scholarly journals The Role of General Practice in Complex Health Care Systems

2021 ◽  
Vol 8 ◽  
Author(s):  
Katharina Schmalstieg-Bahr ◽  
Uwe Wolfgang Popert ◽  
Martin Scherer
Keyword(s):  
Health Care ◽  
Family Medicine ◽  
Health Care System ◽  
Health Care Systems ◽  
Core Values ◽  
International Studies ◽  
Specialty Training ◽  
Care Systems ◽  
Care System

According to the WHO, in a complex system, “there are so many interacting parts that it is difficult (…), to predict the behavior of the system based on knowledge of its component parts. “In countries without general practitioner (GP)-gatekeeping, the number of possible interactions and therefore the complexity increases. Patients may consult any doctor without contacting their GP. Family medicine core values, e.g., comprehensive care, and core tasks, e.g., care coordination, might be harder to implement and maintain. How are GPs perceived and how do they perceive themselves if no GP-gatekeeping exists? Does the absence of any GP-gatekeeping influence family medicine core values? A PubMed and Cochrane search was performed. The results are summarized in form of a narrative review. Four perspectives regarding the GP's role were identified. The GPs' self-perception regarding family medicine core values and tasks is independent of their function as gatekeepers, but they appreciate this role. Patient satisfaction is also independent of the health care system. Depending on the acquisition of income, specialists have different opinions of GP-gatekeeping. Policymakers want GPs to play a central role within the health care system, but do not commit to full gatekeeping. The GPs and policymakers emphasize the importance of family medicine specialty training. Further international studies are needed to determine if family medicine core values and tasks can be better accomplished by GP-gatekeeping. Specialty training should be mandatory in all countries to enable GPs to fulfill these values and tasks and to act as coordinators and/or gatekeepers.

scholarly journals Nurses as advocates between western and traditional wealth practices in RSA

2000 ◽  
Vol 5 (2) ◽  
pp. 29-36
Author(s):  
Valerie Ehlers
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Professionals ◽  
Full Text ◽  
Formal Education ◽  
Health Care Systems ◽  
African Countries ◽  
Care Systems ◽  
Care System

The RSA, like most African countries, have two health care systems. The most visible one is the Westernised hospital and/or clinic based treatment of diseases. This system was introduced by the colonisers and perpetuated by the current formal education programmes of most health care professionals in the RSA. Traditional African medicine has existed since time immemorial and continues to treat vast numbers of people. Both these health care systems will be briefly discussed. Then the role of nurses in the RSA's health care system(s) will be examined. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Unmasking a health care system: the Dutch policy response to the Covid-19 crisis

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Health Care Systems ◽  
Economic Policies ◽  
Hard Time ◽  
Dutch Health ◽  
Care Systems ◽  
Policy Systems ◽  
Care System

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.

scholarly journals Implementation of low-dose CT screening in two different health care systems: Mount Sinai Healthcare System and Phoenix VA Health Care System

2021 ◽  
Vol 10 (2) ◽  
pp. 1064-1082
Author(s):  
Claudia I. Henschke ◽  
David F. Yankelevitz ◽  
Artit Jirapatnakul ◽  
Rowena Yip ◽  
Vivian Reccoppa ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Low Dose ◽  
Health Care Systems ◽  
Ct Screening ◽  
Low Dose Ct ◽  
Care Systems ◽  
Va Health Care System ◽  
Care System

Wettbewerbsorientierte Reformen im Gesundheitssystem der Schweiz – Vorbild für regulierten Wettbewerb in der deutschen GKV?

2004 ◽  
Vol 5 (1) ◽  
pp. 59-70 ◽  
Author(s):  
Stefan Greß ◽  
Ralf Kocher ◽  
Jürgen Wasem
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Behavioral Changes ◽  
Swiss Health ◽  
Care Systems ◽  
Swiss Experience ◽  
Regulated Competition ◽  
Care System ◽  
The Way

Abstract Recent reforms of the Swiss health care system to introduce regulated competition have raised expectations about the possible combination of more efficient services, while at same time maintaining or even increasing the level of solidarity in health care systems. In this article we examine expected behavioral changes of the market actors, the way incentives for market actors have been changed and analyze the way market actors in fact changed their behavior. We conclude that so far only some of the targets of the reforms have been met. For a reasonable assessment of the Swiss experience in regulating competition in health care it is paramount to distinguish expected effects from actual effects.

