scholarly journals Health Status, Health Care and Inequality: Canada vs. the U.S.

2008 ◽  
Vol 10 (1) ◽  
Author(s):  
June E O'Neill ◽  
Dave M O'Neill
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Unmet Needs ◽  
Waiting Times ◽  
Survival Rates ◽  
Health Resources ◽  
Relative Survival ◽  
Chronically Ill ◽  
The U.S

It is often alleged that Canada's publicly-funded, single payer health care system, delivers better health outcomes, and distributes health resources more fairly than the mainly private U.S. multi-payer system. Our findings contradict these allegations. Differences between the U.S. and Canada in infant mortality and life expectancy --the two indicators most commonly used as evidence of better health outcomes in Canada—cannot be attributed to differences in the effectiveness of the two health care systems because they are strongly influenced by differences in cultural and behavioral factors such as the relatively high U.S. incidence of obesity and of accidents and homicides. Moreover, direct measures of the effectiveness of medical care, show that five-year relative survival rates for individuals diagnosed with various types of cancer are higher in the U.S. than in Canada as are infant survival rates of low-birth weight babies. These successes are consistent with the greater U.S. availability of high level technology, higher rates of screening for cancers, and higher treatment rates of the chronically ill. The need to ration when care is delivered "free" ultimately leads to long waits. Waiting times for medical services are a major problem in Canada and a source of unmet needs. In the U.S. costs are more often cited as a source of unmet needs. Nonetheless, with respect to the issue of inequality, we find that the health-income gradient is at least as prominent in Canada as it is in the U.S. When asked about satisfaction with health services and the ranking of the quality of services recently received, more U.S. residents than Canadians respond that they are fully satisfied and rank quality of care as excellent. To address these issues we use the Joint Canada/ U.S. Survey of Health (JCUSH) along with other data sources.

Paying for Prevention: A Critical Opportunity for Public Health

2013 ◽  
Vol 41 (S1) ◽  
pp. 69-72 ◽  
Author(s):  
Jean C. O’Connor ◽  
Bruce J. Gutelius ◽  
Karen E. Girard ◽  
Danna Drum Hastings ◽  
Luci Longoria ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Quality Of Care ◽  
Gross Domestic Product ◽  
Health Outcomes ◽  
Health Care Costs ◽  
Health Care Spending ◽  
Care Costs ◽  
The U.S

Despite spending more on health care than every other industrialized country, the U.S. ranks 37th in health outcomes. These differences cannot be explained away with differences in age and income, or even with quality of care. And, the rate of growth in health care spending in the U.S. continues to increase. The share of the Gross Domestic Product (GDP) attributable to health care grew from 9% in 1980 to more than 17% in 2011. Health care costs are projected to account for more than one-fifth of our economy by 2021. Despite spending more and more, the U.S. does not have better health outcomes than other countries. Worse, our increasing spending is largely attributable to preventable conditions. More than 85 cents of every dollar spent on health in the U.S. are spent on the treatment and management of chronic diseases, such as those caused by preventable conditions related to obesity and tobacco use.

Thriving in the 21st Century: Outcome Assessment, Practice Parameters, and Accountability

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 831-835 ◽  
Author(s):  
David A. Bergman
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Outcomes ◽  
Practice Guidelines ◽  
Scientific Evidence ◽  
Care Practice ◽  
Health Care Outcomes ◽  
Effective Manner ◽  
Care Outcomes

The past two decades have brought about major health care changes that have been driven by an ever-increasing cost of health care, practice variability, and medical malpractice litigation. These changes pose a challenge to pediatricians to contain costs, to reduce inappropriate use of health care services, and to demonstrate improved health care outcomes. To meet this challenge, a new "clinical tool kit" is required, one that will allow the pediatrician to analyze current practices and to document effective interventions. Two of the major tools in this kit are practice guidelines and outcomes assessment instruments. Practice guidelines are optimal care specifications that provide an analytic framework for defining high-quality care and measuring health care outcomes. Ideally, these guidelines should be developed from scientific evidence. In practice, however, scientific evidence to support the majority of recommendations made in guidelines is insufficient. Consequently, these recommendations are instead developed by expert consensus. Measurement of health outcomes includes clinical outcomes, patient satisfaction, cost and use, and quality of life. Health care organizations have become very sophisticated in measuring cost and use, but considerably less work has been done in the patient-centered areas of satisfaction and quality of life. This is particularly true for children, because measures are dependent on the viewpoint chosen (parent, child, or teacher), the age of the child, and the adjustment for severity of illness. Analyzing practice patterns and improving health outcomes will not be easy tasks to accomplish. For the pediatrician to use these tools in an efficient and effective manner, a new research agenda and new skills will be required.

Impact of Career Experiences on Health Outcomes Among Immigrants in the Midwest

2021 ◽  
pp. 101-123
Author(s):  
Caroline Kingori ◽  
Mohammad Rifat Haider ◽  
Seleshi Ayalew Asfaw ◽  
Senya Afi Ghamli
Keyword(s):  
Health Outcomes ◽  
High Growth ◽  
Immigrant Workers ◽  
Career Experiences ◽  
Skilled Immigrants ◽  
Playing Field ◽  
The Us ◽  
The Impact ◽  
The U.S

Immigrants in the US work in diverse professions and contribute to the economy. They play an important role in the economies in which they settle by complementing the skills lacking and create a level playing field for wages in the labor market. The U.S. Midwest has seen exceptionally high growth in immigrant populations in recent decades. While employment leads to a better quality of life when workers can afford basic necessities, immigrants encounter dire health challenges due to unemployment, underemployment, extreme working conditions, long work hours, and no paid leave. There is limited research examining the connection between career development experiences with the health of immigrant workers. This chapter examines the impact that employment circumstances have on skilled immigrants' health outcomes in the Midwest.

