Journal articles on the topic 'Criteria for health reform'
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Lankarani, Kamran Bagheri, Hassan Joulaei, Hamid Reza Khankeh, Nooshin Zarei, Mohammad Fararouei, and Zahra Saboori. "Health Equity as a Challenging Goal for Policymakers: A Systematic Review." Global Journal of Health Science 9, no. 2 (June 30, 2016): 144. http://dx.doi.org/10.5539/gjhs.v9n2p144.
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<p>The ultimate goal of every health system is to maintain and promote community health by ensuring the equitable utilization of health services. In recent years, many countries have undergone health sector reform to improve health equity, but most continue to face challenges ahead. This study reviewed the effects of health system reform on reducing health inequity with a focus on the social determinants of health since 2000. This systematic review included an evidence search within the PubMed/Medline, Google Scholar, and Scopus medical research databases. Out of 1,559 published articles between 2000 and 2014, 29 who met the inclusion and exclusion criteria were chosen. Most countries studied considered financial intervention, such as increasing governmental health expenditure and insurance coverage, to establish universal health coverage. Primary care has been neglected in many reform plans as most countries focused on inpatient or outpatient care. None of the reforms have been entirely successful and health inequity remains among different socioeconomic groups. The articles highlighted the significance of socioeconomic and political determinants on the success rate of reforms within the study context. Moreover, strengthening primary health care, implementing stepwise reform, establishing a robust monitoring system and considering quality along with quantitative coverage is necessary to reduce health inequity.<strong></strong></p>
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Nierenberg, David W., and Marcus M. Reidenberg. "Criteria for judging proposals for national health care reform with respect to therapeutics." Clinical Pharmacology and Therapeutics 55, no. 1 (January 1994): 1–4. http://dx.doi.org/10.1038/clpt.1994.1.
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Kaukonen, Pälvi, Raili K. Salmelin, Ilona Luoma, Kaija Puura, Mervi Rutanen, Tarja Pukuri, and Tuula Tamminen. "Child psychiatry in the Finnish health care reform: National criteria for treatment access." Health Policy 96, no. 1 (June 2010): 20–27. http://dx.doi.org/10.1016/j.healthpol.2009.12.009.
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Duckett, Stephen J. "The Australian health care system: reform, repair or replace?" Australian Health Review 32, no. 2 (2008): 322. http://dx.doi.org/10.1071/ah080322.
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A Festshrift gives us the opportunity to look both backwards and forwards. Ken Donald?s career stretches back to his intern days in 1963 and has encompassed clinical and population health, academe, clinical settings and the bureaucracy, and playing sport at state and national levels. There has been considerable change in the health care system over the period of Ken?s involvement in the sector with more change to come ? where have those changes left us? This paper discusses these changes in relation to performance criteria.
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Foley, Tim, and Christopher J. Ryan. "The frequency of references to decision-making capacity in reports to the NSW Mental Health Review Tribunal did not change after legislative reforms that promoted them." Australasian Psychiatry 28, no. 2 (February 4, 2020): 171–74. http://dx.doi.org/10.1177/1039856220901475.
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Objective: To assess the impact of a 2015 reform to the Mental Health Act 2007 (NSW) ( MHA) that was interpreted as requiring a reference to decision-making capacity (DMC) in reports to the NSW Mental Health Review Tribunal (MHRT). Method: A sample of reports to the MHRT were audited for references to the MHA’s treatment criteria and DMC in periods before and after the reforms, and the frequency of references between the two periods was compared. Results: The frequency of references to DMC did not change significantly after the reforms. (However, references to the ‘least restriction’ criterion increased markedly between the two periods). Conclusion: Despite legislative reforms and a supporting education campaign promoting the importance of consideration of DMC, references to DMC did not increase after the reforms.
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Serdiuk, N., and G. Vangorodska. "Human rights in the context of implementing health reform." Uzhhorod National University Herald. Series: Law, no. 69 (April 15, 2022): 72–78. http://dx.doi.org/10.24144/2307-3322.2021.69.11.
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In general, the legal state of social orientation places the person in the first place as the highest value of society; therefore, human health is not only a guarantee of its long, active and useful life, but also a source of spiritual health of society.
Since health care activities are related to the reproduction of real everyday life of people, it is necessary to identify the main criteria for modernization and organizational and legal support of the state doctrine of health care of the social state governed by the rule of law: 1) socio-economic, psycho-emotional, environmental conditions for health; 2) the level of medical care; 3) availability of safe and healthy forms of life; 4) civil rights and guarantees for receiving medical care and living in a safe environment; 5) the ability to choose medical services and health-friendly behaviors and lifestyles; 6) material and socio-cultural bases for the development of human health potential in accordance with his social status and health status; 7) ways of regulation, social control of health care, pharmacology and medicine; 8) the degree of responsibility of social actors for the preservation of health; 8) the degree of responsibility of social actors for the preservation of health; 9) ways to reduce social inequality in health care and health care; 10) social interests, needs, expectations, motives and incentives of social actors in the field of health care.
The purpose of formation of the state doctrine of health care of the social legal state of the decision of the following tasks: 1) methodological substantiation of the criteria for distinguishing social innovations in the field of health care from the whole array of innovations; 2) sociological analysis of innovative solutions in the field of health care, considered in relation to the principles of social policy in the field of health care: justice, equality (accessibility), efficiency, coordination of interests; 3) sociological analysis of satisfaction with health services and the expectations of different groups and categories of the population on the need and directions for improving certain aspects of its activities; 4) development of methods for studying health self-assessments as a quality in demand in the innovative economy; 5) public opinion on the prospects for the development of the health care system; 6) study of the professional vocation of doctors in the context of increasing work motivation and the formation of a relationship of trust between doctor and patient; 7) development of scientifically substantiated recommendations aimed at improving the quality of management of innovative development in the field of health care.
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Coller, Barry S. "Expand the scorecard for health-care reform to achieve a better result and enhance clinical and translational science." Journal of Clinical and Translational Science 2, no. 5 (October 2018): 276–79. http://dx.doi.org/10.1017/cts.2018.333.
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Clinical and translational science is vitally dependent on the nation’s underlying health-care policies and programs. In a reciprocal fashion, data generated by clinical and translational research can inform both health policy and health-care delivery. It is important, therefore, to rate health reform proposals comprehensively on a set of criteria that reflect the broad goals of reform, including the potential impact on clinical and translational science and medical education. I propose that the criteria include achieving universal coverage, reducing administrative costs, retaining one’s chosen primary care physician, encouraging care coordination, empowering physicians, freeing industry from choosing and administering health plans, providing choice of specialists and hospitals, providing patient education, preventing patient overuse of services, rationalizing resource allocation, encouraging competition, limiting government’s role, supporting medical education, training, and research, and freeing industry to make personnel decisions based on business criteria rather than the impact on health-care costs to the company. I discuss the rationale for each element and offer a rating of current proposals relative to a proposal previously made.
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Raja, Tasneem, Helena Tuomainen, Jason Madan, Dipesh Mistry, Sanjeev Jain, Kamala Easwaran, and Swaran P. Singh. "Psychiatric hospital reform in low- and middle-income countries: a systematic review of literature." Social Psychiatry and Psychiatric Epidemiology 56, no. 8 (April 21, 2021): 1341–57. http://dx.doi.org/10.1007/s00127-021-02075-z.
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Abstract Purpose Psychiatric hospitals or mental asylums grew across the world in the colonial era. Despite concerns over quality of care and human rights violations, these hospitals continue to provide the majority of mental health care in most low- and middle-income countries (LMICs). We sought to review the evidence of reform of mental hospitals and associated patient outcomes. Methods We adopted an integrative review methodology by including experimental and non-experimental research. The review protocol was registered on PROSPERO (CRD42019130399). A range of databases and systematic hand searches were conducted by two independent reviewers. Research conducted between 1980 and May 2019, that focused on any aspect of reform in mental hospitals for adults (age 18 and upwards) with severe mental illness and published in English, were considered. Results 16 studies were included in the review. 12 studies met inclusion criteria, and four additional reports emerged from the hand search. Studies covered—India, China, South Africa, Grenada, Georgia, Sri Lanka, Argentina and Brazil. Key findings emphasise the role of judicial intervention as a critical trigger of reform. Structural reform composed of optimisation of resources and renovations of colonial structures to cater to diverse patient needs. Process reforms include changes in medical management, admission processes and a move from closed to open wards. Staff engagement and capacity building have also been used as a modality of reform in mental hospital settings. Conclusion There is some documentation of reform in psychiatric hospitals. However, poor methodological quality and variation in approach and outcomes measured, make it challenging to extrapolate specific findings on process or outcomes of reform. Despite being integral service providers, psychiatric hospitals still do not adopt patient centric, recovery-oriented processes. Hence, there is an urgent need to generate robust evidence on psychiatric reform and its effect on patient outcomes.
