SUMMATION AND COMMENTARY

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1124-1127
Author(s):  
C. ARDEN MILLER
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Care Systems ◽  
Health Care Financing ◽  
International Comparisons ◽  
The United States ◽  
Individual Responsibility ◽  
The Us ◽  
Care Systems ◽  
Western Democracies

The background papers and presentations document causes for concern about the health of children in the United States. Discussions at the conference affirm a zeal to improve supports and services on behalf of children. The international comparisons stimulate thinking on the approaches that are best suited for this country. Voices will be raised that the US must work out its own solutions and that we cannot learn from what other countries are doing. Understandings are firm that every nation's health care systems grow out of unique political, social, and economic traditions, but those systems are not immutable. A limited number of strategies are available to help children and young families. Insofar as the policies that enable those strategies can be clarified, the likelihood of developing the best approaches for this country is improved. We are grateful for the analysis of policies that prevail in other Western democracies. One of the impressive aspects of health services for children in the five nations represented here is their differences. Health care financing and provider systems differ markedly; they are not cookie-cutter programs. Those differences present a responsibility to identify themes that are common to the nations with the best records of child health. Such themes deserve careful attention. The first of the themes is the need for government action. The US has been through a decade of trying market systems featuring deregulation, individual responsibility, and volunteerism. The impression of most analysts is that these approaches have not worked. Important indicators of child health have worsened or previous favorable trends have slowed.

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.

Continental Divide? The Attitudes of US and Canadian Oncologists on the Costs, Cost-Effectiveness, and Health Policies Associated With New Cancer Drugs

2010 ◽  
Vol 28 (27) ◽  
pp. 4149-4153 ◽  
Author(s):  
Scott R. Berry ◽  
Chaim M. Bell ◽  
Peter A. Ubel ◽  
William K. Evans ◽  
Eric Nadler ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Systems ◽  
The United States ◽  
Drug Costs ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Care Systems ◽  
Effective Treatments

Purpose Oncologists in the United States and Canada work in different health care systems, but physicians in both countries face challenges posed by the rising costs of cancer drugs. We compared their attitudes regarding the costs and cost-effectiveness of medications and related health policy. Methods Survey responses of a random sample of 1,355 United States and 238 Canadian medical oncologists (all outside of Québec) were compared. Results Response rate was 59%. More US oncologists (67% v 52%; P < .001) favor access to effective treatments regardless of cost, while more Canadians favor access to effective treatments only if they are cost-effective (75% v 58%; P < .001). Most (84% US, 80% Canadian) oncologists state that patient out-of-pocket costs influence their treatment recommendations, but less than half the respondents always or frequently discuss the costs of treatments with their patients. The majority of oncologists favor more use of cost-effectiveness data in coverage decisions (80% US, 69% Canadian; P = .004), but fewer than half the oncologists in both countries feel well equipped to use cost-effectiveness information. Majorities of oncologists favor government price controls (57% US, 68% Canadian; P = .01), but less than half favor more cost-sharing by patients (29% US, 41% Canadian; P = .004). Oncologists in both countries prefer to have physicians and nonprofit agencies determine whether drugs provide good value. Conclusion Oncologists in the United States and Canada generally have similar attitudes regarding cancer drug costs, cost-effectiveness, and associated policies, despite practicing in different health care systems. The results support providing education to help oncologists in both countries use cost-effectiveness information and discuss drug costs with their patients.

scholarly journals Η επίδραση του θεσμικού, πολιτικού και διοικητικού περιβάλλοντος στη μεταρρύθμιση του τομέα της υγείας στην Ελλάδα, 1950-2005

2013 ◽  
Author(s):  
Ηλίας Γορανίτης
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Health Care Systems ◽  
Implementation Process ◽  
The United States ◽  
International Experience ◽  
Health Care Reforms ◽  
Care Systems ◽  
Veto Points ◽  
Theories Of Change

The Greek NHS, thirty years after its establishment, faces important performance deficiencies. With an ongoing economic crisis placing a further burden, a call for national health care reform is urgent. This doctoral thesis drawing upon (a) political theories of change, (b) institutional, political and administrative developments in Greece as well as (c) international experience, aims to provide a framework, in terms of planning and implementation process, for health care reform in Greece. The existing order of things, in every public policy system, impedes change and forces policies along specific paths, the deviation from which to a new policy paradigm is extremely difficult. The Greek NHS has never deviated from this path indicating the existence of strong interest groups, institutions with high set-up cost and limited political willingness or ability for strategic approach to overcome the ‘veto points’ of the reform in the system. In this thesis the way forward in reforming fragmented and path-dependent health care systems like the Greek NHS has been identified. By addressing big questions such as: How the Greek NHS reached this low performing level? What are the ingredients of a well performing health care system? What factors impede or promote successful reforms? How health care reforms in systems with multiple ‘veto points’ should be implemented? Political science and international experience from Spain, Portugal, Italy, the Netherlands and the United States provide important insights to our study.

scholarly journals Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. 215-220 ◽  
Author(s):  
Akanksha Sharma ◽  
Christina R. Maxwell ◽  
Jill Farmer ◽  
Diana Greene-Chandos ◽  
Kathrin LaFaver ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The United States ◽  
Survey Study ◽  
Practice Model ◽  
Safety Measures ◽  
Public Health Emergencies ◽  
Care Workers ◽  
Rapid Changes ◽  
Care Systems

ObjectiveTo test the hypothesis that US neurologists were experiencing significant challenges with lack of personal protective equipment (PPE), rapid changes in practice, and varying institutional protocols, we conducted this survey study. The current coronavirus disease of 2019 (COVID-19) pandemic has caused widespread disease and death. Rapid increases in patient volumes have exposed weaknesses in health care systems and challenged our ability to provide optimal patient care and adequate safety measures to health care workers (HCWs).MethodsA 36-item survey was distributed to neurologists around the United States through various media platforms.ResultsOver a 1-week period, 567 responses were received. Of these, 56% practiced in academia. A total of 87% had access to PPE, with 45% being asked to reuse PPE due to shortages. The pandemic caused rapid changes in practice, most notably a shift toward providing care by teleneurology, although a third experienced challenges in transitioning to this model. Wide variations were noted both in testing and in the guidance provided for the exposed, sick, or vulnerable HCWs. Notably, 59% of respondents felt that their practices were doing what they could, although 56% did not feel safe taking care of patients.ConclusionsResults from our survey demonstrate significant variability in preparedness and responsiveness to the COVID-19 pandemic in neurology, affected by region, health care setting, and practice model. Practice guidelines from professional societies and other national entities are needed to improve protection for physicians and their patients, promote recommended practice changes during a pandemic, and optimize future preparedness for public health emergencies.

scholarly journals Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US

2020 ◽  
Vol 180 (10) ◽  
pp. 1328 ◽  
Author(s):  
Molly M. Jeffery ◽  
Gail D’Onofrio ◽  
Hyung Paek ◽  
Timothy F. Platts-Mills ◽  
William E. Soares ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Health Care Systems ◽  
Emergency Department Visits ◽  
The Us ◽  
Care Systems

Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness

2015 ◽  
Vol 10 (1) ◽  
pp. 161-164 ◽  
Author(s):  
John Walsh ◽  
Allan Graeme Swan
Keyword(s):  
United States ◽  
Health Care ◽  
United Kingdom ◽  
Emergency Management ◽  
Emergency Preparedness ◽  
Health Care Systems ◽  
Management Strategies ◽  
The United States ◽  
The United Kingdom ◽  
Care Systems

ABSTRACTThe process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems. (Disaster Med Public Health Preparedness. 2016;10:161–164)

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