Dissertations / Theses on the topic 'Health policy decisions'
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Carpenter, Tyler, Kate E. Beatty, Ross Brownson, and Paul Erwin. "Accreditation Seeking Decisions in Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6848.
Full textBeatty, Kate, Tyler Carpenter, Ross Brownson, and Paul Erwin. "Accreditation Seeking Decisions in Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6854.
Full textAlsaid, Nimer, and Nimer Alsaid. "Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV." Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/626340.
Full textBIGOT, Ana Carina Jorge dos Santos Ferreira Borges. "Alcohol consumption in the African context: contributions to a public health approach to policy decisions." Doctoral thesis, Instituto de Higiene e Medicina Tropical, 2015. http://hdl.handle.net/10362/19307.
Full textAlcohol-related problems and burden of disease in Africa has been largely neglected. Due to the rapidly changing context in several countries and new scientific evidences of alcohol-attributablediseases, such as HIV and TB incidence, alcohol-related problems and burden of disease in Africa might be higher than what has previously been estimated.At the same time there is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region.The overall aim of this thesis is to reviewevidence about alcohol consumption and analyse alcohol-related policies in Africa, thus contributingto the improvement of alcohol-related policy decisions in this region. In particular the thesis concentrates on followingfour objectives: I) estimate alcohol-attributablemortality and morbidityin Africa; II) identifyfactors that might affect magnitude and patterns of alcohol consumption in Africa; III)evaluatenational alcohol policy responses in 46 countries and their effectiveness to reduce alcohol-related harm; IV) document the different stages and actors involved in the development of alcohol policy in one African country (Malawi).The research used different type of methods. Our results show thatalcohol consumption has a large impact on burden of disease and mortality in African countries, withalcohol being responsible, in 2012, for 6.4% of all deaths and 4.7% of all DALYs in the Region(study I). Our analysis identified seven factors which are closely tied to potential changes in alcohol consumption in Africa. Driven largely by globalization, a potential convergence of these factors is likely to be associated with continued growth in alcohol consumption and alcohol-related morbidity and mortality across the continent(study II).Countries have been using different types of policy measuresto control alcohol consumption. When evaluating current policy restrictiveness, countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria). According to our results, actual policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -.353, p = 0.005) (Study III). Study IV reflects the difficulties and complexityof alcohol policy development in Malawi. Despite the influence of the alcohol industry in the agenda-settingand consultative process, when adequately resourced and supported, civil society organizations were found toplay an ximportant and decisiverole in steering policy developments in a sound public-interest direction. Alcohol-attributable fractions of mortality and morbidity in many African countries are considerable and therefore alcohol cannot be left out of countries health and development agendas. African governments need to take a more active role in protecting the public’s health. Although countries have adopted some type of policy measures to control alcohol consumption, our results show that there is a need for a strongerpolicy response to reduce alcohol-related burden in the continent. Finally, due to the inherent difficulties in alcohol policydevelopment, governments should strongly consider increasing the involvement of civil society organisations to support sound public-interest direction.
Carter, Mary Frances. "Beliefs, Costs, and Policies Influencing African American Men's Decisions on PSA Screening." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4605.
Full textAyaebene, Francess Uju. "Maintaining Confidentiality among HIV Infected Couples: Physicians' Patterns of Decision in Nigeria." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7784.
Full textRamos, Raquel de Souza. "As representações sociais da judicialização da saúde para profissionais de saúde." Universidade do Estado do Rio de Janeiro, 2015. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8601.
Full textThe health litigation is an expression increasingly present in the public institutions of health care in Brazil materialized mainly by warrants for performing diagnostic and therapeutic procedures, consultations, hospitalizations and dispensation of medical and surgical supplies. The study aims to analyze the process of legalization of health in Brazil, under the Unified Health System, from the health professionals involved in this process. Were defined as specific goals the description of the structure and content of the social representations of litigation of health activities and services within the managers, regulators and health professionals involved in the process of legalization of health; the comparison of the social representations about the legalization of that social group and the discussion of the contents of these representations in the legalization of health process. This is a qualitative study, based on the Theory of Social Representations, conducted with 152 subjects in a university hospital and the central of regulation of procedures and beds in the city of Rio de Janeiro. We applied the free word association technique by the inducing term "health litigation", that were analyzed with the technique of four-digit chart and also 40 semi-structured interviews that were analyzed through thematic content analysis, instrumentalized by NVivo software. 761 words were evoked with average sized orders recall of 3, with maximum and minimum frequency of 17 and 10. The procedural analysis resulted in six categories, with 2257 units of analysis, distributed in 85 themes. It was identified that health professionals have a negative position towards the reality imposed by the l health litigation, however they recognize this feature as required by the Brazilian public health crisis. Health professionals are working under the pressure of the judiciary, with the threat of arrest leading to a stressful routine of their professional practices due to an ineffective action of the State in the implementation of health policy. It is concluded that social representation is in the final stages of consolidation. Considering the social representation as a determinant of practices, we also concluded that the representations that have emerged from this study may contribute to the changing practices of health professionals that operationalize this system. It is expected therefore, that the promotion of improvements occur on the outcome of direct assistance to users seeking the public health institutions to be cared for in their health needs, characterizing thereby a greater challenge that goes towards making advancing democracy and citizenship.
