scholarly journals In search of healthcare system ideal types — Changeable classifications and dimensions

2021 ◽  
Vol 14 ◽  
Author(s):  
Iris Moolla ◽  
Heikki Hiilamo ◽  
Antti Kouvo
Keyword(s):  
Health System ◽  
Healthcare System ◽  
Hierarchical Cluster ◽  
Healthcare Systems ◽  
Three Dimensions ◽  
Healthcare Provision ◽  
Ideal Types ◽  
Developed Economies ◽  
And Performance ◽  
System Characteristics

This article aims to classify the healthcare systems of 43 developed economies into different healthcare system types, and to examine whether the dimensions of health system characteristics produce coherent health system classification when the dimensions are observed separately. We group health systems into different types based on their institutional structures and performance using healthcare financing, healthcare provision and health outcomes as dimensions of the health system characteristics. Unlike previous classifications, we classify each dimension separately using hierarchical cluster analysis. In particular dimensions, our results resemble those found in previous classifications. However, no coherent clustering of healthcare systems was found across the three dimensions. The results show that healthcare system dimensions differ from each other and each of them form their unique system types. Separating the dimensions helps detecting connections between the healthcare system types and phenomena being studied. It is relevant to note the differences of health system dimensions while discussing healthcare system classifications.

An American Perspective of the Dental and Public Health Initiatives in Cuba

2021 ◽  
pp. 232020682110301
Author(s):  
Colleen Watson ◽  
Laura Rhein ◽  
Stephanie M. Fanelli
Keyword(s):  
Public Health ◽  
United States ◽  
Health Status ◽  
Health System ◽  
Healthcare System ◽  
National Health ◽  
National Health System ◽  
The United States ◽  
Healthcare Systems ◽  
The Us

Aim: To compare following the Cuban Revolution, Cuba’s economy and civil society was transformed by the initiation of a program of nationalization and political consolidation. The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the healthcare of its citizens. Other industrialized nations continue to surpass the US in health-related outcomes indicating areas of improvement in its healthcare system. Assessing the successes and failures as well as the advantages and disadvantages of other countries’ healthcare systems may be instrumental in the development of modifications to the organization and delivery system of healthcare in the US. This paper aims to report the information attained from previous literature as well as from first-hand observations from a public health trip to Cuba in order to compare the healthcare systems in Cuba and the United States. Materials and Methods: A group of New York University College of Dentistry faculty and students traveled to Cuba in April 2019 for professional research and professional meetings (CFR 515.564). While in Cuba, the researchers took written notes of the lecture-based material and conversations. Upon return to the United States, published literature was searched for the collection of any additional data and all qualitative data and quantitative data was compiled and organized. Since 1959, Cuba has made continuous adjustments and improvements to its universal, free and accessible healthcare system. Results: There have been notable improvements to the country’s public health status, such as the implementation of an immunization program and subsequent eradication of communicable diseases, such as polio and rubella. Additionally, the implementation of the National Program on Dentistry guarantees dental care to all Cuban children under the age of 19. Today, the Cuban National Health System (NHS) initiatives have evolved to combat the novel coronavirus (COVID-19) pandemic. Conclusion: Recognizing the advantages as well as the disadvantages of the Cuba’s National Health System (NHS) would be useful for future policymakers in the United States. Cuban approaches to health could be tailored to the United States environment to improve healthcare effectiveness and population health status in the future.

The rules of the game: Healthcare systems and cross-national attitudes about healthcare provision

2021 ◽  
Vol 62 (4) ◽  
pp. 311-348
Author(s):  
Michaela Curran ◽  
Cynthia Cready ◽  
Ronald Kwon
Keyword(s):  
Welfare State ◽  
Healthcare System ◽  
Linear Models ◽  
Public Attitudes ◽  
Public Support ◽  
Healthcare Systems ◽  
Government Responsibility ◽  
Healthcare Provision ◽  
National Attitudes ◽  
Rules Of The Game

In recent years, healthcare typologies are increasingly scrutinized. Prevailing healthcare system categorizations draw on comparative–institutional welfare state arrangements that constitute the “rules of the game” for healthcare provision. Challenging these perspectives, health policy perspectives suggest that ongoing policy changes shifted the “rules of the game” in ways that are not adequately captured by traditional comparative–institutional typologies. As a result, new questions arise about which categorization is most salient for understanding public attitudes about healthcare. We adjudicate between these two perspectives by examining the association between healthcare system typology and two different and important types of attitudes about healthcare provision: government responsibility and spending. Using hierarchical linear models, we find that traditional welfare state conceptions of healthcare systems are more closely associated with public opinions about healthcare provision. In general, respondents in countries with healthcare systems that have greater state involvement and rely more on public financing, which are traditional, institutional–comparative factors, report greater support for government responsibility in and spending on healthcare. We highlight how rallying broad public support for changes to healthcare systems in the wake of the COVID-19 pandemic will require that researchers and policy makers understand what the public has come to expect about healthcare, as well as the institutional arrangements around healthcare that set the “rules of the game.”

