Caught in the “Traps of Managed Competition”? Examples of Russian Health Care Reforms from St. Petersburg and the Leningrad Region

1997 ◽  
Vol 27 (4) ◽  
pp. 661-686 ◽  
Author(s):  
Sarah Curtis ◽  
Natasha Petukhova ◽  
Galina Sezonova ◽  
Nadia Netsenko
Keyword(s):  
Health Care ◽  
Health Service ◽  
Service Systems ◽  
Leningrad Region ◽  
Managed Competition ◽  
Health Care Reforms ◽  
Future Policy ◽  
The City ◽  
Different Parts

Elements of a “managed market” for health services have been introduced into the Russian health care system, which under the Soviet regime was run as a comprehensive state-managed system. The authors examine the recent development of health service reforms in a case study of the city of St. Petersburg and the surrounding Leningrad region. Evidence from key informants and a local survey of service users shows how alternative models of the managed market are being introduced in different parts of the study area. A critical review of the market-oriented strategies for reform emerging in the case study suggests that such reforms carry risks associated with the “traps of managed competition.” Future policy for health service systems in Russia must take these risks more fully into account.

The NHS — is Scotland Different? a Case Study of the Management of Health Care in the Hospital Service in the West of Scotland 1947 – 1987

2000 ◽  
Vol 45 (5) ◽  
pp. 155-158 ◽  
Author(s):  
D. McTavish
Keyword(s):  
Health Care ◽  
Health Service ◽  
Private Practice ◽  
Central Government ◽  
Medical Professional ◽  
Hospital Service ◽  
The West ◽  
New Managerialism ◽  
Hospital Boards

Management of the health service in Scotland and England, has since its creation, shown both divergence and congruence. In the initial decades in Scotland the executive hospital boards (which contained strong medical professional membership) and central government had a clearer relationship than in England. The health service-civil service machinery in Scotland was without doubt more to the forefront with higher status in the Scottish ‘polity’ than was the case in England. The 1970s reforms also indicated difference: despite the pro managerialist tones of the Farquarson Lang report in Scotland, a managerial emphasis was more apparent in the English reforms. By the 1980s, the government's clear intention that their ‘radical’ agenda should apply in Scotland and England was implemented in many instances: aspects of the new managerialism were applied as vigorously in the case examined than anywhere in England: the attempt to draw clinicians into resource management (as advocated in the Griffiths report) appeared to have advanced further in Scotland until well into the 1990s. Yet in other aspects, Scotland diverged from parts of England in the implementation of the 1980's agenda most notably in the growth of private practice though the case indicated significant Scottish developments here too. The article concludes by speculating on some Scottish differences in the coming years.

scholarly journals The city as a theatre of characters. John Hejduk’s Masques

2021 ◽  
Vol 9 (2) ◽  
pp. 51
Author(s):  
Luca Cardani
Keyword(s):  
Design Research ◽  
Strong Connection ◽  
Theoretical Design ◽  
In Series ◽  
Place Of Origin ◽  
The One ◽  
The City ◽  
General Work ◽  
Different Parts

The architectural work of John Hejduk (1929-2000) is marked by theoretical-design research, collected in series with titles and periods. Among these series the one entitled Masques, developed since about 1979, can be considered the nucleus of his research on the architecture of the city and the place of origin of his language of construction later developed in his realized buildings. This paper analyses the dense network of references and analogies established by Hejduk to create his Masques, trying to fix its origin in the idea of the city as a theatre of characters composed of architecture. Starting from the name chosen for the title of this series, the paper tries to trace the threads that lead from the general work of the various projects of the Masques series, to the reflections and ideas that produced it. Then, it comes back again to the observation of architecture and of a case study (Security, 1989), to understand and explain its meaning and the compositional methods involved into the process of genesis of form. Through the entire work named Masques, and its recognizable link with the buildings and installation realized around the world, Hejduk has built an archive of architectural prototypes ready to construct different parts of the city, thus highlighting the strong connection that his work establishes with reality in order "to conceive it, represent it and finally realize it".

scholarly journals The Politics of Health Care Reforms in Kenya and their Failure

2016 ◽  
Vol 2016 (1) ◽  
Author(s):  
Daniel Künzler
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Policy ◽  
Current Literature ◽  
Theoretical Explanation ◽  
Policy Reforms ◽  
Health Care Reforms ◽  
Health Reforms ◽  
Free Health Care

The current literature on the politics of social policy has two major shortcomings: health care reforms are undertheoretized and research on Anglophone Africa tends to neglect health reforms. To tackle this, a case study on Kenya presents (failed) re-forms such as universal or categorical free health care or the introduction of health insurance and the expansion of its coverage. The case study clearly shows that there is no single theoretical explanation of social policy reforms or their failure. Rather, there are different combination of factors at work in Kenya.

