scholarly journals Creating sustainable health care systems

2019 ◽  
Vol 33 (1) ◽  
pp. 18-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Katharina Kieslich ◽  
Albert Weale ◽  
Emma Tumilty ◽  
Georgina Richardson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Systems ◽  
Public Involvement ◽  
Health Care Systems ◽  
Ethical Challenge ◽  
Content Type ◽  
The Public ◽  
Care Systems ◽  
Sustainable Health

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.

scholarly journals Involving citizens in disinvestment decisions: what do health professionals think? Findings from a multi-method study in the English NHS

2017 ◽  
Vol 13 (2) ◽  
pp. 162-188 ◽  
Author(s):  
Tom Daniels ◽  
Iestyn Williams ◽  
Stirling Bryan ◽  
Craig Mitton ◽  
Suzanne Robinson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Public Involvement ◽  
Health Care Systems ◽  
Future Research ◽  
Local Health ◽  
The Public ◽  
Health Care Leaders ◽  
Local Health Care ◽  
Care Systems

AbstractPublic involvement in disinvestment decision making in health care is widely advocated, and in some cases legally mandated. However, attempts to involve the public in other areas of health policy have been accused of tokenism and manipulation. This paper presents research into the views of local health care leaders in the English National Health Service (NHS) with regards to the involvement of citizens and local communities in disinvestment decision making. The research includes a Q study and follow-up interviews with a sample of health care clinicians and managers in senior roles in the English NHS. It finds that whilst initial responses suggest high levels of support for public involvement, further probing of attitudes and experiences shows higher levels of ambivalence and risk aversion and a far more cautious overall stance. This study has implications for the future of disinvestment activities and public involvement in health care systems faced with increased resource constraint. Recommendations are made for future research and practice.

scholarly journals Public-private mix and performance of health care systems in CEE and CIS countries

2016 ◽  
Vol 7 (2) ◽  
pp. 169 ◽  
Author(s):  
Błażej Łyszczarz
Keyword(s):  
Health Care ◽  
Private Sector ◽  
Health Systems ◽  
Health Care Systems ◽  
Public Financing ◽  
The Public ◽  
Care Systems ◽  
Cis Countries ◽  
Public Private Mix

The role of the public and private sector in health care systems remains one of the crucial problems of these systems' operation. The purpose of this research is to identify the relationships between the performance of health systems in CEE and CIS (Central and Eastern Europe and Commonwealth of Independent State) countries, and the mix of public-private sector in the health care of these countries. The study uses a zero unitarization method to construct three measures of health system performance in the following areas: (1) resources; (2) services; and (3) health status. The values of these measures are correlated with the share of public financing that represents the public-private mix in the health systems. The data used is from World Health Organization’s Health for All Database for 23 CEE and CIS countries and comprises the year 2010. The results show that the performance of health systems in the countries investigated is positively associated with a higher proportion of public financing. The strongest relationship links public financing with performance in the area of services production. For policy makers, these results imply that health systems in post-communist transition economies could be susceptible to a decreasing role of the state and that growing reliance on the market mechanism in health care can deteriorate the operation of these systems.

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.

Health Care

2018 ◽  
Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre
Keyword(s):  
Health Care ◽  
Technological Progress ◽  
Health Care Systems ◽  
Third Party ◽  
Medical Expenditure ◽  
Public Health Care ◽  
The Public ◽  
Common Features ◽  
Care Systems

This chapter reviews the public health care systems as well as their challenges. It first shows how expenditure on health care has evolved in previous decades and deals with the reasons for the growth observed in almost every European country. It emphasizes the role of technological progress as a main explanatory factor of the increase in medical expenditure but also points to the challenges facing cost-containment policies. Especially, the main common features of health care systems in Europe, such as third-party payment, single provider approach and cost-based reimbursement are discussed. Finally the chapter shows that although inequalities in health exist in the population, health care systems are redistributive. Reforms are thus needed but the trade-off between budgetary efficiency and equity is difficult.

scholarly journals COVID-19, psychosocial issues, politics, and public mental health care

2021 ◽  
Vol 51 (2) ◽  
pp. 293-303
Author(s):  
Anthony L Pillay ◽  
Anne L Kramers-Olen
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Systems ◽  
Mental Health Policy ◽  
Public Mental Health ◽  
The Public ◽  
Care Systems ◽  
Public Mental Health Care

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

Accountability for Rationing — Theory into Practice

2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Systems ◽  
The Public ◽  
Modern Health Care ◽  
Concept Of Health ◽  
Care Systems ◽  
Health Need

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.

Utilization of dental health services by Danish adolescents attending private or public dental health care systems

2002 ◽  
Vol 60 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Lisa Bøge Christensen ◽  
Poul Erik Petersen ◽  
Annelise Bastholm ◽  
Lone Laurberg
Keyword(s):  
Health Care ◽  
Health Services ◽  
Dental Health ◽  
Health Care Systems ◽  
Dental Health Services ◽  
Dental Health Care ◽  
Care Systems

Pervasive Computing Support in the Transition towards Personalised Health Systems

2011 ◽  
Vol 2 (3) ◽  
pp. 31-47 ◽  
Author(s):  
Martín Serrano ◽  
Ahmed Elmisery ◽  
Mícheál Ó Foghlú ◽  
Willie Donnelly ◽  
Cristiano Storni ◽  
...  
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Pervasive Computing ◽  
Health Care Systems ◽  
Data Systems ◽  
Distributed Information ◽  
Health Care Applications ◽  
Care Systems ◽  
Systems Requirements ◽  
Computing Support

This paper discusses pervasive computing work in the transition from traditional health care programs to personalised health systems (pHealth). A chronological guided transition survey is discussed to highlight trends in medicine describing their most recent developments about health care systems. Future trends in this interdisciplinary techno-medical area are described as research goals. Particularly, research and technological efforts concerning ICT’s and pervasive computing in healthcare and medical applications are presented to identify systems requirements supporting secure and reliable networks and services. The main objectives are to summarise both the pHealth systems requirements providing end-user applications and the necessary pervasive computing support to interconnect device-based health care applications and distributed information data systems in secure and reliable forms, highlighting the role pervasive computing plays in this process. A generic personalised healthcare scheme is introduced to provide guidance in the transition and can be used for multiple medical and health applications. An example is briefly introduced by using the generic scheme proposed.

Sign in / Sign up

Export Citation Format

Share Document