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At least 253 records · Page 14Linked to original sources
PubMed2003

Implementation of provincial/territorial health goals in Canada.

During the past two decades, policy makers in most of Canada's provinces and territories developed broad population-level goal statements about desired health or health and social outcomes. The health goals development process used in each province/territory has been described in government documents and studied by a small number of researchers. However, there is a lack of published research examining the implementation and use of the health goals since they were developed. To begin to fill this gap, we conducted a study between 1998 and 2000 that examined the implementation of provincial/territorial health goals in Canada. Our findings indicate that as the 1990s drew to a close, provincial/territorial health goals were not being used explicitly by policy makers at either provincial/territorial or regional levels in most provinces in Canada to guide health policy and program development, implementation, or evaluation. Instead, the majority of health ministry and regional policy makers were employing strategic/business plans that, at best, reflected or were similar to the original provincial/territorial health goals. Moreover, even though all provinces and the NWT/Nunavut had health goals associated with broad social, economic, and physical environment health determinants, regional-level policy makers were giving priority to health care system goals over all other types of goals. We discuss our findings in relation to studies about health goals in other countries, and we suggest implications that our findings have for both future research and health policy.

Canada↗
PubMed2001

Mental health in Europe: problems, advances and challenges.

OBJECTIVE: To describe mental health care needs and challenges across the WHO European region of 51 nations. METHOD: Based on morbidity and mortality data from HFA Statistical Database and Health2l, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. RESULTS: There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. CONCLUSION: Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services.

Europe↗
PubMed2000

Background on the Oregon Health Plan.

Because of limited resources, the health care industry has been forced to choose how funds are spent. Public fee-for-service systems have begun to face the hard choices inherent in managed care. The Oregon Health Plan was designed to provide a rational approach to addressing these changes directly.

Health Care Rationing↗
PubMed2006

The best practices: use of the guidelines by ten state tobacco control programs.

BACKGROUND: The Best Practices for Comprehensive Tobacco Control Programs by the Centers of Disease Control and Prevention was the first national resource to define the nine required components of a comprehensive state tobacco control program. This evaluation examined how states used the guidelines in their program planning, and identifies strengths and weaknesses of the guidelines. METHODS: During 2002-2003, data were collected and analyzed from ten state tobacco control programs on familiarity, funding, and use of the guidelines. Data were collected via written surveys and qualitative interviews with key tobacco control partners in the states. The typical number of participants interviewed was 17, representing an average of 15 agencies per state. RESULTS: Lead agencies and advisory agencies were the most familiar with the guidelines, while other state agencies were less aware of the guidelines. Participants' prioritization of the nine components was closely related to the lead agencies' estimated category expenditures. Three states modified the guidelines to develop more-tailored frameworks. Major strengths of the guidelines included providing a basic program framework and state-specific funding recommendations. The guidelines did not address implementation strategies or tobacco-related disparities, and had not been updated with current evidence-based research. CONCLUSIONS: The guidelines are important recommendations for state tobacco control programs. To continue to be useful to states, the guidelines need to be updated to address implementation and tobacco disparities, and include additional evidence-based examples. Active dissemination of updated guidelines needs to be increased beyond typical consumers to other tobacco control partners such as coalitions and other state agencies.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

Contraceptive security, information flow, and local adaptations: family planning Morocco.

BACKGROUND: Many developing countries increasingly recognize and acknowledge family planning as a critical part of socio-economic development. However, with few health dollars to go around, countries tend to provide essential drugs for curative care, rather than for family planning products. Donors have historically provided free contraceptives for family planning services. Whether products are donated or purchased by the country, a successful family planning program depends on an uninterrupted supply of products, beginning with the manufacturer and ending with the customer. Any break in the supply chain may cause a family planning program to fail. A well-functioning logistics system can manage the supply chain and ensure that the customers have the products they need, when they need them. METHODOLOGY: Morocco was selected for the case study. The researchers had ready access to key informants and information about the Logistics Management Information System. Because the study had time and resource constraints, research included desktop reviews and interview, rather than data collection in the field. RESULTS: The case study showed that even in a challenging environment an LMIS can be successfully deployed and fully supported by the users. It is critical to customize the system to a country-specific situation to ensure buy-in for the implementation. CONCLUSIONS: Significant external support funding and technical expertise are critical components to ensure the initial success of the system. Nonetheless, evidence from the case study shows that, after a system has been implemented, the benefits may not ensure its institutionalization. Other support, including local funding and technical expertise, is required.

Contraceptive Agents↗
PubMed1994

Business planning: can the health service move from strategy into action?

Advances the case for the use of one particular business planning technique within a National Health Service Trust. At the present time, NHS trusts are required to write strategic direction statements. Evidence suggests that these documents provide an accurate account of past performance and present position of the trust, but do not express the future position intended to be achieved. These documents also tend to be lengthy and lack strategic focus, which means that they are not helpful to managers who want clear organizational goals and objectives to which to work. Attempts to address the difficulties associated with determining how existing skills and resources can be used as the platform for future growth strategies by using the Ansoff Matrix and SWOT Analysis planning tools, given the external changes in the marketplace. Also attempts to shed light on some of the important links between busines strategy and management development by extending planning theory into practice.

Commerce↗
PubMed2003

[Assessment and implementation of guidelines].

