Evolving Federal and State Health Care Policy: Toward a More Integrated and Comprehensive Care-Delivery System for Children With Medical Complexity

PEDIATRICS ◽  
2018 ◽  
Vol 141 (Supplement 3) ◽  
pp. S259-S265 ◽  
Author(s):  
Carolyn S. Langer ◽  
Richard C. Antonelli ◽  
Lisa Chamberlain ◽  
Richard J. Pan ◽  
David Keller
2017 ◽  
Vol 21 (3) ◽  
pp. 263-272 ◽  
Author(s):  
Anne Elizabeth Glassgow ◽  
Molly A Martin ◽  
Rachel Caskey ◽  
Melishia Bansa ◽  
Michael Gerges ◽  
...  

2020 ◽  
Vol 26 (5) ◽  
pp. 351 ◽  
Author(s):  
Ryuki Kassai ◽  
Chris van Weel ◽  
Karen Flegg ◽  
Seng Fah Tong ◽  
Tin Myo Han ◽  
...  

Primary health care is essential for equitable, cost-effective and sustainable health care. It is the cornerstone to achieving universal health coverage against a backdrop of rising health expenditure and aging populations. Implementing strong primary health care requires grassroots understanding of health system performance. Comparing successes and barriers between countries may help identify mutual challenges and possible solutions. This paper compares and analyses primary health care policy in Australia, Malaysia, Mongolia, Myanmar, Thailand and Vietnam. Data were collected at the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Asia–Pacific regional conference in November 2017 using a predetermined framework. The six countries varied in maturity of their primary health care systems, including the extent to which family doctors contribute to care delivery. Challenges included an insufficient trained and competent workforce, particularly in rural and remote communities, and deficits in coordination within primary health care, as well as between primary and secondary care. Asia–Pacific regional policy needs to: (1) focus on better collaboration between public and private sectors; (2) take a structured approach to information sharing by bridging gaps in technology, health literacy and interprofessional working; (3) build systems that can evaluate and improve quality of care; and (4) promote community-based, high-quality training programs.


2005 ◽  
Vol 35 (3) ◽  
pp. 443-463 ◽  
Author(s):  
Stephen Birch ◽  
Amiram Gafni

Health care policy in Canada is based on providing public funding for medically necessary physician and hospital-based services free at the point of delivery (“first-dollar public funding”). Studies consistently show that the introduction of public funding to support the provision of health care services free at the point of delivery is associated with increases in the proportionate share of services used by the poor and in population distributions of services that are independent of income. Claims about the success of Canada's health care policy tend to be based on these findings, without reference to medical necessity. This article adopts a needs-based perspective to reviewing the distribution of health care services. Despite the removal of user prices, significant barriers remain to services being distributed in accordance with need—the objective of needs-based access to services remains elusive. The increased fiscal pressures imposed on health care in the 1990s, together with the failure of health care policy to encompass the changing nature of health care delivery, seem to represent further departures from policy objectives. In addition, there is evidence of increasing public dissatisfaction with the performance of the system. A return to modest increases in public funding in the new millennium has not been sufficient to arrest these trends. Widespread support for first-dollar public funding needs to be accompanied by greater attention to the scope of the legislation and the adoption of a needs-based focus among health care policymakers.


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