Germany

2021 ◽  
pp. 479-519
Author(s):  
Ellen M. Immergut ◽  
Claus Wendt
Keyword(s):  
World War Ii ◽  
Health Insurance ◽  
Healthcare System ◽  
National Socialism ◽  
Risk Sharing ◽  
Political Competition ◽  
Self Regulation ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
German Healthcare System

This chapter provides an extended look at health politics and the compulsory health insurance system in Germany. It traces the historical development of the German healthcare system, characterized by its stability through a series of major regime shifts, including National Socialism, the post-World War II return to democracy, and the re-unification of Germany. Corporatist self-regulation has been a defining characteristic of the German system, but since 1989 elements of market and state-led governance have been enhanced, such as with the introduction of free choice of health insurance fund and elements of market competition among the funds, the pooling of insurance contributions into a central fund, and the introduction of substantial risk-sharing instruments. Despite the polarized left–right debate about introducing a universal citizens’ insurance versus a premium-based system, “grand coalition” politics have prevailed, with the broad contours of the German healthcare system being generally accepted and political competition focused on improving the already high quality of healthcare services.

Monitoring Quality in a Federal State with Shared Powers in Healthcare: The Case of Belgium

2011 ◽  
Vol 18 (4) ◽  
pp. 413-422 ◽  
Author(s):  
Diego Fornaciari ◽  
Arthur Vleugels ◽  
Stefaan Callens ◽  
Kristof Eeckloo
Keyword(s):  
Healthcare System ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Federal State ◽  
Flemish Community ◽  
The Government ◽  
Regulatory Powers ◽  
Monitoring Quality

AbstractThe Belgian healthcare system consists of a complex of more or less autonomous groups of healthcare providers. It is the responsibility of the government to ensure that the fundamental right to qualitative healthcare is secured through the services they provide. In Belgium, the regulatory powers in healthcare are divided between the federal state and the three communities. Both levels, within their area of competence, monitor the quality of healthcare services. Unique to the Belgian healthcare system is that the government that providers are accountable to is not always the same as the government that is competent to set the criteria. The goal of this article is to provide an overview of the main mechanisms that are used by the federal government and the government of the Flemish community to monitor healthcare quality in hospitals. The Flemish community is Belgian’s largest community (6.2 million inhabitants). The overview is followed by a critical analysis of the dual system of quality monitoring.

scholarly journals FINANCING AND EFFECTIVENESS OF GEORGIAN HEALTHCARE SYSTEM

2021 ◽  
Author(s):  
Davit Meparishvili ◽  
◽  
Manana Maridashvili ◽  
Ekaterine Sanikidze ◽  
◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Access To Health Care ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
The State ◽  
Healthcare Sector ◽  
Important Field ◽  
Care System

Assessing the effectiveness of the Georgian healthcare system in the modern period and conditions, takes into account the results achieved, as well as the main problems that hinder the effective functioning of this important field; At the same time, it is important to develop the main directions of their solution, where we consider the improvement of the state policy-making process during the implementation of reforms in the healthcare sector, which should take into account the state of health of the population, quality of healthcare services, results, health care; furthermore disease prevention, equality, financial provision, access to health care, efficiency, rational allocation of health care system resources and other key features of the health care system.

scholarly journals Patient waiting time in the outpatient clinic at a central surgical hospital of Vietnam: Implications for resource allocation

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 454
Author(s):  
Tho Dinh Tran ◽  
Uy Van Nguyen ◽  
Vuong Minh Nong ◽  
Bach Xuan Tran
Keyword(s):  
Health Insurance ◽  
Waiting Time ◽  
Outpatient Clinic ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Patient Waiting Time ◽  
Administrative Procedures ◽  
Patient Waiting

