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health care financing

C Ross Anthony, Melinda Moore, Lee H Hilborne, Anne Rooney, Scot Hickey, Youngbok Ryu, Laura Botwinick
Since 2010, the RAND Corporation has worked with the Ministry of Health and Ministry of Planning of the Kurdistan Regional Government to develop and implement initiatives for improving the region's health care system through analysis, planning, and development of analytical tools. This third phase of the project (reflecting work completed in 2013-2015) focused on development and use of a primary care management information system; health financing reform, focusing on policy reform options to solve the problem of physician dual practice, in which physicians practice in both public and private settings; and hospital patient safety training within the context of health quality improvement...
October 2018: Rand Health Quarterly
Raoul Borbé, Christine Pfäffle, Frank Eisele, Gerhard Längle
OBJECTIVE OF THE STUDY: General practitioners are mainly responsible for primary health care. Patients with mental disorders, in particular patients with complex or multiple needs, use these services infrequently in case of somatic complaints. Psychiatric outpatient clinics have to deal with these patients and have perhaps an additional role in diagnosing and treating somatic co-morbidities. This should be evaluated. METHODS: Physicians in outpatient clinics of the Centre of Psychiatry Suedwuerttemberg were asked about their attitude towards somatic co-morbidities, somatic co-treatment and prescribing somatic drugs...
October 15, 2018: Das Gesundheitswesen
Claudia B Maier, Hannah Budde, James Buchan
Chronic conditions and health inequalities are increasing worldwide. Against this backdrop, several countries, including Israel, have expanded the roles of nurses as one measure to strengthen the primary care workforce. In Israel, community nurses work in expanded roles with increased responsibilities for patients with chronic conditions. They also work increasingly in the field of health promotion and disease prevention. Common barriers to role change in Israel are mirrored by other countries. Barriers include legal and financial restrictions, resistance by professional associations, inflexible labor markets and lack of resources...
October 12, 2018: Israel Journal of Health Policy Research
Christabel C Enweronu-Laryea, Hilary D Andoh, Audrey Frimpong-Barfi, Francis M Asenso-Boadi
The major causes of newborn deaths in sub-Saharan Africa are well-known and countries are gradually implementing evidence-based interventions and strategies to reduce these deaths. Facility-based care provides the best outcome for sick and or small babies; however, little is known about the cost and burden of hospital-based neonatal services on parents in West Africa, the sub-region with the highest global neonatal death burden. To estimate the actual costs borne by parents of newborns hospitalised with birth-associated brain injury (perinatal asphyxia) and preterm/low birth weight, this study examined economic costs using micro-costing bottom-up approach in two referral hospitals operating under the nationwide social health insurance scheme in an urban setting in Ghana...
2018: PloS One
Lauren A Taylor
The health policy community has a growing interest in the impact of nonmedical determinants of health, such as housing, nutrition, and social supports, on both health outcomes and costs. This interest has been spurred by the Affordable Care Act's emphasis on prevention, Robert Wood Johnson's grant-making focus on a Culture of Health, and an uptick of research demonstrating the potential returns to health care from investments in social services. Much of this policy-making, grant making, and research has focused on older Americans...
September 2018: Hastings Center Report
Kate de Medeiros
I am a social gerontologist, broadly defined as a social scientist who studies how later life is experienced, structured, and controlled in a society and in social settings. Although gerontology is often confused with geriatrics (a medical specialty), gerontologists are typically not clinicians but may study issues related to old age and health care such as the societal conditions that shape how medical care is provided and financed and how early exposure to education relates to later life health. In this essay, I argue that thinking like a gerontologist is important when considering what makes a good life in late life...
September 2018: Hastings Center Report
John H Farnsworth, Bronwyn M Krieg, Jayme S Bennetts, Robert A Baker
BACKGROUND: The cost of performing cardiac surgery in the public health system in Australia is unclear. This paper analyses the cost of cardiac surgery performed at Flinders Medical Centre (FMC), South Australia, comparing cost by procedure, rheumatic valvular heart disease status, Aboriginality and location. METHODS: This study is a retrospective, population-based analysis of cardiac surgery data held in the Cardiac Surgery Registry cross-referenced to cost data provided by the FMC Department of Finance and Patient Travel, Accommodation and Transport Services at the Royal Darwin Hospital...
