Fiji's health system.

    PubMed

    Pande, Madhukar

    2003-09-01

    Fiji is currently implementing health care reforms with the first phase of reforms focusing on decentralization of the health system. Part of this effort focuses on looking at financing options. Some options for financing health care include private health insurance, social insurance, community financing, user-pays system (out-of-pocket), health savings accounts, government taxation and subsidies, and overseas loans and aid funding. This paper addresses all these options in detail and provides an analysis into each of these options relevance to Fiji and in some instances to other nations in the South Pacific region. Given the relative small populations of Fiji and its neighbouring nations, a regional approach to financing could prove more viable in the longer-term, however political, social, economic, legal and cultural issues will need to seriously explored.

  11. 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

  12. Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform.

    PubMed

    Shen, Gordon C; Snowden, Lonnie R

    2014-01-01

    Policies generate accountability in that they offer a standard against which government performance can be assessed. A central question of this study is whether ideological imprint left by policy is realized in the time following its adoption. National mental health policy expressly promotes the notion of deinstitutionalization, which mandates that individuals be cared for in the community rather than in institutional environments. We investigate whether mental health policy adoption induced a transformation in the structure of mental health systems, namely psychiatric beds, using panel data on 193 countries between 2001 and 2011. Our striking regression results demonstrate that late-adopters of mental health policy are more likely to reduce psychiatric beds in mental hospitals and other biomedical settings than innovators, whereas they are less likely than non-adopters to reduce psychiatric beds in general hospitals. It can be inferred late adopters are motivated to implement deinstitutionalization for technical efficiency rather than social legitimacy reasons.

  13. Health information systems.

    PubMed

    Hovenga, Evelyn J S; Grain, Heather

    2013-01-01

    Health information provides the foundation for all decision making in healthcare whether clinical at the bed side, or at a national government level. This information is generally collected as part of systems which support administrative or clinical workflow and practice. This chapter describes the many and varied features of systems such as electronic health records (EHRs), how they fit with health information systems and how they collectively manage information flow. Systems engineering methods and tools are described together with their use to suit the health industry. This focuses on the need for suitable system architectures and semantic interoperability. These concepts and their relevance to the health industry are explained. The relationship and requirements for appropriate data governance in these systems is also considered.

  14. National Health Expenditures, 1979

    PubMed Central

    Gibson, Robert M

    1980-01-01

    Outlays for health care in the nation reached $212.2 billion in calendar year 1979—12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. PMID:10309255

  15. Military Health System Transformation Implications on Health Information Technology Modernization.

    PubMed

    Khan, Saad

    2018-03-01

    With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system. In this perspective, we discuss the implications of the intersection of two large-scope and large-scale initiatives, health system transformation, and information technology modernization, being rolled out in the largest and most complex federal agency and potential risk mitigating steps. The Military Health System will require an expanded unified clinical leadership to spearhead short-term transformation; furthermore, developing, organizing, and growing a cadre of informatics expertise to expand the use and diffusion of novel solutions such as health information exchanges, data analytics, and others to transcend organizational barriers are still needed to achieve the long-term aim of health system reform as envisioned by the National Defense Authorization Act for Fiscal Year 2017.

  16. 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.

  17. 76 FR 49645 - National Health Center Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... system. Every day, men, women, and children find help at community health centers. These centers lead the... stronger, healthier Nation that drives the work of community health centers and fuels our efforts to...

  18. Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey.

    PubMed

    Do, Young Kyung; Eggleston, Karen N

    2011-08-01

    To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system. Bivariate and multiple regression analyses of data from a cross-sectional health survey. A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey. Respondents aged 40 or older who self-reported prior diagnosis with diabetes (n= 1418). Seven measures of the care process and health outcomes, namely (i) receiving medical treatment for diabetes, (ii) ever received diabetes education, (iii) received dilated eye examination in the past year, (iv) received microalbuminuria test in the past year, (v) having activity limitation due to diabetes, (vi) poor self-rated health and (vii) self-rated health on a visual analog scale. Except for receiving medical care for diabetes, overall process quality was low, with only 25% having ever received diabetes education, 39% having received a dilated eye examination in the past year and 51% having received a microalbuminuria test in the past year. Lower education level was associated with both poorer care processes and poorer health outcomes, whereas lower income level was only associated with poorer health outcomes. While South Korea's universal health insurance system may have succeeded in substantially reducing financial barriers related to diabetes care, the quality of diabetes care is low overall and varies by education level. System-level quality improvement efforts are required to address the weaknesses of the health system, thereby mitigating educational disparities in diabetes care quality.

  19. 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. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. National Antimicrobial Resistance Monitoring System (NARMS) Program

    USDA-ARS?s Scientific Manuscript database

    The National Antimicrobial Resistance Monitoring System (NARMS) – Enteric Bacteria is a national public health surveillance system in the United States that tracks changes in the susceptibility of certain enteric bacteria to antimicrobial agents of human and veterinary medical importance. The NARMS ...

  1. 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

    ... Collection; National Animal Health Monitoring System; Feedlot 2011 Study AGENCY: Animal and Plant Health... National Animal Health Monitoring Feedlot 2011 Study. DATES: We will consider all comments that we receive.... SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring System; Feedlot 2011 Study. OMB Number: 0579...

  2. Strengthening global health security by embedding the International Health Regulations requirements into national health systems

    PubMed Central

    Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

    2018-01-01

    The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas. PMID:29379650

  3. Strengthening global health security by embedding the International Health Regulations requirements into national health systems.

    PubMed

    Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

    2018-01-01

    The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

  4. 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.

  5. National health policy: a draft prepared by the Indian Medical Association.

    PubMed

    1979-03-16

    The draft of the Indian national health policy deals with health as a fundamental right, the expenses of health, health as an integral part of national development, the health movement, the role of indigenous systems, priority in health care, and the infrastructure of health care delivery. The principles outlined in the policy focus on improvement of living conditions, health education and the health movement, preventive and promotive health, coverage of the felt needs of the people, primary health care, continuing medical education, pharmaceuticals, medical education curriculum, biomedical engineering, legislation, coordination, health insurance, and nationalization. In order for this policy to be implemented, proper strategy and planning needs to be carried out after identifying short-term and long-tern goals. The short-term goals include the following: declaration by the government that enjoyment of health is a fundamental right; 2) eradication/control of communicable diseases; 3) provision of adequate nutrition and rational health care in the rural areas and urban slums; 4) organization of a health movement and health education of the people and spread the message of health and family welfare; and 5) identification of the different areas of indigenous system of medicine to initiate scientific scrutiny of these areas for incorporation in the modern scientific system.

  6. Health Care System Measures to Advance Preconception Wellness: Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative.

    PubMed

    Frayne, Daniel J; Verbiest, Sarah; Chelmow, David; Clarke, Heather; Dunlop, Anne; Hosmer, Jennifer; Menard, M Kathryn; Moos, Merry-K; Ramos, Diana; Stuebe, Alison; Zephyrin, Laurie

    2016-05-01

    Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements.

  7. Developing a Third-Party Analytics Application Using Australia's National Personal Health Records System: Case Study.

    PubMed

    Bidargaddi, Niranjan; van Kasteren, Yasmin; Musiat, Peter; Kidd, Michael

    2018-04-24

    My Health Record (MyHR) is Australia's national electronic health record (EHR) system. Poor usability and functionality have resulted in low utility, affecting enrollment and participation rates by both patients and clinicians alike. Similar to apps on mobile phone app stores, innovative third-party applications of MyHR platform data can enhance the usefulness of the platform, but there is a paucity of research into the processes involved in developing third-party applications that integrate and use data from EHR systems. The research describes the challenges involved in pioneering the development of a patient and clinician Web-based software application for MyHR and insights resulting from this experience. This research uses a case study approach, investigating the development and implementation of Actionable Intime Insights (AI 2 ), a third-party application for MyHR, which translates Medicare claims records stored in MyHR into a clinically meaningful timeline visualization of health data for both patients and clinicians. This case study identifies the challenges encountered by the Personal Health Informatics team from Flinders University in the MyHR third-party application development environment. The study presents a nuanced understanding of different data types and quality of data in MyHR and the complexities associated with developing secondary-use applications. Regulatory requirements associated with utilization of MyHR data, restrictions on visualizations of data, and processes of testing third-party applications were encountered during the development of the application. This study identified several processes, technical and regulatory barriers which, if addressed, can make MyHR a thriving ecosystem of health applications. It clearly identifies opportunities and considerations for the Australian Digital Health Agency and other national bodies wishing to encourage the development of new and innovative use cases for national EHRs. ©Niranjan Bidargaddi

  8. Developing a Third-Party Analytics Application Using Australia’s National Personal Health Records System: Case Study

    PubMed Central

    van Kasteren, Yasmin; Musiat, Peter; Kidd, Michael

    2018-01-01

    Background My Health Record (MyHR) is Australia’s national electronic health record (EHR) system. Poor usability and functionality have resulted in low utility, affecting enrollment and participation rates by both patients and clinicians alike. Similar to apps on mobile phone app stores, innovative third-party applications of MyHR platform data can enhance the usefulness of the platform, but there is a paucity of research into the processes involved in developing third-party applications that integrate and use data from EHR systems. Objective The research describes the challenges involved in pioneering the development of a patient and clinician Web-based software application for MyHR and insights resulting from this experience. Methods This research uses a case study approach, investigating the development and implementation of Actionable Intime Insights (AI2), a third-party application for MyHR, which translates Medicare claims records stored in MyHR into a clinically meaningful timeline visualization of health data for both patients and clinicians. This case study identifies the challenges encountered by the Personal Health Informatics team from Flinders University in the MyHR third-party application development environment. Results The study presents a nuanced understanding of different data types and quality of data in MyHR and the complexities associated with developing secondary-use applications. Regulatory requirements associated with utilization of MyHR data, restrictions on visualizations of data, and processes of testing third-party applications were encountered during the development of the application. Conclusions This study identified several processes, technical and regulatory barriers which, if addressed, can make MyHR a thriving ecosystem of health applications. It clearly identifies opportunities and considerations for the Australian Digital Health Agency and other national bodies wishing to encourage the development of new and innovative use

  9. Developing Expert System for Tuberculosis Diagnose to Support Knowledge Sharing in the Era of National Health Insurance System

    NASA Astrophysics Data System (ADS)

    Lidya, L.

    2017-03-01

    National Health Insurance has been implemented since 1st January 2014. A number of new policies have been established including multilevel referral system. The multilevel referral system classified health care center into three levels, it determined that the flow of patient treatment should be started from first level health care center. There are 144 kind of diseases that must be treat in the first level which mainly consists of general physicians. Unfortunately, competence of the physician in the first level may not fulfil the standard competence yet. To improved the physisians knowledge, government has created many events to accelerate knowledge sharing. However, it still needs times and many resources to give significan results. Expert system is kind of software that provide consulting services to non-expert users in accordance with the area of its expertise. It can improved effectivity and efficiency of knowledge sharing and learning. This research was developed a model of TB diagnose expert system which comply with the standard procedure of TB diagnosis and regulation. The proposed expert system has characteristics as follows provide facility to manage multimedia clinical data, supporting the complexity of TB diagnosis (combine rule-based and case-based expert system), interactive interface, good usability, multi-platform, evolutionary.

  10. Health and safety management systems: liability or asset?

    PubMed

    Bennett, David

    2002-01-01

    Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace.

  11. Public health and national security: the critical role of increased federal support.

    PubMed

    Frist, Bill

    2002-01-01

    Protecting the public's health historically has been a state and local responsibility. However, the growing threat of bioterrorism has highlighted the importance of a strong public health infrastructure to the nation's homeland security and has focused increased attention on the preparedness of the public health system. As a result, federal public health funding has increased exponentially since the anthrax attacks of late 2001, and Congress has passed sweeping new federal legislation intended to strengthen the nation's public health system. This heightened level of federal interest and support should yield important public health benefits. Most recognize that after years of neglect the public health infrastructure cannot be rebuilt overnight. As we implement a comprehensive strategy to increase the capabilities and capacity of our nation's public health system, it is essential to address a series of important policy questions, including the appropriate level of ongoing public health investments from local, state, and federal sources.

  12. A patient centered electronic health: eHealth system development.

    PubMed

    Schiza, Eirini C; Neokleous, Kleanthis C; Petkov, Nikolai; Schizas, Christos N

    2015-01-01

    Medical practice and patient-doctor relationship will continue improving while technology is integrated in our everyday life. In recent years the term eHealth landmarked a new era with improved health provider's skills and knowledge, and increased patient participation in medical care activities. To show why the design and implementation of a healthcare system needs to follow a specific philosophy dictated by the level of eHealth maturity of a country and its citizens. Based on the maturity level, an adaptable framework for implementing an Electronic Health System at national level is derived, guided by the Patient Centered Philosophy as defined and introduced by the EU directives. Implementation prerequisites are analyzed together with guiding principles for identifying the maturity level of an organization or country. Cyprus being a small EU country, it can be used as pilot site for the whole Europe, was chosen for this study and its maturity level analysis is presented. Recommendations that determine general steps needed to prepare the ground for an adequate patient-centered national healthcare system are accompanied. The implementation of an integrated Electronic Health Record at National level, as a prerequisite for a patient-centered eHealth environment is evidently demonstrated.

  13. 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

    ...] Notice of Request for Approval of an Information Collection; National Animal Health Monitoring System... to support the National Animal Health Monitoring System Sheep 2011 Study. DATES: We will consider all... Coordinator, at (301) 851-2908. SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring System...

  14. National Wildlife Refuge System: Ecological context and integrity

    USGS Publications Warehouse

    Scott, J.M.; Loveland, T.; Gergely, K.; Strittholt, J.; Staus, N.

    2004-01-01

    The Refuge Improvement Act of 1997 established a statutory mission and management standards for the National Wildlife Refuge system. The U.S. Fish and Wildlife Service subsequently issued a policy for ensuring the biological integrity, diversity, and environmental health of the system. This policy requires understanding the management objectives of each refuge in a local, regional, and national context. An assessment of the refuge system in a national and regional context reveals that refuges are typically smaller than many conservation holdings and are unevenly distributed across the conterminous U.S. Western rangelands, coastal wetlands, and northern grasslands; wetlands are the best-represented ecosystems, while temperate forests have the poorest representation. In contrast to other agency holdings or management designations in the national protected areas network (e.g., national parks, national forests, wilderness areas), refuges tend to occupy sites at lower elevations and that have higher productivity and soil quality. This difference points to the important contribution of the refuges in providing much needed ecological balance within the national protected areas network. However, the ecological integrity of the refuge system is challenged by the proximity of individual refuges to development. Overall, the refuges are becoming islands in a landscape matrix of urban and agricultural development. This creates future challenges for meeting management objectives to ensure the biological integrity, diversity, and environmental health of the system. If the policy to ensure biological integrity, diversity, and environmental health of the refuge system is to be successful, it may be more important to address issues about what happens on adjacent lands than uses within refuges.

  15. The rise of governmentality in the Italian National Health System: physiology or pathology of a decentralized and (ongoing) federalist system?

    PubMed

    Lega, Federico; Sargiacomo, Massimo; Ianni, Luca

    2010-11-01

    In this paper, we aim to discuss the implications and lessons that can be learnt from the ongoing process of federalism affecting the Italian National Health System (INHS). Many countries are currently taking decisions concerning the decentralization or re-centralization of their health-care systems, with several key issues that are illustrated in the recent history of the INHS. The decentralization process of INHS has produced mixed results, as some regions took advantage of it to strengthen their systems, whereas others were not capable of developing an effective steering role. We argue that the mutual reinforcement of the decentralization and recentralization processes is not paradoxical, but is actually an effective way for the State to maintain control over the equity and efficiency of its health-care system while decentralizing at a regional level. In this perspective, we provide evidence backing up some of the assumptions made in previous works as well as new food-for thought - specifically on how governmentality and federalism should meet - to reshape the debate on decentralization in health care.

  16. National health accounts: Lessons from the U.S. experience

    PubMed Central

    Lazenby, Helen C.; Levit, Katharine R.; Waldo, Daniel R.; Adler, Gerald S.; Letsch, Suzanne W.; Cowan, Cathy A.

    1992-01-01

    The national health accounts (NHA) are the framework within which type of services and sources of funding for health care expenditures are measured. NHA, devised to portray the structure of health care delivery and financing in the United States, provide essential information necessary for the formulation of public health policy and for international comparison. In this article, the authors describe the importance of the NHA nationally and internationally, and provide a blueprint of the definitions, sources, and methods used to create this system of NHA in the United States. PMID:10122006

  17. A case analysis of INFOMED: the Cuban national health care telecommunications network and portal.

    PubMed

    Séror, Ann C

    2006-01-27

    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. 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. 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. 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. 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 and interpretation of values such as individual

  18. 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

  19. Developing a national health research system: participatory approaches to legislative, institutional and networking dimensions in Zambia.

    PubMed

    Chanda-Kapata, Pascalina; Campbell, Sandy; Zarowsky, Christina

    2012-06-06

    For many sub-Saharan African countries, a National Health Research System (NHRS) exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, we discuss the ongoing development of Zambia's NHRS. We reflect on our experience in the ongoing consultative development of Zambia's NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. We argue that three streams of concurrent activity are critical in developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system's boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonize, unify and strengthen the overall capacities of the research community.

  20. 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.

  1. 78 FR 9055 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the..., Medical Systems Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo...

  2. Implementation and integration of regional health care data networks in the Hellenic National Health Service.

    PubMed

    Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

    2002-12-01

    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. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. 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. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. 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.

  3. 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

  4. 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

  5. Electronic health record - public health (EHR-PH) system prototype for interoperability in 21st century healthcare systems.

    PubMed

    Orlova, Anna O; Dunnagan, Mark; Finitzo, Terese; Higgins, Michael; Watkins, Todd; Tien, Allen; Beales, Steven

    2005-01-01

    Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation's healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH)system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal element for a potential technical architecture for a NHIN.

  6. Integrating Child Health Information Systems

    PubMed Central

    Hinman, Alan R.; Eichwald, John; Linzer, Deborah; Saarlas, Kristin N.

    2005-01-01

    The Health Resources and Services Administration and All Kids Count (a national technical assistance center fostering development of integrated child health information systems) have been working together to foster development of integrated child health information systems. Activities have included: identification of key elements for successful integration of systems; development of principles and core functions for the systems; a survey of state and local integration efforts; and a conference to develop a common vision for child health information systems to meet medical care and public health needs. We provide 1 state (Utah) as an example that is well on the way to development of integrated child health information systems. PMID:16195524

  7. Forest health monitoring in the United States: focus on national reports

    Treesearch

    Kurt Riitters; Kevin Potter

    2013-01-01

    The health and sustainability of United States forests have been monitored for many years from several different perspectives. The national Forest Health Monitoring (FHM) Program was established in 1990 by Federal and State agencies to develop a national system for monitoring and reporting on the status and trends of forest ecosystem health. We describe and illustrate...

  8. Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

    PubMed

    Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

    2014-01-01

    Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

  9. 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

  10. National Health Expenditures, 1978

    PubMed Central

    Gibson, Robert M.

    1979-01-01

    Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965. PMID:10309049

  11. 78 FR 55751 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...

  12. 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

  13. 76 FR 71047 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on...., Chief, Extramural Project Review Branch EPRB, NIAAA, National Institutes of Health, 5365 Fishers Lane... Awards., National Institutes of Health, HHS) Dated: November 8, 2011. Jennifer S. Spaeth, Director...

  14. 78 FR 24427 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day..., the National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH), will... Genome Research Institute (NHGRI), National Institutes of Health (NIH). Need and Use of Information...

  15. Strengthening the public health system.

    PubMed

    Roper, W L; Baker, E L; Dyal, W W; Nicola, R M

    1992-01-01

    Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capacity, particularly in local and State public health agencies. To strengthen the public health system, concerted action is needed to meet these five critical needs: First, the knowledge base of public health workers needs to be supplemented through on-the-job training and continuing education programs. To this end, self-study courses will be expanded, and a network of regional training centers will be established throughout the country. Second, communities need dynamic leadership from public health officials and their agencies. To enhance leadership skills and expand the leadership role of public health agencies, focused personal leadership development activities, including a Public Health Leadership Institute, and national conferences will provide a vision of the future role of public health agencies. Third, local and State public health agencies need access to data on the current health status of the people in their communities and guidance from the nation's public health experts. To improve access to information resources, state-of-the-art technologies will be deployed to create integrated information and communication systems linking all components of the public health system. Fourth, local and State agencies need disease prevention and health promotion plans that target problems and develop strategies and the capacity to address them. To provide communities with structured approaches to this process, planning tools have been developed and distributed, and technical assistance will be provided to local and State health agencies to involve each community in planning,priority setting, and constituency building.Finally, public health agencies need adequate resources to fund prevention programs. To improve the use of

  16. Sustainable development and public health: a national perspective.

    PubMed

    Adshead, Fiona; Thorpe, Allison; Rutter, Jill

    2006-12-01

    The increasing policy focus on sustainable development offers new opportunities to align the public health narrative with that of sustainable development to promote both sustainable health for the population, and a sustainable health care system for England. This paper provides some insights into ways in which potential linkages between the two areas can be made meaningful across a wide range of policies at a national level.

  17. 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. © 2012 International Association of Forensic Nurses.

  18. The English National Health Service: 1979--2005.

    PubMed

    Oliver, Adam

    2005-09-01

    This article aims to assess the development of the English National Health Service (NHS) over the period 1979--2005, against the original, and often repeated, core objectives of the system: that it be universal in offering coverage to all members of the population in times of health care need; that it be comprehensive in its provision of health care services; and that it be (largely) free at the point of use. Comprehensiveness is open to interpretation, and may depend upon the wealth of the nation. Universality and (largely) free care at the point of use, which lend themselves to the principle of equal access for equal need, are more concrete, and it is not difficult to ascertain if they have been substantially and/or systematically violated. The article details briefly the developments in resource allocation, provider payment mechanisms, incentives and accountability, and notes that much of the emphasis on health sector change since the mid 1980s has been placed upon improving supply side efficiency and reducing waiting lists/times. Improving NHS efficiency, and indeed related aspirations associated with choice and health outcomes, can be perceived as 'secondary' objectives, in that they should not serve to undermine the core objectives of the system, assuming that the security offered by having an accessible, universal health care system is considered worthy of protection. The overall conclusion is that the NHS has performed quite well against its core objectives to date, although it is possible that the current preoccupation with choice and health outcomes will lead us down a different policy path in the future. Copyright (c) 2005 John Wiley & Sons, Ltd.

  19. Socioeconomic status and waiting times for health services: An international literature review and evidence from the Italian National Health System.

    PubMed

    Landi, Stefano; Ivaldi, Enrico; Testi, Angela

    2018-04-01

    In the absence of priority criteria, waiting times are an implicit rationing instrument where the absence or limited use of prices creates an excess of demand. Even in the presence of priority criteria, waiting times may be unfair because they reduce health care demand of patients in lower socio-economic conditions due to high opportunity costs of time or a decay in their health level. Significant evidence has shown a relationship between socioeconomic status and the length of waiting time. The first phase of the study involved an extensive review of the existent literature for the period of 2002-2016 in the main databases (Scopus, PubMed and Science Direct). Twenty-eight met the eligibility criteria. The 27 papers were described and classified. The e mpirical objective of this study was to determine whether socioeconomic characteristics affect waiting time for different health services in the Italian national health system. The services studied were specialist visits, diagnostics tests and elective surgeries. A classification tree and logistic regression models were implemented. Data from the 2013 Italian Health National Survey were used. The analysis found heterogeneous results for different types of service. Individuals with lower education and economic resources have a higher risk of experiencing excessive waiting times for diagnostic and specialist visits. For elective surgery, socioeconomic inequalities are present but appear to be lower. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. 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.

  1. 76 FR 40383 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Government-Owned Inventions; Availability for Licensing AGENCY: Public Health Service, National Institutes of Health, HHS. ACTION: Notice... the indicated licensing contact at the Office of Technology Transfer, National Institutes of Health...

  2. 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…

  3. National health expenditures, 1991

    PubMed Central

    Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

    1992-01-01

    Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

  4. 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…

  5. Origins and Elaboration of the National Health Accounts, 1926-2006

    PubMed Central

    Fetter, Bruce

    2006-01-01

    The National Health Statistics Group (NHSG) has managed to keep the national health accounts (NHA) apolitical and highly respected. NHSG strategies have included the careful acquisition and presentation of statistics relating to health costs and payers; the use of scholarly journals to disseminate ideas to other government offices and, beyond them, to industry, labor, the professions, and universities; and the promotion of cooperation with related U.S., statistical agencies, provider groups, contractors, and international organizations. Responding to an increasingly complex system of third-party payers in the U.S. health system and controversies over methods, the NHA has continually evolved to meet the demands of health care decisionmakers. Historically, these dialogues have forced health accountants to refine their methods to ensure that their portrayal of spending and financing trends presents information that can inform the decisionmaking process in a non-partisan way. PMID:17290668

  6. Critical role of developing national strategic plans as a guide to strengthen laboratory health systems in resource-poor settings.

    PubMed

    Nkengasong, John N; Mesele, Tsehaynesh; Orloff, Sherry; Kebede, Yenew; Fonjungo, Peter N; Timperi, Ralph; Birx, Deborah

    2009-06-01

    Medical laboratory services are an essential, yet often neglected, component of health systems in developing countries. Their central role in public health, disease control and surveillance, and patient management is often poorly recognized by governments and donors. However, medical laboratory services in developing countries can be strengthened by leveraging funding from other sources of HIV/AIDS prevention, care, surveillance, and treatment programs. Strengthening these services will require coordinated efforts by national governments and partners and can be achieved by establishing and implementing national laboratory strategic plans and policies that integrate laboratory systems to combat major infectious diseases. These plans should take into account policy, legal, and regulatory frameworks; the administrative and technical management structure of the laboratories; human resources and retention strategies; laboratory quality management systems; monitoring and evaluation systems; procurement and maintenance of equipment; and laboratory infrastructure enhancement. Several countries have developed or are in the process of developing their laboratory plans, and others, such as Ethiopia, have implemented and evaluated their plan.

  7. National health information infrastructure model: a milestone for health information management education realignment.

    PubMed

    Meidani, Zahra; Sadoughi, Farhnaz; Ahmadi, Maryam; Maleki, Mohammad Reza; Zohoor, Alireza; Saddik, Basema

    2012-01-01

    Challenges and drawbacks of the health information management (HIM) curriculum at the Master's degree were examined, including lack of well-established computing sciences and inadequacy to give rise to specific competencies. Information management was condensed to the hospital setting to intensify the indispensability of a well-organized educational campaign. The healthcare information dimensions of a national health information infrastructure (NHII) model present novel requirements for HIM education. Articles related to challenges and barriers to adoption of the personal health record (PHR), the core component of personal health dimension of an NHII, were searched through sources including Science Direct, ProQuest, and PubMed. Through a literature review, concerns about the PHR that are associated with HIM functions and responsibilities were extracted. In the community/public health dimension of the NHII the main components have been specified, and the targeted information was gathered through literature review, e-mail, and navigation of international and national organizations. Again, topics related to HIM were evoked. Using an information system (decision support system, artificial neural network, etc.) to support PHR media and content, patient education, patient-HIM communication skills, consumer health information, conducting a surveillance system in other areas of healthcare such as a risk factor surveillance system, occupational health, using an information system to analyze aggregated data including a geographic information system, data mining, online analytical processing, public health vocabulary and classification system, and emerging automated coding systems pose major knowledge gaps in HIM education. Combining all required skills and expertise to handle personal and public dimensions of healthcare information in a single curriculum is simply impractical. Role expansion and role extension for HIM professionals should be defined based on the essence of

  8. 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.

