WorldWideScience

Sample records for care reform policies

  1. Policy challenges in US health care system reform.

    Science.gov (United States)

    Hussain, Aftab; Rivers, Patrick A

    2010-01-01

    Once again, efforts are being made to overhaul the US health care system. Democrats and Republicans have conflicting views on how to repair this ailing system. However, this is not a new phenomenon. Reformers have long struggled to form a universal health care system only to find themselves in conflict with groups whose financial stake is threatened as well as numerous labor associations who are concerned about a loss of power. This struggle is also caused by differences in ideologies. This article surveys social movements for national health insurance (NHI) that occurred in the United States and will examine features that prevented NHI policy formation. PMID:22329329

  2. The Policy Context and Infant and Toddler Care in the Welfare Reform Era

    OpenAIRE

    Witte, Ann Dryden; Queralt, Magaly; Witt, Robert; Griesinger, Harriet

    2001-01-01

    We provide descriptive evidence from Miami-Dade County (MDC) in FL and from five representative areas in Massachusetts (MA) that government policies governing welfare reform, the child-care subsidy system, and minimum-standards regulations have had considerable influence on the availability, price, and quality of infant and toddler care as welfare reform progressed from 1996 to 2000. We suspect that the markedly different proportion of the population that is native born and differences in inc...

  3. The policy and politics of the 2015 long-term care reform in the Netherlands.

    Science.gov (United States)

    Maarse, J A M Hans; Jeurissen, P P Patrick

    2016-03-01

    As of 2015 a major reform in LTC is taking place in the Netherlands. An important objective of the reform is to reign in expenditure growth to safeguard the fiscal sustainability of LTC. Other objectives are to improve the quality of LTC by making it more client-tailored. The reform consists of four interrelated pillars: a normative reorientation, a shift from residential to non-residential care, decentralization of non-residential care and expenditure cuts. The article gives a brief overview of these pillars and their underlying assumptions. Furthermore, attention is paid to the political decision-making process and the politics of implementation and evaluation. Perceptions of the effects of the reform so far widely differ: positive views alternate with critical views. Though the reform is radical in various aspects, LTC care will remain a largely publicly funded provision. A statutory health insurance scheme will remain in place to cover residential care. The role of municipalities in publicly funded non-residential care is significantly upgraded. The final section contains a few policy lessons. PMID:26872702

  4. Policy and the Re-Formation of Hospice: Lessons from the Past for the Future of Palliative Care.

    Science.gov (United States)

    Buck, Joy

    2011-11-01

    During the twentieth-century, dramatic changes in the manner and location of care for the dying resulted in the conception and birth of the modern American hospice movement. Idealistic nurses, clergy, and others concerned about the plight of terminally ill cancer patients launched hospice as a necessary health care reform. As new hospice programs opened across the country, the idealism of the early leaders gave way to more pragmatic issues such as program viability. As hospice was studied and integrated into the health care system, it came to be redefined by the politics of health policy and the health care industry. As a result, there is a disarticulation between the needs of seriously ill persons and their families and the health care that is available to them. Important lessons can be learned from the history of the Medicare hospice benefit to help guide current palliative care policy initiatives. While formalized reimbursement for hospice enhanced organizational sustainability, many critical issues remain. PMID:22184500

  5. Health care policy reform: a microanalytic model for comparing hospitals in the United States and Germany.

    Science.gov (United States)

    Parsons, R J; Woller, G M; Neubauer, G; Rothaemel, F T; Zelle, B

    1999-01-01

    Microcomparison, or single-component analysis, of health care systems offers a potentially better basis for reform than traditional macrocomparison analysis of aggregate elements. Using macroanalysis, available evidence shows that Germany provides cheaper but more effective hospital care than the United States. To find the causes for this outcome, we developed a microanalytic model of hospital administrators' perceptions, financial ratios, medical outcomes, and pharmaceutical costs. However, only data on pharmaceutical costs were available, and these were similar in both countries. Our significant outcome was development of a microcomparative model that gives world medical care providers new criteria for analyzing and improving cost to care ratios.

  6. Socialist government health policy reforms in Bolivia and Ecuador: The underrated potential of integrated care to tackle the social determinants of health

    OpenAIRE

    Herland Tejerina; Werner Soors; Pierre De Paepe; Edison Aguilar Santacruz; Marie-Christine Closon; Jean-Pierre Unger

    2010-01-01

    Background Selective vertical programs prevailed over comprehensive primary health care in Latin America. In Bolivia and Ecuador, socialist governments intend to redirect health policy. We outline both countries’ health system’s features after reform, explore their efforts to rebuild primary health care, identify and explain policy gaps, and offer considerations for improvement. Methods Qualitative document analysis. Findings Earlier reform left Bolivia’s and Ecuador’s population in bad healt...

  7. [PUBLIC ADMINISTRATION OF PERSONNEL POLICY IN REFORMING OF UKRAINIAN HEALTH CARE SYSTEM USING THE EXAMPLE OF DERMATOVENEREOLOGICAL SERVICE].

    Science.gov (United States)

    Korolenko, V V; Dykun, O P; Isayenko, R M; Remennyk, O I; Avramenko, T P; Stepanenko, V I; Petrova, K I; Volosovets, O P; Lazoryshynets, V V

    2014-01-01

    The health care system, its modernization and optimization are among the most important functions of the modern Ukrainian state. The main goal of the reforms in the field of healthcare is to improve the health of the population, equal and fair access for all to health services of adequate quality. Important place in the health sector reform belongs to optimizing the structure and function of dermatovenereological service. The aim of this work is to address the issue of human resources management of dermatovenereological services during health sector reform in Ukraine, taking into account the real possibility of disengagement dermatovenereological providing care between providers of primary medical care level (general practitioners) and providers of secondary (specialized) and tertiary (high-specialized) medical care (dermatovenerologists and pediatrician dermatovenerologists), and coordinating interaction between these levels. During research has been found, that the major problems of human resources of dermatovenereological service are insufficient staffing and provision of health-care providers;,growth in the number of health workers of retirement age; sectoral and regional disparity of staffing; the problem of improving the skills of medical personnel; regulatory support personnel policy areas and create incentives for staff motivation; problems of rational use of human resources for health care; problems of personnel training for dermatovenereological service. Currently reforming health sector should primarily serve the needs of the population in a fairly effective medical care at all levels, to ensure that there must be sufficient qualitatively trained and motivated health workers. To achieve this goal directed overall work of the Ministry of Health of Uktaine, the National Academy of Medical Sciences of Ukraine, medical universities, regional health authorities, professional medical associations. Therefore Ukrainian dermatovenereological care, in particular

  8. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    2002-01-01

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of th

  9. Mandates for Collaboration: Health Care and Child Welfare Policy and Practice Reforms Create the Platform for Improved Health for Children in Foster Care.

    Science.gov (United States)

    Zlotnik, Sarah; Wilson, Leigh; Scribano, Philip; Wood, Joanne N; Noonan, Kathleen

    2015-10-01

    Improving the health of children in foster care requires close collaboration between pediatrics and the child welfare system. Propelled by recent health care and child welfare policy reforms, there is a strong foundation for more accountable, collaborative models of care. Over the last 2 decades health care reforms have driven greater accountability in outcomes, access to care, and integrated services for children in foster care. Concurrently, changes in child welfare legislation have expanded the responsibility of child welfare agencies in ensuring child health. Bolstered by federal legislation, numerous jurisdictions are developing innovative cross-system workforce and payment strategies to improve health care delivery and health care outcomes for children in foster care, including: (1) hiring child welfare medical directors, (2) embedding nurses in child welfare agencies, (3) establishing specialized health care clinics, and (4) developing tailored child welfare managed care organizations. As pediatricians engage in cross-system efforts, they should keep in mind the following common elements to enhance their impact: embed staff with health expertise within child welfare settings, identify long-term sustainable funding mechanisms, and implement models for effective information sharing. Now is an opportune time for pediatricians to help strengthen health care provision for children involved with child welfare. PMID:26403650

  10. Health care reforms

    OpenAIRE

    Marušič Dorjan; Prevolnik Rupel Valentina

    2016-01-01

    In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good da...

  11. U.S. Health Care Reform

    OpenAIRE

    Ellen Marie Nedde

    1993-01-01

    High and rapidly rising health care costs in the United States and growing ranks of uninsured persons have brought health care reform to the top of the U.S. Administration’s policy agenda. This paper describes the health care financing system in the United States, highlights what are viewed as its most serious shortcomings, and explores possible reasons for high and rising medical care costs. After brief descriptions of alternative reform proposals, the paper discusses universal coverage unde...

  12. Health care reforms

    Directory of Open Access Journals (Sweden)

    Marušič Dorjan

    2016-09-01

    Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  13. Incremental health system reform policy: Ecuador's law for the provision of free maternity and child care.

    Science.gov (United States)

    Chiriboga, Sonia Ruiz

    2009-01-01

    This study assessed the impact that the Ley de Maternidad Gratuita y Atencion a la Infancia (LMGAI) [Law for the Provision of Free Maternity and Child Care] in Ecuador has had on health services utilization and infant mortality. These outcomes were also examined by socioeconomic status. This retrospective study used demographic and health surveys, ENDEMAIN 1999 and 2004, with multivariate logistic regression to assess the impact post-LMGAI, controlling for mother's socioeconomic status, maternal and birth history, and demographic characteristics. Primary healthcare services utilization outcomes significantly improved post-LMGAI. Neonatal mortality decreased post-LMGAI. Further evaluation is needed as implementation continues to understand the expansion of primary healthcare services in future health system reforms.

  14. Socialist government health policy reforms in Bolivia and Ecuador: The underrated potential of integrated care to tackle the social determinants of health

    Directory of Open Access Journals (Sweden)

    Herland Tejerina

    2009-12-01

    Full Text Available Background Selective vertical programs prevailed over comprehensive primary health care in Latin America. In Bolivia and Ecuador, socialist governments intend to redirect health policy. We outline both countries’ health system’s features after reform, explore their efforts to rebuild primary health care, identify and explain policy gaps, and offer considerations for improvement. Methods Qualitative document analysis. Findings Earlier reform left Bolivia’s and Ecuador’s population in bad health, with limited access to a fragmented health system. Today, both countries focus their policy on household and community-based promotion and prevention. The negative effects on access to care of decentralization, dual employment, vertical programming and targeting are largely left unattended. Neglecting care is understandable in the light of particular interpretations of social medicine and social determinants, international policy pressures, reliance on external funding and institutional inertia. Current policy choices preserve key elements of selective care and consolidate commodification. It might not improve health and worsen poverty. Interpretation Care can be considered as a social determinant on its own. Key to the accomplishment of primary care is an integrated application of family medicine, taking advantage of individual care as one of the ways to act on social determinants. It deserves a central place on the policy-makers’ priority list, in Bolivia and Ecuador as elsewhere.

  15. Reforming Romanian energy policy

    International Nuclear Information System (INIS)

    Success in reforming energy sector depends on the implementation of the programme of economic reform agreed in February 1993. The difficulty of the negotiations between the International Monetary Fund and the Romanian government reflects the wider difficulties faced by the economy as a whole. They can be blamed in part on the legacy of uneconomic and inflexible industrial development and in part on opposition from interest groups which stand to lose from reform. Nonetheless, in spite of hesitant approach, the government does appear committed to the economic reform necessary to establish a market-oriented economy. But as the danger of a financial crisis engendered by the inadequately supported short-term borrowing of foreign exchange becomes urgent, the question is whether economic reform can be now implemented fast enough to protect economic enterprises and saving from a debt crisis. The scope for further delay in implementing the 1993 economic reform programme is fast disappearing. Procrastination should not be allowed to threaten the success of the reforms achieved in the energy and other sectors of the economy. 8 refs., 2 figs

  16. Oncology payment reform to achieve real health care reform.

    Science.gov (United States)

    McClellan, Mark B; Thoumi, Andrea I

    2015-05-01

    Cancer care is transforming, moving toward increasingly personalized treatment with the potential to save and improve many more lives. Many oncologists and policymakers view current fee-for-service payments as an obstacle to providing more efficient, high-quality cancer care. However, payment reforms create new uncertainties for oncologists and may be challenging to implement. In this article, we illustrate how accountable care payment reforms that directly align payments with quality and cost measures are being implemented and the opportunities and challenges they present. These payment models provide more flexibility to oncologists and other providers to give patients the personalized care they need, along with more accountability for demonstrating quality improvements and overall cost or cost growth reductions. Such payment reforms increase the importance of person-level quality and cost measures as well as data analysis to improve measured performance. We describe key features of quality and cost measures needed to support accountable care payment reforms in oncology. Finally, we propose policy recommendations to move incrementally but fundamentally to payment systems that support higher-value care in oncology.

  17. Exploring the impact of austerity-driven policy reforms on the quality of the long-term care provision for older people in Belgium and the Netherlands.

    Science.gov (United States)

    Janssen, David; Jongen, Wesley; Schröder-Bäck, Peter

    2016-08-01

    In this case study, European quality benchmarks were used to explore the contemporary quality of the long-term care provision for older people in the Belgian region of Flanders and the Netherlands following recent policy reforms. Semi-structured qualitative interviews were conducted with various experts on the long-term care provision. The results show that in the wake of the economic crisis and the reforms that followed, certain vulnerable groups of older people in Belgium and the Netherlands are at risk of being deprived of long-term care that is available, affordable and person-centred. Various suggestions were provided on how to improve the quality of the long-term care provision. The main conclusion drawn in this study is that while national and regional governments set the stage through regulatory frameworks and financing mechanisms, it is subsequently up to long-term care organisations, local social networks and informal caregivers to give substance to a high quality long-term care provision. An increased reliance on social networks and informal caregivers is seen as vital to ensure the sustainability of the long-term care systems in Belgium and in the Netherlands, although this simultaneously introduces new predicaments and difficulties. Structural governmental measures have to be introduced to support and protect informal caregivers and informal care networks. PMID:27531456

  18. Immigration and health care reform: shared struggles.

    Science.gov (United States)

    Gardner, Deborah B

    2007-01-01

    The connection between health care and immigration share overlaping key areas in policy reform. General concern, anger, and fear about immigration has been spreading nationwide. While illegal immigrants' use of expensive emergency department services does add to the cost for uncompensated care, this expenditure is not a primary cost driver but more a symptom of little or no access to preventative or primary health care. As a result of federal inaction, more state politicians are redefining how America copes with illegal residents including how or whether they have access to health care. The overlap of immigration and health care reform offers an opportunity for us to enter the next round of debate from a more informed vantage point. PMID:17847662

  19. Sharing the Caring: Rethinking Current Policies.

    Science.gov (United States)

    Edgar, Don

    1992-01-01

    This article presents an argument for reforming Australian public policy in favor of social care, rather than family, residential, or community care, for the elderly, sick, and disabled. After noting policy assumptions that families are the focus of caring and women are the natural caregivers, the paper describes changes in Australian family…

  20. Study on Tax Policies That Promote China's Health Care Reform%促进医药卫生改革的税收政策研究

    Institute of Scientific and Technical Information of China (English)

    张仲芳

    2012-01-01

    我国医药卫生领域现行税收政策与新一轮医药卫生体制改革目标存在一定冲突。现行税收政策不利于医疗行业公益性目标的实现,不利于吸引民营资本进入,不利于营利性民营医疗机构的发展,不利于鼓励商业健康保险的发展。我国应建立和完善能够与医药卫生体制改革目标相适应的税收政策体系,包括医疗服务营业税及税收优惠制度、医疗机构所得税税收优惠制度、药品增值税及税收优惠制度、商业健康保险税收优惠制度等。%There exist some conflicts between the present tax policies and the objectives of the health care system reform, The current tax policies hamper the realization of public welfare goals of the medical industry, fail to attract the private capital, hinder the development of the profit-making private medical institutions and that of commercial health insurance. A new tax system should be established and improved to comply with the goals of the health care reform, including sales tax policies for medical services, value-added tax policies for medicines, income tax policies for medical institutions, and tax incentives for private health insurance.

  1. Health reform requires policy capacity.

    Science.gov (United States)

    Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D; Helms, David

    2015-05-01

    Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476

  2. Health Reform Requires Policy Capacity

    Directory of Open Access Journals (Sweden)

    Pierre-Gerlier Forest

    2015-05-01

    Full Text Available Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility

  3. Italian health care reform

    OpenAIRE

    Livio Garattini

    1992-01-01

    It is remarkable how health care systems, created over decades and influenced by very different cultures exhibit similar problems. Most health care systems are compartmentalised with managers at margins responding to perverse incentives and seeking to shift patients and costs onto rival organisations. Decision makers behave selfishly, considering the welfare of their own organisations rather than those of the health care system as a whole, and in the absence if evidence about the cost-effecti...

  4. Marginal Tax Rates and Health Care Reform

    OpenAIRE

    Sheiner, Louise

    1994-01-01

    Points out some of the important considerations and compares how two competing health reform initiatives, the Clinton administration's "Health Security Act" and Representative Cooper's "Managed Competition Act," deal with health care reform.

  5. Policy Capacity for Health Reform: Necessary but Insufficient: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Adams, Owen

    2015-09-04

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action.

  6. Policy Capacity for Health Reform: Necessary but Insufficient: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Adams, Owen

    2016-01-01

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. PMID:26673650

  7. Life-Cycle and Intergenerational Effects of Child Care Reforms

    OpenAIRE

    Marc K Chan; Liu, Kai

    2015-01-01

    We investigate the importance of various mechanisms by which child care policies can affect life-cycle patterns of employment and fertility among women, as well as long-run cognitive outcomes among children. A structural life-cycle model of employment, fertility, and child care use is estimated using Norwegian administrative data. The estimation exploits a large-scale child care reform, which provided generous cash transfers to mothers who did not use formal child care facilities. Combining w...

  8. A Guide to Health Care Reform

    OpenAIRE

    Cutler, David M.

    1994-01-01

    There are four rationales for health care reform: increasing the efficiency of health delivery; reforming the market for health insurance; providing universal coverage; and reducing the federal deficit. These goals are reflected in most reform proposals. Achieving these goals involves several problems, however. Paying for universal coverage may lead to labor supply or demand reductions. In addition, reform involves large federal risks that must be dealt with through deficit financing, reduced...

  9. The English and Swedish health care reforms.

    Science.gov (United States)

    Glennerster, H; Matsaganis, M

    1994-01-01

    England and Sweden have two of the most advanced systems of universal access to health care in the world. Both have begun major reforms based on similar principles. Universal access and finance from taxation are retained, but a measure of competition between providers of health care is introduced. The reforms therefore show a movement toward the kind of approach advocated by some in the United States. This article traces the origins and early results of the two countries' reform efforts. PMID:8034391

  10. 76 FR 42625 - International Settlements Policy Reform

    Science.gov (United States)

    2011-07-19

    ... settlement rate adopted for that country in IB Docket No. 96-261, Report and Order, 12 FCC Rcd 19,806, 62 FR... COMMISSION 47 CFR Parts 0, 43 and 64 International Settlements Policy Reform AGENCY: Federal Communications... remove the International Settlements Policy (ISP) from all U.S. international routes except...

  11. Malaysian water sector reform : policy and performance

    OpenAIRE

    Kim, C.T.

    2012-01-01

    One of the measures that can help developing countries in meeting Target 10 of the Millennium  Development Goals – halving the number of people without access to water and adequate sanitation  by 2015 – is through a water sector reform. In this research the Malaysian water sector reform is  assessed by answering the following questions:  • How can we understand and explain the policy process of the reform?  • To what extent have the outputs of th...

  12. Reviewing and reforming policy in health enterprise information security

    Science.gov (United States)

    Sostrom, Kristen; Collmann, Jeff R.

    2001-08-01

    Health information management policies usually address the use of paper records with little or no mention of electronic health records. Information Technology (IT) policies often ignore the health care business needs and operational use of the information stored in its systems. Representatives from the Telemedicine & Advanced Technology Research Center, TRICARE and Offices of the Surgeon General of each Military Service, collectively referred to as the Policies, Procedures and Practices Work Group (P3WG), examined military policies and regulations relating to computer-based information systems and medical records management. Using a system of templates and matrices created for the purpose, P3WG identified gaps and discrepancies in DoD and service compliance with the proposed Health Insurance Portability and Accountability Act (HIPAA) Security Standard. P3WG represents an unprecedented attempt to coordinate policy review and revision across all military health services and the Office of Health Affairs. This method of policy reform can identify where changes need to be made to integrate health management policy and IT policy in to an organizational policy that will enable compliance with HIPAA standards. The process models how large enterprises may coordinate policy revision and reform across broad organizational and work domains.

  13. Reform Trend of China Natural Gas Price Policy

    Institute of Scientific and Technical Information of China (English)

    Du Wei; Liu Xinping

    2012-01-01

    China's natural gas price policy reform lags behind refined oil price reform comparatively, and current natural gas price policy could not adapt to the new situation of large scale import of foreign natural gas. Natural gas price reform could refer to the reform mode of refined oil price.

  14. Policy Capacity in the Learning Healthcare System; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    William Gardner

    2015-12-01

    Full Text Available Pierre-Gerlier Forest and his colleagues make a strong argument for the need to expand policy capacity among healthcare actors. In this commentary, I develop an additional argument in support of Forest et al view. Forest et al rightly point to the need to have embedded policy experts to successfully translate healthcare reform policy into healthcare change. Translation of externally generated innovation policy into local solutions is only one source of healthcare system change. We also need to build learning healthcare systems that can discover new health solutions at the frontline of care. Enhanced policy capacity staffing in those organizations will be key to building continuously learning health systems.

  15. Toward a 21st-century health care system: Recommendations for health care reform

    OpenAIRE

    Arrow, Kenneth; Auerbach, Alan; Bertko, John; Casalino, Lawrence Peter; Crosson, Francis; Enthoven, Alain; Falcone, E.; Feldman, R.C.; Fuchs, Victor; Garber, Alan; Gold, Marthe Rachel; Goldman, D A; Hadfield, Gillian; Hall, Mark Ann; Horwitz, Ralph

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspective...

  16. Policy and Workforce Reform in England

    Science.gov (United States)

    Gunter, Helen M.

    2008-01-01

    Current workforce reform, known as Remodelling the School Workforce, is part of an enduring policy process where there have been tensions between public and private sector structures and cultures. I show that the New Right and New Labour governments who have built and configured site based performance management over the past quarter of a century…

  17. Fiscal Policy Reforms and Dynamic Laffer Effects

    NARCIS (Netherlands)

    van Oudheusden, P.

    2010-01-01

    We examine the impact of fiscal policy reforms on the long-run government budget balance in a one-sector model of endogenous growth with factor income taxes, a tax on consumption, non-productive public goods expenditures, and a labour-leisure trade-off. In addition, we allow for different structures

  18. Reforming the EU Sugar Policy

    OpenAIRE

    Frandsen, Soren E.; Jensen, Hans Grinsted

    2002-01-01

    This article presents and analyses the impacts of the EU sugar policy. Particular attention is given to the modelling of the quite complex policy and the calibration of the global general equilibrium model at the member state level. Two scenarios are analysed, namely a reduction in the intervention price of sugar and the sugar quota. It is found that the economic impacts of the two scenarios are quite different in terms of the effects on European production and trade in sugar as well in terms...

  19. Health Care Reform: Impact on Total Joint Replacement.

    Science.gov (United States)

    Chambers, Monique C; El-Othmani, Mouhanad M; Saleh, Khaled J

    2016-10-01

    The US health care system has been fragmented for more than 40 years; this model created a need for modification. Sociopoliticomedical system-related factors led to the Affordable Care Act (ACA) and a restructuring of health care provision/delivery. The ACA increases access to high-quality "affordable care" under cost-effective measures. This article provides a comprehensive review of health reform and the motivating factors that drive policy to empower arthroplasty providers to effectively advocate for the field of orthopedics as a whole, and the patients served. PMID:27637650

  20. Challenges and reforms in Long-Term Care policy in Spain - See more at: http://www.gigapp.org/index.php/component/jresearch/?view=publication&task=show&id=1808#sthash.QjsbaT7Q.dpuf

    Directory of Open Access Journals (Sweden)

    Moreno-Fuentes, Francisco Javier

    2015-02-01

    Full Text Available The NorSpaR project aims to analyse the main public policy initiatives by which Norway and Spain cope with the new social and economic challenges derived from the so-called New Social Risks (NSR. Although both countries present significant differences in their institutional settings (such as Spanish EU membership, or its belonging to diverse welfare regimes types (Norway is generally included in the Nordic regime, while Spain is part of the Mediterranean one, both countries share a common interest in addressing the aforementioned challenges while maintaining social cohesion. In the last decade, governments in both countries have tried to respond to those challenges by reforming their labour markets, adapting their unemployment schemes, as well as their gender, family and long-term care policies. The analysis covered in this project includes three areas of public policy addressing NSR. First, dependency is one of the most daunting challenges for post-industrial societies experiencing population ageing and with an increasing number of frail people in need of care. This situation is forcing governments to rethink their long-term care policies. Second, family and gender public programs need to respond to the growing difficulties of families in reconciling professional and family life. Third, in the transition to a post-industrial order, and in a context of mass unemployment, social protection systems have a renewed prominence. Along with the so-called passive policies offering financial support to the unemployed, active labour market policies are geared to put people back into work. In our analysis we try to find answers to the following questions: What are the challenges that each of these policies have been trying to address in recent years? How have these policies evolved? What kinds of reforms have been implemented, and which ones have been neglected? Have the policy goals and targets of welfare programs been modified in any significant way

  1. Validity Theory: Reform Policies, Accountability Testing, and Consequences

    Science.gov (United States)

    Chalhoub-Deville, Micheline

    2016-01-01

    Educational policies such as Race to the Top in the USA affirm a central role for testing systems in government-driven reform efforts. Such reform policies are often referred to as the global education reform movement (GERM). Changes observed with the GERM style of testing demand socially engaged validity theories that include consequential…

  2. Consumer subjectivity and U.S. health care reform.

    Science.gov (United States)

    West, Emily

    2014-01-01

    Health care consumerism is an important frame in U.S. health care policy, especially in recent media and policy discourse about federal health care reform. This article reports on qualitative fieldwork with health care users to find out how people interpret and make sense of the identity of "health care consumer." It proposes that while the term consumer is normally understood as a descriptive label for users who purchase health care and insurance services, it should actually be understood as a metaphor, carrying with it a host of associations that shape U.S. health care policy debates in particular ways. Based on interviews with 36 people, patient was the dominant term people used to describe themselves, but consumer was the second most popular. Informants interpreted the health care consumer as being informed, proactive, and having choices, but there were also "semiotic traps," or difficult-to-resolve tensions for this identity. The discourse of consumerism functions in part as code for individual responsibility, and therefore as a classed moral discourse, with implications for U.S. health care policy. PMID:23631595

  3. Health Care Reform: a Socialist Vision

    Directory of Open Access Journals (Sweden)

    Martha Livingston

    2010-04-01

    Full Text Available At first glance, it doesn't seem as though socialism and health-care reform have a whole lot to do with each other. After all, the most visible "left" position in the current discussion of health-care reform merely advocates for the government to assume the function of national insurer, leaving the delivery of health care - from its often-questionable content to its hierarchical relationships - firmly in place. As such, a single payer, Medicare-for-All insurance program is a modest, even tepid reform. Those of us on the left who have been active in the single payer movement have always seen it as a steppingstone toward health-care justice: until the question of access to care is solved, how do we even begin to address not only health care but also health inequities? How, for example, can working-class Americans, Americans of color, and women demand appropriate, respectful, humane, first-rate care when our ability to access any health-care services at all is so tightly constrained?

