Artículos de revistas: "Healthcare reforms"

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Hughes, Reviewed by Clifford Frederick. "Humanising Healthcare Reforms". Australian Health Review 37, n.º 4 (2013): 556. http://dx.doi.org/10.1071/ahv37n4_br.

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Kjellström, Sofia, Gunilla Avby, Kristina Areskoug-Josefsson, Boel Andersson Gäre y Monica Andersson Bäck. "Work motivation among healthcare professionals". Journal of Health Organization and Management 31, n.º 4 (19 de junio de 2017): 487–502. http://dx.doi.org/10.1108/jhom-04-2017-0074.

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Purpose The purpose of this paper is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives. Design/methodology/approach Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. In total, 43 interviews were completed with different medical professions and qualitative deductive content analysis was conducted. Findings Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers’ positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematic quality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. Practical implications Leaders need to consistently translate and integrate reforms with the professionals’ drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work. Social implications The design of the reforms and leadership are essential preconditions for work motivation. Originality/value The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.

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Abdul Rani, Mohammed Fauzi. "Issues in Healthcare Reforms". Journal of Clinical and Health Sciences 3, n.º 2 (31 de diciembre de 2018): 1. http://dx.doi.org/10.24191/jchs.v3i2.7025.

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Rychlik, Reinhard, Karin Guntertgomann, Anne Kilburg y Jeffrey B. Frazier. "Healthcare Reforms in Germany". Disease Management and Health Outcomes 8, n.º 6 (diciembre de 2000): 305–12. http://dx.doi.org/10.2165/00115677-200008060-00001.

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Wise, Sarah, Christine Duffield, Margaret Fry y Michael Roche. "Workforce flexibility – in defence of professional healthcare work". Journal of Health Organization and Management 31, n.º 4 (19 de junio de 2017): 503–16. http://dx.doi.org/10.1108/jhom-01-2017-0009.

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Purpose The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical studies in healthcare that have defined flexibility as an outcome, the purpose of this paper is to draw on classic management and sociological theory to reduce this ambiguity. Design/methodology/approach The paper uses the Weberian tool of “ideal types”. Key workforce reforms are held against Atkinson’s model of functional flexibility which aims to increase responsiveness and adaptability through multiskilling, autonomy and teams; and Taylorism which seeks stability and reduced costs through specialisation, fragmentation and management control. Findings Appeals to an amorphous goal of increasing workforce flexibility make an assumption that any reform will increase flexibility. However, this paper finds that the work of healthcare professionals already displays most of the essential features of functional flexibility but many widespread reforms are shifting healthcare work in a Taylorist direction. This contradiction is symptomatic of a failure to confront inevitable trade-offs in reform: between the benefits of specialisation and the costs of fragmentation; and between management control and professional autonomy. Originality/value The paper questions the conventional conception of “the problem” of workforce reform as primarily one of professional control over tasks. Holding reforms against the ideal types of Taylorism and functional flexibility is a simple, effective way the costs and benefits of workforce reform can be revealed.

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Tao, Wenjuan, Zhi Zeng, Haixia Dang, Bingqing Lu, Linh Chuong, Dahai Yue, Jin Wen, Rui Zhao, Weimin Li y Gerald F. Kominski. "Towards universal health coverage: lessons from 10 years of healthcare reform in China". BMJ Global Health 5, n.º 3 (marzo de 2020): e002086. http://dx.doi.org/10.1136/bmjgh-2019-002086.

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Universal health coverage (UHC) is driving the global health agenda. Many countries have embarked on national policy reforms towards this goal, including China. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. The year of 2019 marks the 10th anniversary of China’s most recent healthcare reform. Sharing China’s experience is especially timely for other countries pursuing reforms to achieve UHC. This study describes the social, economic and health context in China, and then reviews the overall progress of healthcare reform (1949 to present), with a focus on the most recent (2009) round of healthcare reform. The study comprehensively analyses key reform initiatives and major achievements according to four aspects: health insurance system, drug supply and security system, medical service system and public health service system. Lessons learnt from China may have important implications for other nations, including continued political support, increased health financing and a strong primary healthcare system as basis.

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Lin, Vivian. "Transformations in the healthcare system in China". Current Sociology 60, n.º 4 (22 de junio de 2012): 427–40. http://dx.doi.org/10.1177/0011392112438329.

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In April 2009, the Chinese government announced comprehensive reforms to the health system following more than a decade of piecemeal reform efforts. Popular complaints about high healthcare costs and access difficulties eventually received political attention following the government administration change of 2002 and the SARS outbreak of 2003. However, policy differences between ministries resulted in several years of vigorous and open policy debates involving domestic and international stakeholders as well as citizens who are active in expressing opinions virtually (netizens). The 2009 reforms signalled not only policy recognition of the need for a comprehensive and systemic approach if healthcare was to be transformed, but also charted new approaches to policy-making. While the current reforms are being rapidly implemented, the question arises as to whether the shifts in the policy-making process will continue into the future. Further evaluation of the policy process will require cooperation if not collaboration from the policy actors themselves.