Sankaramoorthy, Saravana Kumar. "Distributed Policy Decision Points for Electronic Health Records." Thesis, KTH, Skolan för informations- och kommunikationsteknik (ICT), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-90810.
Full textSaffore, Lateef Yusef PhD. "What Factors Influence Medicare Reimbursement Payments for Healthcare Providers that Admit Diabetic Patients?" University of Akron / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=akron1303145384.
Full textWirtz, Veronika. "Medicine and choices : health policy and individual decision making." Thesis, University College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.404891.
Full textChieffi, Ana Luiza. "Análise das demandas judiciais de medicamentos junto a Secretaria de Estado da Saúde de São Paulo à luz da política de assistência farmacêutica." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-31072017-130420/.
Full textIntroduction: In Brazil, healthcare is a fundamental right that is guaranteed to the citizen by the Federal Constitution of 1988 which allowed for the creation of the Brazilian Universal Health System (Sistema Único de Saúde - SUS). According to its principles of equality, universality, integrality and equity, the SUS provides medication to the population through Pharmaceutical Assistance (PA) programs. Despite the advances in PA policies which include the improvement in access to medications, there has been a significant increase in lawsuits related to health products and services, increasingly constituting a challenge to healthcare managers and providers. Objective: To characterize medication lawsuits filed between 2010 and 2014 against the State Health Secretary of São Paulo (Secretaria de Estado de Saúde de São Paulo - SES/SP), during the period between 2010 and 2014, with emphasis on solicited medication for treating diabetes mellitus, in the light of the policy for incorporation of new technologies in the SUS. Methodology: A descriptive work with secondary data referring to legal proceedings of medicine solicitation filed against the State Health Secretary of São Paulo. The data source was the the S-Codes computerized system. Beside the description, Gini coefficients were calculated in relation to the total processes and in the processes of diabetic pacientes. Poisson regression with robust variance was used to evaluate the associations between the characteristics of actions in the two applicant groups, the diabetics and nondiabetics. Results and discussion: During the analysed period there was an increase of approximately 63% in the judicial demands for the supply of products of healthcare interest, highlighting medicines. Practically 30% of the solicited medicinal items in the judicial proceedings belong to the Pharmaceutical Assistance Programs. In relation to the judged medicines present in the specialized component, 77.3% were prescribed in disagreement with the Protocols published by the Ministry of Health. Out of the granted judicial proceedings in this period, 14.4% indicated diabetes mellitus as the main illness in medical reports. The analogous insulins, glargins (6.3%) and asparte (3.3%), where the most demanded medications, both not approved by the National Commission for Incorporation of Technology for incorporation in the SUS due to the lack of evidence proving superiority in the available treatment for diabetes. It was observed that the judicial proceedings of diabetic patients have less chance of being filed by public defenders and district attorneys than private lawyers. In relation to the kind of lawsuit, one observes that there is a bigger chance of filling a lawsuit through an injunction than through ordinary rite, and less chance of filling a lawsuit through public Civil action in relation to ordinary rite. The analysis of the location in which occurred the medical prescription of the judicialized items, demonstrated a smaller chance of it being elaborated in primary health care units/ medical centre, hospitals and specialized clinics/ speciality environments/polyclinics, when compared to private clinic. The data shows that the judicial proceedings of diabetic patients highlight the private and individual nature of the characteristics of the demand. The Gini Index that was elaborated suggests a concentration of lawyers and doctors in the judicial demands that were studied, for the total of patients and diabetic patients. Conclusion: There was an increase in the judicial actions showing nonconformity of these demands with the protocols, guidelines and rules of the SUS, which is observed both in the collection of demands, and also in the solicitation of medication/treatments for diabetics. The judicialization of health in the state of São Paulo with the presented characteristics in this study suggest a threat to the sustainability of the Unified Healthcare System (SUS). Descriptors: Rigth to health; judicial decisions; National Drug Policy on Pharmaceutical Care; Brazilian National Health System
Wagner, Steven M. "Public Sponsored Health Insurance to Improve Health Outcomes with Implications for Government Health Policy, Design, and Decision Making." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1002.
Full textLewis, Bryan L. "in silico Public Health: The Essential Role of Highly Detailed Simulations in Support of Public Health Decision-Making." Diss., Virginia Tech, 2011. http://hdl.handle.net/10919/26058.
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Dana-Sacco, Gail. "Applying Passamaquoddy wisdom to contemporary tribal health decision-making." Restricted access (UM), 2008. http://libraries.maine.edu/gateway/oroauth.asp?file=orono/etheses/37803141.pdf.