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Winkelman, Robert D., Michael D. Kavanagh, Joseph E. Tanenbaum, Dominic W. Pelle, Edward C. Benzel, Thomas E. Mroz, and Michael P. Steinmetz. "The change in postoperative opioid prescribing after lumbar decompression surgery following state-level opioid prescribing reform." Journal of Neurosurgery: Spine 35, no. 3 (September 2021): 275–83. http://dx.doi.org/10.3171/2020.11.spine201046.
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OBJECTIVE On August 31, 2017, the state of Ohio implemented legislation limiting the dosage and duration of opioid prescriptions. Despite the widespread adoption of such restrictions, few studies have investigated the effects of these reforms on opioid prescribing and patient outcomes. In the present study, the authors aimed to evaluate the effect of recent state-level reform on opioid prescribing, patient-reported outcomes (PROs), and postoperative emergency department (ED) visits and hospital readmissions after elective lumbar decompression surgery. METHODS This study was a retrospective cohort study of patients who underwent elective lumbar laminectomy for degenerative disease at one of 5 hospitals within a single health system in the years prior to and after the implementation of the statewide reform (September 1, 2016–August 31, 2018). Patients were classified according to the timing of their surgery relative to implementation of the prescribing reform: before reform (September 1, 2016–August 31, 2017) or after reform (September 1, 2017– August 31, 2018). The outcomes of interest included total outpatient opioids prescribed in the 90 days following discharge from surgery as measured in morphine-equivalent doses (MEDs), total number of opioid refill prescriptions written, patient-reported pain at the first postoperative outpatient visit as measured by the Numeric Pain Rating Scale, improvement in patient-reported health-related quality of life as measured by the Patient-Reported Outcomes Measurement Information System–Global Health (PROMIS-GH) questionnaire, and ED visits or hospital readmissions within 90 days of surgery. RESULTS A total of 1031 patients met the inclusion criteria for the study, with 469 and 562 in the before- and after-reform groups, respectively. After-reform patients received 26% (95% CI 19%–32%) fewer MEDs in the 90 days following discharge compared with the before-reform patients. No significant differences were observed in the overall number of opioid prescriptions written, PROs, or postoperative ED or hospital readmissions within 90 days in the year after the implementation of the prescribing reform. CONCLUSIONS Patients undergoing surgery in the year after the implementation of a state-level opioid prescribing reform received significantly fewer MEDs while reporting no change in the total number of opioid prescriptions, PROs, or postoperative ED visits or hospital readmissions. These results demonstrate that state-level reforms placing reasonable limits on opioid prescriptions written for acute pain may decrease patient opioid exposure without negatively impacting patient outcomes after lumbar decompression surgery.
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Gostin, Lawrence O. "The Future of Public Health Law." American Journal of Law & Medicine 12, no. 3-4 (1986): 461–90. http://dx.doi.org/10.1017/s0098858800009771.
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AbstractDevelopments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decisionmaking criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This Article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria denning “public health necessity” to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and storage of public health information; (4) empower public health officials to select from a graded series of less restrictive alternatives in dealing with public health problems.
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Ismail, Khalida, Shubulade Smith, and Tony Maden. "Mental health review tribunal medical reports." Psychiatric Bulletin 22, no. 10 (October 1998): 615–18. http://dx.doi.org/10.1192/pb.22.10.615.
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Aims and methodMedical reports submitted to mental health review tribunals should be of a clinically acceptable standard. We examined 100 medical reports to assess whether they stated the four criteria for detention under Section 3 of the Mental Health Act 1983. We compared the standard of reports according to the seniority, qualifications and speciality of the doctor, and with the outcome from the tribunal.ResultsThe majority of the reports were written by junior doctors and did not fulfil the criteria laid down by the Mental Health Act 1983. Consultant and forensic psychiatry status were associated with completed reports.Clinical implicationsThis study was performed in one hospital only but highlights the ongoing need to review and improve the workings of the Mental Health Act before reform is considered.
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Криничко, Лілія, and Олексій Мотайло. "New approaches to financing the health care system." Public administration aspects 9, no. 2 (April 29, 2021): 86–100. http://dx.doi.org/10.15421/152122.
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Main areas of state budget expenditures have been identified in the article. They include financing the staff of the Ministry of Health of Ukraine, the State Service of Ukraine for Medicines and Drug Control, the National Health Service of Ukraine, the Ministry of Health of Ukraine. It has been emphasized that the adoption of the Concept of Health Care Financing Reform at the legislative level was important during the reform of the health care system of Ukraine, according to which the implementation of a large-scale transformation of health care system financing has begun. The initial provisions of the concept of health care financing reform have been studied, namely: the purpose of health care financing reform and its principles. The directions of the health care system's reforming that affected the financial mechanism of public administration have been proposed. One of the key reasons for the successful implementation of the health care financing reform is the stable political commitments and high-quality interdepartmental relations between the Cabinet of Ministers, the Ministry of Health, the National Health Service of Ukraine and the Ministry of Finance. It has been noted that the main problem of imperfection of financial provision of health care in Ukraine is the lack of clear criteria for assessing the effectiveness of the use of budget resources at different levels of government and health care facilities. The transformed system of financing of primary medical care in Ukraine has been presented and characterized, the algorithm of calculation of budgetary financing of the medical sphere has been given. It has been found out that the implementation of the concept of health care financing reform took place together with the development of the legal mechanism, which provided for the adoption of regulations. The main directions of improving the financial mechanism of public administration of the healthcare system have been identified: at the level of public administration of the healthcare system, at the level of reforming the state regulation of healthcare institutions.
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Badger, Doug. "The Center for Medicare and Medicaid Innovation: The Case for Reform." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 59 (January 2022): 004695802211180. http://dx.doi.org/10.1177/00469580221118036.
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Congress created the Center for Medicare and Medicaid Innovation and vested it with extraordinary authority. CMMI tests the hypothesis that policy experts and civil servants, insulated from the vicissitudes of the political process and accorded quasi-legislative authority, could conceive and implement transformative health care financing policy innovations that Congress could neither devise nor enact. Twelve years after its founding, CMMI has disappointed these expectations. Only 6 of the more than 50 models it has tested have met de minimis measures of success (no increase in federal spending or diminution of quality). The incremental savings associated with these 6 models have been more than offset by a string of failed concepts. More significantly, none of the demonstration projects deemed successful has resulted in scalable reforms that meet statutory criteria of reducing health care spending or enhancing its quality. CMMI has increased federal spending without producing meaningful reforms of federal health care entitlement programs. This paper will review CMMI’s statutory authorities and track record and show how faulty fiscal assumptions made by the Congressional Budget Office can impede congressional efforts to reform CMMI. It will also discuss how the law has inverted the relationship between the legislative and executive branches, requiring an Act of Congress to prevent CMMI from effectively amending federal statutes. It recommends that CBO modify its assumptions to reflect that CMMI has not produced federal savings. It also recommends that Congress curtail CMMI’s powers and shoulder the obligation of reforming federal entitlement programs.
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Dawson, John, and George Szmukler. "Fusion of mental health and incapacity legislation." British Journal of Psychiatry 188, no. 6 (June 2006): 504–9. http://dx.doi.org/10.1192/bjp.188.6.504.
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SummaryThe enactment of a single legislative scheme governing nonconsensual treatment of both ‘physical’ and ‘mental’ illnesses, based on incapacity principles, has been mooted in recent law reform debates in the UK. We propose a framework for such legislation and consider in more detail the provisions it should contain. The design of legislation that combines the strengths of both incapacity and civil commitment schemes can be readily imagined, based on the criteria for intervention in England and Wales found in the Mental Capacity Act 2005. Such legislation would reduce unjustified legal discrimination against mentally disordered persons and apply consistent ethical principles across medical law.
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Zhao, Qianlong, Junyi Chen, Fulun Li, Aishu Li, and Qian Li. "An integrated model for evaluation of maternal health care in China." PLOS ONE 16, no. 1 (January 28, 2021): e0245300. http://dx.doi.org/10.1371/journal.pone.0245300.
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In recent years, in the context of China’s continuous medical and health reforms, the health status of Chinese women and children has been significantly improved through the continuous efforts of staff at all levels of maternal and child health care institutions. Many indicators in maternal health care have improved significantly, but the speed and magnitude of changes have varied. The purpose of this study is to evaluate the dynamic changes in China’s maternal health status from 2004 to 2018, in order to determine whether China’s medical and health reform measures in recent years have improved maternal health. A total of 6 evaluation indicators from the data of China Health Statistics Yearbook 2019 were selected. Then, based on the multi-criteria decision-making (MCDA) methodology, the entropy weighted technique for order preference by similarity to an ideal solution (TOPSIS), entropy weighted rank-sum ratio (RSR) method and the fuzzy comprehensive evaluation were employed in this study. In addition, sensitivity analysis was engaged to validate the stability and accuracy of the achieved results. The study results shows the ranking values of various methods were not exactly the same, but the overall trend was consistent. Overall, the maternal health care in China improved from 2004 to 2018 year by year, of which the top four were ranked from 2015 to 2018, and relatively poor from 2004 to 2006. This means that the policies and measures implemented in China’s medical and health reform in the past few decades have effectively promoted China’s maternal health care, and this will also provide a theoretical basis for future decisions to promote maternal health care.