  9. 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

  10. 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

  11. Lessons learnt from the development of the Patient Safety Incidents Reporting an Learning System for the Spanish National Health System: SiNASP.

    PubMed

    Vallejo-Gutiérrez, Paula; Bañeres-Amella, Joaquim; Sierra, Eduardo; Casal, Jesús; Agra, Yolanda

    2014-01-01

    To describe the development process and characteristics of a patient safety incidents reporting system to be implemented in the Spanish National Health System, based on the context and the needs of the different stakeholders. Literature review and analysis of most relevant reporting systems, identification of more than 100 stakeholder's (patients, professionals, regional governments representatives) expectations and requirements, analysis of the legal context, consensus of taxonomy, development of the software and pilot test. Patient Safety Events Reporting and Learning system (Sistema de Notificación y Aprendizajepara la Seguridad del Paciente, SiNASP) is a generic reporting system for all types of incidents related to patient safety, voluntary, confidential, non punitive, anonymous or nominative with anonimization, system oriented, with local analysis of cases and based on the WHO International Classification for Patient Safety. The electronic program has an on-line form for reporting, a software to manage the incidents and improvement plans, and a scoreboard with process indicators to monitor the system. The reporting system has been designed to respond to the needs and expectations identified by the stakeholders, taking into account the lessons learned from the previous notification systems, the characteristics of the National Health System and the existing legal context. The development process presented and the characteristics of the system provide a comprehensive framework that can be used for future deployments of similar patient safety systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  12. 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

  13. Background and data configuration process of a nationwide population-based study using the korean national health insurance system.

    PubMed

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

    2014-10-01

    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. 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. 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. 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.

  14. 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…

  15. Hungary: a health system in transition.

    PubMed

    Mendoza, E M; Henderson, B J

    1996-03-01

    Hungary has an area of 93,030 square kilometers (35,900 square miles), the size of the state of Indiana in the United States. It is landlocked by the Czech Republic and the Slovak Republic to the north, Austria to the west, Yugoslavia to the south, and Romania and the Soviet Union to the east. Although the health care system is based on the Soviet system, there have been dramatic changes since 1991, when the soviet Union and its Eastern European partners discarded their communist structures and the Soviet empire was disbanded. In this report, the current Hungarian health care system and the political structure in which it is housed will be described in terms of a key set of characteristics and their subparts. The purpose of this approach is to facilitate comparison of the Hungarian system with other national health care systems. An expanded version of this article will appear in an upcoming second edition of the College's book, International Health Care: A Framework for Comparing National Health Care Systems, by Drs. Mendoza and Henderson.

  16. 76 FR 16798 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review.... Place: National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892 (Telephone Conference..., National Institutes of Health, 6701 Rockledge Drive, Room 4136, MSC 7850, Bethesda, MD 20892, (301) 435...

  17. 75 FR 6044 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... individual intramural programs and projects conducted by the National Institute of Environmental Health...

  18. The WHO-ITU national eHealth strategy toolkit as an effective approach to national strategy development and implementation.

    PubMed

    Hamilton, Clayton

    2013-01-01

    With few exceptions, national eHealth strategies are the pivotal tools upon which the launch or refocusing of national eHealth programmes is hinged. The process of their development obviates cross-sector ministerial commitment led by the Ministry of Health. Yet countries often grapple with the task of strategy development and best efforts frequently fail to address strategic components of eHealth key to ensure successful implementation and stakeholder engagement. This can result in strategies that are narrowly focused, with an overemphasis placed on achieving technical outcomes. Without a clear link to a broader vision of health system development and a firm commitment from partners, the ability of a strategy to shape development of a national eHealth framework will be undermined and crucial momentum for implementation will be lost. WHO and ITU have sought to address this issue through the development of the National eHealth Strategy Toolkit that provides a basis for the components and processes to be considered in a strategy development or refocusing exercise. We look at this toolkit and highlight those areas which the countries should consider in formulating their national eHealth strategy.

  19. Primary Health Care and Public Health: Foundations of Universal Health Systems

    PubMed Central

    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. PMID:25591411

  20. 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. © 2015 S. Karger AG, Basel.

  1. 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.

  2. 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

  3. 76 FR 53685 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review... data collection projects, the Center for Scientific Review (CSR), National Institutes of Health (NIH... for public comment. The National Institutes of Health may not conduct or sponsor and the respondent is...

  4. 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.

  5. Understanding and valuing the broader health system benefits of Uganda's national Human Resources for Health Information System investment.

    PubMed

    Driessen, Julia; Settle, Dykki; Potenziani, David; Tulenko, Kate; Kabocho, Twaha; Wadembere, Ismail

    2015-08-31

    To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation. This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment. This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health. Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in

  6. [The health system of Nicaragua].

    PubMed

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

    2011-01-01

    This paper describes the health conditions in Nicaragua and discusses the characteristics of its national health system including its structure and coverage, its financial sources its physical, material and human resources the stewardship functions developed by the Ministry of Health the participation of citizens in the operation and evaluation of the system and the level of satisfaction of health care users. It also discusses the most recent policy innovations, including the new General Health Law, the decentralization of the regulation of health facilities and the design and implementation of a new health care model known as Family and Community Health Model.

  7. Designing and implementing E-health Applications in the UK's National Health Service.

    PubMed

    Bower, D Jane; Barry, Nessa; Reid, Margaret; Norrie, John

    2005-12-01

    Telemedicine/e-health applications have the potential to play an important role in Britain's National Health Service (NHS), including the NHS in Scotland. The Scottish Telemedicine Action Forum (STAF) was established by the Scottish Executive Department of Health in 1999 to take a range of applications, targeted on national priorities, into routine service. In the process it has provided insights into how advanced information and communication technologies (ICTs) can be moved from the research stage into routine service. In this article four of the projects are described and analysed focusing on the key issues that have emerged as critical for carrying projects successfully through to implementation in service as follows: 1. A multisite videoconferencing network linking 15 minor injury units to the main accident and emergency (A&E) centre. 2. A single-site neonatal intensive care "cotside" laptop system to assist communication between parents and clinical staff. 3. A single-site outpatient chronic disease management system. 4. A multisite software audit tool to support the care of cleft lip and palate patients from birth onward.

  8. Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries.

    PubMed

    Nsubuga, Peter; Nwanyanwu, Okey; Nkengasong, John N; Mukanga, David; Trostle, Murray

    2010-12-03

    There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO) has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening.With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention.We describe two ways that health ministries in developing countries could leverage President Obama's Global Health Initiative (GHI) to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM]) can also adapt their current health systems strengthening programs to build sustainable public health systems.

  9. Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

    PubMed

    Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

    2014-01-01

    The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

  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. The impact of global health initiatives on the health system in Angola.

    PubMed

    Craveiro, Isabel; Dussault, Gilles

    2016-01-01

    We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs' function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid.

  12. Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned.

    PubMed

    Sombié, Issiaka; Aidam, Jude; Montorzi, Gabriela

    2017-07-12

    Since the Commission on Health Research for Development (COHRED) published its flagship report, more attention has been focused on strengthening national health research systems (NHRS). This paper evaluates the contribution of a regional project that used a participatory approach to strengthen NHRS in four post-conflict West African countries - Guinea-Bissau, Liberia, Sierra Leone and Mali. The data from the situation analysis conducted at the start of the project was compared to data from the project's final evaluation, using a hybrid conceptual framework built around four key areas identified through the analysis of existing frameworks. The four areas are governance and management, capacities, funding, and dissemination/use of research findings. The project helped improve the countries' governance and management mechanisms without strengthening the entire NHRS. In the four countries, at least one policy, plan or research agenda was developed. One country put in place a national health research ethics committee, while all four countries could adopt a research information management system. The participatory approach and support from the West African Health Organisation and COHRED were all determining factors. The lessons learned from this project show that the fragile context of these countries requires long-term engagement and that support from a regional institution is needed to address existing challenges and successfully strengthen the entire NHRS.

  13. National and surgical health care expenditures, 2005-2025.

    PubMed

    Muñoz, Eric; Muñoz, William; Wise, Leslie

    2010-02-01

    Health care expenditures for 2005 in the United States were $1.9733 trillion and 15.9% of the gross domestic product (GDP). Twenty-nine percent of those expenditures were secondary to surgical revenues. Health care expenditures are increasing 2(1/2) times the rate of the general US economy and are being fed by new technologies, new medications, the aging population, more services provided per patient, defensive medicine and little tort reform, the insurance system, and the free rider problem, ie, patients are cared for as emergencies regardless of insurance coverage and legality, which all have contributed to rising health care and surgical expenditures over the last 50 years. The purpose of this study was to project aggregate national health care expenditures, aggregate surgical health care expenditures, and the United States GDP for the years 2005-2025. Model building and existing state and national data were used. Aggregate surgical health care expenditures were computed as 29% of aggregate health care expenditures using a unique model developed by the late Dr. Francis D. Moore. The model of Dr. Moore which used 1981 federal data was verified/tested using data from UMDNJ-University Hospital, and New Jersey and national data from 2005. From 1965 to 2005 mean health care expenditures increased at 4.9% per year, and US GDP increased at a mean of 2.1% per year. Aggregate surgical expenditures are expected to grow from $572 billion in 2005 (4.6% of US GDP) to $912 billion (2005 dollars) in the year 2025 (7.3% of US GDP). Aggregate health care expenditures are projected to increase from $5572 per capita (15.9% of GDP) in 2005 to $8832 per capita (2005 dollars) in 2025 (25.2% of US GDP). Both surgery and national health care expenditures are expected to expand by almost 60% during the period 2005-2025. Thus, surgical health care expenditures by 2025 are likely to be 1/14 of the US economy, and health care expenditures will be (1/4) of the US economy. Real per capita

  14. 78 FR 24760 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Prospective Grant of Start... Prevention in Humans AGENCY: National Institutes of Health, HHS. ACTION: Notice. SUMMARY: This is notice, in accordance with 35 U.S.C. 209(c)(1) and 37 CFR 404.7(a)(1)(i), that the National Institutes of Health...

  15. Political cultures, health systems and health policy.

    PubMed

    Atkinson, Sarah

    2002-07-01

    Policies for restructuring national health systems in low- and middle-income countries tend to follow similar packages of prescriptions along the lines of those discussed in the World Development Report of 1993. An ubiquitous reform measure is that of decentralisation. Research on decentralised health care in Northeast Brazil demonstrates the critical role played by informal aspects of health system management and the political cultures of the wider context on the implementation of policy and the performance of local health systems. Discussion of incorporating these results into policy making highlights a number of points. Health systems research has failed to take seriously the role of the cultural for various reasons, particularly because of the challenge it makes to our own fundamental values and because of the difficulties of including it into approaches based on rational systems models. At the same time, health system researchers cannot easily draw upon and operationalise more complex and sophisticated explorations of the nature of the cultural domain. Nonetheless, without a concerted effort to engage with this literature, to bridge the gap to the applied policy world and tackle the challenge of incorporating considerations of political culture into policy making, health system management through decentralisation is likely to increase inequalities between local districts rather than the opposite.

  16. 77 FR 42255 - Notice of Request for Approval of a New Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... Collection; National Animal Health Monitoring System; Layers 2013 Study AGENCY: Animal and Plant Health... Health Inspection Service's intention to initiate the Layers 2013 Study, an information collection to... INFORMATION: Title: National Animal Health Monitoring System; Layers 2013 Study. OMB Number: 0579-XXXX. Type...

  17. Outcomes, costs and stakeholders' perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review.

    PubMed

    Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee

    2018-02-01

    Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.

  18. Introduction: health of the health care system in Korea.

    PubMed

    Kim, Dong Soo

    2010-03-01

    This study is a mega evaluation of Korea's health care system as developed thus far. It aims to review the historical context in which this system was developed and the political stage and motivation for such development. It will highlight unique features of the system and some comparative analysis with other developed nations. Then it will introduce selective, specific areas and aspects of the health care system, service delivery, and practices. It will suggest its implications for future direction.

  19. Systemic factors of errors in the case identification process of the national routine health information system: A case study of Modified Field Health Services Information System in the Philippines

    PubMed Central

    2011-01-01

    Background The quality of data in national health information systems has been questionable in most developing countries. However, the mechanisms of errors in the case identification process are not fully understood. This study aimed to investigate the mechanisms of errors in the case identification process in the existing routine health information system (RHIS) in the Philippines by measuring the risk of committing errors for health program indicators used in the Field Health Services Information System (FHSIS 1996), and characterizing those indicators accordingly. Methods A structured questionnaire on the definitions of 12 selected indicators in the FHSIS was administered to 132 health workers in 14 selected municipalities in the province of Palawan. A proportion of correct answers (difficulty index) and a disparity of two proportions of correct answers between higher and lower scored groups (discrimination index) were calculated, and the patterns of wrong answers for each of the 12 items were abstracted from 113 valid responses. Results None of 12 items reached a difficulty index of 1.00. The average difficulty index of 12 items was 0.266 and the discrimination index that showed a significant difference was 0.216 and above. Compared with these two cut-offs, six items showed non-discrimination against lower difficulty indices of 0.035 (4/113) to 0.195 (22/113), two items showed a positive discrimination against lower difficulty indices of 0.142 (16/113) and 0.248 (28/113), and four items showed a positive discrimination against higher difficulty indices of 0.469 (53/113) to 0.673 (76/113). Conclusions The results suggest three characteristics of definitions of indicators such as those that are (1) unsupported by the current conditions in the health system, i.e., (a) data are required from a facility that cannot directly generate the data and, (b) definitions of indicators are not consistent with its corresponding program; (2) incomplete or ambiguous, which allow

  20. Urbanization and health in China, thinking at the national, local and individual levels.

    PubMed

    Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong

    2016-03-08

    China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take

  1. Refining estimates of public health spending as measured in national health expenditures accounts: the United States experience.

    PubMed

    Sensenig, Arthur L

    2007-01-01

    Providing for the delivery of public health services and understanding the funding mechanisms for these services are topics of great currency in the United States. In 2002, the Department of Homeland Security was created and the responsibility for providing public health services was realigned among federal agencies. State and local public health agencies are under increased financial pressures even as they shoulder more responsibilities as the vital first link in the provision of public health services. Recent events, such as hurricanes Katrina and Rita, served to highlight the need to accurately access the public health delivery system at all levels of government. The National Health Expenditure Accounts (NHEA), prepared by the National Health Statistics Group, measure expenditures on healthcare goods and services in the United States. Government public health activity constitutes an important service category in the NHEA. In the most recent set of estimates, Government Public Health Activity expenditures totaled $56.1 billion in 2004, or 3.0 percent of total US health spending. Accurately measuring expenditures for public health services in the United States presents many challenges. Among these challenges is the difficult task of defining what types of government activity constitute public health services. There is no clear-cut, universally accepted definition of government public health care services, and the definitions in the proposed International Classification for Health Accounts are difficult to apply to an individual country's unique delivery systems. Other challenges include the definitional issues associated with the boundaries of healthcare as well as the requirement that census and survey data collected from government(s) be compliant with the Classification of Functions of Government (COFOG), an internationally recognized classification system developed by the United Nations.

  2. 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.

  3. [The health system of El Salvador].

    PubMed

    Acosta, Mónica; Sáenz, María del Rocío; Gutiérrez, Blanca; Bermúdez, Juan Luis

    2011-01-01

    This paper describes the health conditions in El Salvador and the main característics of the Salvadoran health system, including its structure and coverage, its financial sources, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health, and the participation of health care users in the evaluation of the system. It also discusses the most recent policy innovations including the approval of the Law for the Creation of the National Health System, which intends to expand coverage, reduce health inequalities and improve the coordination of public health institutions.

  4. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland.

    PubMed

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-01-01

    Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.

  5. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland

    PubMed Central

    Clavier, Carole; Potvin, Louise

    2017-01-01

    Background Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Methods Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Results Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Conclusion Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making. PMID:28589007

  6. 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

  7. 78 FR 42967 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee... Resources Research, National Institutes of Health, HHS) Dated: July 12, 2013. Michelle Trout, Program...

  8. 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.

  9. 75 FR 71134 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U....398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS) Dated...

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

    PubMed

    Cresswell, Kathrin M; Worth, Allison; Sheikh, Aziz

    2012-03-08

    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. 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. 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. This work has highlighted the importance of addressing potentially adverse unintended consequences of workarounds associated with the

  11. National Health Interview Survey (NHIS)

    EPA Pesticide Factsheets

    The NHIS collects data on a broad range of health topics through personal household interviews. The results of NHIS provide data to track health status, health care access, and progress toward achieving national health objectives.

  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. 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…

  14. Vital Directions for Health and Health Care: Priorities From a National Academy of Medicine Initiative.

    PubMed

    Dzau, Victor J; McClellan, Mark B; McGinnis, J Michael; Burke, Sheila P; Coye, Molly J; Diaz, Angela; Daschle, Thomas A; Frist, William H; Gaines, Martha; Hamburg, Margaret A; Henney, Jane E; Kumanyika, Shiriki; Leavitt, Michael O; Parker, Ruth M; Sandy, Lewis G; Schaeffer, Leonard D; Steele, Glenn D; Thompson, Pamela; Zerhouni, Elias

    2017-04-11

    Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity. Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings. The US health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress. The action priorities and essential infrastructure needs represent major

  15. April Spotlight: National Minority Health Month

    Cancer.gov

    Each April, we recognize National Minority Health Month and National Minority Cancer Awareness Week. Dr. Peter Ogunbiyi shares how CRCHD’s work is related to the 2017 theme: Bridging Health Equity Across Communities.

  16. [The Unified National Health System and the third sector: Characterization of non-hospital facilities providing basic health care services in Belo Horizonte, Minas Gerais, Brazil].

    PubMed

    Canabrava, Claudia Marques; Andrade, Eli Iôla Gurgel; Janones, Fúlvio Alves; Alves, Thiago Andrade; Cherchiglia, Mariangela Leal

    2007-01-01

    In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic health care in the country. This article identifies and describes non-hospital nonprofit facilities providing systematically organized basic health care in Belo Horizonte, Minas Gerais, Brazil, in 2004. The research focused on the facilities registered with the National Council on Social Work, using computer-assisted telephone and semi-structured interviews. Identification and description of these organizations showed that the charitable segment of the third sector conducts organized and systematic basic health care services but is not recognized by the Unified National Health System as a potential partner, even though it receives referrals from basic government services. The study showed spatial and temporal overlapping of government and third-sector services in the same target population.

  17. [Barriers for introducing a health technology assessment organization to inform health care decision-making in the Spanish National Health System].

    PubMed

    Artells, Juan José; Peiró, Salvador; Meneu, Ricard

    2014-01-01

    To identify difficulties, obstacles and limitations to establish an organizational structure devoted to the evaluation of healthcare technologies for incorporation, maintenance or removal from the services portfolio of the Spanish National Health System (sNHS). Panel of 14 experts, structured according to processes adapted from brainstorming, nominal group, and Rand consensus method techniques. The panel proposed 77 items as potential obstacles to the establishment of an official and independent "agency" able to inform on sNHS healthcare benefits funding or selective disinvestment. These items were focused on: 1) lack of political motivation to introduce the cost-effectiveness analysis from the state and regional governments and lack of independence and transparency of the evaluation processes, 2) the tension between a decentralized health system and evaluation activities with significant scale economies, 3) technical difficulties of the evaluation processes, including their ability to influence decision making and 4) social and professional refusal to the exclusion of healthcare benefits when it is perceived as indiscriminate. Although there is a different number and type of obstacles for developing the capacity of the sNHS to include or exclude healthcare benefits based on the evaluation of their effectiveness and efficiency, experts place in the political arena (political motivation, transparency, governance) the main difficulties to advance in this field.

  18. Assessment of the French National Health Insurance Information System as a tool for epidemiological surveillance of malaria.

    PubMed

    Delon, François; Mayet, Aurélie; Thellier, Marc; Kendjo, Eric; Michel, Rémy; Ollivier, Lénaïck; Chatellier, Gilles; Desjeux, Guillaume

    2017-05-01

    Epidemiological surveillance of malaria in France is based on a hospital laboratory sentinel surveillance network. There is no comprehensive population surveillance. The objective of this study was to assess the ability of the French National Health Insurance Information System to support nationwide malaria surveillance in continental France. A case identification algorithm was built in a 2-step process. First, inclusion rules giving priority to sensitivity were defined. Then, based on data description, exclusion rules to increase specificity were applied. To validate our results, we compared them to data from the French National Reference Center for Malaria on case counts, distribution within subgroups, and disease onset date trends. We built a reusable automatized tool. From July 1, 2013, to June 30, 2014, we identified 4077 incident malaria cases that occurred in continental France. Our algorithm provided data for hospitalized patients, patients treated by private physicians, and outpatients for the entire population. Our results were similar to those of the National Reference Center for Malaria for each of the outcome criteria. We provided a reliable algorithm for implementing epidemiological surveillance of malaria based on the French National Health Insurance Information System. Our method allowed us to work on the entire population living in continental France, including subpopulations poorly covered by existing surveillance methods. Traditional epidemiological surveillance and the approach presented in this paper are complementary, but a formal validation framework for case identification algorithms is necessary. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  19. Australia's national men's health policy: masculinity matters.

    PubMed

    Saunders, Margo; Peerson, Anita

    2009-08-01

    The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour. We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health. The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

  20. Public health microbiology in Germany: 20 years of national reference centers and consultant laboratories.

    PubMed

    Beermann, Sandra; Allerberger, Franz; Wirtz, Angela; Burger, Reinhard; Hamouda, Osamah

    2015-10-01

    In 1995, in agreement with the German Federal Ministry of Health, the Robert Koch Institute established a public health microbiology system consisting of national reference centers (NRCs) and consultant laboratories (CLs). The goal was to improve the efficiency of infection protection by advising the authorities on possible measures and to supplement infectious disease surveillance by monitoring selected pathogens that have high public health relevance. Currently, there are 19 NRCs and 40 CLs, each appointed for three years. In 2009, an additional system of national networks of NRCs and CLs was set up in order to enhance effectiveness and cooperation within the national reference laboratory system. The aim of these networks was to advance exchange in diagnostic methods and prevention concepts among reference laboratories and to develop geographic coverage of services. In the last two decades, the German public health laboratory reference system coped with all major infectious disease challenges. The European Union and the European Centre for Disease Prevention and Control (ECDC) are considering implementing a European public health microbiology reference laboratory system. The German reference laboratory system should be well prepared to participate actively in this upcoming endeavor. Copyright © 2015 Elsevier GmbH. All rights reserved.

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

    PubMed

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

    2016-12-01

    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. 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. 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. 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.

  2. 75 FR 25259 - National Health Care Workforce Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... GOVERNMENT ACCOUNTABILITY OFFICE National Health Care Workforce Commission AGENCY: Government... members to the National Health Care Workforce Commission, with appointments to be made not later [email protected] . Mail: GAO Health Care, Attention: National Health Care Workforce Commission Nominations, 441...

  3. 78 FR 35837 - National Institute on Minority Health and Health Disparities Research Endowments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health 42 CFR Part 52i [Docket Number NIH-2007-0931] RIN 0925-AA61 National Institute on Minority Health and Health Disparities Research Endowments AGENCY: National Institutes of Health, Department of Health and Human Services. ACTION: Notice of...

  4. 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

  5. The French Health Care System; What can We Learn?

    PubMed

    El Taguri, A; Nasef, A

    2008-12-01

    All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. (Specific, Measurable, Achievable, Realistic, Time specific) objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services. The French Health Care System (FHCS) ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System.

  6. 78 FR 64228 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Health Sciences Special Emphasis Panel Assessment of Toxic and Carcinogenic Effects from Exposure to...

  7. Schisms in the church: National Health Service systems and institutional divergence in England and Wales.

    PubMed

    Hughes, David; Vincent-Jones, Peter

    2008-12-01

    Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.

  8. NATIONAL HEALTH PROVIDER INVENTORY

    EPA Science Inventory

    The National Health Provider Inventory provides data on services, location, staff, capacity, and other characteristics of selected health care providers in the United States. Information is collected via mail questionnaire with telephone follow up to all providers (100% census) o...

  9. Work-Related Injury Surveillance in Vietnam: A National Reporting System Model

    PubMed Central

    Marucci-Wellman, Helen; Wegman, David H.; Leamon, Tom B.; Tuyet Binh, Ta Thi; Diep, Nguyen Bich; Kriebel, David

    2013-01-01

    Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam’s Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system. PMID:24028255

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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.

  11. 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

  12. Right to health: (in) congruence between the legal framework and the health system.

    PubMed

    Mitano, Fernando; Ventura, Carla Aparecida Arena; de Lima, Mônica Cristina Ribeiro Alexandre d'Auria; Balegamire, Juvenal Bazilashe; Palha, Pedro Fredemir

    2016-01-01

    to discuss the right to health, incorporation into the legal instruments and the deployment in practice in the National Health System in Mozambique. this is a documentary analysis of a qualitative nature, which after thorough and interpretative reading of the legal instruments and articles that deal with the right to health, access and universal coverage, resulted in the construction of three empirical categories: instruments of humans rights and their interrelationship with the development of the right to health; the national health system in Mozambique; gaps between theory and practice in the consolidation of the right to health in the country. Mozambique ratified several international and regional legal instruments (of Africa) that deal with the right to health and which are ensured in its Constitution. However, their incorporation into the National Health Service have been limited because it can not provide access and universal coverage to health services in an equitable manner throughout its territorial extension and in the different levels of care. the implementation of the right to health is complex and will require mobilization of the state and political financial, educational, technological, housing, sanitation and management actions, as well as ensuring access to health, and universal coverage.

  13. Private Health Care Coverage in the Brazilian population, according to the 2013 Brazilian National Health Survey.

    PubMed

    Malta, Deborah Carvalho; Stopa, Sheila Rizzato; Pereira, Cimar Azeredo; Szwarcwald, Célia Landmann; Oliveira, Martha; Reis, Arthur Chioro Dos

    2017-01-01

    This study aims to present the percentages of the Brazilian population holding health insurance plans, itemized by social-demographic characteristics, based on the data of the National Health Survey carried out in 2013, and to compare this information with the administrative data of the National Supplementary Health Agency for the same year. Data from the National Health Survey, and from the Beneficiaries Information System of the National Health Agency for the year 2013, were used. The percentage of people having a health plan was described according to stratification for: all of Brazil, urban/rural, Brazilian official Regions, Brazilian States and state capitals, gender, age group, level of schooling, position in the workforce, ethnic classification, and self-assessed state of health. Results include the following: The percentage of people saying they had some health plan in Brazil was 27.9% (CI 95%: 27.1-28.8). A significant difference was found relating to level of schooling - the percentage being highest for those who stated they had complete secondary education (68.8% CI 95%: 67.2-70.4) and for those who said they were currently in work (32.5% CI 95%: 31.5-33.5). The increase in health plan coverage in the Brazilian population reflects the improvement of the suply of employment and the growth in the country's economy.