  4. Medical liability and health care reform.

    Science.gov (United States)

    Nelson, Leonard J; Morrisey, Michael A; Becker, David J

    2011-01-01

    We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.

  5. SOCIAL POLICIES AND STRUCTURAL REFORMS IN EUROPE

    Directory of Open Access Journals (Sweden)

    Ferran Brunet Cid

    2006-12-01

    Full Text Available This paper considers the social and structural policies in contemporary Europe. The presentation is organized in four sections. First, we discuss the emerging Europe, the new unity based on democracy and the market economy, the special European Union formula, and comparisons with America. Second, we analyze the dynamics of the European economy, the convergence process, the gaps between United States in productivity and standard of living, competitiveness issues, and the emergence of a new European economy and new European policy mix.Third, we consider European social conditions, the stationary and aging population, Europe’s low employment rate and permanently high unemployment. European economic growth could draw on two major sources: the labor reserves and reforms in factor, product and service markets. In a monetary union, advanced industrial relations should promote labor mobility and salary flexibility. The social security systems permit the redistribution and cohesion which defines the European model.Fourth, for the new Europe, the structural reform strategy is the way forward for the challenge of European economic policy and social policy: more and better jobs thanks to sustainable growth in a dynamic and competitive knowledge-based economy, favoring greater social cohesion.

  6. Integrating Comprehensive Reform with Quality of Care

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Xianyang City is located in the center of northwest China's Shaanxi Province. In 2001, it was designated as one of the pilot cities for comprehensive reform of family planning work initiated by the National Population and Family Planning Commission. This has provided a good opportunity for the city to better implement the quality of care approach.

  7. Health-Care Reform for Childbirth

    OpenAIRE

    Budin, Wendy C.

    2010-01-01

    In this column, the editor of The Journal of Perinatal Education discusses the current health-care crisis and the need for health-care reform to promote, support, and protect natural, safe, and healthy childbirth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote normal birth.

  8. The EU Sugar Policy Regime and Implications of Reform

    OpenAIRE

    Elbehri, Aziz; Umstaetter, Johannes; Kelch, David R.

    2008-01-01

    The European Union’s sugar policy, in place since 1968, underwent its first major reform in 2005 in response to mounting and unsustainable imbalances in supply and demand. The reform, however, targeted only a few policy instruments (intervention price cut, voluntary production quota buyout, and restrictions on nonquota sugar exports), while leaving other key policies unchanged (interstate quota trading, sugar-substitute competition, and import barriers). Consequently, the extent of the reform...

  9. Trade Policy Reform and the Missing Revenue

    DEFF Research Database (Denmark)

    Arndt, Thomas Channing; Tarp, Finn

    2008-01-01

    In many African countries, large discrepancies exist between revenues implied by published tariff rates multiplied by estimated import volumes and actual receipts. We develop a stylised trade model where average and marginal tariff rates diverge and incorporate insights from this model...... into a computable general equilibrium model of an African economy (Mozambique) to study the implications of trade policy reform. Model simulations indicate that lowering tariff rates and reducing duty-free importation in a manner that maintains official revenue benefit nearly everyone. The main exception is those...

  10. Policy Capacity for Health Reform: Necessary but Insufficient; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Owen Adams

    2016-01-01

    Full Text Available Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government. I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a A means of “policy governance” that would promote an approach to cooperative federalism in the health arena; (b The ability to overcome the ”policy inertia” resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action.

  11. The implementation of payment reform upon policy innovation management

    Directory of Open Access Journals (Sweden)

    An-min WANG

    2014-08-01

    Full Text Available With the implementation of universal health care, participants are basically saturated and the increase space of the health insurance fund is limited, so the government proceeded the total amount control of medicare reform, medicare management into a new stage,which emphasized the importance of medicare quality. So the hospital has to face the challenge of policy management, cost control, and the best medical treatment should be linked with the business development. The hospital should change concepts and keep aware of the health care quality, implement the rules of the three reasonable requirements, relying on and striving for the health insurance policies. The limited medical resources could be fully applied by the innovation of health care management, such as cancer chemotherapy and single disease daytime ward, selective operation and oncology booking service. More effective services should be provided while developing key disciplines, developing new technology to improve the quality of the hospital,be initiative to meet the payment reform to achieve the same purpose of hospital,patients and the government.

  12. The duopoly policy in the Brazilian model of telecommunications reform

    OpenAIRE

    César Mattos; Paulo Coutinho

    2004-01-01

    One of the important characteristics of the Brazilian Model of Telecommunications Reform (BMTR) was the adoption of a duopoly policy, constraining the entry of new players in the wire segment in the transitional phase until free competition in 2002. This policy was also used in the reform experience of the United Kingdom in telecommunications in the 80's. The theoretical explanations behind this kind of policy are not strong enough to justify the duopoly policy in telecommunications. The most...

  13. Through Common Agricultural Policy Reforms: A Short Analysis

    OpenAIRE

    Andrei Jean-Vasile; Mircea Untaru

    2012-01-01

    Common Agricultural Policy (CAP) is one of the major European policies with the highest financial and social impact not only for rural communities but at the whole EU-27 level. Making this policy work has generated serious imbalances and disruptions between member states. For correcting this situation, all the reforms, starting with The MacSharry reform has aimed to improve this policy, the financial allotments and correct the functional mechanism. This paper makes a short analysis regarding ...

  14. Harry and Louise and health care reform: romancing public opinion.

    Science.gov (United States)

    Goldsteen, R L; Goldsteen, K; Swan, J H; Clemeña, W

    2001-12-01

    The question whether the "Harry and Louise" campaign ads, sponsored by the Health Insurance Association of America (HIAA) during the 1993-1994 health care reform debate, influenced public opinion has particular relevance today since interest groups are increasingly choosing commercial-style mass media campaigns to sway public opinion about health policy issues. Our study revisits the issue of the Harry and Louise campaign's influence on public opinion, comparing the ad campaign's messages to changes in opinion about health care reform over a twenty-six-month period in Oklahoma. Looking at the overall trends just prior to the introduction of the Harry and Louise campaign, public opinion was going in the "wrong" direction, from the HIAA perspective. Moreover, public opinion continued in the wrong direction until the mid-point of the campaign. However, in either the turning point of the campaign in terms of message content and tone or in the lag period following it, public opinion reversed on each health reform issue and returned to pre-campaign levels. It appears from these findings that the campaign captured public opinion when support for issues that were unfavorable to HIAA members was increasing and turned public opinion back to pre-campaign levels. The campaign may result in many more such marriages of political interest groups and commercial advertisers for the purpose of demobilizing public support for health policy initiatives that are unfavorable to special interests. PMID:11831582

  15. Land Law Reform : Achieving Development Policy Objectives

    OpenAIRE

    Bruce, John W.; Giovarelli, Renée; Rolfes, Jr., Leonard; Bledsoe, David; Mitchell, Robert

    2006-01-01

    This book examines issues at the forefront of the debate on land law reform, pays particular attention to how reform options affect the poor and disadvantaged, and recommends strategies for alleviating poverty more effectively through land law reform. It reviews the role of the World Bank in land law reform, examining issues of process as well as substance. It also identifies key challenge...

  16. Health care reform: motivation for discrimination?

    Science.gov (United States)

    Navin, J C; Pettit, M A

    1995-01-01

    One of the major issues in the health care reform debate is the requirement that employers pay a portion of their employees' health insurance premiums. This paper examines the method for calculating the employer share of the health care premiums, as specified in the President's health care reform proposal. The calculation of the firm's cost of providing employee health care benefits is a function of marital status as well as the incidence of two-income earner households. This paper demonstrates that this method provides for lower than average premiums for married employees with no dependents in communities in which there is at least one married couple where both individuals participate in the labor market. This raises the non-wage labor costs of employing single individuals relative to individuals which are identical in every respect except their marital status. This paper explores the economic implications for hiring, as well as profits, for firms located in a perfectly-competitive industry. The results of the theoretical model presented here are clear. Under this proposed version of health care reform, ceteris paribus, firms have a clear preference for two-earner households. This paper also demonstrates that the incentive to discriminate is related to the size of the firm and to the size of the average wage of full-time employees for firms which employ fewer than fifty individuals. While this paper examines the specifics of President Clinton's original proposal, the conclusions reached here would apply to any form of employer-mandated coverage in which the premiums are a function of family status and the incidence of two-earner households. PMID:7613598

  17. Education and Health Care Policies in Ghana

    Directory of Open Access Journals (Sweden)

    Ziblim Abukari

    2015-10-01

    Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.

  18. The Impact of Health Care and Immigration Reform on Latino Support for President Obama and Congress

    Science.gov (United States)

    Sanchez, Gabriel R.; Medeiros, Jillian; Sanchez-Youngman, Shannon

    2012-01-01

    At the start of their term, the Obama administration pledged to reform two failing policy systems in the United States: immigration and health care. The Latino populations' attitudes toward these two critical policy areas are particularly relevant due to the large foreign born population in the Latino community and the large number of Latinos who…

  19. Health Care Reform in the USA

    OpenAIRE

    Zemanová, Iva

    2011-01-01

    This thesis is concerned with US health care. It is focused especially on the health insurance market. It introduces basic characteristics of the US insurance system and discusses its main problems. The goal of this thesis is to determine whether voluntary private insurance is the main source of problems that the US health care system currently experiences. In order to do that, greatest deficiencies of US insurance policies, especially private ones, are identified based on the efficiency crit...

  20. Three decades of policy layering and politically sustainable reform in the European Union's agricultural policy

    DEFF Research Database (Denmark)

    Daugbjerg, Carsten; Swinbank, Alan

    2016-01-01

    dynamics that can result in lasting reform trajectories. The European Union's Common Agricultural Policy (CAP) has changed substantially over the last three decades in response to emerging policy concerns by adding new layers. This succession of reforms proved durable and resilient to reversal in the lead......The study of policy reform has tended to focus on single-stage reforms taking place over a relatively short period. Recent research has drawn attention to gradual policy changes unfolding over extended periods. One strategy of gradual change is layering, in which new policy dimensions...... are introduced by adding new policy instruments or by redesigning existing ones to address new concerns. The limited research on single-stage policy reforms highlights that these may not endure in the postenactment phase when circumstances change. We argue that gradual policy layering may create sustainability...

  1. Reform and Relapse in Bilingual Policy in Moldova

    Science.gov (United States)

    Ciscel, Matthew H.

    2010-01-01

    In the Republic of Moldova, language education policy has shifted since independence from an uneven Soviet policy, in which minority Russian dominated, towards somewhat more equitable European norms. Although many reforms in language education have been beneficial in producing a more balanced bilingualism, official policy has at times tended…

  2. Credible Immigration Policy Reform: A Response to Briggs

    Science.gov (United States)

    Orrenius, Pia M.; Zavodny, Madeline

    2012-01-01

    The authors agree with Vernon M. Briggs, Jr., that U.S. immigration policy has had unexpected consequences. The 1965 immigration reforms led to unanticipated chain migration from developing countries whereas the 1986 Immigration Reform and Control Act failed to slow unauthorized immigration. The result is a large foreign-born population with…

  3. LABOUR POLICY AND REFORMS IN INDIA; AN ANALYSIS

    OpenAIRE

    S.R. KESHAVA

    2014-01-01

    The changed economic scenario in India has made the issues of labour a central point. The private as well as foreign investors are demanding more reforms in labour sector. Labour reforms should be under taken carefully without undermining the self esteem, dignity of the labour, but bring in work discipline and remove the redundant labour. Hence Labour Reforms essentially refers to steps taken to increase production, productivity and employment opportunities in the economy with...

  4. Turkey's Party System and the Paucity of Minority Policy Reform

    OpenAIRE

    LIARAS, Evangelos

    2009-01-01

    An earlier version of this paper was presented in Workshop 9: ‘Changing Party Political Constellations and Public Policy Reform in Southern Europe’ at the Tenth Mediterranean Research Meeting, Florence & Montecatini Terme, 25-28 March 2009, organised by the Mediterranean Programme of the Robert Schuman Centre for Advanced Studies at the European University Institute. The purpose of this paper is to explore the question of small and incremental reform in Turkish minority policie...

  5. Water Policy Reform in Victoria: A Spatial Equilibrium Approach

    OpenAIRE

    Eigenraam, M.; Stoneham, G.; Branson, Jane; Sappideen, B.; Jones, R

    1996-01-01

    In February 1994, the Council of Australian Governments (COAG) endorsed a strategic framework for water sector reform in Australia to be implemented by the year 2001. In response to the COAG strategy, a project was initiated in association with the NSW Agriculture and the Victorian Water Bureau to assess the economic welfare effects of different water policy reforms. A spatial equilibrium model was developed to facilitate evaluation of policy measures. The purpose of this paper is to report o...

  6. Costs of care in hemophilia and possible implications of health care reform.

    Science.gov (United States)

    Johnson, Kathleen A; Zhou, Zheng-Yi

    2011-01-01

    Economic evaluation in health care is increasingly used to assist policy makers in their difficult task of allocating limited resources. The high cost of care, including that for clotting factor concentrates, makes hemophilia a potential target for cost-cutting efforts by health care payers. Although the appropriate management of hemophilia is key to minimizing and preventing long-term morbidity, comparative effectiveness studies regarding the relative benefit of different treatment options are lacking. Cost-of-illness (COI) analysis, which includes direct and indirect costs from a societal perspective, can provide information to be used in cost-effectiveness and other economic analyses. Quality-of-life assessment provides another methodology with which to measure outcomes and benefits of appropriate disease management. Health care reform has implications for individuals with hemophilia and their families through changes in payment, insurance coverage expansion, and health care delivery system changes that reward quality and stimulate cooperative, team-based care. Providers will benefit from the expansion of insurance coverage and some financial benefits in rural areas, and from the expansion of coverage for preventive services. Accountable care organizations will potentially change the way providers are paid and financial incentives under reform will reward high quality of care.

  7. [Reform, responsibilities and networks: about mental health care].

    Science.gov (United States)

    Batista e Silva, Martinho Braga

    2009-01-01

    In the context of the Brazilian Psychiatric Reform family members and neighbors of psychiatric patients have been urged to ' participate' in the public policies, mainly as ' social support' although officially considered ' partners' . This reconfiguration of the relationship between State and civil society is reflected in the directive that the services have to take over the responsibility for territories, a change in the logic of supply and demand aimed at stimulating extra-hospital services such as Psychosocial Care Centers, the object of this study, to provide care to the population of a certain geographical area. The purpose of this article is to investigate the psychosocial technologies produced in this specific political, institutional and historical context such as mediation of social changes and conflicts. Among the analyzed materials are the medical records indicating the involvement of the social actors in the social support network. PMID:19142318

  8. Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.

    Science.gov (United States)

    Oberlander, Jonathan

    2016-08-01

    The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA. PMID:27127261

  9. New systems of care for substance use disorders: treatment, finance, and technology under health care reform.

    Science.gov (United States)

    Pating, David R; Miller, Michael M; Goplerud, Eric; Martin, Judith; Ziedonis, Douglas M

    2012-06-01

    This article outlined ways in which persons with addiction are currently underserved by our current health care system. However, with the coming broad scale reforms to our health care system, the access to and availability of high-quality care for substance use disorders will increase. Addiction treatments will continue to be offered through traditional substance abuse care systems, but these will be more integrated with primary care, and less separated as treatment facilities leverage opportunities to blend services, financing mechanisms, and health information systems under federally driven incentive programs. To further these reforms, vigilance will be needed by consumers, clinicians, and policy makers to assure that the unmet treatment needs of individuals with addiction are addressed. Embedded in this article are essential recommendations to facilitate the improvement of care for substance use disorders under health care reform. Ultimately, as addiction care acquires more of the “look and feel” of mainstream medicine, it is important to be mindful of preexisting trends in health care delivery overall that are reflected in recent health reform legislation. Within the world of addiction care, clinicians must move beyond their self-imposed “stigmatization” and sequestration of specialty addiction treatment. The problem for addiction care, as it becomes more “mainstream,” is to not comfortably feel that general slogans like “Treatment Works,” as promoted by Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment during its annual Recovery Month celebrations, will meet the expectations of stakeholders outside the specialty addiction treatment community. Rather, the problem is to show exactly how addiction treatment works, and to what extent it works-there have to be metrics showing changes in symptom level or functional outcome, changes in health care utilization, improvements in workplace attendance and

  10. New Policy for Power Tariff Reform

    Institute of Scientific and Technical Information of China (English)

    Guan Yongsheng; Jin Wen

    2007-01-01

    @@ The "Opinions on Deepening Power Institutional Reform in the 11th Five-Year Period" (referred to as "Opinions" below for short) finally unveiled and appeared clearly in the vision of the public on April 6th, 2007. Being the core of the power institutional reform, the "route map" of power tariff reform in the 11th Five-Year Plan period has also been clearly oriented. However, on the whole, the power tariff reform is no drastic as one imagines. With this doubt, the Journalist discussed this issue with Mr. Huang Shaozhong, deputy director of the Department of Price & Financial Supervision under the State Electricity Regulatory Commission, also a member of the Working Group of Power Institutional Reform.

  11. Harsh choices: Chinese women's paid work and unpaid care responsibilities under economic reform.

    Science.gov (United States)

    Cook, Sarah; Dong, Xiao-yuan

    2011-01-01

    China's economic reforms over the past three decades have dramatically changed the mechanisms for allocating goods and labour in both market and non-market spheres. This article examines the social and economic trends that intensify the pressure on the care economy, and on women in particular in playing their dual roles as care givers and income earners in post-reform China. The analysis sheds light on three critical but neglected issues. How does the reform process reshape the institutional arrangements of care for children and elders? How does the changing care economy affect women's choices between paid work and unpaid care responsibilities? And what are the implications of women's work–family conflicts for the well-being of women and their families? The authors call for a gendered approach to both social and labour market policies, with investments in support of social reproduction services so as to ease the pressures on women. PMID:22164881

  12. European Union dairy policy reform: impact and challenges

    NARCIS (Netherlands)

    Jongeneel, R.A.

    2011-01-01

    Recent Common Agricultural Policy (CAP) reforms have affected dairy policy, including the milk quota system, and increased the market orientation of the sector. A modelling exercise, using the European Dairy Industry Model (EDIM), simulates an initial sharp decline in the EU milk price in response t

  13. Reforming health care : a case for stay well health insurance

    OpenAIRE

    Bogetic, Zeljko; Heffley, Dennis

    1993-01-01

    All countries - whether industrial, developing, or in transition to a market economy - are interested in health care reform. A central focus of reform everywhere is to make patients more responsive to health care costs without diluting the protection offered by public or private insurance. Conventional insurance offers customers little incentive to monitor their own use of health care services or to adopt and maintain better health habits. The authors describe an alternative health insurance ...

  14. Is the pro-competition policy an effective solution for China's public hospital reform?

    Science.gov (United States)

    Pan, Jay; Qin, Xuezheng; Hsieh, Chee-Ruey

    2016-10-01

    The new round of health care reforms in China achieved significant initial results. New and emerging problems coinciding with the deepening of the reforms, however, require further institutional changes to strengthen the competition mechanism and promote public hospital efficiency. This paper provides a conceptual framework and preliminary assessment of public hospital competition in China. Specifically, we distinguish between two closely related concepts - competition and privatization, and identify several critical conditions under which hospital competition can be used as a policy instrument to improve health care delivery in China. We also investigate the current performance and identify several unintended consequences of public hospital competition - mainly, medical arms race, drug over-prescription and the erosion of a trusting relationship between patients and physicians. Finally, we discuss the policy options for enhancing the internal competition in China's hospital market, and conclude that public investment on information provision is key to reaping the positive outcomes of pro-competition policies.

  15. Australia's primary health care workforce--research informing policy.

    Science.gov (United States)

    Douglas, Kirsty A; Rayner, Frith K; Yen, Laurann E; Wells, Robert W; Glasgow, Nicholas J; Humphreys, John S

    2009-07-20

    In 2008, the Australian Primary Health Care Research Institute (APHCRI) held a Primary Health Care Workforce Roundtable with practising clinicians, policymakers and researchers, which drew on Australian evidence in health care policy, systematic reviews, and expertise and experience of participants. Key recommendations for an adequate, sustainable and effective primary health care workforce that arose from the meeting included: simplifying the Medicare Benefits Schedule, which is unnecessarily complex and inflexible; effectively funding undergraduate and prevocational medical and nursing education and training in primary health care; developing career structure and training pathways for general practitioners and primary health care nurses; developing of functional primary health care teams; and using a blended funding model, comprising fee-for-service as well as capitation for patients with chronic or complex needs. A report from the meeting, detailing these policy options, was submitted to the National Health and Hospitals Reform Commission for inclusion in their deliberations. PMID:19619091

  16. Globalisation, policy convergence and labour market: thepolitical economy of reforms

    OpenAIRE

    Mahmood, Zaad

    2012-01-01

    This dissertation shows the relevance of political agency under conditions of globalisation through a sub-national comparative study of labour market reforms. The study builds upon existing literature by highlighting ‘relative autonomy’ of political actors and dynamics in determining policy and outcome. Such an assertion contradicts the purely structuralist interpretations of reform and asserts that forces of globalisation can be negotiated by domestic political actors. Base...

  17. NAFTA and Mexico's Tax Policy Reform

    OpenAIRE

    Jorge Martinez-Vazquez; Duanje Chen

    2001-01-01

    The North American Free Trade Agreement (NAFTA) has had a significant effect on Mexico’s economy and institutions. The ongoing consideration of tax reform in Mexico requires an evaluation of the role of NAFTA in Mexico’s economy, including its tax structure; it also requires an assessment of the impact of the Mexico’s tax system on the trade and capital flows between Mexico and its NAFTA partners, the United States and Canada. Clearly, no good tax reform in Mexico can ignore the role of NAFTA...

  18. Malaysian water sector reform : policy and performance

    NARCIS (Netherlands)

    Kim, C.T.

    2012-01-01

    One of the measures that can help developing countries in meeting Target 10 of the Millennium  Development Goals – halving the number of people without access to water and adequate sanitation  by 2015 – is through a water sector reform. In this research the Malaysian water sect

  19. Setting standards at the forefront of delivery system reform: aligning care coordination quality measures for multiple chronic conditions.

    Science.gov (United States)

    DuGoff, Eva H; Dy, Sydney; Giovannetti, Erin R; Leff, Bruce; Boyd, Cynthia M

    2013-01-01

    The primary study objective is to assess how three major health reform care coordination initiatives (Accountable Care Organizations, Independence at Home, and Community-Based Care Transitions) measure concepts critical to care coordination for people with multiple chronic conditions. We find that there are major differences in quality measurement across these three large and politically important programs. Quality measures currently used or proposed for these new health reform-related programs addressing care coordination primarily capture continuity of care. Other key areas of care coordination, such as care transitions, patient-centeredness, and cross-cutting care across multiple conditions are infrequently addressed. The lack of a comprehensive and consistent measure set for care coordination will pose challenges for healthcare providers and policy makers who seek, respectively, to provide and reward well-coordinated care. In addition, this heterogeneity in measuring care coordination quality will generate new information, but will inhibit comparisons between these care coordination programs.

  20. Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

    Directory of Open Access Journals (Sweden)

    Benson Janie

    2011-12-01

    Full Text Available Abstract Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform.

  1. Quality Reforms in Danish Home Care

    DEFF Research Database (Denmark)

    Rostgaard, Tine

    2012-01-01

    . This reform strategy represents a shift from the welfare state modernisation program of the 1980s, which built mainly on economic strategies of cost-efficiency and New Public Management (NPM) princi-ples, including contract management and performance management. Recent reforms have instead attempted...

  2. Market reforms in Swedish health care

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1993-01-01

    This report presents the main characteristics of reforms in the Swedish health services, as exemplified by the "Stockholm Model" introduced in 1992 in Stockholm county. The author discusses the motives behind these reforms, the already-evident increases in costs that are occurring, and the effect...

  3. Relative Returns to Policy Reform : Evidence from Controlled Cross-Country Regressions

    OpenAIRE

    de Castro, Alexandre Samy; Goldin, Ian; Luiz A. Pereira da Silva

    2002-01-01

    The authors aim at contributing to understand the dispersion of returns from policy reforms using cross-country regressions. The authors compare the "before reform" with "after reform" GDP growth outcome of countries that undertook import-liberalization and fiscal policy reforms. They survey a large sample (about 54) of developing countries over the period 1980-99. The benefits of openness...

  4. The underlying theories of health care reform in the United States--strategy implications for hospitals.

    Science.gov (United States)

    McLaughlin, Daniel B; Militello, Jack

    2011-01-01

    The United State Health Reform (Affordable Care Act) presents health provides with the goals that should be achieved in the reformed health care environment and rationale for those goals. Developing strategies to implement the act's policies by any health care organization must take into account the underlying theories of the act: managed change though payment design and funds flow. Market place competition. To execute strategy effective internal organizational management is a must and can be facilitated through a strong alignment between mission and opperating factors. The mission must relate to the organization's markets. Markets are best addressed through a local perspective where the ACA goals can be applied within a specific community or culture. The systems approach brings as many participants in the system to define their mutual success as it relates to reform. PMID:22235723

  5. What shapes output of policy reform?

    DEFF Research Database (Denmark)

    Carlsen, Kirsten

    This thesis deals with the factors shaping forest policy output during the stages implementation and bases its main message on empirical findings from the forestry sector in Ghana. Policy and institutional factors are important underlying causes for deforestation, especially in the tropics. Forest...

  6. Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

    Science.gov (United States)

    Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

    2006-11-01

    All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance

  7. Political models of macroeconomic policy and fiscal reform

    OpenAIRE

    Alesina, Alberto

    1992-01-01

    The author explains how recent developments in political economics improve our understanding of macroeconomic policy - especially the timing, design, and likelihood of stabilization's success through monetary and fiscal reform. The author reviews the literature on political business cycles and emphasizes several issues involving the relationship between the timing of elections and the timing of macroeconomic policies and outcomes. He also addresses how models can be useful in studying non-dem...