September 24, 2018: Heart, Lung & Circulation
Bruno Meessen
Countries finance health care using a combination of 3 main functions: raising resources for health, pooling resources, and purchasing health services. In this paper, we examine how digital health technologies can be used to enhance these health financing functions in low- and middle-income countries and can thus contribute to progress toward universal health coverage. We illustrate our points by presenting some recent innovations in digital technologies for financing health care, identifying their contributions and their limits...
October 10, 2018: Global Health, Science and Practice
Abel Mukengeshayi Ntambue, Françoise Kaj Malonga, Michèle Dramaix-Wilmet, Tabitha Mpoyi Ilunga, Angel Nkola Musau, Charles Matungulu Matungulu, Karen D Cowgill, Philippe Donnen
OBJECTIVE: In the Democratic Republic of the Congo, insufficient state financing of the health system produced weak progress toward targets of Millennium Development Goals 4 and 5. In Lubumbashi, almost all women pay out-of-pocket for obstetric and neonatal care. As no standard pricing system has been implemented, there is great variation in payments related to childbirth between health facilities and even within the same facility. This work investigates the determinants of this variation...
2018: PloS One
Laura Maria Francisca Kuijpers, Charlotte Gryseels, Sambunny Uk, Panha Chung, Sotharith Bory, Bun Sreng, Amy Parry, Jan Jacobs, Koen Peeters Grietens
Enteric fever is a systemic bacterial infection in humans that is endemic in Cambodia and for which antibiotic resistance is increasingly reported. To guide public health programs, this qualitative study sought to explore community perceptions on transmission and treatment. Participant observation was carried out in hospital settings, pharmacies, and at a community level in Phnom Penh. In-depth interviews 39 and one focus group discussion were carried out with blood culture-confirmed enteric fever patients and purposively selected key informants...
October 8, 2018: American Journal of Tropical Medicine and Hygiene
Katherine Albutt, Kristin Sonderman, Isabelle Citron, Mzaza Nthele, Abebe Bekele, Emmanuel Makasa, Sarah Maongezi, Emile Rwamasirabo, Emmanuel Ameh, Hery Harimanitra Andriamanjato, Ahmed Sa ElSayed, Isaac Smalle, Prosper Tumusiime, Martin Ekeke Monono, John G Meara, Walter Johnson
BACKGROUND: Worldwide, five billion people lack access to safe, affordable surgical, obstetric, and anaesthesia (SOA) care when needed. In many countries, a growing commitment to SOA care is culminating in the development of national surgical, obstetric, and anaesthesia plans (NSOAPs) that are fully embedded in the National Health Strategic Plan. This manuscript highlights the content and outputs from a World Health Organization (WHO) lead workshop that supported country-led plans for improving SOA care as a component of health system strengthening...
October 8, 2018: World Journal of Surgery
K Grimes, J Kitts, B Tholl, C Samuelson-Kiraly, J I Mitchell
Canada faces significant policy and economic challenges related to healthcare for frail older adults. Annual per capita healthcare costs for people over age 65 are five times those for people under 65. Flat economic growth and an aging workforce decrease tax revenue, which funds 70% of health spending. Governments are shifting policy to enhance person-centered care and shifting spending from hospitals to primary and community care. Recognizing that frailty and evidence-based frailty screening can contribute directly to reform initiatives, what are the policy and economic considerations, both nationally and internationally, around frailty screening that will benefit patients, families and/or the wider health system? Based on key informant interviews, we present recommendations for approaching policy and economic challenges in frailty through the following healthcare policy instruments: financing, funding, legislation, regulation, technology, interdisciplinary care, person-centered service and health promotion...
2018: Journal of Frailty & Aging
Nandita Khera, Betty K Hamilton, Joseph A Pidala, William A Wood, Vicky Wu, Jenna Voutsinas, Lynn Onstad, Amin M Alousi, Raewyn Broady, George L Chen, Mukta Arora, Corey Cutler, Mary E Flowers, Alex Ganetsky, Madan Jagasia, Philip L McCarthy, Stefanie Sarantopoulos, Gregory A Abel, Navneet S Majhail, Stephanie J Lee
BACKGROUND: Understanding the socioeconomic impact of chronic GVHD on affected patients is essential to help improve their overall well-being. Using data from the chronic GVHD Consortium, we describe the insurance, employment and financial challenges for these patients and factors associated with being able to work/ go to school and financial burden. METHODS: A 15-item cross-sectional questionnaire designed to measure financial concerns, income, employment and insurance was completed by 190 patients (response rate=68%, 10 centers) enrolled on a multi-center chronic GVHD Consortium Response Measures Validation study...