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Zhang, Xiaoyan y Pengqian Fang. "Job satisfaction of village doctors during the new healthcare reforms in China". Australian Health Review 40, n.º 2 (2016): 225. http://dx.doi.org/10.1071/ah15205.

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Objective China launched new healthcare reforms in 2009 and several policies targeted village clinics, which affected village doctors’ income, training and duties. The aim of the present study was to assess village doctors’ job satisfaction during the reforms and to explore factors affecting job satisfaction. Methods Using a stratified multistage cluster sampling process, 935 village doctors in Jiangxi Province were surveyed with a self-administered questionnaire that collected demographic information and contained a job satisfaction scale and questions regarding their work situation and individual perceptions of the new healthcare reforms. Descriptive analysis, Pearson’s Chi-squared test and binary logistic regression were used to identify village doctors’ job satisfaction and the factors associated with their job satisfaction. Results Only 12.72% of village doctors were either satisfied or very satisfied with their jobs and the top three items leading to dissatisfaction were pay and the amount of work that had to be done, opportunities for job promotion and work conditions. Marriage, income, intention to leave, satisfaction with learning and training, social status, relationship with patients and satisfaction with the new healthcare reforms were significantly associated with job satisfaction (P < 0.05). Conclusions China is facing critical challenges with regard to village doctors because of their low job satisfaction. For future healthcare reforms, policy makers should pay more attention to appropriate remuneration and approaches that incentivise village doctors to achieve the goals of the health reforms. What is known about the topic? Village doctors act as gatekeepers at the bottom tier of the rural health system. However, the policies of the new healthcare reform initiatives in China were centred on improving the quality of care delivered to the rural population and reducing fast-growing medical costs. There have been limited studies on village doctors’ reactions to these reforms. What does this paper add? The findings of the present study indicate that in the process of implementing the new healthcare reforms, village doctors’ overall job satisfaction is low and most respondents are dissatisfied with the reforms. The factors affecting job satisfaction include income, training, social status, relationship with patients and satisfaction with the reforms. What are the implications for practitioners? Health reform policy makers should ensure village doctors feel appropriately remunerated and are motivated while aiming to reduce the financial burden on patients. The views of stakeholders (i.e. patients and village doctors) should be considered when designing future health reforms.

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Vakulenko, Veronika, Anatoli Bourmistrov y Giuseppe Grossi. "Reverse decoupling: Ukrainian case of healthcare financing system reform". International Journal of Public Sector Management 33, n.º 5 (10 de abril de 2020): 519–34. http://dx.doi.org/10.1108/ijpsm-10-2019-0262.

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PurposeThe purpose of this paper is to explore inter-organizational interactions that might result in prolonged decoupling between central governments' ideas and local governments' practices during the reform of an institutional field (i.e. healthcare).Design/methodology/approachThe paper is based on a qualitative study of the centrally directed reform of the healthcare financing system in Ukraine and focusses on practices and reform ideas from 1991 to 2016.FindingsThe findings show that, for more than 25 years, local governments, as providers of healthcare services, faced two major problems associated with drawbacks of the healthcare financial system: line-item budgeting and fragmentation of healthcare funds. Over 25 years, central government's attempts to reform the healthcare financing system did not comprehensively or systematically address the stated problems. The reformers' ideas seemed to focus on creating reform agendas and issuing new laws, instead of paying attention to challenges in local practices.Practical implicationsThis article has two main points that are relevant for practitioners. First, it calls for greater involvement from local actors during all stages of public sector reforms, in order to ensure the relevance of developed reform strategies. Second, it points to potential challenges that central governments may face when conducting healthcare financing system reforms in transitional economies.Originality/valueThe paper's contribution is twofold: it outlines reasons for problematic implementation of healthcare financing system reform in Ukraine and explains them through a “reverse decoupling” concept.

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Temnova, L. V. y E. G. Bapinaeva. "Adaptive practices of healthcare workers under the reforms". RUDN Journal of Sociology 22, n.º 3 (29 de septiembre de 2022): 630–45. http://dx.doi.org/10.22363/2313-2272-2022-22-3-630-645.

