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At least 109 records · Page 6Linked to original sources
PubMed1998

National health policy influence on Medicare home health.

National health policy regulates the delivery of Medicare home health services. These services have grown exponentially over the past several years. Current challenges to service delivery revolve around attempts to contain costs while ensuring quality of and access to care. To meet these challenges, providers must be aware of the societal and ideological influences on national health policies that impact service delivery. This article uses Wong's model of the progression of health care reform to address past health policy influences on Medicare home health delivery, investigate recent sociological trends for relevance to health policy, and propose changes based on current ideology.

Aged↗
PubMed2001

Competitive health policies and community health.

Since 1992 there have been fundamental changes in health care policy in Victoria, Australia, as the state government moves to competitive market models of service delivery and the measurement of service provision through output based funding. The introduction of competitive relationships to the public health system has had a major impact in the primary health care sector, particularly on community health centres. Most community health centres in Victoria have traditionally been semi-independent agencies controlled by community based committees of management. Such policies have had huge implications for the management and organisation of these agencies, as they have led to different patterns of service delivery and different models of management practice, often devaluing traditional philosophical perspectives of 'primary health care practice'. Although many agencies have embraced change as providing opportunities for growth and development and to have more influence in the provision of mainstream public health care, primary health care models of practice should be supported for their intrinsic and increasing value.

Community Health Centers↗
PubMed2002

Health policy and outlook.

Health policy has great influence on the daily work of every cardiologist. The influence of progress of practical cardiology on health policy in our country on the one hand and the influence of health policy on cardiology on the other hand are discussed, In the 1970s cardiac rehabilitation in special rehabilitation clinics was developed as a consequence of the usual therapy at that time with longer periods of bedrest and late invasive diagnostic procedures. Patients got a right on rehabilitation by law. However, in the 1980s the increasing number of rehabilitation clinics in our country and their budgets caused the first controversial discussion on health policy in our society, which was primarily thought to be a scientific one. At that time one of the first guidelines of the Commission of Clinical Cardiology as to coronary dilatation demanded in necessity of immediate cardiac surgery. To get more influence on the ongoing discussion the group of chief clinical cardiologists founded their own working group which had later on considerable influence on policy and scientific work of our society. Overall, the awareness of the need for active health policy was developed relatively late. For instance, the register of nationwide heart catheterization procedures was started in the early 1980s but was not used to influence health policies, for establishment of new catheterization facilities. At present, the development of cardiology is limited by budget and total number of cardiac operations is reduced, so it is time to remember the highly effective conservative "soft" therapy of atherosclerosis with a combination of drugs and changing lifestyle which is well evaluated in prospective studies. It is time to apply and reevaluate the chances of primary and secondary prevention of atherosclerosis and heart insufficiency. New non-invasive techniques as MRT and PET and therapeutic techniques as genetic or stem cell therapy will influence cost and health policy in the near future.

Cardiology↗
PubMed1997

Implementation of ethnic health policy in community mental health centres in Melbourne.

The implementation of ethnic health policy in community mental health centres was investigated by using structured interviews with coordinators and staff of 13 centres in Melbourne. The major finding was that most policy recommendations were not implemented and that work on ethnic issues resulted from the initiatives of individual staff. The study demonstrates that the successful implementation of ethnic health policy requires higher priority from policy makers and government, greater attention to mechanisms to require or encourage implementation, and a strategy to ensure that resources (new or redirected) are allocated to the implementation process.

Adolescent↗
PubMedDate not supplied

Quantitative policy analysis and public health policy: a macro and micro view.

This article considers three examples of the use of quantitative policy analysis in setting public health policy: (1) benefit:cost and cost-effectiveness studies of influenza immunization and their role in achieving Medicare reimbursement for influenza immunization; (2) the 1993 World Bank World Development Report, which compared the burden of various health problems in different regions of the world and the cost-effectiveness of interventions for these problems, recommending a core set of public health and primary care services as being the most cost-effective; and (3) the role of the Agency for Health Care Policy and Research and how it might change if health care reform legislation such as President Clinton's original proposal were to be enacted. Finally, I describe the use of quantitative policy analysis to guide policy in one government agency--the Centers for Disease control and Prevention (CDC).

