scholarly journals The Limits of Free Health Care Schemes: the Case of Access to Care for Beneficiaries of the Moroccan Medical Assistance Scheme (RAMed) Suffering From Cancer

2021 ◽  
Author(s):  
Jean-Noël Ferrié ◽  
Mohammed Ababou ◽  
Wassila Benkirane ◽  
Zineb Omary ◽  
Saadia Radi
Keyword(s):  
Free Access ◽  
African Continent ◽  
Medical Assistance ◽  
Structured Interviews ◽  
Cost Of Transport ◽  
Qualitative Survey ◽  
The Poor ◽  
Free Service ◽  
Free Health Care ◽  
The Cost

Abstract Background: The article discusses the limitations of a free-of-charge scheme for the poor in the case of cancer patients. The literature on free access to hospitals, especially on the African continent, has already mentioned these limits: occasional payments for care and transport. The particularly ambitious Moroccan free-of-charge scheme (RAMEd) presents the same problemsMethods: It is based on a qualitative survey of 120 patients and 30 doctors or nurses with whom we conducted semi-structured interviews over several months.Results: The results show that patients continue to pay for care and medical imaging as well as their transport to the hospital. They pay for care and examinations that are not available at the hospital or wait for them to be available, which is a danger to their chances of survival.Conclusions: The limitation of the RAMed is that it does not cover the cost of transport or the structural deficiencies of the hospital. The result is the paradox of a free service that is costly for patients. We stress that targeted policies cannot replace structural policies and, on their own, do not remedy inequalities, particularly territorial inequalities.

scholarly journals L'émergence du référentiel marchand dans la tarification des cliniques privées algériennes : privatisation du financement et changement de paradigme

2021 ◽  
Vol 88 (1-2) ◽  
pp. 27-52
Author(s):  
Ahcène Zehnati
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Free Access ◽  
Gradual Change ◽  
Full Time ◽  
Structured Interviews ◽  
Time Activity ◽  
Private Healthcare ◽  
Qualitative Survey ◽  
Collective Commitment

Tariff convergence is part of the gradual privatization of the Algerian health care system that began in the late 1980s. The transition from a logic of free access to health care to a market logic represents an upheaval for patients. In order to understand the formation of tariffs in the private healthcare, we mixed a qualitative survey by semi-structured interviews with 16 founders of the clinics and the administration of a questionnaire to 40 permanent doctors of these clinics with a full-time activity. Our results show that the absence of an official tariff scheme in the Algerian private clinics has promoted the establishment of conventional tariff and remuneration systems, adopted by different actors especially to overcome the lack of regulation of the private healthcare. We observe a strong collective commitment to tariff devices, without sacrificing freedom of doctors as autonomous professionals on fixing their own tariff according to their own criteria. The emerging privatization of the Algerian health system is part of an overall international dynamic that would require a gradual change in the paradigm of public action.

scholarly journals Views and experiences of family physicians about Syrian refugee patients in Turkey: a qualitative research

2021 ◽  
Vol 22 ◽  
Author(s):  
Duygu Ayhan Baser ◽  
Özge Mıhcı ◽  
Meltem Tugce Direk ◽  
Mustafa Cankurtaran
Keyword(s):  
Primary Healthcare ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Qualitative Methodology ◽  
Healthcare Delivery ◽  
Family Physicians ◽  
Healthcare Services ◽  
Free Access ◽  
Structured Interviews ◽  
Syrian Refugee

Abstract Aim: The aim of this study was to describe the attitudes, views and solution proposals of family physicians (FPs) about primary healthcare problems of Syrian refugee patients. This study would be the very first study for Turkey that evaluates the attitudes, views and solution proposals of FPs about primary healthcare problems of Syrian refugee patients. Background: Following the anti-regime demonstrations that started in March 2011, the developments in Syria created one of the biggest humanitarian crises in the world and the largest number of asylum seekers continue to be hosted in Turkey. There are some studies evaluating asylum seekers’ access to healthcare services in Europe, and the common result is that refugees have free access to primary healthcare services in most countries; however, they face many obstacles when accessing primary healthcare services. While there are studies in the literature evaluating the situation of access to primary healthcare services from the perspective of asylum seekers; there are few studies evaluating the opinions/views of FPs. Methods: A qualitative methodology informed by the grounded theory was used to guide the research. A total of 20 FPs were interviewed face to face through semi-structured interviews, using 12 questions about their lived experience and views caring of refugee population. Interviews were analysed thematically. Finding: The following themes were revealed: Benefiting from Primary Health Care Services, Benefiting from Rights, Differences Between the Approach/Attitudes of Turkish Citizens and Refugees, Barriers to Healthcare Delivery, Training Needs of Physicians, Solution proposals. FPs reported that there is a need for support in primary care and a need for training them and refugees in this regard and they specified refugee healthcare centres are the best healthcare centres for refugees; however, the number of these and provided services should be increased.