  8. Impacts of the EU sugar policy reforms on developing countries

    NARCIS (Netherlands)

    Berkum, van S.; Roza, P.; Tongeren, van F.W.

    2005-01-01

    This report analyses the impacts of the Commission's July 2004 proposal for sugar policy reforms on developing countries. The study uses three approaches that complement each other: model simulations, literature review and country case studies. Model simulations indicate that the consequences of the

  9. New Directions in Education? A Critique of Contemporary Policy Reforms

    Science.gov (United States)

    Skourdoumbis, Andrew

    2016-01-01

    This paper draws on facets of Foucault's theoretical resources to critique current education policy reform from within the Australian State of Victoria, namely the Department of Education and Early Childhood Development's (DEECD) discussion paper "New directions for school leadership and the teaching profession." Implicit in the reform…

  10. Reforming Higher Education Systems: Some Lessons to Guide Policy Implementation.

    Science.gov (United States)

    Eisemon, Thomas Owen; Holm-Nielsen, Lauritz

    1995-01-01

    Experiences of different countries in establishing mechanisms to coordinate development of higher education systems, diversify institutional financing, and increase efficiency of public investments are examined. Attention is drawn to the need for effective policy structures to manage higher education, link reform costs to benefits, acknowledge…

  11. Social Policy Reforms and Daughters' Schooling in Vietnam

    Science.gov (United States)

    Belanger, Daniele; Liu, Jianye

    2004-01-01

    Vietnam's social policy reforms in the transition to a market economy included the introduction of fees for primary and secondary school in the late 1980s. Using data from the Viet Nam Living Standards Surveys, this paper examines how the increasing costs of education to households have impacted on school enrollment between 1993 and 1998, giving…

  12. The distributional effects of agricultural policy reforms in Switzerland

    NARCIS (Netherlands)

    Benni, El N.; Finger, R.; Mann, S.

    2012-01-01

    This paper analyses the effects of Swiss agricultural policy reforms and the effects of farm income, off-farm income and direct payments on the distribution of the farm household income. To this end, the farm-level income records from the FADN data for the period 1990-2009 are used to calculate Gini

  13. Policy Reform: Testing Times for Teacher Education in Australia

    Science.gov (United States)

    Fitzgerald, Tanya; Knipe, Sally

    2016-01-01

    In Australia as well as elsewhere, initial teacher education has become centre stage to a political agenda that calls for global competitiveness in the knowledge economy. The common problem cited has been declining educational standards linked with the quality of teaching and teacher education. The avalanche of review and policy reform has exposed…

  14. Unpacking “Health Reform” and “Policy Capacity”; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    David Legge

    2015-10-01

    Full Text Available Health reform is the outcome of dispersed policy initiatives in different sectors, at different levels and across time. Policy work which can drive coherent health reform needs to operate across the governance structures as well as the institutions that comprise healthcare systems. Building policy capacity to support health reform calls for clarity regarding the nature of such policy work and the elements of policy capacity involved; and for evidence regarding effective strategies for capacity building.

  15. Full Throttle: Reforming Canada's Aviation Policy

    OpenAIRE

    Benjamin Dachis

    2014-01-01

    Federal government policies are a major cause of high costs throughout the aviation supply chain, often leading Canadians to waste time and money by seeking lower fares at nearby US airports, or not travel at all. High fuel taxes and onerous foreign ownership and airline-specific policies are harming the competitiveness of airlines. Meanwhile, airports have been transformed from the rundown state they were in when operated by the federal government to become world leaders in customer service ...

  16. Tax Reform and Payout Policy:Do Shareholder Clienteles or Payout Policy Adjust?

    OpenAIRE

    Korkeamaki, Timo; Liljeblom, Eva; Pasternack, Daniel

    2011-01-01

    Changes in taxation of corporate dividends offer excellent opportunities to study dividend clientele effects. We explore payout policies and ownership structures around a major tax reform that took place in Finland in 2004. Consistent with dividend clienteles affecting firms’ dividend policy decisions, we find that Finnish firms altered their dividend policies based on the changed tax incentives of their largest shareholders. While firms adjust their payout policies, our results also indica...

  17. Renewable energy policy and electricity market reforms in China

    International Nuclear Information System (INIS)

    The article examines the potential effectiveness of the renewable energy policy in China and its regulatory Law framework. It frames the option of renewable energy technology within the background of the long-lasting electricity problems that China has faced including serious supply shortages, reliance on coal, and severe environmental contamination. Its dual administrative and ownership system based on state and privately owned industry is discussed together with the market reform measures adopted in the sector. Current renewable energy policy is analysed, and the scope of the 2005 Renewable Energy Promotion Law is investigated. This is conducted within the context of the electricity sector reform that China adopted, and its effects upon the prospects of encouraging as well as expanding the development of renewable energy. This study draws upon primary information collected from interviews with stakeholders on the policy adequacy, and identifies three main types of shortcomings that have interfered with a more successful expansion of renewable energy in China. (author)

  18. Japan's universal long-term care system reform of 2005: containing costs and realizing a vision.

    Science.gov (United States)

    Tsutsui, Takako; Muramatsu, Naoko

    2007-09-01

    Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. This article describes the recent reform initiated by the Japanese government to simultaneously contain costs and realize a long-term vision of creating a community-based, prevention-oriented long-term care system. The reform involves introduction of two major elements: "hotel" and meal charges for nursing home residents and new preventive benefits. They were intended to reduce economic incentives for institutionalization, dampen provider-induced demand, and prevent seniors from being dependent by intervening while their need levels are still low. The ongoing LTCI reform should be critically evaluated against the government's policy intentions as well as its effect on seniors, their families, and society. The story of this reform is instructive for other countries striving to develop coherent, politically acceptable long-term care policies. PMID:17767690

  19. LPN-BSN: education for a reformed health care system.

    Science.gov (United States)

    Redmond, G M

    1997-03-01

    Nursing practice has experienced a paradigm shift in health care delivery from hospitals to community-based models of health care. Nursing education must respond to accommodate the shift through curriculum reform. This article discusses a LPN-BSN program to promote educational mobility for LPNs while educating them for a reformed health care system. The needs assessment and curriculum implementation are discussed. Student comments and experiences are included throughout. Student academic support and recruiting which addresses the special needs of the LPN-BSN student are also described. The evaluation of the project thus far indicates student success. PMID:9067870

  20. Policy Capacity Is Necessary but Not Sufficient Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Gen, Sheldon; Wright, Amy Conley

    2015-01-01

    Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve. PMID:26673469

  1. Policy Capacity Is Necessary but Not Sufficient; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Sheldon Gen

    2015-12-01

    Full Text Available Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve.

  2. Reform and Transitional Adjustment of the Health Care System in Slovenia

    Directory of Open Access Journals (Sweden)

    Petra Došenović

    2005-08-01

    Full Text Available In the paper the authors analyse some unresolved issues regarding the health care reform that is under way in the Republic of Slovenia. They believe the reform is necessary due to the problems that have accumulated. So far the transition processes have not been undertaken in a systematic way by the public sector. With this in mind, the authors discuss the problems of compulsory and voluntary insurance, and the goals that can be achieved by enforcing the role of voluntary health insurance. The authors also examine areas that have important implications for the efficiency of Slovenian health care. Emphasis is primarily given to appropriate systems of incentives that affect the behaviour of health care providers, patients, insurers, and policy makers and then, to the management and governance of health care providers.

  3. Enlargement of the European Union and agricultural policy reform

    DEFF Research Database (Denmark)

    Jensen, Maria Skovager; Lind, Kim Martin Hjorth; Zobbe, Henrik

    2009-01-01

    A connection exists between enlargement of the European Union and reforms of the Common Agricultural Policy (CAP). Based upon rational choice theory, we examine whether the member states’ CAP positions are related to structures in their agricultural sectors. The overall hypothesis...... is that intensiveness of agricultural production corresponds to the willingness to reform the CAP. Political CAP positions, together with the development of member states’ structural fundamentals, are analysed using cluster analysis. The results show that EU enlargements have extensified agricultural production...... at the EU level, and that extensive agricultural production in a member state is often an indicator of reduced willingness to reform. However, the intensiveness of agricultural production is only part of the explanation. Moreover, negotiation tactics play an important role for the positions on the CAP....

  4. Agents of Change for Health Care Reform

    Science.gov (United States)

    Buchanan, Larry M.

    2007-01-01

    It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…

  5. Tax policy reform: why we need microeconomics

    OpenAIRE

    Richard Blundell

    1995-01-01

    It is 20 years ago this July that the committee under the chairmanship of James Meade was set up by the Institute for Fiscal Studies to take a fundamental look at the UK tax structure. What it produced stands as a landmark in the history of tax policy analysis and was an important springboard for subsequent IFS research. The membership of the committee included three research ‘secretaries’, two of whom were recent presenters of the IFS Annual Lecture — John Flemming and Mervyn King — and the ...

  6. Toward a 21st-century health care system: Recommendations for health care reform

    NARCIS (Netherlands)

    K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a

  7. EU SUGAR POLICY REFORM: QUOTA REDUCTION AND DEVALUATION

    OpenAIRE

    Witzke, Heinz Peter; Heckelei, Thomas

    2002-01-01

    The research presented is part of a larger study aiming at the analysis of reform options for the EU sugar policy regime. This paper focuses on the effects of quota reduction and support price cuts. A thorough theoretical analysis investigates the implications of farm heterogeneity for aggregate supply modeling purposes under the current sugar regime. It can be shown that the treatment of sugar quantities produced under the different quotas and without quota can be treated as different produc...

  8. No theory of justice can ground health care reform.

    Science.gov (United States)

    Trotter, Griffin

    2012-01-01

    This essay argues that no theory or single conception of justice can provide a fundamental grounding for health care reform in the United States. To provide such a grounding, (1) there would need to be widespread support among citizens for a particular conception of justice, (2) citizens would have to apprehend this common conception of justice as providing the strongest available rationale for health care reform, and (3) this rationale would have to overwhelm countervailing values. I argue that neither of the first two conditions is met.

  9. Why institutions are not the only thing that matters: twenty-five years of health care reform in New Zealand.

    Science.gov (United States)

    Starke, Peter

    2010-08-01

    The literature on the causes of health care reform is dominated by institutionalist accounts, and political institutions are among the most prominent factors cited to explain why change takes place. However, institutionalist accounts have difficulty explaining both the timing and the content of reforms. By applying a range of explanatory approaches to a case study of health reform in New Zealand since the 1970s, this article explores some of the theories of reform beyond institutionalism, particularly those that take into account problem pressure, policy ideas, and the more agency-centered factor of partisan ideology. The aim is not to dismiss institutionalism but to try to fill some of the gaps that cannot be addressed with institutionalist theories alone. The detailed analysis shows that various factors played a role in conjunction, namely, problem pressure, policy ideas, and the ideology of parties in government. Partisan ideology, in particular, has perhaps been prematurely ignored by health care scholars.

  10. GP-income development in relation to recent health care reforms: an international comparison.

    NARCIS (Netherlands)

    Kroneman, M.; Zee, J. van der

    2011-01-01

    Background: Health care reforms have been introduced in several European countries in the past decade. In most countries, these reforms had (intended and unintended) consequences for the remuneration and incomes of GPs. The reforms can be grouped into two types: incremental reforms and reforms that

  11. Ability grouping and science education reform: Policy and research base

    Science.gov (United States)

    Lynch, Sharon

    This article reviews current policy trends concerning the practice of ability grouping in K-12 science education. Relevant statements of key policy-making, policy-influencing organizations such as the NSTA, AAAS, NSF, the National Research Council, the U.S. Office of Education Department of Civil Rights, NAACP, the National Governors' Association, programs related to the Jacob Javits Grants for the Gifted and Talented, and others are summarized. The author's interpretation of the various positions are presented herein. The article also explores the research base supporting the various policies on grouping by examining selected general research literature on grouping, followed by research that is science education specific. Methodological issues color the research findings. The ethical and pragmatic implications of developing research and policy are discussed. The conclusions are that there is a dearth of recent empirical research specifically related to ability grouping in science, and that the time is ripe for the concerted development of a research agenda by key players in science education reform. Moreover, as controversial and value-laden as the topic is, it should be noted that grouping practices alone are unlikely to influence science education reform unless considered in the context of comprehensive restructuring efforts at the local school level.Received: 10 April 1993; Revised: 26 August 1993;

  12. Reforming the health sector in Thailand: the role of policy actors on the policy stage.

    Science.gov (United States)

    Green, A

    2000-01-01

    This paper reports on exploratory research carried out into the processes of policy-making, and in particular health sector reform, in the health sector of Thailand. It is one of a set of studies examining health sector reform processes in a number of countries. Though in the period under study (1970-1996) there had been no single health sector reform package in Thailand, there was interest in a number of quarters in the development of such an initiative. It is clear, however, that despite recognition of the need for reform such a policy was far from being formulated, let alone implemented. The research, based on both documentary analysis and interviews, explores the reasons underpinning the failure of the policy process to respond to such a perceived need. The research findings suggest that the policy formation process in Thailand successfully occurs when there is a critical mass of support from strategic interest groups. The relative power of these interest groups is constantly changing. In particular the last two decades has seen a decline in the power of the bureaucratic élites (military and civilian) and a related rise in the power of the economic élites either directly or through their influence on political parties and government. Other critical groups include the media, NGOs and the professions. Informal policy groups are also significant. A number of implications for policy makers operating under such circumstances are drawn.

  13. Policy analysis: palliative care in Ireland.

    LENUS (Irish Health Repository)

    Larkin, P

    2014-03-01

    Palliative care for patients with advanced illness is a subject of growing importance in health services, policy and research. In 2001 Ireland became one of the first nations to publish a dedicated national palliative care policy. This paper uses the \\'policy analysis triangle\\' as a framework to examine what the policy entailed, where the key ideas originated, why the policy process was activated, who were the key actors, and what were the main consequences. Although palliative care provision expanded following publication, priorities that were unaddressed or not fully embraced on the national policy agenda are identified. The factors underlying areas of non-fulfilment of policy are then discussed. In particular, the analysis highlights that policy initiatives in a relatively new field of healthcare face a trade-off between ambition and feasibility. Key policy goals could not be realised given the large resource commitments required; the competition for resources from other, better-established healthcare sectors; and challenges in expanding workforce and capacity. Additionally, the inherently cross-sectoral nature of palliative care complicated the co-ordination of support for the policy. Policy initiatives in emerging fields such as palliative care should address carefully feasibility and support in their conception and implementation.

  14. Drug policy, values and the public health approach – four lessons from drug policy reform movements

    Directory of Open Access Journals (Sweden)

    Rogeberg Ole

    2015-09-01

    Full Text Available Drug policies affect a large set of outcomes and may reflect the concerns of several policy stakeholder groups. Researchers analysing policies typically employ a public health approach, extended to reflect concerns beyond population health and longevity. I argue that the resulting approach, as currently practised, fails to capture several concerns seen as important by recent drug policy reform movements, that is, the full harms of illegal markets, the subjectively valued consumption of intoxicants, the dysfunctionality of current policy processes in the drug field and the value of the knowledge gained from policy experiments. I illustrate this by referring to the book Drug policy and the public good, a public health-based review of research evidence and its relevance for drug policy written by leading international researchers in the field.

  15. The readiness of addiction treatment agencies for health care reform

    Directory of Open Access Journals (Sweden)

    Molfenter Todd

    2012-05-01

    Full Text Available Abstract The Patient Protection and Affordable Care Act (PPACA aims to provide affordable health insurance and expanded health care coverage for some 32 million Americans. The PPACA makes provisions for using technology, evidence-based treatments, and integrated, patient-centered care to modernize the delivery of health care services. These changes are designed to ensure effectiveness, efficiency, and cost-savings within the health care system. To gauge the addiction treatment field’s readiness for health reform, the authors developed a Health Reform Readiness Index (HRRI survey for addiction treatment agencies. Addiction treatment administrators and providers from around the United States completed the survey located on the http://www.niatx.net website. Respondents self-assessed their agencies based on 13 conditions pertinent to health reform readiness, and received a confidential score and instant feedback. On a scale of “Needs to Begin,” “Early Stages,” “On the Way,” and “Advanced,” the mean scores for respondents (n = 276 ranked in the Early Stages of health reform preparation for 11 of 13 conditions. Of greater concern was that organizations with budgets of  $5 million to have information technology (patient records, patient health technology, and administrative information technology, evidence-based treatments, quality management systems, a continuum of care, or a board of directors informed about PPACA. The findings of the HRRI indicate that the addiction field, and in particular smaller organizations, have much to do to prepare for a future environment that has greater expectations for information technology use, a credentialed workforce, accountability for patient care, and an integrated continuum of care.

  16. Economics and Health Reform: Academic Research and Public Policy.

    Science.gov (United States)

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act.

  17. Four proposals for market-based health care system reform.

    Science.gov (United States)

    Sumner, W

    1994-08-01

    A perfectly free, competitive medical market would not meet many social goals, such as universal access to health care. Micromanagement of interactions between patients and providers does not guarantee quality care and frequently undermines that relationship, to the frustration of all involved. Furthermore, while some North American health care plans are less expensive than others, none have reduced the medical inflation rate to equal the general inflation rate. Markets have always fixed uneven inflation rates in other domains. The suggested reforms could make elective interactions between patients and providers work more like a free market than did any preceding system. The health and life insurance plan creates cost-sensitive consumers, informed by a corporation with significant research incentives and abilities. The FFEB proposal encourages context-sensitive pricing, established by negotiation processes that weigh labor and benefit. Publication of providers' expected outcomes further enriches the information available to consumers and may reduce defensive medicine incentives. A medical career ladder would ease entry and exit from medical professions. These and complementary reforms do not specifically cap spending yet could have a deflationary impact on elective health care prices, while providing incentives to maintain quality. They accomplish these ends by giving more responsibility, information, incentives, and choice to citizens. We could provide most health care in a marketlike environment. We can incorporate these reforms in any convenient order and allow them to compete with alternative schemes. Our next challenge is to design, implement, and evaluate marketlike health care systems.

  18. Aligning payment reform and delivery innovation in emergency care.

    Science.gov (United States)

    Pines, Jesse M; McStay, Frank; George, Meaghan; Wiler, Jennifer L; McClellan, Mark

    2016-08-01

    Current alternative payment models (APMs) that move away from traditional fee-for-service payment often have explicit goals to reduce utilization in episodic settings, such as emergency departments (ED). We apply the new HHS payment reform taxonomy to illustrate a pathway to success for EDs in APMs. Despite the unique challenges faced by EDs, a variety of category 2 and 3 APMs may be applicable to EDs in the short- and long term to improve efficiency and value. Full and partially capitated models create incentives for longitudinal and episodic ED providers and payers to unite to create interventions to reduce costs. However, prospective attribution remains a challenge for EDs because of exogenous demand, which makes it important for EDs to be one of the components of capitated payment along with longitudinal providers who can exert greater control on overall care demands. The goal of payment and delivery reforms in ED care is to improve population health across the continuum of acute and longitudinal care. In order to deliver cost-conscious care, ED providers will need additional resources, expanded information, and new processes and metrics to facilitate cost-conscious decisions. Improved availability of electronic information across settings, evidence generated from developing and testing acute care-specific payment models, and engaging acute care providers directly in reform efforts will help meet these goals. PMID:27541697

  19. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain.

    Science.gov (United States)

    Giovanella, Lígia; Stegmüller, Klaus

    2014-11-01

    The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms' impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems. PMID:25493982

  20. The states and health care reform: the road traveled and lessons learned from seven that took the lead.

    Science.gov (United States)

    Paul-Shaheen, P A

    1998-04-01

    During the past decade, an area of major policy activity among the states has been that of health care reform. As of May 1993, seven states--Florida, Hawaii, Massachusetts, Minnesota, Oregon, Vermont, and Washington--had progressed the furthest in enacting comprehensive statutes designed to expand health insurance coverage and slow the growth of health care costs. This article reviews the activities of these states to achieve health care reform and the lessons learned from those activities. The analysis focuses specifically on identifying the common problems addressed and determining the common factors that maximized states' opportunities for success. In all, some nine lessons are identified that have relevance for other states wishing to follow a similar road to reform. Most important among these are a "window of opportunity" for policy action, having entrepreneurial leadership to push the reform agenda forward, and support from key stakeholder interests. If these conditions of opportunity, policy entrepreneurship, and stakeholder commitment are met, a state can move forward in addressing key aspects of its health care reform agenda. PMID:9565896

  1. Are We There Yet? Early Years Reform in Queensland: Stakeholder Perspectives on the Introduction of Funded Preschool Programs in Long Day Care Services

    Science.gov (United States)

    Irvine, Susan; Farrell, Ann

    2013-01-01

    Australian educators are currently engaging with wide-ranging, national early childhood reform that is reshaping Early Childhood Education and Care (ECEC). The Australian reform agenda reflects many of the early childhood policy directions championed by bodies, such as the Organisation for Economic Cooperation and Development and the United…

  2. Underlying Policy Assumptions of Charter School Reform: The Multiple Meanings of a Movement.

    Science.gov (United States)

    Wells, Amy Stuart; Grutzik, Cynthia; Carnochan, Sibyll; Slayton, Julie; Vasudeva, Ash

    1999-01-01

    Based on interviews with state-level policy makers in six states, examines the policies of charter-school reform, arguing that the bipartisan support for these schools masks often-opposing viewpoints regarding the purpose of the reform. Identifies three salient and conflicting themes that emerge from the policy makers' explanations of their…

  3. Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: The Australian Private Health Insurance Incentive (PHII policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA. METHODS AND FINDINGS: All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3 decrease in public birth rates, a 51% (45.1 to 56.4 increase in private birth rates, a 5% (-5.3 to -5.1 and 8% (-8.9 to -7.9 decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1 increase in caesarean sections with labour and 10% (8.0 to 11.7 increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5, but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1. CONCLUSIONS: Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.

  4. Endogenous Economic Reforms and Local Realities: Cotton policy-making in Burkina Faso

    OpenAIRE

    Kaminski, Jonathan; Serra, Renata

    2011-01-01

    This paper explores the case for believing endogenous reforms to be more developmental than externally-imposed reforms, by drawing on the recent unorthodox experience of cotton sector reform in Burkina Faso. We address questions about reform emergence, feasibility, developmental impact, and sustainability. Our analysis, which carefully incorporates local social and political realities, suggests that the urban elites dominating the Burkinabè state favoured a particular cotton reform process, b...

  5. Summary of Consultations on Child Care Reform = Sommaire des consultations sur la reforme des services de garde d'enfants.

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    This document contains the English and French language versions of a report summarizing the results of a public consultation process on the subject of child care reform in Ontario, Canada. The process began with province-wide distribution of a public document called "Setting the Stage" which outlined a child care reform agenda as a focus for…

  6. Stepwise expansion of evidence-based care is needed for mental health reform.

    Science.gov (United States)

    McGorry, Patrick D; Hamilton, Matthew P

    2016-05-16

    Mortality from mental illnesses is increasing and, because they frequently occur early in the life cycle, they are the largest source of disability and reduced economic productivity of all non-communicable diseases. Successful mental health reform can reduce the mortality, morbidity, growing welfare costs and losses in economic productivity caused by mental illness. The government has largely adopted the recommendations of the National Mental Health Commission focusing on early intervention and stepwise care and will implement a reform plan that involves devolving commissioning of federally funded mental health services to primary health networks, along with a greater emphasis on e-mental health. Stepwise expanded investment in and structural support (data collection, evaluation, model fidelity, workforce training) for evidence-based care that rectifies high levels of undertreatment are essential for these reforms to succeed. However, the reforms are currently constrained by a cost-containment policy framework that envisages no additional funding. The early intervention reform aim requires financing for the next stage of development of Australia's youth mental health system, rather than redirecting funds from existing evidence-based programs. People with complex, enduring mental disorders need more comprehensive care. In the context of the National Disability Insurance Scheme, there is a risk that these already seriously underserved patients may paradoxically receive a reduction in coverage. E-health has a key role to play at all stages of illness but must be integrated in a complementary way, rather than as a barrier to access. Research and evaluation are the keys to cost-effective, sustainable reform. PMID:27169969

  7. Health care financing reform in the United States: the community equity model.

    Science.gov (United States)

    Ford, D E; Kissick, J F

    1995-01-01

    The paper discusses the practical structural aspects required for implementing 'managed competition' reform policy which are often overlooked by policy designers of change. Namely, without fundamentally new organisational structures to mediate among the parties of interest, the policies for change will not be sufficient to meet the future. The paper discusses in some detail an organisational mediating structure called the Community Equity Model which organises care at the local neighbourhood or community level using the community as actual fundsholder. This puts the critical stakeholders in a practical mutual ownership relationship by making allocation, services and resource accountability a local act. The paper briefly discusses the organisational and information technology for this type of health care system redesign. PMID:10141964

  8. Reforming primary care in England--again. Plans for improving the quality of care.

    Science.gov (United States)

    Baker, R

    2000-06-01

    An extensive programme of health service reform has begun in England. Improvement in the quality of care is a key objective of the reforms, and several initiatives are being introduced in response. These include systems to provide national guidance about appropriate treatment and services, a local system to support quality improvement and arrangements to monitor performance, including a new performance framework, an inspection agency and an annual survey of patients. The local quality improvement system has features of particular interest. These include arrangements for setting objectives for quality improvement, the use of various quality improvement methods tailored to local needs and a new system to provide accountability to both the health service and the public. The introduction of clinical governance and all the other reforms presents primary care practitioners with a major challenge. However, if sufficient time is allowed and adequate resources are made available, the reforms do have the potential to improve health care in England. PMID:10944059

  9. Lower Costs, Better Care- Reforming Our Health Care Delivery

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...

