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Perspectives from micronutrient malnutrition elimination/eradication programmes.

Micronutrient malnutrition cannot be eradicated, but the elimination and control of iron, vitamin A and iodine deficiencies and their health-related consequences as public health problems are currently the targets of global programmes. Remarkable progress is occurring in the control of goitre and xerophthalmia, but iron-deficiency anaemia (IDA) has been less responsive to prevention and control efforts. Subclinical consequences of micronutrient deficiencies, i.e. "hidden hunger", include compromised immune functions that increase the risk of morbidity and mortality, impaired cognitive development and growth, and reduced reproductive and work capacity and performance. The implications are obvious for human health and national and global economic and social development. Mixes of affordable interventions are available which, when appropriately adapted to resource availability and context, are proven to be effective. These include both food-based interventions, particularly fortification programmes, such as salt iodization, and use of concentrated micronutrient supplements. A mix of accompanying programmes for infection control, community participation, including education, communication and information exchange, and private sector involvement are lessons learned for overcoming deterrents and sustaining progress towards elimination.

Anemia, Iron-Deficiency↗

[Ambulatory medical care in Mexico: the cost for users].

OBJECTIVE: To analyze the results of the National Health Survey (ENSA-II) as to the costs generated by the search and obtainment of ambulatory medical attention in various institutions of the private and public health sector. MATERIAL AND METHODS: Information was raised from the health care cost indicators reported by the study population of the ENSA-II. The dependent variable was the direct expense for the consumer and the independent variables, the condition of being insured and the income. Variation significance levels were identified using the test by Duncan. RESULTS: The costs at national level in US dollar were: transport $2.20, medical visit $7.90, drugs $9.60, diagnostic studies $13.6; average total cost for ambulatory attention was $22.70. Empirical finding suggest a new direct and indirect cost-for-consumer analysis for the health care users. These costs represent an important burden on the family income, which worsens when users are not insured. CONCLUSIONS: Incorporation of the economic perspective to the analysis of public health issues should not be limited to the analysis of the health provider's expenses, particularly if the problems of equity and accessibility must be solved, which are at present characteristic of health care services in Mexico.

Ambulatory Care↗

Windows NT continues its battle for market share.

A growing number of health care organizations are implementing applications that run on the Microsoft Windows NT network operating system. But most of the early adopters are applying NT at the department level rather than using it for enterprisewide tasks. And the many flavors of Unix continue to dominate the market for network operating systems in health care.

Contract Services↗

Cost containment mechanisms in Canada.

AIM: Describe the mechanisms currently being used by federal and provincial/territorial governments, medical associations, and private insurers to control the cost of health care in our country. METHODS: Descriptive method used. Statistics on percentage GDP spent on health, and health status of the population, were compared with other OECD countries. Questions discussed: importance of cost control, why difficult to control, and what is needed to control costs. RESULTS: System-wide mechanisms used to control health care costs include: single payer financing, universal coverage for hospital/physician services, global budgets, preventive health services, evidence-based information systems, and regionalization. Sector specific mechanisms used to control costs of physicians, hospitals, drugs, and technology. Cost control within the health care sector allows spending on other sectors (e.g., employment) that have a proven impact on one's health. Future health care cost containment policies must focus on restraining private sector costs and encouraging movement towards the determinants of health approach. CONCLUSIONS: Canada's relative success in containing costs is the result of public financing of the health insurance system. Our single payer, publicly financed health care system, allows for cost containment and universal access based on need for services rather than ability to pay. The shift of costs from the public to private sector must be curtailed. The determinants of health approach is instrumental in containing and channeling future spending on health.

Canada↗

When the new millennium rolls in, will your facility still be standing?

The health care industry as a whole lags far behind other industries in preparing for the year 2000. Experts say about half of health care providers won't be ready. Important first steps are taking an inventory of medical devices and systems that may have year 2000-related glitches and then making a prioritized list of what to fix first. Experts advise making contingency plans such as having extra staff available Dec. 31, 1999, and stocking up on battery-powered radios and lights.

Chronology as Topic↗