Background: Patient waiting time is considered as a crucial parameter in the assessment of healthcare quality and patients’ satisfaction towards healthcare services. Data concerning this has remained limited in Vietnam. Thus, this study aims to assess patient waiting time in the outpatient clinic in Viet Duc Hospital (Hanoi, Vietnam) in order to enable stakeholders to inform evidence-based interventions to improve the quality of healthcare services. Methods: A cross-sectional study was conducted from June 2014 to June 2015 in the outpatient clinic at Viet Duc Hospital. Waiting time stratified by years (2014 and 2015), months of the year, weekdays, and hours of the day were extracted from Hospital Management software and carefully calculated. Stata 12.0 was employed to analyze data, including the average time (M± SD), frequencies and percentage (%). Results: There was a total of 137,881 patients involved in the study. The average waiting time from registration to preliminary diagnosis in 2014 was 50.41 minutes, and in 2015 was 42.05 minutes. A longer waiting time was recorded in the morning and in those having health insurance. Conclusions: Our results provided evidence that despite the decrease of waiting time from 2014 to 2015, waiting time was much higher among patients having health insurance compared to their counterparts. The findings suggest that human resources promotion and distribution should be emphasized in outpatient clinics and health insurance-related administrative procedures should be simplified.

Health Insurance and Determinants of Perceived Healthcare Service Quality in Jordan

2021 ◽  
Vol 5 (1) ◽  
pp. 1-17
Author(s):  
Wajd R. Hammad ◽  
Rozaleen B. Abedrabbo ◽  
Diala Mazen Khoury ◽  
Nadia J. Sweis
Keyword(s):  
Health Insurance ◽  
Healthcare Workers ◽  
Quality Care ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Specialist Care ◽  
Cross Sectional ◽  
Perception Of Quality

This study demonstrates the determinants that affect the perception of quality of healthcare services in Jordan. A cross-sectional study was conducted in order to determine the perception of quality of healthcare services and relating variables including availability of health insurance and quality of health insurance. This study supports the findings of other studies that health insurance influences the perception of quality of healthcare services provided. However, it is also clear that Jordanians consider the availability of doctors, ability to obtain specialist care, accessibility to health services, and cooperation of healthcare workers as significant determinants when conceptualizing the quality of healthcare and its services. The amount of premium paid had a significant association, which could reflect on valuing the money they pay and expecting high-quality care in return. Being insured increases the likelihood of perceiving higher quality of healthcare.

scholarly journals A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megi Gogishvili ◽  
Karen R. Flórez ◽  
Sergio A. Costa ◽  
Terry T.-K. Huang
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Insurance ◽  
Healthcare System ◽  
Healthcare Services ◽  
Public Health Insurance ◽  
Hiv Positive ◽  
Royal Decree ◽  
Healthcare Needs ◽  
Insurance Card

Abstract Background Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a result of the 2008 financial crisis, Spain has implemented multiple austerity measures, one of which was the enactments of Royal Decree Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 which abolished universal healthcare coverage. In this context, this study examined: 1) Participants’ mixed experiences in accessing health care after the enactment of 2012 RDL and RD, and 2) Distress felt by the participants and their experiences as HIV-positive immigrants living in Spain. Methods Participants were recruited through a nongovernmental organization (NGO) during routine visits at the center. A total of 12 participants were interviewed to reach data saturation. Participants were HIV-positive immigrants living in Spain for 1 or more years, allowing for substantial experience with navigating the healthcare system. Thematic analysis was performed to identify common themes in participants’ experiences living as HIV-positive individuals in Spain and in accessing healthcare. Results Four primary themes were identified. The primary systemic barrier to accessing health care encountered by participants was the inability to fulfill the requirement of having proof of registration in an Autonomous Community for the required time period, thus not being able to apply for a public health insurance card and utilize free care services. Participants identified a positive impact of third party (NGO, social worker, friend/family member) guidance on their experience of applying for a public health insurance card. Participants expressed experiencing emotional or physical (eg, side effects of medication) distress in adapting to life as HIV-positive individuals. Participants also identified experiencing discrimination while living as HIV-positive immigrants in Spain. Conclusions HIV-positive immigrants are underserved in Spain. They encounter systemic barriers while accessing healthcare services, and experience fear and/or discrimination. The study underscores the role of NGOs in helping HIV-positive immigrants navigate the healthcare system. More research is needed on comprehensive approaches to address healthcare needs of HIV-positive immigrants in Spain.

