scholarly journals ‘Intended’ and ‘unintended’ consequences of the privatisation of health and social care systems in Italy in light of the pandemic

2021 ◽  
pp. 102425892110284
Author(s):  
Andrea Ciarini ◽  
Stefano Neri
Keyword(s):  
Social Care ◽  
Health Care Systems ◽  
Unintended Consequences ◽  
Long Term Effects ◽  
Regional Health ◽  
Regional Health Care ◽  
Italian Regions ◽  
Health And Social Care ◽  
Care Systems ◽  
The Impact

This article analyses the long-term effects of privatisation and marketisation on the Italian regional health and social care systems. The research focuses on three Italian regions – Lombardy, Veneto and Lazio – which are representative of three different models of governance in these sectors. We examine the effects of privatisation and marketisation on the health and social care system by discussing how the regional health-care systems have managed the impact of the COVID-19 pandemic. We also shed light on the dramatic consequences of the pandemic crisis on employment levels and working conditions.

The future healthcare?

2015 ◽  
Vol 39 (4) ◽  
pp. 444 ◽  
Author(s):  
Kate Charlesworth ◽  
Maggie Jamieson ◽  
Colin D. Butler ◽  
Rachel Davey
Keyword(s):  
Social Care ◽  
Health Care Systems ◽  
Transformational Change ◽  
Well Being ◽  
New Approach ◽  
Emerging Trends ◽  
Health And Social Care ◽  
Care Systems ◽  
Health And Well Being ◽  
Sophisticated Technology

Background Healthcare systems in Australia and around the world are failing to address the challenges of the modern world. Healthcare leaders are calling for radical, transformational change and entirely new systems of care. However it is unclear what a future, sustainable healthcare system would look like. Methods A narrative review to examine emerging trends in health and social care was conducted. Results and Conclusions Six key trends were identified. Collectively, they suggest that future systems are likely to be characterised by increasingly sophisticated technology, but at the same time greater personal and community responsibility for health and well being, innovative use of social capital, and a new approach to ageing and end-of-life care. What is known about the topic? Health care systems in Australia and around the world are failing to address the key health challenges of modern society. There are calls for radical, transformational change of our health care systems; however it is unclear what a future, sustainable system would look like. What does this paper add? In this narrative review, we identify and examine six key emerging trends in health and social care. Collectively, these trends suggest that future systems are likely to be characterised by increasingly sophisticated technology; but at the same time greater personal and community responsibility for health and well-being, innovative use of social capital, and a new approach to ageing and end-of-life-care. What are the implications for practitioners? It is becoming increasingly clear that radical change is necessary and there are emerging examples of novel and creative initiatives across many areas of practice. Practitioners need to be engaged in, contributing to and in some cases, leading, this transition to a new health and social care system.

scholarly journals Exploring the impacts of the 2012 Health and Social Care Act reforms to commissioning on clinical activity in the English NHS: a mixed methods study of cervical screening

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024156 ◽  
Author(s):  
Jonathan Hammond ◽  
Thomas Mason ◽  
Matt Sutton ◽  
Alex Hall ◽  
Nicholas Mays ◽  
...  
Keyword(s):  
Quantitative Methods ◽  
Social Care ◽  
Local Authority ◽  
Service Providers ◽  
Cervical Screening ◽  
Unintended Consequences ◽  
Clinical Activity ◽  
Local Authorities ◽  
Health And Social Care ◽  
The Impact