  10. Economic reform in Vietnam - the role of foreign direct investment and trade policy

    International Nuclear Information System (INIS)

    Vietnam was one of the five poorest countries in the world in the 1980's. Since then, Vietnam has adopted a market economic policy, and she has made substantial economic progress. In the last 10 years Meanwhile Vietnam's per capita income has increased by 3 times, the volume of export doubled very two years, and the inflation rate was reduced to 4.5 % in 1997 from 775 % in 1986. The GDP also has increased, the exchange rate with the US$ was stabilized and foreign direct investment (FDI) and trade has increased. There was about US$35 billion were invested by the foreign investors between 1987 to the middle of June 1998. However, the current crisis in the economies of Southeast Asian countries has put pressure on Vietnam to rethink seriously her future reform program with respect to stabilization and sustainable current economic policies. Since FDI is an imperative for the development of a country like Vietnam, it is necessary to use this capital very careful for her economy. Thus, the main objective of this dissertation is to study the role of FDI in the development of Vietnam. To examine this objective, various investigations were made, especially focusing on development dimensions such as reforming state enterprises, foreign trade policy, foreign investment and so on. Therefore, in the future, FDI and privatization policies should be strengthened to maintain and create an international market. Moreover, there are some major reforms required to transform the state sector into a private sector with appropriate policy measures, such as improving management of financial companies, developing the agricultural sector and minimizing bureaucracy and red tapism of the government. This dissertation provides a set of recommendations how to strengthen Vietnams economic and market situation in the 21st century. (author)

  11. Health policy thoughtleaders' views of the health workforce in an era of health reform.

    Science.gov (United States)

    Donelan, Karen; Buerhaus, Peter I; DesRoches, Catherine; Burke, Sheila P

    2010-01-01

    Although registered nurses rank similarly with physicians in the public's esteem, physicians are more visible than nurses in media coverage, public policy, and political spheres. Thus, nursing workforce issues are overshadowed by those of other health priorities, including Medicare and health reform. The purpose of this research was to understand the visibility and salience of the health workforce in general, gain an understanding about the effectiveness of messages concerning the nursing workforce in particular, and to understand why nursing workforce issues do not appear to have gained more traction in national health care policymaking. The National Survey of Thoughtleaders about the Health Workforce was administered via mail, telephone and online to health workforce and policy thoughtleaders from August 2009-October 2009. Of 301 thoughtleaders contacted, 123 completed questionnaires for a response rate of 41%. Thoughtleaders agree that nurses are critical to the quality and safety of our healthcare system, that there are current nursing shortages, and that nursing shortages will be intensified by health reform. Thoughtleaders reported that while they do hear about nursing issues frequently, they do not view most sources of information as proposing effective policy solutions. This study highlights a critical gap in effective policy advocacy and leadership to advance nurse workforce issues higher on the national health agenda. PMID:20637930

  12. Health Care Reform, Care Coordination, and Transformational Leadership.

    Science.gov (United States)

    Steaban, Robin Lea

    2016-01-01

    This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership. PMID:26938188

  13. Investigating the health care delivery system in Japan and reviewing the local public hospital reform

    Directory of Open Access Journals (Sweden)

    Zhang X

    2016-03-01

    Full Text Available Xing Zhang, Tatsuo Oyama National Graduate Institute for Policy Studies, Tokyo, Japan Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described. Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

  14. Evidence-based medicine in health care reform.

    Science.gov (United States)

    Hughes, Gordon B

    2011-10-01

    The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care.

  15. The new institutionalist approaches to health care reform: lessons from reform experiences in Central Europe.

    Science.gov (United States)

    Sitek, Michał

    2010-08-01

    This article discusses the applicability of the new institutionalism to the politics of health care reform in postcommunist Central Europe. The transition to a market economy and democracy after the fall of communism has apparently strengthened the institutional approaches. The differences in performance of transition economies have been critical to the growing understanding of the importance of institutions that foster democracy, provide security of property rights, help enforce contracts, and stimulate entrepreneurship. From a theoretical perspective, however, applying the new institutionalist approaches has been problematic. The transitional health care reform exposes very well some inherent weaknesses of existing analytic frameworks for explaining the nature and mechanisms of institutional change. The postcommunist era in Central Europe has been marked by spectacular and unprecedented radical changes, in which the capitalist system was rebuilt in a short span of time and the institutions of democracy became consolidated. Broad changes to welfare state programs were instituted as well. However, the actual results of the reform processes represent a mix of change and continuity, which is a challenge for the theories of institutional change.

  16. Health Behaviors, Mental Health, and Health Care Utilization Among Single Mothers After Welfare Reforms in the 1990s.

    Science.gov (United States)

    Basu, Sanjay; Rehkopf, David H; Siddiqi, Arjumand; Glymour, M Maria; Kawachi, Ichiro

    2016-03-15

    We studied the health of low-income US women affected by the largest social policy change in recent US history: the 1996 welfare reforms. Using the Behavioral Risk Factor Surveillance System (1993-2012), we performed 2 types of analysis. First, we used difference-in-difference-in-differences analyses to estimate associations between welfare reforms and health outcomes among the most affected women (single mothers aged 18-64 years in 1997; n = 219,469) compared with less affected women (married mothers, single nonmothers, and married nonmothers of the same age range in 1997; n = 2,422,265). We also used a synthetic control approach in which we constructed a more ideal control group for single mothers by weighting outcomes among the less affected groups to match pre-reform outcomes among single mothers. In both specifications, the group most affected by welfare reforms (single mothers) experienced worse health outcomes than comparison groups less affected by the reforms. For example, the reforms were associated with at least a 4.0-percentage-point increase in binge drinking (95% confidence interval: 0.9, 7.0) and a 2.4-percentage-point decrease in the probability of being able to afford medical care (95% confidence interval: 0.1, 4.8) after controlling for age, educational level, and health care insurance status. Although the reforms were applauded for reducing welfare dependency, they may have adversely affected health. PMID:26946395

  17. Oral Health Care Reform in Finland – aiming to reduce inequity in care provision

    Directory of Open Access Journals (Sweden)

    Widström Eeva

    2008-01-01

    Full Text Available Abstract Background In Finland, dental services are provided by a public (PDS and a private sector. In the past, children, young adults and special needs groups were entitled to care and treatment from the public dental services (PDS. A major reform in 2001 – 2002 opened the PDS and extended subsidies for private dental services to all adults. It aimed to increase equity by improving adults' access to oral health care and reducing cost barriers. The aim of this study was to assess the impacts of the reform on the utilization of publicly funded and private dental services, numbers and distribution of personnel and costs in 2000 and in 2004, before and after the oral health care reform. An evaluation was made of how the health political goals of the reform: integrating oral health care into general health care, improving adults' access to care and lowering cost barriers had been fulfilled during the study period. Methods National registers were used as data sources for the study. Use of dental services, personnel resources and costs in 2000 (before the reform and in 2004 (after the reform were compared. Results In 2000, when access to publicly subsidised dental services was restricted to those born in 1956 or later, every third adult used the PDS or subsidised private services. By 2004, when subsidies had been extended to the whole adult population, this increased to almost every second adult. The PDS reported having seen 118 076 more adult patients in 2004 than in 2000. The private sector had the same number of patients but 542 656 of them had not previously been entitled to partial reimbursement of fees. The use of both public and subsidised private services increased most in big cities and urban municipalities where access to the PDS had been poor and the number of private practitioners was high. The PDS employed more dentists (6.5% and the number of private practitioners fell by 6.9%. The total dental care expenditure (PDS plus private

  18. Three policy directions for home care

    OpenAIRE

    Black, Lou

    2012-01-01

    This video clip comprises one of the 5 presentations of the PANEL SESSION: “The Front Line – Home Care Providers” held at the 21st Annual John K. Friesen Conference, "Innovations in Home Care: A Public Policy Perspective," MAY 16-17, 2012, Vancouver, BC. Presented by Lou Black, Researcher and Policy Analyst, BC Hospital Employees’ Union. It is well known that jurisdictions with more comprehensive and integrated home care delivery systems are able to extend independent living for older...

  19. Trends and Impact of Public administration Reforms in Europe: Views and Experiences from Senior Public Sector Executives. COCOPS Policy Brief.

    NARCIS (Netherlands)

    G. Hammerschmid (Gerhard); S.G.J. Van de Walle (Steven); A. Oprisor (Anca); V. Štimac (Vid)

    2013-01-01

    markdownabstract__Abstract__ This policy brief summarizes the findings from a large-scale executive survey on public administration reforms in Europe, and presents initial policy recommendations for current and future reforms.

  20. Perceived Threat Associated with Police Officers and Black Men Predicts Support for Policing Policy Reform

    Science.gov (United States)

    Skinner, Allison L.; Haas, Ingrid J.

    2016-01-01

    Racial disparities in policing and recent high-profile incidents resulting in the deaths of Black men have ignited a national debate on policing policies. Given evidence that both police officers and Black men may be associated with threat, we examined the impact of perceived threat on support for reformed policing policies. Across three studies we found correlational evidence that perceiving police officers as threatening predicts increased support for reformed policing practices (e.g., limiting the use of lethal force and matching police force demographics to those of the community). In contrast, perceiving Black men as threatening predicted reduced support for policing policy reform. Perceived threat also predicted willingness to sign a petition calling for police reform. Experimental evidence indicated that priming participants to associate Black men with threat could also reduce support for policing policy reform, and this effect was moderated by internal motivation to respond without prejudice. Priming participants to associate police officers with threat did not increase support for policing policy reform. Results indicate that resistance to policing policy reform is associated with perceiving Black men as threatening. Moreover, findings suggest that publicizing racially charged police encounters, which may conjure associations between Black men and threat, could reduce support for policing policy reform. PMID:27462294

  1. Effect of Policy Reforms on Market Efficiency: Evidence from Dhaka Stock Exchange

    Directory of Open Access Journals (Sweden)

    Md. Mahmudul Alam

    2011-01-01

    Full Text Available The paper tries to find evidence supporting the impact of continuous policy reforms on the market efficiency on the Dhaka Stock Exchange (DSE. Different policies formed/reformed from 1994 to 2005 were categorized in eleven groups depending on their time of issue and subject matter. To get the result, both nonparametric test (Kolmogrov-Smirnov normality test and run test and parametric test (autocorrelation test, autoregression have been performed. Analyses were done for each policy group, and it is found that formed/reformed policies for DSE during the study period failed to improve the market efficiency even in the weak form level.

  2. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

    Directory of Open Access Journals (Sweden)

    Lígia Giovanella

    2014-11-01

    Full Text Available The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date, and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.

  3. The duopoly policy in the Brazilian model of telecommunications reform

    Directory of Open Access Journals (Sweden)

    César Mattos

    2004-09-01

    Full Text Available One of the important characteristics of the Brazilian Model of Telecommunications Reform (BMTR was the adoption of a duopoly policy, constraining the entry of new players in the wire segment in the transitional phase until free competition in 2002. This policy was also used in the reform experience of the United Kingdom in telecommunications in the 80's. The theoretical explanations behind this kind of policy are not strong enough to justify the duopoly policy in telecommunications. The most plausible idea rests on the prominent role conferred to privatization revenues in the design of the reform as a means of helping the efforts to consolidate price stabilization in the country. We introduce a model with the trade-offs between competition, duplication of fixed costs and privatization revenues. Despite the importance of fixed costs in the objective function of the regulator, we show that the privatization revenue target is the aspect, which justifies the imposition of entry constraints. The British experience shows that the sacrifice of this kind of policy regarding efficiency in the long run can be substantial.Uma das características mais importantes do Modelo Brasileiro de Reforma das Telecomunicações foi a adoção de uma política de duopólio, restringindo a entrada de novas empresas no segmento de telefonia fixa durante a fase de transição até a livre concorrência a ser adotada a partir de 2002. Essa política foi também utilizada na experiência de reforma das telecomunicações ocorrida no Reino Unido na década de 80. As explicações teóricas para justificar a adoção deste tipo de política não são satisfatórias o suficiente para justificar a política de duopólio como prescrição de política nas telecomunicações. A idéia mais plausível se baseia no papel proeminente conferido às receitas de privatização no desenho da reforma como forma de auxiliar os esforços de consolidação da estabilização de preços no

  4. Changing policies, changing patterns of care

    DEFF Research Database (Denmark)

    Rostgaard, Tine; Szebehely, Marta

    2012-01-01

    Despite pursuing the policy of ageing in place, the two Nordic countries of Denmark and Sweden have taken diverse roads in regard to the provision of formal, public tax-financed home care for older people. Whilst Sweden has cut down home care and targeted services for the most needy, Denmark has...... continued the generous provision of home care. This article focuses on the implication of such diverse policies for the provision and combination of formal and informal care resources for older people. Using data from Level of Living surveys (based on interviews with a total of 1,158 individuals aged 67...... countries tax-funded home care is used across social groups but targeting of resources at the most needy in Sweden creates other inequalities: Older people with shorter education are left with no one to resort to but the family, whilst those with higher education purchase help from market providers...

  5. The 2010 U.S. health care reform: approaching and avoiding how other countries finance health care.

    Science.gov (United States)

    White, Joseph

    2013-07-01

    This article describes and analyzes the U.S. health care legislation of 2010 by asking how far it was designed to move the U.S. system in the direction of practices in all other rich democracies. The enacted U.S. reform could be described, extremely roughly, as Japanese pooling with Swiss and American problems at American prices. Its policies are distinctive, yet nevertheless somewhat similar to examples in other rich democracies, on two important dimensions: how risks are pooled and the amount of funds redistributed to subsidize care for people with lower incomes. Policies about compelling people to contribute to a finance system would be further from international norms, as would the degree to which coverage is set by clear and common substantive standards--that is, standardization of benefits. The reform would do least, however, to move the United States toward international practices for controlling spending. This in turn is a major reason why the results would include less standard benefits and incomplete coverage. In short, the United States would remain an outlier on coverage less because of a failure to make an effort to redistribute--a lack of solidarity--than due to a failure to control costs.

  6. Optimising Russian natural gas - reform and climate policy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-18

    The world's largest gas producer and exporter, Russia has an enormous energy saving potential. At least 30 billion cubic meters, a fifth of Russian exports to European OECD countries, could be saved every year by enhanced technology or energy efficiency. As the era of cheap gas in Russia comes to an end, this potential saving is increasingly important for Russians and importing countries. And, as domestic gas prices increase, efficiency investments will become increasingly economic - not to mention the incentive for Gazprom to enhance its efficiency against a backdrop of high European gas prices. The book analyzes and estimates the potential savings and the associated reductions in greenhouse gas emissions in the oil extraction (flaring), gas transmission, and distribution sectors. Achieving these savings will require linking long-standing energy efficiency goals with energy sector reforms, as well as climate policy objectives. The book also describes Russia's emerging climate policy and institutional framework, including work still ahead before the country is eligible for the Kyoto Protocol's flexibility mechanisms and can attract financing for greenhouse gas reductions. Stressed is the need for Russia to tap the full potential of energy savings and greenhouse gas emission reductions through a more competitive environment in the gas sector to attract timely investments.

  7. Federal mandatory spending caps vital for health care reform.

    Science.gov (United States)

    Domenici, P V

    1992-01-01

    Rising health spending creates an increasing burden on families, businesses, and government. Federal health spending--chiefly on Medicare and Medicaid--is a major contributor to a budget deficit that threatens to exceed $400 billion. In order to control that deficit, the President and the Congress must cap mandatory spending, excluding Social Security. In turn, policymakers should adopt health reforms to fit spending within the cap including enrolling more consumers in managed care plans, resolving medical liability disputes in arbitration instead of courts, and increasing assessment of research into cost-effective new technology.

  8. Failure of health care reform in the USA.

    Science.gov (United States)

    Mechanic, D

    1996-01-01

    The failure of health reform in the USA reflects the individualism and lack of community responsibility of the American political culture, the power of interest groups, and the extraordinary process President Clinton followed in developing his highly elaborate plan. Despite considerable initial public support and a strong start, the reform effort was damaged by the cumbersome process, the complexity of the plan itself, and the unfamiliarity of key components such as alliances for pooled buying of health insurance. In addition, the alienation of important interest groups and the loss of presidential initiative in framing the public discussion as a result of international, domestic and personal issues contributed to the failure in developing public consensus. This paper considers an alternative strategy that would have built on the extension of the Medicare program as a way of exploring the possibilities and barriers to achieving health care reform. Such an approach would build on already familiar and popular pre-existing components. The massive losses in the most recent election and large budget cuts planned by the Republican majority makes it unlikely that gaps in insurance or comprehensiveness of coverage will be corrected in the foreseeable future.

  9. Reform and the politics of hybridization in mature health care states.

    Science.gov (United States)

    Tuohy, Carolyn Hughes

    2012-08-01

    This article examines the cases of three health care states -- two of which (Britain and the Netherlands) have undergone major policy reform and one of which (Canada) has experienced only marginal adjustments. The British and Dutch reforms have variously altered the balance of power, the mix of instruments of control, and the organizing principles. As a result, mature systems representing the ideal-typical health care state categories of national health systems and social insurance (Britain and the Netherlands, respectively) were transformed into distinctive national hybrids. These processes have involved a politics of redesign that differs from the politics of earlier phases of establishment and retrenchment. In particular, the redesign phase is marked by the activity of institutional entrepreneurs who exploit specific opportunities afforded by public programs to combine public and private resources in innovative organizational arrangements. Canada stands as a counterpoint: no window of opportunity for major change occurred, and the bilateral monopoly created by its prototypical single-payer model provided few footholds for entrepreneurial activity. The increased significance of institutional entrepreneurs gives greater urgency to one of the central projects of health policy: the design of accountability frameworks to allow for an assessment of performance against objectives.

  10. Health care reform and Connecticut's non-profit hospitals.

    Science.gov (United States)

    Cohen, Jeffrey R; Gerrish, William; Galvin, J Robert

    2010-01-01

    The recent federal Health Care Reform Act signed into law by President Obama is expected to lead to greater patient volumes at non-profit hospitals in Connecticut (and throughout the country). The financial implications for these hospitals depend on how the costs per patient are expected to change in response to the anticipated higher patient volumes. Using a regression analysis of costs with annual data on 30 Connecticut hospitals over the period 2006 to 2008, we find that there are considerable differences between outpatient and inpatient unit cost structures at these hospitals. Based on the results of our analysis, and assuming health care reform leads to an overall increase in the number of outpatients, we would expect Connecticut hospitals to experience lower costs per outpatient treated (economies of scale). On the other hand, an influx of additional inpatients would be expected to raise unit costs (diseconomies of scale). After controlling for other cost determinants, we find that the marginal cost of an inpatient is about $8,000 while the marginal cost of an outpatient is about $44. This disparity may provide an explanation for our finding that the effect of additional patient volumes overall (combining inpatient and outpatient) is an increase in hospitals' unit costs.

  11. A literature review of the regional implementation of the central Swedish government's health care reforms on choice and privatization.

    Science.gov (United States)

    Ekman, Björn; Wilkens, Jens

    2015-12-01

    The introduction in 2010 of the Freedom of Choice Act represents one of the most far-reaching reforms of the Swedish health system. While it is mandatory for the regional counties to introduce choice plans for primary care it is voluntary for ambulatory specialist services. The voluntary nature of the regulations for the latter types of care generates a potential gap between the central government's reform attempts and the regional implementation of the plans. We review the regional implementation of this reform with respect to specialist services from a political economy perspective. Data on the scope of implementation show that counties of the same political ideology as the central government have introduced the most choice plans for specialist care. In particular, counties ruled by right-wing majorities have introduced the Choice Act to a considerably larger extent than left-wing counties. This creates a highly uneven situation across the various parts of the country, possibly at odds with the basic premises of the country's health law of equal access to care. The introduction of choice plans forms part of a decidedly contentious set of issues that are high on the political agenda of Sweden. The nature and impacts of these reforms are also a concern to the general public and the broader industry. Considerably more rigorous analyses will be needed to assess the impact on key policy parameters such as overall system efficiency and equitable access to services as a result of these changes to the health care markets. PMID:26650814

  12. Evidence Use in Mental Health Policy Making for Children in Foster Care.

    Science.gov (United States)

    Hyde, Justeen K; Mackie, Thomas I; Palinkas, Lawrence A; Niemi, Emily; Leslie, Laurel K

    2016-01-01

    Considerable attention is being given to the use of research evidence to inform public policy making. Building upon Weiss's model of research utilization, we examined the types and uses of evidence that child welfare administrators used in response to federal policy reforms requiring psychotropic medications oversight for children in foster care. Participants relied on a range of "global" and "local" evidence types throughout the policy development phase. Global research evidence was used to raise awareness about problems associated with psychotropic medication use. Local evidence helped to contextualize concerns and had problem-solving and political uses. In most states, policy actions were informed by a combination of evidence types. PMID:25711392

  13. The emerging EU quality of care policy

    DEFF Research Database (Denmark)

    Vollaard, Hans; van de Bovenkamp, Hester M.; Vrangbæk, Karsten

    2013-01-01

    Despite the fact that Member States and many citizens of the EU like to keep healthcare a foremost national competence and the EU treaties state that Member States remain primarily responsible for the organization and delivery of health care services, the European Union (EU) has expanded its...... involvement in healthcare policy over the last twenty years. Based on interviews and document and literature analysis we show that the scope of EU involvement has widened from public health and access to care, to quality of care. In this paper we concentrate on the latter. Focusing on the recent EU...

  14. The Transformation of China’s Health Care System and Accounting Methods: Current Reforms and Developments

    OpenAIRE

    David Chu; Kolleen Rask

    2000-01-01

    This paper is a case study of China’s recent reforms in hospital accounting. We analyze the Chinese health care system in transition to highlight the changing role and nature of accounting services before and after the recent reforms. Prior to reforms, the accounting system provided data solely for government central planning purposes. Reforms were supposed to decentralize hospital decision making, thus signaling a need for a new accounting system that would provide information to managers an...

  15. Effectiveness of China's Monetary Policy and Reform of Its Foreign Exchange System

    Institute of Scientific and Technical Information of China (English)

    Xinhua Gu; Lan Zhang

    2006-01-01

    This paper examines the effectiveness of China's monetary policy in curbing the overheating and speculation problems under the current foreign exchange system. The paper stresses the necessity of capital controls in China's gradual foreign exchange reform and the importance of credible government policy in guiding market expectations. Also, the paper discusses the persistence of China's external imbalance, and provides policy recommendations for its reduction.

  16. Redesigning and reforming European regional policy : The reasons, the logic and the outcomes

    NARCIS (Netherlands)

    McCann, P.; Ortega-Argilés, R.

    2013-01-01

    This article discusses the reforms to European Union (EU) regional development policy, or more precisely EU Cohesion Policy, which have been taking place over recent years. Following a discussion of the evolution of the policy, the changes in the rationale, the logic, the architecture, and the outco

  17. Upholding the Malay Language and Strengthening the English Language Policy: An Education Reform

    Science.gov (United States)

    Yamat, Hamidah; Umar, Nur Farita Mustapa; Mahmood, Muhammad Ilyas

    2014-01-01

    Today's global economy and dependency on technology has led to educational reforms in Malaysia, which includes language policies; namely the Upholding the Malay Language, and Strengthening the English Language ("MBMMBI") policy. This policy underpins the project presented and discussed in this paper; on the development of a bilingual…

  18. Care and treatment of the mentally ill in the United States: historical developments and reforms.

    Science.gov (United States)

    Morrissey, J P; Goldman, H H

    1986-03-01

    Three major cycles of reform in public mental health care in the United States--the moral treatment, mental hygiene, and community mental health movements--are described as a basis for assessing the shifting boundaries between the mental health, social welfare, and criminal justice systems. Historical forces that led to the transinstitutionalization of the mentally ill from almshouses to the state mental hospitals in the nineteenth and twentieth centuries have now been reversed in the aftermath of recent deinstitutionalization policies. Evidence is suggestive that the mentally ill are also being caught up in the criminal justice system, a circumstance reminiscent of pre-asylum conditions in the early nineteenth century. These trends shape the current mental health service delivery system and the agenda for policy-relevant research on issues involving the legal and mental health fields.

  19. Comparing the Canadian and US systems of health care in an era of health care reform.

    Science.gov (United States)

    LaPierre, Tracey A

    2012-01-01

    The purpose of this article is to provide an informed comparison of health care in the United States and Canada along multiple dimensions. Specifically this article looks at coverage, access, cost, health outcomes, satisfaction, and underlying ideology. Canada fares better than the United States with regard to coverage, cost, and health outcomes. While overall access is better in Canada, patients are sometimes required to endure longer wait times than in the United States. Reports of satisfaction levels vary across studies, but most evidence points toward comparable levels of satisfaction in Canada and the United States. Strong ideological differences underlie the Canadian and American systems, making the acceptance and implementation of certain reforms difficult. The potential impact of the US Patient Protection and Affordable Care Act (PPACA), as well as recent Canadian health care reforms on coverage, access, cost, and health outcomes are also discussed. PMID:22894018

  20. Values and health care: the Confucian dimension in health care reform.

    Science.gov (United States)

    Lim, Meng-Kin

    2012-12-01

    Are values and social priorities universal, or do they vary across geography, culture, and time? This question is very relevant to Asia's emerging economies that are increasingly looking at Western models for answers to their own outmoded health care systems that are in dire need of reform. But is it safe for them to do so without sufficient regard to their own social, political, and philosophical moorings? This article argues that historical and cultural legacies influence prevailing social values with regard to health care financing and resource allocation, and that the Confucian dimension provides a helpful entry point for a deeper understanding of ongoing health care reforms in East Asia--as exemplified by the unique case of Singapore. PMID:23175795

  1. How Do School Leaders Navigate ICT Educational Reform? Policy Learning Narratives from a Singapore Context

    Science.gov (United States)

    Chua Reyes, Vicente

    2015-01-01

    The purpose of this research inquiry focuses on how school leaders "make sense" of educational reform in their local contexts. In order to do this, an exploratory qualitative case study of two schools that took part in policy reform initiatives directed at ubiquitous use of information communication and technology (ICT) in the Singapore…

  2. The Contribution of Stuart Hall to Analyzing Educational Policy and Reform

    Science.gov (United States)

    Gandin, Luis Armando

    2015-01-01

    This article focuses on the contribution of Stuart Hall to the study of educational policy and reform, using the experience of the Citizen School initiative in Porto Alegre, Brazil as a concrete example. This experience was a participatory educational reform implemented during the 16 years of the Workers' Party tenure in Porto Alegre's municipal…

  3. Higher Education Policy Reform in Ethiopia: The Representation of the Problem of Gender Inequality

    Science.gov (United States)

    Molla, Tebeje

    2013-01-01

    The higher education (HE) subsystem in Ethiopia has passed through a series of policy reforms in the last 10 years. Key reform areas ranged from improving quality and relevance of programmes to promoting equality in access to and success in HE. Despite the effort underway, gender inequality has remained a critical challenge in the subsystem. This…

  4. Deciding Who Decides Questions at the Intersection of School Finance Reform Litigation and Standards-Based Accountability Policies

    Science.gov (United States)

    Superfine, Benjamin Michael

    2009-01-01

    Courts hearing school finance reform cases have recently begun to consider several issues related to standards-based accountability policies. This convergence of school finance reform litigation and standards-based accountability policies represents a chance for the courts to reallocate decision-making authority for each type of reform across the…

  5. Subsidizing "Stayers"? Effects of a Norwegian Child Care Reform on Marital Stability

    Science.gov (United States)

    Hardoy, Ines; Schone, Pal

    2008-01-01

    Since January 1999, all parents in Norway with children aged 1 to 3 years who do not attend publicly subsidized day care are eligible for "cash-for-care" (CFC). One important purpose of the reform is to enable parents to spend more time with their children. We analyze whether the CFC reform has affected marital stability, using individual register…

  6. [President Obama's health care reform: lessons to and from the Israeli health care system].