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The theory of high modernism and the concept ‘metis’ by J. Scott identify one of the reasons for unsuccessful state reform in various areas: when preparing changes, local practical experience is often neglected, but the success of the reform as a whole may depend exactly on such knowledge. The system ignores the possible strategies of workers’ resistance to the coming changes, many of which are unconscious. The reforms in the field of healthcare, including in Russia, have shown that doctors remain the most vulnerable group affected by changes. A side effect of the ongoing reforms is the development by the professional community of doctors of certain adaptive practices aimed at adaptation to changes with the least losses for the individual and professional activity. To identify the adaptive practices of medical workers in response to the reforms and their consequences, the authors examined the available data and conducted interviews with doctors of various specialties. As a result, adaptive practices of doctors in their professional activities were systematized, and their classification was proposed: deviant/non-deviant and active/passive. Active adaptive practices prevail and are implemented in three subsystems: doctor-administration, doctor-doctor and doctor-patient. Most doctors tend to accept changes that involve adding new practices rather than changes removing traditional practices. All respondents positively assessed new technologies, but negatively assessed rigid standards that limit their professional freedom. The development of adaptive practices depends on various factors - gender, age, length of service, specialization, position. Such practices help doctors to keep the habitual way of professional life and to adapt to new working conditions.

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Carter, Melody. "Book review: Humanizing healthcare reforms". Nursing Ethics 20, n.º 5 (agosto de 2013): 604–5. http://dx.doi.org/10.1177/0969733013486578.

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Boscheck*, Ralf. "Healthcare Reforms and Governance Concerns". Intereconomics 40, n.º 2 (marzo de 2005): 75–88. http://dx.doi.org/10.1007/s10272-005-0139-2.

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Spigel, Lauren, Madeline Pesec, Oscar Villegas del Carpio, Hannah L. Ratcliffe, Jorge Arturo Jiménez Brizuela, Andrés Madriz Montero, Eduardo Zamora Méndez, Dan Schwarz, Asaf Bitton y Lisa R. Hirschhorn. "Implementing sustainable primary healthcare reforms: strategies from Costa Rica". BMJ Global Health 5, n.º 8 (agosto de 2020): e002674. http://dx.doi.org/10.1136/bmjgh-2020-002674.

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As the world strives to achieve universal health coverage by 2030, countries must build robust healthcare systems founded on strong primary healthcare (PHC). In order to strengthen PHC, country governments need actionable guidance about how to implement health reform. Costa Rica is an example of a country that has taken concrete steps towards successfully improving PHC over the last two decades. In the 1990s, Costa Rica implemented three key reforms: governance restructuring, geographic empanelment, and multidisciplinary teams. To understand how Costa Rica implemented these reforms, we conducted a process evaluation based on a validated implementation science framework. We interviewed 39 key informants from across Costa Rica’s healthcare system in order to understand how these reforms were implemented. Using the Exploration Preparation Implementation Sustainment (EPIS) framework, we coded the results to identify Costa Rica’s key implementation strategies and explore underlying reasons for Costa Rica’s success as well as ongoing challenges. We found that Costa Rica implemented PHC reforms through strong leadership, a compelling vision and deliberate implementation strategies such as building on existing knowledge, resources and infrastructure; bringing together key stakeholders and engaging deeply with communities. These reforms have led to dramatic improvements in health outcomes in the past 25 years. Our in-depth analysis of Costa Rica’s specific implementation strategies offers tangible lessons and examples for other countries as they navigate the important but difficult work of strengthening PHC.

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Or, Zeynep, Chantal Cases, Melanie Lisac, Karsten Vrangbæk, Ulrika Winblad y Gwyn Bevan. "Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems". Health Economics, Policy and Law 5, n.º 3 (julio de 2010): 269–93. http://dx.doi.org/10.1017/s1744133110000034.

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AbstractIndustrialised countries face similar challenges for improving the performance of their health system. Nevertheless, the nature and intensity of the reforms required are largely determined by each country’s basic social security model. Most reforms in Beveridge-type systems have sought to increase choice and reduce waiting times while those in major Bismarck-type systems have focused on cost control by constraining the choice of providers. This paper looks at the main differences in performance of five countries and reviews their recent reform experience, focusing on three questions: Are there systematic differences in performance of Beveridge and Bismarck-type systems? What are the key parameters of healthcare system, which underlie these differences? Have recent reforms been effective?Our results do not suggest that one system-type performs consistently better than the other. In part, this may be explained by the heterogeneity in organisational design and governance both within and across these systems. Insufficient attention to those structural differences may explain the limited success of a number of recent reforms. Thus, while countries may share similar problems in terms of improving healthcare performance, adopting a ‘copy-and-paste’ approach to healthcare reform is likely to be ineffective.

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Millar, Ross y Helen Dickinson. "Planes, straws and oysters: the use of metaphors in healthcare reform". Journal of Health Organization and Management 30, n.º 1 (21 de marzo de 2016): 117–32. http://dx.doi.org/10.1108/jhom-11-2013-0242.