scholarly journals Relations between morphology, buoyancy and energetics of requiem sharks

2016 ◽  
Vol 3 (10) ◽  
pp. 160406 ◽  
Author(s):  
Gil Iosilevskii ◽  
Yannis P. Papastamatiou
Keyword(s):  
Body Temperature ◽  
Negative Selection ◽  
Swimming Performance ◽  
Ontogenetic Changes ◽  
Cost Of Transport ◽  
Pectoral Fins ◽  
Confined Spaces ◽  
Reef Sharks ◽  
The Cost ◽  
Derivatives Of

Sharks have a distinctive shape that remained practically unchanged through hundreds of millions of years of evolution. Nonetheless, there are variations of this shape that vary between and within species. We attempt to explain these variations by examining the partial derivatives of the cost of transport of a generic shark with respect to buoyancy, span and chord of its pectoral fins, length, girth and body temperature. Our analysis predicts an intricate relation between these parameters, suggesting that ectothermic species residing in cooler temperatures must either have longer pectoral fins and/or be more buoyant in order to maintain swimming performance. It also suggests that, in general, the buoyancy must increase with size, and therefore, there must be ontogenetic changes within a species, with individuals getting more buoyant as they grow. Pelagic species seem to have near optimally sized fins (which minimize the cost of transport), but the majority of reef sharks could have reduced the cost of transport by increasing the size of their fins. The fact that they do not implies negative selection, probably owing to decreased manoeuvrability in confined spaces (e.g. foraging on a reef).

scholarly journals PROBLEMATIKA PENERAPAN ASAS TERJANGKAU DALAM PENDAFTARAN TANAH

2019 ◽  
Vol 18 (2) ◽  
Author(s):  
Denik Puspita
Keyword(s):  
Land Registration ◽  
The Poor ◽  
The Cost

<table width="605" border="0" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="406"><p><em>This study aims to analyze and determine the problems of applying the principle of affordability in land registration in Indonesia. The results showed that the principle of issuing certificates to take care of land registration must be adjusted to simple and affordable principles, where these principles mandate the process of issuing land certificates to run quickly, while the cost of issuing land certificates is not too expensive for the poor.</em><em></em></p><p><strong><em>Keywords:</em></strong></p><p><em>Principle of Affordability; Land: Certificate</em></p></td></tr></tbody></table>

scholarly journals From performance measurement to performance management in the impact investment industry

2020 ◽  
Vol 94 (5/6) ◽  
pp. 205-217
Author(s):  
Jeroen van Raak ◽  
Amber Raaphorst
Keyword(s):  
Performance Measurement ◽  
Performance Management ◽  
Institutional Investors ◽  
Structured Interviews ◽  
Impact Measurement ◽  
Standardized Measures ◽  
External Reporting ◽  
The Cost ◽  
Impact Data ◽  
The Impact

Impact investments have the potential to play an important role in solving social and environmental problems. Although the sector is growing rapidly, it does face a number of challenges, in particular related to impact measurement. Measuring the impact of such investments, which aim to achieve social and/or environmental impact while simultaneously generating financial returns, has proven difficult. This study examines the design and application of measurement systems related to impact investments. To investigate this, the seven impact measurement guidelines of the IMWG are used as a framework. We study to which degree impact investors set concrete investment objectives, how they measure and collect data related to the generated impact of the investments, and how they use such data to evaluate investment opportunities. We rely on a qualitative research methodology, including 13 semi-structured interviews among Dutch institutional investors. We find that impact investors typically set general, but not specific impact objectives. Furthermore, we note that impact investors are still searching for and experimenting with performance measures, and that they would value the development of standardized measures. Such standardized measures may assist in reducing the cost of obtaining investment data, while simultaneously increasing data reliability. Although the obtained impact data is currently hardly used for external reporting and impact data driven investment decisions, the institutional investors expect this to happen in the near future as the process of impact measurement matures. This would enable institutional investors to transition from performance measurement to performance management in the impact investment industry.

