Health

2021 ◽  
pp. 505-523
Author(s):  
Heinz Rothgang

This chapter deals with what is said to be the most important thing in life: health. Health, therefore, is a big deal in all OECD countries, which on average spent almost one-tenth of their GDP on their health-care system. These health-care systems are at the centre of this chapter. After having discussed their origins and developments and the existing typologies of health-care systems we analyse the three functions of each health-care system in detail, i.e. finance, delivery, and regulation. In a nutshell, we find that systems have become more complex and more hybrid over time, while the clear distinctions between different system types have been blurred. One reason for this is the attempt to pick up elements from other system types in order to increase effectiveness and efficiency. As different systems produce different results, performance measurement has become of increasing interest, an issue we turn on then. Respective approaches, however, are still—at best—highly disputable. As health-care systems seem to be in a state of permanent reform, in a subsequent section we present approaches to explain such reforms coming from different strands of theory. The chapter concludes with a view on international and global health, highlighting that health governance issues emerge at the interface of local, national, regional, and global interests.

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.


2021 ◽  
Vol 10 (2) ◽  
pp. 1064-1082
Author(s):  
Claudia I. Henschke ◽  
David F. Yankelevitz ◽  
Artit Jirapatnakul ◽  
Rowena Yip ◽  
Vivian Reccoppa ◽  
...  

2004 ◽  
Vol 5 (1) ◽  
pp. 59-70 ◽  
Author(s):  
Stefan Greß ◽  
Ralf Kocher ◽  
Jürgen Wasem

Abstract Recent reforms of the Swiss health care system to introduce regulated competition have raised expectations about the possible combination of more efficient services, while at same time maintaining or even increasing the level of solidarity in health care systems. In this article we examine expected behavioral changes of the market actors, the way incentives for market actors have been changed and analyze the way market actors in fact changed their behavior. We conclude that so far only some of the targets of the reforms have been met. For a reasonable assessment of the Swiss experience in regulating competition in health care it is paramount to distinguish expected effects from actual effects.


2019 ◽  
Vol 72 (4) ◽  
pp. 685-691
Author(s):  
Borys O. Lohvynenko ◽  
Roman V. Myroniuk ◽  
Olexander P. Svitlychnyy ◽  
Aleksey Y. Prokopenko ◽  
Lidija I. Kalenichenko

Introduction: Nowadays there is the transformation of the national health care system in Ukraine, the ultimate goal of which is to create a modern, competitive model of medical care of citizens on the basis of forming packages of free medical services. However, the model adopted by Ukraine is in contradiction with national legislation in part of free medical aid guaranteed by the Art. 49 of the Constitution of Ukraine, and fragmentary considers positive international practices. The aim of the paper is to determine the mistakes of the reform of the Ukrainian health care system and to reveal the positive international practices of the organization of health care systems that can be implemented in Ukraine. Materials and methods: National and international legislation, official web resources of the executive authorities of Ukraine, statistics of the World Health Organization, materials of journalistic and scientific periodicals are the materials for the research of the health care system in Ukraine in comparison with international practices. Research methods are cross-sectoral, complex statistical, comparative, generalization, analysis and synthesis. In order to obtain the results, the authors have conducted a critical analysis of the current norms of the national Ukrainian legislation in the health care sector. Review: The authors of the article have studied the main disadvantages of the national health care system in accordance with the concept of reforming the medical sector. Positive international practices that can be implemented into Ukrainian system for the real improvement of medical human rights in Ukraine have been revealed. Conclusions: It has been proved that the ongoing reform of the health care system in Ukraine needs to be reviewed and optimized. It has been offered to consolidate a perspective model of the Ukrainian health care system, its principles and guarantees of immunity at the legislative level.


2015 ◽  
Vol 13 (1) ◽  
pp. 729-735 ◽  
Author(s):  
Ewa Banasik

The main argument of this paper is that because the burden of diseases increases with age, a greater numbers of older individuals will increase the demand for health care, and whether this demand will be met very much depends on how health care systems are governed. This task is particularly complex in jurisdictions with multi-layer governing systems such as the Australian health care system. Governance, described in terms of stewardship of the well-being of the population and as a central component for building effective health care systems, is increasingly considered to be very important for a well performing health care system (World Health Organization, 2000, 2007). Governance is, however, the least studied function in a health care system (Alliance 2009). Furthermore, the limited governance frameworks and assessments that have been developed thus far fail to include the political context in which health care systems operate (Baez-Camargo and Jacobs, 2011). This paper intends to fill this knowledge gap by exploring the political dynamics of the Australian health care system’s governance and its accountability. Furthering the discourse on governance is especially important in times when health care systems are confronted with the challenges of ageing populations


