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At least 19 recordsLinked to original sources
PubMed1983

Analysis of cost and coverage of government financed primary health care services in Tanzania.

A method for cost analysis is presented and applied to Primary Health Care Services in Tanzania. Primary care utilization figures are combined with budget and cost data to arrive at estimates of per capita and per visit cost. Data for analysis of geographical coverage, health care needs, and utilization are most readily available for the MCH sector of Primary Health Care Services, the most important health care sector in LDCs, which is used in this paper as a proxy for estimating health care needs and utilization. The importance of separating appropriately identified investment costs from recurrent costs is illustrated. Speedy implementation of health care for all requires assistance for investment costs, the recurrent costs of appropriately designed Primary Health Care Services being within the reach of developing nations themselves.

Costs and Cost Analysis↗
PubMed2006

Effects of health decentralization, financing and governance in Mexico.

OBJECTIVE: To identify the effects of decentralization on health financing and governance policies in Mexico from the perspective of users and providers. METHODS: A cross-sectional study was carried out in four states that were selected according to geopolitical and administrative criteria. Four indicators were assessed: changes and effects on governance, financing sources and funds, the final destination of resources, and fund allocation mechanisms. Data collection was performed using in-depth interviews with health system key personnel and community leaders, consensus techniques and document analyses. The interviews were transcribed and analyzed by thematic segmentation. RESULTS: The results show different effectiveness levels for the four states regarding changes in financing policies and community participation. Effects on health financing after decentralization were identified in each state, including: greater participation of municipal and state governments in health expenditure, increased financial participation of households, greater community participation in low-income states, duality and confusion in the new mechanisms for coordination among the three government levels, absence of an accountability system, lack of human resources and technical skills to implement, monitor and evaluate changes in financing. CONCLUSIONS: In general, positive and negative effects of decentralization on health financing and governance were identified. The effects mentioned by health service providers and users were related to a diversification of financing sources, a greater margin for decisions around the use and final destination of financial resources and normative development for the use of resources. At the community level, direct financial contributions were mentioned, as well as in-kind contributions, particularly in the form of community work.

Community Participation↗
PubMed1994

Services and trends in Israel's mental health system.

Despite a rapidly growing population, continuing funding shortages, and threats to its national security, Israel has developed a comprehensive mental health care system, based on the psychiatric hospital. Services are provided through several networks, including government-financed and for-profit hospitals, government-financed mental health clinics in each of 23 service areas, and four health funds. Other networks provide care for specific groups such as soldiers, kibbutz members, orthodox Jews, and Israeli Arabs. The system's reliance on the hospital creates special problems, such as dependency and fragmentation of care, and a community mental health model adopted almost 20 years ago has yet to achieve the goal of shifting treatment to the community. However, Israel's mental health system is in a transition period. By drawing on its many strengths and learning from other countries' experience, Israel has the potential for developing a unique community-focused system.

Community Mental Health Services↗
PubMed2005

[Reform steps of reestablishing disease prevention and control system of China].

OBJECTIVE: To develop and demonstrate the reform steps of reestablishing disease prevention and control system of China. METHODS: A model named "strategies of fulfilling public functions of disease prevention and control system of China" has been employed to develop reform steps. 154 centers for disease prevention and control (CDC) have been sampled to consult the opinions about the reform steps developed by research team. RESULTS: To reestablish the disease prevention and control system of China, the following reform steps should be kept to: (1) increase government's attention to disease prevention and control, (2) insure feasible government investment to disease prevention and control, (3) increase the stability and efficiency of government financing, (4) reform management system to enhance the operation efficiency of the CDC, (5) revise labor regulation to attract and stabilize specialists, (6) be carefully to dispose the non-public-service now delivered by the CDC. The consent percent of all sampling CDC was 98.7%.

China↗
PubMed1976

The role of the Federal government in financing health and medical services.

Public sector spending and private sector spending for health and medical services have tended to parallel one another over the past four decades. Although total expenditures have grown dramatically, the relationship between the two sectors has not. Government gradually increased its support and provision of health care between 1929 and 1940. Between 1940 and 1966 government spending for health care remained at a plateau. The federal government's major participation since 1966 has been through its role as a transfer agent for the Medicare trust fund, acting as an intermediary, rather than through the expenditure of general revenues for health and medical care services. Rising costs and increased demand for medical services will probably force a larger financial role upon government.

Financing, Government↗
PubMed1995

Can a public health care system achieve equity? The Norwegian experience.

Equity in health care provision is an important policy goal in Norway. This article addresses equality in the services provided by primary care physicians. These services are the responsibility of local government financed mainly through public funding. Patient fees are low. The local government system results in geographical variation in the number of physicians relative to local health demands. The authors present the hypothesis that this generates inequalities in health care utilization. The system of government finance is based on the assumption that utilization of health services is independent of patient income. Therefore, variation in income is expected to have only a small impact on utilization. The authors estimate a demand model by combining extensive micro data with aggregate data on municipal supply. There is very little relationship between indicators of access and health care utilization. The estimated income elasticities approximate zero, supporting the argument that equality in utilization has been achieved. However, the authors results also raise the question of whether equality has been achieved at the cost of limiting supply of services for people who could afford to consume more, or to pay for services of higher quality.

Adolescent↗
PubMed1983

The effectiveness of a regulatory strategy in containing hospital costs. The Ontario experience, 1967-1981.

This study documents the increases in real inputs (e.g., labor and equipment) employed in Ontario's hospital sector between 1968 and 1981--a period of universal government-financed hospital insurance and a government regulatory strategy involving global budgeting. Total expenditures in Ontario increased by only 16 per cent in terms of real inputs, as compared with an increase of 101 per cent in the United States. Real inputs per patient-day increased at a mean annual rate of 0.68 per cent in Ontario versus 5.19 per cent in the United States (P less than 0.001). Real inputs per admission decreased at a mean annual rate of 1.12 per cent in Ontario, as compared with an increase of 4.15 per cent in the United States (P less than 0.0001). We conclude that regulation can contain the growth of real inputs employed in the hospital sector even in the face of an incentive structure that does not promote cost consciousness on the part of patients or physicians. Although the effect of this strategy on the quality of care is unknown, so far it appears to have been politically acceptable in Ontario.

Budgets↗