Full textIncludes Vita. Title from PDF title page (viewed on May 21, 2010) Available through UMI ProQuest Digital Dissertations. Includes bibliographical references (leaves 144-152). Also issued in print.
Smith, Kane. "A Multi-Objective Framework for Information Security Public Policy: The Case of Health Informatics." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5320.
Full textFridkin, Alycia Jayne. "First Nations involvement in health policy decision-making : the paradox of meaningful involvement." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/57073.
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Graduate
Eckard, Nathalie. "The matter of economic evaluations in health policy decision-making : The case of the Swedish national guidelines for heart diseases." Doctoral thesis, Linköpings universitet, Avdelningen för hälso- och sjukvårdsanalys, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-121282.
Full textGillies, Clare Louise. "Development of evidence synthesis methods for health policy decision making - A chain of evidence approach." Thesis, University of Leicester, 2007. http://hdl.handle.net/2381/7462.
Full textHalton, Kate Amanda. "Setting hospital infection control policy : a decision-making framework incorporating health economics and healthcare epidemiology." Thesis, Queensland University of Technology, 2009. https://eprints.qut.edu.au/31145/1/Kate_Halton_Thesis.pdf.
Full textGauld, Robin David Charles. "Policy processing in theory and practice : health reform in Hong Kong and New Zealand /." Thesis, Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B17311664.
Full textBaldeh, Yero H. J. "Information support for district health care planning and decision making in The Gambia : a holistic approach." Thesis, University of Central Lancashire, 1997. http://clok.uclan.ac.uk/21604/.
Full textKiatpongsan, Sorapop. "Decision Making for Medical Innovations." Thesis, Harvard University, 2014. http://dissertations.umi.com/gsas.harvard:11386.
Full textHeffner, Michael D. "Informing Decision-Making for Derailments Involving Hazmat| An Analysis of Phmsa Train Accident Data." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10604290.
Full textA review of literature suggests that train derailments are a statistically relevant concern. While not all train derailments involve hazardous materials, those that do release chemicals pose a public health threat. This study challenges the decision-making mainstay tool of the hazardous materials response community – the Emergency Response Guidebook (ERG) – and its default strategy of evacuation through quantitative research that evaluates data from train derailments involving the release of hazardous materials. It explores whether there are correlations between a derailment’s variables and evacuation, as well as correlations between the number evacuated and the number of those injured or killed. Secondary data on train derailments from the Pipeline Hazardous Material Safety Administration revealed 358 incidents involving the release of 876 substances between October 12, 1989 through August 10, 2016. The resulting data analysis confirms a certain level of predictability between causal factors and worsening outcomes supporting expansion of decision-making tools in the ERG.
Bryan, Lona. "A Limited Rational Choice Theory in Local Public Health Decision Making." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5542.
Full textNavaneelan, Tanya. "Normalization and Informed Decision-making in Public Health Programs: A Case Study of HPV Vaccination in Canada." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23517.
Full textMehter, Hashim Moosa. "Physician approaches to provider-family conflict associated with end-of-life decision-making in the ICU: a qualitative study." Thesis, Boston University, 2014. https://hdl.handle.net/2144/21217.
Full textBACKGROUND: As critically ill patients approach the end of life in an intensive care unit (ICU), their families are often asked to make difficult decisions surrounding the withholding or withdrawal of aggressive care or resuscitative measures. Families are asked to exercise “substituted judgment” by making decisions from the imagined standpoint of the patient. ICU physicians work with families to support them through the decision-making process, but conflict commonly arises between physicians and family members regarding the optimal course of care for a critically ill patient. Existing qualitative data regarding physician perspectives and practical approaches to negotiating and managing these conflicts is limited. OBJECTIVE: To investigate and characterize how critical care physicians approach and manage conflict with surrogates with respect to decisions on withdrawing or withholding aggressive care in the ICU. METHODS: Semi-structured interviews were conducted with eighteen critical care physicians, recruited from two large academic medical centers in Boston. Interview transcripts were analyzed using methods of grounded theory to identify emergent themes and concepts, along with illustrative quotes. RESULTS: Physicians described an initial process of gauging surrogate receptiveness to provider input and recommendations. When faced with resistance to their recommendations for less aggressive care, provider approaches ranged from deference to family wishes to various negotiation strategies designed to change families’ minds. The likelihood of deferring to family in the event of conflict was associated with the perceived sincerity of the family’s “substituted judgment” approach and the ability of the provider to manage patient pain and suffering. Providers described a common theme of concern for the family’s emotional needs; manifestations of this concern included efforts to alleviate guilt and stress associated with end-of-life decision-making by assuming some of the decision-making burden and strategies to repair damage to the provider-family relationship in the aftermath of conflict or disagreement. Providers also described personal stress and anxiety associated with contentious end-of-life decision-making, and the effect of career experience on their approach to conflict with families. CONCLUSIONS: Critical care physicians describe a multi-layered approach to physician-family conflict surrounding end-of-life decision-making in the ICU, including adaptive strategies to achieve optimal outcomes for both patient and family. These findings may help to inform future research and quality-improvement initiatives.