  14. 76 FR 55930 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center For Scientific Review..., National Institutes of Health, 6701 Rockledge Drive, Room 6194, MSC 7804, Bethesda, MD 20892, 301-996-6208... of Health, 6701 Rockledge Drive, Bethesda, MD 20892, (Virtual Meeting). Contact Person: Joseph Thomas...

  15. [National health resources for highly specialised medicine].

    PubMed

    Bratlid, Dag; Rasmussen, Knut

    2005-11-03

    In order to monitor quality and efficiency in the use of health resources for highly specialised medicine, a National Professional Council has since 1990 advised the Norwegian health authorities on the establishing and localisation of such services. A comprehensive review of both the quality, economy and the geographical distribution of patients in each specialised service has been carried out. 33 defined national programmes were centralised to one hospital only and distributed among seven university hospitals. Eight multiregional programmes were centralised to two hospitals only and included four university hospitals. In 2001, a total of 2711 new patients were treated in these programmes. The system seems to have secured a sufficient patient flow to each programme so as to maintain quality. However, a geographically skewed distribution of patients was noted, particularly in some of the national programmes. In a small country like Norway, with 4.5 million inhabitants, a centralised monitoring of highly specialised medicine seems both rational and successful. By the same logic, however, international cooperation should probably be sought for the smallest patient groups.

  16. 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

    ...] Notice of Request for Approval of an Information Collection; National Animal Health Monitoring System... information collection; comment request. SUMMARY: In accordance with the Paperwork Reduction Act of 1995, this... Epidemiologic Investigations, an information collection to support the National Animal Health Monitoring System...

  17. 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

  18. A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex.

    PubMed

    Gostin, Lawrence O; Friedman, Eric A

    2015-05-09

    The Ebola virus disease outbreak in west Africa is pivotal for the worldwide health system. Just as the depth of the crisis ultimately spurred an unprecedented response, the failures of leadership suggest the need for innovative reforms. Such reforms would transform the existing worldwide health system architecture into a purposeful, organised system with an empowered, highly capable WHO at its apex and enduring, equitable national health systems at its foundation. It would be designed not only to provide security against epidemic threats, but also to meet everyday health needs, thus realising the right to health. This retrospective and prospective analysis offers a template for these reforms, responding to the profound harms posed by fragile national health systems, delays in the international response, deficient resource mobilisation, ill defined responsibilities, and insufficient coordination. The scope of the reforms should address failures in the Ebola response, and entrenched weaknesses that enabled the epidemic to reach its heights. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2015-12-01

    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.

  20. Systems, supplies, and staff: a mixed-methods study of health care workers' experiences and health facility preparedness during a large national cholera outbreak, Kenya 2015.

    PubMed

    Curran, Kathryn G; Wells, Emma; Crowe, Samuel J; Narra, Rupa; Oremo, Jared; Boru, Waqo; Githuku, Jane; Obonyo, Mark; De Cock, Kevin M; Montgomery, Joel M; Makayotto, Lyndah; Langat, Daniel; Lowther, Sara A; O'Reilly, Ciara; Gura, Zeinab; Kioko, Jackson

    2018-06-11

    From December 2014 to September 2016, a cholera outbreak in Kenya, the largest since 2010, caused 16,840 reported cases and 256 deaths. The outbreak affected 30 of Kenya's 47 counties and occurred shortly after the decentralization of many healthcare services to the county level. This mixed-methods study, conducted June-July 2015, assessed cholera preparedness in Homa Bay, Nairobi, and Mombasa counties and explored clinic- and community-based health care workers' (HCW) experiences during outbreak response. Counties were selected based on cumulative cholera burden and geographic characteristics. We conducted 44 health facility cholera preparedness checklists (according to national guidelines) and 8 focus group discussions (FGDs). Frequencies from preparedness checklists were generated. To determine key themes from FGDs, inductive and deductive codes were applied; MAX software for qualitative data analysis (MAXQDA) was used to identify patterns. Some facilities lacked key materials for treating cholera patients, diagnosing cases, and maintaining infection control. Overall, 82% (36/44) of health facilities had oral rehydration salts, 65% (28/43) had IV fluids, 27% (12/44) had rectal swabs, 11% (5/44) had Cary-Blair transport media, and 86% (38/44) had gloves. A considerable number of facilities lacked disease reporting forms (34%, 14/41) and cholera treatment guidelines (37%, 16/43). In FDGs, HCWs described confusion regarding roles and reporting during the outbreak, which highlighted issues in coordination and management structures within the health system. Similar to checklist findings, FGD participants described supply challenges affecting laboratory preparedness and infection prevention and control. Perceived successes included community engagement, health education, strong collaboration between clinic and community HCWs, and HCWs' personal passion to help others. The confusion over roles, reporting, and management found in this evaluation highlights a need to

  1. April Spotlight: National Minority Health Month

    Cancer.gov

    Each April, we recognize National Minority Health Month (NMHM) because of its direct relevance to us at the National Cancer Institute’s Center to Reduce Cancer Health Disparities (NCI CRCHD). This year’s NMHM theme, Partnering for Health Equity, brings attention to the need for individuals, institutions, and communities to work together to address social determinants of health, including those related to access to educational, economic, and job opportunities and the quality of education and job training.

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

    PubMed

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

    2014-08-15

    The objective of this paper is to explore approaches to understanding the usability of health information systems at regional and national levels. 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. 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. 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.

  3. 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

  4. Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia

    PubMed Central

    Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

    2017-01-01

    Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in

  5. Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia.

    PubMed

    Lim, Huy Ming; Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

    2017-01-01

    Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71-0.96). Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare

  6. Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach.

    PubMed

    Fragidis, Leonidas L; Chatzoglou, Prodromos D; Aggelidis, Vassilios P

    2016-11-14

    The integration of heterogeneous electronic health records systems by building an interoperable nationwide electronic health record system provides undisputable benefits in health care, like superior health information quality, medical errors prevention and cost saving. This paper proposes a semi-distributed system architecture approach for an integrated national electronic health record system incorporating the advantages of the two dominant approaches, the centralized architecture and the distributed architecture. The high level design of the main elements for the proposed architecture is provided along with diagrams of execution and operation and data synchronization architecture for the proposed solution. The proposed approach effectively handles issues related to redundancy, consistency, security, privacy, availability, load balancing, maintainability, complexity and interoperability of citizen's health data. The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the characteristics of the Greek national healthcare system along with the national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.

  7. 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

  8. VA Suicide Prevention Applications Network: A National Health Care System-Based Suicide Event Tracking System.

    PubMed

    Hoffmire, Claire; Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M

    2016-11-01

    The US Department of Veterans Affairs' Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA's medical records from October 1, 2010, to September 30, 2014-overall, by year, and by region. Data on suicide attempters in the VHA's medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision . Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA's medical records. Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA's medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems.

  9. The state of research funding from the National Institutes of Health for criminal justice health research.

    PubMed

    Ahalt, Cyrus; Bolano, Marielle; Wang, Emily A; Williams, Brie

    2015-03-03

    Over 20 million Americans are currently or have been incarcerated. Most are from medically underserved populations; 1 in 3 African American men and 1 in 6 Latino men born in 2001 are projected to go to prison during their lifetime. The amount of funding from the National Institutes of Health (NIH) to understand and improve the health of persons involved with the criminal justice system is unknown. To describe NIH funding for research on the health and health care needs of criminal justice-involved persons. Review of NIH grants (2008-2012) in the RePORT (Research Portfolio Online Reporting Tools) database. U.S. criminal justice system. Criminal justice-involved persons participating in NIH-funded clinical research. NIH research and training grants awarded, by number, type, research area, institute or center, and dollar amount. Of more than 250 000 NIH-funded grants, 180 (<0.1%) focused on criminal justice health research. The 3 most common foci were substance use or HIV (64%), mental health (11%), and juvenile health (8%). The National Institute on Drug Abuse and the National Institute of Mental Health funded 78% of all grants. In 2012, the NIH invested $40.9 million in criminal justice health research, or 1.5% of the $2.7 billion health disparities budget for that year. NIH-supported research that did not explicitly include current or former prisoners but may have relevance to criminal justice health was not included. Federal funding for research focused on understanding and improving the health of criminal justice-involved persons is small, even compared with the NIH's overall investment in health disparities research. The NIH is well-positioned to transform the care of current and former prisoners by investing in this critical yet overlooked research area.

  10. 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

  11. The Child Health Care System in Italy.

    PubMed

    Corsello, Giovanni; Ferrara, Pietro; Chiamenti, Gianpietro; Nigri, Luigi; Campanozzi, Angelo; Pettoello-Mantovani, Massimo

    2016-10-01

    Pediatric care in Italy has been based during the last 40 years on the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. The pediatric health care system in Italy is part of the national health system. It is made up of 3 main levels of intervention: first access/primary care, secondary care/hospital care, and tertiary care based on specialty hospital care. This overview will also include a brief report on neonatal care, pediatric preventive health care, health service accreditation programs, and postgraduate training in pediatrics. The quality of the Italian child health care system is now considered to be in serious danger because of the restriction of investments in public health caused both by the 2008 global and national economic crisis and by a reduction of the pediatric workforce as a result of progressively insufficient replacement of specialists in pediatrics. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Toward a unified system of accreditation for professional preparation in health education: final report of the National Task Force on Accreditation in Health Education.

    PubMed

    Allegrante, John P; Airhihenbuwa, Collins O; Auld, M Elaine; Birch, David A; Roe, Kathleen M; Smith, Becky J

    2004-12-01

    During the past 40 years, health education has taken significant steps toward improving quality assurance in professional preparation through individual certification and program approval and accreditation. Although the profession has begun to embrace individual certification, program accreditation in health education has been neither uniformly available nor universally accepted by institutions of higher education. To further strengthen professional preparation in health education, the Society for Public Health Education (SOPHE) and the American Association for Health Education (AAHE) established the National Task Force on Accreditation in Health Education in 2001. The 3-year Task Force was charged with developing a detailed plan for a coordinated accreditation system for undergraduate and graduate programs in health education. This article summarizes the Task Force's findings and recommendations, which have been approved by the SOPHE and AAHE boards, and, if implemented, promise to lay the foundation for the highest quality professional preparation and practice in health education.

  13. The National Health Service (NHS) at 70: Bevan's double-edged legacy.

    PubMed

    Klein, Rudolf

    2018-01-08

    The paper analyses the achievements and problems stemming from Nye Bevan's model of a tax funded national health care system, on the assumption that only so could equity be achieved. The evidence shows that indeed the National Health Service (NHS) scores highly on equity, so vindicating Bevan's vision. The price paid is that fiscal crises are the norm for the NHS, with ever more centralisation, intensive regulation and performance management. Successive reorganisations represent attempts to square the circle - to combine the strengths of Bevan's model and those of a less hierarchic system - but have so far failed to deliver and can be expected to continue.

  14. Building a National Culture of Health

    PubMed Central

    Chandra, Anita; Acosta, Joie; Carman, Katherine Grace; Dubowitz, Tamara; Leviton, Laura; Martin, Laurie T.; Miller, Carolyn; Nelson, Christopher; Orleans, Tracy; Tait, Margaret; Trujillo, Matthew; Towe, Vivian; Yeung, Douglas; Plough, Alonzo L.

    2017-01-01

    Abstract Because health is a function of more than medical care, solutions to U.S. health problems must encompass more than reforms to health care systems. But those working to improve health, well-being, and equity still too often find themselves traveling on parallel paths that rarely intersect. In 2013, the Robert Wood Johnson Foundation (RWJF) embarked on a pioneering effort to advance a Culture of Health initiative. A Culture of Health places well-being at the center of every aspect of life, with the goal of enabling everyone in our diverse society to lead healthier lives, now and for generations to come. To put this vision into action, RWJF worked with RAND to develop an action framework that identifies how the nation will work toward achieving these outcomes. This article provides background on the development of this action framework. The Culture of Health action framework is designed around four action areas and one outcome area. Action areas are the core areas in which investment and activity are needed: (1) making health a shared value; (2) fostering cross-sector collaboration to improve well-being; (3) creating healthier, more equitable communities; and (4) strengthening integration of health services and systems. Each action area contains a set of drivers indicating where the United States needs to accelerate change and a set of measures illustrating places for progress. Within the primary Culture of Health outcome---improved population health, well-being, and equity---the authors identified three outcome areas: enhanced individual and community well-being, managed chronic disease and reduced toxic stress, and reduced health care costs. PMID:28845341

  15. Wealth and the nation's health.

    PubMed

    Blackburn, C

    1993-07-01

    Social and economic prosperity to a great extent depend on a healthy population; similarly good health depends on adequate income, writes Clare Blackburn. The government strategy for health promotion outlined most recently in The health of the nation, fails to acknowledge this. Nevertheless health visitors and school nurses cannot ignore the links between health and wealth.

  16. 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

  17. Advancing environmental health surveillance in the US through a national human biomonitoring network.

    PubMed

    Latshaw, Megan Weil; Degeberg, Ruhiyyih; Patel, Surili Sutaria; Rhodes, Blaine; King, Ewa; Chaudhuri, Sanwat; Nassif, Julianne

    2017-03-01

    The United States lacks a comprehensive, nationally-coordinated, state-based environmental health surveillance system. This lack of infrastructure leads to: • varying levels of understanding of chemical exposures at the state & local levels • often inefficient public health responses to chemical exposure emergencies (such as those that occurred in the Flint drinking water crisis, the Gold King mine spill, the Elk river spill and the Gulf Coast oil spill) • reduced ability to measure the impact of public health interventions or environmental policies • less efficient use of resources for cleaning up environmental contamination Establishing the National Biomonitoring Network serves as a step toward building a national, state-based environmental health surveillance system. The Network builds upon CDC investments in emergency preparedness and environmental public health tracking, which have created advanced chemical analysis and information sharing capabilities in the state public health systems. The short-term goal of the network is to harmonize approaches to human biomonitoring in the US, thus increasing the comparability of human biomonitoring data across states and communities. The long-term goal is to compile baseline data on exposures at the state level, similar to data found in CDC's National Report on Human Exposure to Environmental Chemicals. Barriers to success for this network include: available resources, effective risk communication strategies, data comparability & sharing, and political will. Anticipated benefits include high quality data on which to base public health and environmental decisions, data with which to assess the success of public health interventions, improved risk assessments for chemicals, and new ways to prioritize environmental health research. Copyright © 2016 Elsevier GmbH. All rights reserved.

  18. CGH observes National Women’s Health Week

    Cancer.gov

    This week, the U.S. Department of Health and Human Services is observing the 17th annual National Women’s Health Week. The goal of the National Women's Health Week is to empower women to make their health a priority. In celebration, the NCI Center for Global Health held a seminar on the Knowledge Summaries for Comprehensive Breast Cancer Control: Pathways for Advanced Cancer Planning.

  19. National Institute on Minority Health and Health Disparities

    MedlinePlus

    ... both baby and mom. More Minorities and Mental Health: Moving Beyond the Stigma Mental illness is one ... Review Board for Multi-Site Research Resources Public Health 2016 AHRQ National Healthcare Quality and Disparities Report ...

  20. The route to a national health policy lies through the states.

    PubMed Central

    Silver, G. A.

    1991-01-01

    National health program legislation has been becalmed in the Congress for almost 80 years. Despite periodic cries of "crisis," legislation never emerges from committee. Periodically, campaigns have been mounted without success. Tactical efforts to circumvent direct action by legislating bits and pieces of related programs, Medicare and Medicaid, health maintenance organization support, and pre-budgeting, have complicated operation of the medical care system and stimulated intractable cost inflation. For the first 150 years of American history, responsibility for public health and welfare legislation rested with the states. Most public health policies originated in a state or a few states and then later became national legislation. The state efforts were, in effect, natural experiments. After the Depression and the flood of funding from the federal government in subsequent years, the states faded as innovators. It is proposed that funding a few state models to restimulate state initiative in this regard will provide a more effective route to a national health program. PMID:1814058

  1. 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

  2. Right to health: (in) congruence between the legal framework and the health system

    PubMed Central

    Mitano, Fernando; Ventura, Carla Aparecida Arena; de Lima, Mônica Cristina Ribeiro Alexandre d'Auria; Balegamire, Juvenal Bazilashe; Palha, Pedro Fredemir

    2016-01-01

    Objective to discuss the right to health, incorporation into the legal instruments and the deployment in practice in the National Health System in Mozambique. Method this is a documentary analysis of a qualitative nature, which after thorough and interpretative reading of the legal instruments and articles that deal with the right to health, access and universal coverage, resulted in the construction of three empirical categories: instruments of humans rights and their interrelationship with the development of the right to health; the national health system in Mozambique; gaps between theory and practice in the consolidation of the right to health in the country. Results Mozambique ratified several international and regional legal instruments (of Africa) that deal with the right to health and which are ensured in its Constitution. However, their incorporation into the National Health Service have been limited because it can not provide access and universal coverage to health services in an equitable manner throughout its territorial extension and in the different levels of care. Conclusions the implementation of the right to health is complex and will require mobilization of the state and political financial, educational, technological, housing, sanitation and management actions, as well as ensuring access to health, and universal coverage. PMID:27027677

  3. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES).

    PubMed

    Kweon, Sanghui; Kim, Yuna; Jang, Myoung-jin; Kim, Yoonjung; Kim, Kirang; Choi, Sunhye; Chun, Chaemin; Khang, Young-Ho; Oh, Kyungwon

    2014-02-01

    The Korea National Health and Nutrition Examination Survey (KNHANES) is a national surveillance system that has been assessing the health and nutritional status of Koreans since 1998. Based on the National Health Promotion Act, the surveys have been conducted by the Korea Centers for Disease Control and Prevention (KCDC). This nationally representative cross-sectional survey includes approximately 10 000 individuals each year as a survey sample and collects information on socioeconomic status, health-related behaviours, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases and dietary intakes with three component surveys: health interview, health examination and nutrition survey. The health interview and health examination are conducted by trained staff members, including physicians, medical technicians and health interviewers, at a mobile examination centre, and dieticians' visits to the homes of the study participants are followed up. KNHANES provides statistics for health-related policies in Korea, which also serve as the research infrastructure for studies on risk factors and diseases by supporting over 500 publications. KCDC has also supported researchers in Korea by providing annual workshops for data users. KCDC has published the Korea Health Statistics each year, and microdata are publicly available through the KNHANES website (http://knhanes.cdc.go.kr).

  4. Navajo nation public health nurses inspire thoughts on health care reform.

    PubMed

    Douglas, Kathy S

    2012-01-01

    The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing.

  5. 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.

  6. 75 FR 26871 - National Women's Health Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... Part III The President Proclamation 8516--National Women's Health Week, 2010 Proclamation 8517... National Women's Health Week, 2010 By the President of the United States of America A Proclamation In recent decades, our Nation has made extraordinary progress in promoting women's health issues. However...

  7. 76 FR 44597 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee... Health, HHS) Dated: July 20, 2011. Anna P. Snouffer, Deputy Director, Office of Federal Advisory...

  8. 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

  9. Building a Workforce for Future Health Systems: Reflections from Health Policy and Systems Research.

    PubMed

    Javadi, Dena; Tran, Nhan; Ghaffar, Abdul

    2018-05-24

    The era of the Sustainable Development Goals calls for multidisciplinary research and intersectoral approaches to addressing health challenges. This presents a unique opportunity for multidisciplinary fields concerned with complex systems. Those working in system-oriented fields such as health policy and systems research (HPSR) and health services research must be forward-thinking in optimizing their collective ability to address these global challenges. The objective of this commentary was to share reflections on challenges and strategies in managing the HPSR workforce in order to stimulate dialogue and cross-learning across similar fields. The following strategies are discussed here: definitional clarity of expected competencies and coordination across HPS researchers, national investment in HPSR, institutional capacity for coproduction of knowledge across different types of actors, and participatory leadership. Creative approaches in training, financing, developing, and leading the diverse workforce required to strengthen health systems can pave the way for its full-time and part-time members to work together. © Health Research and Educational Trust.

  10. [The Mexican health system: does it require a transformation?].

    PubMed

    Chertorivski Woldenberg, Salomón; Fajardo Dolci, German

    2012-01-01

    National health systems represent an organized social response that enables countries to improve, maintain and enhance the health status of their citizens. These evolve and are transformed according to changes in the biological, economic, political and social components of health. In Mexico there is currently a segmented health system, consisting of a bismarckian model of social security and a social protection in health model. The latter developed to comply with the fourth constitutional article by which health is no longer described as a right linked to the employment status of the individual. Given this reality at least three alternatives seem to emerge for the future: the permanence of a mixed health system with social security and social protection institutions with a similar weight within the national health system, or its opposite, the extension of social protection as a mechanism for widespread access. Given the challenges we face, it is desirable to establish a unified health system, the aim should be that health care is universally protected, as currently happens, but is guaranteed through a much more efficient and based in primary care health care system.

  11. 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

  12. Health system reform.

    PubMed

    Ortolon, Ken

    2009-06-01

    A vote on reforming the nation's health care system seems likely this summer as President Obama makes good on a campaign pledge. Although the Democratic leadership in Congress appears ready to push through reform legislation before the next election, TMA and AMA leaders say very little is known about what that "reform" likely will look like.

  13. 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 ...

  14. Forest health through silviculture: Proceedings of the 1995 National Silviculture Workshop

    Treesearch

    Lane G. Eskew

    1995-01-01

    Includes 32 papers documenting presentations at the 1995 Forest Service National Silviculture Workshop. The workshop's purpose was to review, discuss, and share silvicultural research information and management experience critical to forest health on National Forest System lands and other Federal and private forest lands. Papers focus on the role of natural...

  15. A Consensus Action Agenda for Achieving the National Health Information Infrastructure

    PubMed Central

    Yasnoff, William A.; Humphreys, Betsy L.; Overhage, J. Marc; Detmer, Don E.; Brennan, Patricia Flatley; Morris, Richard W.; Middleton, Blackford; Bates, David W.; Fanning, John P.

    2004-01-01

    Background: Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). Methods: To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Results: Attendees favored a public–private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts. PMID:15187075

  16. A consensus action agenda for achieving the national health information infrastructure.

    PubMed

    Yasnoff, William A; Humphreys, Betsy L; Overhage, J Marc; Detmer, Don E; Brennan, Patricia Flatley; Morris, Richard W; Middleton, Blackford; Bates, David W; Fanning, John P

    2004-01-01

    Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Attendees favored a public-private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts.

  17. Developing the Philippines as a Global Hub for Disaster Risk Reduction - A Health Research Initiative as Presented at the 10th Philippine National Health Research System Week Celebration.

    PubMed

    Banwell, Nicola; Montoya, Jaime; Opeña, Merlita; IJsselmuiden, Carel; Law, Ronald; Balboa, Gloria J; Rutherford, Shannon; Chu, Cordia; Murray, Virginia

    2016-10-25

    The recent Philippine National Health Research System (PNHRS) Week Celebration highlighted the growing commitment to Disaster Risk Reduction (DRR) in the Philippines. The event was lead by the Philippine Council for Health Research and Development of the Department of Science and Technology and the Department of Health, and saw the participation of national and international experts in DRR, and numerous research consortia from all over the Philippines. With a central focus on the Sendai Framework for Disaster Risk Reduction, the DRR related events recognised the significant disaster risks faced in the Philippines. They also illustrated the Philippine strengths and experience in DRR. Key innovations in science and technology showcased at the conference include the web-base hazard mapping applications 'Project NOAH' and 'FaultFinder'. Other notable innovations include 'Surveillance in Post Extreme Emergencies and Disasters' (SPEED) which monitors potential outbreaks through a syndromic reporting system. Three areas noted for further development in DRR science and technology included: integrated national hazard assessment, strengthened collaboration, and improved documentation. Finally, the event saw the proposal to develop the Philippines into a global hub for DRR. The combination of the risk profile of the Philippines, established national structures and experience in DRR, as well as scientific and technological innovation in this field are potential factors that could position the Philippines as a future global leader in DRR. The purpose of this article is to formally document the key messages of the DRR-related events of the PNHRS Week Celebration.

  18. Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and Other Informatics Systems.

    PubMed

    Shah, Gulzar H; Leider, Jonathon P; Castrucci, Brian C; Williams, Karmen S; Luo, Huabin

    2016-01-01

    Assessing local health departments' (LHDs') informatics capacities is important, especially within the context of broader, systems-level health reform. We assessed a nationally representative sample of LHDs' adoption of information systems and the factors associated with adoption and implementation by examining electronic health records, health information exchange, immunization registry, electronic disease reporting system, and electronic laboratory reporting. We used data from the National Association of County and City Health Officials' 2013 National Profile of LHDs. We performed descriptive statistics and multinomial logistic regression for the five implementation-oriented outcome variables of interest, with three levels of implementation (implemented, plan to implement, and no activity). Independent variables included infrastructural and financial capacity and other characteristics associated with informatics capacity. Of 505 LHDs that responded to the survey, 69 (13.5%) had implemented health information exchanges, 122 (22.2%) had implemented electronic health records, 245 (47.5%) had implemented electronic laboratory reporting, 368 (73.0%) had implemented an electronic disease reporting system, and 416 (83.8%) had implemented an immunization registry. LHD characteristics associated with health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, health information systems specialists on staff, larger population size, decentralized governance system, one or more local boards of health, metropolitan jurisdiction, and top executive with more years in the job. Many LHDs lack health informatics capacity, particularly in smaller, rural jurisdictions. Cross-jurisdictional sharing, investment in public health informatics infrastructure, and additional training may help address these shortfalls.

  19. Applying change management metaphors to a national e-Health strategy.

    PubMed

    Saunders, Chad; Scott, Richard E

    2014-01-01

    Recent attempts at a collective understanding of how to develop an e-Health strategy have addressed the individual organisation, collection of organisations, and national levels. At the national level the World Health Organisation's National eHealth Strategy Toolkit serves as an exemplar that consolidates knowledge in this area, guides practical implementations, and identifies areas for future research. A key implication of this toolkit is the considerable number of organisational changes required to successfully apply their ideas in practice. This study looks critically at the confluence of change management and e-Health strategy using metaphors that underpin established models of change management. Several of Morgan's organisational metaphors are presented (highlighting varied beliefs and assumptions regarding how change is enacted, who is responsible for the change, and guiding principles for that change), and used to provide a framework. Attention is then directed to several prominent models of change management that exemplify one or more of these metaphors, and these theoretical insights are applied to evaluate the World Health Organisation's National eHealth Strategy Toolkit. The paper presents areas for consideration when using the WHO/ITU toolkit, and suggestions on how to improve its use in practice. The goal is to seek insight regarding the optimal sequence of steps needed to ensure successful implementation and integration of e-health into health systems using change management models. No single model, toolkit, or guideline will offer all the needed answers, but clarity around the underlying metaphors informing the change management models being used provides valuable insight so potentially challenging areas can be avoided or mitigated.

  20. [European health systems and the integration problem of modern societies].

    PubMed

    Lüschen, G

    2000-04-01

    With reference to the national health systems in Germany and the UK we must acknowledge that it was in particular Bismarck's Reform, originally directed toward a solidarity among the socially weak, which entailed in its development a marked redistribution via progressive health fees and standardized health services. In view of Alfred Marshall's original expectations this has resulted in a specific integration of the socially weak and with some difference for nationally tax-financed and social security financed health systems to a genuine contribution towards integration of modern society. An open research question is whether as a consequence of solidarity and integration through health systems there is a decline of social inequality for health. Equally open is the question as to the socio-structural and economic consequences the expansion of modern health systems has.

