scholarly journals Brazilian’s Health Policy and its misalignment with international guidelines for Health Promotion

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F I Tristão ◽  
I M Gomes
Keyword(s):  
Health Promotion ◽  
Health Plan ◽  
National Health ◽  
National Policy ◽  
Herbal Medicines ◽  
Conference Report ◽  
Control Program ◽  
International Guidelines ◽  
National Health Plan ◽  
National Implementation

Abstract Following the First Health Promotion Conference in Ottawa in 1986, several other global level Conferences were held, and Shanghai was the last City to host the 9th Health Promotion Conference in 2016, where several world leaders assume commitments that meet the common cause of the topic in question, presenting robust outcomes such as the Letters, Declarations and Implementation Guides. This work aimed to analyze the coherence of the development of the current National Health Plan in Brazil in relation to the central axes of the most recent international documents, referring to the Shanghai Declaration and the Guide for the National Implementation of the Shanghai Declaration. The results showed that Brazil presents a National Health Plan that definitely does not include the actions proposed in the most recent international documents, such as the Shanghai Conference report and the Guide for National Implementation of the Shanghai Declaration. Paradoxically, Brazil has other institutionally implemented instruments that consider the activities recommended from these international documents in a very satisfactory way. Among these instruments are a specific National Policy on Health Promotion, and several Health Care Programs and Networks aimed at some of the National Policy on Health Promotion strengthening axes, such as the National Tobacco Control Program, the Health at School Program, the Health Gym Program, in addition to other related National Policies, such as the National Policy on Integrative and Complementary Practices and the National Policy on Medicinal Plants and Herbal Medicines. It is concluded that the National Health Plan is a symbolic instrument that is not in line with international recommendations and, contradictorily, it is also not in line with the own policies and programs that are successfully implemented and developed in national territory. Key messages There is a misalignment between the real meaning that a National Health Plan should present and its current content, what leads to an insuficent instrument for enhancing health promotion. While the national health plan is out of alignment with strengthening health promotion, other nationwide specific policies developed reinforce international guidelines.

scholarly journals Health Promotion in the National Health Plan in Brazil and the incompatibility with global objectives

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F I Tristão ◽  
I M Gomes
Keyword(s):  
Health Promotion ◽  
Health Plan ◽  
National Health ◽  
Epidemiological Data ◽  
Incidence Rates ◽  
World Health ◽  
Ottawa Charter ◽  
National Health Plan ◽  
The Government ◽  
Year 2000

Abstract The First International Conference on Health Promotion held in Canada in 1986 resulted in the Ottawa Charter, which objectively presents the goals to be achieved by the year 2000, which would contribute to the progress achieved since the Declaration of Alma-Ata and with the debate that took place at the World Health Assembly, in order to contemplate the goal of “health for all in the year 2000”. Obviously, even with all the advances, the goal expected for the year 2000 is far from being reached, which requires a continuous effort by the government and an engagement of the global population for the changes to occur in a sensitive and effective way. Thus, it is necessary to monitor the actions that should be developed so that health promotion is an issue that is increasingly present in health services. This work aimed to analyze the current Brazilian National Health Plan to verify if the proposed actions are in line with what has been recommended in the official international documents for the development of health promotion. The results demonstrate that the Plan is composed of epidemiological data, incidence rates about the monitoring of mortality and comorbidities, demographic indicators and issues based in the surveillance of endemic diseases, in addition to thirteen objectives and seven thematic axes that guide disease control and issues related to the structure of the Health System and its organization. In its entire content, there is no mention of the goals defined in the report of the 9th Global Conference on Health Promotion or even the Ottawa Charter, and the expression 'health promotion' appears only once, in a context of mentioning the surveillance and violence prevention actions. It is concluded that the Plan is a mere formal instrument that does not include actions for the development of health promotion, prepared according to the braszillians protocol and bureaucratic requirements, following the procedures to be approved by the National Congress. Key messages The National Health Plan presents a global overview about brazillians health situation, but doesn’t bring factive solutions and do not support the engagement to health promotion. The National Health Plan is not in line with the Global engagement for enhancing Health Promotion and the Sustainable Development Goals.

The public health system in France and the structural developments during the last ten years

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Arwidson
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Health System ◽  
National Health ◽  
Health Agency ◽  
Control Program ◽  
Tobacco Control Program ◽  
Health Strategy ◽  
National Public Health ◽  
Prevention And Health Promotion