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Paredes-Fernández, Daniela, Rony Lenz-Alcayaga, Camila Rojas-Cáceres, and María Begoña Carroza Escobar. "Women’s access to health care: Gaps that the future health care reform in Chile must solve." Medwave 21, no. 10 (November 29, 2021): e8490-e8490. http://dx.doi.org/10.5867/medwave.2021.10.8490.
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Introduction In the Chilean health system, difficulties complicate women’s access to health care and aggravate the complexity of health-illness processes in their interaction as users or caregivers. Objective In the national and international literature, we aimed to identify gaps in women’s access to health care derived from gender disparities and the exercise of gender roles in a prioritized set of health problems. These problems exacerbate gender gaps and should be considered in health reform. Methods We made a literature review through algorithms, snowball sampling, and reference lists from November 2020 to March 2021. The population included were women of all ages, including women users of the health system and women caregivers of specific pathologies. The search was conducted in parallel by four investigators divided into two groups. It was cross-validated to ensure inter-investigator reliability by standardizing evidence eligibility criteria. The analysis showed women users' and caregivers' dimensions for a set of pathologies prioritized by the extent of the disease burden. The pathologies analyzed included stroke, obesity, depression, musculoskeletal pain, and breast cancer. Results Among women users of the health system, problems of access, rates of use, experience, and outcome for the whole group of prioritized pathologies were observed. In the women caregiver dimension, we found that women are the primary health care providers. There is a knowledge gap concerning obesity and musculoskeletal conditions. However, both were reported as health consequences of women’s caregiving roles.
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Paul, Susanne S., and James A. Paul. "The World Bank, Pensions, and Income (In)Security in the Global South." International Journal of Health Services 25, no. 4 (October 1995): 697–725. http://dx.doi.org/10.2190/w99v-7jbj-ep4b-53x2.
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The authors describe and analyze recent reductions and reorganizations of public pension programs in Latin America, as well as trends in pensions in the global South more broadly. They consider the role of the World Bank in the current pension “reform” process and situate the Bank's policies in the context of privatization, reduction of social budgets, and other aspects of structural adjustment. Chilean pension changes are analyzed in particular, showing that even by the Bank's criteria, the reforms have not been successful. The authors then discuss pension changes in China, where the World Bank is also deeply involved. The article concludes with the consideration of a number of arguments about pensions and support mechanisms in later life—including family support and means-tested welfarism—and argues in favor of global policy approaches, such as globally funded pensions and full access by older persons to productive and remunerated labor.
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Shlapko, T., M. Starynskyi, and V. Myrhorod-Karpova. "European landmarks for health care reform in Ukraine compared to Germany." Uzhhorod National University Herald. Series: Law, no. 68 (March 24, 2022): 96–103. http://dx.doi.org/10.24144/2307-3322.2021.68.16.
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The article is devoted to improving the legal regulation of health care in Ukraine in the light of European integration processes, using the experience of Germany. This issue is relevant both in Ukraine and abroad, as the health care systems of many countries are currently in need of improvement and indepth research, especially during the COVID-19 pandemic.
As a country with a vector to join the European Union, Ukraine must meet precise criteria for membership in this economic and political union and continue to reform the health care system. This article discusses the main German regulations concerning the health care system. The main problems that arise during medical services and their financing are summarized. The newest aspects of health care development are considered; in particular, the influence of digitalization on the development of health care, in general, is studied. The emergence, development, and further prospects of digitalization in Germany and Ukraine are analyzed in detail. The latest information and electronic technologies are mentioned, based on which there is a direct connection between patients, healthcare professionals and other participants in relations in healthcare field.
Initiatives for digitalization in European countries, including Germany, which are gradually improving the functioning of the electronic health care system in Germany, are considered because the Federal Ministry of Health receives feedback from consumers of innovative technologies, namely ePa, eHealth, and others. The introduction of new technologies is not unilateral but rather bilateral because citizens can express their views on the functioning of the new electronic system. Ukraine, in turn, is adopting the experience of Germany and implementing it in our electronic healthcare system.
The conclusion is made about perspective directions of state regulation in the sphere of reforming the health care system in Ukraine, taking into account the European experience. Particular attention is paid to highlighting what Ukraine can borrow from Germany to improve its health care system and ensure and improve the quality of medical services.
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Arredondo, Armando, Emanuel Orozco, and Raúl Aviles. "Evidence on equity, governance and financing after health care reform in Mexico: lessons for Latin American countries." Saúde e Sociedade 24, suppl 1 (June 2015): 162–75. http://dx.doi.org/10.1590/s0104-12902015s01014.
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This article includes evidence on equity, governance and health financing outcomes of the Mexican health system. An evaluative research with a cross-sectional design was oriented towards the qualitative and quantitative analysis of financing, governance and equity indicators. Taking into account feasibility, as well as political and technical criteria, seven Mexican states were selected as study populations and an evaluative research was conducted during 2002-2010. The data collection techniques were based on in-depth interviews with key personnel (providers, users and community leaders), consensus technique and document analysis. The qualitative analysis was done with ATLAS TI and POLICY MAKER softwares. The Mexican health system reform has modified dependence at the central level; there is a new equity equation for resources allocation, community leaders and users of services reported the need to improve an effective accountability system at both municipal and state levels. Strategies for equity, governance and financing do not have adequate mechanisms to promote participation from all social actors. Improving this situation is a very important goal in the Mexican health democratization process, in the context of health care reform. Inequality on resources allocation in some regions and catastrophic expenditure for users is unequal in all states, producing more negative effects on states with high social marginalization. Special emphasis is placed on the analysis of the main strengths and weaknesses, as relevant evidences for other Latin American countries which are designing, implementing and evaluating reform strategies in order to achieve equity, good governance and a greater financial protection in health.
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Naccarella, Lucio, James Buchan, Bill Newton, and Peter Brooks. "Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad." Australian Health Review 35, no. 3 (2011): 262. http://dx.doi.org/10.1071/ah10934.
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Objective. To review international experience in order to inform Australian PHC workforce policy on the role of primary healthcare organisations (PHCOs/Medicare Locals) in PHC workforce planning. Method. A NZ and UK study tour was conducted by the lead author, involving 29 key informant interviews with regard to PHCOs roles and the effect on PHC workforce planning. Interviews were audio-taped with consent, transcribed and analysed thematically. Results. Emerging themes included: workforce planning is a complex, dynamic, iterative process and key criteria exist for doing workforce planning well; PHCOs lacked a PHC workforce policy framework to do workforce planning; PHCOs lacked authority, power and appropriate funding to do workforce planning; there is a need to align workforce planning with service planning; and a PHC Workforce Planning and Development Benchmarking Database is essential for local planning and evaluating workforce reforms. Conclusion. With the Australian government promoting the role of PHCOs in health system reform, reflections from abroad highlight the key action within PHC and PHCOs required to optimise PHC workforce planning.
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Gibbons, Patrick, and David Walshe. "Committal law in Ireland." Irish Journal of Psychological Medicine 10, no. 2 (June 1993): 104–9. http://dx.doi.org/10.1017/s0790966700013008.
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AbstractLegislation governing committal practice has been a cause of controversy worldwide. A review of the relevant literature highlights the ongoing debate between those advocating broadly based ‘need for treatment’ criteria as a basis for committal (‘Parens Patriae’), and those who advocate more narrowly defined criteria requiring evidence of ‘dangerousness’ to validate committal. Current committal law in Ireland follows the ‘Parens Patriae’ tradition. However the recently published Green Paper on Mental Health points out that the current law is not compatible with international obligations, making reform inevitable. The Green Paper suggests various alterations in relation to committal criteria and procedures, with the retention of both ‘need for treatment’ as well as ‘dangerousness’ as valid committal criteria. These changes appear to be compatible with the ‘Stone criteria’ adopted as a model committal law by the American Psychiatric Association.
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Wilkins, Chris, Marta Rychert, Rosario Queirolo, Simon R. Lenton, Beau Kilmer, Benedikt Fischer, Tom Decorte, Paul Hansen, and Franz Ombler. "Assessing options for cannabis law reform: A Multi-Criteria Decision Analysis (MCDA) with stakeholders in New Zealand." International Journal of Drug Policy 105 (July 2022): 103712. http://dx.doi.org/10.1016/j.drugpo.2022.103712.
