Legitimate Decision Making: The Achilles' Heel of Solidaristic Health Care Systems

2000 ◽  
Vol 5 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Nicholas Mays
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Systems ◽  
Health Care Systems ◽  
Scarce Resources ◽  
The Future ◽  
Care Systems

The future sustainability of ‘solidaristic’ or universal publicly financed health systems is frequently said to be threatened by lack of resources as rising demand collides with the growing reluctance of the better-off to pay for services mainly used by others. Competitive health care arrangements are also regarded as threatening solidarity. By contrast, I argue that the main threat to the sustainability of such systems lies in the inability of so-called ‘advanced’ societies to develop institutions that are capable of acceptably reconciling inevitably scarce resources with individual and collective desires to have all the health care we want. Many ‘advanced’ societies lack, or fail to incorporate into their health systems, the range of intermediate institutions that could potentially help in more effectively reconciling individual wants with collectively determined levels of resources.

scholarly journals Covid-19 FAQ’s in Paediatric and Congenital Cardiology – AEPC position paper.

2021 ◽  
pp. 1-21
Author(s):  
Skaiste Sendzikaite ◽  
Ruth Heying ◽  
Ornella Milanesi ◽  
Katarina Hanseus ◽  
Ina Michel-Behnke
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Data ◽  
Position Paper ◽  
Paediatric Cardiology ◽  
European Paediatric ◽  
Care Systems ◽  
The Times ◽  
Almost All

Abstract The Covid-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with Covid-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology (AEPC) receive many questions regarding Covid-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding Covid-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.

scholarly journals Unmasking a health care system: the Dutch policy response to the Covid-19 crisis

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Health Care Systems ◽  
Economic Policies ◽  
Hard Time ◽  
Dutch Health ◽  
Care Systems ◽  
Policy Systems ◽  
Care System

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.

scholarly journals Journey of the Patient With Melanoma: Understanding Resource Use and Bridging the Gap Between Dermatologist, Surgeon, and Oncologist in Different Health Care Systems

2019 ◽  
pp. 1-8
Author(s):  
Cássia Rita Pereira da Veiga ◽  
Claudimar Pereira da Veiga ◽  
Ana Paula Drummond-Lage ◽  
Alberto Julius Alves Wainstein ◽  
Andreia Cristina de Melo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Health Resources ◽  
Medical Professionals ◽  
Public And Private ◽  
Patients With Cancer ◽  
Clinical Procedures ◽  
Care Systems

PURPOSE New scientific evidence has led to modifications in the clinical practice of handling melanoma. In health care systems, there is currently a wide variety of clinical procedures to treat cancer, and the various routes have different effects on the survival of patients with cancer. Thus, this article aimed to evaluate the journey of patients with melanoma in the public and private health care systems in Brazil from the viewpoint of different medical professionals involved in the diagnosis and treatment of the disease. The study also considers the resources used for the complete delivery cycle of health care at different stages of the evolution of melanoma. METHODS We conducted a behavioral study by applying a questionnaire to a group of medical professionals. A nonprobabilistic sampling method for convenience was used, justified by the heterogeneous national incidence and the limited availability of medical professionals who diagnose and treat melanoma. RESULTS The questionnaire was answered by 138 doctors, including doctors from the Brazilian states with the highest concentration of medical specialists and regions with a higher melanoma incidence. The results of this study have the potential to enrich our understanding of the reality of Brazilian health care systems and, at the same time, allow us to discuss the multiple ways in which professionals from diverse specialist fields understand and explain decision making in health care. CONCLUSION Health care decision making is complex and, among other factors, depends on the diversity of available health resources and the knowledge of which treatments provide the greatest benefit to patients and greatest value to the system as a whole. This work can inform debates and reflection that are applicable not only in Brazil, but also in various other countries with similar realities.

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.

scholarly journals Back to the Future: Principles on Resuming Outpatient Services in the COVID-19 Era

2020 ◽  
Vol 163 (4) ◽  
pp. 705-706 ◽  
Author(s):  
Taher S. Valika ◽  
Kathleen R. Billings
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Outpatient Services ◽  
Drastic Reduction ◽  
The Public ◽  
Outpatient Visits ◽  
The Future ◽  
Care Systems

The rapidly changing health care climate related to coronavirus disease 2019 (COVID-19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to outpatient care.

Patient Choice and Patient Empowerment in Northern European Health Systems: A Conceptual Framework

1994 ◽  
Vol 24 (2) ◽  
pp. 201-229 ◽  
Author(s):  
Richard B. Saltman
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Patient Empowerment ◽  
Patient Choice ◽  
Care Providers ◽  
Care Systems ◽  
European Health ◽  
The Impact

The issue of patient choice presents a complicated challenge to publicly operated health systems. Increased patient choice can strengthen the citizen's commitment to traditional welfare state objectives, or alternatively, it can severely damage that commitment, depending upon the design of the choice mechanism and the structural context within which patient choice occurs. For patient choice to be linked to true empowerment, choice must reinforce rather than undercut the accountability of health care providers to the population they serve. This article explores the basic issues involved in empowering patients within publicly operated health systems. The author first reviews the conceptual components that could or should be incorporated within the notion of empowered patients, then examines what would be required to actually empower patients within health systems, defined in terms of expanding not only logistical choice but also clinical influence and decision-making participation. The article concludes with a wide-ranging analysis of the impact of potential policies and mechanisms on the long-term objectives of achieving democratically accountable health care systems.

Mental Health Care Funding Systems and their Impact on Access to Psychotherapy

2020 ◽  
Author(s):  
Joelle Robertson-Preidler ◽  
Nikola Biller-Andorno ◽  
Tricia Johnson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Distributive Justice ◽  
Health Systems ◽  
Health Care Systems ◽  
Resource Scarcity ◽  
Trade Offs ◽  
Health Care Funding ◽  
Care Systems

Resource scarcity forces health care systems to set priorities and navigate trade-offs in how they choose to fund different services. Distributive justice principles can help guide health systems to fairly allocate scarce resources in a society. In most countries, mental health care and psychotherapy, in particular, tend to be under-prioritized even though psychotherapy can be an effective treatment for mental health disorders. To create ethical funding systems that support appropriate access to psychotherapy, health care funding systems must consider how they allocate and distribute health care resources through health care financing, coverage criteria, and reimbursement mechanisms. Five health care systems are assessed according to how they finance and reimburse psychotherapy. These health systems use various and often pluralistic approaches that encompass differing distributive justice principles. Although distribution priorities and values may differ, fair and transparent processes that involve all key stakeholders are vital for making ethical decisions on access and distribution.

The Corporatization of Health Care: An Evaluation and An Alternative

1996 ◽  
Vol 9 (2) ◽  
pp. 107-114 ◽  
Author(s):  
K. Jacobs ◽  
V. Nilakant
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Work Organization ◽  
Corporate Form ◽  
Care Systems ◽  
The Usa ◽  
The Impact ◽  
Medical Task

The corporatization of health care organizations has become a significant international trend. This paper examines that trend, comparing the development of corporate health care in the USA with the impact of the New Zealand health reforms. The paper traces the evolution of the organizations of health care systems and explains the emergence of the corporate form. We argue that the corporate model of work organization is unsuited to the complex and ambiguous nature of the medical task as it ignores inherent interdependencies. An alternative is needed which addresses work practices rather than just participation in decision making and is based on a concept of mutual interdependence and support in the execution of work.

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.

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