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Results for “Health Plan Implementation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed2000

Big bang and the policy prescription: health care meets the market in New Zealand.

This article discusses events that led up to and the aftermath of New Zealand's radical health sector restructuring of 1993. It suggests that "big bang" policy change facilitated the introduction of a set of market-oriented ideas describable as a policy prescription. In general, the new system performed poorly, in keeping with problems of market failure endemic in health care. The system was subsequently restructured, and elements of the 1993 structures were repackaged through a series of incremental changes. Based on the New Zealand experience, big bang produces change but not necessarily a predictive model, and the policy prescription has been oversold.

Health Care Sector↗

PubMed2000

A cost measurement study for a home-based telehospice service.

A telehospice service is one in which telemedicine is used to provide hospice care in the home. To date, there have been few studies addressing the cost of home-based telemedical care, and none that specifically addresses cost-effectiveness for telehospice recipients. We measured costs for traditional hospice care as well as those associated with launching and operating a telehospice service. The costs were tallied over two separate three-month periods. For the first study period, costs were measured for traditional hospice home visits. During the second, expenses were monitored for traditional (in-person) and telehospice visits. For traditional care, the cost per visit was $126 and $141, for the first and secod time periods, respectively. The average telehospice visit cost was $29.

Health Plan Implementation↗

PubMed2000

Complex systems in technology and policy: telemedicine and telecare in Japan.

We have examined aspects of the development of telemedicine and telecare in Japan. Despite Japan's reputation as an integrated and technocratic country, the diffusion of telemedicine has fallen below expectations, notwithstanding the urgent need to solve the problems of an ageing society. There has been a fragmentation of objectives and perspectives within the corporate (manufacturing) sector and within the policy sector of central and local government. There has also been a broader fragmentation between manufacturers, government and users (doctors and hospitals). As a result, the success or failure of individual projects appears to depend not on the quality of the technology, and often not on the evident importance of the social need, but on the overall coherence of a complex socio-technical system.

Financing, Government↗

PubMed2006

Putting policy into practice: the example of COPD.

Chronic lung disease is one of the commonest reasons for consulting a health professional, and there may be as many as 3 million people in the UK with undiagnosed chronic obstructive pulmonary disease (COPD). This fourth article in a series on long-term conditions examines the policy developments that have been put in place to manage the burden of chronic disease in England and Wales, and argues that more remains to be done if COPD is to be properly addressed.

Aged, 80 and over↗

PubMedDate not supplied

What the federal government can do about the nonmedical determinants of health.

Growing recognition that the acute health care delivery system contributes proportionally less to health when compared with environment and behavior has focused scholars and public health experts on the need to address nonmedical determinants of health. This paper outlines some steps that the U.S. government can take to address these factors and describes some of the challenges involved. Actions that can be undertaken now are increased education and leadership, development of mechanisms to further collaboration among sectors, expanded monitoring and reporting on nonmedical determinants, and developing new knowledge about how these factors affect health and successful interventions to address them.

Cooperative Behavior↗

PubMedDate not supplied

Health care spending and use of information technology in OECD countries.

In 2003, the United States had fewer practicing physicians, practicing nurses, and acute care bed days per capita than the median country in the Organization for Economic Cooperation and Development (OECD). Nevertheless, U.S. health spending per capita was almost two and a half times the per capita health spending of the median OECD country. One proposal for both lowering health spending and improving quality is the adoption of health information technology (HIT). The United States lags as much as a dozen years behind other industrialized countries in HIT adoption--countries where national governments have played major roles in establishing the rule, and health insurers have paid most of the costs.

Attitude of Health Personnel↗

PubMedDate not supplied

[The family health program and the reconstruction of basic health care in the Systema Unico de Saúde: a contribution of Brazilian nursing].

The present study is a reflection about the historical, political and administrative dimensions of the reorganization of basic attention health services in Brazil, especially PSF and PACS. It also discusses the insertion of nursing professionals in these organizations, focusing on the management of total care in nursing assistance.

Brazil↗

PubMedDate not supplied

Sentinel areas: a monitoring strategy in public health.

Available techniques for monitoring the health situation have proven insufficient, thus leading to a discussion of the need for their improvement based on new data collection strategies allowing for data use by local health systems. This article presents the methodological basis for a strategy to monitor health problems utilizing demarcated intra-urban spaces called "sentinel areas" to collect fundamental social, economic, behavioral, and biological data for public health that allow for a closer approach to the reality of complex social spaces. The authors present an experience that is being developed in Salvador, Bahia, Brazil, to evaluate the epidemiological impact of an environmental sanitation program. They discuss selection criteria for the areas and the potential uses of this strategy allowing for the rapid utilization of epidemiological resources by health services and the timely application of the results to reorient and enhance health intervention practices.