Access of Elderly People to Affordable Healthcare: Problems and Solutions (A View from a Newly Independent State)

2012 ◽  
Vol 19 (2) ◽  
pp. 157-176 ◽  
Author(s):  
Radmyla Hrevtsova
Keyword(s):  
Health System ◽  
Elderly People ◽  
Healthcare System ◽  
Social Protection ◽  
The Elderly ◽  
Independent State ◽  
Problems And Solutions ◽  
European Health ◽  
And Performance

Abstract The problem of ensuring the access of the elderly to healthcare has lately become increasingly important. The accessibility of affordable healthcare for the elderly largely depends on the design and performance of the healthcare system, the level of overall social protection that elderly people can enjoy, as well as on the availability of legislative guarantees and the opportunity to use them. Those drivers, alongside with the prospects of the European health system developments and their potential implications on the access of elderly people to affordable healthcare are discussed in this article.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

scholarly journals HealthTEC Innovation Design - a proposal for a novel Master degree program based on Unmet Clinical Need, global Healthcare Challenges, and 21st century skills

2020 ◽  
Vol 6 (3) ◽  
pp. 599-603
Author(s):  
Michael Friebe
Keyword(s):  
Machine Learning ◽  
21St Century ◽  
21St Century Skills ◽  
Data Analytics ◽  
Industrial Revolution ◽  
Data Gathering ◽  
Healthcare Systems ◽  
Disruptive Innovation ◽  
Incremental Innovation ◽  
Healthcare Provision

AbstractThe effectiveness, efficiency, availability, agility, and equality of global healthcare systems are in question. The COVID-19 pandemic have further highlighted some of these issues and also shown that healthcare provision is in many parts of the world paternalistic, nimble, and often governed too extensively by revenue and profit motivations. The 4th industrial revolution - the machine learning age - with data gathering, analysis, optimisation, and delivery changes has not yet reached Healthcare / Health provision. We are still treating patients when they are sick rather then to use advanced sensors, data analytics, machine learning, genetic information, and other exponential technologies to prevent people from becoming patients or to help and support a clinicians decision. We are trying to optimise and improve traditional medicine (incremental innovation) rather than to use technologies to find new medical and clinical approaches (disruptive innovation). Education of future stakeholders from the clinical and from the technology side has not been updated to Health 4.0 demands and the needed 21st century skills. This paper presents a novel proposal for a university and innovation lab based interdisciplinary Master education of HealthTEC innovation designers.

scholarly journals 1655. Extrapulmonary Tuberculosis in a Large Healthcare System

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S816-S816
Author(s):  
Travis Denmeade ◽  
William Smith ◽  
Banks Kooken ◽  
Michael Leonard
Keyword(s):  
Health System ◽  
Healthcare System ◽  
Extrapulmonary Tuberculosis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Primary Objective ◽  
Hiv Positive ◽  
Hiv Status ◽  
Southeastern Us ◽  
Race Ethnicity

Abstract Background The US has seen a rise in the proportion of patients with extrapulmonary tuberculosis (TB) even though the yearly incidence of new TB cases has been in decline. The purpose of this study was to analyze incidence of extrapulmonary TB at Atrium Health, a large non-profit health system in the Southeastern US. Methods Retrospective chart review of 94 adult patients with culture confirmed extrapulmonary TB between 2008-2019. Individuals younger than 18 years were excluded from analysis. The primary objective was to examine incidence of extrapulmonary TB and compare it to that reported in the literature. Secondary objectives included determination of sites of extrapulmonary disease and associated patient characteristics including HIV status, race, ethnicity, and birthplace. Results 237 patients were identified as having confirmed TB infection from 2008-2019 in a retrospective analysis within the Atrium Health System. 94 (40%) were found to have extrapulmonary disease; 42 (45%) with concomitant pulmonary disease. The patients were 55% male, 40% African American, 21% Hispanic or Latino, and 51% US-born. Median age was 44 years (range 20-62). The most common sites of extrapulmonary TB were lymphatic (35%), pleural (24%), GI/Peritoneal (12%), CNS (10%), and Bone/Joint (10%). Lymphatic involvement was 40% cervical, 19% intrathoracic, and 16% axillary. 66% of skeletal disease was vertebral. Other sites included GU, pericardial, skin, and disseminated disease (5%). 37% were HIV positive, 18% with unknown HIV status as they were never tested. Information regarding patient’s race, ethnicity, and birthplace were unknown for 2 patients. The percentage of extrapulmonary cases were 29% in 2008, 39% in 2012, 38% in 2016, and 49% in 2019. Conclusion Lymphatic and pleural involvement were the most common extrapulmonary sites. Of those tested, 37% were HIV positive but there was a significant portion never tested showing a need for increased testing. The proportion of extrapulmonary TB cases since 2008 is higher at 40% compared to the 31% reported in the United States. There has been a rise in the proportion of extrapulmonary TB within our healthcare system and deserves further analysis. Disclosures All Authors: No reported disclosures

