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At least 613 records · Page 34Linked to original sources
PubMedDate not supplied

The opportunity to do better: lessons old and new from Germany's health system.

As the U.S. undertakes national health reform, it would do well to consider both the old and new lessons offered by Germany's century-old universal health system. "Old" principles include an explicit national policy, shared financial responsibility, universality of coverage, and structured financing. New lessons, which are more concerned with operational strategies, include societal affordability, budgets, supply side restrictions, and volume controls.

Competitive Medical Plans↗
PubMed1988

AIDS funding: competing needs and the politics of priorities.

Despite the Department of Health and Human Service's 1983 claim that AIDS is the nation's "number one health priority," funding for AIDS research, prevention, and treatment remains inadequate. Worse, it is often marshaled from or juxtaposed against other necessary health allocations. Consequent AIDS-related resource crises include diverting funds for research on other diseases to AIDS investigations, propping up AIDS prevention efforts at the expense of traditional sexually transmitted disease control programs, and pitting the health needs of AIDS patients against the needs of those seeking other urgent health services, e.g., prenatal care. While this forced competition typically is blamed on fiscal constraints, examination of federal spending priorities suggests that it results principally from Reagan Administration policies. This Administration has consistently boosted military spending at the expense of social and health services, and has deliberately undermined efforts to obtain sufficient and new allocations for AIDS. In order to avert political divisions spurred by competition for currently scarce resources, AIDS and other health activists together must argue that excessive military allocations must be shifted to health research and services, and that a national health program must be implemented, if AIDS programs are to be funded appropriately without jeopardizing other necessary health initiatives.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Epidemiologic field investigations by the Centers for Disease control and Epidemic Intelligence Service, 1946-87.

The epidemiologic field investigation is an important tool used by the Centers for Disease Control (CDC) to provide assistance to State, local, and international public health agencies. The Epidemic Intelligence Service (EIS) of the CDC is an ongoing program that gives physicians and other health professionals opportunities to learn and practice epidemiology. In the period 1946-87, EIS Officers and other professional staff based at CDC headquarters participated in 2,900 epidemiologic field investigations requested by State, local, and international public health agencies. Nearly two-thirds of the investigations involved infectious disease problems, while 13 percent involved noninfectious conditions; for 21.1 percent, the etiology of the problem was unknown when the investigation was initiated. Among the specific subcategories, bacterial causes were the most common, accounting for 864 (29.8 percent) of all investigations. During this 41-year period, an increasing proportion of the field epidemiologic investigations involved public health problems of noninfectious etiology. Trends in the types of investigations done probably represent the influence of such factors as CDC's priorities, organizational structure, and budget; the size of the EIS Program; national health initiatives; and the States' needs and programs.

Centers for Disease Control and Prevention, U.S.↗
PubMed1992

The merging of alcohol and drug treatment: a policy review.

Alcohol and drug treatment have separate histories in the United States. The large public treatment systems were established as separate institutions in the early 1970s and have developed separate research traditions and treatment programs. However, as a response to current treatment financing policy and epidemiologic descriptions of combined alcohol and other drug use in the population, the two treatment systems are merging at the state and local levels. This large structural change is taking place without the development and evaluation of treatment methods for combined problems and without discussion of overall health service or policy implications. This paper describes the changes occurring, examines the literature for its contributions in providing direction, and presents treatment method and policy issues which need to be part of the overall discourse.

Adolescent↗
PubMed1989

System of Scientific Advisory Boards at the National Cancer Institute.

This article describes the Boards of Scientific Counselors of the National Cancer Institute (NCI) and focuses on their role and their relationship to the other advisory boards used by NCI in the governance of the National Cancer Program. The advisory boards consist of the President's Cancer Panel, the National Cancer Advisory Board, the Boards of Scientific Counselors of the four programmatic divisions, and the Frederick Cancer Research Facility Advisory Committee. Each of these boards is an element of the organized system by which NCI obtains its scientific advice. The system provides a forum in which scientific directions and priorities are debated, ideas for research initiatives compete, and advice is given on the allocation of research and training funds. This article is a sequel to a number of earlier papers reviewing the corporate management structure that has been developed over the past decade at NCI.