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Purpose – The purpose of the paper is to examine the metaphors used by senior managers and clinicians in the delivery of healthcare reform. Design/methodology/approach – A study of healthcare reform in England carried out a series of semi structured interviews with senior managers and clinicians leading primary and secondary care organisations. Qualitative data analysis examines instances where metaphorical language is used to communicate how particular policy reforms are experienced and the implications these reforms have for organisational contexts. Findings – The findings show how metaphorical language is used to explain the interactions between policy reform and organisational contexts. Metaphors are used to illustrate both the challenges and opportunities associated with the reform proposals for organisational change. Originality/value – The authors provide the first systematic study of patterns and meanings of metaphors within English healthcare contexts and beyond. The authors argue that these metaphors provide important examples of “generative” dialogue in their illustration of the opportunities associated with reform. Conversely, these metaphors also provide examples of “degenerative” dialogue in their illustration of a demarcation between the reform policy proposals and existing organisational contexts.

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Pereira, Miguel Alves, Rui Cunha Marques y Diogo Cunha Ferreira. "An Incentive-Based Framework for Analyzing the Alignment of Institutional Interventions in the Public Primary Healthcare Sector: The Portuguese Case". Healthcare 9, n.º 7 (16 de julio de 2021): 904. http://dx.doi.org/10.3390/healthcare9070904.

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Over the years, the Portuguese National Health Service has undergone several reforms to face the challenges posed by internal and external factors on the access to and quality of its health services. One of its most recent reforms addressed the primary healthcare sector, where understanding the incentives behind the actors of the inherent institutional interventions and how they are aligned with the governing health policies is paramount for reformative success. With the purpose of acknowledging the alignment of the primary healthcare sector’s institutional interventions from an incentive-based perspective, we propose a framework resting on a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, which was built in cooperation with a panel of decision-making actors from the Portuguese Ministry of Health. In the end, we derive possible policy implications and strategies. This holistic approach highlighted the positive impact of the primary healthcare reform in the upgrade of physical resources and human capital but stressed the geosocial asymmetries and the lack of intra- and inter-sectorial coordination. The proposed framework serves also as a guideline for future primary healthcare reforms, both national- and internationally.

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Shankar, Darshan. "Health sector reforms for 21stcentury healthcare". Journal of Ayurveda and Integrative Medicine 6, n.º 1 (2015): 4. http://dx.doi.org/10.4103/0975-9476.154214.

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Siegel-Itzkovich, J. "Israeli committee maps out healthcare reforms". BMJ 326, n.º 7380 (11 de enero de 2003): 70c—70. http://dx.doi.org/10.1136/bmj.326.7380.70/c.

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Dorozynski, A. "French doctors grumble at healthcare reforms". BMJ 316, n.º 7142 (9 de mayo de 1998): 1407. http://dx.doi.org/10.1136/bmj.316.7142.1407l.

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Ford-Roegner, Patricia. "The Academy's work on healthcare reforms". Nursing Outlook 57, n.º 6 (noviembre de 2009): 355–56. http://dx.doi.org/10.1016/j.outlook.2009.10.002.

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Rovner, Julie. "Clinton tackles healthcare reforms head on". Lancet 353, n.º 9152 (febrero de 1999): 570. http://dx.doi.org/10.1016/s0140-6736(05)75642-7.

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Burstrom, B. "Will Swedish healthcare reforms affect equity?" BMJ 339, dec22 2 (22 de diciembre de 2009): b4566. http://dx.doi.org/10.1136/bmj.b4566.

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Hamer, Susan. "Humanizing Healthcare Reforms Arbuckle Gerald A Humanizing Healthcare Reforms 272pp £19.99 Jessica Kingsley Publishers 9781849053181 1849053189". Primary Health Care 23, n.º 9 (noviembre de 2013): 13. http://dx.doi.org/10.7748/phc2013.11.23.9.13.s13.

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Christensen, Tom y Yongmao Fan. "Post-New Public Management: a new administrative paradigm for China?" International Review of Administrative Sciences 84, n.º 2 (23 de mayo de 2016): 389–404. http://dx.doi.org/10.1177/0020852316633513.

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From three theoretical perspectives – instrumental, cultural and mythical – this article analyses the reasons for the worldwide emergence of post-New Public Management reforms and summarizes the typical features of those measures. In particular, it explores the link between post-New Public Management and public-sector reforms in China and argues that the ongoing reforms in China, including the super-ministry reform, the regulation of industry, the affordable housing policy, social and healthcare reforms, and the anti-corruption campaign, have shed light on various aspects of post-New Public Management measures. However, because China’s complex public administrative systems are more centralized than they are in many Western countries, it faces big challenges in deciding on and implementing reforms. Points for practitioners The examined administrative reforms demonstrate that China is imitating post-New Public Management reforms and adapting them to Chinese cultural traditions. China’s case reveals that the public sector is a complicated combination of elements from New Public Management and post-New Public Management reforms in a process where new reform elements are continuously added to old ones. China’s reforms are still ongoing; in the past years, China focused more on economic reform, decentralization and efficiency, but today its reforms are turning to social stability, political order and central control.