scholarly journals THE WAY THE HEALTH CARE SYSTEM IN UKRAINE LOOKS LIKE: INTERNATIONAL PRACTICES WITHIN NATIONAL REALITIES

2019 ◽  
Vol 72 (4) ◽  
pp. 685-691
Author(s):  
Borys O. Lohvynenko ◽  
Roman V. Myroniuk ◽  
Olexander P. Svitlychnyy ◽  
Aleksey Y. Prokopenko ◽  
Lidija I. Kalenichenko
Keyword(s):  
Health Care ◽  
Health Care System ◽  
National Health ◽  
Health Care Systems ◽  
World Health ◽  
National Health Care ◽  
National Health Care System ◽  
Care Systems ◽  
Health Organization ◽  
Care System

Introduction: Nowadays there is the transformation of the national health care system in Ukraine, the ultimate goal of which is to create a modern, competitive model of medical care of citizens on the basis of forming packages of free medical services. However, the model adopted by Ukraine is in contradiction with national legislation in part of free medical aid guaranteed by the Art. 49 of the Constitution of Ukraine, and fragmentary considers positive international practices. The aim of the paper is to determine the mistakes of the reform of the Ukrainian health care system and to reveal the positive international practices of the organization of health care systems that can be implemented in Ukraine. Materials and methods: National and international legislation, official web resources of the executive authorities of Ukraine, statistics of the World Health Organization, materials of journalistic and scientific periodicals are the materials for the research of the health care system in Ukraine in comparison with international practices. Research methods are cross-sectoral, complex statistical, comparative, generalization, analysis and synthesis. In order to obtain the results, the authors have conducted a critical analysis of the current norms of the national Ukrainian legislation in the health care sector. Review: The authors of the article have studied the main disadvantages of the national health care system in accordance with the concept of reforming the medical sector. Positive international practices that can be implemented into Ukrainian system for the real improvement of medical human rights in Ukraine have been revealed. Conclusions: It has been proved that the ongoing reform of the health care system in Ukraine needs to be reviewed and optimized. It has been offered to consolidate a perspective model of the Ukrainian health care system, its principles and guarantees of immunity at the legislative level.

scholarly journals Governance of health care systems in an ageing world – the case of Australia

2015 ◽  
Vol 13 (1) ◽  
pp. 729-735 ◽  
Author(s):  
Ewa Banasik
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Well Being ◽  
World Health ◽  
The Political ◽  
Central Component ◽  
Australian Health ◽  
Care Systems ◽  
Care System

The main argument of this paper is that because the burden of diseases increases with age, a greater numbers of older individuals will increase the demand for health care, and whether this demand will be met very much depends on how health care systems are governed. This task is particularly complex in jurisdictions with multi-layer governing systems such as the Australian health care system. Governance, described in terms of stewardship of the well-being of the population and as a central component for building effective health care systems, is increasingly considered to be very important for a well performing health care system (World Health Organization, 2000, 2007). Governance is, however, the least studied function in a health care system (Alliance 2009). Furthermore, the limited governance frameworks and assessments that have been developed thus far fail to include the political context in which health care systems operate (Baez-Camargo and Jacobs, 2011). This paper intends to fill this knowledge gap by exploring the political dynamics of the Australian health care system’s governance and its accountability. Furthering the discourse on governance is especially important in times when health care systems are confronted with the challenges of ageing populations

scholarly journals Human-geographical peculiarities of the healthcare system of Ukraine in the conditions of modern challenges

2021 ◽  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Swot Analysis ◽  
Health Care Systems ◽  
Practical Significance ◽  
Medical Systems ◽  
Advantages And Disadvantages ◽  
Care Systems ◽  
Key Features ◽  
Care System