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Islam, Md Shahidul, and Caitlyn Brennan. "Can National Oral Health Policy Reform Be Successfully Translated into Practice and Reduce the Burden of Disease in Australia?" Asia Pacific Journal of Health Management 16, no. 2 (June 27, 2021): 123–36. http://dx.doi.org/10.24083/apjhm.v16i2.345.
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BACKGROUND: The discrepancy between policy makers decisions, current research and clinical practice is of huge significance to the health industry and the Australian community.
AIM: Evaluate of translational research frameworks and policy formulation within the Australian oral health context.
METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a focused systematic search was conducted using an electronic search of the CINAHL database, including Medline, Cochrane and Scopus. A combination of key terms including “oral health”, “prevention’’, 'translational research’, “public policy”, were used for the searches.
RESULTS: The initial literature search found 561 abstracts in CINAHL database. Review against the inclusion criteria and removal of duplicates yielded 129 abstracts; further reviewed against the inclusion criteria resulted in 35 included in the review of translational research models. Across the 35 papers 8 different frameworks for translation of research evidence into policy and practice were utilised across the literature. The results reported in this studies show that the PARiHS framework depicts successful translation as a function of the relationship between evidence, context and facilitation. These interplays of elements are particularly of relevance to oral health due to the complexity of the sector. Context (current and historical) and facilitation (including governance/regulation) are the foundational drivers of successful implantation of evidence into practice.
CONCLUSION: The PARiHS framework for implementing research into practice is an appropriate model for oral health. Universal access is a feasible step in addressing the current inequities of access to oral health care.
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Leli, Hassan, Osman Addulahi, and Benjamin Tsofa. "Public hospitals’ finance management systems, and accountability mechanisms in the context of decentralized health systems in low- and middle-income countries – A thematic review." AAS Open Research 2 (June 4, 2019): 18. http://dx.doi.org/10.12688/aasopenres.12962.1.
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Background: Health sector decentralization, defined as the transfer of decision making over health sector resources from a central to a peripheral entity; has been and continues to be a widely adopted health system reforms in many low and middle-income countries (LMICs). However, its reported effects have been varied. Nevertheless, decentralization reforms aimed at providing public hospital management autonomy are increasing in prevalence in many LMICs. The range and form of this autonomy because of these reforms has often produced mixed effects. We set out to understand the range of financial management autonomy that has been granted to public hospitals in decentralized health systems in LMICs, and what forms of accountability arrangements have been used to facilitate this autonomy. Methods: We systematically searched PubMed, Google Scholar, Web of Science and CINAHL databases for published articles on this subject. We only included articles that reported empirical findings on hospital level financing and financial management in the context of decentralization in LMICs and/or those that included findings on hospital level finance management accountability arrangements. After a systematic search we found four articles that met our inclusion criteria. We undertook a thematic synthesis of the data and narrative reporting of our findings. Results: From the review – we find that decentralization reforms did not result in improved funding flows, finance management autonomy or accountability mechanisms and for public hospitals. These outcomes were irrespective of the mode and form of decentralization reform adopted. Conclusion: From our review, it is evident that though health sector decentralization reforms have been widely promoted and adopted in the past few decades across LMICs, there is minimal evidence that these reforms have improved funding flows to public hospitals, improved financial management autonomy or accountability mechanisms; so as to enhance the performance of these hospitals at sub-national level.
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van der Aa, Maartje J., Aggie T. G. Paulus, Mickaël J. C. Hiligsmann, Johannes A. M. Maarse, and Silvia M. A. A. Evers. "Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801775198. http://dx.doi.org/10.1177/0046958017751981.
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In Europe, health insurance arrangements are under reform. These arrangements redistribute collectively financed resources to ensure access to health care for all. Allocation of health services is historically based on medical needs, but use of other criteria, such as lifestyle, is debated upon. Does the general public also have preferences for conditional allocation? This depends on their opinions regarding deservingness. The aim of this study was to gain insight in those opinions, specifically by examining the perceived weight of different criteria in allocation decisions. Based on literature and expert interviews, we included 5 criteria in a discrete choice experiment: need, financial capacity, lifestyle, cooperation with treatment, and package/premium choice. A representative sample of the Dutch population was invited to participate (n = 10 760). A total of 774 people accessed the questionnaire (7.2%), of whom 375 completed it (48.4%). Medical need was overall the most important criterion in determining deservingness (range β = 1.60). Perceived deservingness decreased if claimants had higher financial capacity (1.26) and unhealthier lifestyle (1.04), if their cooperation was less optimal (1.05), or if they had opted for less insurance coverage (0.56). However, preferences vary among respondents, in relation to demographic and ideological factors.
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Lidz, Charles W., and Suzanne Garverich. "What the ANPRM Missed: Additional Needs for IRB Reform." Journal of Law, Medicine & Ethics 41, no. 2 (2013): 390–96. http://dx.doi.org/10.1111/jlme.12050.
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The federal Common Rule, which governs the conduct of research with human subjects, specifies the criteria and procedures by which Institutional Review Boards (IRBs) should review such research. Although there is wide agreement that IRBs, or Research Ethics Committees as they are called in most of the world, are essential to assuring that human subjects research meets common standards of ethics, IRBs have always come under considerable criticism. Some have critiqued IRBs for using important resources inefficiently, including the large amount of time researchers put into submitting applications, modifications, and reports and delaying the start of data collection within the limited time that grants and contracts provide. Others have critiqued the inconsistency of review of multi-site projects.
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Bahari Jokandan, Samid, Ataollah Asadi Louyeh, Zahra Majd Teimoori, and Ehsan Kazem Nezhad Leili. "Patients’ Satisfaction of Health Care System Reform Plan in Educational-Medical Centers of Rasht City in North of Iran, 2018." Journal of Holistic Nursing And Midwifery 30, no. 4 (July 1, 2020): 191–99. http://dx.doi.org/10.32598/jhnm.30.4.2013.
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Introduction: One of the goals of the health system is to ensure that people are healthy. Reaching this goal is only possible through the provision of the proper services. The satisfaction of patients with the quality of health care services is used as a questionare to investigate the effectiveness of hospital services concerning consumption management and patient care quality. It assists managers and the decision-making network to identify the strengths and weaknesses of the system. Objective: This study aimed to investigate the satisfaction of hospitalized patients in educational and medical centers of Rasht City, Iran with the “Health Care System Reform Plan” in 2019. Materials and Methods: The present study is an analytical cross-sectional study. A total of 395 patients hospitalized in educational and medical centers of Rasht City were selected based on the stratified random sampling method and according to the inclusion criteria. The study data were collected by a questionnaire examining patients' satisfaction with the “Health Care System Reform Plan” developed by the Treatment Deputy of Guilan University of Medical Sciences. The questionnaire has 37 questions in 5 areas of patient’s satisfaction with hoteling, hospital bills reduction program, resident physician program, notification program, the program for the promotion of normal childbirth. Data analysis performed using descriptive statistics indicators and Mann-Whitney U, Kruskal Wallis, and logistic regression model. Results: The results showed the mean±SD of samples' age was 43.51±18 years. The majority (23.8%) of the samples were less than 30 years old. Moreover, there was a significant difference between satisfaction score of the Plan (P = 0.009) in terms of gender, hospital bills (P = 0.001), resident physicians (P = 0.009), and notification program (P = 0.032). Also, men had a higher overall score than women. The findings of this study showed that the mean ± SD satisfaction was equal to 82.8 9.1 with a minimum score of 39.71. In the logistics model, only two variables of the hospital (P = 0.017) and job (P = 0.001) were considered as the most important factors related to the overall satisfaction with the “Health Care System Reform Plan.” Conclusion: Based on the results of the study, patients' satisfaction with the implementation of the “Health Care System Reform Plan” was at the acceptable level and various factors have contributed to this level of satisfaction.
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Gallego, Gisselle, Sandra Fowler, and Kees van Gool. "Decision makers' perceptions of health technology decision making and priority setting at the institutional level." Australian Health Review 32, no. 3 (2008): 520. http://dx.doi.org/10.1071/ah080520.
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This study describes health care decision makers? perceptions about decision making processes for the introduction, diffusion and prioritisation of new health technologies at the regional and institutional level. The aim of the study was to aid the design of a new process of technology assessment and decision making for the Northern Sydney and Central Coast Area Health Service (NSCCAHS). Twelve in-depth, semi-structured interviews were conducted with senior health service managers, nurse managers and senior medical clinicians in the NSCCAHS. Interviewees described prioritisation and decision-making processes as ?ad hoc?. Safety and effectiveness were considered the most important criteria in decision making but budgetary consideration often drove decisions about the uptake and diffusion of new technologies. Current dissatisfaction with decision- making processes creates opportunities for reform, including the introduction of consistent local technology assessments.