Understanding the impacts of NPM and proposed solutions to the healthcare system reforms in Indonesia: the case of BPJS

2020 ◽  
Vol 35 (3) ◽  
pp. 346-353
Author(s):  
Erniaty Erniaty ◽  
Harun Harun
Keyword(s):  
Health Insurance ◽  
Healthcare System ◽  
New Public Management ◽  
Healthcare Services ◽  
Unintended Consequences ◽  
Healthcare Sector ◽  
Social Security Administration ◽  
Insurance Programme ◽  
The Impact ◽  
Health Insurance Programme

Abstract This study critically evaluates the adoption of a universal healthcare system recently introduced by the Indonesian government in 2014. Our study is driven by the lack of critical analysis of social and political factors and unintended consequences of New Public Management, which is evident in the healthcare sector reforms in emerging economies. This study not only examines the impact of economic and political forces surrounding the introduction of a universal health insurance programme in the country but also offers insights into the critical challenges and undesirable outcomes of a fundamental reform of the healthcare sector in Indonesia. Through a systematic and detailed review of prior studies, legal sources and reports from government and media organizations about the implementation and progress of an UHC health insurance programme in Indonesia, the authors find that a more democratic political system that emerged in 1998 created the opportunity for politicians and international financial aid agencies to introduce a universal social security administration agency called Badan Penyelenggara Jaminan Sosial (BPJS). Despite the introduction of BPJS to expand the health services’ coverage, this effort faces critical challenges and unintended outcomes including: (1) increased financial deficits, (2) resistance from medical professionals and (3) politicians’ tendency to blame BPJS’s management for failing to pay healthcare services costs. We argue that the adoption of the insurance system was primarily motivated by politicians’ own interests and those of international agencies at the expense of a sustainable national healthcare system. This study contributes to the healthcare industry policy literature by showing that a poorly designed UHC system could and will undermine the core values of healthcare services. It will also threaten the sustainability of the medical profession in Indonesia. The authors offer several suggestions for devising better policies in this sector in the developing nations.

scholarly journals Middle Eastern Immigrants' Satisfaction With Malaysian Healthcare

2021 ◽  
Vol 12 (2) ◽  
pp. 238
Author(s):  
Haliyana Khalid ◽  
Mohamad Saleem Anis ◽  
Adriana Mohd Rizal
Keyword(s):  
Healthcare System ◽  
Language Proficiency ◽  
Middle Eastern ◽  
Descriptive Analysis ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Living Conditions ◽  
Cross Sectional ◽  
Middle Eastern Immigrants

There has been an increasing number of Middle Eastern immigrants arriving in Malaysia over the last decade due to political and economic instability in their countries. Given their somewhat ambiguous living conditions and residence status here (e.g. legal, illegal, refugee, etc.), it is imperative to understand their situation in-depth. One of the most important aspects that impact the living conditions of these immigrants is health; accordingly, in this research, we attempted to discover the extent and factors of Middle Eastern immigrants’ satisfaction with the Malaysian healthcare system and its facilities. In this cross-sectional study, we used a questionnaire to collect data from 219 respondents both online and in-person. Various statistical methods were employed to analyze the data, including descriptive analysis, Pearson’s correlation, and multiple regression. The findings indicate a slight dissatisfaction among Middle Eastern immigrants with respect to the Malaysian healthcare system, due to the cost of health services and communication barriers. The results also highlight that marital status, monthly income, awareness of services, Malay language proficiency, and culture are factors that impact immigrants’ perception of the quality of healthcare services. Therefore, this study provides valuable insights into this important group of immigrants in terms of their experience in public and private healthcare facilities that shape their opinions and satisfaction with the Malaysian healthcare system.

