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At least 1,135 records · Page 63Linked to original sources
PubMed1998

Financing changes of schistosomiasis control programmes in China 1980-1995: a case study in Songzi county.

To assess the financing changes of schistosomiasis control programmes in China and estimate the impact of these changes on patients' treatment-seeking behaviour and control of schistosomiasis, a survey was conducted in five schistosomiasis-endemic areas of the lake regions, Hubei province, in 1996. This paper reports financing changes and their impact on the incidence and prevalence of schistosomiasis from one of the five areas as a case study. By examining the surveillance and financial data from 1980 to 1995, and through focus group discussions we found that the schistosomiasis control programmes in People's Republic of China have gone through dramatic financing changes from 1980 to 1995, when the transitions of China's social, economic, and political systems happened. The proportions of funding to schistosomiasis control programmes from high level governmental agencies, county budgets, and services revenue changed from 60%, 23%, and 17%, respectively, in 1980-1987 to 0.7%, 22.3%, and 72% in 1995. The percentages of expenditure of schistosomiasis control activities, salaries and bonuses, and other activities unrelated to schistosomiasis control, were 53.5%, 14.4, and 17.2% in 1980. These percentages changed to 7.7%, 33.3%, and 53.3%, respectively, in 1995. The preponderant role of the state in organizing, financing, and delivery of the services was replaced with the new system which is more influenced by the market economy. The incidence and the prevalence of schistosomiasis in the study area have increased year by year from 1980 to 1990, although there has been a tendency to decrease after 1991 but not to the low pre1980 levels. The collapse of the community-based medical system in rural areas and the dramatic financing changes of schistosomiasis control programmes have created major difficulties for schistosomiasis control in China.

China↗
PubMed1992

The cost of fragmented mental health financing: is it worth it?

Three major aspects of mental health systems--the way they are financed, the configuration of services, and the outcome of services--are discussed. Problems of resource consumption, fragmentation of goals, and deleterious impacts due to financing systems, per se, are described. Levels of staff involvement in the financing system (as distinct from direct services) influence staff attitudes toward financing, services, and clients. Financing schemes appear to both influence the effectiveness of mental health systems and provide the dubious "advantage" of costing more. Studies are suggested that will compare comprehensive systems with an eye toward reform.

Chronic Disease↗
PubMed1997

Methodologies for informing beneficiaries of their rights: evaluating the Important Message from Medicare.

The Important Message from Medicare, a letter given to US Medicare patients upon hospital admission, was originally designed to allay the concerns of the Health Care Financing Administration (HCFA), Peer Review Organizations (PROs), and the beneficiary community that patients did not know their rights under Medicare and the PRO program. The effectiveness of the current Message may be adversely affected by the complexity of its language, the multifaceted admissions process, priorities of sick patients, and the demand for hospital resources. This study evaluated the effectiveness of the Message and various alternatives for informing beneficiaries of their rights. With HCFA financing, PROs in 10 states surveyed random samples of Medicare beneficiaries to measure knowledge of their rights under the current system and after the implementation of alternatives. This study found that there are alternative ways of informing Medicare beneficiaries of their rights which are more effective than the current Important Message from Medicare.

Aged↗
PubMed1983

An evaluation of institutional care of the aged in South Africa.

Problems associated with the care of elderly persons in institutions in South Africa are described. The importance of keeping ageing people in the community is stressed. The results of questionnaires sent to general hospitals, psychiatric institutions and old-age homes relative to the quality of medical and psychosocial care, availability of beds and finance are described. Recommendations for improvement in preventive sociomedical facilities in the community and in the education of medical, paramedical and nursing personnel involved in the care of the elderly are made. The development of assessment units and facilities for rehabilitation and convalescence as well as day-care centres and day hospitals is discussed. Improved co-ordination of services between hospitals, local authorities and voluntary organizations is required. Suggestions are made for the subsidization of old-age homes.

Black or African American↗
PubMed2002

[Financing medical research in the Netherlands: start taking care of the future now].