October 5, 2018: Biology of Blood and Marrow Transplantation
Stephen Maluka, Dereck Chitama, Esther Dungumaro, Crecensia Masawe, Krishna Rao, Zubin Shroff
BACKGROUND: Governments increasingly recognize the need to engage non-state providers (NSPs) in health systems in order to move successfully towards Universal Health Coverage (UHC). One common approach to engaging NSPs is to contract-out the delivery of primary health care services. Research on contracting arrangements has typically focused on their impact on health service delivery; less is known about the actual processes underlying the development and implementation of interventions and the contextual factors that influence these...
October 5, 2018: International Journal for Equity in Health
Pooja Bhalla, Karla Damus, Terri LaCoursiere-Zucchero, Michelle Beauchesne
PURPOSE: This quality improvement, educational intervention project aimed to develop nurse leaders at a large urban federally funded Health Care for the Homeless Program (HCH), using the Nursing Leadership Institute Competency Model. METHODS: A leadership seminar series which addressed six leadership topics for homeless health care nurses was developed, implemented, and evaluated using a one group pre/posttest design. The Leadership Practices Inventory (LPI) was also administered before and after the seminar series...
October 2018: Journal of Community Health Nursing
Essa Tawfiq, Jaikishan Desai, Dean Hyslop
Objective To examine the impact of a results-based financing programme on patient satisfaction in Afghanistan. Methods We analysed data collected from over 3000 patients from a stratified sample of 112 health facilities (56 results-based financing and 56 non-results-based financing) in 11 out of the 34 provinces of Afghanistan over a three-year period. The 112 facilities were part of 442 primary care facilities that were stratified on facility type and randomly assigned to the results-based financing (intervention) and non-results-based financing (control) groups in the 11 provinces...
October 3, 2018: Journal of Health Services Research & Policy
Triin Habicht, Marge Reinap, Kaija Kasekamp, Riina Sikkut, Laura Aaben, Ewout van Ginneken
This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. In 2017, the Estonian government took the historic step of expanding the revenue base of the health system, which has been a longstanding challenge. However, in terms of percentage of GDP it remains a small increase and long-term financial sustainability could still pose a problem. That said, if these additional funds are invested wisely, they could play a positive role in further improving the health system...
March 2018: Health Systems in Transition
Enrique Bernal-Delgado, Sandra Garcia-Armesto, Juan Oliva, Fernando Ignacio Sanchez Martinez, Jose Ramon Repullo, Luz Maria Pena-Longobardo, Manuel Ridao-Lopez, Cristina Hernandez-Quevedo
This analysis of the Spanish health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health status continues to improve in Spain, and life expectancy is the highest in the European Union. Inequalities in self-reported health have also declined in the last decade, although long-standing disability and chronic conditions are increasing due to an ageing population. The macroeconomic context in the last decade in the country has been characterized by the global economic recession, which resulted in the implementation of health system-specific measures addressed to maintain the sustainability of the system...
May 2018: Health Systems in Transition
Florian Bachner, Julia Bobek, Katharina Habimana, Joy Ladurner, Lena Lepuschutz, Herwig Ostermann, Lukas Rainer, Andrea E Schmidt, Martin Zuba, Wilm Quentin, Juliane Winkelmann
This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Two major reforms implemented in 2013 and 2017 are among the main issues today. The central aim of the reforms that put in place a new governance system was to strengthen coordination and cooperation between different levels of government and self-governing bodies by promoting joint planning, decision-making and financing...
August 2018: Health Systems in Transition
Antoniya Dimova, Maria Rohova, Stefka Koeva, Elka Atanasova, Lubomira Koeva-Dimitrova, Todorka Kostadinova, Anne Spranger
This analysis of the Bulgarian health system reviews developments in its organization and governance, health financing, health care provision, health reforms and health system performance. With the 2015 National Health Strategy 2020 at its core, there have been ambitious reform plans to introduce more decentralization, strategic purchasing and integrated care into the Bulgarian social health insurance system. However, the main characteristics of the Bulgarian health system, including a high level of centralization and a single payer to administer social health insurance, remain intact and very few reforms have been implemented (for example, the introduction of health technology assessment)...
September 2018: Health Systems in Transition
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