Cost-Benefit Analysis↗
PubMedDate not supplied

The need for evidence-based health policy to address health care variations.

Medicare policy making now deals mostly with price-setting issues. However, as Warren Buffet has noted: "Price is what you pay. Value is what you get." Victor Fuchs's studies raise fundamental issues for a value-oriented Medicare program. Florida offers one of many regional patterns of Medicare mortality that are not yet adequately explained. Valued-oriented, evidence-based Medicare policies would target opportunities to improve population health and would foster greater use of evidence-based medicine.

Delivery of Health Care↗
PubMed1980

Social and economic attitudes shaping American health policy.

The Health Clark Lectures (University of London) explore the development of American health care policy in a social and economic context; the probability of transatlantic relevance is substantial. I. American Health Care: Selected Policy Issues. The U.S. economy is beset with difficulties, and social policy bends to these realities and to perceptions of them. In the climate of growing neoconservatism, efforts to develop a coherent and cohesive national health policy are discontinuous and even inconsistent. II. Efficiency and Equity in Medicine: The Role of the Economist. The critical issue for economic policy is the amount spent for health care in society; for social policy it is the way that amount is shared. Certainly, there is an interplay between the two, but we must be wary of finding common ground in economic-investment and benefit-cost approaches. Striving for equity offers the best strategy to attain efficiency.

Attitude to Health↗
PubMed1992

The organic dimensions of health policy.

The health care system is a level of the larger social system, within which it must seek and find its equilibrium. This organic concept leads to a more realistic assessment of needs and goals, and can make a significant contribution in helping reshape national health policy. It also suggests a re-examination of a two-tiered approach to health benefits: a universally available level of care deemed essential for meeting social needs, and an optional coverage level directed toward meeting those individual life goals which may exceed social needs.

Delivery of Health Care↗
PubMedDate not supplied

[Health policy and occupational health: tools and methods to assure quality and appropriateness of interventions].

BACKGROUND: Although all health care organizations and professionals are encouraged to follow the explicit aim of reducing the burden of illness, accidents and disability, there is increasing pressure on health professionals to ensure that the practice be based on a quality standard and on evidence of appropriateness. OBJECTIVES AND METHODS: The paper aims to focus on both the concept and dimensions of appropriateness (a complex issue with various dimensions and definitions) and on the different research and practice models aimed at search, analysis and synthesis of the best available evidence to be applied in the decision process of health and medical practice. Literature analysis has been carried out to find available tools and methods to identify, implement and monitor the evidence of efficacy in health care systems and services. RESULTS: Most definitions of appropriateness address a number of requirements. An appropriate practice should be effective (based on sound evidence); efficient (providing that cost is considered) and consistent with the ethical principles and preferences of the relevant individual, community or society. Appropriateness is considered as the next frontier in the development of health care research: there is still limited knowledge, awareness, or research on this aspect. Health Technology Assessment consists of a multidisciplinary activity based on the systematic examination of technical performance, safety, clinical effectiveness and efficiency, including socio-economic, legal and ethical aspects. Evidence Based Medicine originates from an individual perspective and aims at using rigorous criteria to obtain the best available evidence in order to provide efficient interventions. The Clinical Practice Guidelines, based on both evidence and opinions of experts, are intended to assist clinical decisions for health professional and providers for the improvement of professional practices and system efficiency, taking into account local customers, health needs and preferences. CONCLUSIONS: Several models exist for measuring and evaluating the efficacy of health systems and health services. They can be adapted for evaluating and measuring public and occupational health practices. These tools support good practice through quality-standardized interventions aiming at the health protection of communities and individuals. These models, which are presented in a specific framework in which their outcomes and critical factors are evaluated, should be adapted to public and occupational health interventions to satisfy implicit and explicit needs of individuals and populations at risk thus assuring their quality and appropriateness.

Biomedical Technology↗