A Case Study of the Emergence of Data Analytics in Health Care

2012 ◽  
Vol 14 (4) ◽  
pp. 56-62 ◽  
Author(s):  
Au Vo ◽  
Rahul Bhaskar
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Technology Implementation ◽  
Data Analytics ◽  
Health Care Reforms ◽  
Profound Impact ◽  
Almost All ◽  
The Impact ◽  
Rapid Transformation

In the era of health care reforms, the executives and CEO of the SBC Company are faced with many questions. They wonder about the impact of these changes on their market share. They also wanted to determine the impact on prices they can charge for their services. The changes in the ways the health care will be bought were causing a rapid transformation in the behavior of the consumers. The executives determined that they need to focus on specific areas to keep abreast of all the changes. These will have a profound impact on the information technology implementation across the company. For example, the need for analyzing a large amount of data and data in real time was becoming acute among many departments; there was a need for different skillsets in the employees in almost all the departments across the company. These changes across the industry were presenting new and unique challenges to the executive team.

scholarly journals Embedding the Pillars of Quality in Health Information Technology Solutions Using “Integrated Patient Journey Mapping” (IPJM): Case Study (Preprint)

2019 ◽  
Author(s):  
Stephen McCarthy ◽  
Paidi O'Raghallaigh ◽  
Simon Woodworth ◽  
Yoke Yin Lim ◽  
Louise C Kenny ◽  
...  
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Health Service ◽  
Health Information ◽  
Health Care Quality ◽  
Care Quality ◽  
Multidisciplinary Teams ◽  
Patient Journey ◽  
Connected Health

BACKGROUND Health information technology (HIT) and associated data analytics offer significant opportunities for tackling some of the more complex challenges currently facing the health care sector. However, to deliver robust health care service improvements, it is essential that HIT solutions be designed by parallelly considering the 3 core pillars of health care quality: clinical effectiveness, patient safety, and patient experience. This requires multidisciplinary teams to design interventions that both adhere to medical protocols and achieve the tripartite goals of effectiveness, safety, and experience. OBJECTIVE In this paper, we present a design tool called <i>Integrated Patient Journey Mapping</i> (IPJM) that was developed to assist multidisciplinary teams in designing effective HIT solutions to address the 3 core pillars of health care quality. IPJM is intended to support the analysis of requirements as well as to promote empathy and the emergence of shared commitment and understanding among multidisciplinary teams. METHODS A 6-month, in-depth case study was conducted to derive findings on the use of IPJM during <i>Learning to Evaluate Blood Pressure at Home</i> (LEANBH), a connected health project that developed an HIT solution for the perinatal health context. Data were collected from over 700 hours of participant observations and 10 semistructured interviews. RESULTS The findings indicate that IPJM offered a constructive tool for multidisciplinary teams to work together in designing an HIT solution, through mapping the physical and emotional journey of patients for both the current service and the proposed connected health service. This allowed team members to consider the goals, tasks, constraints, and actors involved in the delivery of this journey and to capture requirements for the digital touchpoints of the connected health service. CONCLUSIONS Overall, IPJM facilitates the design and implementation of complex HITs that require multidisciplinary participation. CLINICALTRIAL

scholarly journals Cycling in the city: Novi Sad on its way to become more bike-friendly city through the social activism

2021 ◽  
pp. 24-32
Author(s):  
Ivana Komadina
Keyword(s):  
Social Activism ◽  
Integrative Approach ◽  
Storage Space ◽  
The Social ◽  
Future Policy ◽  
Novi Sad ◽  
The City ◽  
Insight Into ◽  
Different Parts

Novi Sad is a city with great potential for becoming a major cycling city. However, there have been certain obstacles standing in the way. Via survey, people who cycle expressed their satisfaction with the number of parking spots, storage space at home, safety in traffic, quality of cycling paths, and density of cycling paths. On the other hand, a group that does not cycle was asked for reasons behind it as well as for their opinion on how to involve more cyclists. Furthermore, we tried to illustrate the importance of social activism in promoting cycling as well as its role in implementing new social policies. This paper offers an insight into the origins of the present issues while presenting potential solutions based on already implemented methods from other major cycling capitals. Overall we propose novel approaches to tackling this issue with the hope of using this research for making the future policy more coherently and continuously. Only with a multidisciplinary and integrative approach from different parts of the community, Novi Sad can fulfill its potential to become a safe and efficient area for cyclists.

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