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At least 703 records · Page 39Linked to original sources
PubMed2002

Mongolian experiences with health insurance: are success factors unique?

We describe the health insurance model implemented in Mongolia after the Soviet Bloc collapsed in 1990, and note some of its good features. We then discuss the structural weaknesses that became evident over the first ten years of use, and some current proposals for reform. Finally, we consider the factors that appear to have affected success. We argue that the main constraints are much the same as in other countries including Australia--and relate more to confusion and disagreement over broad policy issues than to detailed knowledge of technical aspects or the research evidence.

Capitalism↗
PubMed1998

Local reinvention of the CDC HIV prevention community planning initiative.

The Centers for Disease Control and Prevention (CDC), in coordination with 65 states, cities, and territories, implemented HIV prevention community planning beginning in 1994. This large scale innovation in public health planning has involved tens of thousands of professionals and community residents. Though a single case study, Michigan provides a strong test of the implementation of this national prevention planning model because of the state's decentralized approach to HIV prevention community planning involving several hundred residents. A decentralized approach to community planning promises to maximize participation and the sharing of leadership as well as obstacles to community planning. Here, the CDC Guidance for community planning is contrasted with empirical observation of implementation in Michigan. We conclude that the high expectations for a decentralized approach to HIV prevention community planning can be best achieved when a distinction is drawn between information-seeking tasks and decision-making tasks. We recommend that information-seeking tasks be centrally coordinated, and that decision-making tasks be decentralized, to most fully achieve the potential of HIV prevention community planning.

Centers for Disease Control and Prevention, U.S.↗
PubMed2006

Local implementation of the Family Health Program in Brazil.

This article discusses the implementation of the Family Health Program in the municipalities of Camaragibe, Aracaju, São Gonçalo, and the Federal District of Brazil, aiming to identify possible interfaces between the program's shaping and different incentives structures, the local health system's case-resolving capacity, experiences with social participation, and accountability mechanisms. The article shows that aspects related to the constitution of local health systems in terms of the quantitative and qualitative supply of services, technical and management training within the Municipal Health Department, investment in other levels of care, and local political traditions are crucial variables for understanding the diversity of experiences in the implementation of the Family Health Program.

Brazil↗
PubMedDate not supplied

The history of US national health plans: will these same issues resurface in 2004?

Health care managers are an important aspect of any proposed national health care plan; the implementation of such a plan will change their work lives in significant ways, no matter which type of plan is adopted. It is important to occasionally revisit historical developments, especially when they resurface in the people's consciousness. It appears that health care reform and various national health plan proposals may become an important part of the 2004 election, particularly given the economic concerns today. This article reviews health care plans in a historical perspective, particularly from the time of the 1930s onward, with a special longer look at Clinton's failure to implement a national health plan when the timing for such seemed perfect. Whether an individual manager is a supporter of national health plans or not, this article seeks to educate the manager on past efforts to better understand what may develop in the future.

History, 20th Century↗
PubMed1995

The role of research in systems reform.

Knowledge concerning the care of people with severe and persistent mental illness has grown dramatically, but that knowledge is seldom translated into improvements in care. The authors describe their involvement in three service delivery projects in Ontario and discuss how, by assuming multiple roles, they were able to ensure that planning and policy development were informed by current knowledge. In addition to being an investigator, such roles may include being an administrator, planner, consultant and advocate. The redevelopment of Whitby Psychiatric Hospital resulted in an innovative plan for a comprehensive, integrated service delivery system based upon community support services research. Implementation of the Graham Report in Ontario provided an array of district mental health plans which incorporate current knowledge with regard to service delivery. Ontario's mental health reform strategy represents a close connection between public policy and scientific information. The authors recommend that researchers be prepared to assume multiple roles in the service delivery field so as to reduce the gap between science and practice.

Comprehensive Health Care↗
PubMed2000

Lessons learned.

Mental health care reform in the public sector remains a local proposition. Oregon has thus far been able to avoid major failures and has modest successes to report. Although the road to achieving all that was envisioned at the outset remains long, the inclusive process followed gives reason for hope.

Health Care Reform↗
PubMed2000

Managed care and the implementation of the State Children's Health Insurance Program.

More than two years after its enactment, the Health Care Financing Administration, Baltimore, issued proposed regulations implementing the State Children's Health Insurance Program (SCHIP), enacted under the Balanced Budget Act of 1997. This program was enacted to provide health insurance coverage to the estimated 10 million uninsured children living in the United States. This article provides an overview of SCHIP and how it has been implemented in the various states.

Age Factors↗
PubMed2000

The mental health organizations.

The mental health organizations in the mental health phase-in were Oregon's pioneers moving into public managed care. A delicate balance between county mental health authority and private expertise was struck locally to yield a variety of organizational models across the state.

Health Maintenance Organizations↗
PubMedDate not supplied

Tobacco-control policies in 11 leading managed care organizations: progress and challenges.

CONTEXT: Although evidence-based national guidelines for tobacco-dependence treatment have been available since 1996, translating these guidelines into clinical practice is challenging. PRACTICE PATTERN EXAMINED: Policies regarding tobacco-dependence treatment (e.g., written guidelines and coverage of pharmacotherapy) and implementation strategies of 11 U.S. managed care organizations known to have strong tobacco-control programs. DATA SOURCES: Detailed telephone interviews with multiple informants at each health plan and review of written treatment guidelines and policies for tobacco dependence. RESULTS: Although 10 of 11 plans had adopted tobacco-dependence treatment guidelines consistent with the national guideline, fewer had guidelines for special groups, such as adolescents (6 plans), parents (5 plans), pregnant women (5 plans), and hospitalized smokers (3 plans). Most plans offered clinician training and recommended office systems to support provider efforts; however, fewer actively facilitated their implementation. Most plans provided other support for tobacco treatment, including dedicated budgets, designated staff, and an oversight committee. All plans offered some coverage for tobacco-cessation pharmacotherapy and behavioral counseling, although not to the extent recommended by the national guideline. CONCLUSION: Implementation of national tobacco-treatment guidelines is feasible in closed-panel managed care organizations. However, even these leading health plans could do more to comply with national practice guidelines on tobacco-dependence treatment and make it easier for clinicians to help patients stop smoking (e.g., through increased training and expanded coverage of tobacco-dependence treatment).

Evidence-Based Medicine↗