Public-private: unequal competition Israeli public hospitals vs the private health-care system following government reforms

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lior Naamati Schneider
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Data Gathering ◽  
State Regulation ◽  
Public Hospitals ◽  
Content Type ◽  
Creative Solutions ◽  
Government Reforms ◽  
Care System

Purpose This study aims to map perceptions and changes in public hospitals in response to competition with the private health system, describes solutions adopted by the public hospitals and considers their implications for the business and strategic management of those hospitals. Design/methodology/approach This paper opted for a qualitative study using the open-ended approach of grounded theory, including 40 in-depth interviews with key figures in the health system and administrators at various levels of management. Findings Public hospitals are constantly adopting changes because of state-mandated reforms and growing competition with private hospitals. Notable measures include making hospitals customer-oriented and adopting business-oriented behaviors and competitive and marketing strategies. However, because public hospitals are unable to institute radical changes, they typically introduce hybrid services (private services within public services) and other creative solutions such as business-funded research foundations operating alongside them. Research limitations/implications The main methodological limitation of this study was the difficulty in obtaining data because of the limited cooperation and lack of transparency of Israel’s health-care system. The interviewees expressed concerns that their department or hospital would appear in a negative light, especially as motivated solely by financial considerations. In anticipation of this difficulty, requests for participation were addressed individually and contained extensive detail regarding the study, the ethics committee’s approval, the data gathering and the strict maintenance of anonymity and confidentiality. Originality/value Adopting business-oriented behaviors in public hospitals is somewhat contrary to the principles of public medicine. Their adaptation to the market is partial, and their creative hybrid solutions require state regulation. The absence of controls leads to duplication and waste, causing various problems, including increased social inequality, costs and deficits.

A decision support healthcare system based on IoT and neural network technique

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Khadeja Al_Sayed Fahmy ◽  
Ahmed Yahya ◽  
M. Zorkany
Keyword(s):  
Neural Network ◽  
Health Care ◽  
Deep Learning ◽  
Decision Support ◽  
Health System ◽  
Health Care System ◽  
Virus Disease ◽  
Activation Function ◽  
Content Type ◽  
Care System

Purpose The purpose of this paper is to develop e-health and patient monitoring systems remotely to overcome the difficulty of patients going to hospitals especially in times of epidemics such as virus disease (COVID-19). Artificial intelligence (AI) technology will be combined Internet of Things (IoT) in this research to overcome these challenges. The research aims to select the most appropriate, best-hidden layers numbers and the activation function types for the neural network (NN). Then, define the patient data sent through protocols of the IoT. NN checks the patient’s medical sensors data to make the appropriate decision. Then it sends this diagnosis to the doctor. Using the proposed solution, the patients can diagnose and expect the disease automatically and help physicians to discover and analyze the disease remotely without the need for patients to go to the hospital. Design/methodology/approach AI technology will be combined with the IoT in this research. The research aims to select the most appropriate’ best-hidden layers numbers’ and the activation function types for the NN. Findings Decision support health-care system based on IoT and deep learning techniques was proposed. The authors checked out the ability to integrate the deep learning technique in the automatic diagnosis and IoT abilities for speeding message communication over the internet has been investigated in the proposed system. The authors have chosen the appropriate structure of the NN (best-hidden layers numbers and the activation function types) to build the e-health system is performed in this work. Also, depended on the data from expert physicians to learn the NN in the e-health system. In the verification mode, the overall evaluation of the proposed diagnosis health-care system gives reliability under different patient’s conditions. From evaluation and simulation results, it is clear that the double hidden layer of feed-forward NN and its neurons contain Tanh function preferable than other NN. Originality/value AI technology will be combined IoT in this research to overcome challenges. The research aims to select the most appropriate, best-hidden layers numbers and the activation function types for the NN.

scholarly journals Searching for Elysium: teaching universal health care as a human right

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Souza ◽  
T C Garcia ◽  
M N Sayão
Keyword(s):  
High School ◽  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Human Right ◽  
School Class ◽  
Federal Constitution ◽  
High School Class ◽  
Free Health Care ◽  
Care System

Abstract Background Brazil have a huge free health care system. Inspired on UK National Health System (NHS), the Sistema Único de Saúde (SUS, that means Unified Health System) was consolidate as a right for all citizens after 1988's Brazilian Federal Constitution. Despite your spread, part of Brazilian citizens have an opposite opinions about SUS. So, the main question is: How to teach the relevance of a universal free health care system as a human right. Objectives The main aim of this work is teaching the recognize of SUS as a human right and ratified by Brazilian Federal Constitution in a High School class. In this sense, we used the cinema and debate for stimulate an effective comprehension of Universal Declaration of Human Rights (UDHR) and health promotion as a human right in a high school class. We used the movie Elysium (Neill Blomkamp, 2013) that show a dystopian world with two social class: citizen and non-citizen of Elysium (an artificial satellite of the Earth with high technology of cure for your citizens). Results The class has three Lessons: in first lesson we teaching about different notions about rights and the UDHR. In the second lesson we teaching about free health care systems in the world and a historical perspective about SUS. The third lesson we show the movie Elysium and proceed a debate. In debate we discuss about citizenship and rights, how the movie show two societies with different rights about work, transport and health, and how this aspects impact the quality of life of human being. Conclusions What options we have? The notion of free health care as a human right isn't an easy concept. So, efforts are needed for this comprehension and cinema can be used, followed by discussion, as a significant teaching tool for achieving humanistic educational objectives about free health care system as a human right in the high school curriculum. Key messages Health care is a human right and free health care system is a concretization of this right. Cinema can be used for stimulate a critical evaluation and effective understanding of rights in a high school classroom.