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Potseluiev, V. I. "ASSESSMENT AND INFLUENCE OF A FAMILY PHYSICIAN ON THE HEALTH STATUS OF THE POPULATION OF AMALGAMATED TERRITORIAL COMMUNITIES." Eastern Ukrainian Medical Journal 8, no. 3 (2020): 307–13. http://dx.doi.org/10.21272/eumj.2020;8(3):307-313.
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Introduction: Primary health care is the most important part of the health system. Family physicians, as representatives of this link, are key figures who are assigned a number of responsibilities for the prevention, diagnosis, and treatment of both adults and children. An indicator of the effectiveness of their work is the level of satisfaction of citizens with the quality of service. To understand the effectiveness of reform implementation, the authors evaluated the activities of the family physician and its influence on the health of citizens living on the entrusted territory. The aim of the study is an empirical analysis of the selection criteria, frequency and reasons for the citizens' visits to a family physician in the amalgamated territorial communities of the Sumy region. Materials and methods: During the research, methods of a systematic approach and comparative analysis were used. The study was conducted in the form of a survey. Calculations and processing of statistical information were carried out using the "OSA" application. Study results and discussion: The paper shows the condition of primary care as a result of the health system reform. The sociological survey on the work of family physicians in the amalgamated territorial communities concerned the criteria for choosing a family physician, the frequency of requests for medical care, and the reasons for requests, in particular for preventive purposes. The analysis showed that the percentage of signing declarations is relatively high. However, a certain formality of this process was observed, since a significant percentage of citizens who signed the declaration have never met their family physician. The result indicates that citizens often do not seek medical care in outpatient clinics on the territory of the amalgamated territorial community, and they rarely visit the physician for preventive purposes. According to respondents, the reason for not seeking prevention is the lack of need. Conclusion: A high percentage of residents of the amalgamated territorial communities signed declarations with family physicians. However, having analyzed the survey data, we can note a rather formal attitude to this procedure, since many residents seek medical services in other medical institutions. It is a consequence of the insufficient effectiveness of the reform of primary health care and insufficient attention on the part of local authorities to provide outpatient clinics with qualified specialists. There is a need to raise awareness about the importance of preventive measures. Keywords family medicine, family physician, preventive work, declaration, communication.
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Rizakhanova, O. A., E. A. Melnikova, V. N. Filatov, and N. T. Gonchar. "USING QUALITY EVALUATION CRITERIA FOR EDUCATIONAL SERVICES IMPROVEMENT IN THE CHALLENGING POST-GRADUATE MEDICAL EDUCATION CONDITIONS." HERALD of North-Western State Medical University named after I.I. Mechnikov 9, no. 2 (June 15, 2017): 109–13. http://dx.doi.org/10.17816/mechnikov201792109-113.
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The article is devoted to the research of evaluation criteria of the educational services' quality and search possibilities of these criteria analysis influence on educational process improvement. The work presents theoretical analysis of the problem of assessment of the quality of education in the conditions of additional professional education system reform in Russia. The article presents data from retrospec- tive analysis of questionnaires from the trainees of the department of Public Health, Economics and Management in Health Care System on the questions, related to the quality of educational process in the frame of the post-graduate training courses and primary professional education. The work presents retrospective analysis of the education quality assessment based on the testing methods of professional competencies of trainees. Approaches towards educational process, proposed in the research, aimed to help in the objective assessment of the readiness of the suppliers and end-users of educational services in the professional medical additional professional education to implement new forms of education in the conditions of the challenging professional education in Russia.
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Bjegovich-Weidman, Marija, Jill Kahabka, Amy Bock, Jacob Frick, Helga Kowalski, and Joseph Mirro. "Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites." Journal of Oncology Practice 8, no. 2 (March 2012): 70. http://dx.doi.org/10.1200/jop.2011.000425.
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Purpose: Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. Methods: We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. Results: The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.
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McLaren, Niall. "Science and the Psychiatric Publishing Industry." Ethical Human Psychology and Psychiatry 11, no. 1 (April 2009): 29–36. http://dx.doi.org/10.1891/1559-4343.11.1.29.
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Objective: An empirical examination of the scientific status of psychiatry. Method and Results: Analysis of the publications policy of the major English-language psychiatric journals shows that no journal meets the minimum criteria for a scientific publishing policy. Conclusion: Psychiatry lacks the fundamental elements of any field claiming to be a science. Furthermore, its present policies are likely to inhibit scientific development of models of mental disorder rather than facilitate them. The psychiatric publishing industry is in urgent need of radical reform.
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Sousa, Maria-Sharmila, Mabel Figueiró, Aline Silva, Everton Silva, Marcus Silva, Viviane Pereira, and Jorge Barreto. "PP162 Bridging Brazil's Know-Do Gap On Social Engagement In Health Technology Assessment." International Journal of Technology Assessment in Health Care 34, S1 (2018): 129–30. http://dx.doi.org/10.1017/s0266462318002866.
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Introduction:Social engagement in health encompasses the idea of involving (parts of) society as full partners in the decision-making regarding both development and implementation of health technologies. Evidence shows that patient engagement is linked with fewer adverse events, better patient self-management, fewer diagnostic tests, decreased use of healthcare services and shorter lengths of stay in hospitals. Matching the escalating healthcare requirements to face the ongoing societal and economic challenges regarding access and coverage to (new) health technologies is not an easy task for health providers.Methods:We conducted a systematic review (CRD42017068714) designed to address the institutional implementation of social engagement by the Brazilian Ministry of Health. All systematic reviews were evaluated using the new version of AMSTAR and, once all findings are synthesized, we will use the GRADE-CERQual approach to assess for confidence.Results:From 399 publications that met the inclusion criteria, 80 described the implementation of social engagement during the development and implementation of (new) health technologies at various levels (local, regional, national, supranational), countries and for different health technologies and social actors. The remaining 319 publications constitute case studies describing barriers and enablers to implementing social engagement in HTA and coverage decision-making processes. By mapping barriers and facilitators, we explored effectiveness and sustainability, further observing how citizen science-based strategies can ultimately reform health service delivery by innovating the social engagement in health technology development and implementation.Conclusions:This systematic review addresses the know-do gap on social engagement in health technology development and implementation, from a global perspective, as a way of improving the Brazilian Ministry of Health's HTA activities and enabling a Brazilian strategy to reform health service delivery. Enabling social engagement as early as possible, during all the stages of the development cycle, grants a more effective and sustainable health care system.
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McAweeney, Mary J., and Robert Heinrich. "Steps for Evaluating and Interpreting Quantitative Research." Journal of Applied Rehabilitation Counseling 27, no. 1 (March 1, 1996): 57–61. http://dx.doi.org/10.1891/0047-2220.27.1.57.
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All rehabilitation professionals should attain basic competencies in evaluating the design, methodology, and statistical validity of published or proposed research studies. Evaluation of rehabilitation counseling research is becoming more important as health care reform demands that rehabilitation professionals demonstrate the efficacy of their practices. This article presents fifteen criteria for use in critically evaluating rehabilitation research, and is intended for use in the evaluation of published research and in planning future research studies. The elements of a research article are discussed in detail, with examples provided. Several recommendations are made to improve the clinical usefulness of quantitative research conducted in rehabilitation counseling.
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Kinchin, Irina, Komla Tsey, Marion Heyeres, and Yvonne Cadet-James. "Systematic review of youth mental health service integration research." Australian Journal of Primary Health 22, no. 4 (2016): 304. http://dx.doi.org/10.1071/py15114.
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Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998–2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12–25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.
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Jensen, Natasja Koitzsch, Henrik Brønnum-Hansen, Ingelise Andersen, Karsten Thielen, Ashley McAllister, Bo Burström, Ben Barr, Margaret Whitehead, and Finn Diderichsen. "Too sick to work, too healthy to qualify: a cross-country analysis of the effect of changes to disability benefits." Journal of Epidemiology and Community Health 73, no. 8 (April 29, 2019): 717–22. http://dx.doi.org/10.1136/jech-2019-212191.