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Boxenbaum, Eva. "The partnership metaphor in Quebec health care policy : the decision-making process with cognitively impaired elderly clients in home care." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33063.
Full textWaldau, Susanne. "Creating organisational capacity for priority setting in health care : using a bottom-up approach to implement a top-down policy decision." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-36316.
Full textKhalil, Doris Deedei. "A study of four international donor agencies : their role and influence in decision-making and health policy in Ghana from 1983-1995." Thesis, University of Liverpool, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343997.
Full textDavis, Millicent Amanda. "Decision Making of Environmental Engineers on Project Selection." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2808.
Full textSullivan, Shannon. "Knowledge Translation of Economic Evaluations and Network Meta-Analyses." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32109.
Full textDarnell, Whittney H. "NAVIGATING THE MICHELLE P. WAIVER: A NARRATIVE EXAMINATION OF THE IMPACT OF PARENT CAREGIVER-RELATED UNCERTAINTY AND DECISION MAKING FOR CHILDREN WITH DISABILITIES." UKnowledge, 2019. https://uknowledge.uky.edu/comm_etds/82.
Full textGonçalves, Maria de Lourdes. "Participação social no sistema único de saúde: a experiência do conselho municipal de saúde de Ribeirão Preto - SP." Universidade de São Paulo, 1999. http://www.teses.usp.br/teses/disponiveis/83/83131/tde-14022003-102526/.
Full textThis study analysed the experience of building social participation in the Unique Health System (Sistema Único de Saúde), having as its study object the Municipal Health Council of Ribeirão Preto, during the period of 1991 - 1998. The theoretical reference was built from the countys redemocratization and the Sanitary Reform, broaching the study object in the dimensions: the Right to Health, Participation, Social Control and Citizenship. The methodology was Case Study, in the qualitative aspect of health research. We sought, from document analysis and interviews with Counsellors and former Municipal Healt Secretaries, through the technique of Thematic Analysis, to identify relations established among the social subjects which compose the Council, projects of interest and the conception on the Right to Health; we sought to point out limits and potencialities of the space of participation for the construction of citizenship. Main limits: the themes are sent to the Council for aprovement only, not allowing previous discussions; the bond between the Municipal Health Fund and the Secretary of Treasure, obstructs Manager and Council of having autonomy in the decision on the use of resources; some segments dont take their pleas to the Council, using other channels; the corporativism of some segments dont allow publicizing projects of interest. As potentiality, we observed that those interviewed have in the Council, the legitimate political forum to discuss and deliberate on the political directions for health in the Municipality, legitimating it as a public space for the construction of Rights and Citizenship. This allowed its functioning, during 8 years, without interruption.
Hansson, Jonas. "Mind the blues : Swedish police officers' mental health and forced deportation of unaccompanied refugee children." Doctoral thesis, Umeå universitet, Enheten för polisutbildning vid Umeå universitet, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-138923.
Full textIntroduktion: Polisarbete är i mångt och mycket en folkhälsofråga, något som inte minst blir tydligt i polisers möte med utsatta människor. Poliser har ett stort handlingsutrymme, vilket kan påverka hur de bemöter utsatta människor. I mötet med dessa människor behöver poliserna vara professionella; att ta hand om sin psykiska hälsa när man möts av utmaningar är en del av professionalismen. Att möta utsatta människor kan påverka polisernas psykiska hälsa, som i sin tur kan påverka hur de använder sitt handlingsutrymme när de fattar beslut. Bakgrund: Sverige tar emot fler ensamkommande asylsökande flyktingbarn än något annat land i Europa. Antalet asylansökningar för sådana barn ökade från 400 år 2004 till 7000 år 2014 till över 35 000 år 2015. Dessa barn kommer till Sverige och ansöker om asyl utan sina föräldrar eller annan vårdnadshavare. Somliga av dem nekas asyl. Om de inte återvänder till sitt ursprungsland frivilligt är polisen ansvariga för utvisningen. Den svenska regeringen kräver ett ökande antal verkställigheter av av- och utvisningar samt fastlår att verkställigheterna ska genomföras med respekt för människors värdighet. Denna avhandling handlar om polisers uppfattningar och tolkningar av de till synes motsägelsefulla kraven på att verkställa fler av- och utvisningar, det vill säga effektivitet; och hur man hanterar de mänskliga rättigheterna under utvisningsprocessen, det vill säga värdighet. Detta beskrivs och analyseras med hjälp av tre teoretiska ramverk: a) gräsrotsbyråkrati, b) jobb-krav-kontroll-socialt stödmodellen och c) coping. Dessa teoretiska ramverk visar på arbetsuppgiftens komplexitet och fungerar som utgångspunkt för att skapa förståelse för polisernas uppfattningar av arbetet med att verkställa