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Witecki, Stanisław. "Healthcare and Catholic Enlightenment in the Polish-Lithuanian Commonwealth". Studies in Church History 58 (junio de 2022): 150–72. http://dx.doi.org/10.1017/stc.2022.8.

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In the eighteenth century, the ideal of the priest in society was reformed by Polish and Lithuanian Catholic bishops. Instrumental in these reforms were Ignacy Massalski (1726–94), bishop of Vilnius (1762–94) and Michał Poniatowski (1736–94), bishop of Płock (1773–85), then archbishop of Gniezno (1785–94), and simultaneously administrator of the diocese of Kraków (1782–90). Their programmes included making clergy responsible for medical education and the organization of healthcare, and seeking to reform customs which were viewed as detrimental to health. The article draws on pastoral letters, popular educational books and administrative decrees to ascertain what ideas reformers imposed on the clergy. Episcopal visitation protocols, sermons and parish school textbooks are analysed to verify the effects of reforms and ascertain what was taught about health in the parishes. The examination of the relatively rare egodocuments of priests sheds light on how they experienced their afflictions. The article concludes that healthcare was an important topic for Catholic enlighteners in the Polish-Lithuanian Commonwealth, and that priests played a significant role in promoting it. Reforms were driven by humanitarian and physiocratic principles, and were facilitated by an optimistic belief in the benefits of medicine. Nonetheless, many enlightened programmes failed because priests were unwilling or unable to implement changes that interfered with lived religion.

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Donato, Ronald y Leonie Segal. "Does Australia have the appropriate health reform agenda to close the gap in Indigenous health?" Australian Health Review 37, n.º 2 (2013): 232. http://dx.doi.org/10.1071/ah12186.

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This paper provides an analysis of the national Indigenous reform strategy – known as Closing the Gap – in the context of broader health system reforms underway to assess whether current attempts at addressing Indigenous disadvantage are likely to be successful. Drawing upon economic theory and empirical evidence, the paper analyses key structural features necessary for securing system performance gains capable of reducing health disparities. Conceptual and empirical attention is given to the features of comprehensive primary healthcare, which encompasses the social determinants impacting on Indigenous health. An important structural prerequisite for securing genuine improvements in health outcomes is the unifying of all funding and policy responsibilities for comprehensive primary healthcare for Indigenous Australians within a single jurisdictional framework. This would provide the basis for implementing several key mutually reinforcing components necessary for enhancing primary healthcare system performance. The announcement to introduce a long-term health equality plan in partnership with Aboriginal people represents a promising development and may provide the window of opportunity needed for implementing structural reforms to primary healthcare. What is known about the topic? Notwithstanding the intention of previous policies, considerable health disparity exists between Indigenous and non-Indigenous Australians. Australia has now embarked on its most ambitious national Indigenous health reform strategy, but there has been little academic analysis of whether such reforms are capable of eliminating health disadvantage for Aboriginal people. What does the paper add? This paper provides a critical analysis of Indigenous health reforms to assess whether such policy initiatives are likely to be successful and outlines key structural changes to primary healthcare system arrangements that are necessary to secure genuine system performance gains and improve health outcomes for Indigenous Australians. What are the implications for practitioners? For policymakers, the need to establish genuine partnership and engagement between Aboriginal people and the Australian government in pursuing a national Indigenous reform agenda is of critical importance. The establishment of the National Congress of Australia’s First Peoples provides the opportunity for policymakers to give special status to Indigenous Australians in health policy development and create the institutional breakthrough necessary for effecting primary healthcare system change.

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McClellan, Mark. "Reforming Payments to Healthcare Providers: The Key to Slowing Healthcare Cost Growth While Improving Quality?" Journal of Economic Perspectives 25, n.º 2 (1 de mayo de 2011): 69–92. http://dx.doi.org/10.1257/jep.25.2.69.

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This paper focuses on a broad movement toward a fundamentally different way of paying healthcare providers. The approach reaches beyond the old dichotomies about whether healthcare providers are reimbursed on a fee-for-service or a “capitated” or per-person payment. Instead, these reforms seek to create direct linkages between payments to healthcare providers and measures of the quality and efficiency of care. After an overview of payment reforms for healthcare providers and their welfare implications, this paper discusses a range of empirical studies. These often small-scale studies suggest that provider payment reforms in conjunction with greater attention to improving measurements of care quality and outcomes can have a significant impact on quality of care and, in some cases, resource use and costs of care.

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Einav, Liran, Amy Finkelstein, Yunan Ji y Neale Mahoney. "Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform". Proceedings of the National Academy of Sciences 117, n.º 32 (27 de julio de 2020): 18939–47. http://dx.doi.org/10.1073/pnas.2004759117.