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BackgroundDenmark and Sweden have implemented reforms that narrowed disability benefit eligibility criteria. Such reforms in combination with increasing work demands create a pincer movement where in particular those with moderate health problems might be unable to comply with work demands, but still not qualify for permanent disability benefits, ending up with temporary means-tested or no benefits. This paper examines whether this actually happened before and after the reforms.MethodsThe Survey of Health, Ageing and Retirement in Europe (SHARE) study waves 1–2 and 4–6 in Denmark and Sweden for the age group 50–59 years (N=5384) was used to analyse changes in employment rates and benefits among people with different levels of health before, during and after disability benefit reforms. Interaction between time and health in relation to employment versus permanent or temporary benefits was used as a criterion for whether our hypotheses was confirmed.ResultsOverall, employment rates have increased in the age group, but only among the healthy. The OR for receiving temporary or no benefits increased from 1.25 (95% CI: 0.81 to 1.90) before to 1.73 (95% CI: 1.14 to 2.61) after policy reforms for the 29% with moderate health problems and from 2.89 (95% CI: 1.66 to 5.03) to 6.71 (95% CI: 3.94 to 11.42) among the 11% with severe health problems. The interaction between time and health was statistically significant (p<0.001).ConclusionPeople with impaired health and workability are forced into a life with temporary means-tested or no benefits when pressed by rising work demands and stricter disability benefit eligibility criteria.
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Kelly, Maria, Katie M. O'Brien, and Ailish Hannigan. "Using linked administrative health data for palliative and end of life care research in Ireland: potential and challenges." HRB Open Research 4 (February 9, 2021): 17. http://dx.doi.org/10.12688/hrbopenres.13215.1.
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Background: This study aims to examine the potential of currently available administrative health data for palliative and end-of-life care (PEoLC) research in Ireland. Objectives include to i) identify administrative health data sources for PEoLC research ii) describe the challenges and opportunities of using these and iii) estimate the impact of recent health system reforms and changes to data protection laws. Methods: The 2017 Health Information and Quality Authority catalogue of health and social care datasets was cross-referenced with a recognised list of diseases with associated palliative care needs. Criteria to assess the datasets included population coverage, data collected, data dictionary and data model availability and mechanisms for data access. Results: Eight datasets with potential for PEoLC research were identified, including four disease registries, (cancer, cystic fibrosis, motor neurone and interstitial lung disease), death certificate data, hospital episode data, community prescription data and one national survey. The ad hoc development of the health system in Ireland has resulted in i) a fragmented information infrastructure resulting in gaps in data collections particularly in the primary and community care sector where much palliative care is delivered, ii) ill-defined data governance arrangements across service providers, many of whom are not part of the publically funded health service and iii) systemic and temporal issues that affect data quality. Initiatives to improve data collections include introduction of i) patient unique identifiers, ii) health entity identifiers and iii) integration of the eircode postcodes. Recently enacted general data protection and health research regulations will clarify legal and ethical requirements for data use. Conclusions: With appropriate permissions, detailed knowledge of the datasets and good study design currently available administrative health data can be used for PEoLC research. Ongoing reform initiatives and recent changes to data privacy laws will facilitate future use of administrative health data for PEoLC research.
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GOIZUETA VÉRTIZ, Juana. "El acceso a la sanidad pública: transformaciones del modelo y límites constitucionales." RVAP 109-II, no. 109-II (December 29, 2017): 171–94. http://dx.doi.org/10.47623/ivap-rvap.109.2017.2.07.
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LABURPENA: Apirilaren 20ko 16/2012 Lege Dekretuaren bidez, osasun-erreforma delakoa onartu zen Espainian. Kritika ugari eta autonomia-erkidegoen konstituzio-errekurtso bat baino gehiago eragin zituen, lehena 2016ko uztailean ebatzia. Erreforma hori jorratzen da lan honetan, bi ikuspuntutatik. Lehenik, ea nor den eskubidearen titularra, titulu zilegitasun emaile baita, osasun publikorako sarbide-ahalmena ematen duena. Eta zer gertatzen den? Aseguratua behar dela izan osasun-sistema publikoan sarbidea izateko, eta, hortaz, giza talde oso bat osasunsistema nazionaletik erauzita geratzen dela, Espainian duten administrazio-egoera dela-eta. Eta, bigarrenik, ea osasuna babesteko ereduan zer-nolako ondorioak ekarri dituen erreformak, unibertsaltasuna ez baita, jada, osasun-eskubidera iristeko bidean argi egiten duen printzipio gidaria. RESUMEN: A través del Real Decreto-Ley 16/2012, de 20 de abril, se aprueba en España la llamada reforma sanitaria objeto de múltiples críticas y «caldo de cultivo» de varios recursos de inconstitucionalidad interpuestos por diversas Comunidades Autónomas, el primero de los cuales se resolvió en julio de 2016. Una reforma que se aborda en este trabajo desde una doble perspectiva. En primer lugar, la de la titularidad del derecho en tanto título legitimador que permite el acceso a la Sanidad Pública. En este sentido, el hecho de que el acceso al sistema público sanitario se vincule a la condición de asegurado conlleva la expulsión del Sistema Nacional de Salud de todo un colectivo de personas atendiendo al criterio de su situación administrativa en España. Y en segundo lugar, desde la óptica de las implicaciones de la reforma respecto al modelo de protección de la salud provocando la ruptura de la universalidad como principio rector que informa el acceso al ejercicio del derecho a la salud. ABSTRACT: By means of the Royal Decree-Law 16/2012 from April 20th, Spain has adopted the so called health reform which has been subject of multiple critics and the «breeding ground» for several appeals of unconstitutionality filed by different Autonomous communities, the first of them was settled in July 2016. A reform that this work studies from a twofold perspective. Firstly, from the point of view of the holder of the right as legitimating title to access to the health public system. In this respect, the fact that access to the health public system is linked to the condition of insured entails the expulsion from the National Health system of a whole entire group of people taking into account their administrative situation in Spain. And secondly, from the perspective of the implications of the reform regarding the model of the health protection which provokes the rupture of universality as a guiding principle that informs the access to the exercise of the right to health.
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Kelly, Maria, Katie M. O'Brien, and Ailish Hannigan. "Using administrative health data for palliative and end of life care research in Ireland: potential and challenges." HRB Open Research 4 (May 26, 2021): 17. http://dx.doi.org/10.12688/hrbopenres.13215.2.
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Background: This study aims to examine the potential of currently available administrative health and social care data for palliative and end-of-life care (PEoLC) research in Ireland. Objectives include to i) identify data sources for PEoLC research ii) describe the challenges and opportunities of using these and iii) evaluate the impact of recent health system reforms and changes to data protection laws. Methods: The 2017 Health Information and Quality Authority catalogue of health and social care datasets was cross-referenced with a recognised list of diseases with associated palliative care needs. Criteria to assess the datasets included population coverage, data collected, data dictionary and data model availability, and mechanisms for data access. Results: Nine datasets with potential for PEoLC research were identified, including death certificate data, hospital episode data, pharmacy claims data, one national survey, four disease registries (cancer, cystic fibrosis, motor neurone and interstitial lung disease) and a national renal transplant registry. The ad hoc development of the health system in Ireland has resulted in i) a fragmented information infrastructure resulting in gaps in data collections particularly in the primary and community care sector where much palliative care is delivered, ii) ill-defined data governance arrangements across service providers, many of whom are not part of the publically funded health service and iii) systemic and temporal issues that affect data quality. Initiatives to improve data collections include introduction of i) patient unique identifiers, ii) health entity identifiers and iii) integration of the Eircode postcodes. Recently enacted general data protection and health research regulations will clarify legal and ethical requirements for data use. Conclusions: Ongoing reform initiatives and recent changes to data privacy laws combined with detailed knowledge of the datasets, appropriate permissions, and good study design will facilitate future use of administrative health and social care data for PEoLC research in Ireland.
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Corpus Quiguanás, Juliana, Edna Johana Mondragón Sánchez, and Lina Karina Bernal Ordoñez. "The Nurse’s Work Process in Primary Health Care: an Integrative Review." Hacia la Promoción de la Salud 27, no. 2 (July 1, 2022): 222–36. http://dx.doi.org/10.17151/hpsal.2022.27.2.16.
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Objective. This work sought to analyze the scientific production regarding the work process of nurses in Primary Health Care in the Colombian context. Methodology. Integrative literature review. The research question was: how is the work process of nurses in Primary Health Care in Colombia? Information collection was carried out during August and September 2021. The databases consulted were: SCOPUS, LILACS, Science Direct, VHL, PubMed and the SciELO electronic library. The inclusion criteria were: original articles published between 2015 and 2021. Results. Three articles were selected to comprise the final sample. Three thematic categories emerged from the results for analysis: knowledge of nursing professionals about PHC; barriers in the work process of nursing professionals in PHC; nursing professional practices in PHC. Conclusions. This review of the literature revealed lack of scientific evidence concerning the role of nursing professionals in primary care in Colombia. It is essential to elucidate the role of nurses in primary care to continue on the path of consolidating and improving actions and strategies, especially in the current context of policy reform of the Colombian health system and the global interests to strengthen primary care.
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Edelman, Alexandra, Judy Taylor, Pavel V. Ovseiko, and Stephanie M. Topp. "The role of academic health centres in improving health equity: a systematic review." Journal of Health Organization and Management 32, no. 2 (April 9, 2018): 279–97. http://dx.doi.org/10.1108/jhom-09-2017-0255.