    Science.gov (United States)

    Balicer, Ran D; Shadmi, Efrat

    2011-08-01

    In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U.S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. Changes to the current structure and financing of the U.S. health system will have implications for other health systems, for science (e.g., through enhanced federal funding for comparative effectiveness research), and for technological advance (e.g., through accelerated development and use of electronic health records). There are several lessons from the reform, and the factors leading to its implementation, for the Israeli health system. Firstly, the basic principles of the Israeli health system are a source of pride, and undermining its main values can have deleterious effects. Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U.S. health care reform and the potential implications for the IsraeLi health system. PMID:21939111

  7. Health care reform and its impact on radiology practice.

    Science.gov (United States)

    Bindman, Andrew B

    2014-03-01

    CMS is testing a range of payment policy options, including pay for performance, bundled payments, and shared savings through accountable care organizations. Radiologists can anticipate that the basis for how they are paid by Medicare will change and that they will need to play a greater role than has been required of them in the traditional fee-for-service payment system to demonstrate that imaging studies are used safely and efficiently. PMID:24445166

  8. Assisted reproduction in Indonesia: policy reform in an Islamic culture and developing nation.

    Science.gov (United States)

    Purvis, Taylor E

    2015-11-01

    This article considers how religious and economic factors shape assisted reproductive technology (ART) policy in Indonesia, the world's most populous Muslim country. Infertility clinic policies are grounded on both the views of the country's powerful Islamic coalition and those of the worldwide Islamic community. Indonesian government officials, physicians, and Islamic scholars have expressed concern over who can use ART and which procedures can be performed. Indonesia has also faced economic challenges related to ART, including inadequate health insurance coverage, inequitable access to ART, and maintenance of expensive ART infrastructure. The prohibitive price of infertility treatment and regional differences in the provision of health care prohibit most Indonesians from obtaining ART. In the absence of a shift in religious mores and a rapid reduction in poverty and inequality, Indonesia will need to adopt creative means to make ART both more available and less necessary as a solution to infertility. This paper suggests policy reforms to promote more affordable treatment methods and support preventative health programmes to reduce infertility rates. This country-specific analysis of the laws and customs surrounding ART in Indonesia reveals that strategies to reduce infertility must be tailored to a country's unique religious and economic climate.

  9. Assisted reproduction in Indonesia: policy reform in an Islamic culture and developing nation.

    Science.gov (United States)

    Purvis, Taylor E

    2015-11-01

    This article considers how religious and economic factors shape assisted reproductive technology (ART) policy in Indonesia, the world's most populous Muslim country. Infertility clinic policies are grounded on both the views of the country's powerful Islamic coalition and those of the worldwide Islamic community. Indonesian government officials, physicians, and Islamic scholars have expressed concern over who can use ART and which procedures can be performed. Indonesia has also faced economic challenges related to ART, including inadequate health insurance coverage, inequitable access to ART, and maintenance of expensive ART infrastructure. The prohibitive price of infertility treatment and regional differences in the provision of health care prohibit most Indonesians from obtaining ART. In the absence of a shift in religious mores and a rapid reduction in poverty and inequality, Indonesia will need to adopt creative means to make ART both more available and less necessary as a solution to infertility. This paper suggests policy reforms to promote more affordable treatment methods and support preventative health programmes to reduce infertility rates. This country-specific analysis of the laws and customs surrounding ART in Indonesia reveals that strategies to reduce infertility must be tailored to a country's unique religious and economic climate. PMID:26371707

  10. Educational research in Sweden: Reform strategies and research policy

    Science.gov (United States)

    Marklund, Inger

    1981-06-01

    Educational R & D in Sweden is to a large extent policy-oriented. It has been an integrated part of the Swedish educational reform system and has brought about a dialogue between politicians, administrators and researchers. Several circumstances have contributed to the `Swedish model'. One is the system with government-appointed committees in which researchers often play an active part. Another is that the Swedish educational system is highly centralized, with the National Board of Education (NBE) as the central authority, responsible for primary, secondary and adult education. A third — and a crucial one — is that, since 1962, the NBE has had increasing funds for educational R & D at its disposal. These funds account for the main part of the economic resources for R & D, along with resources allocated to research appointments at research departments of universities. Educational R & D, conducted primarily within the NBE funds, has recently been evaluated by a government-appointed committee. In its evaluations of the impact of educational R & D, the committee distinguished between the effects of R & D and the effect correlates. It concluded that the impact of R & D is more indirect than direct, more long-term than immediate. The effects are also more easily recognized at levels above the actual school situation. This finding could be interpreted as a consequence of the policy-orientation of educational R & D, which at the same time shows the difficulties in reaching the `school level' with research and development results. There are two general trends in Sweden, which will influence both research planning and research use. First, there is a trend towards the decentralization of decision-making and responsibility for the educational system. Secondly, there is a trend towards the `sectionalization' of the R & D system as a whole. This sectionalization will mean that research will to a great extent be planned to meet needs from different parts of society — labour

  11. Financing institutional long-term care for the elderly in China: a policy evaluation of new models

    OpenAIRE

    Yang, Wei; Jingwei He, Alex; Fang, Lijie; Mossialos, Elias

    2016-01-01

    A rapid ageing population coupled with changes in family structure has brought about profound implications to social policy in China. Although the past decade has seen a steady increase in public funding to long-term care (LTC), the narrow financing base and vast population have created significant unmet demand, calling for reforms in financing. This paper focuses on the financing of institutional LTC care by examining new models that have emerged from local policy experiments against two pol...

  12. Property rights and hierarchies of power: a critical evaluation of land-reform policy in South Africa

    OpenAIRE

    André van der Walt

    1999-01-01

    The programme of land reform laws introduced in South Africa since 1991 is often seen and discussed as nothing more than a highly technical, black-letter aspect of South African law. In this article, the author directs attention to the policies that underly the land reform laws, and discusses the transformative potential and effect of land reform laws in view of these policies. The main question is whether the land reform programme has succeeded in breaking away from or undermining the hierar...

  13. A democratic responsiveness approach to real reform: an exploration of health care systems' resilience.

    Science.gov (United States)

    Grignon, Michel

    2012-08-01

    Real reforms attempt to change how health care is financed and how it is rationed. Three main explanations have been offered to explain why such reforms are so difficult: institutional gridlock, path dependency, and societal preferences. The latter posits that choices made regarding the health care system in a given country reflect the broader societal set of values in that country and that as a result public resistance to real reform may more accurately reflect citizens' personal convictions, self-interest, or even active social choices. "Conscientious objectors" may do more to derail reform than previously recognized. PMID:22466049

  14. Diffusion of complex health innovations--implementation of primary health care reforms in Bosnia and Herzegovina.

    Science.gov (United States)

    Atun, Rifat A; Kyratsis, Ioannis; Jelic, Gordan; Rados-Malicbegovic, Drazenka; Gurol-Urganci, Ipek

    2007-01-01

    Most transition countries in Central and Eastern Europe and Central Asia are engaged in health reform initiatives aimed at introducing primary health care (PHC) centred on family medicine to enhance performance of their health systems. But, in these countries the introduction of PHC reforms has been particularly challenging; while some have managed to introduce pilots, many have failed to these scale up. Using an innovation lens, we examine the introduction and diffusion of family-medicine-centred PHC reforms in Bosnia and Herzegovina (BiH), which experienced bitter ethnic conflicts that destroyed much of the health systems infrastructure. The study was conducted in 2004-05 over a 18-month period and involved both qualitative and quantitative methods of inquiry. In this study we report the findings of the qualitative research, which involved in-depth interviews in three stages with key informants that were purposively sampled. In our research, we applied a proprietary analytical framework which enables simultaneous and holistic analysis of the context, the innovation, the adopters and the interactions between them over time. While many transition countries have struggled with the introduction of family-medicine-centred PHC reforms, in spite of considerable resource constraints and a challenging post-war context, within a few years, BiH has managed to scale up multifaceted reforms to cover over 25% of the country. Our analysis reveals a complex setting and bidirectional interaction between the innovation, adopters and the context, which have collectively influenced the diffusion process. Family-medicine-centred PHC reform is a complex innovation-involving organizational, financial, clinical and relational changes-within a complex adaptive system. An important factor influencing the adoption of this complex innovation in BiH was the perceived benefits of the innovation: benefits which accrue to the users, family physicians, nurses and policy makers. In the case of Bi

  15. Health policy and the policymaking system: A case study of primary care in Ireland.

    Science.gov (United States)

    Kelly, Niall; Garvey, John; Palcic, Dónal

    2016-08-01

    In 2001 the Irish government published a reforming policy intended to modernise and expand the delivery of primary care in Ireland. Fifteen years later, the Irish health system remains beset by problems indicative of a fragmented and underdeveloped primary care system. This case study examines the formation and implementation of the 2001 primary care policy and identifies key risk categories within the policymaking process itself that inhibited the timely achievement of policy objectives. Our methodology includes a directed content analysis of the policy formation and implementation documents and the influencing academic literature, as well as semi-structured interviews with key personnel involved in the process. We identify three broad risk categories - power, resources and capability - within the policymaking process that strongly influenced policy formation and implementation. We additionally show that the disjoint between policy formation and policy implementation was a contested issue among those involved in the policy process and provided space for these risks to critically undermine Ireland's primary care policy. PMID:27342835

  16. Health care reform: understanding individuals' attitudes and information sources.

    Science.gov (United States)

    Shue, Carolyn K; McGeary, Kerry Anne; Reid, Ian; Khubchandani, Jagdish; Fan, Maoyong

    2014-01-01

    Since passage of the Affordable Care Act (ACA) was signed into law by President Barrack Obama, little is known about state-level perceptions of residents on the ACA. Perceptions about the act could potentially affect implementation of the law to the fullest extent. This 3-year survey study explored attitudes about the ACA, the types of information sources that individuals rely on when creating those attitudes, and the predictors of these attitudes among state of Indiana residents. The respondents were split between favorable and unfavorable views of the ACA, yet the majority of respondents strongly supported individual components of the act. National TV news, websites, family members, and individuals' own reading of the ACA legislation were identified as the most influential information sources. After controlling for potential confounders, the respondent's political affiliation, age, sex, and obtaining ACA information from watching national television news were the most important predictors of attitudes about the ACA and its components. These results mirror national-level findings. Implications for implementing health care reform at the state-level are discussed. PMID:25045705

  17. Health Care Reform: Understanding Individuals’ Attitudes and Information Sources

    Directory of Open Access Journals (Sweden)

    Carolyn K. Shue

    2014-01-01

    Full Text Available Since passage of the Affordable Care Act (ACA was signed into law by President Barrack Obama, little is known about state-level perceptions of residents on the ACA. Perceptions about the act could potentially affect implementation of the law to the fullest extent. This 3-year survey study explored attitudes about the ACA, the types of information sources that individuals rely on when creating those attitudes, and the predictors of these attitudes among state of Indiana residents. The respondents were split between favorable and unfavorable views of the ACA, yet the majority of respondents strongly supported individual components of the act. National TV news, websites, family members, and individuals’ own reading of the ACA legislation were identified as the most influential information sources. After controlling for potential confounders, the respondent’s political affiliation, age, sex, and obtaining ACA information from watching national television news were the most important predictors of attitudes about the ACA and its components. These results mirror national-level findings. Implications for implementing health care reform at the state-level are discussed.

  18. Professional responses to post bureaucratic hospital reforms and their impact on care provision

    DEFF Research Database (Denmark)

    Johnsen, Helle

    2015-01-01

    receivers. Question To explore experiences of post bureaucratic hospital reforms and their impact on care provision. Method Data builds on nine mini group interviews with midwives (n = three), nurses (n = three) and physiotherapists (n = three), in all thirty participants. Data was analysed using existing....... Although midwives, nurses and physiotherapists share similar experiences of post bureaucratic hospital reforms, changes in care provision can impact these professions in different ways. As a discipline, midwifery is founded on relationships between women and midwives. Standardised clinical care...

  19. Explaining Large-Scale Policy Change in the Turkish Health Care System: Ideas, Institutions, and Political Actors.

    Science.gov (United States)

    Agartan, Tuba I

    2015-10-01

    Explaining policy change has been one of the major concerns of the health care politics and policy development literature. This article aims to explain the specific dynamics of large-scale reforms introduced within the framework of the Health Transformation Program in Turkey. It argues that confluence of the three streams - problem, policy, and politics - with the exceptional political will of the Justice and Development Party's (JDP) leaders opened up a window of opportunity for a large-scale policy change. The article also underscores the contribution of recent ideational perspectives that help explain "why" political actors in Turkey would focus on health care reform, given that there are a number of issues waiting to be addressed in the policy agenda. Examining how political actors framed problems and policies deepens our understanding of the content of the reform initiatives as well as the construction of the need to reform. The article builds on the insights of both the ideational and institutionalist perspectives when it argues that the interests, aspirations, and fears of the JDP, alongside the peculiar characteristics of the institutional context, have shaped its priorities and determination to carry out this reform initiative.

  20. Educational Turbulence: The Influence of Macro and Micro-Policy on Science Education Reform

    Science.gov (United States)

    Johnson, Carla C.

    2013-01-01

    Enactment of federal educational policy has direct implications for states and local school districts across the nation, particularly in the areas of accountability and funding. This study utilized constructivist grounded theory to examine the impact of policy on science education reform in a large, urban school district over a 5-year period. The…

  1. Policy reforms to promote efficient and systainable water use in Swiss agriculture

    NARCIS (Netherlands)

    Finger, R.; Lehmann, N.

    2012-01-01

    The more sustainable use of scarce water resources is a policy goal in several countries. In this regard, current discussions on potential policy reforms in Switzerland revolve around the subsidization of water-saving irrigation technologies. Today, the share of drip irrigation systems is low, at 3%

  2. Getting the product right: how competition policy can improve health care markets.

    Science.gov (United States)

    Sage, William M

    2014-06-01

    As hospital, physician, and health insurance markets consolidate and change in response to health care reform, some commentators have called for vigorous enforcement of the federal antitrust laws to prevent the acquisition and exercise of market power. In health care, however, stricter antitrust enforcement will benefit consumers only if it accounts for the competitive distortions caused by the sector's long history of government regulation. This article directs policy makers to a neglected dimension of health care competition that has been altered by regulation: the product. Competition may have failed to significantly lower costs, increase access, or improve quality in health care because we have been buying and selling the wrong things. Competition policy makers-meaning both antitrust enforcers and regulators-should force the health care industry to define and market products that can be assembled and warranted to consumers while keeping emerging sectors such as mHealth free from overregulation, wasteful subsidy, and appropriation by established insurer and provider interests.

  3. Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives.

    Science.gov (United States)

    Wilson, Anne; Whitaker, Nancy; Whitford, Deirdre

    2012-05-01

    Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice. PMID:22686113

  4. Policy entrepreneurship in the development of public sector strategy: the case of London health reform.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Exworthy, Mark

    2011-01-01

    The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform. PMID:22069793

  5. Policy entrepreneurship in the development of public sector strategy: the case of London health reform.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Exworthy, Mark

    2011-01-01

    The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.

  6. Privatizing the welfarist state: health care reforms in Malaysia.

    Science.gov (United States)

    Khoon, Chan Chee

    2003-01-01

    In Malaysia, the shifting balance between market and state has many nuances. Never a significant welfare state in the usual mold, the Malaysian state nonetheless has been a dominant social and economic presence dictated by its affirmative action-type policies, which eventually metamorphosed into state-led indigenous capitalism. Privatisation is also intimately linked with emergence of an indigenous bourgeoisie with favored access to the vast accumulation of state assets and prerogatives. Internationally, it is conditioned by the fluid relationships of converging alliances and contested compromise with international capital, including transnational health services industries. As part of its vision of a maturing, diversified economy, the Malaysian government is fostering a private-sector advanced health care industry to cater to local demand and also aimed at regional and international patrons. The assumption is that, as disposable incomes increase, a market for such services is emerging and citizens can increasingly shoulder their own health care costs. The government would remain the provider for the indigent. But the key assumption remains: the growth trajectory will see the emergence of markets for an increasingly affluent middle class. Importantly, the health care and social services market would be dramatically expanded as the downsizing of public-sector health care proceeds amid a general retreat of government from its provider and financing roles.

  7. Privatizing the welfarist state: health care reforms in Malaysia.

    Science.gov (United States)

    Khoon, Chan Chee

    2003-01-01

    In Malaysia, the shifting balance between market and state has many nuances. Never a significant welfare state in the usual mold, the Malaysian state nonetheless has been a dominant social and economic presence dictated by its affirmative action-type policies, which eventually metamorphosed into state-led indigenous capitalism. Privatisation is also intimately linked with emergence of an indigenous bourgeoisie with favored access to the vast accumulation of state assets and prerogatives. Internationally, it is conditioned by the fluid relationships of converging alliances and contested compromise with international capital, including transnational health services industries. As part of its vision of a maturing, diversified economy, the Malaysian government is fostering a private-sector advanced health care industry to cater to local demand and also aimed at regional and international patrons. The assumption is that, as disposable incomes increase, a market for such services is emerging and citizens can increasingly shoulder their own health care costs. The government would remain the provider for the indigent. But the key assumption remains: the growth trajectory will see the emergence of markets for an increasingly affluent middle class. Importantly, the health care and social services market would be dramatically expanded as the downsizing of public-sector health care proceeds amid a general retreat of government from its provider and financing roles. PMID:17208722

  8. Child Care Reform Consultation Infopack = Consultation sur la reforme des services de garde d'enfants. Trousse d'information.

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    This information packet presented here in both the English and French language versions, summarizes the results of a public consultation on the subject of child care reform in Ontario, Canada. The packet consists of: (1) a table that describes the six modes of consultation that were used in the consultation process (public meetings, round table…

  9. Policies lost in translation? Unravelling water reform processes in African waterscapes

    OpenAIRE

    Kemerink-Seyoum, J.S.

    2015-01-01

    Since the 1980s a major change took place in public policies for water resources management. The role of governments shifted under this reform process from an emphasis on investment in the development, operation and maintenance of water infrastructure to a focus on managing water resources systems by stipulating general frameworks and defining key principles for water allocation. This interdisciplinary research examines how this water reform process unfolds within four African waterscapes tha...

  10. Care systematization in psychiatric nursing within the psychiatric reform context.

    Science.gov (United States)

    Hirdes, A; Kantorski, L P

    2002-02-01

    The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended 'Nossa Casa', São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving's nursing process were used as theoretical-methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.

  11. Indonesia Development Policy Review : The Imperative for Reform

    OpenAIRE

    World Bank

    2001-01-01

    Indonesia's recovery was already slowing several months before the events of September 11. Political instability had raised social tensions and slowed reforms--fueling capital flight, alarming investors, and delaying official external finance for development. Progress on bank restructuring had slowed and the debt of financially strapped corporations remained largely unresolved. Corruption ...

  12. Day Care: A Program in Search of a Policy.

    Science.gov (United States)

    Bikales, Gerda

    This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

  13. Health Related Policy Reform in Nigeria;- Empirical Analysis From 2001 to 2010; The Past, Trend and Future Directions For Sustainable Health Financing and Development

    Directory of Open Access Journals (Sweden)

    M. J. Saka

    2012-03-01

    Full Text Available The study was carried out to demonstrate the impact of National weight on the process of health sector reform from 2001 to 2010 and to specifically determine Health policies and plans initiated at Federal level and adopted or adapted at State level including capacity for implementation. Multiple data collection was used to collate data. A tool was developed and sent to trained interviewers each for each state including Federal Capital Territory (FCT to administer on the States within their span of work. Reportedly, at least 21 States in Nigeria had either started or are implementing various types of reforms. However, it is not very clear how much of these efforts may be attributed to an interest groups, professional groups, Talkawa group, Eminent personality group (EPG, and other elite groups. National, State and LGAs levels elite had dominated policy through their control of resources, but more importantly through their ‘control of the terms of debate through expert knowledge, support of research, and occupation of key nodes’ in the network. The findings were not that a small group of leaders shaped the policy debates, but rather that the leadership was not representative of the interest at stake: ‘the national policy network on health sector reform had been narrowly based in a small number of institutions. We concluded that without continuous and sustained institutional or structural reform in health, it is unlikely that existing organizational structures and management systems in health sector will be able to deal adequately with the weak and fragile National Health Care Delivery System and improving its performance. It is recommended that health sector reform should therefore be concerned with defining priorities, refining policies and reforming the institutions through which those policies are implemented.

  14. Time is ripe for health-care reform

    OpenAIRE

    2008-01-01

    The global financial crisis has created an environment that is more favourable to government intervention, social protection and health reform in the United States of America (USA) than in recent years. Paul Krugman, this year’s Nobel economics laureate, talks to the Bulletin about the challenges of pushing through health reform and the shape this could take after the 4 November presidential election.

  15. Financing of health care in four Caribbean territories: a comparison with reforms in Europe.

    Science.gov (United States)

    Rutten, F; Lapré, R; Antonius, R; Dokoui, S; Haqq, E; Roberts, R; Mills, A

    2002-10-01

    This paper considers health care finance in four Caribbean territories and plans for reform in comparison with developments in European countries, to which these territories are historically linked. European health care reforms are aimed at making resource allocation in health care more efficient and more responsive to consumers' demands and preferences. These reforms in Europe have been continuing without appearing to have influenced the developments in the Caribbean very much, except in Martinique. In Trinidad and Tobago current reform entails delegation of responsibility for providing services to four regional health authorities and no purchaser/provider split at the regional or facility level as in the UK has been implemented. In the Bahamas, managed care arrangements are likely to emerge given the proximity of the United States. Recent universal coverage reform in Martinique was aimed at harmonisation of finance by bringing social security and social aid functions together under one management structure and may provide more opportunities for contracting and other initiatives towards greater efficiency. The first priority in Suriname is to restore proper functioning of the current system. Reforms in the four Caribbean territories have a largely administrative character and affect the organisation of the third party role in health care rather than fundamentally changing the relationship between this third party and the various other parties in health care. PMID:12151137

  16. The Small State, Markets and Tertiary Education Reform in a Globalised Knowledge Economy: Decoding Policy Texts in Botswana's Tertiary Education Reform

    Science.gov (United States)

    Polelo, Mompati Mino

    2009-01-01

    A number of global discourses have gained currency in national education policies. The need to reform education systems is coated in economic terms, the rationale of which is efficiency, productivity and competitiveness. Education is assigned the task of producing a competitive workforce in the global market. In these reforms, education is…

  17. Evaluating the impact of economic agricultural policies during the reform era for major crops and crop rotations in Egypt: a policy analysis matrix approach

    OpenAIRE

    El-Kholei, Ahmed Mohammed Salah

    2003-01-01

    In 1986, Egypt implemented a succession of comprehensive economic reforms both in the agriculture sector and more generally such as the Economic Reform and Structural Adjustment Program (ERSAP) of 1991. Since then, the agricultural sector has been gradually transformed from one characterised by central planning and governmental controls to one that is more free market oriented. This study employs the Policy Analysis Matrix technique to evaluate the impacts of reform policies on eleven maj...

  18. Long-Term Care Policy: Singapore's Experience.

    Science.gov (United States)

    Chin, Chee Wei Winston; Phua, Kai-Hong

    2016-01-01

    Singapore, like many developed countries, is facing the challenge of a rapidly aging population and the increasing need to provide long-term care (LTC) services for elderly in the community. The Singapore government's philosophy on care for the elderly is that the family should be the first line of support, and it has relied on voluntary welfare organizations (VWOs) or charities for the bulk of LTC service provision. For LTC financing, it has emphasized the principles of co-payment and targeting of state support to the low-income population through means-tested government subsidies. It has also instituted ElderShield, a national severe disability insurance scheme. This paper discusses some of the challenges facing LTC policy in Singapore, particularly the presence of perverse financial incentives for hospitalization, the pitfalls of over-reliance on VWOs, and the challenges facing informal family caregivers. It discusses the role of private LTC insurance in LTC financing, bearing in mind demand- and supply-side failures that have plagued the private LTC insurance market. It suggests the need for more standardized needs assessment and portable LTC benefits, with reference to the Japanese Long-Term Care Insurance program, and also discusses the need to provide more support to informal family caregivers. PMID:26808468

  19. Which moral hazard? Health care reform under the Affordable Care Act of 2010.

    Science.gov (United States)

    Mendoza, Roger Lee

    2016-06-20

    Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim. Through the US Affordable Care Act (ACA) of 2010, this study seeks to examine the validity and relevance of moral hazard in health care reform and determine how welfare losses or inefficiencies could be mitigated. Design/methodology/approach - This study is divided into three sections. The first contrasts conventional moral hazard from an emerging or alternative theory. The second analyzes moral hazard in terms of the evolution, organization, management, and marketing of health insurance in the USA. The third explains why and how salient reform measures under the ACA might induce health care consumption and production in ways that could either promote or restrict personal health and safety as well as social welfare maximization. Findings - Insurance generally induces health care (over) consumption. However, not every additional consumption, with or without adverse selection, can be considered wasteful or risky, even if it might cost insurers more in the short run. Moral hazard can generate welfare and equity gains. These gains might vary depending on which ACA provisions, insured population, covered illnesses, treatments, and services, as well as health outcomes are taken into account, and because of the relative ambiguities surrounding definitions of "health." Actuarial risk models can nonetheless benefit from incorporating welfare and equity gains into their basic assumptions and estimations. Originality/value - This is the first study which examines the ACA in the context of the new or alternative theory of moral hazard. It suggests that containing inefficient moral hazard, and encouraging its desirable

  20. Which moral hazard? Health care reform under the Affordable Care Act of 2010.

    Science.gov (United States)

    Mendoza, Roger Lee

    2016-06-20

    Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim. Through the US Affordable Care Act (ACA) of 2010, this study seeks to examine the validity and relevance of moral hazard in health care reform and determine how welfare losses or inefficiencies could be mitigated. Design/methodology/approach - This study is divided into three sections. The first contrasts conventional moral hazard from an emerging or alternative theory. The second analyzes moral hazard in terms of the evolution, organization, management, and marketing of health insurance in the USA. The third explains why and how salient reform measures under the ACA might induce health care consumption and production in ways that could either promote or restrict personal health and safety as well as social welfare maximization. Findings - Insurance generally induces health care (over) consumption. However, not every additional consumption, with or without adverse selection, can be considered wasteful or risky, even if it might cost insurers more in the short run. Moral hazard can generate welfare and equity gains. These gains might vary depending on which ACA provisions, insured population, covered illnesses, treatments, and services, as well as health outcomes are taken into account, and because of the relative ambiguities surrounding definitions of "health." Actuarial risk models can nonetheless benefit from incorporating welfare and equity gains into their basic assumptions and estimations. Originality/value - This is the first study which examines the ACA in the context of the new or alternative theory of moral hazard. It suggests that containing inefficient moral hazard, and encouraging its desirable

  1. Can Historical Institutionalism Explain the Reforms of the Common Agricultural Policy?

    Directory of Open Access Journals (Sweden)

    Nicoleta Lăşan

    2012-03-01

    Full Text Available Historical institutionalism, one of the three variants of new institutionalism, has been largely employed by scholars to explain the development of one of the first policies developed at the European level, namely the Common Agricultural Policy (CAP. Due to historical institutionalism’s claim that policies tend to follow the path set at their creation, it is not surprising that it could easily account for the development of the CAP before 1990s since this was one of the most resistant policies set by the member states of the European Union. The main challenge for historical institutionalism is to explain the shifts that occurred in this policy due to the reforms agreed after 1990, reforms that are often mentioned in the literature as being crucial. The aim of this paper is to show that historical institutionalism can accommodate the 1992 and 2003 reforms of the Common Agricultural Policy, and from this we can infer that the changes needed to adapt this policy of the EU to the conditions of an ever enlarging Europe will take place slowly, if at all.