Incorporating Human Factors Into a Healthcare System’s COVID-19 Communication Strategy

2021 ◽  
Vol 10 (1) ◽  
pp. 175-179
Author(s):  
Rebecca L. Butler ◽  
Ann Katherine Hoobler ◽  
Lucy C. Stein ◽  
Erica S. Hoenig ◽  
Laura M. Lee ◽  
...  
Keyword(s):  
Human Factors ◽  
Healthcare System ◽  
Communication Strategies ◽  
Clinical Information ◽  
Effective Communication ◽  
Healthcare Systems ◽  
User Feedback ◽  
Communication Strategy ◽  
Successful Communication

The COVID-19 era has been an age of change for healthcare systems worldwide. At the beginning of the pandemic in particular, there was a huge need to rapidly communicate new and constantly changing information with critical safety implications. Previously successful communication strategies were not adequate for this unprecedented challenge. At MedStar Health, the Quality & Safety team led a unique partnership between human factors experts, clinical teams, and the communications department to develop a three-pronged strategy for effective communication during the pandemic. This strategy incorporated the following components: 1) Using human factors and usability concepts to distill complex clinical information into easy-to-understand infographics for frontline associates; 2) Creating regular, succinct messaging to distribute the information and provide frequent updates throughout the healthcare system; and 3) Designing and maintaining a usable webpage where associates could access up-to-date information relevant to their specialty at any time, on or off the hospital network. This strategy, which was dynamic and adapted to user feedback, was supported by associates as a streamlined method for communicating important information throughout the pandemic.

scholarly journals Radiológiai osztályon dolgozó szakdolgozók kiégési szintje Magyarországon

2019 ◽  
Vol 160 (27) ◽  
pp. 1070-1077 ◽  
Author(s):  
Dávid Sipos ◽  
Veronika Varga ◽  
Attila András Pandur ◽  
András Kedves ◽  
Melinda Petőné Csima ◽  
...  
Keyword(s):  
Healthcare System ◽  
Emotional Exhaustion ◽  
Negative Impact ◽  
Maslach Burnout Inventory ◽  
Three Dimensions ◽  
Radiology Department ◽  
Online Questionnaire ◽  
Descriptive Data ◽  
Cross Sectional ◽  
Work Related

Abstract: Introduction: Burnout can have a wide negative impact on the quality and the effectiveness of the health care system. The aim of our research was to assess the burnout level of the radiology department workers in Hungary. Method: Our quantitative, cross-sectional, descriptive data collection lasted from June to September 2018 using an online questionnaire. Simple, non-random sampling was carried out among radiology department workers in Hungary. In addition to our self-made questionnaire which included socio-demographic and work-related questions, an internationally validated Maslach Burnout Inventory questionnaire was sent out. Results: After data cleaning, a total number of 404 (n = 404) respondents were included in the statistical analysis. The majority of the respondents works in county hospital, the average year spent in the healthcare system was 18.3 (SD 13,7). The sample’s values at the depersonalization and emotional exhaustion dimension were slightly elevated in contrast to the average values. Educational level, age and years spent in the healthcare system had a significant influence on all the three dimensions of burnout (p≤0.05). The group of workers being 31–35 years old and the group of those who spent 16–20 years in the healthcare system are considered to be the most compromised groups in all the three dimensions of burnout. Respondents with master degree had significantly lower emotional exhaustion values than their colleagues. Conclusion: The increased value of the depersonalization and the emotional exhaustion can be an indicator for employers. Our results are similar like described in the international literature. Orv Hetil. 2019; 160(27): 1070–1077.

scholarly journals Different Reasons for Different Responses: A Review of Incumbents’ Adaptation in Carbon-Intensive Industries

2020 ◽  
pp. 108602661989399 ◽  
Author(s):  
Franziska Sump ◽  
Sangyoon Yi
Keyword(s):  
Carbon Emissions ◽  
Organizational Adaptation ◽  
Three Dimensions ◽  
External Shocks ◽  
Review Of The Literature ◽  
Organizational Responses ◽  
Environmental Pressure ◽  
One Dimensional ◽  
And Performance ◽  
Performance Heterogeneity

Organizations often respond in different ways to common external shocks. To advance theories on organizational adaptation and performance heterogeneity, it is essential to understand different reasons for different organizational responses. We examine how incumbents in carbon-intensive industries adapt to heightened environmental pressure to reduce carbon emissions. Based on a review of the literature, we propose three dimensions along which diverse organizational responses can be efficiently mapped out: goal, timing, and scope. Building on our proposed dimensions, we develop a typology of five different organizational responses. With this, we show that organizational responses are more diverse than a one-dimensional scale could show but that the heterogeneity is somehow limited as the positions on the dimensions are not independent but correlated. To understand this observed limited heterogeneity, we proceed by identifying reasons behind different organizational responses. Furthermore, we discuss the theoretical implications of our findings for research on organizational adaptation and sustainability.

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