Less money is spent on medical research in the Netherlands than in other industrialised countries, even though Dutch science, and certainly Dutch medical science, scores qualitatively among the best in the world. Part of the explanation is that a relatively large part of scientific research in the Netherlands is financed directly by the government. As a result of several rounds of cutbacks in government spending, that were executed each time by cutting research that performed less well, the remaining research groups are at high qualitative level and highly competitive. In countries that surpass the Netherlands, there is an important second stream of government funding via Medical and Health Research Councils. In the same countries, the pharmaceutical industry also provides more money for medical research. The other side of the coin is that medical research in those countries seems more or less 'for sale'. Too heavy dependence on market oriented research leads to doubts regarding the independence of medical research. International observers judged that the direct financing of research by government in the Netherlands was an enormous bonus since it leads to flexibility to start new topics and at the same time stability of positions. However, a major concern for Dutch science is that there are too few possibilities to attract and hold promising young people. It is especially difficult to keep promising young women; though this is true for all industrialised countries, the Netherlands lags behind its major competitors as far as the position of women in the higher ranks of science is concerned. These problems will have to be solved by stimulation programmes for young researchers and flexibility of the higher echelons. The educational system must not be directed only at the production of more doctors for medical practice, but also at sufficient scientific training for these doctors so that they will be able to comprehend new developments. The ordinary daily practice of medical science is to verify the usefulness of new developments--which is just as important as breakthroughs at the top. This means that there should be new investments, not only for top ranking scientists in fashionable areas, but also to maintain sufficient numbers of medical scientists at all levels. It cannot be foreseen where the next new developments will arise, and even in a small country, active research should be ongoing in many areas to maintain contact with the international research community. New investments should primarily be in direct government financing and in augmentation of streams of money via Medical and Health Research Councils.

Education, Medical↗
PubMed1993

A community strategic planning process for elder services.

Dynamic changes in population, patient demographics, and healthcare financing mechanisms create shifting service priorities. Strategic planning has become a vitally important skill for nurse executives, who must extend their efforts and influence beyond traditional agency boundaries. The authors present an application of the strategic planning process as it was used to develop recommendations for eldercare services in one southwestern, urban community.

Adult↗
PubMed2005

[Financing of the scientific publication and protection of the scientific knowledge].

The main purpose of a study is its publication on a scientific journal. Research financing agencies are important institutions so that studies can be developed and published. The most important research financing agencies that are discussed in this article are: "Coordenação de Aperfeiçoamento de Pessoal de Nível Superior" (CAPES), "Conselho Nacional de Desenvolvimento Científico e Tecnológico" (CNPq) and "Fundação de Amparo à Pesquisa do Estado de São Paulo" (FAPESP). CAPES' activities can be grouped in four different strategy lines: a) it evaluates the stricto sensu, at the post-graduation level; b) it provides access and development of scientific research; c) it provides investment on the development of high qualified human resources in Brazil and abroad, and d) it promotes international scientific cooperation. Although CAPES does not support directly scientific publications, almost all actions of this agency contribute to the development of scientific research and publication. CNPq has two main purposes: financing researches and development of human resources. It provides the researchers with financial aid to scientific publication. The grants for editing were specifically created for supporting the national scientific and technical publications edited by Brazilians institutions or societies. CNPq can also support Congresses, Symposiums and similar short-term courses. The Plataforma Lattes is also a branch of CNPq on which the Curriculum Lattes is available. This site has the curriculum vitae of the scientific community and is of great value for researchers. FAPESP also finances journal publications, articles and books that bring up original results of studies made by researchers from the state of São Paulo. It finances, partially, the travel expenses of innovative papers authors in meetings within the country or abroad. Brazilian authors are increasing the number of international publications. Universities, research institutes, financing agencies and private companies are more and more concerned with knowledge property. Researchers must understand the need of knowledge property and the financing agencies have to consider the patents achieved as a criteria of evaluation of scientific production.

Biomedical Research↗
PubMed1979

Evaluation of drug abuse rehabilitation efforts: a review.

During the 1960s, three modalities of treatment aimed at rehabilitation of the drug abuser (methadone maintenance, outpatient drug free treatment, and the residential therapeutic community) were developed. Large amounts of public and private monies have gone to supporting these modalities; little evaluation as to the efficacy of such rehabilitation efforts has been done. This paper attempts to delineate the evaluative research efforts undertaken in the drug abuse field to date. In addition, the findings of an eight-year evaluation of six drug treatment programs in Newark, NJ are presented. The authors propose a paradigm for quick, effective evaluation of drug and alcohol programs at minimal cost.

Ambulatory Care↗
PubMed1987

Joint finance: promoting a new balance of care and responsibilities in England?

British government policy has long aimed at substituting local government community services for centrally-funded long-stay hospital services. Thus, the health service has depended on the willingness of locally administered and financed services to accept a shift in the balance of care. A special financial programme--joint finance--was introduced in 1976 to provide local authorities with an incentive to implement this shift. The programme apparently provided health authorities with the power to ensure that joint finance spending met their own priorities for service development. In practice, a number of influences combined to ensure that local authority interests and priorities prevailed. The principal lesson of this initiative, and its successor, is the importance of devising balanced incentives which prevent either party from exercising a veto over inter-agency transactions.