The importance of guidelines increases continuously on the political level whereas on the user level reservations and uncertainty persist. Consequently guidelines are not considered as they should be. Guidelines will develop their effectiveness only if they are firmly implemented in the delivery process. Acceptance problems spring from problems in development and from aspects of dissemination and implementation not sufficiently considered so far. Therefore a lot of countries have developed quality criteria for guidelines and programmes for quality promotion. To further the use of guidelines in the care process aspects of dissemination and implementation have to be recognized even in the development process. This has not been recognized sufficiently so far. Implementation of guidelines is a systematic approach which has to be connected seamlessly with other activities (e. g. quality management). The implementation process should be accompanied and evaluated so that a continuous adjustment is possible. Most of the existing guideline programmes do not consider this sufficiently. The following contribution gives a survey of results and introduces means and instruments for assessment and implementation of guidelines.

Forecasting↗
PubMedDate not supplied

Health care reform in Kenya: a review of the process.

The paper looks at the process of health care reform in Kenya during the past 30 years, with a focus on implementation strategies. The data are from official documents of the government. The main finding is that development plans served as the medium through which the government announced its intentions as well as its decisions to implement reforms. A decision to implement a reform was normally accompanied by an implementation budget, whereas an announcement of an intention typically lacked such support. Some of the reforms were implemented speedily and firmly, whereas others suffered delays and reversals. Reforms were implemented with speed and firmness when research provided clear guidance on key policy issues or when political will and skill existed. Donor influence on the timing of reforms might have been excessive. Policy lessons from the process are indicated.

Delivery of Health Care↗
PubMed1990

Operational research need in guineaworm eradication programme.

To achieve global guineaworm (GW) eradication in 1990s, it is of paramount importance for GW endemic countries to immediately identify and solve the existing deficiencies and inconsistencies in GW eradication programmes (GWEP). This is possible only through concurrent evaluation and operational research. The present communication highlights the simple operational research which could be undertaken by GWEP managers to improve programme efficiency at various levels of its implementation.

Animals↗
PubMed2000

The Children's Health Insurance Program: expanding the framework to evaluate state goals and performance.

A comprehensive framework was devised to evaluate the State Children's Health Insurance Program (SCHIP) established in 1997. The framework relies on a number of potential measures and data sources for reviewing the program information recorded by states in SCHIP applications, particularly their strategic objectives and proposed performance measures. The analysis reveals that the states propose a wide range of objectives and measures and that there is considerable variation among the states. Overall, states' SCHIP plans tend to stress program enrollment and access to services but fail to emphasize the type and quality of services children receive once they are enrolled in the program. A broader conceptual framework is needed for policy makers, advocates, and researchers to make a full assessment of state goals and SCHIP performance.

Child↗
PubMed1996

Physician attitudes toward computerized practice guidelines.

Computerized information systems are gaining ground in quality improvement, and will become even more important as health plans implement, evaluate, and maintain clinical guidelines. PacifiCare of California explored physicians' attitudes toward applying computerized technologies to direct clinical guidelines. The results indicate not only physician acceptance factors, but illustrate the issues, such as information for medical decision making, that health plans must consider in developing computerized case management systems to manage the care of the chronically ill.

Attitude of Health Personnel↗
PubMed2006

Renal health models in Latin America: development of national programs of renal health.

PURPOSE: To verify the actions and degree of progress achieved in countries of Latin America and the Caribbean in the implementation of the Sustainable and Tenable Renal Health Model promoted by the Latin American Society of Nephrology and Hypertension (SLANH), together with local societies and the participation of the Pan-American Health Organization. (PAHO/WHO). METHOD: The implementation of workshops (e.g., "Toward a Sustainable and Tenable Renal Health Model") in each country involving health ministries, social security agencies, PAHO, scientific societies, medical organizations, and NGOs, among others, as well as start-up conferences with a special emphasis on local problems. Working teams will state the bases for planning, programming and evaluation in the Logical Framework Matrix and Matrix of Activities and Resources in the First Level of Care. The signature of the document "Declaration" with commitments undertaken by both public and private parties and a work schedule are required. RESULTS: So far, eleven countries in the region have conducted workshops and started activity in the frame of the Model/Program of Renal Health, which articulates the traditional vertical programs and generates a cross-program in the First Level of Care. Its components and strategies make up a cost-efficient control of cardiovascular, renal and endocrine-metabolic health. CONCLUSION: The Renal Health Model and its program is being built into public health care policies of countries in Latin America and the Caribbean and adapted to the needs of each country with an increasing acceptance on the part of health care professionals. It should not be implemented in isolation but within the framework of non transmissible diseases.

Cardiovascular Diseases↗
PubMed1998

Evaluating the Israeli health care reform: strategy, challenges and lessons.

Evaluating the implementation of health care reform provides important information on its effect, as well as a factual basis for deciding upon mid-course modifications. Although researchers in various countries are addressing the impact of reform, only few governments have initiated a structured, planned evaluation to accompany reform efforts. In Israel, the 1995 National Health Insurance Law earmarked 0.1% of the health care budget for research on the law, coordinated by the National Institute for Health Policy and Health Services Research. This paper describes the evaluation strategy of the JDC-Brookdale Institute which is taking part in the research efforts. Implementation of the evaluation strategy and the challenges of evaluating a major reform of the health system are discussed. The evaluation strategy combines elements of formative and summative evaluation using a 'case study' approach which seeks to integrate in-depth understanding of the changing health system and of health care provider's organizational behavior, with a variety of outcome measures. The Israeli case provides support for the proposition that an integrated approach to evaluating health reform provides a better understanding of the subject under review and thus a better basis for making useful recommendations to policy makers. In addition, such an approach enhances the validity and credibility of the data and thus the probability of making an impact, which is a main objective of formative evaluation. Examination of the Israeli case, provides important insights about evaluation of health system reform, and may benefit researchers in other countries attempting to evaluate health care reform.

Evaluation Studies as Topic↗