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Purpose Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity. Design/methodology/approach Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included. Findings In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution. Originality/value This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.
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Fuddah, Hanin, and Samar Zeitoun. "Health Knowledge, Attitudes, Practices, and Beliefs of Lebanese and Palestinian School Children in Lebanon." Journal of Education and Learning 6, no. 1 (December 7, 2016): 227. http://dx.doi.org/10.5539/jel.v6n1p227.
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The indicators for health risk factors among school children in Lebanon associated with increased mortality and morbidity were higher than the global percentage based on WHO (2014) statistics. Knowing that the Ministry of Education in Lebanon has been trying to include health education in the national school curriculum since the last reform in 1997, this qualitative exploratory study analyzed the students’ arguments resulting from focus group discussions to identify their level of knowledge, attitudes and perceptions and to provide suggestions for improving the national textbooks and teaching practices. Data were collected through focus group discussions with grade 5 students in 2 schools: Lebanese public school and UNRWA Palestinian School. The content analysis technique was used to perform the analysis and interpretation of data. Data was coded based on criteria from the Rational Model as well as the Health Belief Model. The study found, among other things, that students in both schools acquired the knowledge present in the textbooks about the benefits of balanced nutrition but they gave inaccurate and incomplete justifications with no scientific reasoning. Regarding attitudes, they show negative attitudes toward prefer unhealthy food over healthy ones. Some of their practices were healthy but unhealthy snacks, skipping breakfast, drinking big amounts of soft drinks were prevalent. The arguments of the students in both schools also showed some social related practices as related to the opinions, behavior, advice, and support of the people surrounding students influence their feelings and behavior, and the students have a reciprocal effect on those people.
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Batchelor, Madeleine, Stephanie J. Brown, Karen Glover, and Deirdre Gartland. "A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand." International Journal of Environmental Research and Public Health 18, no. 23 (December 1, 2021): 12669. http://dx.doi.org/10.3390/ijerph182312669.
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While much is known about the health implications of low birthweight for infants and adults, there is limited information about the health implications in childhood, particularly for Indigenous children. The aim of this systematic review was to assess associations between low birthweight (LBW) and/or small for gestational age (SGA) and the developmental, physical or mental health outcomes for Australian, Canadian and New Zealand Indigenous children (5–12 years), including the potential mediating role of cultural connections. The review was guided by an Aboriginal Advisory Group established to guide the Aboriginal Families Study. Four databases were investigated with pre-determined inclusion/exclusion criteria. The search identified 417 articles after independent screening by two authors. Eight studies assessing six child outcomes were included. The review identified limited evidence, although the review suggested possible links between LBW and/or SGA and childhood asthma, lower body mass index (BMI) and poorer academic performance. Links between LBW, SGA and disability, global health and developmental vulnerability were inconclusive. One study identified cultural-based resilience as protective against perinatal adversity. In summary, research on the relationship between adverse birth outcomes and Indigenous children’s health and development is limited. Further investigation and collaboration with Indigenous communities is required to drive optimised health and social services responses and equitable system reform.
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Behrmann, Jason. "Allergies and Asthma: Employing principles of social justice as a guide in public health policy development." Les ateliers de l'éthique 5, no. 1 (April 6, 2018): 119–30. http://dx.doi.org/10.7202/1044420ar.
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The growing epidemic of allergy and allergy-induced asthma poses a significant challenge to population health. This article, written for a target audience of policy-makers in public health, aims to contribute to the development of policies to counter allergy morbidities by demonstrating how principles of social justice can guide public health initiatives in reducing allergy and asthma triggers. Following a discussion of why theories of social justice have utility in analyzing allergy, a step-wise policy assessment protocol formulated on Rawlsian principles of social justice is presented. This protocol can serve as a tool to aid in prioritizing public health initiatives and identifying ethically problematic policies that necessitate reform. Criteria for policy assessment include: 1) whether a tentative public health intervention would provide equal health benefit to a range of allergy and asthma sufferers, 2) whether targeting initiatives towards particular societal groups is merited based on the notion of ‘worst-off status’ of certain population segments, and 3) whether targeted policies have the potential for stigmatization. The article concludes by analyzing three examples of policies used in reducing allergy and asthma triggers in order to convey the general thought process underlying the use of the assessment protocol, which public health officials could replicate as a guide in actual, region-specific policy development.
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Burtseva, Olena. "Transformation of the Health Protection System as a Component of the National Security of Ukraine." Herald of the Economic Sciences of Ukraine, no. 2(39) (2020): 123–27. http://dx.doi.org/10.37405/1729-7206.2020.2(39).123-127.
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The article considers the impact of globalization on the state and development of the national security system, the sphere of national security management, in particular health care. The approaches of scientists to the formation of the problem of ensuring the national security of Ukraine in the political, economic, socio-cultural, informational and environmental spheres are considered. Based on the analysis of the processes of transformational changes in the national health care system, it is proposed to introduce organizational and managerial, regulatory and legal principles and criteria for evaluating activities. The characteristics of subjects and objects of national security of Ukraine are given. The components and essence of national security of Ukraine are generalized. The results of the health care reform of Ukraine have been studied. It is proved that in modern conditions the concept of national security is expanding due to the inclusion of new spheres of public life. Based on the analysis, it is proposed to add a separate structural element of the national security system “safety and public health”, the essence of which will reflect the state of protection of physical and mental health and the ability to feel effective state support for quality medical services. public health care sector and private medicine.
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Kinderman, Peter. "Mental health law and incapacity: The role of the Clinical Psychologist." International Journal of Mental Health and Capacity Law, no. 7 (September 8, 2014): 179. http://dx.doi.org/10.19164/ijmhcl.v0i7.364.
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From an academic clinical psychological perspective, mental health problems are seen as existing on a number of continua with normal functioning, rather than being explicable in terms of categorical diagnoses. Clinical Psychologists use clinical case formulations in their professional practice and are critical of the validity and utility of diagnosis. Psychologists also see mental health problems as stemming from disturbances in psychological processes. In turn, these processes may be disrupted by a variety of causes – biological, social and psychological. Nevertheless, we see disturbance or impairment of such psychological processes as the central issue in mental ill health.<br /><br />Mental health legislation should therefore reflect these perspectives in terms of the criteria for compulsory treatment and in terms of the procedures and practices governing care.<br /><br />To an extent this is welcome in the Government’s current proposals for mental health legislative reform. A basis of compulsion based on criteria rather than diagnosis is proposed, as are care plans rather than diagnosis and treatment. Clinical psychology, however, would go further. Since there seem to be differences between ‘well’ and ‘ill’ in terms only of the degree and nature of the disturbance of psychological process and the impact on functioning, this speaks to the nature of<br />‘unsoundness of mind’. Clinical psychologists contend that it follows that mental health legislation is appropriate and necessary only if people are impaired in their judgement to the extent of being unable to make valid decisions for themselves.<br />It has been proposed that Clinical Psychologists could act as ‘clinical supervisors’ (the term which is to replace ‘responsible medical officers’). If, indeed, mental ill health is the disturbance of complex, inter-related psychological processes, it makes perfect sense to employ psychologists to coordinate care and decision-making. Clinical psychologists are ready to take their place as partners with lawyers and psychiatrists.
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Silva, Patricia Oliveira, Daniel Vinícius Alves Silva, Carolina Amaral Oliveira Rodrigues, Natália Hiany Fonseca Santos, Samara Frantheisca Almeida Barbosa, Viviane Dias Souto, and Ricardo Otávio Maia Gusmão. "Cuidado clínico de enfermagem em saúde mental." Revista de Enfermagem UFPE on line 12, no. 11 (November 6, 2018): 3133. http://dx.doi.org/10.5205/1981-8963-v12i11a236214p3133-3146-2018.
