scholarly journals Diagnostic Delay of Inflammatory Bowel Disease Is Significantly Higher in Public versus Private Health Care System in Mexican Patients

2021 ◽  
pp. 1-9
Author(s):  
Jesús K. Yamamoto-Furusho ◽  
Norma N. Parra-Holguín

<b><i>Introduction:</i></b> Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn’s disease (CD) characterized by a fluctuating course with periods of clinical activity and remission. No previous studies have demonstrated the frequency of delay at diagnosis and its associated factors in Mexico and Latin America. The aim of this study was to evaluate diagnostic delay of IBD in the last 4 decades in 2 different health care systems (public vs. private) and its associated factors. <b><i>Methods:</i></b> This is a cohort study that included 1,056 patients with a confirmed diagnosis of IBD from public and private health care systems. The diagnostic delay was defined as time &#x3e;1 year from the onset of symptoms to the confirmed diagnosis for patients with UC and 2 years for patients with CD. Statistical analysis was performed with the SPSS v.24 program. A value of <i>p</i> ≤ 0.05 was taken as significant. <b><i>Results:</i></b> The delay at diagnosis decreased significantly by 24.9% in the last 4 decades. The factors associated with the diagnostic delay were proctitis in UC, clinical course &#x3e;2 relapses per year and IBD surgeries for CD. We found a delay at diagnosis in 35.2% of IBD patients in the public versus 16.9% in the private health care system (<i>p</i> = 0.00001). <b><i>Conclusions:</i></b> We found a significant diagnosis delay of IBD in 35.2% from the public health care system versus 16.9% in the private health care system.

2021 ◽  
pp. 1-18
Author(s):  
Linn Kullberg ◽  
Paula Blomqvist ◽  
Ulrika Winblad

Abstract Voluntary private health insurance (VHI) has generally been of limited importance in national health service-type health care systems, especially in the Nordic countries. During the last decades however, an increase in VHI uptake has taken place in the region. Critics of this development argue that voluntary health insurance can undermine support for public health care, while proponents contend that increased private funding for health services could relieve strained public health care systems. Using data from Sweden, this study investigates empirically how voluntary health insurance affects the public health care system. The results of the study indicate that the public Swedish health care system is fairly resilient to the impact of voluntary health insurance with regards to support for the tax-based funding. No difference between insurance holders and non-holders was found in willingness to finance public health care through taxes. A slight unburdening effect on public health care use was observed as VHI holders appeared to use public health care to a lesser extent than those without an insurance. However, a majority of the insurance holders continued to use the public health care system, indicating only a modest substitution effect.


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.


2014 ◽  
Vol 10 (3) ◽  
pp. 293-310 ◽  
Author(s):  
Dani Filc ◽  
Nissim Cohen

AbstractBlack medicine represents the most problematic configuration of informal payments for health care. According to the accepted economic explanations, we would not expect to find black medicine in a system with a developed private service. Using Israel as a case study, we suggest an alternative yet a complimentary explanation for the emergence of black medicine in public health care systems – even though citizens do have the formal option to use private channels. We claim that when regulation is weak and political culture is based on ‘do it yourself’ strategies, which meant to solve immediate problems, blurring the boundaries between public and private health care services may only reduce public trust and in turn, contribute to the emergence of black medicine. We used a combined quantitative and qualitative methodology to support our claim. Statistical analysis of the results suggested that the only variable significantly associated with the use of black medicine was trust in the health care system. The higher the respondents’ level of trust in the health care system, the lower the rate of the use of black medicine. Qualitatively, interviewee emphasized the relation between the blurred boundaries between public and private health care and the use of black medicine.


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.


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