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Changes in the way health insurers pay healthcare providers may not only directly affect the insurer’s patients but may also affect patients covered by other insurers. We provide evidence of such spillovers in the context of a nationwide Medicare bundled payment reform that was implemented in some areas of the country but not in others, via random assignment. We estimate that the payment reform—which targeted traditional Medicare patients—had effects of similar magnitude on the healthcare experience of nontargeted, privately insured Medicare Advantage patients. We discuss the implications of these findings for estimates of the impact of healthcare payment reforms and more generally for the design of healthcare policy.

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Toth, Federico. "Healthcare policies over the last 20 years: Reforms and counter-reforms". Health Policy 95, n.º 1 (abril de 2010): 82–89. http://dx.doi.org/10.1016/j.healthpol.2009.11.006.

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Mei, Jixia y Ian Kirkpatrick. "Public hospital reforms in China: towards a model of new public management?" International Journal of Public Sector Management 32, n.º 4 (13 de mayo de 2019): 352–66. http://dx.doi.org/10.1108/ijpsm-03-2018-0063.

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Purpose The purpose of this paper is to explore how far plans to “modernize” hospital management in China are converging toward a global model of new public management (NPM) or represent a distinctive pathway. Design/methodology/approach This paper draws on a systematic review of available secondary sources published in English and Chinese to describe both the nature and trajectory of hospital management reforms in China. Findings In China, while public hospital reforms bear many of the hallmarks of the NPM, they are distinctive in two key respects. First, the thrust of current reforms is to partially reverse, not extend, the trend toward marketization in order to strengthen the public orientation of public hospitals. Second is a marked gap between the rhetoric and reality of empowering managers and freeing them from political control. Practical implications This paper develops a framework for understanding the drivers and obstacles to hospital management reforms in China that is useful for managers, clinicians and policy makers. Originality/value In China, few authors have considered NPM reform in relation to healthcare. This paper contributes in better understanding current reforms taking place in China’s expanding healthcare sector and locates these within broader theoretical and policy debates.

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Tagaeva, Tatyana y Lidiya Kazantseva. "Social impacts of health care reforms in Russia". E3S Web of Conferences 210 (2020): 17011. http://dx.doi.org/10.1051/e3sconf/202021017011.

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The article considers the stages of healthcare sector reforms in Russia and the impact of this process on public health as the main indicator of the social state. A definition of public health is given; the scientific significance and relevance of the research are justified. The works of foreign and domestic authors, their approaches to the study of factors affecting public health are analysed. The analysis of the state of public health in 80s-90s of the last century during the political and economic crisis is made; the transition process from the so-called “budget-funded” financing model to the “insurance” one is described. Based on statistics and expert assessments, as well as international confrontations, conclusions are drawn about the multi-year underfunding of the healthcare sector, primarily from the state budget. A new stage of reforms is analysed: since 2014, the Russian government has begun the so-called “optimization” of healthcare. Its goals, results, feedbacks from doctors and patients are stated. They show the new reform is a negative process for health system. The blunders of health care reform have been sharply marked with the beginning of the pandemic of coronavirus infection. The facts of the self-sacrificing work of the doctors and nursing personnel during the pandemic period, the measures of the Government and the society to support medical workers were described.

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Khujanazarov, A. y Sh Allamuratov. "Healthcare System in Uzbekistan: Problems and Reforms". Bulletin of Science and Practice 7, n.º 2 (15 de febrero de 2021): 405–10. http://dx.doi.org/10.33619/2414-2948/63/46.

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The article is devoted to the history of medicine in our country, as well as to questions and solutions. Analyzing, for example, how the health care system has taken into account the impact of reforms over the past four years.

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Gillen, Sally. "Chief nursing officer sets out healthcare reforms". Learning Disability Practice 18, n.º 8 (28 de septiembre de 2015): 7. http://dx.doi.org/10.7748/ldp.18.8.7.s5.

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Palmer, Cally. "British Healthcare Reforms: A Hospital Manager's View". Business Strategy Review 6, n.º 3 (septiembre de 1995): 41–50. http://dx.doi.org/10.1111/j.1467-8616.1995.tb00098.x.

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35

Ross, Yaounde. "Nurses can lead on implementing healthcare reforms". Nursing Management 19, n.º 7 (26 de octubre de 2012): 9. http://dx.doi.org/10.7748/nm2012.11.19.7.9.p9744.

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36

Hellman, Matilda. "Social and healthcare reforms and vulnerable groups". Nordic Studies on Alcohol and Drugs 36, n.º 1 (febrero de 2019): 3–5. http://dx.doi.org/10.1177/1455072519829392.