Health system responsiveness in Iran: a cross-sectional study in hospitals of Mazandaran province

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Roya Malekzadeh ◽  
Samereh Yaghoubian ◽  
Edris Hasanpoor ◽  
Matina Ghasemi
Keyword(s):  
Health Care ◽  
Social Security ◽  
Health Care System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mazandaran Province ◽  
Cross Sectional ◽  
Content Type ◽  
System Responsiveness ◽  
Care System

Purpose Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran. Design/methodology/approach The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section. Findings All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy. Originality/value In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.

The role of transformative healthcare technology on quality of life during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammad Asif Salam ◽  
Saleh Bajaba
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Saudi Arabia ◽  
Service Delivery ◽  
Health Care System ◽  
Service System ◽  
Content Type ◽  
Care System

Purpose The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL). Design/methodology/approach A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model. Findings The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process. Research limitations/implications One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement. Originality/value This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.

Cost-effectiveness of continuous positive airway pressure therapy for obstructive sleep apnea: health care system and societal perspectives

SLEEP ◽  
2019 ◽  
Vol 42 (12) ◽  
Author(s):  
Jared Streatfeild ◽  
David Hillman ◽  
Robert Adams ◽  
Scott Mitchell ◽  
Lynne Pezzullo
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health System ◽  
Health Care System ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Cpap Therapy ◽  
System Perspective ◽  
Obstructive Sleep ◽  
Care System

Abstract Study Objectives To determine cost-effectiveness of continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) in Australia for 2017–2018 to facilitate public health decision-making. Methods Analysis was undertaken of direct per-person costs of CPAP therapy (according to 5-year care pathways), health system and other costs of OSA and its comorbidities averted by CPAP treatment (5-year adherence rate 56.7%) and incremental benefit of therapy (in terms of disability-adjusted life years [DALYs] averted) to determine cost-effectiveness of CPAP. This was expressed as the incremental cost-effectiveness ratio (= dollars per DALY averted). Direct costs of CPAP were estimated from government reimbursements for services and advertised equipment costs. Costs averted were calculated from both the health care system perspective (health system costs only) and societal perspective (health system plus other financial costs including informal care, productivity losses, nonmedical accident costs, deadweight taxation and welfare losses). These estimates of costs (expressed in US dollars) and DALYs averted were based on our recent analyses of costs of untreated OSA. Results From the health care system perspective, estimated cost of CPAP therapy to treat OSA was $12 495 per DALY averted while from a societal perspective the effect was dominant (−$10 688 per DALY averted) meaning it costs more not to treat the problem than to treat it. Conclusions These estimates suggest substantial community investment in measures to more systematically identify and treat OSA is justified. Apart from potential health and well-being benefits, it is financially prudent to do so.

scholarly journals Development of a gender-relevant tobacco cessation intervention for women in Brazil—an intervention mapping approach to planning

2019 ◽  
Vol 34 (5) ◽  
pp. 505-520
Author(s):  
N�dia Kienen ◽  
Tha�s Dist�fano Wiltenburg ◽  
Lorna Bittencourt ◽  
Isabel C Scarinci
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Tobacco Cessation ◽  
Public Health System ◽  
Intervention Mapping ◽  
The Public ◽  
Cessation Intervention ◽  
Care System

Abstract The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. One of major advantages of utilizing IM was that decisions were made in a transparent and supportive manner with involvement of all stakeholders throughout the process. Despite the fact that this process is very taxing on researchers and the health care system as it takes time, resources and negotiation skills, it builds trust and promotes ownership which can assure sustainability.

Health Care System Structure in the State of Israel

2019 ◽  
Vol 88 (1) ◽  
pp. 39-46
Author(s):  
Mohammad Yasser Sabbah
Keyword(s):  
Health Care ◽  
Medical Treatment ◽  
Health System ◽  
Health Care System ◽  
The State ◽  
The Public ◽  
The Right ◽  
To Receive ◽  
State Of Israel ◽  
Care System

The health care system in the State of Israel consists of two sectors - the public sector, which includes government-owned hospitals and medical institutes. The public health sector includes the community health system, health funds, family medicine, the general care system and the mental health care system. The second sector is the private sector, which includes private hospitals and medical institutes. Both sectors are supervised by the Israeli Ministry of Health, which is the supreme governmental authority through which it implements its policy in the entire health system in Israel. The law provides and guarantees medical insurance for every resident of Israel, the right to receive medical treatment, the prohibition of discrimination, informed consent to medical treatment, the right to receive an additional medical opinion, the dignity and privacy of the patient and the right to attend. Health funds in Israel were established before the State of Israel was established. The ideological concept of the health funds was based on the principle of equality and mutual assistance.

scholarly journals Swedish health care system – some trends of its reforming

2010 ◽  
Vol 1 (1) ◽  
pp. 151-164 ◽  
Author(s):  
Marcin Moks
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Service Providers ◽  
Diagnosis Related Groups ◽  
Health Care Facilities ◽  
System Reform ◽  
Swedish Health Care ◽  
Care Facilities ◽  
Care System

The constant increase in public health expenditure, which is being observed from the 60s, initiated research into way to optimize it. The aim the article is to show concepts of the health reforms which have been applied in the Swedish health service. In the article are presented main proposals of changes in the system financing and service provision. Article characterizes patient participation in costs of services, private health insurance, privatisation of health care facilities, purchase-provider split and providers reimbursement. The articles begins with the overview of concepts related to health care system reform. Next, the health system in Sweden is shortly presented. The main part of the article presents the reforms which has been implemented in the financing and services provision. Patients’ participation in financing of the health system has been extended by fees for service. The importance of private medical insurance is marginal. Purchaser-provider split has been introduced in most of counties. In general primary care facilities have been privatised. In regard to service providers reimbursement is generally used global budgeting, feed for service or diagnosis-related groups.

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