Relevance. The paper examines the issues of the health care system development of Ukraine in the context of modern challenges. Today, there are many global environmental, socio-demographic, and economic problems threatening the existence of human civilization. One of the problems was the spread of coronavirus infection COVID-19, which demonstrated unpreparedness of Ukraine and post-socialist countries' health care systems. These countries are undergoing health care transformations, but they do not meet modern world norms and standards. The purpose of the article is to establish the key features of the health care system of Ukraine during its transformation given the positive experience of medical systems in the world, from the positions of human geography to identify current challenges and to assess the ability to respond to social demand and the threat of the global crisis in the form of new diseases, the spread of epidemics threatening to human health, quality and life expectancy. Methods. This research is conducted on the basis of human-geographical approach with use of the set of methods and tools to analyze the health care system, which is extremely important for obtaining verified and scientifically sound results. In particular, the authors used methods of induction and deduction, comparison, formalization, analogy, analysis, systematization, including ranking and grouping, historical, graphical, mathematical and statistical, SWOT-analysis methods. Results. Scientific novelty and practical significance. The features, advantages and disadvantages of existing models of health care systems in different countries were identified. In particular, models of medical systems were considered: a model of the single-payer, model of obligatory insurance, and hybrid system. The peculiarities of the formation of the health care system of Ukraine were determined, the key features and principles of the M.O. Semashko’s system were identified, its positive and negative features preserved to this day were outlined. The distribution of European and post-socialist countries was analyzed according to the indicators of state budget expenditures on health care and GDP, number of doctors, hospital beds per capita. The transformational processes in the health care system of Ukraine, the peculiarities of the medical reform in Ukraine were revealed, the peculiarities of the development of the medical system in the conditions of the pandemic were characterized. The SWOT analysis identified the strengths and weaknesses of the Ukraine’s health care system in terms of reform and transformation, its opportunities and threats in the light of current challenges.

scholarly journals Enhancement of Reputation Aggregation based Dynamic Trust Protocols for Edge Computing based E-Health Care System

2021 ◽  
Author(s):  
Mary Subaja Christo ◽  
Bommi R M ◽  
Anandaraj S P ◽  
Udhaya Sankar S M ◽  
Anbarasu V ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Trust Model ◽  
Edge Computing ◽  
Trust Value ◽  
Dynamic Trust ◽  
Care Systems ◽  
E Learning ◽  
Care System

Abstract In recent years, E-services such as e-healthcare, e-learning, e-ticketing, depend on computer networks where the attackers have started introducing new types of attacks. Therefore, it is necessary to enhance security for communication which is needed for the transfer of confidential information relating to patients through the network. In our research we have developed a reputation aggregation based dynamic trust model for edge computing based E-health care systems. In this model, the edge node evaluates the trust value of a user and allows the user to access the E-health care system only when the trust value is satisfied. In order to do this, initially the user information is collected with the help of user agents and then this information is processed and the relevant data alone is sent to the edge nodes for evaluating the trust. Finally, the trusted users can be identified through edge nodes and they are only given the permission to access the e-health care system. Attacks generated in the simulations are detected using the prevailing algorithms and also the suggested techniques. The simulation results of this work prove the ability of the proposed techniques which are used to detect the attacks accurately and to prevent them effectively.

scholarly journals Źródła finansowania ochrony zdrowia w Polsce i we Włoszech

2019 ◽  
Vol 115 ◽  
pp. 81-95
Author(s):  
Paweł Lenio
Keyword(s):  
Health Care ◽  
Local Government ◽  
Health Care System ◽  
Health Care Systems ◽  
Specific Model ◽  
Legal Structure ◽  
Care Systems ◽  
Financing Health Care ◽  
The Difference ◽  
Care System

SOURCES OF FINANCING OF THE HEALTH CARE SYSTEM IN POLAND AND IN ITALYThe study found that the majority of similarities and differences in the legal structure of Polish and Italian sources of financing of health care are the result of the adoption of a specific model of health care, and therefore there are fundamental differences between the catalogues of sources of financing health care in Poland and Italy. The basis for the difference between the Italian and Polish catalogues of sources of financing health care is the obligation of patients to contribute to the costs of the health care system in Italy by paying fees in return for receiving a certain type of service. In the reforms of the Polish and Italian health care systems one can see signs of transferring more and more responsibility to local government units. However, Italian and Polish local government units have no influence on the principles of functioning of the system and the shape of basic sources of financing health care.

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