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Results for “Universal Health Insurance”

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PubMed2001

Implementing the universal health coverage: which source of information is more reliable?

The implementation of universal health coverage needs accurate data on the distribution of health benefit coverage, particularly the uninsured. The national surveys and routine reports are two important sources of information ready for use. This study shows the validation of data from two sources. The data from national household surveys on the medical welfare, the health card and the social security schemes were validated with the routine report data of the Ministry of Public Health (MOPH) and the Social Security Office (SSO) by provinces. There were considerable differences between these data sets. The national survey data gave a 1.5 times higher estimate than the report data of the MOPH and the SSO. Financial implications of using inaccurate data to implement the universal health coverage could be huge, depending on the capitation rate.

Adolescent↗
PubMedDate not supplied

Access to care.

Explore the source record for details and available documents.

Health Services Accessibility↗
PubMed2001

The right to health care.

They have needs, and because they live within a welfare state, these needs confer entitlements--rights--to the resources of people like me. Their needs and their entitlements establish a silent relation between us. As we stand together in line at the post office, while they cash their pension cheques, some tiny portion of my income is transferred into their pockets through the numberless capillaries of the state. The mediated quality of our relationship seems necessary to both of us. They are dependent on the state, not upon me, and we are both glad of it.... My responsibilities towards them are mediated through a vast division of labour.... When they can't go on, an ambulance will take them to the hospital, and when they die, a nurse will be there to listen to the ebbing of their breath. It is this solidarity among strangers, this transformation through the division of labour of needs into rights and rights into care that gives us whatever fragile basis we have for saying that we live in a moral community.

Canada↗
PubMed2002

Equity in waiting times for major joint arthroplasty.

OBJECTIVE: To ascertain whether waiting lists are managed in an equitable fashion in a universal health system by examining demographic, socioeconomic and clinical factors, along with 2 health systems variables. DESIGN: A prospective survey by questionnaire. SETTING: The Capital Health Region of Edmonton, Alta. PATIENTS AND METHODS: A cohort of 553 patients, who were waiting for either total hip or total knee replacement surgery, seen between Dec. 18, 1995, and Jan. 24, 1997. INTERVENTIONS: A home visit was made when the patient was first placed on the waiting list and again just before surgery to complete the questionnaires. The Western Ontario and McMaster Universities (WOMAC) instrument and the Medication Quantification Score were administered at the time the patient was placed on the waiting list. MAIN OUTCOME MEASURE: The length of waiting time, defined as the date the patient was put on the waiting list to the date the patient was operated on. RESULTS: There were no biases in waiting time with respect to age, gender, education or work status. Although pain and function were not related to waiting time, multivariate analyses found that marital status, primary language, body mass index, pain medication use and the size of the surgeons' major joint replacement practice determined waiting time for surgery. However, this model explained only 10% of the variance in waiting time. CONCLUSION: Waiting lists were managed unfairly in terms of clinical equity (clinical severity) but managed fairly in terms of social equity.

Aged↗
PubMed2002

When do developing countries adopt managed care policies and technologies? Part I: Policies, experience, and a framework of preconditions.

OBJECTIVE: For developing countries with constrained economic resources, managed care holds out the promise of being able to control healthcare costs and reduce unnecessary utilization. However, little empirical evidence has been gathered about when managed care techniques can be applied to these countries and no framework considers the macroeconomic context. We propose a straightforward method to evaluate the economic and policy environment of a developing country to assess when managed care might be introduced. STUDY DESIGN AND METHODS: Analysis of available developing country health system and healthcare spending data, review of the available literature, and authors' experience evaluating healthcare reforms in developing countries. RESULTS: Many countries have implemented managed care techniques, which are driven by policy efforts to increase quality or to control costs. Successful implementation of managed care, however, appears to depend on five major preconditions. One precondition is an adequately developed formal wage sector in which patients have a sufficient ability to pay for healthcare services. Another is an adequate labor supply of trained professionals to support managed care administration, foster competition, and use available information technology. CONCLUSIONS: Although managed care encompasses a range of incentives and arrangements, implementation in developing countries appears to depend on attaining macroeconomic preconditions.

Developing Countries↗
PubMed2002

How to reform the health care system given the experience of past failures.

There have been a number of attempts at a large-scale reform of the US health care system during the 20th century and all have failed. Problems continue to exist, however, in the organization, delivery, and financing of health care services. Under current economic conditions, the possibility for both reform and recovery is slim if at all. In this article, we discusses a realistic option to incremental reform that takes a more realistic view of the US social and economic situation of the 21st century and is more consistent with basic US values. Perhaps it is time for reformers to take such a pragmatic approach to this long-term problem.

Health Care Reform↗
PubMed2002

[HIV screening in pregnancy--too many failures?].

Danish official guidelines recommend that women belonging to risk groups should be offered HIV testing during pregnancy. Universal HIV testing during antenatal care is not required. We describe three infants with vertically acquired HIV infection born to mothers, who, despite belonging to high-risk groups (one from Thailand, two from Sub-Saharan Africa), had not been offered an HIV test during pregnancy. The infants, born within a one-year period, presented with AIDS-defining symptoms during their first months of life. Two children had Pneumocystis carinii pneumonia and one had severe failure to thrive. These cases demonstrate that a significant number, perhaps up to 20% of women with known risk factors, are not HIV-tested during pregnancy. Thus, selective screening for HIV during pregnancy is ineffective and should be replaced by a universal offer of an HIV test.

Denmark↗