  1. [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.

  2. Attitudes of Nigerian physicians toward a National Health Service.

    PubMed

    Umeh, J C; Freeman, R A; Garner, D D; Blevins, D E

    1986-01-01

    Despite efforts to improve health services in Nigeria, considerable problems in distribution and access persist. At present, the health care system in Nigeria is organized and financed at the states' level rather than at the national level. A severe maldistribution of resources exists, as does a lack of coordination among states. An alternative system, albeit expensive, is a National Health Service (NHS). The purpose of this research is to quantify physicians' attitudes towards the concept of NHS. Although physicians in Nigeria are mandated to provide government-funded support, a substantial private practice thrives. Accordingly, physicians' attitudes that may be transferred into behavior are a major determinate of a potential NHS' long term success. In summary, Hausa physicians from the north tended to be more favorable to NHS than did others. Also, younger physicians and those who believed Nigeria's present system to be inadequate favored NHS. There was no association between a physician's gender, locus of medical education, and source of support for medication education and attitude. Finally, physicians in private practice and those in urban areas held more negative attitudes. In spite of Nigeria's present difficulties, a NHS may become a viable alternative. At this point, the overall concept is not opposed by physicians.

  3. Health system changes under pay-for-performance: the effects of Rwanda's national programme on facility inputs.

    PubMed

    Ngo, Diana K L; Sherry, Tisamarie B; Bauhoff, Sebastian

    2017-02-01

    Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda's 2006 national P4P programme by examining the programme's impact on structural quality measures drawn from international and national guidelines. Given the programme's previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme's quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P's impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. National Minority Health Month Spotlight: Career Development

    Cancer.gov

    April is National Minority Health Month and in support of the 2016 theme, Accelerating Health Equity for the Nation, the NCI Center to Reduce Cancer Health Disparities (CRCHD) is highlighting how diversity training and career development opportunities are contributing to efforts to reduce the unequal burden of cancer in our society.

  5. Health Systems Integration of Sexual and Reproductive Health and HIV Services in Sub-Saharan Africa: A Scoping Study

    PubMed Central

    Kendall, Tamil; Langer, Ana; Bärnighausen, Till

    2014-01-01

    Objective: Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. Methods: We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. Results: The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Conclusions: Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery. PMID:25436826

  6. [Implementing strategies to improve the institutional governance of the Spanish National Health System].

    PubMed

    Repullo, José Ramón; Freire, José Manuel

    2016-11-01

    The 2008 economic crisis made the issue of good governance more present and visible, but the debate risks stalling in an academic and political discourse that barely exceeds the declarative. We acknowledge the existence of noteworthy documents from scientific medical societies and some institutional proposals that point towards promising changes. Viewing good governance as accountability, participation, transparency, intelligence and integrity, our objective is to identify the determinants of inaction and remove the barriers that prevent the adoption of rational and widely agreed-upon proposals. This led us: 1) to allocate the proposals to their appropriate governance level (macro, meso, micro and system environment) so as to more directly engage the agents of change; and 2) to highlight some decision nodes that can act as levers to catalyse selective transformations and to initiate the change processes. Taking into account the diversity of actors and scenarios, a top-down rational, integrated and reformist strategy for the whole Spanish National Health System does not seem likely or viable. Therefore, the purpose of this paper is to promote changes, setting a targeted and reasoned agenda to visualise key issues and to enable multilevel and multidimensional thinking and advocacy of health-sector and society stakeholders. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. 75 FR 33983 - Establishing the National Prevention, Health Promotion, and Public Health Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... 13544 of June 10, 2010 Establishing the National Prevention, Health Promotion, and Public Health Council... of Health and Human Services, the National Prevention, Health Promotion, and Public Health Council... Health and Human Services; (4) the Secretary of Transportation; (5) the Secretary of Education; (6) the...

  8. U.S. Physicians’ Views on Financing Options to Expand Health Insurance Coverage: A National Survey

    PubMed Central

    Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H.; Himmelstein, David U.

    2009-01-01

    BACKGROUND Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. OBJECTIVE To assess physician views on financing options for expanding health care coverage and on access to health care. DESIGN AND PARTICIPANTS Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. MEASUREMENTS Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. MAIN RESULTS 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. CONCLUSIONS The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians. PMID:19184240

  9. Proposal of the Physicians' Working Group for Single-Payer National Health Insurance.

    PubMed

    Woolhandler, Steffie; Himmelstein, David U; Angell, Marcia; Young, Quentin D

    2003-08-13

    The United States spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet more than 41 million Americans have no health insurance. Many more are underinsured. Confronted by the rising costs and capabilities of modern medicine, other nations have chosen national health insurance (NHI). The United States alone treats health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In this market-driven system, insurers and providers compete not so much by increasing quality or lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers. This creates the paradox of a health care system based on avoiding the sick. It generates huge administrative costs that, along with profits, divert resources from clinical care to the demands of business. In addition, burgeoning satellite businesses, such as consulting firms and marketing companies, consume an increasing fraction of the health care dollar. We endorse a fundamental change in US health care--the creation of an NHI program. Such a program, which in essence would be an expanded and improved version of traditional Medicare, would cover every American for all necessary medical care. An NHI program would save at least 200 billion dollars annually (more than enough to cover all of the uninsured) by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Physicians and hospitals would be freed from the concomitant burdens and expenses of paperwork created by having to deal with multiple insurers with different rules, often designed to avoid payment. National health insurance would make it possible to set and enforce overall spending limits for the health care system, slowing cost growth over the long run. An NHI program

  10. National health policies under the Reagan Administration and the new Congress.

    PubMed

    Bromberg, M D

    1981-03-01

    The projected impact of the recent U.S. elections on federal health-care policies and programs is discussed. The elections brought Ronald Reagan to the White House, Republican control to the Senate, and a conservative majority to the House of Representatives. The voters have thus produced a mandate for an end to government intervention as the solution to all the nation's ills. The new power base in Washington will increasingly turn to private industry for provision of health-related services. Costs under a privately based system will be controlled by competition, which is the basis for free enterprise. The nation is at a crossroads in health-care policy. An aging population is in need of more health services, while the government, faced with limited resources, has been moving toward rationing services. Costs must be held down in the short run by voluntary efforts; promoting increased competition provides long-range hope for cost control. Today's leaders should seize the opportunity offered by the new conservative focus of the federal government to shape a viable health-payment system for the future.

  11. The USGS National Wildlife Health Center: Advancing wildlife and ecosystem health

    USGS Publications Warehouse

    Moede Rogall, Gail; Sleeman, Jonathan M.

    2017-01-11

    In 1975, the Federal government responded to the need for establishing national expertise in wildlife health by creating the National Wildlife Health Center (NWHC), a facility within the Department of the Interior; the NWHC is the only national center dedicated to wildlife disease detection, control, and prevention. Its mission is to provide national leadership to safeguard wildlife and ecosystem health through active partnerships and exceptional science. Comparisons are often made between the NWHC, which strives to protect the health of our Nation’s wildlife, and the Centers for Disease Control and Prevention (CDC), which strive to protect public health. The NWHC, a science center of the U.S. Geological Survey (USGS) with specialized laboratories, works to safeguard the Nation’s wildlife from diseases by studying the causes and drivers of these threats, and by developing strategies to prevent and manage them. In addition to the main campus, located in Madison, Wisconsin, the NWHC also operates the Honolulu Field Station that addresses wildlife health issues in Hawaii and the Pacific Region.

  12. 78 FR 54651 - Sole Source Cooperative Agreement Award to the National Association of County and City Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Sole Source Cooperative Agreement Award to the National...: Notification of a Sole Source Cooperative Agreement Award to the National Association of County and City Health... resilience, and strengthen health care, public health, and emergency management systems. One of the...

  13. Postdeployment military mental health training: cross-national evaluations.

    PubMed

    Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

    2013-05-01

    Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  14. 76 FR 16795 - The National Antimicrobial Resistance Monitoring System Strategic Plan 2011-2015; Request for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ....fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/NationalAntimicrobialResistanceMonitoringSystem/default.htm , http://www.fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/NationalAntimicrobialResistanceMonitoringSystem/ucm062630.htm , http://www.fda.gov/AnimalVeterinary/Safety...

  15. The State Public Health Laboratory System.

    PubMed

    Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

  16. [The health system of Honduras].

    PubMed

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

    2011-01-01

    This paper describes the health system of Honduras, including its challenges, structure coverage, sources of financing, resources and stewardship activities. This system counts with a public and a private sector. The public sector includes the Ministry of Health (MH) and the Honduran Social Security Institute (HSSI). The private sector is dominated by a set of providers offering services payed mostly out-of-pocket. The National Health Plan 2010-2014 includes a set of reforms oriented towards the creation of an integrated and plural system headed by the MH in its stewardship role. It also anticipates the creation of a public health insurance for the poor population and the transformation of the HSSI into a public insurance agency which contracts services for its affiliates with public and private providers under a family medicine model.

  17. Iceland: health system review.

    PubMed

    Sigurgeirsdóttir, Sigurbjörg; Waagfjörð, Jónína; Maresso, Anna

    2014-01-01

    This analysis of the Icelandic health system reviews the developments in its organization and governance, health financing, health care provision, health reforms and health system performance. Life expectancy at birth is high and Icelandic men and women enjoy longer life in good health than the average European. However, Icelanders are putting on weight, more than half of adult Icelanders were overweight or obese in 2004, and total consumption of alcohol has increased considerably since 1970. The health care system is a small, state centred, publicly funded system with universal coverage, and an integrated purchaser provider relationship in which the state as payer is also the owner of most organizations providing health care services. The country's centre of clinical excellence is the University Hospital, Landspitali, in the capital Reykjavik, which alone accounts for 70 percent of the total national budget for general hospital services. However, since 1990, the health system has become increasingly characterized by a mixed economy of care and service provision, in which the number and scope of private non profit and private for profit providers has increased. While Iceland's health outcomes are some of the best among OECD countries, the health care system faces challenges involving the financial sustainability of the current system in the context of an ageing population, new public health challenges, such as obesity, and the continued impact of the country's financial collapse in 2008. The most important challenge is to change the pattern of health care utilization to steer it away from the most expensive end of the health services spectrum towards more cost efficient and effective alternatives. To a large degree, this will involve renewed attempts to prioritize primary care as the first port of call for patients, and possibly to introduce a gatekeeping function for GPs in order to moderate the use of specialist services. World Health Organization 2014 (acting as

  18. [Effectiveness of a quality control program in mammography for the Brazilian National Health System].

    PubMed

    Corrêa, Rosangela da Silveira; Freitas-Junior, Ruffo; Peixoto, João Emílio; Rodrigues, Danielle Cristina Netto; Lemos, Maria Eugênia Fonseca; Dias, Cíntia Melazo; Ferreira, Rubemar de Souza; Rahal, Rosemar Macedo Souza

    2012-10-01

    To assess the effectiveness of a quality control program in mammography services of the Brazilian National Health System (SUS). A prospective study using temporal analysis of a health surveillance action was conducted. A total of 35 service providers that had mammography equipment in operation and regularly performed exams between 2007 and 2009 in the state of Goiás, Central-Western Brazil, participated in this study. Services were assessed during three site visits by performance testing of mammography equipment, film processors, and other materials, and image quality and entrance surface dose in a phantom were also assessed. Each service was scored according to the percentage of tests that conformed to standards. The mean percentage for compliance among the participating service providers were 64.1% (± 13.3%) in the first visit, 68.4% (± 15.9%) in the second, and 77.1% (± 13.3%) in the third (p < 0.001). The main improvements resulted from adjustments to the breast compression force, the automatic exposure control system, and the alignment of the compression paddle. The doses measured were within the conformity range in 80% of the services assessed. The implementation of this program in the mammography services was effective at improving the operational parameters of the mammography machines, although 40% of the services did not reach the acceptable level of 70%. This result indicates the need to continue this health surveillance action.

  19. The influence of medical cost controls implemented by Taiwan's national health insurance program on doctor-patient relationships.

    PubMed

    Chiu, Jhih-Ling

    2015-01-01

    To prevent medical costs from rising, the National Health Insurance administration implemented the global budget system for financial reform, effective 1 July 2004. Since the implementation of this system, patients have been required to pay for some medicines to limit costs to the system. More recently, as they have faced constant increases in health insurance fees and also faced an increase in the number of medical expenses they must pay during an economic recession and a rise in unemployment, would the economic burden on the people of Taiwan not be increased? Even though National Health Insurance is a form of social insurance, does it guarantee social equality? The value of the healthcare industry is irreplaceable, so the most critical concern is whether worsening doctor-patient relationships will worsen healthcare quality. In short, while the global budget system saves on National Health Insurance costs, whether its implementation has affected healthcare quality is also worth exploring. This commentary also hopes to serve as a reference for the implementation of national health insurance in the United States. Copyright © 2014 John Wiley & Sons, Ltd.

  20. Forest health monitoring: 2007 national technical report

    Treesearch

    Barbara L. Conkling

    2011-01-01

    The Forest Health Monitoring Program produces an annual technical report that has two main objectives. The first objective is to present information about forest health from a national perspective. The second objective is to present examples of useful techniques for analyzing forest health data new to the annual national reports and new applications of techniques...

  1. Forest health monitoring: 2009 national technical report

    Treesearch

    Kevin M. Potter; Barbara L. Conkling

    2012-01-01

    The annual national technical report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

  2. Preliminary physician and pharmacist survey of the National Health Insurance PharmaCloud system in Taiwan.

    PubMed

    Tseng, Yu-Ting; Chang, Elizabeth H; Kuo, Li-Na; Shen, Wan-Chen; Bai, Kuan-Jen; Wang, Chih-Chi; Chen, Hsiang-Yin

    2017-10-01

    The PharmaCloud system, a cloud-based medication system, was launched by the Taiwan National Health Insurance Administration (NHIA) in 2013 to integrate patients' medication lists among different medical institutions. The aim of the preliminary study was to evaluate satisfaction with this system among physicians and pharmacists at the early stage of system implementation. A questionnaire was developed through a review of the literature and discussion in 6 focus groups to understand the level of satisfaction, attitudes, and intentions of physicians and pharmacists using the PharmaCloud system. It was then administered nationally in Taiwan in July to September 2015. Descriptive statistics and multiple regression were performed to identify variables influencing satisfaction and intention to use the system. In total, 895 pharmacist and 105 physician questionnaires were valid for analysis. The results showed that satisfaction with system quality warranted improvement. Positive attitudes toward medication reconciliation among physicians and pharmacists, which were significant predictors of the intention to use the system (β= 0.223, p < 0.001). Most physicians and pharmacists agreed that obtaining signed patient consent was needed but preferred that it be conducted by the NHIA rather than by individual medical institutions (4.02 ± 1.19 vs. 3.49 ± 1.40, p < 0.01). The preliminary study results indicated a moderate satisfaction toward the PharmaCloud system. Hospital pharmacists had a high satisfaction rate, but neither are physicians and community pharmacists. Continuously improvement on system quality has been performing based on the results of this preliminary survey. Policies and standardization processes, including privacy protection, are still warranted further actions to make the Taiwan PharmaCloud system a convenient platform for medication reconciliation. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. National action for European public health research.

    PubMed

    McCarthy, Mark; Zeegers Paget, Dineke; Barnhoorn, Floris

    2013-11-01

    Research and innovation are the basis for improving health and health services. The European Union (EU) supports research through multi-annual programmes. Public Health Innovation and Research in Europe (PHIRE) investigated how European countries cooperate for action in public health research. In PHIRE, following stakeholder workshops and consultations, a national report on public health research was created for 24 of 30 European countries. The report template asked five questions, on national links to European public health research and on national research through the Structural Funds and Ministry of Health. The national reports were assessed with framework analysis, and the country actions were classified strong/partial/weak or none. There were responses to the five questions sufficient for this analysis for between 14 and 20 countries Six countries had public health research aligned with the EU, while three (large) countries were reported not aligned. Only two countries expressed strong engagement in developing public health research within Horizon 2020: most Ministries of Health had no position and only had contact with EU health research through other ministries. Only two countries reported use of the 2007-13 Structural Funds for public health research. While seven Ministries of Health led research from their own funds, or linked with Ministries of Science in six, the Ministries of Health of seven countries were reported not to be involved in public health research. Ministries of Health and stakeholders are poorly engaged in developing public health research, with the Horizon 2020 research programme, or the Structural Funds. The European Commission should give more attention to coordination of public health research with member states if it is to give best value to European citizens.

  4. 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.

  5. National Health Expenditures, 19801

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.

    1981-01-01

    The United States spent an estimated $247 billion for health care in 1980 (Figure 1), an amount equal to 9.4 percent of the Gross National Product (GNP). Highlights of the figures that underlie this estimate include the following: Health care expenditures in 1980 accelerated at a time when the economy as a whole exhibited sluggish growth. The 9.4 percent share of the GNP was a dramatic increase from the 8.9 percent share in 1979.Health care expenditures amounted to $1,067 per person in 1980 (Table 1). Of that amount, $450, or 42.2 percent, came from public funds.Expenditures for health care included $64.9 billion in premiums to private health insurance, $70.9 billion in Federal payments, and $33.3 billion in State and local government funds (Table 2).Hospital care accounted for 40.3 percent of total health care spending in 1980 (Table 3). These expenditures increased 16.2 percent between 1979 and 1980, to a level of $99.6 billion.Spending for the services of physicians increased 14.5 percent to $46.6 billion, 18.9 percent of all health care spending.All third parties combined—private health insurers, governments, philanthropists, and industry—financed 67.6 percent of the $217.9 billion spent for personal health care in 1980 (Table 4), ranging from 90.9 percent of hospital care services to 62.7 percent of physicians' services and 38.5 percent of the remainder (Table 5).Direct payments by consumers reached $70.6 billion in 1980 (Table 6). This accounted for 32.4 percent of all personal health care expenses.Outlays for health care benefits by the Medicare and Medicaid programs totaled $60.6 billion, including $35.8 billion for hospital care. The two programs combined to pay for 27.8 percent of all personal health care in the nation (Table 7). PMID:10309470

  6. Forest health monitoring: 2008 national technical report

    Treesearch

    Kevin M. Potter; Barbara L. Conkling

    2012-01-01

    The Forest Health Monitoring (FHM) Program’s annual national technical report has three objectives: (1) to present forest health status and trends from a national or a multi-State regional perspective using a variety of sources, (2) to introduce new techniques for analyzing forest health data, and (3) to report results of recently completed evaluation monitoring...

  7. 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. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. 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

  9. Functioning information in the learning health system.

    PubMed

    Stucki, Gerold; Bickenbach, Jerome

    2017-02-01

    In this methodological note on applying the ICF in rehabilitation, we introduce functioning information as fundamental for the "learning health system" and the continuous improvement of the health system's response to people's functioning needs by means of the provision of rehabilitation. A learning health system for rehabilitation operates at the micro-level of the individual patient, meso-level of operational management, and the macro-level of policy that guides rehabilitation programming. All three levels rely on the capacity of the informational system of the health system for standardized documentation and coding of functioning information, and the development of national rehabilitation quality management systems. This methodological note describes how functioning information is used for the continuous improvement of functioning outcomes in a learning health system across these three levels.

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

    PubMed

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

    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.

  11. Assessment of the Status of National Oral Health Policy in India.

    PubMed

    Kothia, Nandita Rani; Bommireddy, Vikram Simha; Devaki, Talluri; Vinnakota, Narayana Rao; Ravoori, Srinivas; Sanikommu, Suresh; Pachava, Srinivas

    2015-07-26

    National oral health policy was conscripted by the Indian Dental Association (IDA) in 1986 and was accepted as an integral part of National Health Policy (NHP) by the Central Council of Health and Family Welfare in one of its conferences in the year 1995. Objectives of this paper were to find out the efforts made or going on towards its execution, its current status and recent oral health-related affairs or programs, if any. Literature search was done using the institutional library, web-based search engines like 'Google' and 'PubMed' and also by cross referencing. It yielded 108 articles, of which 50 were excluded as they were not pertinent to the topic. Twenty-four were of global perspective rather than Indian and hence were not taken into account and finally 34 articles were considered for analyses. Documents related to central and state governments of India were also considered. All the articles considered for analysis were published within the past 10 years with gradual increase in number which depicts the researchers' increasing focus towards oral health policy. Criticisms, suggestions and recommendations regarding national oral health programs, dental manpower issues, geriatric dentistry, public health dentistry, dental insurance, oral health inequality, and public-private partnerships have taken major occupancies in the articles. Proposals like "model for infant and child oral health promotion" and "oral health policy phase 1 for Karnataka" were among the initiatives towards national oral health policy. The need for implementation of the drafted oral health policy with modification that suits the rapidly changing oral health system of this country is inevitable. © 2015 by Kerman University of Medical Sciences.

  12. Assessment of the Status of National Oral Health Policy in India

    PubMed Central

    Kothia, Nandita Rani; Bommireddy, Vikram Simha; Devaki, Talluri; Vinnakota, Narayana Rao; Ravoori, Srinivas; Sanikommu, Suresh; Pachava, Srinivas

    2015-01-01

    Background: National oral health policy was conscripted by the Indian Dental Association (IDA) in 1986 and was accepted as an integral part of National Health Policy (NHP) by the Central Council of Health and Family Welfare in one of its conferences in the year 1995. Objectives of this paper were to find out the efforts made or going on towards its execution, its current status and recent oral health-related affairs or programs, if any. Methods: Literature search was done using the institutional library, web-based search engines like ‘Google’ and ‘PubMed’ and also by cross referencing. It yielded 108 articles, of which 50 were excluded as they were not pertinent to the topic. Twenty-four were of global perspective rather than Indian and hence were not taken into account and finally 34 articles were considered for analyses. Documents related to central and state governments of India were also considered. Results: All the articles considered for analysis were published within the past 10 years with gradual increase in number which depicts the researchers’ increasing focus towards oral health policy. Criticisms, suggestions and recommendations regarding national oral health programs, dental manpower issues, geriatric dentistry, public health dentistry, dental insurance, oral health inequality, and public-private partnerships have taken major occupancies in the articles. Proposals like "model for infant and child oral health promotion" and "oral health policy phase 1 for Karnataka" were among the initiatives towards national oral health policy. Conclusion: The need for implementation of the drafted oral health policy with modification that suits the rapidly changing oral health system of this country is inevitable. PMID:26340486

  13. Predictors of Army National Guard and Reserve members' use of Veteran Health Administration health care after demobilizing from OEF/OIF deployment.

    PubMed

    Harris, Alex H S; Chen, Cheng; Mohr, Beth A; Adams, Rachel Sayko; Williams, Thomas V; Larson, Mary Jo

    2014-10-01

    This study described rates and predictors of Army National Guard and Army Reserve members' enrollment in and utilization of Veteran Health Administration (VHA) services in the 365 days following demobilization from an index deployment. We also explored regional and VHA facility variation in serving eligible members in their catchment areas. The sample included 125,434 Army National Guard and 48,423 Army Reserve members who demobilized after a deployment ending between FY 2008 and FY 2011. Demographic, geographic, deployment, and Military Health System eligibility were derived from Defense Enrollment Eligibility Reporting System and "Contingency Tracking System" data. The VHA National Patient Care Databases were used to ascertain VHA utilization and status (e.g., enrollee, TRICARE). Logistic regression models were used to evaluate predictors of VHA utilization as an enrollee in the year following demobilization. Of the study members demobilizing during the observation period, 56.9% of Army National Guard members and 45.7% of Army Reserve members utilized VHA as an enrollee within 12 months. Demographic, regional, health coverage, and deployment-related factors were associated with VHA enrollment and utilization, and significant variation by VHA facility was found. These findings can be useful in the design of specific outreach efforts to improve linkage from the Military Health System to the VHA. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  14. Brundtland's World Health Organization: A Test Case for United Nations Reform

    PubMed Central

    Robbins, Anthony

    1999-01-01

    Gro Harlem Brundtland, who became Director General of the World Health Organization in July 1998, has created a small revolution at the WHO headquarters in Geneva. She is in the process of changing how WHO works, how it interacts with other parts of the United Nations system, and how it enlists ministries, whole governments, universities, and other private organizations to improve health in the world. Here, the Editor describes the reorganization, the new people and resources, and prospects for setting a precedent in United Nations reform. Imagesp30-ap31-ap39-a PMID:9925169

  15. 77 FR 47765 - National Health Center Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... Health Center Week, 2012 By the President of the United States of America A Proclamation For nearly half a century, health centers have helped make primary care services available and affordable for... lives. During National Health Center Week, we recognize the professionals who power our Nation's health...

  16. [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.

  17. Harmonizing health information systems with information systems in other social and economic sectors.

    PubMed Central

    Macfarlane, Sarah B.

    2005-01-01

    Efforts to strengthen health information systems in low- and middle-income countries should include forging links with systems in other social and economic sectors. Governments are seeking comprehensive socioeconomic data on the basis of which to implement strategies for poverty reduction and to monitor achievement of the Millennium Development Goals. The health sector is looking to take action on the social factors that determine health outcomes. But there are duplications and inconsistencies between sectors in the collection, reporting, storage and analysis of socioeconomic data. National offices of statistics give higher priority to collection and analysis of economic than to social statistics. The Report of the Commission for Africa has estimated that an additional US$ 60 million a year is needed to improve systems to collect and analyse statistics in Africa. Some donors recognize that such systems have been weakened by numerous international demands for indicators, and have pledged support for national initiatives to strengthen statistical systems, as well as sectoral information systems such as those in health and education. Many governments are working to coordinate information systems to monitor and evaluate poverty reduction strategies. There is therefore an opportunity for the health sector to collaborate with other sectors to lever international resources to rationalize definition and measurement of indicators common to several sectors; streamline the content, frequency and timing of household surveys; and harmonize national and subnational databases that store socioeconomic data. Without long-term commitment to improve training and build career structures for statisticians and information technicians working in the health and other sectors, improvements in information and statistical systems cannot be sustained. PMID:16184278

  18. National guidelines for high-cost drugs in Brazil: achievements and constraints of an innovative national evidence-based public health policy.

    PubMed

    Picon, Paulo D; Beltrame, Alberto; Banta, David

    2013-04-01

    The translation of best evidence into practice has become an important purpose of policy making in health care. In Brazil, a country of continental dimensions with widespread regional and social inequalities, the dissemination and use of the best-evidence in policy making is a critical issue for the healthcare system. The main purpose of this study is to describe an evidence-based public health policy with special emphasis on guidelines creation for high-cost medicines. We also describe how that strategy was diffused to the judiciary system and to other parts of the healthcare system. We present an 11-year follow-up of a national project for creating and updating guidelines for high-cost medicines in Brazil. A total of 109 national guidelines were published (new or updated versions) for 66 selected diseases, the first such effort in Brazilian history. The project influenced the Brazilian legislature, which has recently established a Federal Law requiring national guidelines for any new technology listed for payment by the Brazilian public healthcare system. We were able to involve many different stakeholders in a partnership between academia and policy makers, which made possible the widespread dissemination of the clinical practice guidelines. Problems and constraints were also encountered. This evolving public health strategy might be useful for other developing countries.