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37

Li, L. "The challenges of healthcare reforms in China". Public Health 125, n.º 1 (enero de 2011): 6–8. http://dx.doi.org/10.1016/j.puhe.2010.10.010.

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Contandriopoulos, Damien, Astrid Brousselle, Catherine Larouche, Mylaine Breton, Michèle Rivard, Marie-Dominique Beaulieu, Jeannie Haggerty, Geneviève Champagne y Mélanie Perroux. "Healthcare reforms, inertia polarization and group influence". Health Policy 122, n.º 9 (septiembre de 2018): 1018–27. http://dx.doi.org/10.1016/j.healthpol.2018.07.007.

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Ramesh, M., X. Wu y A. J. He. "Health governance and healthcare reforms in China". Health Policy and Planning 29, n.º 6 (4 de enero de 2013): 663–72. http://dx.doi.org/10.1093/heapol/czs109.

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40

Langsdale, Tracey. "Healthcare reforms needed to avert funding crises". PharmacoResources 43, n.º 1 (diciembre de 1995): 8–9. http://dx.doi.org/10.1007/bf03319545.

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41

Eskelinen, Pia. "Lawton Robert Burns and Gordon G. Liu (eds.) (2017)." British Journal of Chinese Studies 8, n.º 2 (15 de marzo de 2019): 150–53. http://dx.doi.org/10.51661/bjocs.v8i2.12.

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Lawton Robert Burns and Gordon G. Liu’s edited book China’s Healthcare System and Reform aims to make sense of one of the biggest healthcare systems in the world. At first glance, the scope of the book’s theme appears alarmingly broad. However, the collection of expert essays constructs a comprehensive analysis of the development of the Chinese healthcare system and its reforms. All contributors are professionals in their own fields, and it is a breath of fresh air to collect their expertise into one comprehensive package.

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42

Pei, Likun, Pauline Stanton y David Legge. "Improving human resource management in Chinese healthcare: identifying the obstacles to change". Australian Health Review 27, n.º 1 (2004): 124. http://dx.doi.org/10.1071/ah042710124.

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Health sector reform in China has led to increasing responsibility for hospital managers in the management of staff,but constraints continue. New personnel reforms offer new opportunities but face a number of difficulties. Drawingon research in Chinese hospitals in 1997 this paper identifies two major obstacles to improved human resourcemanagement: wage policy and lack of control by local managers over staffing.

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43

Moskalenko, Vitaliy, Iryna Nizhenkovskaya y Elena Welchinska. "INCREASE IN THE ROLE OF PHARMACIST AS A PROFESSIONAL UNDER THE CONDITIONS OF THE BOLOGNA SYSTEM IN UKRAINE". CBU International Conference Proceedings 2 (1 de julio de 2014): 319–22. http://dx.doi.org/10.12955/cbup.v2.478.

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Countries worldwide are facing similar healthcare problems. Medicine develops new methods for treatment, and pharmaceutical companies invent more efficient products. These technological advances are, however, expensive, and put a double-strain on public healthcare spending: the cost of sophisticated treatment keeps growing, and improved healthcare allows patients to live longer, thus requiring more treatment. Budgetary constraints, however, require government to restrict expenditure. These challenges have to be answered in the context of existing public healthcare systems, which, are well established and complex. Healthcare reforms will necessarily reflect these characteristics, as well as the relative political weight of the partners. Such reforms will most likely affect all partners involved in the provision and healthcare management, including social security institutions (state agencies, sickness funds, etc.), doctors, and other health professionals—pharmacists. Currently one of most important strategic tasks of modernization of the system of higher education in Ukraine is the high quality education provided to pharmacists in order to satisfy the worldwide needs.Whatever specific reform will be adopted, the main goals are to make the system more efficient and, thus, more cost effective; and, because the first aspect will not sufficiently decrease the expenditure, it is necessary to limit the scope of public health care while maintaining a balance of benefits.

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KADIOGLU, FUNDA GULAY. "An Ethical Analysis of Performance-Based Supplementary Payment in Turkey’s Healthcare System". Cambridge Quarterly of Healthcare Ethics 25, n.º 3 (27 de junio de 2016): 493–96. http://dx.doi.org/10.1017/s096318011600013x.

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Abstract:In 2003 Turkey introduced the Health Transition Program to develop easily accessible, high-quality, and effective healthcare services for the population. This program, like other health reforms, has three primary goals: to improve health status, to enhance financial protection, and to ensure patients’ satisfaction. Although there is considerable literature on the anticipated positive results of such health reforms, little evidence exists on their current effectiveness. One of the main initiatives of this health reform is a performance-based supplementary payment system, an additional payment healthcare professionals receive each month in addition to their regular salaries. This system may cause some ethical problems. Physicians have an ethical duty to provide high-quality care to each patient; however, pay-for-performance and other programs that create strong incentives for high-quality care set up a potential conflict between this duty and the competing interest of complying with a performance measure.