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RESUMO Objetivo: identificar os elementos que caracterizam o cuidado clínico de Enfermagem em Saúde Mental no contexto da Reforma Psiquiátrica e da Humanização da Assistência. Método: trata-se de um estudo bibliográfico, descritivo, do tipo revisão integrativa, com busca de artigos na BVS, entre os anos de 1995 e 2017. Realizou-se a sistematização dos dados pela técnica de Análise de Conteúdo. Apresentaram-se os resultados em três categorias “Humanização da assistência e a sua relação com o cuidado de Enfermagem na Saúde Mental”; “Estratégias de cuidado no campo da Saúde Mental: incorporando as novas tecnologias” e “Cuidado clínico de Enfermagem humanizado: resgatando a subjetividade”. Resultados: identificaram-se 16 estudos de acordo com os critérios estabelecidos. Apresentaram-se as características dos artigos selecionados segundo os autores, o ano de publicação, o título do periódico, o Qualis, o fator de impacto e o nível de evidência, o local de publicação, o delineamento metodológico adotado, os objetivos e os principais resultados. Conclusão: constata-se que se devem respeitar, na Enfermagem aplicada à Saúde Mental, os preceitos da Reforma Psiquiátrica Brasileira e da Política Nacional de Humanização. Considera-se, além disso, a interdisciplinaridade como um recurso para a ampliação da clínica. Descritores: Humanização da assistência; Enfermagem; Enfermagem Psiquiátrica; Saúde Mental; Psicanálise; Serviços de Saúde Mental.ABSTRACT Objective: to identify the elements, that characterize clinical nursing care in mental health in the context of Psychiatric Reform and Humanization of Care. Method: this is a bibliographic, descriptive study, of integrative type, with search of articles in the VHL, between 1995 and 2017. The data was systematized using the Content Analysis technique. Results were presented in three categories: Humanization of Care and its implications on Nursing care in mental health; Care strategies in the field of mental health: incorporating new technologies; Humanized nursing care: rescuing subjectivity. Results: 16 studies were identified according to established criteria. The characteristics of the selected articles were presented, according to authors, year of publication; title of the periodical; QUALIS; impact factor and level of evidence; place of publication, methodological design adopted; objectives and main results. Conclusion: the precepts of the Brazilian Psychiatric Reform and the National Humanization Policy must be respected in nursing in mental health. In addition, interdisciplinarity is considered as a resource for the expansion of the clinic. Descriptors: Humanization of Assistance; Nursing; Psychiatric Nursing; Mental Health; Psychoanalysis; Mental Health Services.RESUMEN Objetivo: identificar los elementos que caracterizan el cuidado clínico de Enfermería en Salud mental en el contexto de la Reforma Psiquiátrica y Humanización de la Asistencia. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión integrativa con búsqueda de artículos en la BVS, entre los años 1995 y 2017. Se realizó la sistematización de los datos por la técnica de Análisis de contenido. Se presentaron los resultados en tres categorías: Humanización de la Asistencia y sus imbricaciones sobre el cuidado de enfermería en la salud mental; Las estrategias de cuidado en el campo de la salud mental: incorporando nuevas tecnologías; Cuidado clínico de Enfermería humanizado: rescatándose la subjetividad. Resultados: se identificaron 16 estudios de acuerdo a los criterios establecidos. Se presentaron las características de los artículos seleccionados, según autores, año de publicación; título del periódico; QUALIS; factor de impacto y nivel de evidencia; lugar de publicación, delineamiento metodológico adoptado; objetivos y principales resultados. Conclusión: se debe respetar en la enfermería en la salud mental los preceptos de la Reforma Psiquiátrica Brasileña y de la Política Nacional de Humanización. Además, se considera la interdisciplinaridad como recurso a la ampliación de la clínicaDescriptores: Humanización de la Atención; Enfermería; Enfermería Psiquiátrica; Salud Mental; Psicoanálisis; Servicios de Salud Mental.
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AGUADO I CUDOLÀ, Vicenç, and Raquel PRADO PÉREZ. "Derecho a la protección de la salud y exclusión de la asistencia sanitaria: la crisis económica como pretexto para la limitación del acceso a los servicios y prestaciones del estado del bienestar." RVAP 99-100, no. 99-100 (December 30, 2014): 125–48. http://dx.doi.org/10.47623/ivap-rvap.99.100.2014.004.
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LABURPENA: 16/2010 Errege Lege Dekretuak osasun-laguntzan ezarritako erreformak asegurudun eta onuradun kontzeptuak erabiltzen ditu osasun-sistema publikoa erabiltzeko bide gisa. Sistema guztiz unibertsalizatzeko joera geldiarazten da horrela, eta, soilik irizpide ekonomikoetan oinarrituta, sistematik kanpo utzi nahi dira egoera ahulean dauden zenbait kolektibo, hala nola, egoera irregularrean dauden etorkinak eta langabezian dauden, laurogeita hamar egun baino gehiagoz atzerrian dauden eta langabezia-prestazioa edo –subsidioa jasotzeari utzi dioten emigratzaile espainiarrak. Defendatzen den tesia da egoera ahulean dauden taldeak kanporatzea osasuna babesteko konstituzio-eskubidearen eta estatu espainiarrak bere gain hartutako nazioarteko betebeharren kontrakotzat jo daitekeela. Gainera, erreformak berriz zentralizatzeko asmo garbia dauka, Gizarte Segurantzako berezko ideiak erabiliz; autonomia-erkidegoek barne-osasunaren alorrean haien gain hartutako eskumenak zatikatzen ditu erkidegoetako osasun-zerbitzuak deskoordinatuta daudenaren aitzakian baina hori inola frogatu gabe. RESUMEN: La reforma de la asistencia sanitaria llevada a cabo por el Real Decreto-Ley 16/2012 utiliza las nociones de asegurado y beneficiario como vias de acceso al sistema publico de salud. Se frena una tendencia dirigida a una plena universalizacion del sistema para excluir, en base a criterios meramente economicos, a determinados colectivos vulnerables como los inmigrantes en situacion irregular y los emigrantes espanoles en paro que estan mas de noventa dias en el extranjero y que han dejado de percibir la prestacion o subsidio de desempleo. La tesis que se defiende es que la exclusion de grupos vulnerables puede entenderse contraria al derecho constitucional a la proteccion de la salud y a las obligaciones internacionales asumidas por el Estado espanol. La reforma tiene, ademas, un rasgo claramente recentralizador, a traves de la utilizacion de las nociones propias de la Seguridad Social, que laminan competencias que habian asumido las comunidades autonomas en materia de sanidad interior, bajo el pretexto de una no acreditada descoordinacion entre los servicios de salud autonomicos. ABSTRACT: The reform of medical care carried out by means of the Royal Decreelaw uses the concepts of insured and beneficiary as ways of access to the publich health system. It curbs the trend towards a full univesalization of the system in order to exclude, based upon merely economic criteria, some specific vulnerable groups as irregular inmigrants and Spanish unemployed emigrants who are abroad more than ninety days and who are not receiving the unemployment benefit. The thesis is that the exclusion of vulnerable groups can be considered against the constitutional right to the health protection and to the international obligations assumed by the Spanish state. Besides the reform has a clear recentralizing feature by using notions typical to Social Security which laminate the competences that had been taken by the Autonomous Communities in the field of home health, with the excuse of a non proved discordination between the automic health services.
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Sautkina, V. "Criteria for the Evaluation of Social Policy Effectiveness of States." World Economy and International Relations, no. 7 (2014): 87–97. http://dx.doi.org/10.20542/0131-2227-2014-7-87-97.
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The following article is devoted to the study of current state of national education and healthcare systems. The cost of services in these areas constantly increases, there for even developed countries are forced to make significant efforts in order to maintain earlier achieved results. Due to this reason countries entered into the period of constant reforms with the purpose of maintaining that high level of health and educational services for all segments of population with a constant reduction of its volume of financing. The legal aspects of these changes are requiring manifestation of the will of politicians in order to overcome the opposition of parties which are defending their interests. As an example, the main opponents of the healthcare reforms proposed by Barak Obama in the USA are Republicans who are concerned about a significant increase of a state control over the entire national insurance system. The author comes to the conclusion that only joint actions of the government and every segment of population might actually improve the quality of medical and educational services.
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Shendell, Derek G., Saisattha Noomnual, Shumaila Chishti, MaryAnn Sorensen Allacci, and Jaime Madrigano. "Exposures Resulting in Safety and Health Concerns for Child Laborers in Less Developed Countries." Journal of Environmental and Public Health 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/3985498.
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Objectives. Worldwide, over 200 million children are involved in child labor, with another 20 million children subjected to forced labor, leading to acute and chronic exposures resulting in safety and health (S&H) risks, plus removal from formal education and play. This review summarized S&H issues in child labor, including forced or indentured domestic labor as other sectors of child labor. Specifically, we focused on exposures leading to S&H risks.Methods. We used PubMed, Scopus, Science Direct, and Google Scholar. References were in English, published in 1990–2015, and included data focused on exposures and S&H concerns of child labor.Results. Seventy-six journal articles were identified, 67 met criteria, 57 focused on individual countries, and 10 focused on data from multiple countries (comparing 3–83 countries). Major themes of concern were physical exposures including ergonomic hazards, chemical exposure hazards, and missed education. Childhood labor, especially forced, exploitative labor, created a significant burden on child development, welfare, and S&H.Conclusions. More field researche data emphasizing longitudinal quantitative effects of exposures and S&H risks are needed. Findings warranted developing policies and educational interventions with proper monitoring and evaluation data collection, plus multiple governmental, international organization and global economic reform efforts, particularly in lower-income, less developed countries.