  19. Developing the Philippines as a Global Hub for Disaster Risk Reduction - A Health Research Initiative as Presented at the 10th Philippine National Health Research System Week Celebration

    PubMed Central

    Banwell, Nicola; Montoya, Jaime; Opeña, Merlita; IJsselmuiden, Carel; Law, Ronald; Balboa, Gloria J.; Rutherford, Shannon; Chu, Cordia; Murray, Virginia

    2016-01-01

    The recent Philippine National Health Research System (PNHRS) Week Celebration highlighted the growing commitment to Disaster Risk Reduction (DRR) in the Philippines. The event was lead by the Philippine Council for Health Research and Development of the Department of Science and Technology and the Department of Health, and saw the participation of national and international experts in DRR, and numerous research consortia from all over the Philippines. With a central focus on the Sendai Framework for Disaster Risk Reduction, the DRR related events recognised the significant disaster risks faced in the Philippines. They also illustrated the Philippine strengths and experience in DRR. Key innovations in science and technology showcased at the conference include the web-base hazard mapping applications ‘Project NOAH’ and ‘FaultFinder’. Other notable innovations include ‘Surveillance in Post Extreme Emergencies and Disasters’ (SPEED) which monitors potential outbreaks through a syndromic reporting system. Three areas noted for further development in DRR science and technology included: integrated national hazard assessment, strengthened collaboration, and improved documentation. Finally, the event saw the proposal to develop the Philippines into a global hub for DRR. The combination of the risk profile of the Philippines, established national structures and experience in DRR, as well as scientific and technological innovation in this field are potential factors that could position the Philippines as a future global leader in DRR. The purpose of this article is to formally document the key messages of the DRR-related events of the PNHRS Week Celebration. PMID:27867737

  20. 76 FR 37356 - 2011 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-27

    ... animal and retail sampling methods for the National Antimicrobial Resistance Monitoring System (NARMS... Web site at http://www.fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/National...] 2011 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public Meeting...

  1. 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.

  2. Indigenous Values and Health Systems Stewardship in Circumpolar Countries

    PubMed Central

    Chatwood, Susan; Paulette, Francois; Baker, G. Ross; Eriksen, Astrid M. A.; Hansen, Ketil Lenert; Eriksen, Heidi; Lavoie, Josée; Lou, Wendy; Mauro, Ian; Orbinski, James; Pambrun, Nathalie; Retallack, Hanna; Brown, Adalsteinn

    2017-01-01

    Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared areas of concern, the Arctic states health ministers recently met and signed a declaration that identified shared priorities for international cooperation. Among the areas for collaboration raised, the declaration highlighted the importance of enhancing intercultural understanding, promoting culturally appropriate health care delivery and strengthening circumpolar collaboration in culturally appropriate health care delivery. This paper responds to the opportunity for further study to fully understand indigenous values and contexts, and presents these as they may apply to a framework that will support international comparisons and systems improvements within circumpolar regions. We explored the value base of indigenous peoples and provide considerations on how these values might interface with national values, health systems values and value bases between indigenous nations particularly in the context of health system policy-making that is inevitably shared between indigenous communities and jurisdictional or federal governments. Through a mixed methods nominal consensus process, nine values were identified and described: humanity, cultural responsiveness, teaching, nourishment, community voice, kinship, respect, holism and empowerment. PMID:29186925

  3. 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

  4. 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.

  5. Integrating Public Health and Personal Care in a Reformed US Health Care System

    PubMed Central

    Chernichovsky, Dov

    2010-01-01

    Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns. PMID:20019310

  6. Trends Affecting the U.S. Health Care System. Health Planning Information Series.

    ERIC Educational Resources Information Center

    Cerf, Carol

    This integrated review of national trends affecting the health care system is primarily intended to facilitate the planning efforts of health care providers and consumers, Government agencies, medical school administrators, health insurers, and companies in the medical market. It may also be useful to educators as a textbook to give their students…

  7. National health care providers' database (NHCPD) of Slovenia--information technology solution for health care planning and management.

    PubMed

    Albreht, T; Paulin, M

    1999-01-01

    The article describes the possibilities of planning of the health care providers' network enabled by the use of information technology. The cornerstone of such planning is the development and establishment of a quality database on health care providers, health care professionals and their employment statuses. Based on the analysis of information needs, a new database was developed for various users in health care delivery as well as for those in health insurance. The method of information engineering was used in the standard four steps of the information system construction, while the whole project was run in accordance with the principles of two internationally approved project management methods. Special attention was dedicated to a careful analysis of the users' requirements and we believe the latter to be fulfilled to a very large degree. The new NHCPD is a relational database which is set up in two important state institutions, the National Institute of Public Health and the Health Insurance Institute of Slovenia. The former is responsible for updating the database, while the latter is responsible for the technological side as well as for the implementation of data security and protection. NHCPD will be inter linked with several other existing applications in the area of health care, public health and health insurance. Several important state institutions and professional chambers are users of the database in question, thus integrating various aspects of the health care system in Slovenia. The setting up of a completely revised health care providers' database in Slovenia is an important step in the development of a uniform and integrated information system that would support top decision-making processes at the national level.

  8. [Organization of healthcare for transsexual persons in the Spanish national health system].

    PubMed

    Esteva de Antonio, Isabel; Gómez-Gil, Esther; Almaraz, M Cruz; Martínez-Tudela, Juana; Bergero, Trinidad; Olveira, Gabriel; Soriguer, Federico

    2012-01-01

    Recognition of transexuality as a clinical entity for which medical attention should be available is currently a well-established reality, but institutional care has not been uniformly instituted throughout Spain. The aim of the present study was to determine the current situation of healthcare for transexualism in the publicly-funded health service in Spain. A descriptive study based on data provided by the Spanish Society of Endocrinology Group on Identity and Sexual Differentiation was performed. The resources in the regions that have created specific gender units for these disorders are described. Nine autonomous regions (55%) have started to provide various procedures, although only four provide genitoplastic procedures. The first region to include all sex reassignment surgeries was Andalusia (year 1999). At the same time, Madrid and Catalonia also began to provide specialized mental health care and endocrinology but did not include surgical procedures until 2007 and institutional recognition until 2008. Since 2007 other regions have incorporated healthcare for transsexual patients. Overall, 3,303 patients (a male-to female/female-to-male transsexual ratio of 1.9/1) and 864 surgical procedures have been registered in this study. The composition and proportion of working hours of specialists, as well as the kinds of treatments provided, differ widely in each region. The geographical distribution of healthcare to transsexual persons and the services provided vary. Few regions offer genitoplastic procedures. The number of applicants exceeds the number estimated by the national health system. Copyright © 2011 SESPAS. Published by Elsevier España. All rights reserved.

  9. 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

    Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

    2014-08-05

    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. 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. 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. As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear

  10. 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.

  11. Secondary Data Analysis of National Surveys in Japan Toward Improving Population Health

    PubMed Central

    Ikeda, Nayu

    2016-01-01

    Secondary data analysis of national health surveys of the general population is a standard methodology for health metrics and evaluation; it is used to monitor trends in population health over time and benchmark the performance of health systems. In Japan, the government has established electronic databases of individual records from national surveys of the population’s health. However, the number of publications based on these datasets is small considering the scale and coverage of the surveys. There appear to be two major obstacles to the secondary use of Japanese national health survey data: strict data access control under the Statistics Act and an inadequate interdisciplinary research environment for resolving methodological difficulties encountered when dealing with secondary data. The usefulness of secondary analysis of survey data is evident with examples from the author’s previous studies based on vital records and the National Health and Nutrition Surveys, which showed that (i) tobacco smoking and high blood pressure are the major risk factors for adult mortality from non-communicable diseases in Japan; (ii) the decrease in mean blood pressure in Japan from the late 1980s to the early 2000s was partly attributable to the increased use of antihypertensive medication and reduced dietary salt intake; and (iii) progress in treatment coverage and control of high blood pressure is slower in Japan than in the United States and Britain. National health surveys in Japan are an invaluable asset, and findings from secondary analyses of these surveys would provide important suggestions for improving health in people around the world. PMID:26902170

  12. Reform towards National Health Insurance in Malaysia: the equity implications.

    PubMed

    Yu, Chai Ping; Whynes, David K; Sach, Tracey H

    2011-05-01

    This paper assesses the potential equity impact of Malaysia's projected reform of its current tax financed system towards National Health Insurance (NHI). The Kakwani's progressivity index was used to assess the equity consequences of the new NHI system (with flat rate NHI scheme) compared to the current tax financed system. It was also used to model a proposed system (with a progressive NHI scheme) that can generate the same amount of funding more equitably. The new NHI system would be less equitable than the current tax financed system, as evident from the reduction of Kakwani's index to 0.168 from 0.217. The new flat rate NHI scheme, if implemented, would reduce the progressivity of the health finance system because it is a less progressive finance source than that of general government revenue. We proposed a system with a progressive NHI scheme that generates the same amount of funding whilst preserving the equity at the Kakwani's progressivity index of 0.213. A NHI system with a progressive NHI scheme is proposed to be implemented to raise health funding whilst preserving the equity in health care financing. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Forest health monitoring: 2004 national technical report

    Treesearch

    John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling

    2005-01-01

    The Forest Health Monitoring (FHM) Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. Results presented in the report pertain to the Santiago Declaration’s Criterion 1— Conservation of Biological Diversity and Criterion 3—Maintenance of Forest Ecosystem Health and...

  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.

  15. National Health Expenditures, 1993

    PubMed Central

    Levit, Katharine R.; Sensenig, Arthur L.; Cowan, Cathy A.; Lazenby, Helen C.; McDonnell, Patricia A.; Won, Darleen K.; Sivarajan, Lekha; Stiller, Jean M.; Donham, Carolyn S.; Stewart, Madie S.

    1994-01-01

    This article presents data on health care spending for the United States, covering expenditures for various types of medical services and products and their sources of funding from 1960 to 1993. Although these statistics show a slowing in the growth of health care expenditures over the past few years, spending continues to increase faster than the overall economy. The share of the Nation's health care bill funded by the Federal Government through the Medicaid and Medicare programs steadily increased from 1991 to 1993. This significant change in the share of health expenditures funded by the public sector has caused Federal health expenditures as a share of all Federal spending to increase dramatically. PMID:10140156

  16. National Health Expenditures, 19811

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.

    1982-01-01

    The United States spent an estimated $287 billion for health care in 1981 (Figure 1), an amount equal to 9.8 percent of the Gross National Product (GNP). Highlights of the figures that underly this estimate include the following: Health care expenditures continued to grow at a rapid rate in 1981, at a time when the economy as a whole exhibited sluggish growth. The 9.8 percent share of the GNP was a dramatic increase from the 8.9 percent share seen just two years earlier.Health care expenditures amounted to $1,225 per person in 1981 (Table 1). Of that amount, $524, or 42.7 percent, came from public funds.Hospital care accounted for 41.2 percent of total health care spending in 1981 (Table 2). These expenditures increased 17.5 percent from 1980, to a level of $118 billion.Spending for the services of physicians increased 16.9 percent to $55 billion—19.1 percent of all health care spending.Public sources provided 42.7 percent of the money spent on health in 1981, including Federal payments of $84 billion and $39 billion in State and local government funds (Table 3).All third parties combined—private health insurers, governments, private charities, and Industry—financed 67.9 percent of the $255 billion in personal health care in 1981 (Table 4), covering 89.2 percent of hospital care services, 62.1 percent of physicians' services, and 41.3 percent of the remainder (Table 5).Direct patient payments for health care reached $82 billion in 1981, accounting for 32.1 percent of all personal health care expenses (Table 6). Consumers and their employers paid another $73 billion in premiums to private health insurers, $67 billion of which was returned in the form of benefits.Outlays for health care benefits by the Medicare and Medicaid programs totaled $73 billion, including $42 billion for hospital care. The two programs combined paid for 28.6 percent of all personal health care in the nation (Table 7). PMID:10309718

  17. 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

  18. Implementing Health Impact Assessment at National Level: An Experience in Iran.

    PubMed

    Damari, Behzad; Vosoogh-Moghaddam, Abbas; Riazi-Isfahani, Sahand

    2018-02-01

    According to the general health policies issued in 2014, Health Impact Assessment (HIA) or Health Annex should be implemented in Iran. The present study provided a model for executing HIA in the Iranian context as a developing country. This is a system design study with the qualitative approach. The data on the system components were gathered via reviews of the literature, in-depth interviews and focused group discussions (FGDs) with experts. The information were contently analyzed in order to draft the model and a consensus was reached on by the steering committee. Fifteen in-depth interviews and six FGD meeting were conducted. The equity-based approach in assessing the health impacts of policies, programs and projects were chosen as the most practical tool. Experts believe that for the next five years, HIA should be used just for the "national projects" so that the ministries and national agencies could be empowered. Components of the model including structure, procedures, and standards, management style, mission and resources were prepared. The national regulations and protocols were sent to the SCHFS Secretariat for final revision and the council approval. The hasty implementation of HIA will face serious resistances as the health-oriented attitude and behavior in both government and non-governmental sectors will gradually form. Also, the overlapping of the contents of HIA with other tools such as Environmental, Cultural and Social Impact Assessments, currently used by other sectors, causes difficulties in implementing the HIA by the Ministry of Health and Medical Education.

  19. A layman's guide to the U.S. health care system

    PubMed Central

    De Lew, Nancy; Greenberg, George; Kinchen, Kraig

    1992-01-01

    This article provides an overview of the U.S. health care system and recent proposals for health system reform. Prepared for a 15-nation comparative study for the Organization for Economic Cooperation and Development (OECD), the article summarizes descriptive data on the financing, utilization, access, and supply of U.S. health services; analyzes health system cost growth and trends; reviews health reforms adopted in the 1980s; and discusses proposals in the current health system reform debate. PMID:10124436

  20. [Relationship between research funding in the Spanish National Health System and the burden of disease].

    PubMed

    Catalá López, Ferrán; Alvarez Martín, Elena; Gènova Maleras, Ricard; Morant Ginestar, Consuelo

    2009-01-01

    The Carlos III Health Institute (Instituto de Salud Carlos III - Spain) allocates funding to health research support in the Spanish National Health System (NHS). This study aimed to analyse the correlation of health research fund allocations in the NHS and the burden of disease in Spanish population. Cross-sectional study. Burden of disease measures were calculated: disability-adjusted life-years (DALYs), years of life lost (YLLs) and mortality by cause. A correlation analysis (Spearman s Rho) was applied to test the association between these measures and 2006/2007 health research funding. Using disease categories (n=21), the correlation between funding and disease-burden measures is: DALY (r=0.72; p <0.001), mortality (r=0.60; p=0.004) and YLL (r=0.56; p=0.008). By disease-specific subcategories (n=52): DALY (r=0.55; p<0.001), mortality (r=0.54; p <0.001) and YLL (r=0.55; p <0.001). Malignant neoplasms, neuropsychiatric conditions, cardiovascular diseases and infectious and parasitic diseases receive the greater health research funding support. However, the higher funds allocated per DALY lost ratios were for blood and endocrine disorders, infectious and parasitic diseases and congenital anomalies. Our analysis suggests that NHS research funding is positive moderately high-associated with the burden of disease in Spain, although there exists certain diseases categories that are over or under-funded in relation to their burden generated. In health planning, burden of disease studies contributes with useful information for setting health research priorities.

  1. The National Institutes of Health Clinical Center Digital Imaging Network, Picture Archival and Communication System, and Radiology Information System.

    PubMed

    Goldszal, A F; Brown, G K; McDonald, H J; Vucich, J J; Staab, E V

    2001-06-01

    In this work, we describe the digital imaging network (DIN), picture archival and communication system (PACS), and radiology information system (RIS) currently being implemented at the Clinical Center, National Institutes of Health (NIH). These systems are presently in clinical operation. The DIN is a redundant meshed network designed to address gigabit density and expected high bandwidth requirements for image transfer and server aggregation. The PACS projected workload is 5.0 TB of new imaging data per year. Its architecture consists of a central, high-throughput Digital Imaging and Communications in Medicine (DICOM) data repository and distributed redundant array of inexpensive disks (RAID) servers employing fiber-channel technology for immediate delivery of imaging data. On demand distribution of images and reports to clinicians and researchers is accomplished via a clustered web server. The RIS follows a client-server model and provides tools to order exams, schedule resources, retrieve and review results, and generate management reports. The RIS-hospital information system (HIS) interfaces include admissions, discharges, and transfers (ATDs)/demographics, orders, appointment notifications, doctors update, and results.

  2. Exploring the barriers to implementing National Health Insurance in South Africa: The people's perspective.

    PubMed

    Passchier, R V

    2017-09-22

    This article explores the challenges of implementing the proposed National Health Insurance for South Africa (SA), based on the six building blocks of the World Health Organization Health System Framework. In the context of the current SA health system, leadership, finance, workforce, technologies, information and service delivery are explored from the perspective of the people at ground level. Through considerations such as these, the universal health coverage goals of health equity, efficiency, responsiveness and financial risk protection, might be realised.

  3. Toward a national health risk management approach in Australia.

    PubMed

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

  4. Assessment of Health-Cost Externalities of Air Pollution at the National Level using the EVA Model System

    NASA Astrophysics Data System (ADS)

    Brandt, Jørgen; Silver, Jeremy David; Heile Christensen, Jesper; Skou Andersen, Mikael; Geels, Camilla; Gross, Allan; Buus Hansen, Ayoe; Mantzius Hansen, Kaj; Brandt Hedegaard, Gitte; Ambelas Skjøth, Carsten

    2010-05-01

    Air pollution has significant negative impacts on human health and well-being, which entail substantial economic consequences. We have developed an integrated model system, EVA (External Valuation of Air pollution), to assess health-related economic externalities of air pollution resulting from specific emission sources/sectors. The EVA system was initially developed to assess externalities from power production, but in this study it is extended to evaluate costs at the national level. The EVA system integrates a regional-scale atmospheric chemistry transport model (DEHM), address-level population data, exposure-response functions and monetary values applicable for Danish/European conditions. Traditionally, systems that assess economic costs of health impacts from air pollution assume linear approximations in the source-receptor relationships. However, atmospheric chemistry is non-linear and therefore the uncertainty involved in the linear assumption can be large. The EVA system has been developed to take into account the non-linear processes by using a comprehensive, state-of-the-art chemical transport model when calculating how specific changes to emissions affect air pollution levels and the subsequent impacts on human health and cost. Furthermore, we present a new "tagging" method, developed to examine how specific emission sources influence air pollution levels without assuming linearity of the non-linear behaviour of atmospheric chemistry. This method is more precise than the traditional approach based on taking the difference between two concentration fields. Using the EVA system, we have estimated the total external costs from the main emission sectors in Denmark, representing the ten major SNAP codes. Finally, we assess the impacts and external costs of emissions from international ship traffic around Denmark, since there is a high volume of ship traffic in the region.

  5. 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

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

    PubMed

    Takian, Amirhossein; Petrakaki, Dimitra; Cornford, Tony; Sheikh, Aziz; Barber, Nicholas

    2012-04-30

    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. 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). 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. 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 reflecting a constantly changing milieu of policies

  7. History of the national licensing examination for the health professions under the Japanese Government-General of Korea (1910-1945)

    PubMed Central

    Park, In-Soon

    2015-01-01

    During the reign of Japanese Government-General of Korea (Joseon) from 1910 to 1945, the main health professionals who were educated about modern medicine were categorized into physicians, dentists, pharmacists, midwives, and nurses. They were clearly distinguished from traditional health professionals. The regulations on new health professionals were enacted, and the licensing system was enforced in earnest. There were two kinds of licensing systems: the license without examination through an educational institution and the license with the national examination. The Japanese Government-General of Korea (Joseon) combined education with a national examination system to produce a large number of health professionals rapidly; however, it was insufficient to fulfill the increasing demand for health services. Therefore, the government eased the examination several times and focused on quantitative expansion of the health professions. The proportion of professionals licensed through national examination had increased. This system had produced the maximum number of available professionals at low cost. Furthermore, this system was significant in three respects: first, the establishment of the framework of the national licensing examination still used today for health professionals; second, the protection of people from the poor practices of unqualified practitioners; and third, the standardization of the quality of health. PMID:26013111

  8. PEPFAR, health system strengthening, and promoting sustainability and country ownership.

    PubMed

    Palen, John; El-Sadr, Wafaa; Phoya, Ann; Imtiaz, Rubina; Einterz, Robert; Quain, Estelle; Blandford, John; Bouey, Paul; Lion, Ann

    2012-08-15

    Evidence demonstrates that scale-up of HIV services has produced stronger health systems and, conversely, that stronger health systems were critical to the success of the HIV scale-up. Increased access to and effectiveness of HIV treatment and care programs, attention to long-term sustainability, and recognition of the importance of national governance, and country ownership of HIV programs have resulted in an increased focus on structures that compromise the broader health system. Based on a review published literature and expert opinion, the article proposes 4 key health systems strengthening issues as a means to promote sustainability and country ownership of President's Emergency Plan for AIDS Relief and other global health initiatives. First, development partners need provide capacity building support and to recognize and align resources with national government health strategies and operational plans. Second, investments in human capital, particularly human resources for health, need to be guided by national institutions and supported to ensure the training and retention of skilled, qualified, and relevant health care providers. Third, a range of financing strategies, both new resources and improved efficiencies, need to be pursued as a means to create more fiscal space to ensure sustainable and self-reliant systems. Finally, service delivery models must adjust to recent advancements in areas of HIV prevention and treatment and aim to establish evidence-based delivery models to reduce HIV transmission rates and the overall burden of disease. The article concludes that there needs to be ongoing efforts to identify and implement strategic health systems strengthening interventions and address the inherent tension and debate over investments in health systems.

  9. Development of the National Healthy Sleep Awareness Project Sleep Health Surveillance Questions

    PubMed Central

    Morgenthaler, Timothy I.; Croft, Janet B.; Dort, Leslie C.; Loeding, Lauren D.; Mullington, Janet M.; Thomas, Sherene M.

    2015-01-01

    Objectives: For the first time ever, as emphasized by inclusion in the Healthy People 2020 goals, sleep health is an emphasis of national health aims. The National Healthy Sleep Awareness Project (NHSAP) was tasked to propose questions for inclusion in the next Behavioral Risk Factor Surveillance System (BRFSS), a survey that includes a number of questions that target behaviors thought to impact health, as a means to measure community sleep health. The total number of questions could not exceed five, and had to include an assessment of the risk for obstructive sleep apnea (OSA). Methods: An appointed workgroup met via teleconference and face-to-face venues to develop an inventory of published survey questions being used to identify sleep health, to develop a framework on which to analyze the strengths and weaknesses of current survey questions concerning sleep, and to develop recommendations for sleep health and disease surveillance questions going forward. Results: The recommendation was to focus on certain existing BRFSS questions pertaining to sleep duration, quality, satisfaction, daytime alertness, and to add to these other BRFSS existing questions to make a modified STOP-BANG questionnaire (minus the N for neck circumference) to assess for risk of OSA. Conclusions: Sleep health is an important dimension of health that has previously received less attention in national health surveys. We believe that 5 questions recommended for the upcoming BRFSS question banks will assist as important measures of sleep health, and may help to evaluate the effectiveness of interventions to improve sleep health in our nation. Citation: Morgenthaler TI, Croft JB, Dort LC, Loeding LD, Mullington JM, Thomas SM. Development of the National Healthy Sleep Awareness Project sleep health surveillance questions. J Clin Sleep Med 2015;11(9):1057–1062. PMID:26235156

  10. An Electronic Health Record - Public Health (EHR-PH) System Prototype for Interoperability in 21st Century Healthcare Systems

    PubMed Central

    Orlova, Anna O.; Dunnagan, Mark; Finitzo, Terese; Higgins, Michael; Watkins, Todd; Tien, Allen; Beales, Steven

    2005-01-01

    Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation’s healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH) system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal element for a potential technical architecture for a NHIN. PMID:16779105

  11. Designing for scale: optimising the health information system architecture for mobile maternal health messaging in South Africa (MomConnect).

    PubMed

    Seebregts, Christopher; Dane, Pierre; Parsons, Annie Neo; Fogwill, Thomas; Rogers, Debbie; Bekker, Marcha; Shaw, Vincent; Barron, Peter

    2018-01-01

    MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South Africa. We describe the system design and architecture of the MomConnect technical platform, planned as a nationally scalable and extensible initiative. It uses a health information exchange that can connect any standards-compliant electronic front-end application to any standards-compliant electronic back-end database. The implementation of the MomConnect technical platform, in turn, is a national reference application for electronic interoperability in line with the South African National Health Normative Standards Framework. The use of open content and messaging standards enables the architecture to include any application adhering to the selected standards. Its national implementation at scale demonstrates both the use of this technology and a key objective of global health information systems, which is to achieve implementation scale. The system's limited clinical information, initially, allowed the architecture to focus on the base standards and profiles for interoperability in a resource-constrained environment with limited connectivity and infrastructural capacity. Maintenance of the system requires mobilisation of national resources. Future work aims to use the standard interfaces to include data from additional applications as well as to extend and interface the framework with other public health information systems in South Africa. The development of this platform has also shown the benefits of interoperability at both an organisational and technical level in South Africa.

  12. 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.

  13. [Clinical governance and patient safety culture in clinical laboratories in the Spanish National Health System].

    PubMed

    Giménez-Marín, Á; Rivas-Ruiz, F

    To conduct a situational analysis of patient safety culture in public laboratories in the Spanish National Health System and to determine the clinical governance variables that most strongly influence patient safety. A descriptive cross-sectional study was carried out, in which a Survey of Patient Safety in Clinical Laboratories was addressed to workers in 26 participating laboratories. In this survey, which consisted of 45 items grouped into 6 areas, scores were assigned on a scale from 0 to 100 (where 0 is the lowest perception of patient safety). Laboratory managers were asked specific questions about quality management systems and technology. The mean scores for the 26 participating hospitals were evaluated, and the following results observed: in 4of the 6areas, the mean score was higher than 70 points. In the third area (equipment and resources) and the fourth area (working conditions), the scores were lower than 60 points. Every hospital had a digital medical record system. This 100% level of provision was followed by that of an electronic request management system, which was implemented in 82.6% of the hospitals. The results obtained show that the culture of security is homogeneous and of high quality in health service laboratories, probably due to the steady improvement observed. However, in terms of clinical governance, there is still some way to go, as shown by the presence of weaknesses in crucial dimensions of safety culture, together with variable levels of implementation of fail-safe technologies and quality management systems. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. A qualitative study of health information technology in the Canadian public health system.

    PubMed

    Zinszer, Kate; Tamblyn, Robyn; Bates, David W; Buckeridge, David L

    2013-05-25

    Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technology (HIT) policy related to public health in Canada that have succeeded, to identify remaining challenges, and to suggest future directions to improve the adoption and use of HIT in the public health system. A qualitative case study was performed with 24 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Identified benefits of HIT in public health included improved communication among jurisdictions, increased awareness of the need for interoperable systems, and improvement in data standardization. Identified barriers included a lack of national vision and leadership, insufficient investment, and poor conceptualization of the priority areas for implementing HIT in public health. The application of HIT in public health should focus on automating core processes and identifying innovative applications of HIT to advance public health outcomes. The Public Health Agency of Canada should develop the expertise to lead public health HIT policy and should establish a mechanism for coordinating public health stakeholder input on HIT policy.

  15. 77 FR 40622 - Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Mine Safety and Health Research Advisory Committee, National Institute for Occupational Safety and Health (MSHRAC, NIOSH..., oxygen supply partnership, safety culture, occupational health and safety management systems, preventing...