scholarly journals The co-design approach in the MIWOCA project

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Frahsa ◽  
R Farquet ◽  
T Abel
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Healthcare System ◽  
Chronically Ill ◽  
Participatory Planning ◽  
Practical Training ◽  
Extensive Experience ◽  
Swiss Health ◽  
Care System

Abstract MIWOCA study group Background The project MIWOCA researches how chronically ill women of Portuguese, Turkish and German origin and women without a migration background subjectively experience, understand, interpret and use the Swiss health care system. Methods We conducted 48 qualitative semi-structured interviews with chronically ill women between the ages of 23 and 85 in Bern and Geneva (n = 36 with German, Portuguese and Turkish migrant backgrounds) and n = 12 Swiss women. In addition, n = 12 stakeholder interviews were conducted (doctors, nurses, social workers, psychologists, physiotherapists). In focus groups with interviewed women in Bern and Geneva, results are reflected back, identified topics from the interviews prioritized and representatives named for the cooperative planning. In a participatory planning approach, affected women in the canton of Bern, together with stakeholders from the Swiss healthcare system selected by a systematic stakeholder analysis (e.g. Swiss Medical Association, Red Cross Switzerland, Spitex, Federal Office of Public Health), develop recommendations for improving the quality of care and concrete dissemination strategies. Results Interviewees had multiple and chronic diseases and resulting extensive experience with the Swiss healthcare system. Relevant aspects referred to issues such as quality of specific services, complexity of the healthcare system, costs of care, role of family and social support, and multidimensional stigmatization (migration, chronic illness, alleged overuse of the care system). Findings are incorporated in evidence briefs and narrative stories for focus groups and participatory planning. Conclusions MIWOCA contributes to a targeted and differentiated improvement of structures and options for action in health care for specific groups. Results will be relevant for planning in the health system and may be incorporated into academic teaching and practical training in PH, medicine and social sciences.

Experimental Evidence on the Long-Run Impact of Community-Based Monitoring

2017 ◽  
Vol 9 (1) ◽  
pp. 33-69 ◽  
Author(s):  
Martina Björkman Nyqvist ◽  
Damien de Walque ◽  
Jakob Svensson
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Lower Cost ◽  
Care Delivery ◽  
Care Provision ◽  
Community Based ◽  
Long Run ◽  
Short Run

We evaluate the longer run impact of a local accountability intervention in primary health care provision in Uganda. Short-run improvements in health care delivery and health outcomes remained in the longer run despite minimal follow-up. We find no impact on the quality of care or health outcomes of a lower cost intervention that focused on encouraging participation but did not provide information on staff performance. We provide suggestive evidence that informed beneficiaries are more likely to identify and challenge (mis)behavior by providers and, as a result, turn their focus to issues that they can manage locally. (JEL H75, I11, I18, O15, O18)

Profits in Medicine: A Context and an Accounting

1978 ◽  
Vol 8 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Gelvin Stevenson
Keyword(s):  
Health Care ◽  
Final Section ◽  
Health Care Expenditures ◽  
Relative Growth ◽  
Non Profit ◽  
Price Controls ◽  
For Profit ◽  
Before And After ◽  
The U.S

The U.S. health care industry is composed of a dynamic mixture of profit and non-profit entities. These sectors sometimes compete in the same activities and may have virtual monopolies over other activities. Estimates of the relative and absolute sizes and growth trends of the profit and non-profit sectors are developed in this article. These estimates show that approximately 39 percent of total health care expenditures in the U.S. in 1975 went to for-profit institutions, generating $3.3 billion in profit. This represented 7 percent of for-profit and 2.8 percent of total expenditures. Some for-profit subsectors grew more rapidly and others less rapidly than total health care expenditures. As a whole, the for-profit sector grew faster than the non-profit sector before and after Medicare and Medicaid were introduced as well as during the period when price controls were in effect. The relative growth of the for-profit sector was greatest right after the introduction of Medicare and Medicaid. The true significance of profit lies not in numbers, but in the effects that the drive for profit have on the nature and quality of health and health care. This is discussed in the final section.

Quality of health care, survival and health outcomes in Ghana

1996 ◽  
Vol 15 (3) ◽  
pp. 333-357 ◽  
Author(s):  
Victor Lavy ◽  
John Strauss ◽  
Duncan Thomas ◽  
Philippe de Vreyer
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Quality Of Health Care

Zufriedenheit mit der Gesundheitsversorgung: Gibt es strukturelle Unterschiede?

2018 ◽  
Vol 67 (3) ◽  
pp. 288-307
Author(s):  
Katharina Lima de Miranda ◽  
Daniel Prosi ◽  
Ulrich Schmidt ◽  
Hanna Wecker
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Statutory Health Insurance ◽  
Waiting Times ◽  
Private Insurance ◽  
Public And Private ◽  
Structural Differences ◽  
Urban And Rural Areas ◽  
Care Costs

Abstract This study examines structural differences in the subjective quality of health care in Germany using a newspaper survey. We find that there are significant differences between urban and rural areas as well as between public and private insurance. In rural areas, the provision of general practitioners, specialists and hospitals are considered as worse than in cities. In particular, public insured individuals asses the provision of specialized doctors and hospitals as lower than private insured and criticize long waiting times for appointments and lacking coverage of health care costs by the statutory health insurance.

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