scholarly journals Problems and prospect of development of health insurance system in China

2020 ◽  
pp. 11-16
Author(s):  
Khentsze Lyu
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Medical Services ◽  
Health Insurance System ◽  
Insurance System ◽  
Guaranteed Service ◽  
State Subsidies

This article examines the current health insurance system in China. Emphasis is made on determination of the key features and peculiarities of Chinese health insurance system, as well as its flaws and ways for overcoming them. The author believes that resolution of major issues in Chinese health insurance system requires increased state involvement thereof, since the marked-based approach that has been in effect for the past 30 years lead to inequality and deterioration of the quality of healthcare. The following recommendations are made on the improvement of health insurance system: launch the targeted financing projects that would allow the citizens with especially dangerous diseases, such as cardiovascular, oncological, digestive and nervous system, diabetes, to be paid in full by insurance and state subsidies in receiving medical services and medications; forgo the principle of “annual limit” for medical services and medications under insurance coverage; unify insurance payment systems in different regions in order to improve the quality of rendering healthcare services in poor areas. The author also offers to consider the possibility of implementation of the universal guaranteed service standards that would ensure equal level of the quality of basic services regardless the type of insurance.

scholarly journals 生命倫理基礎的形成——從中國醫療衛生體制改革的歷史進程看

2012 ◽  
Vol 10 (2) ◽  
pp. 93-114
Author(s):  
Lin BIAN
Keyword(s):  
Healthcare System ◽  
Healthcare Reform ◽  
Public Policies ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Economic Transformation ◽  
Moral Foundation ◽  
Digital Commons ◽  
The Government

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在中國醫療衛生體制改革近30 年的風雨歷程中，由於前改革時期沒有條件形成公共生活的倫理精神，在醫療衛生體制改革的第一階段，即過渡期的10幾年中，同樣沒有能夠為改革確立合理的價值目標和形成強有力的道德基礎。在此後改革的推進期，政策制定和制度安排過程倫理基礎的缺失，是改革不成功的重要原因之一。中國社會在對改革的質疑和經驗教訓的反思中啟動的新一輪醫改，無論是政策制定還是框架設計，以及幾年來所取得的成就，都表明此一輪改革具備了較為自覺的生命倫理意識和公共生活倫理精神。中國醫療衛生體制改革的生命倫理基礎生成過程表明，生命倫理學研究在方法上應該堅持中國化的立場。Medical and healthcare reform in China over the past three decades has faced various challenges, one of which has been the lack of an ethical spirit in public life. The old moral foundation has collapsed and a new ethical system has not been established. It follows that neither the validity of reform nor public policies derived from that reform have a solid moral and ethical foundation. As the government seeks an effective way of reshaping the national healthcare system in terms of quality and accessibility to keep pace with rapid socio-political and economic transformation, it has to deal with various moral challenges. This essay provides a critical review of healthcare reform in past 30 years, with the shift away from a state-controlled, comprehensive healthcare system. While “fairness” is considered an ethical principle in a socialist systemlike China, it has always been a problem in reality given the huge disparity between wealthy cities and poverty-stricken countryside brought about by differences in economic situations and medical human resources. The reform has been welcomed by many, but it has also led to a decline in the scope and quality of healthcare services in certain regions. Hence, recent healthcare changes have focused primarily on grassroots medical networks, which aim to penetrate lower-tier and remote regions. However, the moral basis for these changes is ambiguous. The essay argues that it is crucial for Chinese scholars, healthcare professionals, and government administrators to think about the moral foundation upon which legal regulations and public policies can be implemented to meet specific needs in China.DOWNLOAD HISTORY | This article has been downloaded 34 times in Digital Commons before migrating into this platform.

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