av- och utvisningar av ensamkommande asylsökande flyktingbarn och hur sådant arbete är associerat med polisernas psykiska hälsa. Syfte: Denna avhandling syftar till att undersöka och analysera svenska polisers psykiska hälsa i relation till av- och utvisningar av ensamkommande asylsökande flyktingbarn. Metod: Både kvalitativ och kvantitativ metod användes i denna avhandling. Det kvalitativa tillvägagångssättet innefattade intervjuer för att uppnå en djupare förståelse för hur poliser uppfattar av- och utvisningar av ensamkommande asylsökande flyktingbarn. Den kvantitativa metoden innebar tillämpning av validerade frågeformulär för att undersöka sambandet mellan polisernas psykiska hälsa och psykosociala jobbkarakteristika samt coping. Detta tillvägagångssätt gjorde det möjligt att studera en komplex fråga i en komplex miljö och att presentera relevanta rekommendationer. Totalt intervjuades 14 gränspoliser och 714 poliser svarade på en enkätundersökning. Resultat: Resultatet visar att poliserna utnyttjar sitt stora handlingsutrymme och uppfattar att de gör det som är bäst i situationen, att de försöker lyssna på barnet och vara medvetna om barnets behov. Poliser med erfarenhet av av- och utvisningar av ensamkommande asylsökande flyktingbarn har inte visat sig ha en sämre psykisk hälsa än poliser utan sådan erfarenhet. Vidare är höga krav och lågt beslutsutrymme på arbetet, låga nivåer av arbetsrelaterat socialt stöd, skiftarbete och singelliv associerat med dålig psykisk hälsa. Coping mildrar effekten på den psykiska hälsan hos de som har erfarenhet av att utföra av- och utvisningar av ensamkommande asylsökande flyktingbarn. Poliserna verkar utnyttja både emotionell och problemlösande coping under en och samma komplexa utvisningsprocess. Slutsats: Den viktigaste slutsatsen i denna avhandling är att om poliser utsätts för rimliga krav, har stort beslutsutrymme, tillgång till arbetsrelaterat socialt stöd och använder sig av anpassningsbar coping, verkar det som att arbetet med av- och utvisningar inte påverkar deras psykiska hälsa. När poliser möter utsatta människor utnyttjar de sitt handlingsutrymme för att hantera de till synes motsägelsefulla kraven, det vill säga effektivitet och värdighet. Den verkställande rollen i av- och utvisningar av ensamkommande asylsökande flyktingbarn och medvetenheten om att hantera ett barn som hotas av utvisning kan ge upphov till en aktivering av känslan att ge skydd, trygghet och säkerhet. Handlingsutrymmet kan göra det möjligt att agera på denna känsla av skydd, trygghet och säkerhet samt att kunna kombinera effektivitet och värdighet. Ytterligare studier, som integrerar kognitivt och känslomässigt handlingsutrymme med coping, behöver emellertid genomföras.
Nembhard, Kimberly T. "Knowledge of Overdiagnosis and the Decision To Participate in Breast Cancer Screening." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/467.
Full textBotkins, Elizbeth R. "Three Essays on the Economics of Food and Health Behavior." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu149208205990797.
Full textSá, Maria Célia Delduque Nogueira Pires de. "Controle judicial da política pública de vigilância sanitária: a proteção da saúde no Judiciário." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-08122010-140717/.
Full textThe 1988 Constitution of the Federative Republic of Brazil has given health a fundamental social right status and also has created a centralized health system called SUS which is responsible, among other subjects, for health surveillance services. In Brazil, actions and health services are created and implemented as public policies. Those are government actions and programs supported by laws that have been stimulating lawyers to speculate about the subject, notably because of numerous court decisions in public policies, especially those with a social character. In Brazil, health surveillance is jurisdiction of federal government through the National Health Surveillance Agency (Anvisa). This agency in order to implement public policies in health surveillance enforces acts to regulate such activities. However, such acts are often challenged in court. In order to determine if Judiciary decisions takes into account Health Law / Not Health law Niklas Luhmann\'s binary system or simply ignores the subject resulting in sentences based on other sources but Health Law and health surveillance public policy. The conclusion was that Federal Judiciary has decided mostly in favor of health, although not much experienced in public health matters they are influenced by health surveillance and health hazard notions
Mohamed, Marwa Awad. "“YOU DO IT WITHOUT THEIR KNOWLEDGE”: IS NONCONSENSUAL COMDOM REMOVAL THE NEW PUBLIC HEALTH EMERGENCY?" CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/897.
Full textAstbury, Ruth A. "What processes will support effective shared decision making when health visitors and parent are planning to improve the wellbeing of babies and children within the context of the Getting It Right For Every Child (GIRFEC) policy framework?" Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/22356.
Full textBackteman-Erlanson, Susann. "Burnout, work, stress of conscience and coping among female and male patrolling police officers." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-71206.
