scholarly journals Robotic surgery in Nigeria: an uncertain possibility

2020 ◽  
Vol 7 (11) ◽  
pp. 3876
Author(s):  
Tunde A. Oyebamiji
Keyword(s):  
Health Care ◽  
Robotic Surgery ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Surgical Robot ◽  
Surgical Robots ◽  
Middle Income ◽  
Care Systems ◽  
The Cost ◽  
Developed Nations

Since its introduction about 2 decades ago, surgical robots are becoming increasingly used in many surgical operations. The emerging technology has increased the efficiency, reliability and precision of surgical procedures. It has minimized overall post-operative complications and led to faster patient recovery. Although there are some limitations to robotic surgery, its many advantages have generated great excitement within the surgical community. Thus, there is an exponential growth in the use of the surgical robot across numerous surgical specialties and in many developed nations of the world. In Africa, the robotic surgical system has only been adopted in South Africa and Egypt for limited surgical cases. However, there has been no documented use in Nigeria. The implementation of robotic surgery in Nigeria is been hampered by low budget allocation to health, a regressive health care financing model, epileptic power supply and most of all, poor leadership make the implementation of robotic surgery in Nigeria challenging. The cost of acquiring and maintaining the surgical robot will gradually become cheaper as more robotic surgical manufacturers enter the marketplace, thereby making it more affordable and accessible in low- and middle-income countries. Effective leadership and critical investment in health care systems and human capital, will increase the possibility of implementing a robotic surgical program in the future.

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.

Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention

2017 ◽  
Vol 37 (03) ◽  
pp. 237-258 ◽  
Author(s):  
Amytis Towfighi ◽  
Valerie Hill
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Stroke Prevention ◽  
Health Care Systems ◽  
Dose Intensity ◽  
Lifestyle Changes ◽  
Theoretical Frameworks ◽  
Middle Income ◽  
Modifiable Factors ◽  
Care Systems

AbstractThe pathophysiology of stroke is well characterized, and 9 out of 10 strokes are due to modifiable factors. However, preventive strategies thus far have been relatively ineffective in curbing the global stroke burden, which is projected to increase given the aging of the world's population and epidemiological transition in many low- to middle-income countries. In this review we will summarize our current understanding of behavioral, environmental, and metabolic stroke risk factors not covered elsewhere in this issue. Specifically, we will review the evidence for environmental and household air pollution, smoking, and alcohol use. We will subsequently provide a conceptual framework for stroke prevention strategies, categorizing them as those aimed at changing health care systems and/or provider behavior and those targeting behaviors of patients and/or their caregivers, families, and support networks. The field of stroke prevention is relatively nascent, and little is known about how to optimize health care systems so that providers prescribe evidence-based care for stroke prevention, patients have access to care to receive such services, adherence and control of risk factors are optimized, and patients are empowered to manage their own risk factors and make lifestyle changes, including eating healthy diets (high in fruits, vegetables, and whole grains and low in sodium and sugar-sweetened beverages), engaging in regular physical activity, not smoking, and limiting alcohol consumption. In the next several years, we will likely develop a better understanding of which strategies are effective for modifying vascular risk factors, and how to design and implement successful interventions. Key questions to be answered include optimal theoretical frameworks, delivery models, team composition, timing, dose, intensity, and frequency, taking into account cultural, sociodemographic, and regional differences in patient populations.

scholarly journals How to assess the value of low-value care

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
José Antonio Sacristán
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Services ◽  
Health Care Systems ◽  
Effective Intervention ◽  
Use Of Resources ◽  
True Value ◽  
Care Systems ◽  
Definition Of ◽  
The Cost

Abstract Background Many of the strategies designed to reduce “low-value care” have been implemented without a consensus on the definition of the term “value”. Most “low value care” lists are based on the comparative effectiveness of the interventions. Main text Defining the value of an intervention based on its effectiveness may generate an inefficient use of resources, as a very effective intervention is not necessarily an efficient intervention, and a low effective intervention is not always an inefficient intervention. The cost-effectiveness plane may help to differentiate between high and low value care interventions. Reducing low value care should include three complementary strategies: eliminating ineffective interventions that entail a cost; eliminating interventions whose cost is higher and whose effectiveness is lower than that of other options (quadrant IV); and eliminating interventions whose incremental or decremental cost-effectiveness is unacceptable in quadrants I and III, respectively. Defining low-value care according to the efficiency of the interventions, ideally at the level of subgroups and individuals, will contribute to develop true value-based health care systems. Conclusion Cost-effectiveness rather than effectiveness should be the main criterion to assess the value of health care services and interventions. Payment-for-value strategies should be based on the definition of high and low value provided by the cost-effectiveness plane.

scholarly journals Health equality, social justice and the poverty of autonomy

2017 ◽  
Vol 12 (4) ◽  
pp. 411-433 ◽  
Author(s):  
Christopher Newdick
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Systems ◽  
Public Health Care ◽  
Public Health Policies ◽  
Public Health Systems ◽  
Care Systems ◽  
Health Equality ◽  
The Cost ◽  
Lifestyle Diseases

AbstractHow does the concept of autonomy assist public responses to ‘lifestyle’ diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a ‘nanny’ state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

Countering Moral Hazard in Public and Private Health Care Systems: A Review of Recent Evidence

