Decentralized Socialism: Medical Care in Yugoslavia

The health care system in Yugoslavia is based on the principles of reciprocity and solidarity, as regulated by constitutional provisions which guarantee medical care and use of health services as the basic right of all citizens. Medical care is organized on the basis of needs and resources of the society. Its funds are generated through individual contributions of citizens and sociopolitical, working, and other organizations which are accumulated into social insurance funds, for reimbursement of health institutions for the services they provide. Coordination among health institutions, associations of social insurance, and sociopolitical and other concerned organizations is regulated by law. Insured persons within their associations decide on the extent of medical care to which to subscribe and on all rights emanating from the insurance. There are several reimbursement mechanisms such as fee–for–service, capitation, and daily charges. Insured persons through their associations influence the administration of social insurance by means of specifying priorities in terms of certain needs and by deciding on specific contracts with health institutions. The emphasis in contract arrangements is placed on preventive services, home care services, and dispensary care, for which health institutions proportionally receive more money than for hospital services. This arrangement influences the pattern of organization of health institutions and health workers. The new type of institutions that are more and more dominant are integrated health services, so–called medical centers, which provide both preventive and curative services for the population they cover.

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Pemberdayaan Kader Kesehatan Melalui Inovasi Teknologi Excellent Care Menuju Masyarakat Sehat, Sejahtera dan Bebas COVID-19 di Desa Darul Amin Kecamatan Lawe Alas Kabupaten Aceh Tenggara

JPKMI (Jurnal Pengabdian Kepada Masyarakat Indonesia) ◽

10.36596/jpkmi.v2i2.147 ◽

2021 ◽

Vol 2 (2) ◽

pp. 134-144

Author(s):

Yusnaini Yusnaini

Keyword(s):

Health Service ◽

Health Services ◽

Home Care ◽

Health Workers ◽

Home Care Services ◽

Healthcare Team ◽

Social Distancing ◽

Care Services ◽

Excellent Care ◽

Care Technology

Abstrak: Desa Darul Amin merupakan desa yang berada di Kecamatan Lawe Alas Kabupaten Aceh Tenggara, Provinsi Aceh, Indonesia. Survey awal selama masa pandemi COVID-19 didapatkan beberapa permasalahan berupa masyarakat sering berkumpul bersama bila ada acara/kegiatan, masyarakat merasa khawatir ke tempat layanan kesehatan, prevalensi penyakit tertinggi seperti hipertensi, rematik, asam urat dan diabetes. Adapun hasil pertanian masyarakat berupa jagung, padi, jahe, kunyit, lengkuas dan minyak kelapa. Oleh karena itu, pentingnya pengembangan inovasi teknologi Excellent Care sebagai sarana fasilitas pelayanan kesehatan dan bisnis online untuk mewujudkan masyarakat sehat, sejahtera dan bebas COVID-19. Kegiatan yang dilakukan terdiri dari pemberdayaan kader kesehatan, desiminasi ilmu tentang ramuan herbal, pengembangan inovasi teknologi Excellent Care dan kunjungan tim tenaga kesehatan untuk layanan homecare kepada masyarakat. Kegiatan tersebut bertujuan meningkatkan kesehatan melalui layanan konsultasi dan homecare, mendukung program pemerintah dalam penerapanan social distancing, memberikan peluang bisnis bagi masyarakat dalam mempromosikan ramuan herbal serta mengembangkan Desa Darul Amin sebagai desa percontohan yang memanfaatkan fasilitas pelayanan kesehatan online yang dapat memandirikan masyarakat untuk hidup sehat dan produktif. Kelompok sasaran dalam kegiatan ini adalah masyarakat dan kader di Desa Darul Amin. Adapun hasil capaian kegiatan yaitu masyarakat sudah memanfaatkan layanan kesehatan online, masyarakat sudah mempromosikan ramuan herbalnya melalui www.excellentcare.com, kader dan tenaga kesehatan sudah mendapatkan penghasilan dari layanan homecare.Abstract: Darul Amin Village is a village located in Lawe Alas District, Southeast Aceh Regency, Aceh Province, Indonesia. During the COVID-19 pandemic period, the initial survey found several community problems, often gathering together when there was an event/activity. The community was worried about health services, the highest prevalence of hypertension, rheumatism, gout, and diabetes. The community agricultural products are corn, rice, ginger, turmeric, galangal, and coconut oil. Therefore, the importance of developing Excellent Care technology innovation as a means of health service facilities and online businesses create a healthy, prosperous, and free of COVID-19 society. Activities carried out consisted of empowering health cadres, disseminating knowledge about herbal ingredients, developing Excellent Care technology innovations, and visiting a healthcare team for home care services to the community. This activity aims to improve health through consultation and home care services, support government programs in the application of social distancing, provide business opportunities for the community in promoting herbal concoctions and develop Darul Amin Village as a pilot village that utilizes online health service facilities that can empower people to live healthy and productive. The target groups in this activity are the community and cadres in Darul Amin Village. The results of the activity are that the community has made use of online health services, the community has promoted their herbal ingredients through www.excellentcare.com, cadres and health workers have earned income from homecare services.

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Building trust and enhancing localization to improve access to women’s health services in Afghanistan

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.928 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F R Rab ◽

S S Stranges ◽

A D Thind ◽

S S Sohani

Keyword(s):

Health Care ◽

Health Services ◽

Vulnerable Populations ◽

Time Trend ◽

Health Workers ◽

Healthcare Services ◽

Delivery Of Healthcare ◽

Care Services ◽

Women And Children ◽

Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

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MEDICAL CARE AND HOME CARE SERVICES

Nursing Research ◽

10.1097/00006199-196811000-00069 ◽

1968 ◽

Vol 17 (6) ◽

pp. 569

Author(s):

R. M. COE ◽

E. A. FRIEDMANN ◽

R JACK SIGLE ◽

L DOUGLAS MARSHAL ◽

H. P. BREHM ◽

...