Relevance. The paper examines the issues of the health care system development of Ukraine in the context of modern challenges. Today, there are many global environmental, socio-demographic, and economic problems threatening the existence of human civilization. One of the problems was the spread of coronavirus infection COVID-19, which demonstrated unpreparedness of Ukraine and post-socialist countries' health care systems. These countries are undergoing health care transformations, but they do not meet modern world norms and standards. The purpose of the article is to establish the key features of the health care system of Ukraine during its transformation given the positive experience of medical systems in the world, from the positions of human geography to identify current challenges and to assess the ability to respond to social demand and the threat of the global crisis in the form of new diseases, the spread of epidemics threatening to human health, quality and life expectancy. Methods. This research is conducted on the basis of human-geographical approach with use of the set of methods and tools to analyze the health care system, which is extremely important for obtaining verified and scientifically sound results. In particular, the authors used methods of induction and deduction, comparison, formalization, analogy, analysis, systematization, including ranking and grouping, historical, graphical, mathematical and statistical, SWOT-analysis methods. Results. Scientific novelty and practical significance. The features, advantages and disadvantages of existing models of health care systems in different countries were identified. In particular, models of medical systems were considered: a model of the single-payer, model of obligatory insurance, and hybrid system. The peculiarities of the formation of the health care system of Ukraine were determined, the key features and principles of the M.O. Semashko’s system were identified, its positive and negative features preserved to this day were outlined. The distribution of European and post-socialist countries was analyzed according to the indicators of state budget expenditures on health care and GDP, number of doctors, hospital beds per capita. The transformational processes in the health care system of Ukraine, the peculiarities of the medical reform in Ukraine were revealed, the peculiarities of the development of the medical system in the conditions of the pandemic were characterized. The SWOT analysis identified the strengths and weaknesses of the Ukraine’s health care system in terms of reform and transformation, its opportunities and threats in the light of current challenges.


2021 ◽  
Author(s):  
Mary Subaja Christo ◽  
Bommi R M ◽  
Anandaraj S P ◽  
Udhaya Sankar S M ◽  
Anbarasu V ◽  
...  

Abstract In recent years, E-services such as e-healthcare, e-learning, e-ticketing, depend on computer networks where the attackers have started introducing new types of attacks. Therefore, it is necessary to enhance security for communication which is needed for the transfer of confidential information relating to patients through the network. In our research we have developed a reputation aggregation based dynamic trust model for edge computing based E-health care systems. In this model, the edge node evaluates the trust value of a user and allows the user to access the E-health care system only when the trust value is satisfied. In order to do this, initially the user information is collected with the help of user agents and then this information is processed and the relevant data alone is sent to the edge nodes for evaluating the trust. Finally, the trusted users can be identified through edge nodes and they are only given the permission to access the e-health care system. Attacks generated in the simulations are detected using the prevailing algorithms and also the suggested techniques. The simulation results of this work prove the ability of the proposed techniques which are used to detect the attacks accurately and to prevent them effectively.


2019 ◽  
Vol 115 ◽  
pp. 81-95
Author(s):  
Paweł Lenio

SOURCES OF FINANCING OF THE HEALTH CARE SYSTEM IN POLAND AND IN ITALYThe study found that the majority of similarities and differences in the legal structure of Polish and Italian sources of financing of health care are the result of the adoption of a specific model of health care, and therefore there are fundamental differences between the catalogues of sources of financing health care in Poland and Italy. The basis for the difference between the Italian and Polish catalogues of sources of financing health care is the obligation of patients to contribute to the costs of the health care system in Italy by paying fees in return for receiving a certain type of service. In the reforms of the Polish and Italian health care systems one can see signs of transferring more and more responsibility to local government units. However, Italian and Polish local government units have no influence on the principles of functioning of the system and the shape of basic sources of financing health care.


2020 ◽  
Author(s):  
Kevin Morisod ◽  
Xhyljeta Luta ◽  
Joachim Marti ◽  
Jacques Spycher ◽  
Mary Malebranche ◽  
...  

Abstract Background: Achieving equity in health care remains a challenge for health care systems worldwide and marked inequities in access and quality of care persist. The performance assessment of health care systems is often limited to quality and efficiency indicators. Identifying indicators of health care equity is an important first step in integrating the concept of equity into assessments of health care system performance. Because emergency care serves as the interface between ambulatory and inpatient care, it appears to be a key setting in which to begin this process.Methods: We conducted a systematic review of administrative data-derived health care equity indicators and their association with socio-economic determinants of health (SEDH) in emergency care settings. Ovid MEDLINE, EMBASE, PUBMED and Web of Science were searched for relevant studies using administrative data following PRISMA-equity guidelines. The outcomes of interest were indicators of health care equity and the associated SEDH they examine.Results: Among 29 studies identified, 14 equity indicators were identified and grouped into four categories that reflect the patient emergency care pathway. Total emergency department (ED) visits and ambulatory care sensitive condition-related ED visits were the two most frequently used indicators. The studies analysed equity based on seven SEDH: social deprivation, income, education level, social class, insurance coverage, health literacy and financial and non-financial barriers. Despite some conflicting results, all identified SEDH are associated with inequalities in access to and use of emergency care. Conclusion: The use of administrative data-derived indicators in combination with identified SEDH could improve the measurement of health care equity in emergency care settings across health care systems worldwide. Using a combination of indicators is likely to lead to a more comprehensive, well-rounded analysis of health care equity than using any one indicator in isolation. Though studies analysed focused on emergency care settings, it seems possible to extrapolate these indicators to measure equity in other areas of the health care system. Further studies elucidating root causes of health inequities in and outside the health care system are needed.


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