1989 ◽  
Vol 18 (2) ◽  
pp. 235-251 ◽  
Author(s):  
Cam Donaldson ◽  
Karen Gerard
Keyword(s):  
Health Care ◽  
Health Services ◽  
Moral Hazard ◽  
Financial Incentives ◽  
Care Delivery ◽  
Health Care Systems ◽  
Health Care Financing ◽  
General Effect ◽  
Health Maintenance ◽  
Care Systems

ABSTRACTWithin both publicly and privately financed health care Systems different funding mechanisms have evolved, or have been proposed, to deal with the problem of ‘moral hazard’. Moral hazard arises when financial incentives within the health care System lead to either inefficient demands for care by consumers or inefficient supply of care by providers. In this paper the problem of moral hazard is outlined in more detail, and different ways of countering moral hazard are reviewed in terms of three criteria: effect on patient utilisation of health services in general; effect on utilisation by different groups of patients; and effect on health status. It is concluded that evidence on different methods of funding health services can only be judged in the context of objectives. If the objectives of health care delivery are ‘maintenance or improvement of health’ and ‘equal access for equal need’ then charges and finance of care through health maintenance organisations both appear to be less favourable than ‘free’ care at the point of delivery whilst the latter is not necessarily more costly as a resuit. Research on other suggested alternatives is required, otherwise radical changes to health care financing in the UK will simply result in movement from one unproven system to another.

scholarly journals Structural Barriers to Diagnosis and Treatment of Cancer in Low- and Middle-Income Countries: The Urgent Need for Scaling Up

2016 ◽  
Vol 34 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Eduardo Cazap ◽  
Ian Magrath ◽  
T. Peter Kingham ◽  
Ahmed Elzawawy
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Health Care Systems ◽  
Diagnosis And Treatment ◽  
Middle Income ◽  
Health Crisis ◽  
Middle Income Countries ◽  
Care Systems ◽  
Low And Middle Income

Noncommunicable diseases are now recognized by the United Nations and WHO as a major public health crisis. Cancer is a main part of this problem, and health care systems are facing a great challenge to improve cancer care, control costs, and increase systems efficiency. The disparity in access to care and outcomes between high-income countries and low- and middle-income countries is staggering. The reasons for this disparity include cost, access to care, manpower and training deficits, and a lack of awareness in the lay and medical communities. Diagnosis and treatment play an important role in this complex environment. In different regions and countries of the world, a variety of health care systems are in place, but most of them are fragmented or poorly coordinated. The need to scale up cancer care in the low- and middle-income countries is urgent, and this article reviews many of the structural mechanisms of the problem, describes the current situation, and proposes ways for improvement. The organization of cancer services is also included in the analysis.

Umverteilungseffekte in der Finanzierung von Gesundheitsleistungen / Redistribution Effects of Health Care Financing

2007 ◽  
Vol 227 (5-6) ◽  
Author(s):  
Florian Buchner ◽  
Rebecca Deppisch ◽  
Jürgen Wasem
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Social Health Insurance ◽  
Health Care Expenditures ◽  
Social Health ◽  
Financing System ◽  
Out Of Pocket Payments ◽  
Care Systems

SummaryHealth care systems are financed through a mixture of different components: taxes, contributions to social health insurance, premiums to private health insurance, out of pocket payments by patients. These components can be combined differently leading to specific effects of interpersonal redistribution. This can be compared between different countries. In such a comparison the redistributional impact of the German health care systems is rather regressive - which is basically caused by the opportunity for people with high income to leave social health insurance. In comparison to a health insurance system with risk rated premiums, financing of the German social health insurance leads to interpersonal redistribution from higher to lower income, from the young to the elderly, from healthy to sick and from singles to families with children. The pay-as-you-go character of the system leads especially in combination with an aging population and technological change to burden for future generations. In comparison to a system in which each region finances its own health care expenditures, there are also considerable interregional redistributions. The financing system in Germany is not conceptually consistent. Reform proposals (unified health insurance for all; flat rate premiums) tackle these inconsistencies.

scholarly journals The Role of Private Health Care Financing in the Central and Eastern European Countries

Ekonomika ◽  
2008 ◽  
Vol 83 ◽  
Author(s):  
Marta Borda
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Health Care Services ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Economic Transformation ◽  
Eastern European ◽  
Private Health Care ◽  
Out Of Pocket Payments ◽  
Care Systems

The economic transformation process in the central and Eastern European (CEE) countries has included, among others, a thorough reform of the previous, centrally planned health care systems. Consequently, the contemporary health care systems functioning in these countries, despite common directions of changes, vary in the area of detailed aspects. The purpose of the paper is to provide an overview of private sources of the health care financing (including out-of-pocket payments and prepaid plans), which are considered to be an important component of each health care system. In the first part of the paper, the results of comparative analysis of total health expenditure incurred by the CEE countries between 2000 and 2004 are presented in order to indicate the main trends, problems and differences among the analysed states. Next, the main types of private health expenditure are described and their contribution to the health care financing is presented. Finally, voluntary health insurance offered in the Polish market, considered as an additional method of health care financing. is characterized.The obtained results allow to compare and evaluate the range of using private health care funds in the analysed countries during the last few years. Moreover, the results indicate a need for the further development of private methods of health care financing. which in practice can supplement or duplicate health care services delivered by the public sector.

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