Discharge against Medical Advice in Some Paediatric Wards

1988 ◽  
Vol 18 (3) ◽  
pp. 125-127 ◽  
Author(s):  
H S Goyea
Keyword(s):  
Hospital Care ◽  
Preventive Health Care ◽  
Medical Advice ◽  
Preventive Health ◽  
Against Medical Advice ◽  
The Poor ◽  
Discharge Against Medical Advice ◽  
The Cost ◽  
The University ◽  
Family Opposition

Sixty-four cases of discharge against medical advice (DAMA) from 3 paediatric units in the University of Benin Teaching Hospital within a period of 18 months were analysed. The incidence was highest among the very young, even when they were still very ill. Financial problems accounted for 65.6% of the cases. Other reasons included difficulties related to the siblings (9.4%), the wish to try traditional methods (7.8%), family opposition (1.6%) and distance from the hospital (4.1%). It is recommended that greater attention be given to preventive health care, and placing the cost of hospital care within the reach of the poor. Improved communication is also recommended as a way of helping parents seek alternatives to DAMA.

Cost-Effectiveness of Erythromycin Versus Mupirocin for the Treatment of Impetigo in Children

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 210-214 ◽  
Author(s):  
Teresa Duryea Rice ◽  
Anne K. Duggan ◽  
Catherine DeAngelis
Keyword(s):  
Cost Effectiveness ◽  
Side Effects ◽  
Drug Regimen ◽  
School Age Children ◽  
Controlled Clinical Trial ◽  
Structured Interviews ◽  
Working Parents ◽  
The Cost ◽  
To Receive ◽  
Medication Changes

A new topical antibiotic, mupirocin, has been found to be as effective as erythromycin for the treatment of impetigo, but concerns about its expense have been raised. This controlled clinical trial sought to compare the cost-effectiveness of erythromycin (E) and mupirocin (M). Ninety-three children, aged 3 months to 16 years, were randomly assigned to receive 10 days of oral erythromycin (n = 46) or topical mupirocin (n = 47). Costs and effects were measured through structured interviews. Cost per case differed significantly by group (E = $56.85; M = $62.30; P &lt; .05) due chiefly to extra visits and medication changes needed by those treated with mupirocin. Erythromycin and mupirocin were equally effective. The likelihood of side effects (E = 43%, M = 22%) approached significance (P &lt; .07); those treated with erythromycin were willing to pay more for a different medicine to avoid the side effects experienced (P &lt; .05). Working parents and school-age children were more likely to alter their daily activities when the patient was taking erythromycin (P &lt; .04). Compliance and parental satisfaction did not differ by treatment group; however, parents of children treated with erythromycin were more likely to prefer the alternate drug regimen. It is concluded that the type of medication prescribed can be based on parental preference because the increased cost of mupirocin is offset by increased side effects and number of schooldays and workdays lost with erythromycin.

Semantic Search Engine and Object Database Guidelines for Service Oriented Architecture Models

2013 ◽  
pp. 225-250
Author(s):  
Omar Shehab ◽  
Ali Hussein Saleh Zolait
Keyword(s):  
Search Engine ◽  
Service Oriented Architecture ◽  
Query Language ◽  
Semantic Search ◽  
Semantic Query ◽  
Qualitative Survey ◽  
Ontology Language ◽  
Service Oriented ◽  
The Cost ◽  
Semantic Search Engine

In this paper, the authors propose a Semantic Search Engine, which retrieves software components precisely and uses techniques to store these components in a database, such as ontology technology. The engine uses semantic query language to retrieve these components semantically. The authors use an exploratory study where the proposed method is mapped between object-oriented concepts and web ontology language. A qualitative survey and interview techniques were used to collect data. The findings after implementing this research are a set of guidelines, a model, and a prototype to describe the semantic search engine system. The guidelines provided help software developers and companies reduce the cost, time, and risks of software development.

New Evolutionary Algorithm Based on 2-Opt Local Search to Solve the Vehicle Routing Problem with Private Fleet and Common Carrier

2012 ◽  
pp. 125-148
Author(s):  
Jalel Euchi ◽  
Habib Chabchoub ◽  
Adnan Yassine
Keyword(s):  
Local Search ◽  
Evolutionary Algorithm ◽  
Vehicle Routing ◽  
Cost Savings ◽  
Alternative Mode ◽  
Cost Of Transport ◽  
Routing Problem ◽  
The Cost ◽  
Specific Assignment ◽  
Selection Of

Mismanagement of routing and deliveries between sites of the same company or toward external sites leads to consequences in the cost of transport. When shipping alternatives exist, the selection of the appropriate shipping alternative (mode) for each shipment may result in significant cost savings. In this paper, the authors examine a class of vehicle routing in which a fixed internal fleet is available at the warehouse in the presence of an external transporter. The authors describe hybrid Iterated Density Estimation Evolutionary Algorithm with 2-opt local search to determine the specific assignment of each tour to a private vehicle (internal fleet) or an outside carrier (external fleet). Experimental results show that this method is effective, allowing the discovery of new best solutions for well-known benchmarks.

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