ObjectivesExplore the impact of changes to commissioning introduced in England by the Health and Social Care Act 2012 (HSCA) on cervical screening activity in areas identified empirically as particularly affected organisationally by the reforms.MethodsQualitative followed by quantitative methods. Qualitative: semi-structured interviews (with NHS commissioners, managers, clinicians, senior administrative staff from Clinical Commissioning Groups (CCGs), local authorities, service providers), observations of commissioning meetings in two metropolitan areas of England. Quantitative: triple-difference analysis of national administrative data. Variability in the expected effects of HSCA on commissioning was measured by comparing CCGs working with one local authority with CCGs working with multiple local authorities. To control for unmeasured confounders, differential changes over time in cervical screening rates (among women, 25–64 years) between CCGs more and less likely to have been affected by HSCA commissioning organisational change were compared with another outcome—unassisted birth rates—largely unaffected by HSCA changes.ResultsInterviewees identified that cervical screening commissioning and provision was more complex and ‘fragmented’, with responsibilities less certain, following the HSCA. Interviewees predicted this would reduce cervical screening rates in some areas more than others. Quantitative findings supported these predictions. Areas where CCGs dealt with multiple local authorities experienced a larger decline in cervical screening rates (1.4%) than those dealing with one local authority (1.0%). Over the same period, unassisted deliveries decreased by 1.6% and 2.0%, respectively, in the two groups.ConclusionsArrangements for commissioning and delivering cervical screening were disrupted and made more complex by the HSCA. Areas most affected saw a greater decline in screening rates than others. The fact that this was identified qualitatively and then confirmed quantitatively strengthens this finding. The study suggests large-scale health system reforms may have unintended consequences, and that complex commissioning arrangements may be problematic.

scholarly journals Financing of Health Care in the Conditions of Pandemic Threats

Federalism ◽  
2020 ◽  
pp. 110-116
Author(s):  
A. G. Kolomiets
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Social Groups ◽  
Regional Health ◽  
Free Riders ◽  
Regional Health Care ◽  
Care Systems ◽  
The Usa ◽  
Using Data ◽  
Excess Profit

The author, using data of health care systems and COVID in the USA, Italy and other countries makes a conclusion that effective parrying of pandemic threats demands correction of a health care system and its financing. In particular, expansion of access for «marginal» social groups to services of out-patient and polyclinic institutions including non-payable services on a constant basis is necessary. Situation when involvement of the low-paid migrants who are actually excluded from regional health care systems allows to get excess profit for employers, creates for society not only additional expenses, but also risks of catastrophic development of epidemiological situations. Such employers are a kind of «free-riders» too expensive for society.

scholarly journals The National Practice Benchmark for Oncology: 2015 Report for 2014 Data

2016 ◽  
Vol 12 (4) ◽  
pp. e437-e475 ◽  
Author(s):  
Carla Balch ◽  
John D. Ogle ◽  
James L. Senese
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Business Practices ◽  
Competitive Advantages ◽  
Regional Health ◽  
Regional Health Care ◽  
Community Oncology ◽  
Care Systems ◽  
National Practice ◽  
Business Structure

The National Practice Benchmark (NPB) is a unique tool used to measure oncology practices against others across the country in a meaningful way despite variations in practice demographics, size, and setting. In today’s challenging economic environment, each practice positions service offerings and competitive advantages to attract patients. Although the data in the NPB report are primarily reported by community oncology practices, the business structure and arrangements with regional health care systems are also reflected in the benchmark report. The ability to produce detailed metrics is an accomplishment of excellence in business and clinical management. With these metrics, a practice should be able to measure and analyze its current business practices and make appropriate changes, if necessary. In this report, we build on the foundation initially established by Oncology Metrics (acquired by Flatiron Health in 2014) over years of data collection and refine definitions to deliver the NPB, which is uniquely meaningful in the oncology market.

scholarly journals The governance of pluralist health care systems: An initial review and typology

2016 ◽  
Vol 30 (2) ◽  
pp. 61-71 ◽  
Author(s):  
Ewan Ferlie ◽  
Juan I. Baeza ◽  
Rachael Addicott ◽  
Rakesh Mistry
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Empirical Investigation ◽  
Social Care ◽  
Health Care Systems ◽  
Health Care Sector ◽  
Governance Systems ◽  
Health And Social Care ◽  
Care Systems ◽  
Care System

