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PubMed2004

Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence.

Rising pharmaceutical expenditures have led to the use of cost-sharing measures. The authors undertook a systematic review of the effects of cost sharing on vulnerable populations (the poor and those with chronic illnesses). Virtually every article reviewed supports the view that cost sharing decreases the use of prescription drugs in these populations. Copayments or a cap on the monthly number of subsidized prescriptions lower drug costs for the payer, but any savings may be offset by increases in other health care areas. Cost sharing also leads to patients foregoing essential medications and to a decline in health care status.

Chronic Disease↗
PubMed1993

Nurses and independent fee-for-service practice: a critical view.

A contemporary development in nursing in Australia is the move to independent private practice. This move is made in support of autonomy for the individual nurse practitioner and in the interests of improved patient care. This paper examines this development using the literature as data and critical theory as the framework of analysis. Critical theory argues that much human knowledge is bound by 'ideological' interests in either the technical or interpretative. Emancipatory knowledge attempts to peel off the various ideological layers in search of truth. Using work to examine the 'technical interest' and professionalism to examine the 'interpretative interest', it is argued that in the contemporary Australian health care system the nurse's claim to autonomy through independent practice calls for continuing debate and reflection.

Australia↗