  16. A Community Health Education System to meet the health needs of Indo-Chinese women.

    PubMed

    Ratnaike, R N; Chinner, T L

    1992-04-01

    This paper presents a Community Health Education System which is cost-effective, sustainable, strongly community-based, and directed at improving the health status of rural women in Indo-china (Kampuchea, Laos and Vietnam). The system is developed through a series of steps which are concerned with the education of Community Health Education Units (in national ministries of health) and, at the village level, among community health workers, women's groups, and other women. The ultimate aim is the establishment of a community health education program in Indochinese villages.

  17. National Health Insurance by Regulation: Mandated Employee Benefits,

    DTIC Science & Technology

    1980-04-01

    A0AO95 050 RANW CORP SANTA MONICA CA F/0 S/I1 NATIONAL HEALTH INSURANCE BY REKULATION: MANDATED EMPLOYEE NE-TC(U) APR 80 C E PI4ELPS LICLASSIFIED...31 ! 9 : I NATIONAL HEALTH INSURANCE BY REGULATION: MANDATED EMPLOYEE BENEFITS 1 I. INTRODUCTION Social issues have often been solved...offer a variety of insurance packages to employees , iThis paper was presented at the Conference on "National Health Insurance: Ihat Now, What Later, What

  18. [National Policy of Humanization and education of health care professionals: integrative review].

    PubMed

    Barbosa, Guilherme Correa; Meneguim, Silmara; Lima, Silvana Andréa Molina; Moreno, Vania

    2013-01-01

    The National Policy of Humanization aims at innovations in health production, management and care with emphasis on permanent education for workers in the Unified Public Health System and training of university students in the health care field. This study aimed to know, through an integrative review of the literature, the scientific production about the National Policy of Humanization and education of health care professionals, from 2002 to 2010. Ten articles were analyzed in thematic strand through three axes: humanization and users caring, humanization and the work process, humanization and training. The articles point to the need to overcome the biological conception, valuing cultural aspects of users. The work process is marked by the devaluation of workers and by users deprived of their rights. The training of health professionals is grounded in health services where the prevailing standards are practices that hinder innovative attitudes.

  19. Forest health monitoring: 2002 national technical report

    Treesearch

    John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling

    2005-01-01

    The Forest Health Monitoring (FHM) Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. This annual report focuses on “Criterion 3—Maintenance of Forest Ecosystem Health and Vitality” from the “Criteria and Indicators of Sustainable Forestry of the Santiago Declaration”...

  20. 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.

  1. The national community mental health care project in Vietnam: a review for future guidance.

    PubMed

    Ng, Chee Hong; Than, Phong Thai; La, Cuong Duc; Van Than, Quang; Van Dieu, Chu

    2011-04-01

    The aim of this paper is to review the national community mental health care (CMHC) project in Vietnam and recommend improvements to the model based on findings reported at a national workshop of major service providers, and supplemented by information gathered from site visits and discussions with mental health leaders, professionals and stakeholders in the hospital and community mental health services. Since 2000, the CMHC project has been carried out in all 63 provinces with an overall national district coverage of around 64% and a total registry of 145 160 patients. It demonstrates a commitment by the government to integrate mental health into primary health care, in line with the World Health Organization recommendations, and set up a national community mental health network. Free treatment is provided for patients, mostly with schizophrenia (62.83%) and epilepsy (34.78%), at the local community level, and a national monitoring system is well established. However, the limitations include the lack of project funds, human resources and facilities, treatment scope, and linkages with families and community. A revised model of CMHC that builds on the strengths of existing services is proposed. While progress in community mental health care in Vietnam has been significant, many challenges facing the CMHC project need addressing.

  2. Local Public Health Systems and the Incidence of Sexually Transmitted Diseases

    PubMed Central

    Chen, Jie; Owusu-Edusei, Kwame; Suh, Allen; Bekemeier, Betty

    2012-01-01

    Objectives. We examined the associations of local public health system organization and local health department resources with county-level sexually transmitted disease (STD) incidence rates in large US health jurisdictions. Methods. We linked annual county STD incidence data (2005–2008) to local health department director responses (n = 211) to the 2006 wave of the National Longitudinal Study of Local Public Health Systems, the 2005 national Local Health Department Profile Survey, and the Area Resource File. We used nested mixed effects regression models to assess the relative contribution of local public health system organization, local health department financial and resource factors, and sociodemographic factors known to be associated with STD incidence to county-level (n = 307) STD incidence. Results. Jurisdictions with local governing boards had significantly lower county-level STD incidence. Local public health systems with comprehensive services where local health departments shoulder much of the effort had higher county-level STD rates than did conventional systems. Conclusions. More integration of system partners in local public health system activities, through governance and interorganizational arrangements, may reduce the incidence and burden of STDs. PMID:22813090

  3. 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

  4. [Process of construction of the national research agenda on Human Resources in Health in Peru 2011 - 2014].

    PubMed

    Curisinche, Maricela; Yagui, Martín; Castilla, Teresa; Cabezas, César; Escalante, Giovanni; Casas, María; Lucero, Jorge

    2011-06-01

    The National Health Authority of Peru, as part of the implementation of national priorities for health research in 2010 developed the process of building the national research agenda on health manpower (HM). In a scenario of technical challenges, national and international policy and under a nation-wide participatory approach with key stakeholders in the health system, training and aid HM linked to the subject, establishing a socially agreed agenda. Process consists of 3 phases: 1. National review of evidence and relevant information on RHUS, 2. Consultation with opinion leaders and subject experts, and 3. A collaborative space (national workshop) of deliberation, consensus and legitimacy of the agenda. Finally, we present the agenda consists of 30 research topics on health manpower, to be developed in the period 2011- 2014, and raises the challenges and prospects for implementation.

  5. Incorporation of Personal Single Nucleotide Polymorphism (SNP) Data into a National Level Electronic Health Record for Disease Risk Assessment, Part 2: The Incorporation of SNP into the National Health Information System of Turkey

    PubMed Central

    Beyan, Timur

    2014-01-01

    Background A personalized medicine approach provides opportunities for predictive and preventive medicine. Using genomic, clinical, environmental, and behavioral data, the tracking and management of individual wellness is possible. A prolific way to carry this personalized approach into routine practices can be accomplished by integrating clinical interpretations of genomic variations into electronic medical record (EMR)s/electronic health record (EHR)s systems. Today, various central EHR infrastructures have been constituted in many countries of the world, including Turkey. Objective As an initial attempt to develop a sophisticated infrastructure, we have concentrated on incorporating the personal single nucleotide polymorphism (SNP) data into the National Health Information System of Turkey (NHIS-T) for disease risk assessment, and evaluated the performance of various predictive models for prostate cancer cases. We present our work as a miniseries containing three parts: (1) an overview of requirements, (2) the incorporation of SNP into the NHIS-T, and (3) an evaluation of SNP data incorporated into the NHIS-T for prostate cancer. Methods For the second article of this miniseries, we have analyzed the existing NHIS-T and proposed the possible extensional architectures. In light of the literature survey and characteristics of NHIS-T, we have proposed and argued opportunities and obstacles for a SNP incorporated NHIS-T. A prototype with complementary capabilities (knowledge base and end-user applications) for these architectures has been designed and developed. Results In the proposed architectures, the clinically relevant personal SNP (CR-SNP) and clinicogenomic associations are shared between central repositories and end-users via the NHIS-T infrastructure. To produce these files, we need to develop a national level clinicogenomic knowledge base. Regarding clinicogenomic decision support, we planned to complete interpretation of these associations on the end

  6. Incorporation of personal single nucleotide polymorphism (SNP) data into a national level electronic health record for disease risk assessment, part 2: the incorporation of SNP into the national health information system of Turkey.

    PubMed

    Beyan, Timur; Aydın Son, Yeşim

    2014-08-11

    A personalized medicine approach provides opportunities for predictive and preventive medicine. Using genomic, clinical, environmental, and behavioral data, the tracking and management of individual wellness is possible. A prolific way to carry this personalized approach into routine practices can be accomplished by integrating clinical interpretations of genomic variations into electronic medical record (EMR)s/electronic health record (EHR)s systems. Today, various central EHR infrastructures have been constituted in many countries of the world, including Turkey. As an initial attempt to develop a sophisticated infrastructure, we have concentrated on incorporating the personal single nucleotide polymorphism (SNP) data into the National Health Information System of Turkey (NHIS-T) for disease risk assessment, and evaluated the performance of various predictive models for prostate cancer cases. We present our work as a miniseries containing three parts: (1) an overview of requirements, (2) the incorporation of SNP into the NHIS-T, and (3) an evaluation of SNP data incorporated into the NHIS-T for prostate cancer. For the second article of this miniseries, we have analyzed the existing NHIS-T and proposed the possible extensional architectures. In light of the literature survey and characteristics of NHIS-T, we have proposed and argued opportunities and obstacles for a SNP incorporated NHIS-T. A prototype with complementary capabilities (knowledge base and end-user applications) for these architectures has been designed and developed. In the proposed architectures, the clinically relevant personal SNP (CR-SNP) and clinicogenomic associations are shared between central repositories and end-users via the NHIS-T infrastructure. To produce these files, we need to develop a national level clinicogenomic knowledge base. Regarding clinicogenomic decision support, we planned to complete interpretation of these associations on the end-user applications. This approach gives us

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

    PubMed

    2016-01-06

    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

  8. Broader health coverage is good for the nation's health: evidence from country level panel data.

    PubMed

    Moreno-Serra, Rodrigo; Smith, Peter C

    2015-01-01

    Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries.

  9. Broader health coverage is good for the nation's health: evidence from country level panel data

    PubMed Central

    Moreno-Serra, Rodrigo; Smith, Peter C

    2015-01-01

    Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries. PMID:25598588

  10. Burden of disease in Japan: using national and subnational data to inform local health policy.

    PubMed

    Gilmour, Stuart; Liao, Yi; Bilano, Ver; Shibuya, Kenji

    2014-05-01

    The Global Burden of Disease (GBD) study has been instrumental in guiding global health policy development since the early 1990s. The GBD 2010 project provided rich information about the key causes of mortality, disability-adjusted life years, and their associated risk factors in Japan and provided a unique opportunity to incorporate these data into health planning. As part of the latest update of this project, GBD 2013, the Japanese GBD collaborators plan to update and refine the available burden of disease data by incorporating sub-national estimates of the burden of disease at the prefectural level. These estimates will provide health planners and policy makers at both the national and prefectural level with new, more refined tools to adapt local public health initiatives to meet the health needs of local populations. Moreover, they will enable the Japanese health system to better respond to the unique challenges in their rapidly aging population and as a complex combination of non-communicable disease risk factors begin to dominate the policy agenda. Regional collaborations will enable nations to learn from the experiences of other nations that may be at different stages of the epidemiological transition and have different exposure profiles and associated health effects. Such analyses and improvements in the data collection systems will further improve the health of the Japanese, maintain Japan's excellent record of health equity, and provide a better understanding of the direction of health policy in the region.

  11. Forest health monitoring: 2006 national technical report

    Treesearch

    Mark J. Ambrose; Barbara L. Conkling

    2009-01-01

    The Forest Health Monitoring Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the...

  12. Forest health monitoring: 2005 national technical report

    Treesearch

    Mark J. Ambrose; Barbara L. Conkling

    2007-01-01

    The Forest Health Monitoring program's annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the Santiago Declaration. The results...

  13. Does the private finance initiative promote innovation in health care? The case of the British National Health Service.

    PubMed

    Petratos, Pythagoras

    2005-12-01

    The Private Finance Initiative (PFI) is a specific example of health care privatization within the British National Health Service. In this essay, I critically assess the ways in which various Private Finance Initiatives have increased health care efficiency and effectiveness, as well as encouraged medical innovation. Indeed, as the analysis will demonstrate, significant empirical evidence supports the conclusion that Private Finance Initiatives are a driving force of innovation within the British Health Care System.

  14. It takes a whole nation ... to create a health care system.

    PubMed

    Curtin, Leah

    2003-01-01

    The biggest failure we face today is that we argue about the effects of poverty and the benefits of welfare rather than about how to sustain a reasonably cohesive and integrated community that optimizes human development for everybody. Yet that is exactly what must happen if we are to integrate our recreational, educational, health care, and health promotion systems and employment policies to create a healthier population. Care of the sick and the elderly is not a primary wealth- (or health-) producing social function; it is a derivative activity. If a society overinvests in it, it may underinvest in the real economy ... which then will not create the jobs, stability, and wealth that support the health of the population. This is not the kind of problem that the health care system alone, or any one sector of society, can actually tackle on its own. The challenge is to create real partnerships with all sectors: employers, labor leaders, educators, police, and governmental groups.

  15. Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission.

    PubMed

    Samal, Janmejaya

    2015-01-01

    Decades back AYUSH systems of medicine were limited to their own field with few exceptions in some states as health in India is a state issue. This took a reverse turn after the initiation of National Rural Health Mission (NRHM) in 2005 which brought the concept of "Mainstreaming of AYUSH and Revitalization of Local Health Traditions" utilizing the untapped AYUSH workforces, therapeutics and principles for the management of community health problems. As on 31/03/2012 AYUSH facilities were co-located in 468 District Hospitals, 2483 Community Health Centers and 8520 Primary Health Centers in the country. Several therapeutics are currently in use and few drugs have been included in the ASHA drug kit to treat common ailments in the community. At the same time Government of India has recognized few principles and therapeutics of Ayurveda as modalities of intervention to some of the community health problems. These include Ksharasutra (medicine coated thread) therapy for ano-rectal surgeries and Rasayana Chikitsa (rejuvenative therapy) for senile degenerative disorders etc. Similarly respective principles and therapeutics can also be utilized from other systems of AYUSH such as Yoga and Naturopathy, Unani, Siddha and Homoeopathy. Akin to Ayurveda these principles and therapeutics can also help in managing community health problems if appropriately implemented. This paper is a review on the role of AYUSH, as a system, in the delivery of health care in India with special reference to National Rural Health Mission.

  16. Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission

    PubMed Central

    Samal, Janmejaya

    2015-01-01

    Decades back AYUSH systems of medicine were limited to their own field with few exceptions in some states as health in India is a state issue. This took a reverse turn after the initiation of National Rural Health Mission (NRHM) in 2005 which brought the concept of “Mainstreaming of AYUSH and Revitalization of Local Health Traditions” utilizing the untapped AYUSH workforces, therapeutics and principles for the management of community health problems. As on 31/03/2012 AYUSH facilities were co-located in 468 District Hospitals, 2483 Community Health Centers and 8520 Primary Health Centers in the country. Several therapeutics are currently in use and few drugs have been included in the ASHA drug kit to treat common ailments in the community. At the same time Government of India has recognized few principles and therapeutics of Ayurveda as modalities of intervention to some of the community health problems. These include Ksharasutra (medicine coated thread) therapy for ano-rectal surgeries and Rasayana Chikitsa (rejuvenative therapy) for senile degenerative disorders etc. Similarly respective principles and therapeutics can also be utilized from other systems of AYUSH such as Yoga and Naturopathy, Unani, Siddha and Homoeopathy. Akin to Ayurveda these principles and therapeutics can also help in managing community health problems if appropriately implemented. This paper is a review on the role of AYUSH, as a system, in the delivery of health care in India with special reference to National Rural Health Mission. PMID:26730131

  17. 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

  18. National Institutes of Health eliminates funding for national architecture linking primary care research.

    PubMed

    Peterson, Kevin A

    2007-01-01

    With the ending of the National Electronic Clinical Trial and Research Network (NECTAR) pilot programs and the abridgement of Clinical Research Associate initiative, the National Institutes of Health Roadmap presents a strategic shift for practice-based research networks from direct funding of a harmonized national infrastructure of cooperating research networks to a model of local engagement of primary care clinics performing practice-based research under the aegis of regional academic health centers through Clinical and Translational Science Awards. Although this may present important opportunities for partnering between community practices and large health centers, for primary care researchers, the promise of a transformational change that brings a unified national primary care community into the clinical research enterprise seems likely to remain unfulfilled.

  19. Do existing research summaries on health systems match immunisation managers' needs in middle- and low-income countries? Analysis of GAVI health systems strengthening support

    PubMed Central

    2011-01-01

    Background The GAVI Alliance was created in 2000 to increase access to vaccines. More recently, GAVI has supported evidence-based health systems strengthening to overcome barriers to vaccination. Our objectives were: to explore countries' priorities for health systems strengthening; to describe published research summaries for each priority area in relation to their number, quality and relevance; and to describe the use of national data from surveys in identifying barriers to immunisation. Methods From 44 health systems strengthening proposals submitted to GAVI in 2007 and 2008, we analysed the topics identified, the coverage of these topics by existing systematic reviews and the use of nation-wide surveys with vaccination data to justify the needs identified in the proposals. Results Thirty topics were identified and grouped into three thematic areas: health workforce (10 topics); organisation and management (14); and supply, distribution and maintenance (6). We found 51 potentially relevant systematic reviews, although for the topic that appeared most frequently in the proposals ('Health information systems') no review was identified. Thematic and geographic relevance were generally categorised as "high" in 33 (65%) and 25 (49%) reviews, respectively, but few reviews were categorised as "highly relevant for policy" (7 reviews, 14%). With regard to methodological quality, 14 reviews (27%) were categorised as "high". The number of topics that were addressed by at least one high quality systematic review was: seven of the 10 topics in the 'health workforce' thematic area; six of the 14 topics in the area of 'organisation and management'; and none of the topics in the thematic area of 'supply, distribution and maintenance'. Only twelve of the 39 countries with available national surveys referred to them in their proposals. Conclusion Relevant, high quality research summaries were found for few of the topics identified by managers. Few proposals used national surveys

  20. National Institutes of Health Pathways to Prevention Workshop: Advancing Research to Prevent Youth Suicide.

    PubMed

    Little, Todd D; Roche, Kathleen M; Chow, Sy-Miin; Schenck, Anna P; Byam, Leslie-Ann

    2016-12-06

    The National Institutes of Health (NIH) Pathways to Prevention Workshop "Advancing Research to Prevent Youth Suicide" was cosponsored by the NIH Office of Disease Prevention, National Institute of Mental Health, National Institute on Drug Abuse, and National Center for Complementary and Integrative Health. A multidisciplinary working group developed the agenda, and an evidence-based practice center prepared an evidence report that addressed data systems relevant to suicide prevention efforts through a contract with the Agency for Healthcare Research and Quality. During the workshop, experts discussed the evidence and participants commented during open forums. After considering the data from the evidence report, expert presentations, and public comments, an independent panel prepared a draft report that was posted on the NIH Office of Disease Prevention Web site for 5 weeks for public comment. This abridged version of the final report provides a road map for optimizing youth suicide prevention efforts by highlighting strategies for guiding the next decade of research in this area. These strategies include recommendations for improving data systems, enhancing data collection and analysis methods, and strengthening the research and practice community.

  1. Aligning incentives in health care: physician practice and health system partnership.

    PubMed

    Levin, L Scott; Gustave, Lori

    2013-06-01

    The key to successfully aligning hospitals and physicians is financial integration and joint incentives for academic, quality, and clinical productivity. Many physician practices and health systems are moving toward closer integration, but mainly through consolidation and employment strategies. We describe a fully integrated physician and hospital relationship including an overview of an aligned funds flow process that affords the department support for clinical services and teaching, research, and administrative activity. We also describe a physician compensation model that provides incentive not only for increased clinical performance, but also quality and academic objectives. The content of this article was acquired through our own experience in managing the Department of Orthopaedic Surgery at the University of Pennsylvania Health System including the health system's funds flow process. Based on input from both health system leaders and the faculty, the department's compensation plan was totally redesigned to create a line-of-sight plan that credits clinical performance and academic productivity. Our model is multifactorial and provides sustainable support for the department and a compensation plan that is competitive within the local market and nationally. The health system's funds flow process has enhanced alignment of the faculty and hospitals by providing compensation for nonclinical time and assists the department's growth strategies by providing funding for new faculty and gain-sharing of improved hospital margin. The implementation of the compensation plan increased productivity by 8% in its first year with no additional resources. Academic productivity in that same year was arguably at or above any other year in the department's history in terms of accepted publications, national presentations, and research grants awarded. A model of complete integration between an academic department and a health system is achievable through a systematic process of

  2. Why some countries have national health insurance, others have national health services, and the U.S. has neither.

    PubMed

    Navarro, V

    1989-01-01

    This article presents a discussion of why some capitalist developed countries have national health insurance schemes, others have national health services, and the U.S. has neither. The first section provides a critical analysis of some of the major answers given to these questions by authors belonging to the schools of thought defined as 'public choice', 'power group pluralism' and 'post-industrial convergence'. The second section puts forward an alternative explanation rooted in an historical analysis of the correlation of class forces in each country. The different forms of funding and organization of health services, structured according to the corporate model or to the liberal-welfare market capitalism model, have appeared historically in societies with different correlations of class forces. In all these societies the major social force behind the establishment of a national health program has been the labor movement (and its political instruments--the socialist parties) in its pursuit of the welfare state. In the final section the developments in the health sector after World War II are explained. It is postulated that the growth of public expenditures in the health sector and the growth of universalism and coverage of health benefits that have occurred during this period are related to the strength of the labor movement in these countries.

  3. Child Health and School Readiness: Background Paper on a National Education Goal.

    ERIC Educational Resources Information Center

    Zill, Nicholas

    One of the objectives of the U.S. Department of Education's National Goals for Education is that "Children will receive the nutrition and health care needed to arrive at school with healthy minds and bodies, and the number of low birthweight babies will be significantly reduced through enhanced prenatal health systems." This paper…

  4. Practical recommendations for strengthening national and regional laboratory networks in Africa in the Global Health Security era.

    PubMed

    Best, Michele; Sakande, Jean

    2016-01-01

    The role of national health laboratories in support of public health response has expanded beyond laboratory testing to include a number of other core functions such as emergency response, training and outreach, communications, laboratory-based surveillance and data management. These functions can only be accomplished by an efficient and resilient national laboratory network that includes public health, reference, clinical and other laboratories. It is a primary responsibility of the national health laboratory in the Ministry of Health to develop and maintain the national laboratory network in the country. In this article, we present practical recommendations based on 17 years of network development experience for the development of effective national laboratory networks. These recommendations and examples of current laboratory networks, are provided to facilitate laboratory network development in other states. The development of resilient, integrated laboratory networks will enhance each state's public health system and is critical to the development of a robust national laboratory response network to meet global health security threats.

  5. Practical recommendations for strengthening national and regional laboratory networks in Africa in the Global Health Security era

    PubMed Central

    2016-01-01

    The role of national health laboratories in support of public health response has expanded beyond laboratory testing to include a number of other core functions such as emergency response, training and outreach, communications, laboratory-based surveillance and data management. These functions can only be accomplished by an efficient and resilient national laboratory network that includes public health, reference, clinical and other laboratories. It is a primary responsibility of the national health laboratory in the Ministry of Health to develop and maintain the national laboratory network in the country. In this article, we present practical recommendations based on 17 years of network development experience for the development of effective national laboratory networks. These recommendations and examples of current laboratory networks, are provided to facilitate laboratory network development in other states. The development of resilient, integrated laboratory networks will enhance each state’s public health system and is critical to the development of a robust national laboratory response network to meet global health security threats. PMID:28879137

  6. Collaboration of occupational physicians with national health system and general practitioners in Italy

    PubMed Central

    PERSECHINO, Benedetta; FONTANA, Luca; BURESTI, Giuliana; RONDINONE, Bruna Maria; LAURANO, Patrizia; FORTUNA, Grazia; VALENTI, Antonio; IAVICOLI, Sergio

    2016-01-01

    A good cooperation between occupational physicians and other healthcare professionals is essential in order to achieve an overall improvement of workers/patients’ well-being. Unfortunately, collaboration between occupational physicians and other physicians is often lacking or very poor. In this context, using a self-administered questionnaire, we investigated the cooperation of Italian occupational physicians with the National Health System (NHS) facilities and with the general practitioners in order to identify any potential critical issues that may hinder an effective and collaborative relationships between these professionals. The survey was conducted from October 2013 to January 2014. Nearly all of the interviewed occupational physicians have had contacts with colleagues of the Departments for Prevention and Occupational Health and Safety of the NHS. Regarding the relationship between occupational physicians and general practitioners findings showed that their cooperation is quite difficult and it would not seem a two-way collaboration. Cooperation between occupational physicians and NHS would benefit from the development of communication strategies and tools enhancing the support and assistance functions of the NHS facilities. The elaboration and subsequent application of operational guidelines and standardized procedures of communication would also improve collaboration between occupational physicians and general practitioners that is currently considered rather insufficient and incomplete. PMID:27733729

  7. Forest health monitoring: 2003 national technical report

    Treesearch

    John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling; William D. Smith

    2005-01-01

    The Forest Health Monitoring Program’s annual national reports present results from forest health data analyses focusing on a national perspective. The Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests are used as a reporting framework. This report has five main sections. The first contains introductory material....

  8. National animal health surveillance: Return on investment.

    PubMed

    Scott, Aaron E; Forsythe, Kenneth W; Johnson, Cynthia L

    2012-08-01

    A weighted benefit-cost analysis (BCA) supports prioritization of animal health surveillance activities to safeguard animal agriculture industries and reduce the impact of disease on the national economy. We propose to determine the value of investment in surveillance by assessing benefits from: avoiding disease incursion and expansion modified by the probability of occurrence of the disease event, the sensitivity of systems to detect it, and the degree to which we can mitigate disease impact when detected. The weighted benefit-cost ratio is the modified value of surveillance as laid out above divided by the cost of surveillance. We propose flexible, stream-based surveillance that capitalizes on combining multiple streams of information from both specific pathogen based and non-pathogen based surveillance. This stream-based type of system provides high value with lower costs and will provide a high return for the funds invested in animal health surveillance. Published by Elsevier B.V.

  9. The Health Care System Under French National Health Insurance: Lessons for Health Reform in the United States

    PubMed Central

    Rodwin, Victor G.