Keyword(s):

Home Care ◽

Medical Care ◽

Home Care Services ◽

Care Services

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Structure of Medical Care Services in the U.S.S.R.

International Journal of Health Services ◽

10.2190/ha4m-k6vw-hmp6-ht4l ◽

1972 ◽

Vol 2 (2) ◽

pp. 239-242

Author(s):

J. Fry

Keyword(s):

Health Services ◽

Medical Care ◽

Rural Areas ◽

Free Choice ◽

Work Load ◽

Master Plan ◽

Medical Assistants ◽

Occupational Physicians ◽

Care Services ◽

Primary Physicians

The health services of the U.S.S.R. are organized and administered on a master plan based on central and monolithic planning according to Marxist socioeconomic principles. The health services have provided good available and accessible medical care to all its peoples. This has been a great and remarkable achievement. Primary medical services in the U.S.S.R. are provided by a series of specialists— uchastok (neighborhood) pediatricians, therapists (internists), occupational physicians, and dentists. Each has an allocated geographic locality and there is no free choice of physician. The uchastok physicians work from polyclinics with specialists. They also carry out daily home visits. There are no hospital facilities. The nature of the work and the work load is similar to that of primary physicians in other systems. In rural areas because of dispersal of populations, primary medical care is carried out by medical assistants (feldshers) who work under the supervision of physicians.

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Medical Care under Social Security in France

International Journal of Health Services ◽

10.2190/gtkt-plu3-7hv4-khaf ◽

1971 ◽

Vol 1 (4) ◽

pp. 331-341

Author(s):

R. F. Bridgman

Keyword(s):

Social Security ◽

Medical Care ◽

Local Governments ◽

Social Insurance ◽

Medical Profession ◽

Great Influence ◽

Payment System ◽

Public Hospitals ◽

Health Institutions ◽

The Government

Social insurance was initiated in France on a national scale in 1930 and now covers about 98.5 per cent of the population. The coverage expanded the limits of traditional sickness insurance for curative medicine and had a growing impact on overall health and social policy. French social insurance is a public service run by organizations which retain the voluntary status of the old mutual funds. The social security budget is independent of that of the government, which contributes less than 20 per cent of the overall social budget of the nation. The relationships between the medical profession, private and public hospitals, preventive care organizations, social insurance funds, and central and local governments have become very complex. The huge social security organization has acquired competence in planning and in technical organizational matters and consequently has had a great influence on medical care patterns. Social security adopted the direct payment system in its relationships with the medical profession; therefore the latter has retained its independent status. But, for public and private hospitals, the payment system is indirect. A special branch was created in 1945 to deal with capital investments in hospitals and health institutions concerned with preventive medicine. Social insurance contributed greatly to facilitating access of patients to all kinds of medical care, either public or private, curative or preventive, and helped the government by participating in the construction of a complex network of health institutions for the benefit of the whole population. This task is not yet achieved, and greater coordination and additional resources are necessary. But there is no doubt that social insurance was and still is a powerful factor in the continuing improvement of the nation's health and living conditions.

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MEDICAL CARE AND HOME CARE SERVICES

Nursing Research ◽

10.1097/00006199-196801000-00101 ◽

1968 ◽

Vol 17 (1) ◽

pp. 90

Author(s):

B. E. Levine ◽

D. B. Bigelow ◽

R. D. Hamstra ◽

H. J. Beckwith ◽

R. S. Mitchell ◽

...

Keyword(s):

Home Care ◽

Medical Care ◽

Home Care Services ◽

Care Services

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MEDICAL CARE AND HOME CARE SERVICES

Nursing Research ◽

10.1097/00006199-196801000-00097 ◽

1968 ◽

Vol 17 (1) ◽

pp. 90

Author(s):

Halsel L Marilyn

Keyword(s):

Home Care ◽

Medical Care ◽

Home Care Services ◽

Care Services

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Who Is Doing What in Home Care Services?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910504 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10504

Author(s):

Berit Irene Helgheim ◽

Birgithe Sandbaek

Keyword(s):

Home Care ◽

Registered Nurses ◽

Health Workers ◽

Care Service ◽

Home Care Services ◽

Smartphone Application ◽

Care Staff ◽

Care Services ◽

Patient Work ◽

Assistant Nurses

(1) Background: This paper investigates the distribution of work hours by activity, for the main staff categories in home care services in three rural Norwegian municipalities. In Norway these categories are registered nurses, assistant nurses and assistant health workers. (2) Methods: The three categories of home care staff recorded 20,964 eligible observations over 8 weeks. We identified 19 activities, which were recorded. The majority of staff used a smartphone application for the time measuring, while some staff used a manual form for reporting purposes. (3) Results: The registered nurses (RNs) spent 32% of their time on direct patient work, while driving accounted for 18%. Direct patient work and driving accounted for the majority of activities performed by assistant nurses (48% and 29%, respectively) and assistant health workers (70% and 17%, respectively). (4) Conclusions: The demand for home care services is increasing in terms of both size and complexity. Simultaneously, there is a growing shortage of skilled staff. RNs is the group with the least face-to-face time with patients. To meet the patients’ needs, it is necessary to discuss and modify existing home care service systems in order to use resources appropriately and effectively.

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