Abstract In 2009, the hospitals, health and territories act has entrusted the responsibility for care and public health to the regional health agencies. This decentralisation aims to adapt strategies to local situations. These regional agencies have a very strong autonomy. In 2013, it was stated in the national health strategy that it was necessary to develop a scientifically based prevention. Two tracks are to be followed: either by importing and adapting validated or promising programs by identifying effective programs in the international literature; or from existing French initiatives (tobacco, alcohol, psychoactive substances, physical activity). The high prevalence of smoking motivated the establishment of a National tobacco reduction program in 2014, which was then relayed by a national tobacco control program. In 2016, the Health System Improvement Act created a major national public health agency combining surveillance, prevention, health promotion and emergency response. The motivation was to achieve greater synergy and collaboration between the different functions in public health. A report from the Inspectorate General of Social Affairs has recommended that this agency should establish a national portal with evidence-based prevention and health promotion programmes. Established in 2018, the Priority Prevention Plan is a major interdepartmental project to improve the health of the population, and is part of the National Health Strategy. This interdepartmental approach reflects the Government’s desire that all ministries should be able to contribute to prevention and health promotion. The increased investment in prevention and health promotion is starting to bear fruit with 1.6 million fewer smokers between 2016 and 2018. Immunisation coverage has also been improved. NutriScore, a nutritional information on the front of food containers, very easy to understand, has been put in place with partnership with 100 companies.

Italy's national health plan for 1998–2000

The Lancet ◽  
1998 ◽  
Vol 352 (9122) ◽  
pp. 125 ◽  
Author(s):  
Bruno Simini
Keyword(s):  
Health Plan ◽  
National Health ◽  
National Health Plan

National Health Plan Legislation

Challenge ◽  
1979 ◽  
Vol 22 (3) ◽  
pp. 11-16
Author(s):  
Jimmy Carter
Keyword(s):  
Health Plan ◽  
National Health ◽  
National Health Plan

Cost Burden Analysis of Ineffective Induction Chemotherapy in Elderly Patients with AML.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4531-4531
Author(s):  
Aileen Cleary Cohen ◽  
Nancy Davidson ◽  
Jason Scharf ◽  
Derek Middlebrook
Keyword(s):  
Elderly Patients ◽  
Incremental Cost ◽  
Induction Chemotherapy ◽  
Health Plan ◽  
National Health ◽  
Induction Therapy ◽  
Patient Population ◽  
Complete Response ◽  
Cost Burden ◽  
National Health Plan

Abstract Abstract 4531 Introduction According to the Surveillance, Epidemiology, and End Results (SEER) database 12,810 patients will be diagnosed with acute myeloid leukemia (AML) in 2009 with an incidence rate of 3.5 per 100,000 persons in the United States. The SEER data estimates that 55% of those diagnosed are 65 years or older. Standard first line therapy for the treatment of AML consists of at least one round of chemotherapy commonly referred to as induction. A significant portion of those patients who receive standard induction chemotherapy will have leukemia that fails to show a complete response as defined by less than 5% leukemia blasts in the bone marrow with normal tri-lineage hematopoiesis and peripheral blood count recovery (Mueller S, et al. BMC Cancer 2006, 6:143). Age, patient performance status, the presence of secondary AML, cytogenetics, and molecular markers are prognostic for particular cohorts of patients, however, there is currently no means to predict whether an individual's leukemia will or will not undergo a complete response (CR) after the administration of standard AML induction chemotherapy. Methods A budget impact model was designed to assess the incremental societal cost and incremental cost to a typical national health plan of treating patients who will fail induction therapy. The analysis only evaluated elderly patients over the age of sixty five. Data were gathered from the peer reviewed literature. All costs have been updated to 2009 dollars using the medical care component of the consumer price index. The patient population was determined to be 6,981 patients in 2009 with 30% receiving induction therapy (Menzin J, et al. Arch Intern Med. 2002; 162:1597-1603) and only 38% demonstrating a CR (Appelbaum FR, et al. Blood 2006 107:3481-5) resulting in 1,303 patients failing during induction therapy. The costs were taken from Menzin et al., which used Medicare claims data to determine the associated costs of AML patients during the first two years post diagnosis. In the model Medicare payments are used as a proxy for direct costs to society and a national health plan. These reimbursements are able to capture the costs of the initial hospital visit, lab/diagnostic/radiology, supportive care, drugs, and adverse events through the observation of payments across all appropriate settings of care (inpatient hospitalization, skilled nursing facility, outpatient hospital/clinical, physician's office, home health, and hospice). A patient undergoing chemotherapy incurred costs of $120,468 over two years, while a patient avoiding chemotherapy only incurred costs of $40,720. Results The incremental cost of a patient receiving induction therapy was calculated to be $79,748. For a national health care plan with an assumed average of one million members results in a cost of $283,856 to treat patients whose leukemia would not respond to induction chemotherapy. The overall societal impact of treating this patient population with ineffective therapy is $104 million. Conclusions Patients who are subjected to ineffective chemotherapy face the cytotoxic effects of the treatment, none of the benefits of treatment response, and impose a significant cost burden to themselves and the healthcare payment system. Diagnostics currently in development that can identify patients at the time of diagnosis with disease unresponsive to therapy may have the ability to alleviate unnecessary costs, while steering patients to better tailored and more effective therapies. Disclosures: Cleary Cohen: Nodality, Inc: Employment. Middlebrook:Nodality Inc: Employment.

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