scholarly journals Preparing national health systems to cope with the impending tsunami of ageing and its associated complexities: Towards more sustainable health care

2016 ◽  
Vol 28 (3) ◽  
pp. 412-414 ◽  
Author(s):  
René Amalberti ◽  
Wendy Nicklin ◽  
Jeffrey Braithwaite
2009 ◽  
Vol 38 (4) ◽  
pp. 607-625 ◽  
Author(s):  
KATH CHECKLAND ◽  
STEPHEN HARRISON ◽  
ANNA COLEMAN

AbstractAlford's theory of structural interests has been used as a framework within which to analyse health systems across the world. However, authors have often been uncritical in their acceptance of Alford's original analytic categories. In this article we use data from a detailed qualitative study of the introduction of Practice Based Commissioning in the UK NHS to interrogate Alford's work more critically. Disrupting Alford's original categories of ‘professional monopolisers’ as dominant interests, challenged by management ‘corporate rationalisers’, we suggest that the new structures established in the NHS since 2002 systematically privilege an interest that we call ‘corporate monopolisers’, and that this is under challenge from ‘professional rationalisers’.


Author(s):  
Robert B. Lloyd ◽  
Melissa Haussman ◽  
Patrick James

The chapter summarizes our findings about the roles of national health systems and ngo’s as well as the international ones in addressing health concerns in the three countries under study. Since many of the health-care issues discussed have been specifically gendered, we look at the opening provided to both faith-based and secular ngo’s under the MDG framework since 2000. We posit future areas of research affecting the interaction of secular and faith-based health providers in Africa.


2018 ◽  
Vol 50 ◽  
pp. 01201
Author(s):  
Elena V. Vorontsova ◽  
Andrey L. Vorontsov

The article is devoted to the study of the peculiarities of the formation of health protection institutes in Russia and European countries. Their importance for the current state of health systems is analyzed from the standpoint of historical and socio-legal analysis. The authors note that the formation of an administrative mechanism for the prevention and control of diseases took place in Eastern and Western Europe throughout the Middle Ages and New Times. However, the turning point in the development of health care institutions in Russia and in Europe was the 18th century. Since that time, we can talk about the formation of health systems in the modern sense. According to the authors, the idea of the state responsibility for the health of its population, as well as the belief of European scientists about the social nature of many diseases, which spread in Western Europe, contributed to this formation. In the authors’ opinion, this fact led to the emergence of the first health laws, in which the main factor in the health of citizens was recognized as an improvement in their living conditions. It is noted that international recognition of health as a subjective right of every person has led to revolutionary changes in national health systems. National health standards began to change in the direction of their compliance with international standards. According to the authors, there are legal prerequisites for the formation of an effective and socially-oriented health care system in Russia. The authors think that there are legal prerequisites for the formation of an effective and socially-directed health care system in Russia. This is due to the constitutional consolidation of the right to health protection, as well as the treatment of health in its international legal significance. The main methods used were the method of analysis, the rationale, the comparative-historical method.


2017 ◽  
Vol 13 (1) ◽  
pp. 10-32 ◽  
Author(s):  
Laura Anselmi ◽  
Mylène Lagarde ◽  
Kara Hanson

AbstractThe analysis of efficiency in health care has largely focussed either on individual health care providers, or on sub-national health systems conceived as a unique decision-making unit. However, in hierarchically organized national health services, two separate entities are responsible for turning financial resources into services at the local level: health administrations and health care providers. Their separate roles and the one of health administrations in particular have not been explicitly considered in efficiency analysis. We applied stochastic frontier analysis to district-level panel data from Mozambique (2008-2011) to assess district efficiency in delivering outpatient care. We first assessed the efficiency of the whole district considered as an individual decision-making unit, and then we assessed separately the efficiency of health administrations and health care providers within the same district. We found that on average only 73% of the outpatient consultations deliverable using available inputs were realized, with large differences in performance across districts. Individual districts performed differently in administrative or health care delivery functions. On average, a reduction of administrative inefficiency by 10 percentage points, for a given expenditure would increase by 0.2% the volume of services delivered per thousand population per year. Identifying and targeting the specific drivers of administrative inefficiencies can contribute to increase service.