Community Mental Health Services↗
PubMed1996

Alternative tertiary care pathways for a rural Department of Veterans Affairs Medical Center.

This study addresses the cost of rural health care delivery where veterans do not have ready access to tertiary Department of Veterans Affairs Medical Centers (VAMCs) but where local community health care is available. The study sample was 209 patients referred for tertiary care to a VAMC 50 miles distant from the referring rural VAMC. The cost of tertiary referral VAMC care was retrospectively compared with the cost had the patients received the tertiary care in the local community hospital located in the immediate vicinity. In addition, the cost of travel resulting from the remote access was also computed. Findings indicate that a savings of +309,293 could have been obtained had a local community hospital provided the tertiary care utilizing the Health Care Financing Administration Medicare rate. Data generated by the methodology of this study are expected to provide a baseline for policy decisions relating to alternative pathways for tertiary care in the Department of Veterans Affairs.

Cost Savings↗
PubMed1998

Changing patterns of psychiatric inpatient care in the United States, 1988-1994.

Using data from the National Hospital Discharge Survey and the Inventory of Mental Health Organizations, this article examines national trends in psychiatric inpatient care from 1988 to 1994 in general hospitals and mental hospitals. We find that discharges with a primary diagnosis of mental illness in general hospitals increased from 1.4 to 1.9 million during this period. The total increase of 1.2 million days of care in general hospitals was small relative to the reduction of 12.5 million inpatient days in mental hospitals. General hospital discharges increased most in private nonprofit hospitals and declined substantially in public hospitals. Length of stay has fallen most substantially in private nonprofit hospitals. Public programs have increasingly replaced private insurance as the major source of payment. These observations suggest that psychiatric inpatient care in general hospitals can be characterized as a process in which patients who would have been clients of public mental hospitals in a prior period replace privately insured patients who, under managed care, are largely treated in community settings. Private nonprofit general hospitals increasingly treat publicly financed patients with more severe illnesses.

Episode of Care↗
PubMed1988

Student health. Medical care within institutions of higher education.

The field of student health care lacks a positive identity in medicine and is often not well understood by the higher education community. This article explores the history, organization, staffing, utilization, financing, and governance of student health centers (SHCs). Student health centers are available to approximately 10 million of the 12.5 million US university students. As many as 27,000 individuals, including probably more than 3000 physicians, work in SHCs. Sources and amount of funds expended for this care vary widely from campus to campus, as does the intensity of services offered. A survey of this nation's largest institutions suggests that an average of $102 per student per year is spent on SHCs. The total amount spent on student health care in this country may exceed $1 billion each year. Student health care faces opportunities and obstacles in the future as our ability to promote health and prevent disease improves, as institutions of higher education allocate their limited educational resources, and as society determines where to invest its limited medical resources.

Health Promotion↗
PubMed1989

Capitated payments for mental health care: the Rhode Island programs.

Capitation financing for the delivery of mental health care under public programs is receiving increasing attention from policymakers. Most initiatives in this respect are in the planning or early implementation stages. This paper describes five years of experience with capitated financing for mental health care in the state of Rhode Island. It discusses the motivation for the programs, their design, and the issues that have arisen with respect to their operation. The Rhode Island experience demonstrates that capitated financing for mental health care is feasible and that Community Mental Health Centers can operate effectively as providers of care under these arrangements. It also suggests that capitated programs can have unanticipated impacts on the operation of community-based mental health service delivery programs.

Capitation Fee↗
PubMed1994

New and borrowed strategies for mental health systems in the decade of the 1990s.

Use of the paradigm shifts advocated by futurists and the supporters of total quality management can facilitate access to new options for mental health systems. New views and innovative systems, however, become difficult to maintain in the context of increasingly rapid and unexpected change occurring in the environment. One strategy that can be employed is the use of leverage, a term usually associated with finance or politics.

Community Mental Health Services↗
PubMed1997

Psychiatric rehospitalization following hospital discharge.

The purpose of this study was twofold: to examine the patient characteristics at discharge from an acute psychiatric unit that were associated with an increased likelihood of rehospitalization within the following six months, and to examine the relationship between rehospitalization and the nature of psychiatric aftercare in a well-integrated hospital and community based psychiatric service. The study reviewed the extent of psychiatric rehospitalization following the closure of large numbers of institutional psychiatric beds. At six months after discharge 38% of the patients had been readmitted to an institution, most commonly a hospital. Despite the provision of an integrated hospital and community health service with excellent welfare support, dissatisfaction with finances independently exerted an influence on the risk of readmission. Implications for future research and treatment planning are discussed focussing on the complex integration of health and welfare services.

Adolescent↗