Health system deregulation. Some aspects of health care system reform need not be held hostage

The constant increase in public health expenditure, which is being observed from the 60s, initiated research into way to optimize it. The aim the article is to show concepts of the health reforms which have been applied in the Swedish health service. In the article are presented main proposals of changes in the system financing and service provision. Article characterizes patient participation in costs of services, private health insurance, privatisation of health care facilities, purchase-provider split and providers reimbursement. The articles begins with the overview of concepts related to health care system reform. Next, the health system in Sweden is shortly presented. The main part of the article presents the reforms which has been implemented in the financing and services provision. Patients’ participation in financing of the health system has been extended by fees for service. The importance of private medical insurance is marginal. Purchaser-provider split has been introduced in most of counties. In general primary care facilities have been privatised. In regard to service providers reimbursement is generally used global budgeting, feed for service or diagnosis-related groups.

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Determinants of vaccination after the Colombian health system reform

Revista de Saúde Pública ◽

10.1590/s0034-89102005000300013 ◽

2005 ◽

Vol 39 (3) ◽

pp. 421-429 ◽

Cited By ~ 9

Author(s):

Naydú Acosta-Ramírez ◽

Luis G Durán-Arenas ◽

Julia I Eslava-Rincón ◽

Julio C Campuzano-Rincón

Keyword(s):

Health Care ◽

Health System ◽

Healthcare System ◽

Health Care System ◽

Care Delivery ◽

Behavioral Model ◽

Population Characteristics ◽

System Reform ◽

Poor Population ◽

Care System

OBJECTIVE: To assess the effects of individual, household and healthcare system factors on poor children's use of vaccination after the reform of the Colombian health system. METHODS: A household survey was carried out in a random sample of insured poor population in Bogota, in 1999. The conceptual and analytical framework was based on the Andersen's Behavioral Model of Health Services Utilization. It considers two units of analysis for studying vaccination use and its determinants: the insured poor population, including the children and their families characteristics; and the health care system. Statistical analysis were carried out by chi-square test with 95% confidence intervals, multivariate regression models and Cronbach's alpha coefficient. RESULTS: The logistic regression analysis showed that vaccination use was related not only to population characteristics such as family size (OR=4.3), living area (OR=1.7), child's age (OR=0.7) and head-of-household's years of schooling (OR=0.5), but also strongly related to health care system features, such as having a regular health provider (OR=6.0) and information on providers' schedules and requirements for obtaining care services (OR=2.1). CONCLUSIONS: The low vaccination use and the relevant relationships to health care delivery systems characteristics show that there are barriers in the healthcare system, which should be assessed and eliminated. Non-availability of regular healthcare and deficient information to the population are factors that can limit service utilization.

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HEALTH SYSTEM REFORM IN UKRAINE AND FOREIGN EXPERIENCE OF FINANCING MODELS

Eastern Ukrainian Medical Journal ◽

10.21272/eumj.2020;8(1):100-107 ◽

2020 ◽

Vol 8 (1) ◽

pp. 100-107

Author(s):

M. Yu. Yusiuk ◽

A. M. Yusiuk ◽

L. A. Yusiuk

Keyword(s):

Health Care ◽

Health System ◽

Health Care System ◽

Health Financing ◽

System Reform ◽

Medical Reform ◽

Current State ◽

The Moment ◽

Quantitative Indicators ◽

Care System

Inroduction. Due to the fact that the reform of the healthcare system in Ukraine is in transition phase at the moment and, in addition, from April 1, 2020 changes are introduced at the second level of healthcare, it is advisable to describe the current state of medical reform in Ukraine, plans and prospects for further implementation and development, as well as the establishment of the features of various health financing systems and comparing the level of expenditures on the medical industry between countries, experience of which should be taken into account. Materials and Methods. The article uses the reports of the Ministry of Health of Ukraine and the analytical materials of medical experts. In addition, when analyzing various models of financing the health system and their features, quantitative indicators of expenditures of the countries surveyed are used. A comparison is made of the level of expenditures on the health care system between Ukraine and some European countries: Great Britain, the Czech Republic, Poland and Germany. Discussion. The main achievements of the first stage of the health care reform and plans for further changes are described. The strengths and weaknesses of each model of financing the health system are identified. It is proved that the level of government spending on the health care system in Ukraine is the smallest among the other countries examined, but one of the largest in terms of payments out of pocket. In addition, a model has been established for financing the health care system in Ukraine, which most fully meets it in modern conditions.

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Four proposals for market-based health care system reform

Archives of Family Medicine ◽

10.1001/archfami.3.8.660 ◽

1994 ◽

Vol 3 (8) ◽

pp. 660-664 ◽

Cited By ~ 1

Author(s):

W. Sumner

Keyword(s):

Health Care ◽

Health Care System ◽

System Reform ◽

Care System

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Searching for Elysium: teaching universal health care as a human right

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1399 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Souza ◽

T C Garcia ◽

M N Sayão

Keyword(s):

High School ◽

Health Care ◽

Health System ◽

Health Care System ◽

Human Right ◽

School Class ◽

Federal Constitution ◽

High School Class ◽

Free Health Care ◽

Care System

Abstract Background Brazil have a huge free health care system. Inspired on UK National Health System (NHS), the Sistema Único de Saúde (SUS, that means Unified Health System) was consolidate as a right for all citizens after 1988's Brazilian Federal Constitution. Despite your spread, part of Brazilian citizens have an opposite opinions about SUS. So, the main question is: How to teach the relevance of a universal free health care system as a human right. Objectives The main aim of this work is teaching the recognize of SUS as a human right and ratified by Brazilian Federal Constitution in a High School class. In this sense, we used the cinema and debate for stimulate an effective comprehension of Universal Declaration of Human Rights (UDHR) and health promotion as a human right in a high school class. We used the movie Elysium (Neill Blomkamp, 2013) that show a dystopian world with two social class: citizen and non-citizen of Elysium (an artificial satellite of the Earth with high technology of cure for your citizens). Results The class has three Lessons: in first lesson we teaching about different notions about rights and the UDHR. In the second lesson we teaching about free health care systems in the world and a historical perspective about SUS. The third lesson we show the movie Elysium and proceed a debate. In debate we discuss about citizenship and rights, how the movie show two societies with different rights about work, transport and health, and how this aspects impact the quality of life of human being. Conclusions What options we have? The notion of free health care as a human right isn't an easy concept. So, efforts are needed for this comprehension and cinema can be used, followed by discussion, as a significant teaching tool for achieving humanistic educational objectives about free health care system as a human right in the high school curriculum. Key messages Health care is a human right and free health care system is a concretization of this right. Cinema can be used for stimulate a critical evaluation and effective understanding of rights in a high school classroom.

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