  2. Getting what we pay for: innovations lacking in provider payment reform for chronic disease care.

    Science.gov (United States)

    Tynan, Ann; Draper, Debra A

    2008-06-01

    Despite wide recognition that existing physician and hospital payment methods used by health plans and other payers do not foster high-quality and efficient care for people with chronic conditions, little innovation in provider payment strategies is occurring, according to a new study by the Center for Studying Health System Change (HSC) commissioned by the California HealthCare Foundation. This is particularly disconcerting because the nation faces an increasing prevalence of chronic disease, resulting in continued escalation of related health care costs and diminished quality of life for more Americans. To date, most efforts to improve care of patients with chronic conditions have focused on paying vendors, such as disease management firms, to intervene with patients or redesigning care delivery without reforming underlying physician and hospital payment methods. While there is active discussion and anticipation of physician and hospital payment reform, current efforts are limited largely to experimental or small-scale pilot programs. More fundamental payment reform efforts in practice are virtually nonexistent. Existing payment systems, primarily fee for service, encourage a piecemeal approach to care delivery rather than a coordinated approach appropriate for patients with chronic conditions. While there is broad agreement that existing provider payment methods are not well aligned with optimal chronic disease care, there are significant barriers to reforming payment for chronic disease care, including: (1) fragmented care delivery; (2) lack of payment for non-physician providers and services supportive of chronic disease care; (3) potential for revenue reductions for some providers; and (4) lack of a viable reform champion. Absent such reform, however, efforts to improve the quality and efficiency of care for chronically ill patients are likely to be of limited success.

  3. Getting what we pay for: innovations lacking in provider payment reform for chronic disease care.

    Science.gov (United States)

    Tynan, Ann; Draper, Debra A

    2008-06-01

    Despite wide recognition that existing physician and hospital payment methods used by health plans and other payers do not foster high-quality and efficient care for people with chronic conditions, little innovation in provider payment strategies is occurring, according to a new study by the Center for Studying Health System Change (HSC) commissioned by the California HealthCare Foundation. This is particularly disconcerting because the nation faces an increasing prevalence of chronic disease, resulting in continued escalation of related health care costs and diminished quality of life for more Americans. To date, most efforts to improve care of patients with chronic conditions have focused on paying vendors, such as disease management firms, to intervene with patients or redesigning care delivery without reforming underlying physician and hospital payment methods. While there is active discussion and anticipation of physician and hospital payment reform, current efforts are limited largely to experimental or small-scale pilot programs. More fundamental payment reform efforts in practice are virtually nonexistent. Existing payment systems, primarily fee for service, encourage a piecemeal approach to care delivery rather than a coordinated approach appropriate for patients with chronic conditions. While there is broad agreement that existing provider payment methods are not well aligned with optimal chronic disease care, there are significant barriers to reforming payment for chronic disease care, including: (1) fragmented care delivery; (2) lack of payment for non-physician providers and services supportive of chronic disease care; (3) potential for revenue reductions for some providers; and (4) lack of a viable reform champion. Absent such reform, however, efforts to improve the quality and efficiency of care for chronically ill patients are likely to be of limited success. PMID:18630402

  4. Health Care Policies for Children in Out-of-Home Care.

    Science.gov (United States)

    Risley-Curtiss, Christina; Kronenfeld, Jennie Jacobs

    2001-01-01

    Examined health care policies and services for children under 46 state welfare agencies. Found that most states had written policies regarding health care for foster children, but half had no management system to record health care data. Most states did not meet standards set by the Child Welfare League of America for health care of these…

  5. Neoliberalism, Policy Reforms and Higher Education in Bangladesh

    Science.gov (United States)

    Kabir, Ariful Haq

    2013-01-01

    Bangladesh has introduced neoliberal policies since the 1970s. Military regimes, since the dramatic political changes in 1975, accelerated the process. A succession of military rulers made rigorous changes in policy-making in various sectors. This article uses a critical approach to document analysis and examines the perceptions of key…

  6. Negotiating care in the context of Finnish and Italian elder care policies

    OpenAIRE

    Zechner, Minna; Valokivi, Heli

    2012-01-01

    Negotiation is an integral part of all elder care, which by definition involves a relation between at least two people. In this article we analyse negotiations concerning elder care in the context of Finnish and Italian elder care policies. At the macro level negotiations on elder care are shaped by elder care policies and at the micro level by individual skills and resources. Our focus is on the negotiations on eligibility that take place when elders attempt to access care. The data consist ...

  7. Effects of EU dairy policy reform for Dutch dairy farming : a primal approach using GMM estimation

    NARCIS (Netherlands)

    Ooms, D.L.; Peerlings, J.H.M.

    2005-01-01

    This paper estimates a production function for milk using a generalised method of moments estimator to avoid the endogeneity problem. Using the first-order conditions for profit maximisation, the economic effects for individual Dutch dairy farms of the 2003 EU dairy policy reform are analysed. With

  8. Tensions between Teaching Sexuality Education and Neoliberal Policy Reform in Quebec's Professional Competencies for Beginning Teachers

    Science.gov (United States)

    Parker, Dan; McGray. Robert

    2015-01-01

    This research draws into question the effects that neoliberal policy reforms--with an emphasis on individual and measurable "competencies"--has on new teachers teaching sexuality education in Quebec. While we examine professional competencies that teachers can use to define their mandate for teaching sexuality education as a beginning…

  9. Bearing the Cost: An Examination of the Gendered Impacts of Water Policy Reform in Malawi

    Science.gov (United States)

    Marra, Simona

    2008-01-01

    Water insecurity is one of the most pressing issues currently faced by Malawi. The consequences of these issues are borne significantly by women, who are most directly involved with water provision and use, particularly at the household level. Since the mid-1990s, Malawi has undertaken a process of water policy reform. Reflective of international…

  10. Policies lost in translation? Unravelling water reform processes in African waterscapes

    NARCIS (Netherlands)

    Kemerink-Seyoum, J.S.

    2015-01-01

    Since the 1980s a major change took place in public policies for water resources management. The role of governments shifted under this reform process from an emphasis on investment in the development, operation and maintenance of water infrastructure to a focus on managing water resources systems b

  11. Promoting Educational Reforms in Weak States: The Case of Radical Policy Discontinuity in Peru

    Science.gov (United States)

    Balarin, Maria

    2008-01-01

    The present article explores the making of education policies in weak states, particularly in the context of developing nations and in view of the increasing influence of international organisations, such as the World Bank, in definition of education reform agendas. The discussion seeks to contribute to the theory of weak states by highlighting…

  12. Market Accountability in Schools: Policy Reforms in England, Germany, France and Italy

    Science.gov (United States)

    Mattei, Paola

    2012-01-01

    This article concentrates on the policy reforms of schools in England, Germany, France and Italy, from 1988 to 2009, with a focus on the introduction of market accountability. Pressing demands for organisational change in schools, shaped by the objectives of "efficiency" and competition, which were introduced in England in the 1980s, have been…

  13. Effects of agricultural policy reforms and farm characteristics on income risks in Swiss agriculture

    NARCIS (Netherlands)

    Benni, El N.; Finger, R.

    2012-01-01

    Purpose – The purpose of this study is to examine the effects of agricultural policy reform – specifically the change from market to direct payment support – on income variability of Swiss farming households. In addition, the observed heterogeneity in income risks across farms and time is explained

  14. Policy and finance for preconception care opportunities for today and the future.

    Science.gov (United States)

    Johnson, Kay; Atrash, Hani; Johnson, Alison

    2008-01-01

    This special supplement of Women's Health Issues offers 2 types of articles related to the policy and finance context for improving preconception health and health care. These articles discuss the impact of finance and policy on preconception health and health care, as well as the strategies that are being used to overcome the challenge of implementing preconception care with limited resources and inadequate health coverage for women. Invited papers from authors with expertise in health policy and finance issues describe how women's health and preconception care fit into the larger debates on health reform and how the paradigm for women's health must change. Other invited papers discuss opportunities and challenges for using programs such as Medicaid, Title X Family Planning, Title V Maternal and Child Health Services Block Grant, Healthy Start, and Community Health Centers in improving preconception health and health care. Contributed articles on health services research in this supplement characterize the types of change occurring across the country. This paper also presents a framework for understanding the role of policy and finance in the larger Centers for Disease Control and Prevention Preconception Health and Health Care Initiative.

  15. Power sector reform in Africa: Policy guidelines for the sustainability of the sector. Chapter 3

    International Nuclear Information System (INIS)

    Since more than a decade and half, a number of African countries have embarked on implementing power sector reform programmes in a bid to address the deficiencies in the management and operations of their power utilities. The rationale for power sector reforms was to: (i) improve the technical, commercial and financial performance of utilities; (ii) boost sector cash flow and enhance utilities' creditworthiness; (iii) facilitate mobilization of resources for capital investment on a commercial basis, thereby releasing public funds for other investments; and (iv) extend access to electricity to poor and rural communities. However, one of the most critical drivers for power sector reform, which is linked to lack of capital to expand and rehabilitate existing systems, is probably pressure from the development finance institutions including the World Bank. Most African countries have thus decided to embark on reforming their power sectors following the announcement of the 1993 World Bank's Electric Power Lending Policy calling developing countries to demonstrate a clear indication to implement comprehensive power sector reform programmes as a precondition of the Bank's continued assistance in the sector. Under this Bank's new policy, developing countries were invited to: - Establish transparent regulatory processes; - Commercialize and corporatize the power enterprises; - Allow for importation of power services in some cases; and - Encourage private investment in the power sector. As a follow-up to its new electric power lending policy, the World Bank Energy Sector Management Assistance Programme (ESMAP) organized a symposium on 'Power Sector Reform and Efficiency Improvement in sub-Saharan Africa' in Johannesburg, South Africa, in December 1995 with a view to addressing the problem of inefficiencies in operations and management of the power utilities. The purpose of the symposium was to provide an open forum in which high-level decision-makers in the Ministries of

  16. [Gender equity in health sector reform policies in Latin America and the Caribbean].

    Science.gov (United States)

    Gómez, Elsa Gómez

    2002-01-01

    Gender equity is increasingly being acknowledged as an essential aspect of sustainable development and more specifically, of health development. The Pan American Health Organization's Program for Women, Health, and Development has been piloting for a year now a project known as Equidad de género en las políticas de reforma del sector de salud, whose objective is to promote gender equity in the health sector reform efforts in the Region. The first stage of the project is being conducted in Chile and Peru, along with some activities throughout the Region. The core of the project is the production and use of information as a tool for introducing changes geared toward achieving greater gender equity in health, particularly in connection with malefemale disparities that are unnecessary, avoidable, and unfair in health status, access to health care, and participation in decision-making within the health system. We expect that in three years the project will have brought about changes in the production of information and knowledge, advocacy, and information dissemination, as well as in the development, appropriation, and identification of intersectoral mechanisms that will make it possible for key figures in government and civil society to work together in setting and surveying policy on gender equity in health.

  17. The future of global sugar markets: Policies, reforms, and impact

    OpenAIRE

    Bureau, Jean-Christophe; Gohin, Alexandre; Guindé, Loïc; Millet, Guy; Brandão, Antônio Salazar P.; Haley, Stephen; Wagner, Owen; Orden, David; Sandrey, Ron; Vink, Nick

    2008-01-01

    "Sugar is one of the most highly protected agricultural commodities worldwide. This protection depresses trade opportunities and the prices received by exporters without preferential market access. For this reason, dialogues about sugar policy are often polarized and short sound bites caustic. Yet today's sugar markets are being driven by a complex array of dynamic and emerging supply, demand, and policy forces that need to be understood. A number of these forces have the potential to reshape...

  18. How to reform the health care system given the experience of past failures.

    Science.gov (United States)

    Longo, Daniel R; Cox, Ryan R

    2002-01-01

    There have been a number of attempts at a large-scale reform of the US health care system during the 20th century and all have failed. Problems continue to exist, however, in the organization, delivery, and financing of health care services. Under current economic conditions, the possibility for both reform and recovery is slim if at all. In this article, we discusses a realistic option to incremental reform that takes a more realistic view of the US social and economic situation of the 21st century and is more consistent with basic US values. Perhaps it is time for reformers to take such a pragmatic approach to this long-term problem. PMID:12462654

  19. On the choice of farm management practices after the reform of the Common Agricultural Policy in 2003.

    Science.gov (United States)

    Schmid, Erwin; Sinabell, Franz

    2007-02-01

    The Common Agricultural Policy (CAP) was fundamentally reformed in 2003. From 2005, farmers will receive decoupled income support payments instead of production premiums if basic standards for environment, food safety, animal health and welfare are met. Farmers are likely to adjust production and management practices to the new policy framework. We describe how this reform fits into the EU strategy of making agricultural production more environmentally friendly by concentrating on the financial aspects of the reforms. Using an agricultural sector model for Austria, we show that the reform will further decrease agricultural outputs, reduce farm inputs, lessen nitrogen surpluses and make environmentally friendly management practices more attractive for farmers.

  20. Optimum temperature policy for sorption enhanced steam methane reforming process for hydrogen production

    Energy Technology Data Exchange (ETDEWEB)

    Retnamma, Rajasree [National Laboratory of energy and Geology (LNEG), Lisbon (PT). Energy Systems Modeling and Optimization Unit (UMOSE); Ravi Kumar, V.; Kulkarni, B.D. [National Chemical Laboratory, Pune (India). Chemical Engineering and Process Development

    2010-07-01

    Sorption enhanced steam methane reforming (SE-SMR) process offers high potential for producing H{sub 2} in fuel cell applications compared to conventional catalytic steam methane reforming (SMR) process. The reactor temperature can significantly affect the performance of the SE-SMR reaction and simultaneous adsorption behavior of CO{sub 2}. Determination of an optimal temperature policy in SE-SMR reactor is therefore an important optimization issue. Multi-stage operation is a possible way to implement optimum temperature policies. In the present work, simulation study has been carried out for multi-stage operation using a mathematical model incorporating basic mechanisms operating in a fixed bed reactor with nonlinear reaction kinetic features of an SE-SMR process. Three cases were considered for implementing the multi-stage concept and the results show that increase in temperature based on a policy leads to considerable improvement in the process performance. (orig.)

  1. Cannabis policy reforms in the Americas: a comparative analysis of Colorado, Washington, and Uruguay.

    Science.gov (United States)

    Pardo, Bryce

    2014-07-01

    Legal reforms in the Americas are influencing the public debate on cannabis policy. Uruguay and the two US states of Colorado and Washington have taken steps to regulate and legitimize the production, distribution, and use of cannabis and its derivatives. Earlier experiences with medical cannabis in the United States and limited access and production models in Europe have been insightful. However, these reforms are going further still, venturing into a new area of cannabis policy. A lack of empirical evidence regarding the effects of such reforms poses a challenge for policymakers. These examples will inform the design and implementation of any future cannabis policies. Therefore, a clear understanding of the details of each jurisdiction is necessary in developing future legal changes. Literature comparing the models of Uruguay, Colorado, and Washington is thin. This paper is based on an exhaustive examination of the laws, regulations, and discussions with regulators and functionaries of each jurisdiction. The research and analysis herein will provide policymakers with a greater understanding of the laws and regulations relevant to legal cannabis in these three jurisdictions, as well as draw to their attention some potential impacts and challenges of cannabis reform that require additional consideration to ensure public safety and health.

  2. Reform and Transitional Adjustment of the Health Care System in Slovenia

    OpenAIRE

    Petra Došenović; Maks Tajnikar

    2005-01-01

    In the paper the authors analyse some unresolved issues regarding the health care reform that is under way in the Republic of Slovenia. They believe the reform is necessary due to the problems that have accumulated. So far the transition processes have not been undertaken in a systematic way by the public sector. With this in mind, the authors discuss the problems of compulsory and voluntary insurance, and the goals that can be achieved by enforcing the role of voluntary health insurance. The...

  3. Nursing education reform in South Africa – lessons from a policy analysis study

    Directory of Open Access Journals (Sweden)

    Duane Blaauw

    2014-12-01

    Full Text Available Background: Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. Objective: We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. Design: We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. Results: The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. Conclusions: The study found significant weaknesses in the policy capacity of the main institutions

  4. Nursing education reform in South Africa – lessons from a policy analysis study

    Science.gov (United States)

    Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C.

    2014-01-01

    Background Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. Objective We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. Design We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. Results The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. Conclusions The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and

  5. [Health care reform in the Obama administration: difficulties of reaching a similar agreement in Argentina].

    Science.gov (United States)

    Belmartino, Susana

    2014-04-01

    This article presents a comparative analysis of the processes leading to health care reform in Argentina and in the USA. The core of the analysis centers on the ideological references utilized by advocates of the reform and the decision-making processes that support or undercut such proposals. The analysis begins with a historical summary of the issue in each country. The political process that led to the sanction of the Obama reform is then described. The text defends a hypothesis aiming to show that deficiencies in the institutional capacities of Argentina's decision-making bodies are a severe obstacle to attaining substantial changes in this area within the country.

  6. Managed care contracting and payment reform: avoiding a showdown.

    Science.gov (United States)

    Nugent, Michael E

    2010-07-01

    Health reform promises to fundamentally change what and how CMS and commercial payers reimburse providers. Providers need to transition from their traditionally adversarial, transactions-based payer relationships to ones that optimize purchaser and patient value for the dollar. To avoid negotiation table showdowns and to prepare for reform, commercial payers and providers should take three actions: Recognize the dead ends with their historical relationships. Formulate their road map to value-based contracting. Avoid operational pot-holes along the way. PMID:20608414

  7. The scope for policy reforms in rural microfinance

    OpenAIRE

    Sharma, Manohar

    2000-01-01

    This brief considers the scope for policy action in seven areas: (1) regulation of microfinance institutions, (2) provision of saving services, (3) product innovation, (4) organizational issues in microfinance, (5) poverty impact of microfinance, (6) agricultural finance, and (7) subsidy and sustainability issues.

  8. Primary School English Reform in Japan: Policies, Progress and Challenges

    Science.gov (United States)

    Ng, Chin Leong Patrick

    2016-01-01

    In April 2011, the Ministry of Education in Japan formally introduced Primary School English (PSE) language teaching in Japanese elementary schools. The PSE policy made it mandatory for fourth- and fifth-graders to attend English lessons once a week. Using the theoretical framework on why educational language plans fail [Kaplan, R. B., Baldauf, R.…

  9. Reformers or Roadblocks: Educational Interest Groups and State Policy Formation

    Science.gov (United States)

    Emerson, Joseph; Lemasters, Linda; Howerton, Everett

    2008-01-01

    Given the overt political nature of this topic, an additional theoretical postulate, the Triadic Theory of Power was also presented as another framework to conceptualize the external and internal forces which shape the formation of contemporary education policy. Predicated upon the scholarship of Nobel laureate James Q. Wilson, Andrew McFarland…

  10. Economic Policies and Reforms in Era of Debt

    Institute of Scientific and Technical Information of China (English)

    Luo Yang

    2010-01-01

    @@ During the financial crisis of the past three years,central banks and governments around the world have adopted of prompt,decisive and innovative measures to settle down the world economy.With these policies,the market conditions tend to improve,though some countries troubled by deficits and structural problems.

  11. Access To Medical Health Care And its Current Health Care Policy: Malaysia

    OpenAIRE

    Chong, Chyi Ming

    2005-01-01

    The indications of Malaysia government to remove its subsidize policy in its health care system and privatizing certain hospitals and health care services has inflicted numerous heated debates and discussions among individuals and Non-Governmental Organizations (NGO). The author wishes to contribute some insightful information to the public through her research about Malaysia citizen’s access to medical health care inline with its current health care system and policy. Health care systems of ...

  12. COMMON AGRICULTURAL POLICY FROM HEALTH CHECK DECISIONS TO THE POST-2013 REFORM

    Directory of Open Access Journals (Sweden)

    Niculescu Oana Marilena

    2011-07-01

    Full Text Available The paper proposed for being presented belongs to the field research International Affairs and European Integration. The paper entitled Common Agricultural Policy from Health Check decisions to the post-2013 reform aims to analyze the Common Agricultural Policy (CAP from the Health Check adoption in November 2008 to a new reform post-2013. The objectives of the paper are the presentation of the Health Check with its advantages and disadvantages as well as the analysis of the opportunity of a new European policy and its reforming having in view that the analysis of Health Check condition was considered a compromise. The paper is related to the internal and international research consisting in several books, studies, documents that analyze the particularities of the most debated, controversial and reformed EU policy. A personal study is represented by the first report within the PhD paper called The reform of CAP and its implications for Romanias agriculture(coordinator prof. Gheorghe Hurduzeu PhD, Academy of Economic Studies Bucharest, Faculty of International Business, research studies in the period 2009-2012. The research methodology used consists in collecting and analysis data from national and international publications, their validation, followed by a dissemination of the results in order to express a personal opinion regarding CAP and its reform. The results of the research consist in proving the opportunity of a new reform due to the fact that Health Check belongs already to the past. The paper belongs to the field research mentioned, in the attempt to prove the opportunity of building a new EU agricultural policy. The challenges CAP is facing are: food safety, environmental and climate changes, territorial balance as well as new challenges-improving sustainable management of natural resources, maintaining competitiveness in the context of globalization growth, strengthening EU cohesion in rural areas, increasing the support of CAP for

  13. Five un-easy pieces of pharmaceutical policy reform.

    Science.gov (United States)

    Rodwin, Marc A

    2013-01-01

    Improper dependencies slant policy over a drug's life span, biasing the development of new drugs, the testing and marketing approval for new drugs, and the monitoring of patient safety after drugs are marketed. This article examines five ways in which the public improperly depends on pharmaceutical firms that compromise the integrity of pharmaceutical policy. Today the public relies on pharmaceutical firms: (1) to set priorities on drug research and development; (2) to conduct clinical trials to test whether drugs are safe and effective; (3) to decide what clinical trial data to disclose to the public; (4) to monitor post marketing drug safety; (5) to supply product information to physicians and to finance continuing medical education and other professional activities. The article suggests options to overcome each of these dependencies. PMID:24088148

  14. Social policy and entitlements : a proposal for reform

    NARCIS (Netherlands)

    Nentjes, Andries; Meijer, G; Heijman, WJM; VanOphem, JAC; Verstegen, BHJ

    2006-01-01

    Welfare states citizens have entitlements to a variety of social services provided for free or a price far below cost, such as education, health care, social security and housing. Every citizen benefits, but in their present organisation the social services also have major deficiencies: lack of choi

  15. Rehabilitation, Research, and Reform: Prison Policy in Ireland

    OpenAIRE

    Rogan, Mary

    2012-01-01

    The paper tracks the concept of rehabilitation within official thinking in Ireland since the foundation of the State. It explores when and how the term was first used and how it has fared since. It then examines barriers to and the role of research in the making of prison policy and comments on data deficits in the system at present. Finally it looks at the role of interest groups within the criminal justice system in Ireland, and specifically their effect, or potential effect,...

  16. Multilateral Trade and Agricultural Policy Reforms in Sugar Markets

    OpenAIRE

    Amani Elobeid; John C. Beghin

    2004-01-01

    We analyze the removal of current market interventions in world sugar markets using a partial-equilibrium international sugar model calibrated on 2002 market data and current policies. We analyze the impact of trade liberalization and the removal of production subsidies and consumption distortions. The removal of trade distortions alone induces a 27 percent price increase by the end of the decade relative to the baseline level for sugar. The removal of all trade and production distortions ind...

  17. Institutional Reform:Improving the Effectiveness of Policy Delivery

    OpenAIRE

    Lara, Carlos Icaza; Pezzini, Mario; Villarreal, Roberto; Garcilazo, Enrique; Davies, Andrew

    2009-01-01

    The characteristics, assets and economic performance of Chile’s regions are particularly diverse, and their potential for growth will largely depend on how public policies are adapted to their diversity and integrate their different synergies, attributes and assets. Enhancing the productivity and competitiveness of specific regions and sectors requires agile, responsive institutional arrangements that can make targeted efforts to improve the quality of specific public investments and servi...

  18. Should the EU climate policy framework be reformed?

    Directory of Open Access Journals (Sweden)

    David ELLISON

    2011-12-01

    Full Text Available Though to-date the European Union (EU has played the most significant leadership role in international negotiations to reduce greenhouse gas (GHG emissions, the emission-reducing performance of individual EU Member states has for many been less than stellar. Several EU15 Member states continue to raise rather than lower emissions. Analysing the most successful policy instruments, this paper argues EU policy efforts could benefit from three important innovations. The following strategies – the adoption of an EU-wide FIT (feed-in tariff, an EU-wide carbon tax and more flexibility in the trading of carbon credits – could significantly improve emission reductions, their relative cost-efficiency and spread burden-sharing more evenly across technologies and Member states. This raises important questions, both about the effectiveness of EU and Kyoto-style commitments, as well as the EU Emission Trading Scheme (ETS. The commitment strategy, and in particular the EU ETS mechanism, have had the smallest impact on emission reductions. The proposed set of strategies could make a far greater contribution to future EU efforts and potentially lock in the impressive progress already made. Such a policy shift, if successful, would also greatly enhance the EU’s already significant credibility and bargaining power in international climate negotiations.

  19. Teacher education policies, practices, and reform in Scotland: Implications in the Indian context

    Directory of Open Access Journals (Sweden)

    Pradeep Kumar Misra

    2015-12-01

    Full Text Available India, a country of 1.27 billion, nowadays needs reforms, improvements, and new approaches in teacher education to cater to the demands of changing economy and society. This call to improve teacher education becomes more significant considering the fact that 50% of India’s current population is below the age of 25 and over 65% below 35. There are two ways to proceed in this direction. First, making an internal review and assessment of present scenario of teacher education and suggesting need-based measures. The second one is to learn from those countries that have recently reviewed their teacher education systems and are continuously working for the betterment of teacher education. Following second approach, present paper analyzes teacher education policies, practices, and reform in Scotland, argues that concerns and commitments to reform teacher education in India and Scotland are similar, and suggests implications of Scottish experiences in the Indian context.

