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.

scholarly journals NEED FOR DRUG PRICE CONTROL IN INDIA

2018 ◽  
Vol 1 (4) ◽  
pp. 12-18
Author(s):  
Sachin K. R. Parasiya ◽  
V. Balamuralidhara ◽  
Pramod Kumar T.M ◽  
A.J. Dave ◽  
R. Gujarati ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Essential Medicine ◽  
Care Facility ◽  
Price Control ◽  
Health Care Facilities ◽  
Pharmaceutical Pricing ◽  
Price Variation ◽  
Care Facilities ◽  
Care System

India is one of the developing countries. A substantial proportion of population of this country is largely exposed to the drug market whose purchasing power is extremely low. Around 42% population of this country lives under the National poverty line ($1.25 per day).  Vital issue concerning them is to access the health care facility at an affordable cost. Medicine is a part of health care cost and it costs to around 70% to 80% of total cost. Thus, cost of medicine is a governing factor of health care system especially when it comes to price control of health care facilities. To bring down the cost of health care facilities, government spends money for health care facilities. A comparative expenditure made by state government is depicted in this article. NPPA (National Pharmaceutical Pricing Authority) is the Indian pharmaceutical pricing regulating authority and it achieves its objectives by implementing the DPCO (Drug Pricing control order). In spite of existence of the DPCO, drastic price variation is observed between the products of same API (Active Pharmaceutical Ingredient) and several factors are responsible for the same. To overcome the stated problem and monopolistic trade practice by patent holder/brand manufacturer, TRIPS (Trade Related Intellectual Properties Rights) provides Compulsory Licenses which has its unique role to play in affordability of medicines. Essential medicine is a basic requirement of health care system to serve their customers and hence an effective and overt price control on drugs is the need of present. This study will thus try to justify the need to bring NLEM (National List of Essential Medicine) under DPCO.

scholarly journals Detection of imported COVID-19 cases worldwide: early assessment of airport entry screening, 24 January until 17 February 2020

2020 ◽  
Vol 48 (1) ◽  
Author(s):  
Varvara A. Mouchtouri ◽  
Zacharoula Bogogiannidou ◽  
Martin Dirksen-Fischer ◽  
Sotirios Tsiodras ◽  
Christos Hadjichristodoulou
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Facilities ◽  
Early Assessment ◽  
Point Of Entry ◽  
Care Facilities ◽  
Imported Cases ◽  
Early Case ◽  
Early Case Detection ◽  
Care System

Abstract The purpose of this study was to provide an overview of entry screening measures applied at airports in response to the COVID-19 epidemic worldwide. Between 24 January and 17 February 2020, 5.2% (95% CI 3.1–8.5) of the 271 total imported COVID-19 cases worldwide (excluding imported cases arriving in China, Macao, and Hong Kong) with known detection location were captured through airport entry screening. The majority of imported COVID-19 cases (210) were identified by the health care system (77.5%). Efforts should focus on health care system preparedness for early case detection, since according to our and previous studies health care facilities are the actual point of entry of imported cases.

scholarly journals COVID-19 in Italy: targeted testing as a proxy of limited health care facilities and a key to reducing hospitalization rate and the death toll

2020 ◽  
Author(s):  
Arnab Bandyopadhyay ◽  
Marta Schips ◽  
Tanmay Mitra ◽  
Sahamoddin Khailaie ◽  
Sebastian Binder ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Facilities ◽  
Effective Control ◽  
Death Toll ◽  
Care Facilities ◽  
Targeted Testing ◽  
Limited Health ◽  
The Impact ◽  
Care System

AbstractThe novel Coronavirus SARS-CoV-2 (CoV) has induced a worldwide pandemic, notably in Italy, one of the worst-hit countries in Europe, which witnessed a death toll unseen in the recent past. There are potentially many factors, such as infections from undetected index cases, early vs late testing strategies, limited health care facilities etc., that might have aggravated the COVID-19 situation in Italy. We developed a COVID-19 specific infection epidemic model composed of susceptible (S), exposed (E), carrier (C), infected (I), recovery (R) and dead (D) (SECIRD), specifically parameterized for Italy to disentangle the impact of these factors and their implications on infection dynamics to help planning an effective control strategy for a possible second wave. Our model discriminates between detected infected and undetected individuals who played a crucial role in the disease spreading and is not well addressed by classical SEIR-like transmission models. We first estimated the number of undetected infections through a Bayesian Markov Chain Monte Carlo (MCMC) framework, which ranges from ∼ 7 to ∼ 22 fold higher than reported infections, depending upon regions. We exploited this information to evaluate the impact of the undetected component on the evolution of the pandemic and the benefits of an enhanced testing strategy. In high testing regions like Veneto, 18% of all infections resulted in hospitalization, while for Lombardia and Piemonte, it is 25% and 27%, respectively. We investigated the impact of an overwhelmed health care system upon death toll by applying hospital and intensive care unit (ICU) capacities in the SECIRD model, and we estimated a 10% reduction in death in Lombardia, the worst hit region, if a higher number of hospital facilities had been available since the beginning. Adopting a combined strategy of rapid early and targeted testing (∼ 10 fold) with increased hospital capacity would help in avoiding bottlenecks affecting the health care system. Our results demonstrate that the early testing would have a strong impact on the overall hospital accessibility and, hence, upon death toll (∼20% to 50% reduction) and could have mitigated the lack of facilities at the crucial middle stage of the epidemic.