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45

Guy, Mary. "Between ‘going private’ and ‘NHS privatisation’: patient choice, competition reforms and the relationship between the NHS and private healthcare in England". Legal Studies 39, n.º 3 (8 de mayo de 2019): 479–98. http://dx.doi.org/10.1017/lst.2018.55.

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AbstractPatient choice in the context of National Health Service (NHS) reforms in England can refer to the law and policy underpinning patient movement between the NHS and private healthcare sector (in existence since the introduction of the NHS in 1948), as well as recent competition reforms of the Health and Social Care Act 2012, the National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013 and the 2014 Private Healthcare Market Investigation by the Competition and Markets Authority (CMA). This paper highlights the existence of two discrete, yet related frameworks: the ‘NHS patient – private patient’ framework based on Department of Health, NHS England and latterly Clinical Commissioning Group policy, and the ‘NHS patient choice’ framework, derived from New Labour choice and competition policies and subsequently enshrined by the 2012 Act reforms. The juxtaposition of these frameworks underscores the symbiotic relationship between the NHS and private healthcare, which raises questions about the fitness for purpose of current policy. It also helps explain why the competition reforms are difficult to implement, and suggests that the knitting together of patient choice and competition may unravel following the 2012 Act reforms and CMA private healthcare market development.

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Maka Kuchava, Maka Kuchava y Marina Metreveli Marina Metreveli. "Impact of Health Care Reforms on the Development of the Countries Hospital Sector". Economics 105, n.º 4-5 (8 de mayo de 2022): 21–30. http://dx.doi.org/10.36962/ecs105/4-5/2022-21.

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Health care reforms in Georgia have played a significant role in the country's economic development. Among the reforms, the "General Plan for the Development of the Hospital Sector" was of particular importance. As a result of the reform, initiated in 2007, the old and outdated hospitals have been renovated and equipped with the latest technologies and more hospital beds were added to the country’s hospitals. As a result, more jobs were created for medical staff and competition has been introduced among the hospital industry. This resulted in investing more resources on staff development, creation of better potential for the export of medical services which in turn contributed to the overall economic development of the country. Keywords: Healthcare reforms, Hospital sector, Economic development.

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Agartan, Tuba I. "Marketization and universalism: Crafting the right balance in the Turkish healthcare system". Current Sociology 60, n.º 4 (22 de junio de 2012): 456–71. http://dx.doi.org/10.1177/0011392112438331.

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Turkey is undertaking comprehensive reforms in its healthcare sector which bring about a major transformation in the boundaries between the public and private sectors. As in many transition and late-developing countries reforms seek to universalize coverage, increase efficiency and improve quality of healthcare services. The Turkish case is interesting as it draws attention to the balance that is being struck between two major components of the reforms, namely marketization and universalism. Expansion of coverage and improvements in equity are taking place alongside state-induced market and managerial reforms. This article assesses the extent of marketization and argues that while market elements have been limited to the provision dimension, in the long run they may lead to some erosion in universalism. The Turkish case serves as an example of transformations in developing countries where market reforms have to be accompanied by a strong and active state for universalism to be achieved.

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Reibling, Nadine y Claus Wendt. "Gatekeeping and provider choice in OECD healthcare systems". Current Sociology 60, n.º 4 (22 de junio de 2012): 489–505. http://dx.doi.org/10.1177/0011392112438333.

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Gatekeeping and provider choice have become central in health policymaking within the last two decades. This article contributes to the debates in two ways: first, it provides an extended review of evidence on the impact of gatekeeping and provider choice on efficiency, costs, quality, equality and patient empowerment; and second, it empirically analyses regulations and identifies common trends in healthcare reforms in OECD countries since 1990. More than half of the countries analysed have established gatekeeping systems, while a smaller number provides free access to secondary care. The study discovers a trend towards strengthening gatekeeping regulations within free access countries. Free choice of provider is the standard in the OECD, where only a small number of countries restrict provider choice. The article identifies a diverging trend of reforms, with some traditionally restrictive countries offering more provider choice and other countries limiting the choice of providers as a result of managed care reforms.

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Akkazieva, Baktygul, Laszlo Gulacsi, Agnes Brandtmuller, M??rta P??ntek y John F. P. Bridges. "Patients??? Preferences for Healthcare System Reforms in Hungary". Applied Health Economics and Health Policy 5, n.º 3 (2006): 189–98. http://dx.doi.org/10.2165/00148365-200605030-00005.

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Chilver, Karen. "Failure to trial healthcare reforms could spell disaster". Nursing Standard 26, n.º 10 (9 de noviembre de 2011): 33. http://dx.doi.org/10.7748/ns2011.11.26.10.33.p6882.

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