  20. Kosovo : Health Financing Reform Study

    OpenAIRE

    World Bank

    2008-01-01

    The objective of this report is to present information on the different health financing reform options available to Kosovo, which can help the government to make informed policy decisions about financing reforms. The report focuses on the key insurance functions of revenue collection and management, risk pooling, and purchasing of health care, as well as the supportive regulatory and gove...

  1. Risks and Opportunities of Reforms Putting Primary Care in the Driver’s Seat

    Science.gov (United States)

    Andersson Bäck, Monica

    2016-01-01

    Recognizing the advantages of primary care as a means of improving the entire health system, this text comments on reforms of publicly funded primary health centers, and the rapid development of private for-profit providers in Sweden. Many goals and expectations are connected to such reforms, which equally require critical analyses of scarce resources, professional trust/motivation and business logic in the wake of freedom and control of ownership and management. In line with Saltman and Duran, this article calls for research and a methodologically developed approach to capture everyday practice in-depth and how regulation, market incentives and patient demands are met by professionals and primary care leaders.

  2. Impact of structural reforms on planning systems and policies

    DEFF Research Database (Denmark)

    Galland, Daniel; Enemark, Stig

    2013-01-01

    limited strategic reasoning and geographical thinking in addressing the potential physical structure of and functional relationships within the national territory. At the same time, the planning system seems to display narrower measures of spatial coherence in terms of horizontal and vertical coordination......This paper argues that a planning system that allows its policies and practices to gradually lose spatial reflection and spatial coordination capacities within and across different levels of planning administration is less likely to make national and regional plans matter or to have a say in future...

  3. Primary care in Ontario, Canada: New proposals after 15 years of reform.

    Science.gov (United States)

    Marchildon, Gregory P; Hutchison, Brian

    2016-07-01

    Primary care has proven to be extremely difficult to reform in Canada because of the original social compact between the state and physicians that led to the introduction of universal medical care insurance in the 1960s. However, in the past decade, the provincial government of Ontario has led the way in Canada in funding a suite of primary care practice models, some of which differ substantially from traditional solo and group physician practices based on fee-for-service payment. Independent evaluations show some positive improvements in patient care. Nonetheless, the Ontario government's large investment in the reform combined with high expectations concerning improved performance and the deteriorating fiscal position of the province's finances have led to major conflict with organized medicine over physician budgets and the government's consideration of an even more radical restructuring of the system of primary care in the province. PMID:27160481

  4. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Dragoi Mihaela Cristina

    2011-12-01

    Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

  5. EU rural policy reform (1997-1999): between politics and policy learning

    DEFF Research Database (Denmark)

    Steffensen, Jonny Trapp

    2006-01-01

    EU rural development policy is gaining in relative significance as the "second pillar" of the Common Agricultural Policy (CAP). Its substance - objectives and instruments - is still under development. This article explores the contribution of so-called "policy learning" by the European Commission...... to the 1997-1999 revision of EU rural development policy...

  6. The crisis as catalyst for reframing health care policies in the European Union.

    Science.gov (United States)

    Helderman, Jan-Kees

    2015-01-01

    Seen from the perspective of health, the global financial crisis (GFC) may be conceived of as an exogenous factor that has undermined the fiscal sustainability of European welfare states and consequently, their (expanding) health systems as well. Being one of the core programs of European welfare states, health care has always belonged to the sovereignty of European Member States. However, in past two decades, European welfare states have in fact become semi-sovereign states and the European Union (EU) no longer is an exogenous actor in European health policy making. Today, the EU not only puts limits to unsustainable growth levels in health care spending, it also acts as an health policy agenda setter. Since the outbreak of the GFC, it does so in an increasingly coercive and persuasive way, claiming authority over health system reforms alongside the responsibilities of its Member States. PMID:25662196

  7. Reforming minute reserve policy in Germany: A step towards efficient markets?

    International Nuclear Information System (INIS)

    The present paper provides an empirical assessment of the effects associated with the reorganization of minute reserve markets in Germany. As the aim of the regulator is to assure a competitive market with transparent pricing, we analyze whether the recent policy reform has had an impact on the dynamics of minute reserve prices. Our results show that the level and volatility of positive and negative minute reserve prices decreased substantially. Furthermore, we provide evidence that the degree of integration between reserve and spot markets has increased. Overall, prices reacted to the policy change in a manner that is in line with the regulator's objective. The reform can thus be viewed as a step towards an efficient reserve market.

  8. Policy Imperative, Management Challenge: A Case Study in College of Education Reform from Kwara State in Nigeria

    Science.gov (United States)

    Thomas, Harold G.

    2012-01-01

    In 2007, Kwara State in Nigeria embarked on a process of college of education reform. This article explores the strategic and managerial issues associated with that process. It sets out the policy imperative for reform within the context of an urgent need to improve the quality of education in Nigeria and traces progress over a four year period,…

  9. Changing emphases in public health and medical education in health care reform.

    Science.gov (United States)

    Patrick, Walter K; Cadman, Edwin C

    2002-01-01

    Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research and designer drugs have dramatically changed medical practice. Creatively, educational institutions have adopted the use of: (1) New educational and communication technologies: internet and health informatics; (2) Problem based learning approaches; Integrated Practice and Theory Curricula; Research and Problem Solving methodologies and (3) Partnership and networking of institutions to synergise new trends (e.g. core competencies). Less desirably, changes are inadequate in key areas, e.g., Health Economics, Poverty and Health Development, Disaster Management & Bioterrorism and Ethics. Institutions have begun to adjust and develop new programs of study to meet challenges of emerging diseases, design methodologies to better understand complex social and economic determinants of disease, assess the effects of violence and address cost containment strategies in health. Besides redesigning instruction, professional schools need to conduct research to assess the impact of health reform. Such studies will serve as sentinels for the public's health, and provide key indicators for improvements in training, service provision and policy. PMID:12597516

  10. Evaluating the Impacts of Competition Policy Reforms on the Efficiency of Philippine Commercial Banks

    OpenAIRE

    Manlagñit, Ma. Chelo V.; Lamberte, Mario B.

    2004-01-01

    This paper has attempted to examine the impacts of competition policy reforms on the efficiency of the Philippine commercial banking system. It uses the stochastic frontier approach to come up with estimates of profit efficiency and cost inefficiency measures. The results are quite interesting. First, the average measured profit efficiency is 0.85, implying that on the average the commercial banks are using only 85 percent of their resources efficiently compared to the best practice commercia...

  11. Indigenous Cultural Heritage: Issues of Canadian Law, Policy, and Reform- President's Dream Colloquium

    OpenAIRE

    Catherine Bell

    2014-01-01

    Catherine Bell discusses the Tsilhqot'in ruling (2014), and explores how Canadian Aboriginal rights law and consultation is applied to First Nations heritage sites, the challenges to realizing First Nation ownership and control through Canadian Constitutional Law, the unique issues that arise when heritage sites are located on private land, and the need for legal and policy reform.   Catherine Bell is Professor of Law at the University of Alberta, specializing in Aboriginal leg...

  12. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  13. An Economic Analysis of Deferred Examination System: Evidence from Policy Reforms in Japan

    OpenAIRE

    YAMAUCHI Isamu; NAGAOKA, SADAO

    2014-01-01

    We investigate how a deferred patent examination system promotes ex-ante screening of patent applications, which reduces both the number of granted patents and the use of economic resources for examinations, without reducing the return from R&D. Based on a real option theory, we develop a model of examination request behaviors. Exploiting the responses of Japanese firms to recent policy reform, we find that the shortening of the allowable period for an examination request significantly increa...

  14. The historical context of Land Reform in South Africa and early policies

    OpenAIRE

    Henk J Kloppers; Gerrit J. Pienaar

    2014-01-01

    The need for the current land reform programme arose from the racially discriminatory laws and practices which were in place for the largest part of the twentieth century, especially those related to land ownership. The application of these discriminatory laws and practices resulted in extreme inequalities in relation to land ownership and land use. This article provides an overview of the most prominent legislation which provides the framework for the policy of racially-based territorial seg...

  15. The Relative Value Relevance of Shareholder versus Stakeholder Corporate Governance Disclosure Policy Reforms in South Africa

    OpenAIRE

    Ntim, Collins G; Opong, Kwaku K.; Danbolt, jo

    2012-01-01

    Manuscript Type: EmpiricalResearch Question/Issue: South Africa (SA) has pursued distinctive corporate governance (CG) disclosure policy reforms in the form of the King Reports, which require firms to disclose a set of recommended good CG practices on both shareholders and stakeholders. This paper investigates the effect of the new shareholder and stakeholder CG disclosure rules on firm value, as well as the relative value relevance of disclosing good CG practices on shareholders versus stake...

  16. Smallholder Livelihood Adaptation in the Context of Neoliberal Policy Reforms: A Case of Maize Farmers in Southern Veracruz, Mexico.

    NARCIS (Netherlands)

    Groenewald, S.F.; Berg, van den M.M.

    2012-01-01

    Governments around the world have embraced trade liberalisation as a means of enhancing efficiency to realise economic growth and alleviate poverty. Likewise, the Mexican government implemented neoliberal policy reforms, the NAFTA in particular, to stimulate sustainable development. Using the Mexica

  17. Review: Miller, Michelle Ann (2009, Rebellion and Reform in Indonesia – Jakarta’s Security and Autonomy Policies in Aceh

    Directory of Open Access Journals (Sweden)

    Antje Missbach

    2009-01-01

    Full Text Available Review of the monograph: Miller, Michelle Ann, Rebellion and Reform in Indonesia – Jakarta’s Security and Autonomy Policies in Aceh, London/ New York: Routledge, 2009, ISBN 13: 978-0-415-45467-4, 240 pages.

  18. Impact of the joint-stock reform of commercial banks on the effectiveness of monetary policy in China

    Directory of Open Access Journals (Sweden)

    Fang Xianming

    2016-01-01

    Full Text Available Over the past decade, the Chinese government has conducted the joint-stock reform of state-owned commercial banks. The joint-stock reform improves the marketization level of the ownership structure of commercial banks and consequently leads to impacts on the effectiveness of monetary policy. This paper first presents the impacting mechanisms of the joint-stock reform of commercial banks on the effectiveness of monetary policy and then constructs an empirical model to test those impacts. The empirical results show that the increasing degree of joint-stock reform of commercial banks enhances the effectiveness of expansionary monetary policy but weakens the effectiveness of contractionary monetary policy in China.

  19. Reform,Interaction of Policies,and Economic Growth:Evidence from China's Provincial Panel Data

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhao; LU Ming; YAN Ji

    2006-01-01

    Based on provincial panel data,we tested the effects of openness,denationalization,fiscal reform,and their interactions on Chinese regional economic growth.We found the following:(1) Openness,especially the growth of foreign-direct-investment/gross-domesticproduct ratio,has been important in enhancing China's growth since the mid-1980s,while this effect is not so significant in western China.(2) Fiscal reform is another significant factor for economic growth.If local governments deregulate,higher growth will be obtained.In particular,reducing extrabudget expenditure helps push economic growth,especially in western China.(3) The interaction of economic policies,such as openness,denationalization,and fiscal reform,also plays an essential role in local economic growth.Both for the whole nation and for the eastern area,denationalization does not affect growth independently but expands the effects of deregulation.(4) After controlling economic policies and their interactions,conditional convergence exists.(5) With other factors controlled,eastern China achieved higher growth,while the middle and western areas did not differ significantly in growth.(6) Western China,where policy variables have lower explanatory power for growth,has a growth pattern different from those of the eastern and middle areas.

  20. What is the appropriate counterfactual when estimating effects of multilateral trade policy reform

    DEFF Research Database (Denmark)

    Anderson, Kym; Jensen, Hans Grinsted; Nelgen, Signe;

    2015-01-01

    of the DDA’s possible effects thus requires first modelling the world economy to 2030 and, in that process, projecting what trade-related policies might be by then without a DDA. Typically, modelers assume the counterfactual policy regime to be a ‘business-as-usual’ projection assuming the status quo. Yet we...... by projecting the world economy to 2030 using the Global Trade Analysis Project (GTAP) model with those two alternative policy regimes and then simulating a move to global free trade (the maximum benefit from a multilateral trade reform) in each of those two cases. The welfare effects of removing...... the counterfactual price distortions in 2030 are shown to be much larger in the case where agricultural protection grows endogenously than in the case assuming no policy changes over the projection period. This suggests the traditional way of estimating effects of a multilateral agricultural trade agreement may...

  1. What is the appropriate counterfactual when estimating effects of multilateral trade policy reform

    DEFF Research Database (Denmark)

    Anderson, Kym; Jensen, Hans Grinsted; Nelgen, Signe;

    2016-01-01

    of the DDA’s possible effects thus requires first modelling the world economy to 2030 and, in that process, projecting what trade-related policies might be by then without a DDA. Typically, modelers assume the counterfactual policy regime to be a ‘business-as-usual’ projection assuming the status quo. Yet we...... by projecting the world economy to 2030 using the Global Trade Analysis Project (GTAP) model with those two alternative policy regimes and then simulating a move to global free trade (the maximum benefit from a multilateral trade reform) in each of those two cases. The welfare effects of removing...... the counterfactual price distortions in 2030 are shown to be much larger in the case where agricultural protection grows endogenously than in the case assuming no policy changes over the projection period. This suggests the traditional way of estimating effects of a multilateral agricultural trade agreement may...

  2. Administrative Dimensions of Tax Reform

    OpenAIRE

    Bird, Richard M.

    2003-01-01

    The best tax policy in the world is worth little if it cannot be implemented effectively. Tax policy design in developing countries must therefore take the administrative dimension of taxation carefully into account. What can be done may to a considerable extent determine what is done in any country. This paper discusses the relationship between tax policy and tax administration. When can policy lead administration? When must policy initiatives wait on administrative reform? How exactly can b...

  3. Patients' rights to care under Clinton's Health Security Act: the structure of reform.

    Science.gov (United States)

    Mariner, W K

    1994-08-01

    Like most reform proposals, President Clinton's proposed Health Security Act offers universal access to care but does not significantly alter the nature of patients' legal rights to services. The act would create a system of delegated federal regulation in which the states would act like federal administrative agencies to carry out reform. To achieve uniform, universal coverage, the act would establish a form of mandatory health insurance, with federal law controlling the minimum services to which everyone would be entitled. Because there is no constitutionally protected right to health care and no independent constitutional standard for judging what insurance benefits are appropriate, the federal government would retain considerable freedom to decide what services would and would not be covered. If specific benefits are necessary for patients, they will have to be stated in the legislation that produces reform. PMID:8059899

  4. Incomplete Markets and Imperfect Institutions: Some Challenges Posed by Trust for Contemporary Health Care and Health Policy.

    Science.gov (United States)

    Schlesinger, Mark; Gray, Bradford H

    2016-08-01

    As contemporary health policy promotes evidence-based practices using targeted incentives, policy makers may lose track of vital aspects of care that are difficult to measure. For more than a half century, scholars have recognized that these latter aspects play a crucial role in high-quality care and equitable health system performance but depend on the potentially frail reed of providers' trustworthiness: that is, their commitment to facets and outcomes of care not easily assessed by external parties. More recently, early experience with pay for performance in health settings suggests that enhancing financial rewards for the measurable undermines providers' commitment to the unmeasurable, degrading the trustworthiness of their practices. Reformers have looked to revised professional norms or reorganized practice arrangements to bolster the intrinsic motivations required for trustworthiness. We suggest here that these responses are likely to prove inadequate. We propose that they be complemented by a renewed policy-making commitment to nonprofit ownership among health care providers, insurers, and integrated delivery systems. We identify some of the concerns raised in the past with ownership-based policies and propose a set of responses. If these are pursued in combination, they hold the promise of a sustainable ownership-based policy reform for the United States. PMID:27127254

  5. 欧洲卫生服务供给模式的改革%Health care delivery reforms in European countries

    Institute of Scientific and Technical Information of China (English)

    鲁菁; 方红娟; 王小万

    2011-01-01

    基于WHO欧洲委员会"增加财富与增进健康的卫生系统-塔林宪章"的卫生改革框架,卫生服务的供给模式已经成为欧洲卫生改革的重点.本文从卫生服务供给的角度介绍了欧洲国家近年来所实施的改革政策与措施.通过强调转变卫生服务模式,提高卫生系统的反应性,改善卫生服务的质量,加强公共卫生、疾病预防和健康促进,以及加强卫生人力资源建设等关键措施来完善卫生服务供给模式,为我国深化卫生改革提供了可以借鉴和学习的经验.%Based on the health reform framework of WHO European Commission"increasing wealth and the promotion of a healthy health system-Tallinn charter", Health care delivery has been the key point in the European health care reforms. This paper introduced the policies and measures of health care delivery reforms in recent years. European countries have changed their health care models, made health systems more responsive to patients needs; enhanced the quality of care; strengthened public health, disease prevention and health promotion; and invested in human and capital resources to improve health care delivery model. These policies and methods have provided valuable references to our deepening health reformation.

  6. Memphis Business Group on Health: a model for health care reform and cost containment.

    Science.gov (United States)

    Miller, D

    1994-01-01

    A market-driven, community-based, competitive health care model has effectively assisted Memphis employers to achieve their cost containment and health care reform objectives. Members of the Memphis Business Group on Health joined forces and successfully implemented a variety of programs and services that resulted in dramatic cost savings and reform of health care delivery systems. Programs included development of a purchasing alliance for negotiating contracts for hospital, medical, workers' compensation, psychiatric, and substance abuse care and other service and product options. Utilization management programs focused on appropriate consumption of resources and intensive management of critical cases. While increases in per employee costs averaged 14.7 percent per year for five years nationally, members of the Memphis Business Group on Health held their increases to an average of 6 percent per year. PMID:10132786

  7. Economic crisis and counter-reform of universal health care systems: Spanish case

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  8. Economic crisis and counter-reform of universal health care systems: Spanish case

    Directory of Open Access Journals (Sweden)

    Paulo Antônio de Carvalho Fortes

    2015-01-01

    Full Text Available The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities.

  9. Economic crisis and counter-reform of universal health care systems: Spanish case.

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  10. The second pillar of the CAP: the role of Commission policy learning in the creation and reform of EU rural development policy (1968-1999)

    DEFF Research Database (Denmark)

    Steffensen, Jonny Trapp

    This thesis examines the concept of 'policy learning' and explores its applicability to the European Commission's role in EU policymaking. Policy learning refers to 'knowledge-based' policy formulation, where content of policy proposals is shaped to a 'non-trivial' extent by administrative experi....... Whilst policy learning was not found to be a primary driver of CAP reform it was significant in shaping the rural policy alternative, now the second pillar of the CAP....... reform of EU rural development policy (1997-1999). The central finding is that policy learning plays a highly significant - and largely overlooked - role in determining the contents of Commission proposals. This finding offers an important corrective to interest centred accounts of policymaking in the EU...

  11. ICT Policy Planning in a Context of Curriculum Reform: Disentanglement of ICT Policy Domains and Artifacts

    Science.gov (United States)

    Vanderlinde, Ruben; van Braak, Johan; Dexter, Sara

    2012-01-01

    Researchers and policy makers around the world are increasingly acknowledging the importance of developing a school-based ICT policy plan to facilitate the integration of information and communication technology (ICT) in education. Despite this interest, not much is known about how schools can develop their local ICT policy capacity and how to…

  12. Managing Medical Costs by Reducing Demand for Services: The Missing Element in Health Care Reform.

    Science.gov (United States)

    Kelly, Edward K.; And Others

    1994-01-01

    It is argued that higher education institutions can play a major role in health care reform by providing campus cultures that foster healthy lifestyle choices and in turn reduce medical costs. Specific issues discussed include elimination of unnecessary tests, focus on special high-risk populations, and use of advance directives. (MSE)

  13. Hospital Systems, Convenient Care Strategies, and Healthcare Reform.

    Science.gov (United States)

    Kaissi, Amer; Shay, Patrick; Roscoe, Christina

    2016-01-01

    Retail clinics (RCs) and urgent care centers (UCCs) are convenient care models that emerged on the healthcare scene in the past 10 to 15 years. Characterized as disruptive innovations, these models of healthcare delivery seem to follow a slightly different path from each other. Hospital systems, the very organizations that were originally threatened by convenient care models, are developing them and partnering with existing models. We posit that legislative changes such as the Affordable Care Act created challenges for hospital systems that accelerated their adoption of these models. In this study, we analyze 117 hospital systems in six states and report on their convenient care strategies. Our data suggest that UCCs are more prevalent than RCs among hospital systems, and that large and unexplained state-by-state variations exist in the adoption of these strategies. We also postulate about the future role of hospital systems in leading these innovations. PMID:27111934

  14. Child protection and out of home care: Policy, practice, and research connectionsAustralia and New Zealand

    Directory of Open Access Journals (Sweden)

    2014-03-01

    Full Text Available This article provides an outline of the early development of care and protection in Australia and New Zealand as a backdrop to an overview of child protection systems and policies and the current childprotection profile in both countries. Key issues that have become the focus of policy reform are canvassed and legislative and policy initiatives to promote child safety as well as strengthen families are elaborated. An overview of trends in relation to out of home care, including routes into care, care arrangements and permanency policies is provided. The article profiles selected research studies from Australia focusing on outcomes of care: stability of care, mental health and educational outcomes of looked after children, abuse in care, and routes out of care through reunification and aging out. Other issues treated are the overrepresentation of indigenous children in care systems in both countries and the challenges of maintaining cultural connections. The article concludes with a brief comparative analysis identifying similarities and differences in child welfare systems in both countries.

  15. 政策制定中多源流因素交互作用机制及其动态不稳定性——美国新一轮医疗卫生改革的经验%The Interaction Mechanism of the Multiple Streams of Factors in Policy-Making and Its Dynamic Instability Experiences from the New Round of Health Care Reform in the USA

    Institute of Scientific and Technical Information of China (English)

    赵德余

    2012-01-01

    "医改"对于一些国家而言既是对公民权利问题的回应,又是治理社会危机问题的一种政治努力。就权利而言,那些缺乏医疗卫生保险的公民是否应该得到政府的帮助而享有一定的社会保障权?从危机的视角来看,社会医疗卫生总费用的不断膨胀,无论是个人、社会保险机构,还是政府都已面临严重的支出负担压力。一旦个人无法支付医疗卫生费用,医疗保险机构与政府由此造成的入不敷出以及财务赤字严重到一定程度之后,社会性的医疗危机就爆发了。因此,医改就其性质而言,可以被视为如何通过政策制定的政治过程,以实现医疗卫生总费用的控制和公民权利保障的双重目标。%Health care reforms are not only a response to the issues of civil rights for some countries, but also a political effort to control the problem of a social crisis. With regard to civil rights, should citizens who lack health insurance get help from the government and enjoy certain social security rights? With regard to the social crisis, due to increases in total health costs, individuals, social insurance agencies and governments all face in- creased pressure to take on greater expenses. Once individuals can no longer afford health care and social insurance agencies and governments can not make ends meet and their financial deficits reach a certain level, a social health care crisis will ensue. Therefore, in terms of health care reforms, the question is how to use the political process of policy making to achieve the goals of controlling health care costs and protecting civil rights.

  16. Rural health care in Vietnam and China: conflict between market reforms and social need.

    Science.gov (United States)

    Huong, Dang Boi; Phuong, Nguyen Khanh; Bales, Sarah; Jiaying, Chen; Lucas, Henry; Segall, Malcolm

    2007-01-01

    China and Vietnam have adopted market reforms in the health sector in the context of market economic reforms. Vietnam has developed a large private health sector, while in China commercialization has occurred mainly in the formal public sector, where user fees are now the main source of facility finance. As a result, the integrity of China's planned health service has been disrupted, especially in poor rural areas. In Vietnam the government has been an important financer of public health facilities and the pre-reform health service is largely intact, although user fees finance an increasing share of facility expenditure. Over-servicing of patients to generate revenue occurs in both countries, but more seriously in China. In both countries government health expenditure has declined as a share of total health expenditure and total government expenditure, while out-of-pocket health spending has become the main form of health finance. This has particularly affected the rural poor, deterring them from accessing health care. Assistance for the poor to meet public-sector user fees is more beneficial and widespread in Vietnam than China. China is now criticizing the degree of commercialization of its health system and considers its health reforms "basically unsuccessful." Market reforms that stimulate growth in the economy are not appropriate to reform of social sectors such as health.

  17. Situational analysis of the health insurance market and related educational needs in the era of health care reform in Thailand.

    Science.gov (United States)

    Sriratanaban, J; Supapong, S; Kamolratanakul, P; Tatiyakawee, K; Srithamrongsawat, S

    2000-12-01

    The purposes of this study were to explore the situation of health insurance in Thailand, to compare public and private perspectives and to identify related educational needs. Between March and April of 1998, the study employed in-depth interviews of 12 public and private major stakeholders of the health insurance systems, including policy makers, providers and insurers. Additional inputs were gathered in a brainstorming session with 41 participants from organizations with important roles in regulating, monitoring, paying, or providing health care services, as well as research and education. The findings indicated the health insurance market was expanding. But there was no national policy on health insurance. Insurance-related law was outdated. Public and private schemes overlapped, and were generally characterized by inadequate risk diversification, overutilization of services, lack of effective cost containment, inconsistent service quality, and poor understanding of health insurance principles. There were needs for more education and training in various aspects of health services management and health-insurance related functions. Consequently, continuing education and training related to health insurance services for policy makers, system administrators, managers, providers and insurers are strongly recommended during the health-care reform process. PMID:11253889

  18. Farmers' preferences for water policy reforms: Results from a survey in Alberta

    Science.gov (United States)

    Zhang, W.; Bjornlund, H.; Klein, K.

    2012-12-01

    Facing increasingly urgent stress on global water scarcity, many reforms have been launched in countries around the world. As the biggest group of natural resource managers, farmers' behaviour is drawing increasingly wide attention. Satisfying new demands for water will depend on farmers' support since, generally, water will need to be transferred from farmers who have historically secure rights. Although water pricing reform is widely considered to lead to water conservation, the uncertainty of its potential impacts hinders the process of reform. This farmer-level empirical research explores farmers' possible responses to introduction of reforms in water pricing. A survey was conducted of about 300 farm households that use water for irrigating crops in Southern Alberta, an area that is facing water shortages and has had to stop issuing new water licences. By using structural equation modelling, the strength and direction of direct and indirect relationships between external, internal and behavioural variables as proposed in general attitude theory have been estimated. Farming as a family engagement, family members' and family unit's characteristics doubtlessly affect farming practice and farm decisions. Farmers' behaviour was explored under the family and farm context. In developing and testing conceptual models that integrate socio-demographic, psychological, farming context and social milieu factors, we may develop a deeper understanding of farmers' behaviour. The findings and recommendations will be beneficial for environmental practitioners and policy makers.