Implementation of care near home model (CNH) for cancer patients in response to COVID-19 pandemic.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 32-32
Author(s):  
Abdul-Rahman Jazieh ◽  
Nashmia Al Mutairi ◽  
Abdulrahman Al Hadab ◽  
Ashwaq Al Olayan ◽  
Ayman Al Hejazi ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Patients ◽  
Health Care System ◽  
Cancer Care ◽  
Health Care Facilities ◽  
Care Process ◽  
New Model ◽  
Care Facilities ◽  
Care System ◽  
Virtual Clinic

32 Background: Cancer care is heavily centered in health care facilities due to the requirements of providing complex multidisciplinary care with multiple testing and interventions. We describe our experience in implementing a new model of care to minimize cancer patients visit to health care facilities and to reduce the risk of infections and to decrease the pressure on the health care system. Methods: In response to the COVID-19 pandemic, we reengineered the cancer care process to reduce patients visit to the hospital by the implementation of a Care Near Home (CNH) Model, which comprises of four components: virtual clinic, laboratory testing near home, shipping medications and supplies, and involving local health care facilities. The effectiveness and acceptance of this new model has been assessed by the delivery of timely care successfully and assessing the satisfaction patients and healthcare providers. Results: On March 18, 2020, we launched the virtual clinics followed by different components of the model. The number of virtual clinic visits has increased significantly from 399 visits in March to 1107 in April 2020. More the 90% of physicians and patients who responded to the survey expressed their acceptance and satisfaction with the virtual clinic services. Medications were shipped to total of 603 patients. Of those, 578 (96%) patients received their medications (378 patients outside city, 200 patients inside city of which, 95% received medications within 24 hours). Only 25 (4%) patients did not receive their medications and we arrange for alternative solutions. Laboratories in various regions were set up to perform the tests for our patients and to communicate the results through our electronic healthcare records system. The process of ordering and performing the test were piloted with success and now we are at the scaling up phase. Conclusions: Although the implementation of CNH Model was driven by COVID-19 pandemic, it will be integrated in our work process and utilized as a long term approach to manage many of our patients because it is more convenient to them and more cost effective to the health care system.

Improvement of financial security of health system of the Russian Federation in modern conditions

2015 ◽  
Vol 9 (2) ◽  
pp. 0-0
Author(s):  
Наталья Махнова ◽  
Natalya Makhnova
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Russian Federation ◽  
Single Channel ◽  
Health Care Facilities ◽  
Financing System ◽  
Medical Institutions ◽  
The Russian Federation ◽  
Care System

The essence of the problems and ways of improving the single-channel system of financial support of health care system implemented in the Russian Federation today are described in the article. The basic advantages (payment of the final result, the principle of extraterritoriality, etc.) and disadvantages of this type of financing (the growth of corruption in health care facilities, the claiming by regional authorities in advance reduced volumes of work of medical institutions under the territorial program programs of compulsory health insurance etc.) are highlighted. The legal aspects of functioning of the single-channel financing system are represented. In our view the measures for optimize the work of the health system in the Russian Federation should include: transition to the new salary system of health workers and the development of basic and additional list of criteria for the effectiveness of both health professionals and managers of health facilities. The problem of satisfaction of staff requirements in the Russian health care system has a systemic, multifactorial character. Forming an interconnected list of criteria of efficiency of medical staff and their managers would allow, on the one side to attract qualified staff to the region, on the other - to improve control of financial and economic activity of the heads of medical institutions. Furthermore, these measures will allow slightly reduce social tension among health care workers, that will positively impact on the quality of medical care.

scholarly journals Tuberculosis in the veterans healthcare system: a six-year review and evaluation of programme effectiveness

2000 ◽  
Vol 125 (2) ◽  
pp. 315-323 ◽  
Author(s):  
G. A. ROSELLE ◽  
L. H. DANKO ◽  
S. M. KRALOVIC ◽  
L. A. SIMBARTL ◽  
K. W. KIZER
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Hospital Setting ◽  
Health Care Facilities ◽  
Successful Outcome ◽  
Multi Drug Resistance ◽  
Veterans Health ◽  
Free Standing ◽  
Care Facilities ◽  
Care System