    2003-01-01

    The French health system combines universal coverage with a public–private mix of hospital and ambulatory care and a higher volume of service provision than in the United States. Although the system is far from perfect, its indicators of health status and consumer satisfaction are high; its expenditures, as a share of gross domestic product, are far lower than in the United States; and patients have an extraordinary degree of choice among providers. Lessons for the United States include the importance of government’s role in providing a statutory framework for universal health insurance; recognition that piecemeal reform can broaden a partial program (like Medicare) to cover, eventually, the entire population; and understanding that universal coverage can be achieved without excluding private insurers from the supplementary insurance market. PMID:12511380

  10. The Gap Between Physicians and the Public in Satisfaction with the National Health Insurance System in Korea

    PubMed Central

    Kim, Kye-Hyun; Park, Eun-Cheol

    2012-01-01

    The Korean National Health Insurance (NHI) system was an unprecedented accomplishment that was achieved in a short period of time. In this study, we sought to identify gaps between physicians and the public with respect to attitudes toward the NHI system in Korea. The study population was derived from the 2008 Korean Medical Association Survey, which was conducted to investigate satisfaction with and perceptions of the NHI system among physicians (n = 961) and the public (n = 935). Only 6.5% of the physicians were satisfied with NHI system, and 71.5% were dissatisfied with it. In contrast, 28.3% of the public were satisfied with the NHI system, and 21.4% were dissatisfied. The level of dissatisfaction expressed by physicians (2.03 ± 0.91 on a five-point scale) was also higher than that expressed by the public (3.06 ± 0.84). Despite rapid growth of NHI system, a large gap in satisfaction exists between physicians and the public. PMID:22690087

  11. National Delphi study to determine competencies for nursing leadership in public health.

    PubMed

    Misener, T R; Alexander, J W; Blaha, A J; Clarke, P N; Cover, C M; Felton, G M; Fuller, S G; Herman, J; Rodes, M M; Sharp, H F

    1997-01-01

    To identify competencies needed by nurse leaders in public health programs. Five-round national Delphi. Convenience sample of members of major public health nursing associations and nurse and non-nurse public health leaders in the USA. Mailed survey in 1994-1995 using a modified snowball technique based on a modification of the Pew Foundation health professions' competencies for Round 1. Four additional rounds produced consensus. Initially, 62 competencies were identified. Factor analysis resulted in four factors: political competencies, business acumen, program leadership, and management capabilities; 57 competencies were clustered in the four groupings and accounted for 91.4% of the variance. Graduate schools in nursing and public health must prepare students with broad-based competencies from a variety of disciplines. Findings of this national survey provide a database for curriculum development and evaluation of programs to prepare nurse leaders for roles in public health-based delivery systems.

  12. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership

    PubMed Central

    2013-01-01

    Background Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women’s Hospital. Description of intervention The PHIT Partnership’s health systems support aligns with the World Health Organization’s six health systems building blocks. HSS activities focus across all levels of the health system — community, health center, hospital, and district leadership — to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. Evaluation design The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted

  13. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

    PubMed

    Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

    2013-01-01

    Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific

  14. Designing for scale: optimising the health information system architecture for mobile maternal health messaging in South Africa (MomConnect)

    PubMed Central

    Seebregts, Christopher; Dane, Pierre; Parsons, Annie Neo; Fogwill, Thomas; Rogers, Debbie; Bekker, Marcha; Shaw, Vincent; Barron, Peter

    2018-01-01

    MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South Africa. We describe the system design and architecture of the MomConnect technical platform, planned as a nationally scalable and extensible initiative. It uses a health information exchange that can connect any standards-compliant electronic front-end application to any standards-compliant electronic back-end database. The implementation of the MomConnect technical platform, in turn, is a national reference application for electronic interoperability in line with the South African National Health Normative Standards Framework. The use of open content and messaging standards enables the architecture to include any application adhering to the selected standards. Its national implementation at scale demonstrates both the use of this technology and a key objective of global health information systems, which is to achieve implementation scale. The system’s limited clinical information, initially, allowed the architecture to focus on the base standards and profiles for interoperability in a resource-constrained environment with limited connectivity and infrastructural capacity. Maintenance of the system requires mobilisation of national resources. Future work aims to use the standard interfaces to include data from additional applications as well as to extend and interface the framework with other public health information systems in South Africa. The development of this platform has also shown the benefits of interoperability at both an organisational and technical level in South Africa. PMID:29713506

  15. Health research systems: promoting health equity or economic competitiveness?

    PubMed

    Pratt, Bridget; Loff, Bebe

    2012-01-01

    International collaborative health research is justifiably expected to help reduce global health inequities. Investment in health policy and systems research in developing countries is essential to this process but, currently, funding for international research is mainly channelled towards the development of new medical interventions. This imbalance is largely due to research legislation and policies used in high-income countries. These policies have increasingly led these countries to invest in health research aimed at boosting national economic competitiveness rather than reducing health inequities. In the United States of America and the United Kingdom of Great Britain and Northern Ireland, the regulation of research has encouraged a model that: leads to products that can be commercialized; targets health needs that can be met by profitable, high-technology products; has the licensing of new products as its endpoint; and does not entail significant research capacity strengthening in other countries. Accordingly, investment in international research is directed towards pharmaceutical trials and product development public-private partnerships for neglected diseases. This diverts funding away from research that is needed to implement existing interventions and to strengthen health systems, i.e. health policy and systems research. Governments must restructure their research laws and policies to increase this essential research in developing countries.

  16. Health research systems: promoting health equity or economic competitiveness?

    PubMed Central

    Loff, Bebe

    2012-01-01

    Abstract International collaborative health research is justifiably expected to help reduce global health inequities. Investment in health policy and systems research in developing countries is essential to this process but, currently, funding for international research is mainly channelled towards the development of new medical interventions. This imbalance is largely due to research legislation and policies used in high-income countries. These policies have increasingly led these countries to invest in health research aimed at boosting national economic competitiveness rather than reducing health inequities. In the United States of America and the United Kingdom of Great Britain and Northern Ireland, the regulation of research has encouraged a model that: leads to products that can be commercialized; targets health needs that can be met by profitable, high-technology products; has the licensing of new products as its endpoint; and does not entail significant research capacity strengthening in other countries. Accordingly, investment in international research is directed towards pharmaceutical trials and product development public–private partnerships for neglected diseases. This diverts funding away from research that is needed to implement existing interventions and to strengthen health systems, i.e. health policy and systems research. Governments must restructure their research laws and policies to increase this essential research in developing countries. PMID:22271965

  17. The National Adolescent Student Health Survey: Survey Replication Booklet.

    ERIC Educational Resources Information Center

    American School Health Association, Kent, OH.

    The National Adolescent Student Health Survey (NASHS), initiated in 1985, is conducted to examine the health-related knowledge, practices, and attitudes of the nation's youth in the following health areas: AIDS; Nutrition; Consumer Health; Sexually Transmitted Disease; Drug and Alcohol Use; Suicide; Injury Prevention; and Violence. Findings…

  18. Developing Tomorrow's Integrated Community Health Systems: A Leadership Challenge for Public Health and Primary Care

    PubMed Central

    Welton, William E.; Kantner, Theodore A.; Katz, Sheila Moriber

    1997-01-01

    As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health. PMID:9184684

  19. 77 FR 27469 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health... Extramural Activities, National Institute of Mental Health, National Institutes of Health, 6001 Executive...

  20. 77 FR 29675 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Extramural Activities, National Institute of Mental Health, National Institutes of Health, 6001 Executive...

  1. 75 FR 82408 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Initial... Extramural Activities, National Institute of Mental Health, National Institutes of Health, 6001 Executive...

  2. 76 FR 77239 - National Institute of Mental Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... U.S.C. App.), notice is hereby given of a meeting of the National Advisory Mental Health Council... clearly unwarranted invasion of personal privacy. Name of Committee: National Advisory Mental Health...

  3. 75 FR 51276 - National Institute of Mental Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... U.S.C. App.), notice is hereby given of a meeting of the National Advisory Mental Health Council... clearly unwarranted invasion of personal privacy. Name of Committee: National Advisory Mental Health...

  4. 78 FR 77692 - National Institute of Mental Health Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental....S.C. App.), notice is hereby given of a meeting of the National Advisory Mental Health Council. The... clearly unwarranted invasion of personal privacy. Name of Committee: National Advisory Mental Health...

  5. 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…

  6. An integrated national mortality surveillance system for death registration and mortality surveillance, China.

    PubMed

    Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

    2016-01-01

    In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

  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. © The Author(s) 2015.

  8. Public Trust in Health Information Sharing: A Measure of System Trust.

    PubMed

    Platt, Jodyn E; Jacobson, Peter D; Kardia, Sharon L R

    2018-04-01

    To measure public trust in a health information sharing in a broadly defined health system (system trust), inclusive of health care, public health, and research; to identify individual characteristics that predict system trust; and to consider these findings in the context of national health initiatives (e.g., learning health systems and precision medicine) that will expand the scope of data sharing. Survey data (n = 1,011) were collected in February 2014. We constructed a composite index of four dimensions of system trust-competency, fidelity, integrity, and trustworthiness. The index was used in linear regression evaluating demographic and psychosocial predictors of system trust. Data were collected by GfK Custom using a nationally representative sample and analyzed in Stata 13.0. Our findings suggest the public's trust may not meet the needs of health systems as they enter an era of expanded data sharing. We found that a majority of the U.S. public does not trust the organizations that have health information and share it (i.e., the health system) in one or more dimensions. Together, demographic and psychosocial factors accounted for ~18 percent of the observed variability in system trust. Future research should consider additional predictors of system trust such as knowledge, attitudes, and beliefs to inform policies and practices for health data sharing. © Health Research and Educational Trust.

  9. Health systems research in the time of health system reform in India: a review.

    PubMed

    Rao, Krishna D; Arora, Radhika; Ghaffar, Abdul

    2014-08-09

    Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period. We reviewed 9,477 publications between 2005 and 2013 in two online databases, PubMed and IndMED. Articles were classified according to the WHO classification of health systems building blocks. Our findings indicate the number of publications on health systems progressively increased every year from 92 in 2006 to 314 in 2012. The majority of papers were on service delivery (40%), with fewer on information (16%), medical technology and vaccines (15%), human resources (11%), governance (5%), and financing (8%). Around 70% of articles were lead by an author based in India, the majority by authors located in only four states. Several states, particularly in eastern and northeastern India, did not have a single paper published by a lead author located in a local institution. Moreover, many of these states were not the subject of a single published paper. Further, a few select institutions produced the bulk of research. Of the foreign author lead papers, 77% came from five countries (USA, UK, Canada, Australia, and Switzerland). The growth of published research during the reform period in India is a positive development. However, bulk of this research is produced in a few states and by a few select institutions Further strengthening health systems research requires attention to neglected health systems domains like human resources, financing, and governance. Importantly, research capacity needs to be strengthened in

  10. 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.

  11. 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

    ... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2011-0084] Notice of Request for Reinstatement of an Information Collection; National Animal Health Monitoring System; Swine 2012 Study AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Reinstatement...

  12. National Institutes of Health Funding in Rhode Island.

    PubMed

    Mao, George; Ramratnam, Bharat

    2017-07-05

    We present an overview of the National Institutes of Health (NIH) funding in Rhode Island through analysis of 935 NIH grants received during the fiscal years of 2012 to 2016. NIH funded over 2,600 grants from 2012 to 2016, of which approximately 900 were new grant awards, and the remainder were annual grant renewals. The most funded type of research in Rhode Island is mental health and substance abuse, followed by infectious disease, neurology, and public health. Research funding of cardiovascular diseases, on a per capita basis, are on par with the rest of the nation, while cancer research funding is less than one half the national average. The largest NIH institutional funding source is the National Institute of General Medical Sciences (NIGMS), followed by National Institute of Mental Health (NIMH) and National Institute on Alcohol Abuse and Alcoholism (NIAAA). While research grants (R01s) remain the predominant source of NIH funding, investigators in Rhode Island have secured additional funding through program project (P) grants with the aim of bolstering research resources and collaboration throughout the state. [Full article available at http://rimed.org/rimedicaljournal-2017-07.asp].

  13. Projections of national health expenditures through the year 2000

    PubMed Central

    Sonnefeld, Sally T.; Waldo, Daniel R.; Lemieux, Jeffrey A.; McKusick, David R.

    1991-01-01

    In this article, the authors present a scenario for health expenditures during the 1990s. Assuming that current laws and practices remain unchanged, the Nation will spend $1.6 trillion for health care in the year 2000, an amount equal to 16.4 percent of that year's gross national product. Medicare and Medicaid will foot an increasing share of the Nation's health bill, rising to more than one-third of the total. The factors accounting for growth in national health spending are described as well as the effects of those factors on spending by type of service and by source of funds. PMID:10114931

  14. The global and domestic politics of health policy in emerging nations.

    PubMed

    Gómez, Eduardo J; Ruger, Jennifer Prah

    2015-02-01

    In recent years, several emerging nations with burgeoning economies and in transition to democracy have pursued health policy innovations. As these nations have integrated into the world economy through bilateral trade and diplomacy, they have also become increasingly exposed to international pressures and norms and focused on more effective, equitable health care systems. There are several lessons learned from the case studies of Brazil, Ghana, India, China, Vietnam, and Thailand in this special issue on the global and domestic politics of health policy in emerging nations. For the countries examined, although sensitive to international preferences, domestic governments preferred to implement policy on their own and at their own pace. During the policy-making and implementation process, international and domestic actors played different roles in health policy making vis-à-vis other reform actors -- at times the state played an intermediary role. In several countries, civil society also played a central role in designing and implementing policy at all levels of government. International institutions also have a number of mechanisms and strategies in their tool box to influence a country's domestic health governance, and they use them, particularly in the context of an uncertain state or internal discordance within the state. Copyright © 2015 by Duke University Press.

  15. 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. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. Strengthening the role of Community Health Representatives in the Navajo Nation.

    PubMed

    King, Caroline; Goldman, Alex; Gampa, Vikas; Smith, Casey; Muskett, Olivia; Brown, Christian; Malone, Jamy; Sehn, Hannah; Curley, Cameron; Begay, Mae-Gilene; Nelson, Adrianne Katrina; Shin, Sonya Sunhi

    2017-04-21

    Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE) Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR) Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015) about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80. 2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. These findings suggest that CHRs have experienced positive benefits from COPE through training. COPE may provide a

  17. Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy.

    PubMed

    Lavoie, Josée G

    2013-12-27

    Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.

  18. 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).

  19. 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

  20. The French National Nutrition and Health Program: 2001-2006-2010.

    PubMed

    Hercberg, Serge; Chat-Yung, Stacie; Chaulia, Michel

    2008-01-01

    Established in 2001-2005 then extended to 2010, the French National Nutrition and Health Program (PNNS) is a nutrition policy whose objective is to improve the health status of the population by acting on one of its major determinants, nutrition. Nine priority objectives focusing on diet, physical activity and nutritional status were determined. Program strategies are based on fundamental principles including food culture, pleasure, and gastronomy. This multidisciplinary program involves stakeholders from ministries, research and educational institutions, food industry, healthcare, and consumers. More than 75% of the public health actions planned were accomplished or in progress by the end of 2005, particularly those concerning nutrition communication, education, research and nutritional surveillance. Dietary guidelines were established and are now considered the official reference in France. Actions focusing on the healthcare system, economic actors and players and specific population groups need further development. The success of a public health program like the PNNS requires a combination of synergistic and complementary actions, measures, regulations and laws. A national study at the end of the PNNS will determine if objectives were achieved.

  1. Safe use of electronic health records and health information technology systems: trust but verify.

    PubMed

    Denham, Charles R; Classen, David C; Swenson, Stephen J; Henderson, Michael J; Zeltner, Thomas; Bates, David W

    2013-12-01

    We will provide a context to health information technology systems (HIT) safety hazards discussions, describe how electronic health record-computer prescriber order entry (EHR-CPOE) simulation has already identified unrecognized hazards in HIT on a national scale, helping make EHR-CPOE systems safer, and we make the case for all stakeholders to leverage proven methods and teams in HIT performance verification. A national poll of safety, quality improvement, and health-care administrative leaders identified health information technology safety as the hazard of greatest concern for 2013. Quality, HIT, and safety leaders are very concerned about technology performance risks as addressed in the Health Information Technology and Patient Safety report of the Institute of Medicine; and these are being addressed by the Office of the National Coordinator of HIT of the U.S. Dept. of Human Services in their proposed plans. We describe the evolution of postdeployment testing of HIT performance, including the results of national deployment of Texas Medical Institute of Technology's electronic health record computer prescriber order entry (TMIT EHR-CPOE) Flight Simulator verification test that is addressed in these 2 reports, and the safety hazards of concern to leaders. A global webinar for health-care leaders addressed the top patient safety hazards in the areas of leadership, practices, and technologies. A poll of 76 of the 221 organizations participating in the webinar revealed that HIT hazards were the participants' greatest concern of all 30 hazards presented. Of those polled, 89% rated HIT patient/data mismatches in EHRs and HIT systems as a 9 or 10 on a scale of 1 to 10 as a hazard of great concern. Review of a key study of postdeployment testing of the safety performance of operational EHR systems with CPOE implemented in 62 hospitals, using the TMIT EHR-CPOE simulation tool, showed that only 53% of the medication orders that could have resulted in fatalities were

  2. Libyan National Health Services The Need to Move to Management-by-Objectives

    PubMed Central

    El Taguri, A; Elkhammas, EA; Bakoush, O; Ashammakhi, N; Baccoush, M; Betilmal, I

    2008-01-01

    In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART (specific, measurable, achievable, and realistic and time specific) objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude. PMID:21499467

  3. Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change

    PubMed Central

    Swanson, R Chad; Cattaneo, Adriano; Bradley, Elizabeth; Chunharas, Somsak; Atun, Rifat; Abbas, Kaja M; Katsaliaki, Korina; Mustafee, Navonil; Mason Meier, Benjamin; Best, Allan

    2012-01-01

    While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key ‘systems thinking’ tools and strategies that have the potential for transformational change in health systems. Three overarching themes span these tools and strategies: collaboration across disciplines, sectors and organizations; ongoing, iterative learning; and transformational leadership. The proposed tools and strategies in this paper can be applied, in varying degrees, to every organization within health systems, from families and communities to national ministries of health. While our categorization is necessarily incomplete, this initial effort will provide a valuable contribution to the health systems strengthening debate, as the need for a more systemic, rigorous perspective in health has never been greater. PMID:23014154

  4. Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change.

    PubMed

    Swanson, R Chad; Cattaneo, Adriano; Bradley, Elizabeth; Chunharas, Somsak; Atun, Rifat; Abbas, Kaja M; Katsaliaki, Korina; Mustafee, Navonil; Mason Meier, Benjamin; Best, Allan

    2012-10-01

    While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key 'systems thinking' tools and strategies that have the potential for transformational change in health systems. Three overarching themes span these tools and strategies: collaboration across disciplines, sectors and organizations; ongoing, iterative learning; and transformational leadership. The proposed tools and strategies in this paper can be applied, in varying degrees, to every organization within health systems, from families and communities to national ministries of health. While our categorization is necessarily incomplete, this initial effort will provide a valuable contribution to the health systems strengthening debate, as the need for a more systemic, rigorous perspective in health has never been greater.

  5. Health and demographic surveillance systems: a step towards full civil registration and vital statistics system in sub-Sahara Africa?

    PubMed Central

    2012-01-01

    Background In the developed world, information on vital events is routinely collected nationally to inform population and health policies. However, in many low-and middle-income countries, especially those in sub-Saharan Africa (SSA), there is a lack of effective and comprehensive national civil registration and vital statistics system. In the past decades, the number of Health and Demographic Surveillance Systems (HDSSs) has increased throughout SSA. An HDSS monitors births, deaths, causes of death, migration, and other health and socio-economic indicators within a defined population over time. Currently, the International Network for the Continuous Demographic Evaluation of Populations and Their Health (INDEPTH) brings together 38 member research centers which run 44 HDSS sites from 20 countries in Africa, Asia and Oceana. Thirty two of these HDSS sites are in SSA. Discussion This paper argues that, in the absence of an adequate national CRVS, HDSSs should be more effectively utilised to generate relevant public health data, and also to create local capacity for longitudinal data collection and management systems in SSA. If HDSSs get strategically located to cover different geographical regions in a country, data from these sites could be used to provide a more complete national picture of the health of the population. They provide useful data that can be extrapolated for national estimates if their regional coverage is well planned. HDSSs are however resource-intensive. Efforts are being put towards getting them linked to local or national policy contexts and to reduce their dependence on external funding. Increasing their number in SSA to cover a critical proportion of the population, especially urban populations, must be carefully planned. Strategic planning is needed at national levels to geographically locate HDSS sites and to support these through national funding mechanisms. Summary The paper does not suggest that HDSSs should be seen as a replacement for

  6. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    PubMed

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  7. 78 FR 54477 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Initial...., Scientific Review Officer, Division of Extramural Activities, National Institute of Mental Health National...

  8. 77 FR 61011 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Officer, Division of Extramural Activities, National Institute of Mental Health, National Institutes of...

  9. Funding of Medical Research in Australia by the National Health & Medical Research Council.

    ERIC Educational Resources Information Center

    McCloskey, Ian

    1994-01-01

    The role of Australia's National Health and Medical Research Council, an independent statutory body, in distribution of funds for research projects, programs, units, and major institutes. The agency's evaluation system, resource allocation practices, and training and career support system are described briefly. (MSE)

  10. Evaluation of health care system reform in Hubei Province, China.

    PubMed

    Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

    2014-02-21

    This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

  11. What is Clinical Safety in Electronic Health Care Record Systems?

    NASA Astrophysics Data System (ADS)

    Davies, George

    There is mounting public awareness of an increasing number of adverse clinical incidents within the National Health Service (NHS), but at the same time, large health care projects like the National Programme for IT (NPFIT) are claiming that safer care is one of the benefits of the project and that health software systems in particular have the potential to reduce the likelihood of accidental or unintentional harm to patients. This paper outlines the approach to clinical safety management taken by CSC, a major supplier to NPFIT; discusses acceptable levels of risk and clinical safety as an end-to-end concept; and touches on the future for clinical safety in health systems software.

  12. Design of a National Retail Data Monitor for Public Health Surveillance

    PubMed Central

    Wagner, Michael M.; Robinson, J. Michael; Tsui, Fu-Chiang; Espino, Jeremy U.; Hogan, William R.

    2003-01-01

    The National Retail Data Monitor receives data daily from 10,000 stores, including pharmacies, that sell health care products. These stores belong to national chains that process sales data centrally and utilize Universal Product Codes and scanners to collect sales information at the cash register. The high degree of retail sales data automation enables the monitor to collect information from thousands of store locations in near to real time for use in public health surveillance. The monitor provides user interfaces that display summary sales data on timelines and maps. Algorithms monitor the data automatically on a daily basis to detect unusual patterns of sales. The project provides the resulting data and analyses, free of charge, to health departments nationwide. Future plans include continued enrollment and support of health departments, developing methods to make the service financially self-supporting, and further refinement of the data collection system to reduce the time latency of data receipt and analysis. PMID:12807802

  13. The Dutch National Atlas of Public Health.

    PubMed

    Zwakhals, S L N; Giesbers, H; Mac Gillavry, E; van Boven, P F; van der Veen, A A

    2004-09-01

    The Dutch National Atlas of Public Health (http://www.zorgatlas.nl) maps the regional distribution of demand and usage of health care, public health status and influencing factors. The Atlas provides answers to locational questions, e. g. 'Where are the highest mortality rates?', 'Where are the longest waiting lists?' and 'Where are hospitals located?' Maps play a pivotal role in the Atlas. Texts, graphics and diagrams support the interpretation of the maps. The information in the Atlas specifically targets policy makers at the Ministry of Health, Welfare and Sport. For them, the Atlas is a tool for problem detection, policy making and policy evaluation. The Atlas is also aimed at all professionals in health care. In practice, also the general public appears to access and use the Atlas. The Atlas is part of the Dutch Public Health Status and Forecasts (PHSF). The PHSF is made by the National Institute of Public Health and the Environment mandated by the Ministry of Health, Welfare and Sport.

  14. 76 FR 82313 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Initial... Institute of Mental Health, National Institutes of Health, 6001 Executive Blvd., Room 6154, MSC 9609...

  15. 78 FR 54478 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... of Mental Health, National Institutes of Health, 6001 Executive Blvd., Room 6154, MSC 9606, Bethesda...

  16. 75 FR 53320 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Initial... of Mental Health, National Institutes of Health, 6001 Executive Blvd., Room 6154, MSC 9609, Bethesda...

  17. Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

    PubMed

    Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

    2013-09-30

    Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

  18. 77 FR 24207 - National Committee on Vital and Health Statistics: Teleconference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics...) announces the following advisory committee meeting. Name: National Committee on Vital and Health Statistics... Secretary, NCVHS, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311...

  19. 77 FR 9660 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ..., Executive Secretary, NCVHS, National Center for Health Statistics, Centers for Disease Control and... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics...

  20. 75 FR 52950 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics... from Marjorie S. Greenberg, Executive Secretary, NCVHS, National Center for Health Statistics, Centers...

  1. 76 FR 20989 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the Following Advisory Committee Meeting. Name: National Committee on Vital and Health Statistics..., Executive Secretary, NCVHS, National Center for Health Statistics, Centers for Disease Control and...

  2. 75 FR 31789 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics... from Marjorie S. Greenberg, Executive Secretary, NCVHS, National Center for Health Statistics, Centers...

  3. 75 FR 39531 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics... Secretary, NCVHS, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311...

  4. 76 FR 61706 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics.... Greenberg, Executive Secretary, NCVHS, National Center for Health Statistics, Centers for Disease Control...

  5. 76 FR 45810 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics..., NCVHS, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo...

  6. Health system reform and the role of field sites based upon demographic and health surveillance.

    PubMed Central

    Tollman, S. M.; Zwi, A. B.

    2000-01-01

    Field sites for demographic and health surveillance have made well-recognized contributions to the evaluation of new or untested interventions, largely through efficacy trials involving new technologies or the delivery of selected services, e.g. vaccines, oral rehydration therapy and alternative contraceptive methods. Their role in health system reform, whether national or international, has, however, proved considerably more limited. The present article explores the characteristics and defining features of such field sites in low-income and middle-income countries and argues that many currently active sites have a largely untapped potential for contributing substantially to national and subnational health development. Since the populations covered by these sites often correspond with the boundaries of districts or subdistricts, the strategic use of information generated by demographic surveillance can inform the decentralization efforts of national and provincial health authorities. Among the areas of particular importance are the following: making population-based information available and providing an information resource; evaluating programmes and interventions; and developing applications to policy and practice. The question is posed as to whether their potential contribution to health system reform justifies arguing for adaptations to these field sites and expanded investment in them. PMID:10686747

  7. The National Integrated Heat Health Information System (NIHHIS) as a Learning System for Extreme Heat: Evolving Future Resilience from Present Climate Extremes

    NASA Astrophysics Data System (ADS)

    Jones, H.; Trtanj, J.; Pulwarty, R. S.; Higgins, W.

    2016-12-01

    There is presently no consensus indicator for the effect of extreme heat on human health. At the early warning timescale, a variety of approaches to setting temperature thresholds (minimum, maximum, time-lagged) or more complex approaches (Heat Index, Thermal Comfort, etc...) for issuing alerts and warnings have been recommended by literature and implemented, leading to much heterogeneity. At longer timescales, efforts have been made to quantify potential future health outcomes using climate projections, but nonstationarity of the climate system, economy, and demography may invalidate many of the assumptions which were necessarily made in these studies. Furthermore, in our pursuit of developing the best models and indicators to represent the impacts of climate extremes, perhaps we have not paid enough attention to what makes them policy-relevant, responsive to changing assumptions, and targeted at elements that can actually be predicted. In response to this concern, a comprehensive approach to improving the impactfulness of these indicators is underway as part of the National Integrated Heat Health Information System (NIHHIS), which was initiated by NOAA and CDC, but has grown to include many other federal agency and non-governmental partners. NIHHIS is a framework that integrates what we know about extreme heat and health outcomes within a learning system - simultaneously informing early warning and long-term risk reduction prior to, during, and while recovering from extreme heat events. NIHHIS develops impactful evolutionary responses to climate extremes. Through ongoing regional engagements, we are applying the lessons of impact modeling studies to create learning systems in the Southwest, Northeast, Midwest, and soon other regions of the U.S. This session will provide a view of this process as it has been carried out in the Southwest region - focused on the transboundary (US-Mexico) region around El Paso, Texas, and the NIHHIS approach to indicators overall.

