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At least 793 records · Page 44Linked to original sources
PubMed2000

Health technology assessment in Belgium.

The Belgian healthcare system has a Bismarck-type compulsory health insurance, covering almost the entire population, combined with private provision of care. Providers are public health services, independent pharmacists, independent ambulatory care professionals, and hospitals and geriatric care facilities. Healthcare responsibilities are shared between the national Ministries of Public Health and Social Affairs, and the Dutch-, French-, and German-speaking Community Ministries of Health. The national ministries are responsible for sickness and disability insurance, financing, determination of accreditation criteria for hospitals and heavy medical care units, and construction of new hospitals. The six sickness and disability insurance funds are responsible for reimbursing health service benefits and paying disability benefits. The system's strength is that care is highly accessible and responsive to patients. However, the healthcare system's size remained relatively uncontrolled until recently, there is an excess supply of certain types of care, and there is a large number of small hospitals. The national government created a legal framework to modernize the insurance system to control budgetary deficits. Measures for reducing healthcare expenditures include regulating healthcare supply, healthcare evaluation, medical practice organization, and hospital budgets. The need to control healthcare facilities and quality of care in hospitals led to formal procedures for opening hospitals, acquiring expensive medical equipment, and developing highly specialized services. Reforms in payment and regulation are being considered. Health technology assessment (HTA) has played little part in the reforms so far. Belgium has no formal national program for HTA. The future of HTA in Belgium depends on a changing perception by providers and policy makers that health care needs a stronger scientific base.

Belgium↗
PubMed1995

Computer-models for management of a cardiopulmonary clinic.

To optimize the transition of a cardiopulmonary ward management from a centrally directed (so called "socialist") healthcare system to a free market oriented one, the authors constructed two computer-models: one for the simulation of distribution of the financing and another for the simulation of interventional pathways in an operational flow chart. For parameter estimation specificity, sensitivity, and diagnosis probability, function curves have been defined. After using these models, the effectiveness of ward performance and the quality of care have improved.

Computer Simulation↗
PubMed2004

Capital access.

To maintain their viability, hospitals are being compelled to invest in big capital projects such as information technology and renovation and construction. This gatefold examines the trends in credit and capital, and how they affect hospitals' access to money.

Capital Expenditures↗
PubMed2005

Hospital development plans: a new tool to break ground for strategic thinking in Tanzanian hospitals.

Tanzanian hospitals suffer from underfunding and poor management. In particular, planning and strategic thinking need improvement. Cultural values such as subordination, risk aversion, and high time preference, together with a long history of socialist government, result in lack of responsibility, accountability, and planning. This has been addressed by the health sector reform with its focus on decentralization, strengthened by the introduction of basket funding facilitated by the Comprehensive Council Health Plans. As a consequence of this the next logical step is to improve the authority of regional and district hospitals in the use of their resources by introducing hospital development plans. These strategic plans were introduced as tools of strategic planning in 2001 by the Kreditanstalt für Wiederaufbau in close collaboration with the Tanzanian Ministry of Health, binding the release of rehabilitation funds to presentation of a strategic hospital plan. This study examines the rationale and content of hospital development plans. Initial experiences are discussed. The quality of presented plans has steadily improved, but there is a tendency for hospitals with a close connection to development partners to present well prepared reports while other hospitals have severe problems fulfilling the requirements. For many hospitals it is in fact the first time that they have had to define their functions and future role, thus breaking ground for strategic thinking.

Budgets↗
PubMed1975

Changing health care opinions in Regionville, 1946-1973.

This study is a partial replication study of a community with the fictious name of Regionville which was first studied by E. L. Koos in the period 1946-50. In the present paper, we are concerned principally with that part having to do with the changing health care beliefs in this community. The indications are that: 1) there has been considerably liberalization of opinion, particularly among upper class respondents, in terms of issues relating to national health insurance and the role of ancillary medical personnel such as social workers; and 2) social classes are much more similar in their perceptions of many medical care issues now than they were a generation ago. Finally, we suggest that the changing pattern of response of the questions asked in the late 1940s and again in the 1973 is reflective of profound changes in American life.

Attitude to Health↗
PubMed1987

The political development of the Hill-Burton program: a case study in distributive policy.

The Hill-Burton program offers a rare opportunity to study a distributive health policy from its adoption to its elimination. This study reveals that the political dynamics of the policy changed over time. It concludes by observing that interest group influence on distributive health policies may only be decisive when circumstances permit. Those circumstances include the involvement of powerful elected officials and the degree of consensus among policy experts about the need for the policy and the appropriateness of its objectives.

Financing, Government↗
PubMed1983

Investing for efficiency.

The French Revolution set out to abolish hospitals but in fact strengthened them, made them the core of medicine and improved their effectiveness. Mortality rates more than halved between 1789 and 1850. This reduction was bought about by improvement and investment in old hospitals, appropriate separation of institutions and new administrative organisations. Our modern hospitals and institutions started with the French Revolution and have been going through similar cycles of neglect and abolition or concern and investment. This paper will look at the effects of investments, neglect and "pork- barrelling " by successive governments which has led to inappropriate locations of hospitals, sub-standard facilities, inefficient location of facilities within hospitals, outdated equipment, insufficient maintenance and dangers to public health and human safety. Operating costs, consequences of inefficient layout, buildings and sites within a number of Australian hospitals are then analysed. It is then suggested that orderly capital funding on a triennium basis be established in a similar way to university capital funding.

Australia↗