How health care regionalisation in Italy is widening the North–South gap

2014 ◽  
Vol 9 (3) ◽  
pp. 231-249 ◽  
Author(s):  
Federico Toth
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The South ◽  
Hospital System ◽  
The North ◽  
Level Of Satisfaction ◽  
Italian National Health Service ◽  
Care Systems ◽  
System 2 ◽  
The Individual

AbstractThe Italian National Health Service began experimenting with a significant regionalisation process during the 1990s. The purpose of this article is to assess the effects that this regionalisation process is having on the rift between the north and the south of the country. Has the gap between the health care systems of the northern and southern regions been increasing or decreasing during the 1999–2009 decade? Three indicators will be utilised to answer this question: (1) the level of satisfaction expressed by the citizens towards the regional hospital system; (2) the mobility of the patients among regions; (3) the health care deficit accumulated by the individual regions. On the basis of these three indicators, there is evidence to conclude that, during the decade under study, the gap between the North and the South, already significant, has increased further.

Organizing a diabetes service

2011 ◽  
pp. 2005-2011
Author(s):  
Stephen C. L. Gough
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Health Care Need ◽  
Delivery Of Care ◽  
Strategic Approach ◽  
Effective Manner ◽  
Care Systems ◽  
The Individual ◽  
The Uk

The increasing worldwide incidence and prevalence of diabetes is placing substantial pressures on health care systems and economies. As a consequence individuals involved in the care of people with diabetes are looking at services currently being provided and examining ways in which care can be organized in the most cost-effective manner. Whilst the degree to which diabetes care is delivered differs from country to country, similar fundamental questions are being asked by those involved in the delivery of care, including: What are we currently providing? What do we need to provide? What are we able to provide? Although the answers to these questions are quite different not just between countries but often within specific localities within a country, the ultimate aim is the same: to provide the best possible care to as many people with diabetes as possible. The global diversity of diabetes health care need is enormous and while the solutions will be equally diverse, the approach to the development of a diabetes service will, for many organizations, be similar. The main focus of this chapter is based upon the model or the strategic approach developed in the UK, but many of the individual component parts are present in most health care settings.

scholarly journals Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries

2018 ◽  
Vol 10 (12) ◽  
pp. 4439 ◽  
Author(s):  
Elio Borgonovi ◽  
Paola Adinolfi ◽  
Rocco Palumbo ◽  
Gabriella Piscopo
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Financial Economic ◽  
Point Of View ◽  
Health Care Environment ◽  
Health Gains ◽  
Care Systems ◽  
The One ◽  
The Individual

Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.

Personal responsibility for health: the impact of digitalisation

2019 ◽  
Vol 7 (3) ◽  
pp. 241-258
Author(s):  
Andrea Martani ◽  
Georg Starke
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Personal Responsibility ◽  
Health Care Systems ◽  
Individual Level ◽  
Fine Grained ◽  
Care Systems ◽  
Gerald Dworkin ◽  
The Individual ◽  
The Impact

Fostering the personal responsibility of patients is often considered a potential remedy for the problem of resource allocation in health care systems. In political and ethical debates, systems of rewards and punishments based on personal responsibility have proved very divisive. However, regardless of the controversies it has sparked, the implementation of personal responsibility in concrete policies has always encountered the problem of practical enforceability, i.e.how causally relevant behaviour can be tracked, allowing policies of this kind to be applied in a fine-grained, economically viable and accurate fashion. In this paper, we show how this hurdle can be seemingly overcome with the advent of digitalisation in health and delineate the potential impact of digitalisation on personal responsibility for health. We discuss how digitalisation – by datafying health and making patients transparent – promises to close the loophole of practical enforceability by allowing to trace health-related lifestyle choices of individuals as well as their exposure to avoidable risk factors. Digitalisation in health care thereby reinforces what Gerald Dworkin has called the causal aspect of personal responsibility and strengthens the implicit syllogism that – since exposure to risk factors happens at the individual level – responsibility for health should be ascribed to the individual. We conclude by addressing the limitations of this approach and suggest that there are other ways in which the potential of digitalisation can help with the allocation of resources in health care.