  8. Dynamics between doctors and managers in the Italian National Health Care System.

    PubMed

    Vicarelli, Giovanna M; Pavolini, Emmanuele

    2017-11-01

    This article focuses on the changes in the Italian NHS by concentrating on patterns in the managerialisation of doctors. It addresses a series of shortcomings in studies on the response by doctors to managerialisation. The first is a shortcoming of theoretical and analytical nature. It is necessary to adopt a broader perspective whereby analysis considers not only the interaction between doctors and managers, but also the public control and regulation agencies that operate in that field. The second shortcoming is a methodological one. The literature on managerialisation is more theoretical than applied. It is necessary to adopt a strategy based on a plurality of methodologies and sources in order to focus attention on a national case (Italy in the present study), discussing the changes over time (from the beginning of managerialisation until today) and considering different groups within the medical profession. The outcome is a complex picture of the dynamics between doctors and managers which foregrounds the managerial co-optation processes of a small group of national health service doctors, the transition from strategic adaptation to forms of resistance against managerialisation by the majority of Italian NHS doctors, and the emergence of restratification processes among self-employed doctors working with the NHS. © 2017 Foundation for the Sociology of Health & Illness.

  9. The political abuse of international health system comparisons.

    PubMed

    Ehlke, Daniel

    2011-07-01

    Though the science of medicine subscribes to learning from best practices and the transmission of superior treatment regimens across national boundaries, the same ethos does not inform political debates surrounding health system reform. The Canadian and English health systems have been used - and, more frequently - abused by American politicians in their quest to support their own model of reform, or preserve the status quo.

  10. 77 FR 70444 - Office of the National Coordinator for Health Information Technology; Health Information...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the National Coordinator for Health Information...) Policy Committee, Office of the National Coordinator for Health Information Technology (ONC), Department... assured consideration, electronic comments must be received no later than 11:59p.m. ET on January 14, 2013...

  11. National Health Guidelines in I.R of Iran, an Innovative Approach for Developing Countries

    PubMed Central

    Esmaeil Akbari, Mohammad; Mohammadi, Gohar; Vosoogh-Moghaddam, Abbas; Rabanikhah, Fahimeh; Javadi, Hamideh; Rostami-Gooran, Narges; Safaei, Asal; Akbari, Atieh

    2015-01-01

    Background Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. Methods A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. Results In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. Conclusion National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility. PMID:25960845

  12. National health guidelines in I.R of iran, an innovative approach for developing countries.

    PubMed

    Esmaeil Akbari, Mohammad; Mohammadi, Gohar; Vosoogh-Moghaddam, Abbas; Rabanikhah, Fahimeh; Javadi, Hamideh; Rostami-Gooran, Narges; Safaei, Asal; Akbari, Atieh

    2015-01-01

    Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility.

  13. 77 FR 55214 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics..., National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Room...

  14. 76 FR 4696 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics..., National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Room...

  15. Data liquidity in health information systems.

    PubMed

    Courtney, Paul K

    2011-01-01

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

  16. Impact of innovations in national public health markets in Europe.

    PubMed

    McCarthy, Mark; Alexanderson, Kristina; Voss, Margaretha; Conceição, Claudia; Grimaud, Olivier; Narkauskaité, Laura; Katreniakova, Zuzana; Saliba, Amanda; Sammut, Marvic

    2013-11-01

    Social innovations can contribute to health and wellbeing. PHIRE (Public Health Innovation and Research in Europe) investigated the impacts at national level of innovation projects funded by the European Union Public Health Programme. Through the European Public Health Association, experts assessed the uptake of the eight public health projects, for 30 European countries. Their reports were assembled by country and, thereafter, national public health associations reviewed the reports. Following stakeholder workshops, or internal and external consultations, 11 national reports were produced which included discussion on the impacts of the public health innovations in national product markets. In 11 countries, there were reports on the eight innovations for 45 (51%) of the possible public health markets. The innovations contributed positively to policy, practice and research, across different levels and in different ways, in 35 (39%) market, while competing innovation activities were recorded in 10 (11%) markets. The workshops also discussed contributing factors and limitations in dissemination and timing for policy cycles. The impacts of European Union social innovations in public health markets can be identified through national discussions. Further attention should be given to understanding drivers and incentives for successful public health innovations.

  17. [Gender systems and/in the Spanish National Health Interview Survey].

    PubMed

    Ruiz Cantero, María Teresa; Papí Gálvez, Natalia; Carbrera Ruiz, Virginia; Ruiz Martínez, Ana; Alvarez-Dardet Díaz, Carlos

    2006-01-01

    To analyze the Spanish National Health Interview Survey (NHIS) from a gender perspective, with special emphasis on gender division of labor. We analyzed the 2003 Spanish NHIS from the perspective of the levels of gender observation, with gender understood as: a) the basis of social norms (responsibilities by sex, health risks, and problems related to masculine/feminine roles); b) the organizer of the social structure: gender division of labor, work overload, vertical/horizontal segregation, time spent in activities according to social times, access to resources), and c) a component of individual identity (conflicts due to multiple roles, body image dissatisfaction, self-esteem, self-perceived recognition of the work performed, assimilation of the sexual gender role, sex differences in health conditions). The Spanish NHIS is centered on the main provider, referred to in masculine grammatical form. Gender division of domestic labor is identified only by a general question. When using the concept of main activity for productive or reproductive work, the survey requires respondents to evaluate them and select only one, thus losing information and hampering analysis of the impact of an overload of work on health. Information on time used for reproductive work and leisure is not solicited. Assaults (intentional) and accidents (non-intentional) are combined in the same question, thus preventing research on gender-related violence. The Spanish NHIS includes the variable of sex, but its more descriptive than analytic focus limits gender analysis. The survey allows specific circumstances of employment-related inequalities between sexes to be measured, but does not completely allow other indicators of gender inequalities, such as the situation of housewives or work overload, to be measured.

  18. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  19. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  20. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  1. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  2. NATIONAL EMPLOYER HEALTH INSURANCE SURVEY (NEHIS)

    EPA Science Inventory

    The National Employer Health Insurance Survey (NEHIS) was developed to produce estimates on employer-sponsored health insurance data in the United States. The NEHIS was the first Federal survey to represent all employers in the United States by State and obtain information on all...

  3. Politics and medicine: the case of Israeli National Health Insurance.

    PubMed

    Yishai, Y

    1982-01-01

    The paper focuses on the attempts to introduce a national health insurance system in Israel. So far all these attempts advanced through six public committees and various legislative initiatives have been futile. The major actors involved in the process of NHI formulation are (a) the sick funds, the largest of which (KH) nearly monopolizes the health services; (b) political parties which are affiliated with the sick funds; (c) the Israeli medical association. The labor oriented parties and sick funds aimed for the introduction of an NHI system which would strengthen KH and preserve its autonomy. The right wing parties and sick fund advocated nationalization of the NHI. The IMA took a mid-way position not identifying with either of the parties. By allying with a small coalition party it was effective in impeding the legislative process that was initiated by the Labor Party. The vigorous opposition of KH has hindered the adoption of the Likud's version of the NHI. Hence, the issue, torn between conflicting parties, reached a stalemate which is not likely to be resolved in the near future.

  4. An overview of mental health care system in Kilifi, Kenya: results from an initial assessment using the World Health Organization's Assessment Instrument for Mental Health Systems.

    PubMed

    Bitta, Mary A; Kariuki, Symon M; Chengo, Eddie; Newton, Charles R J C

    2017-01-01

    Little is known about the state of mental health systems in Kenya. In 2010, Kenya promulgated a new constitution, which devolved national government and the national health system to 47 counties including Kilifi County. There is need to provide evidence from mental health systems research to identify priority areas in Kilifi's mental health system for informing county health sector decision making. We conducted an initial assessment of state of mental health systems in Kilifi County and documented resources, policy and legislation and spectrum of mental, neurological and substance use disorders. This was a pilot study that used the brief version of the World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 to collect data. Data collection was based on the year 2014. Kilifi county has two public psychiatric outpatient units that are part of general hospitals. There is no standalone mental hospital in Kilifi. There are no inpatients or community based facilities for people with mental health problems. Although the psychiatric facilities in Kilifi have an essential drugs list, supply of drugs is erratic with frequent shortages. There is no psychiatrist or psychologist in Kilifi with only two psychiatric nurses for a population of approximately 1.2 million people. Schizophrenia was the commonest reason for visiting outpatient facilities (47.1%) while suicidal ideation was the least common (0.4%). Kenya's mental health policy, which is being used by Kilifi County, is outdated and does not cater for the current mental health needs of Kilifi. There is no specific legislation to protect the rights of people with mental health problems. No budget exists specifically for mental health care. There have been no efforts to integrate mental health care into primary care in Kilifi, and there is no empirical research work to evaluate its feasibility. There is an urgent need to increase resources allocated for mental health in particular

  5. Future Directions for the National Health Accounts

    PubMed Central

    Huskamp, Haiden A.; Newhouse, Joseph P.

    1999-01-01

    Over the past 15 years, the Health Care Financing Administration (HCFA) has engaged in ongoing efforts to improve the methodology and data collection processes used to develop the national health accounts (NHA) estimates of national health expenditures (NHE). In March 1998, HCFA initiated a third conference to explore possible improvements or useful extensions to the current NHA projects. This article summarizes the issues discussed at the conference, provides an overview of three commissioned papers on future directions for the NHA that were presented, and summarizes suggestions made by participants regarding future directions for the accounts. PMID:11481786

  6. Critical interactions between the Global Fund-supported HIV programs and the health system in Ghana.

    PubMed

    Atun, Rifat; Pothapregada, Sai Kumar; Kwansah, Janet; Degbotse, D; Lazarus, Jeffrey V

    2011-08-01

    The support of global health initiatives in recipient countries has been vigorously debated. Critics are concerned that disease-specific programs may be creating vertical and parallel service delivery structures that to some extent undermine health systems. This case study of Ghana aimed to explore how the Global Fund-supported HIV program interacts with the health system there and to map the extent and nature of integration of the national disease program across 6 key health systems functions. Qualitative interviews of national stakeholders were conducted to understand the perceptions of the strengths and weaknesses of the relationship between Global Fund-supported activities and the health system and to identify positive synergies and unintended consequences of integration. Ghana has a well-functioning sector-wide approach to financing its health system, with a strong emphasis on integrated care delivery. Ghana has benefited from US $175 million of approved Global Fund support to address the HIV epidemic, accounting for almost 85% of the National AIDS Control Program budget. Investments in infrastructure, human resources, and commodities have enabled HIV interventions to increase exponentially. Global Fund-supported activities have been well integrated into key health system functions to strengthen them, especially financing, planning, service delivery, and demand generation. Yet, with governance and monitoring and evaluation functions, parallel structures to national systems have emerged, leading to inefficiencies. This case study demonstrates that interactions and integration are highly varied across different health system functions, and strong government leadership has facilitated the integration of Global Fund-supported activities within national programs.

  7. Prevention in Poland: health care system reform.

    PubMed Central

    Sheahan, M D

    1995-01-01

    Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints. PMID:7610217

  8. Prevention in Poland: health care system reform.

    PubMed

    Sheahan, M D

    1995-01-01

    Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints.

  9. Trans-National Scale-Up of Services in Global Health

    PubMed Central

    Shahin, Ilan; Sohal, Raman; Ginther, John; Hayden, Leigh; MacDonald, John A.; Mossman, Kathryn; Parikh, Himanshu; McGahan, Anita; Mitchell, Will; Bhattacharyya, Onil

    2014-01-01

    Background Scaling up innovative healthcare programs offers a means to improve access, quality, and health equity across multiple health areas. Despite large numbers of promising projects, little is known about successful efforts to scale up. This study examines trans-national scale, whereby a program operates in two or more countries. Trans-national scale is a distinct measure that reflects opportunities to replicate healthcare programs in multiple countries, thereby providing services to broader populations. Methods Based on the Center for Health Market Innovations (CHMI) database of nearly 1200 health programs, the study contrasts 116 programs that have achieved trans-national scale with 1,068 single-country programs. Data was collected on the programs' health focus, service activity, legal status, and funding sources, as well as the programs' locations (rural v. urban emphasis), and founding year; differences are reported with statistical significance. Findings This analysis examines 116 programs that have achieved trans-national scale (TNS) across multiple disease areas and activity types. Compared to 1,068 single-country programs, we find that trans-nationally scaled programs are more donor-reliant; more likely to focus on targeted health needs such as HIV/AIDS, TB, malaria, or family planning rather than provide more comprehensive general care; and more likely to engage in activities that support healthcare services rather than provide direct clinical care. Conclusion This work, based on a large data set of health programs, reports on trans-national scale with comparison to single-country programs. The work is a step towards understanding when programs are able to replicate their services as they attempt to expand health services for the poor across countries and health areas. A subset of these programs should be the subject of case studies to understand factors that affect the scaling process, particularly seeking to identify mechanisms that lead to

  10. Contributions of national and global health estimates to monitoring health-related Sustainable Development Goals in Thailand.

    PubMed

    Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

    2017-01-01

    The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper draws lessons learned from Thailand's burden of disease study (BOD) on capacity development for NHEs, and discusses the contributions and limitation of GHEs in informing policies at country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and sub-national levels. Initially, the quality of cause of death reporting in the death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This helped improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the 2010 Global Burden of Diseases (GBD) estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and effective interfaces between researchers and decision makers contribute to enhanced country policy responses, while sub-national data are intended to be used by various sub-national-level partners. Though GHEs contribute to benchmarking country achievement compared with global health

  11. 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.

  12. Projections of National Health Expenditures, 1980, 1985, and 1990

    PubMed Central

    Freeland, Mark; Calat, George; Schendler, Carol Ellen

    1980-01-01

    This paper presents projections of national health expenditures by type of expenditure and sources of funds for 1980, 1985, and 1990. A major purpose of these projections is to provide a baseline for health care expenditures in the absence of national health insurance and cost containment. Rapid growth in health expenditures is projected to continue to 1990. National health expenditures increased 350 percent between 1965 and 1978, reaching $192 billion in 1978. They are projected to reach $245 billion in 1980, $440 billion in 1985 and $760 billion in 1990, under current legislation. As a proportion of the Gross National Product (GNP), health expenditures rose from 6.2 percent to 9.1 percent between 1965 and 1978. They are projected to continue to rise, reaching 10.5 percent by 1985 and 11.5 percent by 1990. Sources of payments for these expenditures are also shifting. From 1965 to 1978, the percentage of total health expenditures that was government financed increased 16 percentage points, from 25 to 41 percent. The Federal share of public funds during the same period grew rapidly, from 53 percent in 1965 to 69 percent in 1978. In 1985, approximately 42 percent of total health spending is projected to be financed from public funds, of which 72 percent will be paid by the Federal government. Public funds are expected to account for 43 percent of total national health expenditures by 1990. PMID:10309132

  13. National Institutes of Health Funding in Plastic Surgery: A Crisis?

    PubMed

    Silvestre, Jason; Abbatematteo, Joseph M; Serletti, Joseph M; Chang, Benjamin

    2016-09-01

    Decreasing funding rates and increasing competition for National Institutes of Health research grants have prompted diverse interventions in various fields of biomedicine. Currently, the state of National Institutes of Health funding for plastic surgery research is poorly understood. The purpose of this study was to describe the portfolio of National Institutes of Health grants in academic plastic surgery. Plastic surgery faculty at integrated and independent programs were queried individually in the National Institutes of Health RePORTER database for grants awarded in 2014. Funding totals, mechanisms, and institutes were calculated. Abstracts were categorized by research type and field of interest. Characteristics of National Institutes of Health-funded principal investigators were elucidated. Eight hundred sixty-one academic plastic surgeons at 94 programs were queried, and only 18 investigators (2.1 percent) were funded at 12 programs (12.8 percent). National Institutes of Health-funded investigators were predominately male (72 percent), fellowship-trained (61 percent), and aged 49.3 ± 7.8 years. A total of 20 awards amounted to $6,916,886, with an average award of $345,844 ± $222,909. Costs were primarily awarded through the R01 mechanism (77.2 percent). The top three National Institutes of Health institutes awarded 72.9 percent of the entire portfolio. Funding supported clinical (41.1 percent), translational (36.9 percent), and basic science (22.0 percent) research. Craniofacial (20.5 percent), hand (18.7 percent), and breast (16.2 percent) had the greatest funding. Few programs and faculty drive the National Institutes of Health portfolio of plastic surgery research. These data suggest a tenuous funding situation that may be susceptible to future spending cuts. Future research is needed to identify barriers to National Institutes of Health funding procurement in academic plastic surgery.

  14. [Lessons learned in the implementation of interoperable National Health Information Systems: a systematic review].

    PubMed

    Ovies-Bernal, Diana Paola; Agudelo-Londoño, Sandra M

    2014-01-01

    Identify shared criteria used throughout the world in the implementation of interoperable National Health Information Systems (NHIS) and provide validated scientific information on the dimensions affecting interoperability. This systematic review sought to identify primary articles on the implementation of interoperable NHIS published in scientific journals in English, Portuguese, or Spanish between 1990 and 2011 through a search of eight databases of electronic journals in the health sciences and informatics: MEDLINE (PubMed), Proquest, Ovid, EBSCO, MD Consult, Virtual Health Library, Metapress, and SciELO. The full texts of the articles were reviewed, and those that focused on technical computer aspects or on normative issues were excluded, as well as those that did not meet the quality criteria for systematic reviews of interventions. Of 291 studies found and reviewed, only five met the inclusion criteria. These articles reported on the process of implementing an interoperable NHIS in Brazil, China, the United States, Turkey, and the Semiautonomous Region of Zanzíbar, respectively. Five common basic criteria affecting implementation of the NHIS were identified: standards in place to govern the process, availability of trained human talent, financial and structural constraints, definition of standards, and assurance that the information is secure. Four dimensions affecting interoperability were defined: technical, semantic, legal, and organizational. The criteria identified have to be adapted to the actual situation in each country and a proactive approach should be used to ensure that implementation of the interoperable NHIS is strategic, simple, and reliable.

  15. [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.

  16. National Environmental Health Association - Big Cities Webinar

    EPA Science Inventory

    Exposure to wildfire smoke is an environmental health topic that is growing in importance and impact and having relevance to many health officials across the country, as well as federal, state and local decision-makers. The webinar presented to the National Environmental Health ...

  17. 77 FR 74198 - National Institute of Mental Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... U.S.C. App.), notice is hereby given of a meeting of the National Advisory Mental Health Council... Institute of Mental Health, NIH, Neuroscience Center, 6001 Executive Blvd., Room 6154, MSC 9609, Bethesda...

  18. 77 FR 10746 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics...; March 9, 2012: 9 a.m.-3 p.m. EST. Place: National Center for Health Statistics, 3311 Toledo Road...

  19. 75 FR 61761 - National Committee on Vital and Health Statistics: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Committee on Vital and Health Statistics: Meeting... the following advisory committee meeting. Name: National Committee on Vital and Health Statistics..., 2010 9 a.m.-3 p.m. EST. Place: National Center for Health Statistics, 3311 Toledo Road, Auditorium A&B...

  20. 75 FR 22411 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... Committee: National Institute of Mental Health Initial Review Group; Interventions Committee for Disorders... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health...

  1. 76 FR 23826 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... Committee: National Institute of Mental Health Initial Review Group; Interventions Committee for Disorders... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Initial...

  2. 76 FR 11799 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health..., Scientific Review Officer, Division of Extramural Activities, National Institute of Mental Health, NIH...

  3. 75 FR 68612 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Review Officer, Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience...

  4. 78 FR 45933 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health...., Scientific Review Officer, Division of Extramural Activities, National Institute of Mental Health, NIH...

  5. 77 FR 16249 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Officer, Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center...

  6. 77 FR 32649 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special..., Division of Extramural Activities, National Institute of Mental Health, NIH Neuroscience Center, 6001...

  7. 75 FR 65642 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001 Executive...

  8. 75 FR 12243 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-15

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Review Officer, Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience...

  9. 77 FR 11139 - National Institute of Mental Health Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special...., Scientific Review Officer, Division of Extramural Activities, National Institute of Mental Health, NIH...

  10. 75 FR 8372 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special... Review Officer, Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience...

  11. 75 FR 17150 - National Institute of Mental Health; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... personal privacy. Name of Committee: National Institute of Mental Health Special Emphasis Panel; Child..., Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001...

  12. 78 FR 64228 - National Institute of Mental Health; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Mental Health Special..., Division of Extramural Activities, National Institute of Mental Health, NIH, Neuroscience Center, 6001...

  13. National Health Expenditures: Short-Term Outlook and Long-Term Projections

    PubMed Central

    Freeland, Mark S.; Schendler, Carol Ellen

    1981-01-01

    This paper presents projections of national health expenditures by type of expenditure and source of funds for 1981, 1985, and 1990. Rapid growth in national health expenditures is projected to continue through 1990. National health expenditures increased 400 percent between 1965 and 1979, reaching $212 billion in 1979. As a proportion of the Gross National Product (GNP), health expenditures rose from 6.1 percent to 9.0 percent between 1965 and 1979. They are expected to continue to rise, reaching 10.8 percent by 1990. This study projects that, under current legislation, national health expenditures will reach $279 billion in 1981, $462 billion in 1985, and $821 billion in 1990. Sources of payments for these expenditures are shifting. From 1965 to 1979, the percentage of total health expenditures financed by public funds increased 17 percentage points—from 26 to 43 percent. The Federal share of public funds during this same period grew rapidly, from 51 percent in 1965 to 67 percent in 1979. This study projects that in 1985 approximately 45 percent of total health spending will be financed from public funds, of which 68 percent will be paid for by the Federal government. Public funds will account for 46 percent of total national health expenditures by 1990. PMID:10309366

  14. Strengthening national health laboratories in sub-Saharan Africa: a decade of remarkable progress

    PubMed Central

    Alemnji, G. A.; Zeh, C.; Yao, K.; Fonjungo, P. N.

    2016-01-01

    OBJECTIVES Efforts to combat the HIV/AIDS pandemic have underscored the fragile and neglected nature of some national health laboratories in Africa. In response, national and international partners and various governments have worked collaboratively over the last several years to build sustainable laboratory capacities within the continent. Key accomplishments reflecting this successful partnership include the establishment of the African-based World Health Organization Regional Office for Africa (WHO-AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA); development of the Strengthening Laboratory Management Toward Accreditation (SLMTA) training programme; and launching of a Pan African-based institution, the African Society for Laboratory Medicine (ASLM). These platforms continue to serve as the foundations for national health laboratory infrastructure enhancement, capacity development and overall quality system improvement. Further targeted interventions should encourage countries to aim at integrated tiered referral networks, promote quality system improvement and accreditation, develop laboratory policies and strategic plans, enhance training and laboratory workforce development and a retention strategy, create career paths for laboratory professionals and establish public–private partnerships. Maintaining the gains and ensuring sustainability will require concerted action by all stakeholders with strong leadership and funding from African governments and from the African Union. PMID:24506521

  15. National Training and Education Standards for Health and Wellness Coaching: The Path to National Certification

    PubMed Central

    Wolever, Ruth Q.; Lawson, Karen; Moore, Margaret

    2015-01-01

    The purpose of this article is twofold: (1) to announce the findings of the job task analysis as well as national training and education standards for health and wellness coaching (HWC) that have been developed by the large-scale, collaborative efforts of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and (2) to invite commentary from the public. The rapid proliferation of individuals and organizations using the terms of health and/or wellness coaches and the propagation of private industry and academic coach training and education programs endeavoring to prepare these coaches has created an urgent and pressing need for national standards for use of the term health and wellness coach, as well as minimal requirements for training, education, and certification. Professionalizing the field with national standards brings a clear and consistent definition of health and wellness coaching and accepted practice standards that are uniform across the field. In addition, clear standards allow for uniform curricular criteria to ensure a minimal benchmark for education, training, and skills and knowledge evaluation of professional health and wellness coaches. PMID:25984418

  16. Earth Science and Public Health: Proceedings of the Second National Conference on USGS Health-Related Research

    USGS Publications Warehouse

    Buxton, Herbert T.; Griffin, Dale W.; Pierce, Brenda S.

    2007-01-01

    The mission of the U.S. Geological Survey (USGS) is to serve the Nation by providing reliable scientific information to describe and understand the earth; minimize loss of life and property from natural disasters; manage water, biological, energy, and mineral resources; and enhance and protect our quality of life. As the Nation?s largest water, earth, and biological science and civilian mapping agency, the USGS can play a significant role in providing scientific knowledge and information that will improve our understanding of the relations of environment and wildlife to human health and disease. USGS human health-related research is unique in the Federal government because it brings together a broad spectrum of natural science expertise and information, including extensive data collection and monitoring on varied landscapes and ecosystems across the Nation. USGS can provide a great service to the public health community by synthesizing the scientific information and knowledge on our natural and living resources that influence human health, and by bringing this science to the public health community in a manner that is most useful. Partnerships with health scientists and managers are essential to the success of these efforts. USGS scientists already are working closely with the public health community to pursue rigorous inquiries into the connections between natural science and public health. Partnering agencies include the Armed Forces Institute of Pathology, Agency for Toxic Substances Disease Registry, Centers for Disease Control and Prevention, U.S. Environmental Protection Agency, Food and Drug Administration, Mine Safety and Health Administration, National Cancer Institute, National Institute of Allergy and Infectious Disease, National Institute of Environmental Health Sciences, National Institute for Occupational Safety and Health, U.S. Public Health Service, and the U.S. Army Medical Research Institute of Infectious Diseases. Collaborations between public

  17. Programming microphysiological systems for children's health protection (SEBM meeting)

    EPA Science Inventory

    Presentation: Programming microphysiological systems for children’s health protectionAuthors: Knudsen1 T, Klieforth2 B, and Slikker3 W Jr.1National Center for Computational Toxicology/EPA, Research Triangle Park NC2National Center for Environmental Research/EPA, Washington DC3Nat...

  18. The National Institutes of Health Clinical Center

    MedlinePlus

    ... Issue Past Issues The National Institutes of Health Clinical Center Past Issues / Spring 2007 Table of Contents ... Communications, NIH Clinical Center Welcome to the nation's clinical research hospital. The NIH Clinical Center: For more ...

  19. Nonemergent emergency department visits under the National Health Insurance in Taiwan.

    PubMed

    Tsai, Jeffrey Che-Hung; Chen, Wen-Yi; Liang, Yia-Wun

    2011-05-01

    To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Achieving meaningful use: a health system perspective.

    PubMed

    Bero, Cynthia L; Lee, Thomas H

    2010-12-01

    In 2002, Partners HealthCare (Partners) launched a strategy to accelerate the use of ambulatory electronic medical records across its network of 6000 physicians. Through focus on quality software products, creation of a system of financial incentives, and active engagement of health system leadership, Partners reached high levels of physician adoption by late 2006. Partners eventually introduced a mandate that made ambulatory electronic medical record use a requirement for all of its physicians. During this multi-year initiative, Partners also focused on the effective use of electronic medical records and introduced a series of tactics designed to optimize the use of these systems. With introduction of the meaningful-use concepts in the Health Information Technology for Economic and Clinical Health (HITECH) Act, Partners will transition its efforts toward this important national priority. Partners' experience offers some unique insights into the process of electronic medical record adoption across a large, diverse health system.