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Biomedical subjects

D Hunter

Publications and source records attributed to D Hunter.

276 records · Page 16Linked to original sources

Alpine travel. Mountain sickness, the unwelcome companion.

A personal observation and two cases from the literature are described to draw attention to the dangers of mountain sickness and to the rapid progression from the milder form, termed acute mountain sickness, to the more serious conditions of high-altitude pulmonary or cerebral oedema and their possible fatal outcome. The pathogenesis and treatment of the disorders are briefly reviewed. It is stressed that there are no substitutes for acclimatization through gradual ascent and that the best treatment is to descend to a lower altitude.

Acclimatization↗

The challenges of health care restructuring.

Since the late 1980s, virtually every developed, and many developing, countries have re-examined the structure of their health care systems. Health care reform has become a truly global phenomenon with considerable potential for cross-nation lesson-learning. In countries where the state has been the central actor in the health sector, its role is being reassessed and, in some cases, reconfigured. The introduction of market principles to health care is a feature of many countries: market romantics believe markets in health care will improve efficiency, empower consumers, control costs, and overthrow monolithic bureaucracies. But will they? The evidence, such as it is, suggests otherwise. The greatest pressure for change and for introducing markets into health care has been in the relative role of the private sector in the operation, and in some countries also the financing of health care services. But it is not a simple case of the state versus the market. The issues are much more complex and various hybrid models are emerging involving some sort of public-private mix. The move is towards greater diversity and pluralism, an inevitable consequence of which is growing fragmentation in the funding and provision of care with all the associated on-costs in terms of increased coordination and management that this entails. The policy aim is to harness the benefits of market behaviour without also adopting the inherent weaknesses of markets with regard to questions of distributive justice and equity.

Evidence-Based Medicine↗