Brazil↗

PubMed2002

The World Health Report 2000: World Health Organization health policy steering off course-changed values, poor evidence, and lack of accountability.

The World Health Report 2000 on health systems has raised concerns about its political biases, its methods and indicators, and its lack of reliable data. Tracing the origins of the Report, this article argues that it counteracts many of the concerns that gave rise to preparation of the Report in the first place. The mutually agreed-upon value-base, expressed in the Health for All strategy, has been largely abandoned. The Report includes contradictory messages, and many of its recommendations are not evidence-based. Furthermore, the ranking of countries according to their health systems' performance is not useful for health-policy-making, even if the methods and data could be improved. Because the member states and governing bodies of the WHO were not consulted during the production of the Report, the WHO secretariat has not received a mandate to change the value-base of the WHO's health policy or the aims of the Report. The WHO should return to its mandate as a normative intergovernmental U.N. agency on health.

Communicable Disease Control↗

PubMed2001

Bioterrorism preparedness and response in European public health institutes.

The terrorist attacks on 11 September 2001 and the deliberate release of anthrax in the United States had consequences for public health not only there, but also in Europe. Europe's public health systems had to manage numerous postal materials possibly contaminated with anthrax. Our survey aimed to document the response of European public health institutes to recent bioterrorist events to identify the gaps that need to be addressed; 18 institutes from 16 countries participated in this Euroroundup. Bioterrorist threats in Europe were hoaxes only, and should be considered as a "preparedness exercise" from which three lessons can be drawn. Firstly, because of inadequate preparedness planning and funding arrangements, Europe was not ready in October 2001 to respond to bioterrorism. Secondly, although European institutes reacted quickly and adapted their priorities to a new type of threat, they need adequate and sustained support from national governments to maintain their overall capacity. Thirdly, the recent crisis demonstrated the need for increased investment in epidemiology training programmes and the establishment of a technical coordination unit for international surveillance and outbreak response in the European Union.

Bioterrorism↗

PubMedDate not supplied

Recruiting worksites to participate in a health promotion research study.

PURPOSE: In this study, the type and size of participating and nonparticipating worksites in a health promotion research trial were examined. DESIGN: In-person and telephone contacts were made with representatives from a random sample of eligible worksites recruited to participate in a research trial to increase fruit and vegetable consumption. SETTING: Worksites that had 250 to 2000 employees and a worksite cafeteria were recruited. SUBJECTS: Eighty-one worksites were contacted. MEASURES: A census of eligible worksites (N = 109) formed the recruitment base, and a random selection of worksites (N = 81) was personally contacted and asked to participate in the research. Information on size, type of worksite, and a worksite representative was obtained from a privately compiled list covering the greater Puget Sound area. Eligibility for the project included the presence of an onsite cafeteria at the worksite as assessed by a brief telephone call. RESULTS: Thirty-six of the contacted worksites (44.5%) agreed to participate. There were no significant differences in participation by type or size of worksite. DISCUSSION: Worksites can be recruited to participate in research trials. No particular type or size of worksite is more likely to participate. Instituting pre-randomization participation conditions may reduce post-randomization dropout by ascertaining compliance with research requirements before randomization.

Feeding Behavior↗

PubMedDate not supplied

Project Salsa: development and institutionalization of a nutritional health promotion project in a Latino community.

PURPOSE: Project Salsa was a community-based effort seeking to promote health through nutritional behavior change in a Latino community of San Diego, California. The purpose of this article is to report on program factors related to long-term institutionalization of Project Salsa interventions. DESIGN: Project Salsa was a demonstration rather than an experimental project. To ensure maximum sensitivity to the needs and values of the community, Project Salsa began with an extensive health needs assessment, including development of an advisory council, telephone survey, archival research, and key informant interviews. SETTING: Project Salsa interventions took place in San Ysidro, California, located near the U.S.-Mexico border adjacent to Tijuana from 1987 to 1992. SUBJECTS: The intervention community had 14,500 residents, of which nearly 83% were Latino. INTERVENTIONS: Interventions included coronary heart disease risk factor screenings, meal preparation classes, newspaper columns, point-of-purchase education, school health and cafeteria programs, and breast-feeding promotion. MEASURES: Institutionalization of intervention components. RESULTS: Two of the interventions, the risk factor screenings and school health programs, are still in operation 4 years after the end of project funding. CONCLUSIONS: Four factors common to institutionalized components are presented in the paper.

Adult↗

PubMedDate not supplied