The Department of Veterans Affairs operates a large, centrally administered health care system consisting of 173 hospitals and 4 free standing outpatient clinics nationwide with approximately 945115 hospital discharges, 24·2 million outpatient visits, and 2·86 million persons served annually over the time frame of the review. The purpose of the study was to define whether such a system could effect timely change in the incidence of tuberculosis (TB) using centralized programme planning and flexible field implementation. A retrospective review of the number of newly diagnosed cases of active TB treated at veterans health care facilities between 1 October 1990 and 30 September 1997 was determined by using a standardized annual case census.Intervention included implementation of the most current guidelines for the prevention of transmission of TB in the community and hospital setting, including administrative and engineering controls and a change in personal protective equipment. Centrally directed programme guidance, education, and funding were provided for field use in health care facilities of widely varying size and complexity.The numbers of total reported cases of TB decreased significantly (P < 0·001) throughout the veterans health care system (nationally and regionally), with the case rate decreasing at a rate significantly greater than that seen in the USA as a whole (P < 0·0001). TB associated with multi-drug resistance (isoniazid and rifampin) and HIV coinfection also significantly decreased over the study period. Therefore, a large, centrally administered health care system can effectively combat a re-emerging infectious disease and may also demonstrate a successful outcome greater than seen in other, perhaps less organized health care settings.

scholarly journals Determinants of vaccination after the Colombian health system reform

2005 ◽  
Vol 39 (3) ◽  
pp. 421-429 ◽  
Author(s):  
Naydú Acosta-Ramírez ◽  
Luis G Durán-Arenas ◽  
Julia I Eslava-Rincón ◽  
Julio C Campuzano-Rincón
Keyword(s):  
Health Care ◽  
Health System ◽  
Healthcare System ◽  
Health Care System ◽  
Care Delivery ◽  
Behavioral Model ◽  
Population Characteristics ◽  
System Reform ◽  
Poor Population ◽  
Care System

OBJECTIVE: To assess the effects of individual, household and healthcare system factors on poor children's use of vaccination after the reform of the Colombian health system. METHODS: A household survey was carried out in a random sample of insured poor population in Bogota, in 1999. The conceptual and analytical framework was based on the Andersen's Behavioral Model of Health Services Utilization. It considers two units of analysis for studying vaccination use and its determinants: the insured poor population, including the children and their families characteristics; and the health care system. Statistical analysis were carried out by chi-square test with 95% confidence intervals, multivariate regression models and Cronbach's alpha coefficient. RESULTS: The logistic regression analysis showed that vaccination use was related not only to population characteristics such as family size (OR=4.3), living area (OR=1.7), child's age (OR=0.7) and head-of-household's years of schooling (OR=0.5), but also strongly related to health care system features, such as having a regular health provider (OR=6.0) and information on providers' schedules and requirements for obtaining care services (OR=2.1). CONCLUSIONS: The low vaccination use and the relevant relationships to health care delivery systems characteristics show that there are barriers in the healthcare system, which should be assessed and eliminated. Non-availability of regular healthcare and deficient information to the population are factors that can limit service utilization.

scholarly journals HEALTH SYSTEM REFORM IN UKRAINE AND FOREIGN EXPERIENCE OF FINANCING MODELS

2020 ◽  
Vol 8 (1) ◽  
pp. 100-107
Author(s):  
M. Yu. Yusiuk ◽  
A. M. Yusiuk ◽  
L. A. Yusiuk
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Health Financing ◽  
System Reform ◽  
Medical Reform ◽  
Current State ◽  
The Moment ◽  
Quantitative Indicators ◽  
Care System

Inroduction. Due to the fact that the reform of the healthcare system in Ukraine is in transition phase at the moment and, in addition, from April 1, 2020 changes are introduced at the second level of healthcare, it is advisable to describe the current state of medical reform in Ukraine, plans and prospects for further implementation and development, as well as the establishment of the features of various health financing systems and comparing the level of expenditures on the medical industry between countries, experience of which should be taken into account. Materials and Methods. The article uses the reports of the Ministry of Health of Ukraine and the analytical materials of medical experts. In addition, when analyzing various models of financing the health system and their features, quantitative indicators of expenditures of the countries surveyed are used. A comparison is made of the level of expenditures on the health care system between Ukraine and some European countries: Great Britain, the Czech Republic, Poland and Germany. Discussion. The main achievements of the first stage of the health care reform and plans for further changes are described. The strengths and weaknesses of each model of financing the health system are identified. It is proved that the level of government spending on the health care system in Ukraine is the smallest among the other countries examined, but one of the largest in terms of payments out of pocket. In addition, a model has been established for financing the health care system in Ukraine, which most fully meets it in modern conditions.

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