The Canadian Charter of Rights and Freedoms: Implications for Involuntary Admission

1985 ◽  
Vol 4 (1) ◽  
pp. 5-13
Author(s):  
Elaine Newman
Keyword(s):  
Health Care ◽  
Government Intervention ◽  
Health Care Systems ◽  
Involuntary Admission ◽  
Canadian Charter ◽  
Present Practice ◽  
Effective Administration ◽  
Care Systems ◽  
Legal Professions ◽  
The Individual

The paper poses a challenge to the medical and legal professions. Our Charter of Rights and Freedoms defines the standard for government intervention in the lives of the citizens of Canada. It has an immediate and significant impact upon involuntary admissions to psychiatric facilities, in as much as those admissions constitute a deprivation of liberty to the individual. The challenge to our professions is one of reviewing present practice in the field, and of reconciling the need for effective administration of health care systems with the protective standards set by the Charter.

scholarly journals Multiple Sclerosis and Pregnancy: A Comparison Study

2013 ◽  
Vol 40 (4) ◽  
pp. 590-596 ◽  
Author(s):  
Sura Alwan ◽  
Magdalena Dybalski ◽  
Irene M. Yee ◽  
Talitha M. Greenwood ◽  
Elaine Roger ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Care Program ◽  
Care Providers ◽  
Research Committee ◽  
The North ◽  
Reproductive Decision Making ◽  
Care Systems

Abstract:Objective:To determine whether different health care systems may affect reproductive decision-making among patients with Multiple Sclerosis (MS), we describe the reproductive practices and attitudes of Canadian MS patients ascertained from the multidisciplinary MS Clinic at Hôpital Notre-Dame in Montreal, Quebec (NDMSC), in comparison to those of matched American selfregistrants from the database of the North American Research Committee on Multiple Sclerosis (NARCOMS).Methods:A total of 665 self-administered questionnaires on reproductive practices were sent out to eligible attendees attending the NDMSC. The short questionnaires were completed and returned to the authors in an anonymous format for analysis.Results:A total of 459 completed questionnaires were returned. The majority of NDMSC respondents (72.5%) and NARCOMS subset (75.2% females), did not encounter a pregnancy following diagnosis of MS. The most common MS-related reason for this decision was “symptoms interfering with parenting” (75.0% for the NDMSC, 72.6% for the NARCOMS). The most commonly reported non-MS-related reason was “a completed family” by the time of diagnosis in both the NDMSC and NARCOMS subset (58.0%, 40.4%, respectively). Concerns about financial issues both related and unrelated to MS were also commonly reported by males and females in both cohorts but significantly more so among the NARCOMS participants.Conclusion:These results indicate that reproductive decisions of MS patients are highly affected by their illness and its associated disability, regardless of the available health care program. Health care providers should discuss their patients' reproductive needs and perceptions to help them make more informed decisions.

scholarly journals Budgetary bias in the Finnish public hospital system

2019 ◽  
Vol 33 (4) ◽  
pp. 401-418
Author(s):  
Alpo Karila ◽  
Jarmo Vakkuri ◽  
Juhani Lehto
Keyword(s):  
Health Care ◽  
Qualitative Content Analysis ◽  
Health Care Systems ◽  
Public Hospitals ◽  
Research Knowledge ◽  
Hospital System ◽  
Content Type ◽  
Care Systems ◽  
Public Hospital System ◽  
Practical Implications

Purpose The purpose of this paper is to analyze the dynamics of budgetary biasing in the context of public hospitals. Design/methodology/approach The study applies theories of accounting and budgeting behaviors in the specific institutional context of health care systems. Based on the theoretical framework, data from interviews with hospital budget officers were analyzed using qualitative content analysis. Findings A typology of biases is provided. It proved to be useful and highlighted the central empirical assumptions and preliminary results of biasing dynamics. Practical implications Understanding the logic of budgeting actors and the drivers of bias may help explain why bias so often appears in health care budgeting. It further contributes to understanding whether the bias is functional or dysfunctional. Originality/value The concepts of budgetary bias are rarely used in the context of health care budgeting, so the study fills a gap in research knowledge.

scholarly journals The state-individual relationship during COVID-19 pandemic – from the human rights point of view

2020 ◽  
pp. 33-48
Author(s):  
Iwona Florek
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Research Method ◽  
Negative Impact ◽  
Health Care Systems ◽  
The State ◽  
Point Of View ◽  
Care Systems ◽  
The Individual ◽  
The Relationship

Since the outbreak of the Covid-19 epidemic in November 2019 in Wuhan (China) countries experience negative impact of the coronavirus actions on their health care systems. Therefore different administrative regulations are imposed to flatten the disease curve, to ensure fluent and undisturbed work of health units. The goal of the article is to get a closer look at practical aspects of legal and administrative regulations that are imposed in different countries to prevent the spread of coronavirus and analyse them in the context of human rights restrictions. It is difficult, if not impossible, the give a simple answer whether or which restraints are needed. Therefore, the author aims at drawing attention on the slight borderline where the restrictions are necessary for the sake of health and where are they exaggeration of public authority’s power over individuals. The novum of the article is a look at the state-individual relationship according to the concept of W. Osiatyński in the situation of the Covid-19 epidemic. The research method used by the author is the analysis of the relationship between the state and the individual in terms of human rights, taking into account the provisions of law. The practical assessment of the implementation of the protection of individual rights was illustrated by the most recent press reports, both Polish and international.

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