National Health Programs↗
PubMed2004

Social science and health research: growth at the National Institutes of Health.

Programs within the National Institutes of Health (NIH) have recently taken steps to enhance social science contributions to health research. A June 2000 conference convened by the NIH Office of Behavioral and Social Sciences Research highlighted the role of the social sciences in health research and developed an agenda for advancing such research. The conference and agenda underscored the importance of research on basic social scientific concepts and constructs, basic social science research on the etiology of health and illness, and the application of basic social science constructs in health services, treatment, and prevention research. Recent activities at NIH suggest a growing commitment to social science research and its integration into interdisciplinary multilevel studies of health.

Culture↗
PubMed1992

Creating a healthy public.

Significant change in thought and action will be required for our health system to become capable of serving all citizens effectively. Reliance on market forces and political expediency to shape health policy has focused attention inappropriately on finding ways to pay for illness care rather than maximizing health status. This misdirection of thought and effort has led many of us to search for ways to assure that health policy decisions are consistently based on both science and an ethic of humane concern. Courageous and disciplined local leadership will be needed to motivate policymakers to focus on the task of creating a healthy public. Linkage of academicians and practitioners with the public in a manner than empowers communities to assess and prioritize their own health problems could foster a strong community-based demand for ethical and humane decision making. Constituent demand for improved health status could provide the support politicians need if they are to legislate a national health program that emphasizes health promotion and disease prevention as well as illness care.

Forecasting↗
PubMed2001

Federal efforts to improve quality of care: the Quality Interagency Coordination Task Force (QuIC).

FORMATION OF THE QUIC: The Quality Interagency Coordination Task Force (QuIC) was established in 1998 to enable the participating federal agencies to coordinate their activities to study, measure, and improve the quality of care delivered by federal health programs; provide people with information to help them in making more informed choices about their care; and develop the research base and infrastructure needed to improve the health care system, including knowledgeable and empowered workers, well-designed systems of care, and useful information systems. STUDY, MEASURE, AND IMPROVE CARE: The QuIC's initial efforts to improve the care delivered in federal health care programs have focused on diabetes, depression, and the effect of working conditions on quality of care. More recently, patient safety efforts are under way to establish a coordinating center that will enable those who are testing methods of reducing errors to share information across their projects and with experts in error reduction. DEVELOP A RESEARCH BASE AND INFRASTRUCTURE: The QuIC has coordinated efforts in credentialing, information on measures of quality, a taxonomy of quality improvement methods, and errors data collection. PROVIDE INFORMATION TO AMERICANS ABOUT HEALTH CARE QUALITY: The QuIC agencies are developing products that will enhance their ability to communicate with the American people about their health care choices: improved gateways for consumer information available from federal agencies, a glossary of commonly used terms, and guidance for producing report cards on quality of care. MOVING THE QUALITY IMPROVEMENT AGENDA FORWARD: Federal efforts to improve quality of care are moving forward in a more integrated fashion on a wide number of fronts.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

What kind of healthcare 'internal market'? A cross-Europe view of the options.

Many governments are trying to invent new types of 'internal' healthcare market that will expose health services to competitive pressures to innovate, contain costs, raise service quality, and respond better to consumer demands; but not expose them to 'market failures' which prejudice universal access to 'basic' health services. Policy debates in this area are muddled and constricted by a failure to differentiate the variants of internal market that are available. This article outlines a taxonomy of the main types of internal market: primary doctor purchasing; managed competition; competitive bidding; social insurance; and compulsory private insurance. It notes their main structural characteristics and differences. Although internal market reforms have been intended to support the commercialization of healthcare, the idea of designing new types of economic structure to avoid market failure in healthcare has wider and more radical implications than most policy-makers intend.

Competitive Bidding↗