Full textKorchagina, Daria. "Development of a Multi-Criteria Procedure to Inform the Decision on Price and Reimbursement of Orphan Drugs." Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS288.
Full textIn order to improve the access to treatment for patients suffering from rare diseases, the governments of several countries put in place specific ‘orphan’ legislation aiming at promoting research in the field. In response to these measures, the number of approved orphan drugs has dramatically increased and continues to grow. Nevertheless, a number of issues remain unresolved. Thus, high per-patient costs, poor knowledge of the diseases and other specificities of medicines for rare diseases make it impossible to apply standard methods of health technology assessment to orphan drugs. The objective of the present research was to identify the criteria that determine the value of orphan drugs and study public preferences regarding these criteria.In the first phase of the research, a detailed review was conducted of the current situation on orphan drug market. Challenges related to the development and appraisal of orphan drugs were described and catalogued. A review was carried out of all approvals of orphan drugs in Europe, as well as of orphan drug markets in France, Italy and England and Wales. Orphan drug availability, price and reimbursement status, as well as the details of assessment were analysed.In the second phase, a literature review was conducted to identify potential determinants of orphan drug value. The impact of some of these determinants (choice was based on the availability of data) on orphan drug prices in France, Italy and England and Wales was then explored in a regression analysis.Finally, preferences of French general population in relation to the most relevant determinants of orphan drug value were analysed using an online survey. The list of determinants was developed based on a focus group and expert interviews. The survey was designed as a discrete choice experiment and allowed estimating relative weights of the included determinants.The study allowed identification of orphan drug characteristics that are most valued by the society. Its results may be taken into consideration in drug appraisal process in order to enable a fair assessment and pricing of orphan drugs
Pathak, Amit. "Forecasting Models to Predict EQ-5D Model Indicators for Population Health Improvement." Ohio University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1480959312370497.
Full textMcFerran, Ethna. "Health economic evaluation of alternatives to current surveillance in colorectal adenoma at risk of colorectal cancer." Thesis, Queen's University Belfast, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.766286.
Full textJabot, Françoise. "L'évaluation des politiques publiques : cadres conceptuel et étude de son utilisation par les décideurs des institutions régionales de santé en France." Thesis, Université de Lorraine, 2014. http://www.theses.fr/2014LORR0201/document.
Full textContext: Despite the willingness showed in texts and procedures, evaluation in France is little integrated in the decision making process. However, in the health sector which faces multiple challenges, evaluation should be a useful approach to select choices. The use of evaluation depends on multiple factors such as, knowledge and its production process, characteristics of decision makers and others users, and the political and institutional context of the evaluation Objective: The objectives were: to assess the use of evaluation on health policies; to identify levers associated with use; to assess the capacity of evaluation to fit with decision-makers needs and to enhance usability. Method: Literature review allowed to enrich the understanding of the concept of use and to identify the main influent factors as well as the related issues. Regarding evaluation as a complex system, a model based on a systemic approach was built and tested in evaluations of regional public health plans (PRSP) in 4 steps: (1) global analysis of 16 evaluations; (2) relation process/use in on region; (3) use at short/medium term in 9 regions; (4) case studies and multicriteria analysis in 5 regions. Results: A first analysis enlighted the context and the contribution of the PRSP to the coherence of regional policies. A deeper process analysis carried out in one region pointed out the relation between final aims, management and evaluation use. The examination of evaluation consequences conducted in nine regions identified different forms of use and the major factors associated with them. The dynamic of change has been apprehended as a whole through the interactions between context, users and evaluation in five regions. Discussion: The effects of evaluation are more obvious in terms of knowledge building and evolution of practice than in radical change of policies. Context, evaluation credibility, actors’ commitment and motivation are key factors. Future research should help to better understand how to foster the culture and the capacities of evaluation. These are important prerequisites to a wider use of evaluation
Brain, David C. "An economic evaluation of healthcare interventions designed to reduce Clostridium difficile infection." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/100099/1/David_Brain_Thesis.pdf.
Full textLaokri, Samia. "Assessing cost-of-illness in a user's perspective: two bottom-up micro-costing studies towards evidence informed policy-making for tuberculosis control in Sub-saharan Africa." Doctoral thesis, Universite Libre de Bruxelles, 2014. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209273.