We here argue that study of governance systems within increasingly pluralist health care systems needs to be broadened beyond traditionally public sector orientated literature. We develop an initial typology of multiple governance systems within the English health care sector and derive exploratory questions to inform future empirical investigation. We add to existing literature by considering the coexistence of – and possible tensions between – multiple governance systems in a pluralised health and social care system.

scholarly journals Health management at the regional level: multivariable performance assessment

2020 ◽  
Vol 1 (2) ◽  
pp. 8-16
Author(s):  
Andrii Shipko ◽  
Nadiia Demikhova ◽  
Krzysztof Pajak ◽  
Vira Motrechko
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Systems ◽  
Functional Model ◽  
Regional Health ◽  
Health Technologies ◽  
Regional Health Care ◽  
Study Results ◽  
Care Systems ◽  
Legislative Initiative

This article provides an analysis of areas for improving the state policy bases in public health services. The purpose of the research is to substantiate and develop systematized regulatory support for the structural-functional care model for children in particular regions. The authors systematized the legislative acts on the health technologies introduction in the structural-functional model. To achieve the study goal, the authors used a systematic approach to provide quantitative and qualitative analysis of the organization and optimization of medical-social justification of the structural-functional model; bibliosemantic – for the analysis of national and international experience in providing medical care to patients; epidemiological – to determine the levels, structure and dynamics of morbidity and prevalence of pathology in childhood; statistical – for collecting, processing and analyzing received information. The article presented the authors’ development on regulatory support for the structural-functional medical model components for children. Besides, special attention was paid to the improvement of health technologies in regional health care systems. The authors identified areas for implementing the legislative initiative to improve the regulatory support for medical care provision. This paper provides the author’s regulatory support of structural-functional medical model’s components toward children with bronchopulmonary dysplasia and dysplastic pathology of the bronchopulmonary system. The authors emphasized the improvement of health technologies in regional health care systems. To improve the area of legislative and regulatory support, the study identified the directions for implementing the legislative initiative. Based on the study results, the authors proposed considering 7 legislative acts of Ukraine on improving the normative-legal provision of components of the structural-functional model. The obtained results could further assess their impact on implementing health technologies at the regional, municipal and family levels.

Integrated care nursing in Canterbury, New Zealand

2016 ◽  
Vol 24 (3) ◽  
pp. 150-160 ◽  
Author(s):  
Lynne Wigens
Keyword(s):  
Integrated Care ◽  
Social Care ◽  
Health Care Systems ◽  
Positive Culture ◽  
Content Type ◽  
Nurse Leadership ◽  
Care Services ◽  
Health And Social Care ◽  
Care Systems ◽  
Travel Scholarship

Purpose – The purpose of this paper is to outline how nursing has contributed to the development of integrated care in an internationally recognised centre of excellence (Timmins and Ham, 2013). Design/methodology/approach – During a three-week travel scholarship the author undertook interviews, focus groups and observation and has reflected on this through three themes. These are: system working, nursing leadership and examples of integrated care in action. Findings – Elements of the Canterbury approach could have implications for other health care systems, e.g. New Care Models within England. Time was spent on developing the vision, involving many staff. Stability in the senior leadership team allowed decisions to be made in a collective, transformational way. Nurse leadership authenticity meant nursing staff saw integrated decision making being role modelled at a senior level and this appeared to empower them to operate in a similar way. Time was invested in redesign. Creating a positive culture where innovation was tried, without staff feeling the risks and challenges would not be supported by their leaders. Originality/value – This system worked most effectively where there was cohesion between health and social care, and strong relationships developed between leaders and staff working for different providers. The reflection includes practice examples of integrated care services in action. There is potential to inform integrated care developments within other health and social care systems, e.g. Vanguards within England.

scholarly journals The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Pomey ◽  
M. de Guise ◽  
M. Desforges ◽  
K. Bouchard ◽  
C. Vialaron ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Patient Experience ◽  
Emotional Support ◽  
Social Care ◽  
Legal Issues ◽  
Care Services ◽  
Health And Social Care ◽  
Ethical And Legal Issues ◽  
The Impact

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.

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