Author(s):  
K.V. Pocheniuk

Diabetes mellitus is one of the most common human diseases that lead to disability and death. According to the reports of Ministry of Health, in Ukraine at the end of 2018 there were about 1,300,000 diabetic patients and 9,000 of them were children under 18 years of age. The sooner a child is diagnosed with diabetes, the more likely he/she is to save from the complications that cause disability and premature death. Solving issues on diabetes is one of the top priorities of national health systems. Purpose. The paper is aimed at the study of current health care provision for children with diabetes. Methods and Material. The steps in organization of health care provision for children with diabetes in Ukraine have been studied. The following methods have been used: bibliosemantic: for the analysis of scientific literature; content-analysis: to study the regulatory framework; system analysis: to analyze the organizational provision of health care for children with diabetes. Results. Type 1 diabetes is characterized by the destruction of beta cells, which leads to absolute insulin deficiency. About 75% of all type 1 diabetes cases are diagnosed in people under 18 years of age. Children and adolescents are assigned to a special category of patients who need more attention from physicians. Children find it difficult to understand what negative manifestations and the development of specific complications, leading to early disability, can be caused by a persistent and long-term decompensation of the disease. Based on the Adapted Clinical Guidelines for Type 1 Diabetes, the Working Group has developed Unified Clinical Protocols for Type 1 Diabetes in Young People and Adults and Type 1 Diabetes in Children, using evidence-based provisions for the effectiveness of medical interventions, which also served as the basis for identifying quality indicators for the health care provision for patients with type 1 diabetes. The main directions of the developed therapeutic and rehabilitation approach to medical assistance for patients with type 1 diabetes are the provision of medical, psychological and social assistance by multidisciplinary teams, involving an endocrinologist, specialists (therapist, neurologist, ophthalmologist, nephrologist, pediatrician), a social worker, a guidance counselor at the Diabetes School, a nurse. First of all, it is necessary to raise the awareness of physicians, especially at the primary level. The improvement of outpatient and in-patient care for children with diabetes, involving children themselves and their parents is also relevant. It is important to organize and provide an effective school for diabetes awareness and self-control. It is indisputably necessary to constantly and continuously monitor the state of clinical and metabolic compensation of diabetes. Attention should be paid to the need for more active use of the advanced technologies, such as pump insulin therapy. The main components of treatment are diet and insulin therapy, which the child must keep to throughout the whole life to compensate his/her health state. The role of the international diabetes movement in overcoming the diabetes epidemic in Ukraine and worldwide is noteworthy, since it called on all nations to adopt National Diabetes Prevention and Treatment Programs. Consequently, the Ministry of Health of Ukraine, together with international and national experts, has developed a number of fundamental legal acts that initiate structural changes in the health care system. Conclusion. Ukraine is one of the countries with the highest incidence of diabetes. Currently, there is a very significant increase in the incidence of diabetes among children of preschool and school age. Therefore, solving issues on diabetes is one of the top priorities of national health systems. Consequently, the life of a sick child depends on the level of organization of medical and social assistance. It is crucial that awareness and support for diabetes self-management, drug therapy and psychosocial assistance be provided from the time of diagnosis and regularly thereafter. Living a long life with diabetes is possible in proper disease control and prevention. In recent years, diabetes treatment has improved, though it has not solved all the problems. The novel modes of treatment are being actively implemented, namely, insulin analogues and insulin pumps.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
M R Gonçalves ◽  
N Katz ◽  
R S Silva ◽  
C A A Schmitz ◽  
...  

Abstract Primary health care has been considered by the World Health Organization (WHO) as the most efficient way of organizing health systems in order to achieve universal health coverage, preserving its attributes and focusing on people. Several countries in the world have developed instruments to measure access, use of services and lifestyles of their populations. In Europe, European Union members have validated the European Health Interview Survey (EHIS / Eurostat), which is in its third wave of application. Brazil, for over 20 years, has developed, through the Brazilian Institute of Geography and Statistics (IBGE) - the Brazilian Federal Statistics Bureau - in partnership with the Ministry of Health, a national household health survey throughout its territory, the so-called National Health Survey (PNS). PNS-2019 questionnaire innovated by including a module of questions that allows assessing the scores of the attributes proposed by Shi and Starfield in the 2000s. The Primary Care Assessment Tool (PCAT) was included in its brazilian statistically validated version for adult users and applied in more than 100,000 households in all five regions and 27 states in Brazil. Over a six-month period, a sample of approximately 10,000 adults was registered, according to the inclusion criteria of the PCAT considered (being 18 years old or older, having had more than one medical appointment in the last six months, having performed this appointment in a public primary health care facility). We consider it essential to use statistically validated instruments that allow cross-country comparisons and we encourage Governments all over the world to follow Brazilian example in incorporating in their national health surveys a module containing the validated version of the PCAT. This instrument has already been validated and used in the evaluation of primary care in regions of all five continents of the world, demonstrating, therefore, its capacity for cultural adaptation to each reality. Key messages PCAT's set of instruments remains current for the evaluation of primary health care services from the users' perspective nationwide. The importance of using National Health Surveys in each country, with random household sampling to assess health systems and conditions.


Health Policy ◽  
2018 ◽  
Vol 122 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Natasha Azzopardi-Muscat ◽  
Rita Baeten ◽  
Timo Clemens ◽  
Triin Habicht ◽  
Ilmo Keskimäki ◽  
...  

2021 ◽  
Vol 5 (2) ◽  
pp. e66-e68
Author(s):  
Andrea J MacNeill ◽  
Forbes McGain ◽  
Jodi D Sherman

2019 ◽  
Vol 33 (1) ◽  
pp. 18-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Katharina Kieslich ◽  
Albert Weale ◽  
Emma Tumilty ◽  
Georgina Richardson ◽  
...  

Purpose In order to create sustainable health systems, many countries are introducing ways to prioritise health services underpinned by a process of health technology assessment. While this approach requires technical judgements of clinical effectiveness and cost effectiveness, these are embedded in a wider set of social (societal) value judgements, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritisation and the resulting decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritisation process. Design/methodology/approach Through a multidisciplinary collaboration involving a series of international workshops, ethical and political theory (including accountability for reasonableness) have been applied to develop a practical way forward through the creation of a values framework. The authors have tested this framework in England and in New Zealand using a mixed-methods approach. Findings A social values framework that consists of content and process values has been developed and converted into an online decision-making audit tool. Research limitations/implications The authors have developed an easy to use method to help stakeholders (including the public) to understand the need for prioritisation of health services and to encourage their involvement. It provides a pragmatic way of harmonising different perspectives aimed at maximising health experience. Practical implications All health care systems are facing increasing demands within finite resources. Although many countries are introducing ways to prioritise health services, the decisions often face legal, political, commercial and ethical challenge. The research will help health systems to respond to these challenges. Social implications This study helps in increasing public involvement in complex health challenges. Originality/value No other groups have used this combination of approaches to address this issue.


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