Full textTo begin, filling a knowledge gap (Russell 2004), we have performed microeconomic research on the households’ costs-and-consequences-of-tuberculosis in Burkina Faso and Benin. The two case studies have been conducted both in rural and urban resource-poor settings between 2007 and 2009. This thesis provides new empirical findings on the remaining financial, social and ‘healthcare delivery related organizational’ barriers to access diagnosis and treatment services that are delivered free-of-charge to the population. The direct costs associated with illness incurred by the tuberculosis pulmonary smear-positive patients have constituted a severe economic burden for these households living in permanent budget constraints. Most of these people have spent catastrophic health expenditure to cure tuberculosis and, at the same time, have faced income loss caused by the care-seeking. To cope with the substantial direct and indirect costs of tuberculosis, the patients have shipped their families in impoverishing strategies to mobilize funds for health such as depleting savings, being indebted and even selling livestock and property. Damaging asset portfolios of the disease-affected households on the long run, the coping strategies result in a public health threat. In resource-poor settings, the lack of financial protection for health may impose inability to meet basic needs such as the rights to education, housing, food, social capital and access to primary healthcare. Special feature of our work lies in the breakdown of the information gathered. We have been able to demonstrate significant differences in the volume and nature of the amounts spent across the successive stages of the care-seeking pathway. Notably, pre-diagnosis spending has been proved critical both in the rural and urban contexts. Moreover, disaggregated cost data across income quintiles have highlighted inequities in relation to the direct costs and to the risk of incurring catastrophic health expenditure because of tuberculosis. As part of the case studies, the tuberculosis control strategies have failed to protect the most vulnerable care users from delayed diagnosis and treatment, from important spending even during treatment – including significant medical costs, and from hidden costs that might have been exacerbated by poor health systems. To such devastating situations, the tuberculosis patients have had to endure other difficulties; we mean intangible costs such as pain and suffering including stigmatization and social exclusion as a result of being ill or attending tuberculosis care facilities. The analysis of all the social and economic consequences for tuberculosis-affected households over the entire care-seeking pathway has been identified as an essential element of future cost-of-illness evaluations, as well as the need to conduct benefit incidence assessment to measure equity.
This work has allowed identifying a series of policy weaknesses related to the three dimensions of the universal health coverage for tuberculosis (healthcare services, population and financial protection coverage). The findings have highlighted a gap between the standard costs foreseen by the national programs and the costs in real life. This has suggested that the current strategies lack of patient-centered care, context-oriented approaches and systemic vision resulting in a quality issue in healthcare delivery system (e.g. hidden healthcare related costs). Besides, various adverse effects on households have been raised as potential consequences of illness; such as illness poverty trap, social stigma, possible exclusion from services and participation, and overburdened individuals. These effects have disclosed the lack of social protection at the country level and call for the inclusion of tuberculosis patients in national social schemes. A last policy gap refers to the lack of financial protection and remaining inequities with regards to catastrophic health expenditure still occurring under use fee exemptions strategies. Thereby, one year before 2015 – the deadline set for the Millennium Development Goals – it is a matter of priority for Benin and Burkina Faso and many other countries to tackle adverse effects of the remaining social, economic and health policy and system related barriers to tuberculosis control. These factors have led us to emphasize the need for countries to develop sustainable knowledge.
National decision-makers urgently need to document the failures and bottlenecks. Drawing on the findings, we have considered different ways to strengthen local capacity and generate bottom-up decision-making. To get there, we have shaped a decision framework intended to produce local evidence on the root causes of the lack of policy responsiveness, synthesize available evidence, develop data-driven policies, and translate them into actions.
Beyond this, we have demonstrated that controlling tuberculosis was much more complex than providing free services. The socio-economic context in which people affected by this disease live cannot be dissociated from health policy. The implications of microeconomic research on the households’ costs and responses to tuberculosis may have a larger scope than informing implementation and adaptation of national disease-specific strategies. They can be of great interest to support the definition of guiding principles for further research on social protection schemes, and to produce evidence-based targets and indicators for the reduction and the monitoring of economic burden of illness. In this thesis, we have build on prevailing debates in the field and formulated different assumptions and proposals to inform the WHO Global Strategy and Targets for Tuberculosis Prevention, Care and Control After 2015. For us, to reflect poor populations’ needs and experiences, global stakeholders should endorse bottom-up and systemic policy-making approaches towards sustainable people-centered health systems.
The findings of the thesis and the various global and national challenges that have emerged from case studies are crucial as the problems we have seen for tuberculosis in West Africa are not limited to this illness, and far outweigh the geographical context of developing countries.
Keywords: Catastrophic health expenditure, Coping strategies, Cost-of-illness studies, Direct, indirect and intangible costs, Evidence-based Public health, Financial and Social protection for health, Health Economics, Health Policy and Systems, Informed Decision-making, Knowledge translation, People-centered policy-making, Systemic approach, Universal Health Coverage
Doctorat en Sciences de la santé publique
info:eu-repo/semantics/nonPublished
Telemo, Nilsson Sara, and Laurinda Rexha. "When the physical patient becomes digital : A study of the innovation “digital health care center” on the Swedish market." Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-32145.
Full textCastro, Regina Célia Figueiredo. "Comunicação científica na área de Saúde Pública: perspectivas para a tomada de decisão em saúde baseada em conhecimento." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-29082014-152052/.
Full textObjectives. Social changes introduced by Knowledge Society are perceptible in the health management context in Brazil. Literature on these social changes, on National Health System - SUS legislation, on health information systems, on the health scientific production and on its use for decision making was reviewed. Brazilian public health scientific literature as support to health decision making was analyzed. Methods. Qualitative exploratory methods and document analysis were used to study bibliographic databases available at the Virtual Health Library, health agendas and sites of the State Secretaries of Health. Results. The main results were: LILACS and MEDLINE databases were the most comprehensive sources for searching Brazilian public health literature; 39 per cent of LILACS-SP records corresponds to Brazilian public health literature; universities and government institutions are the main producers of public health scientific literature; public health journal articles are published also in journals from other health fields; Internet, which is already being used by Ministry and State Secretaries of Health for communication, could be a favorable environment for dissemination of scientific information for health decision making. Conclusions and recommendations. Available health scientific and technical information could support health decision making processes but the channels between its production and use are not linear and need to be strengthened. Recommendations to improve relationship and interaction between health research and policy were presented.
Lucas, D. Pulane. "Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.
Full textPeixoto, Neto João. "A intervenção sanitária moderna e a quebra da confiança social sobre o risco: atores e pressupostos técnicos e políticos envolvidos na experiência de criação do modelo regulatório paraibano." Universidade Federal da Paraíba, 2011. http://tede.biblioteca.ufpb.br:8080/handle/tede/7265.
Full textCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
This monograph is a overview discussion of the political situation of Paraíba s brazilian state in which the first Paraíba s State Health Surveillance Agency (in portuguese Agência Estadual de Vigilância Sanitária - AGEVISA-PB) was created in 2002, specially all the decision process involved in the implementation of it s Public Health. The main points studied were the decisions, the governors agents, politicians and others interested persons involved on this process. Were highlighted during this study the participation of all agents involved in the early negociation, their interests, as well as their conflicting and cooperanting relationship, the strategies to induce the decisions and the rules that had effect on the action to be made, including the relation among the Executive and Legislative powers, on the State and Federal scope. This study was conducted between the year 2001 e 2002 and followed the influence of the first State Conference of Health Surveilance related to the changes that turned the State Coordination Health Surveillance to Paraíba s State Health Surveillance Agency, besides all the Public Health problems in that age. In this context, we emphasize the discussion about the Health Surveillance and contemporary risk society, as well all the alternatives that could be possible to the State Coordination Health Surveillance to become a agency and meet the demands of the healthcare and economic scenario and political situation of the state. As a consequence, we report the technical and political ways that were followed in the institutional transformation, whose design will be defined by complex processes of negotiation and consensus. The research was funded in large documentary material and interviews with key actors, which allowed empirically unravel the power relations that in a short time, led to the creation of the Paraíba s State Health Surveillance Agency (AGEVISA-PB). As such, it constituted itself as a political-institutional improvement, the first steps toward the discussions and reflections on its implementation, that this work proposes to introduce.
O presente projeto enfoca o estudo sobre o panorama político estadual que permeou a criação da primeira Agência Estadual de Vigilância Sanitária do país, a AGEVISA-PB, em especial todo o processo decisório envolvido na fase de formulação de sua política pública, na Paraíba, quando de sua instituição, no ano de 2002. Priorizaram-se, como terreno de pesquisa, as arenas decisórias, os agentes públicos, os atores políticos e os interesses organizados envolvidos no processo. Foram ressaltados, na abordagem realizada, os registros descritivos quanto à participação dos atores envolvidos nas negociações, seus interesses, bem como as relações conflituosas e de cooperação, as estratégias para influenciar a tomada de decisão e as regras do jogo que influenciaram as alternativas de ação, incluindo as relações entre os Poderes Executivo e Legislativo, em âmbito estadual e federal. O estudo abrange o período entre 2001 e 2002, e destaca os principais aspectos referentes à influência estratégica da I Conferência Estadual de Vigilância Sanitária na trajetória de mudança da então Coordenadoria Estadual para o modelo de agência reguladora de Vigilância Sanitária da Paraíba, além dos graves problemas sanitários estaduais e nacionais que permearam a época. Nesse contexto, ressalta-se a discussão sobre a Vigilância Sanitária contemporânea e a sociedade do risco, bem como sobre as diversas alternativas que possibilitassem à coordenadoria assumir um novo formato institucional, face às exigências do cenário sanitário-econômico e da conjuntura política estadual. Como conseqüência, relata-se os caminhos técnicos e políticos que foram percorridos na transformação institucional, cujo desenho vai ser definido por complexos processos de negociação e consenso. A pesquisa foi subsidiada em amplo material documental e entrevistas com atores privilegiados, o que possibilitou desvendar empiricamente as relações de força que, em um curto espaço de tempo, levaram à criação da Agência Estadual de Vigilância Sanitária da Paraíba, a AGEVISA-PB. Como tal, constituiu-se em um processo político-institucional em aperfeiçoamento, cujos primeiros passos em direção às discussões e reflexões sobre sua implementação, o presente trabalho se propõe a introduzir.