  19. Examining the streams of a retention policy to understand the politics of high-stakes reform.

    Directory of Open Access Journals (Sweden)

    Christopher P. Brown

    2007-04-01

    Full Text Available Using John Kingdon's (2003 multiple streams approach to agenda setting, I analyze how key actors within the state of Wisconsin understood the need to construct and implement the state's No Social Promotion statutes to improve students' academic performance. Policymakers within the state focused their standards-based reforms on the issue of improving students' academic performance through increasing accountability. In doing so, they did not see these high-stakes policies as a form of punishment for those who fail, but rather, as a tool to focus the education establishment on improving the academic skills and knowledge of all their students. Thus, the retained student is not the primary concern of the policymaker, but rather, the retained student demonstrates the state's system of accountability works. Raising the question as to whether those who support or oppose high-stakes policies such as these should focus their efforts on the agenda setting process rather than analyzing effects of such policies. I contend that while evaluating a policy's effects is important, education stakeholders must pay attention to all three streams of the agenda setting process as they promote particular reforms to improve students' academic performance.

  20. The EU’s Security Sector Reform Policies in the Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Stephan Keukeleire

    2010-08-01

    Full Text Available In this article we approach the functioning of bureaucracy in ESDP from a governance perspective that also focuses on informal patterns of interaction between the relevant bureaucratic actors. Following the governance and related network governance approaches, the interplay between formal and informal patterns of interaction can help to overcome deadlock in policy-making and to procure effective problem-solving. This perspective is applied to security sector reform (SSR in the Democratic Republic of Congo (DRC. SSR is one of the major emerging fields of activity within the civilian crisis management dimension of ESDP, that also in the DRC became a focal point in the EU’s new security and defence policy since its inception. However, as the EU involvement in the Congolese security sector reform policies illustrates, coordination and negotiation among European actors to overcome deadlock and produce effective problem-solving is not self-evident or even desirable for all actors. In the case of the EU’s SSR policies in Congo, coordination indeed occurs between the actors that are dependent upon each other in terms of resources and have the willingness to jointly tackle the problems related to the SSR in the DRC. However, it is also often undermined by actors that prefer to engage bilaterally because they possess the resources to do so and the personal relationships with the Congolese authorities to act more efficiently and effectively.

  1. Accountable Care Organizations in the Era of Healthcare Reform

    OpenAIRE

    2010-01-01

    Under the Patient Protection and Affordable Care Act (PPACA) of 2010, Medicare providers, including physician groups and hospitals, will soon have the option to form accountable care organizations (ACOs) to improve quality and efficiency. ACO participants may share financial gains generated from improved clinical and economic performance, provided that quality goals and patient safeguards are met. Through future regulations, the Centers for Medicare & Medicaid Services (CMS) must implement th...

  2. Early appraisal of China's huge and complex health-care reforms.

    Science.gov (United States)

    Yip, Winnie Chi-Man; Hsiao, William C; Chen, Wen; Hu, Shanlian; Ma, Jin; Maynard, Alan

    2012-03-01

    China's 3 year, CN¥850 billion (US$125 billion) reform plan, launched in 2009, marked the first phase towards achieving comprehensive universal health coverage by 2020. The government's undertaking of systemic reform and its affirmation of its role in financing health care together with priorities for prevention, primary care, and redistribution of finance and human resources to poor regions are positive developments. Accomplishing nearly universal insurance coverage in such a short time is commendable. However, transformation of money and insurance coverage into cost-effective services is difficult when delivery of health care is hindered by waste, inefficiencies, poor quality of services, and scarcity and maldistribution of the qualified workforce. China must reform its incentive structures for providers, improve governance of public hospitals, and institute a stronger regulatory system, but these changes have been slowed by opposition from stakeholders and lack of implementation capacity. The pace of reform should be moderated to allow service providers to develop absorptive capacity. Independent, outcome-based monitoring and evaluation by a third-party are essential for mid-course correction of the plans and to make officials and providers accountable. PMID:22386036

  3. Developing and implementing an oral care policy and assessment tool.

    LENUS (Irish Health Repository)

    Stout, Michelle

    2012-01-09

    Oral hygiene is an essential aspect of nursing care. Poor oral care results in patients experiencing pain and discomfort, puts individuals at risk of nutritional deficiency and infection, and has an adverse effect on quality of life. This article describes how an oral care policy and assessment tool were updated to ensure the implementation of evidence-based practice at one hospital in the Republic of Ireland.

  4. Future European health care: cost containment, health care reform and scientific progress in drug research.

    Science.gov (United States)

    Emilien, G

    1997-01-01

    The cost of the development of a new pharmaceutical product from its conception and synthesis through to the regulatory approval process has more than quadrupled in the last 20 years. Both clinical and total development times have increased substantially. To amortize the costs incurred, the pharmaceutical industry has taken an international dimension. The incentives for pharmaceutical firms to discover and develop new drugs depend on the length of the development and regulatory review process plus the potential market size. Recent regulatory, economic and political changes may have significant implications for the future of new drug developments in Europe. The European Union industrial policy felt that there is a need for convergence in the area of pricing. It is recommended that the policy should aim to contain growth in pharmaceutical expenses by means specific to reimbursement rather than direct price controls. By encouraging doctors to prescribe and customers to use generics, competition is enhanced to bring down drug prices. More emphasis is being laid by government in educating customers to cost-awareness and cost-benefit ratios with regard to pharmaceuticals. Concerning clinical trials, European harmonization has been achieved by significant developments: the rights and integrity of the trial subjects are protected; the credibility of the data is established; and the ethical, scientific and technical quality of the trials has improved. Future European health care forecasts a whole change in the pharmaceutical business. Important issues in cost and outcome measurement should be carefully planned and considered in drug development. Due to important mergers and acquisitions, the pharmaceutical sector will consist mainly of important multinational corporations. In this way, valuable new products may be brought to the market.

  5. Media Framing Of U.S. Health Care Reform: A New Era Or Reinforcing Dominant Ideologies Of Health And The Health Care System?

    OpenAIRE

    Jaworski, Beth Kristen

    2012-01-01

    March 2010 marked the passage of historic health care reform legislation, the Patient Protection and Affordable Care Act (ACA). The partisan showdown that surrounded the introduction of health care reform, through its passage, captivated the public and dominated news coverage. The media undoubtedly influenced public opinion about key areas of contention as well as policymakers’ support or opposition to the ACA. The primary purpose of this study was to investigate how mainstream newspape...

  6. Getting the product right: how competition policy can improve health care markets.

    Science.gov (United States)

    Sage, William M

    2014-06-01

    As hospital, physician, and health insurance markets consolidate and change in response to health care reform, some commentators have called for vigorous enforcement of the federal antitrust laws to prevent the acquisition and exercise of market power. In health care, however, stricter antitrust enforcement will benefit consumers only if it accounts for the competitive distortions caused by the sector's long history of government regulation. This article directs policy makers to a neglected dimension of health care competition that has been altered by regulation: the product. Competition may have failed to significantly lower costs, increase access, or improve quality in health care because we have been buying and selling the wrong things. Competition policy makers-meaning both antitrust enforcers and regulators-should force the health care industry to define and market products that can be assembled and warranted to consumers while keeping emerging sectors such as mHealth free from overregulation, wasteful subsidy, and appropriation by established insurer and provider interests. PMID:24841884

  7. Health professionals should take an active role in health care reform in China%广大医卫工作者应积极投身医改

    Institute of Scientific and Technical Information of China (English)

    钟南山

    2011-01-01

    The reform of medical and health system involves a number of disciplines,and is therefore a difficult, complicated, and long-term systematic project. In this article, Academician Zhong Nan-shan appreciated the achievements made in China's medical and health system since adoption of the reform and opening-up policy. However,he also pointed out the problems so far existing and lessons to be learned,and proposed new ideas and suggestions for deepening the health care reform. According to Zhong, "Suggestions towards an in-depth reform of medical and health system" developed by CPC Central Committee and State Council should be the guideline health care reform. He called on health professionals to take an active role in the health care reform for the benefit of our people.%医药卫生体制改革涉及多个领域,是一项艰巨、复杂、长期的系统工程.文章既肯定了改革开放以来中国医药卫生事业取得的成就,又指出了存在的问题、教训与反思,并且提出了深化医药卫生体制改革的设想和建议.钟院士认为,中共中央国务院"关于深化医药卫生体制改革的意见"是深入医改的行动指南,号召广大医务工作者和卫生工作者积极投身医改.以造福于人民的健康事业.

  8. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

    Directory of Open Access Journals (Sweden)

    Henrickson Michael

    2011-08-01

    Full Text Available Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career

  9. The politics of ideas in welfare state transformation: Christian Democracy and the reform of family policy in Germany.

    Science.gov (United States)

    Fleckenstein, Timo

    2011-01-01

    The expansion of employment-centered family policies of the Grand Coalition in Germany came with some surprise, as Christian Democrats have traditionally been strongly committed to the male breadwinner model and corresponding family policies. This article investigates why Christian Democrats (though with some inconsistencies) promoted “social-democratic” family policies guided by the adult worker rather than by the male breadwinner model. Illuminating the politics of recent family policy reforms, the electoral rationale for this modernization of family policy, the role of political entrepreneurship, and intraparty political conflicts over the new policy paradigm are discussed. PMID:22292173

  10. Tax reforms in EU Member States - Tax policy challenges for economic growth and fiscal sustainability – 2012 Report

    OpenAIRE

    European Commission

    2012-01-01

    The 2012 edition of the report ‘Tax reforms in EU Member States’ intends to contribute to the tax policy debate in the EU. Following the successful 2011 edition, the report consists of two parts: i) a short analysis of tax revenue data and an overview of recent tax reforms in Member States, and ii) a discussion of selected up-to-date tax policy topics in the form of two analytical chapters. The first analytical chapter focuses on the economic implications and policy challenges of the EU VAT s...

  11. Health-care reforms in the People's Republic of China--strategies and social implications.

    Science.gov (United States)

    Wong, V C; Chiu, S W

    1998-01-01

    Analyses the features, strategies and characteristics of health-care reforms in the People's Republic of China. Since the 14th Central Committee of the Chinese Communist Party held in 1992, an emphasis has been placed on reform strategies such as cost recovery, profit making, diversification of services, and development of alternative financing strategies in respect of health-care services provided in the public sector. Argues that the reform strategies employed have created new problems before solving the old ones. Inflation of medical cost has been elevated very rapidly. The de-linkage of state finance bureau and health service providers has also contributed to the transfer of tension from the state to the enterprises. There is no sign that quasi-public health-care insurance is able to resolve these problems. Finally, cooperative medicine in the rural areas has been largely dismantled, though this direction is going against the will of the state. Argues that a new balance of responsibility has to be developed as a top social priority between the state, enterprises and service users in China in order to meet the health-care needs of the people. PMID:10351255

  12. Health-care reforms in the People's Republic of China--strategies and social implications.

    Science.gov (United States)

    Wong, V C; Chiu, S W

    1998-01-01

    Analyses the features, strategies and characteristics of health-care reforms in the People's Republic of China. Since the 14th Central Committee of the Chinese Communist Party held in 1992, an emphasis has been placed on reform strategies such as cost recovery, profit making, diversification of services, and development of alternative financing strategies in respect of health-care services provided in the public sector. Argues that the reform strategies employed have created new problems before solving the old ones. Inflation of medical cost has been elevated very rapidly. The de-linkage of state finance bureau and health service providers has also contributed to the transfer of tension from the state to the enterprises. There is no sign that quasi-public health-care insurance is able to resolve these problems. Finally, cooperative medicine in the rural areas has been largely dismantled, though this direction is going against the will of the state. Argues that a new balance of responsibility has to be developed as a top social priority between the state, enterprises and service users in China in order to meet the health-care needs of the people.

  13. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

    Directory of Open Access Journals (Sweden)

    Li Zhijian

    2012-06-01

    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  14. Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform.

    Science.gov (United States)

    Ormond, Meghann

    2011-01-01

    "Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers.

  15. Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform.

    Science.gov (United States)

    Ormond, Meghann

    2011-01-01

    "Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers. PMID:22216474

  16. Arkansas: a leading laboratory for health care payment and delivery system reform.

    Science.gov (United States)

    Bachrach, Deborah; du Pont, Lammot; Lipson, Mindy

    2014-08-01

    As states' Medicaid programs continue to evolve from traditional fee-for-service to value-based health care delivery, there is growing recognition that systemwide multipayer approaches provide the market power needed to address the triple aim of improved patient care, improved health of populations, and reduced costs. Federal initiatives, such as the State Innovation Model grant program, make significant funds available for states seeking to transform their health care systems. In crafting their reform strategies, states can learn from early innovators. This issue brief focuses on one such state: Arkansas. Insights and lessons from the Arkansas Health Care Payment Improvement Initiative (AHCPII) suggest that progress is best gained through an inclusive, deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and a strategy grounded in the state's particular health care landscape. PMID:25204031

  17. Arkansas: a leading laboratory for health care payment and delivery system reform.

    Science.gov (United States)

    Bachrach, Deborah; du Pont, Lammot; Lipson, Mindy

    2014-08-01

    As states' Medicaid programs continue to evolve from traditional fee-for-service to value-based health care delivery, there is growing recognition that systemwide multipayer approaches provide the market power needed to address the triple aim of improved patient care, improved health of populations, and reduced costs. Federal initiatives, such as the State Innovation Model grant program, make significant funds available for states seeking to transform their health care systems. In crafting their reform strategies, states can learn from early innovators. This issue brief focuses on one such state: Arkansas. Insights and lessons from the Arkansas Health Care Payment Improvement Initiative (AHCPII) suggest that progress is best gained through an inclusive, deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and a strategy grounded in the state's particular health care landscape.

  18. [Position paper for a reform of medical emergency care in German emergency departments].

    Science.gov (United States)

    Riessen, R; Gries, A; Seekamp, A; Dodt, C; Kumle, B; Busch, H-J

    2015-06-01

    The hospital emergency departments play a central role for the in- and outpatient care of patients with medical emergencies in Germany. In this position paper we point out some general financial and organizational problems of German emergency departments and urge for a higher significance of emergency care in the German health system as an element of public services. The corresponding reform proposals include a change in hospital financing towards a more budget-based system for the emergency departments, an improved structural planning for regional and transregional emergency care, an intensified cooperation with the emergency services of the ambulatory care physicians, a better organizational representation of emergency care within the hospitals and an advancement of emergency medicine in postgraduate medical education. PMID:26024948

  19. Impact of Structural Reforms on Planning Systems and Policies: Loss of Spatial Consciousness?

    Directory of Open Access Journals (Sweden)

    Daniel Galland

    2013-09-01

    Full Text Available This paper argues that a planning system that allows its policies and practices to gradually lose spatial consciousness and spatial coordination capacities within and across different levels of planning administration is less likely to make national and regional plans and strategies matter or have a say in future spatial development processes. The reasoning behind this argument stems from the case of Denmark, where a structural reform that changed the country’s geographies of inter-governmental arrangements in 2007 significantly transformed the configuration and functioning of the national planning system. Originally designed to support the principle of equal development through spatial planning policies aimed at the promotion of equal access to public and private services across the national territory, the Danish planning policy framework has increasingly evolved towards expressing a lack of explicit spatial consciousness in its current plans and strategies. At the same time, the Danish planning system seems to reveal narrower measures of spatial coherence in terms of horizontal and vertical coordination and integration of sectors and policies within and across different levels of planning administration. Based on an analysis regarding the evolution of planning policies and an examination of the current governance landscape influencing planning practices at national and regional levels, the paper attempts to generate an understanding concerning how the underlying rationale and the institutional relations of Danish spatial planning have been reoriented over time.

  20. Critical interactionism: an upstream-downstream approach to health care reform.

    Science.gov (United States)

    Martins, Diane Cocozza; Burbank, Patricia M

    2011-01-01

    Currently, per capita health care expenditures in the United States are more than 20% higher than any other country in the world and more than twice the average expenditure for European countries, yet the United States ranks 37th in life expectancy. Clearly, the health care system is not succeeding in improving the health of the US population with its focus on illness care for individuals. A new theoretical approach, critical interactionism, combines symbolic interactionism and critical social theory to provide a guide for addressing health care problems from both an upstream and downstream approach. Concepts of meaning from symbolic interactionism and emancipation from critical perspective move across system levels to inform and reform health care for individuals, organizations, and societies. This provides a powerful approach for health care reform, moving back and forth between the micro and macro levels. Areas of application to nursing practice with several examples (patients with obesity; patients who are lesbian, gay, bisexual, and transgender; workplace bullying and errors), nursing education, and research are also discussed. PMID:22067231

  1. The health-care system: an assessment and reform agenda.

    Science.gov (United States)

    Mataria, Awad; Khatib, Rana; Donaldson, Cam; Bossert, Thomas; Hunter, David J; Alsayed, Fahed; Moatti, Jean-Paul

    2009-04-01

    Attempts to establish a health plan for the occupied Palestinian territory were made before the 1993 Oslo Accords. However, the first official national health plan was published in 1994 and aimed to regulate the health sector and integrate the activities of the four main health-care providers: the Palestinian Ministry of Health, Palestinian non-governmental organisations, the UN Relief and Works Agency, and a cautiously developing private sector. However, a decade and a half later, attempts to create an effective, efficient, and equitable system remain unsuccessful. This failure results from arrangements for health care established by the Israeli military government between 1967 and 1994, the nature of the Palestinian National Authority, which has little authority in practice and has been burdened by inefficiency, cronyism, corruption, and the inappropriate priorities repeatedly set to satisfy the preferences of foreign aid donors. Although similar problems exist elsewhere, in the occupied Palestinian territory they are exacerbated and perpetuated under conditions of military occupation. Developmental approaches integrated with responses to emergencies should be advanced to create a more effective, efficient, and equitable health system, but this process would be difficult under military occupation. PMID:19268349

  2. The science of green chemistry and its role in chemicals policy and educational reform.

    Science.gov (United States)

    Cannon, Amy S; Warner, John C

    2011-01-01

    Over the past 10 years, the science of green chemistry has continued to evolve and has been adopted in research labs in industry and academia. At the same time, new innovations in chemicals policy have widened opportunities for legislative action to protect human health and the environment. This article addresses the mechanisms by which the science of green chemistry and chemicals policy can work together to help attain a more sustainable future. It also speaks to the pitfalls of inappropriately merging these two, and explores how such a merger could inhibit the creation of sustainable technologies. Green chemistry's role in educational reform is discussed as a means for training students who are prepared to create truly sustainable technologies. PMID:22001044

  3. The science of green chemistry and its role in chemicals policy and educational reform.

    Science.gov (United States)

    Cannon, Amy S; Warner, John C

    2011-01-01

    Over the past 10 years, the science of green chemistry has continued to evolve and has been adopted in research labs in industry and academia. At the same time, new innovations in chemicals policy have widened opportunities for legislative action to protect human health and the environment. This article addresses the mechanisms by which the science of green chemistry and chemicals policy can work together to help attain a more sustainable future. It also speaks to the pitfalls of inappropriately merging these two, and explores how such a merger could inhibit the creation of sustainable technologies. Green chemistry's role in educational reform is discussed as a means for training students who are prepared to create truly sustainable technologies.

  4. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    Science.gov (United States)

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  5. Exploring limits to market-based reform: managed competition and rehabilitation home care services in Ontario.

    Science.gov (United States)

    Randall, Glen E; Williams, A Paul

    2006-04-01

    The rise of neo-liberalism, which suggests that only markets can deliver maximum economic efficiency, has been a driving force behind the trend towards using market-based solutions to correct health care problems. However, the broad application of market-based reforms has tended to assume the presence of fully functioning markets. When there are barriers to markets functioning effectively, such as the absence of adequate competition, recourse to market-based solutions can be expected to produce less than satisfactory, if not paradoxical results. One such case is rehabilitation homecare in Ontario, Canada. In 1996, a "managed competition" model was introduced as part of a province-wide reform of home care in an attempt to encourage high quality at competitive prices. However, in the case of rehabilitation home care services, significant obstacles to achieving effective competition existed. Notably, there were few private provider agencies to bid on contracts due to the low volume and specialized nature of services. There were also structural barriers such as the presence of unionized employees and obstacles to the entry of new providers. This paper evaluates the impact of Ontario's managed competition reform on community-based rehabilitation services. It draws on data obtained through 49 in-depth key informant interviews and a telephone survey of home care coordinating agencies and private rehabilitation provider agencies. Instead of reducing costs and improving quality, as the political rhetoric promised, the analysis suggests that providing rehabilitation homecare services under managed competition resulted in higher per-visit costs and reduced access to services. These findings support the contention that there are limits to market-based reforms. PMID:16198035

  6. The Impact of the Health Care System Reform on the Romanian Nurses Professionalization Process

    Directory of Open Access Journals (Sweden)

    Silvia POPOVICI

    2012-06-01

    Full Text Available The Romanian health sector went through a process of reform began in 2000 which entered into a final adjustment phase in 2010 when the economic crisis, the health professionals accelerated trend of labour migration, the precarious health of the population brought new challenges to the unsolved existing problems. Nurses are numerically the most important category of health professionals. Since 1994 they experienced a convergent movement of professionalization in the interior of the nurse profession. The aim of the study is to explore the nurses’ perceptions of the impact of the health care system reform on their own profession and on the internal process of professionalization. As a result a quantitative research was conducted on a sample including 411 nurses of different specialties working in Iasi county. The results of the research point out the significant impact of factors related to the reform of the health care system on the quality of the care process, on the nurses’ work conditions and professional satisfaction. The external disruptive factors produce negative effects on nurses’ group cohesion, despite the centripetal efforts of the professional organization and induce a slowdown movement of the nurses professionalization process.

  7. Identifying Effective Policy and Technologic Reforms for Sustainable Groundwater Management in Oman

    Science.gov (United States)

    Madani, K.; Zekri, S.; Karimi, A.

    2014-12-01

    Oman has gone through three decades of efforts aimed at addressing groundwater over-pumping and the consequent seawater intrusion. Example of measures adopted by the government since the 1990's include a vast subsidy program of irrigation modernization, a freeze on drilling new wells, delimitation of several no-drill zones, a crop substitution program, re-use of treated wastewater and construction of recharge dams. With no major success through these measures, the government laid the ground for water quotas by creating a new regulation in 1995. Nevertheless, groundwater quotas have not been enforced to date due to the high implementation and monitoring costs of traditional flow meters. This presentation discusses how sustainable groundwater management can be secured in Oman using a suit of policy and technologic reforms at a reasonable economic, political and practical cost. Data collected from farms with smart meters and low-cost wireless smart irrigation systems have been used to propose sustainable groundwater withdrawal strategies for Oman using a detailed hydro-economic model that couples a MODFLOW-SEAWAT model of the coastal aquifers with a dynamic profit maximization model. The hydro-economic optimization model was flexible to be run both as a social planner model to maximize the social welfare in the region, and as an agent-based model to capture the behavior of farmers interested in maximizing their profits independently. This flexibility helped capturing the trade-off between the optimality of the social planner solution developed at the system's level and its practicality (stability) with respect to the concerns and behaviors of the profit-maximizing farmers. The idetified promising policy and technolgical reforms for Oman include strict enforcement of groundwater quotas, smart metering, changing crop mixes, improving irrigation technologies, and revising geographical distribution of the farming activities. The presentation will discuss how different

  8. The financial crisis and recent family policy reforms in Finland, Germany and the United Kingdom : Is there a connection?

    Directory of Open Access Journals (Sweden)

    Mikael Nygård

    2015-03-01

    Full Text Available The turmoil created by the financial crisis and economic recession in Europe has served as an impetus for austerity measures in many countries. In this article, we ask whether these crises have also triggered reforms in family policy, and we focus on three European welfare states – Finland, Germany and the United Kingdom – countries that are often considered members of different family policy regimes. The article addresses two main research questions. The first one relates to the number, direction and magnitude of family policy reforms in these three countries since the beginning of the financial crisis in 2008/2009, while in the second we discuss whether the reforms observed during this period can be seen as being related to the financial crisis and its later repercussions on the Euro-zone area, or if there are other explanations.

  9. Stakeholders’ perception on the organization of chronic care: a SWOT analysis to draft avenues for health care reforms

    Science.gov (United States)

    2014-01-01

    other countries faced with the challenge of drafting reforms to tackle the issue of chronic care. PMID:24742204

  10. On Rural Medical Care and Health Undertaking Development during New Medical Reform

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yi-huan

    2012-01-01

    Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

  11. The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers.

    Science.gov (United States)

    Chon, Yongho

    2013-01-01

    One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.

  12. A comparison of job satisfaction of community health workers before and after local comprehensive medical care reform: a typical field investigation in Central China.

    Directory of Open Access Journals (Sweden)

    Hong Ding

    Full Text Available BACKGROUND: The government of China promulgated new medical care reform policies in March 2009. After that, provincial-level governments launched new medical care reform which focusing on local comprehensive medical care reform (LCMR. Anhui Province is an example of an area affected by LCMR, in which the LCMR was started in October 2009 and implemented in June 2010. The objective of this study was to compare the job satisfaction (JS of community health workers (CHWs before and after the reform in Anhui Province. METHODS: A baseline survey was carried out among 813 community health workers (CHWs of 57 community health centers (CHCs (response rate: 94.1% and an effect evaluation survey among 536 CHWs of 30 CHCs (response rate: 92.3% in 2009 and 2012 respectively. A self-completion questionnaire was used to assess the JS of the CHWs (by the job satisfaction scale, JSS. RESULTS: The average scores of total JS and satisfaction with pay, contingent rewards, operating procedures and communication in the effect evaluation survey were statistically significantly higher than those of the baseline survey (P<0.05. The average score of satisfaction with promotion (2.55 ± 1.008 in the effect evaluation survey was statistically significantly lower than that in the baseline survey (2.71 ± 0.730 (P=0.002. In both surveys, the average scores of satisfaction with pay, benefits and promotion were statistically significantly lower than the others (all P<0.05. CONCLUSIONS: After two years' implementation of the LCMR, CHWs' total JS have a small improvement. However, CHWs have lower satisfaction in the dimensions of pay, promotion and benefits dimensions before and after the LCMR. Therefore, policy-makers should take corresponding measures to raise work reward of CHWs and pay more attention to CHWs' professional development to further increase their JS.

  13. Evidence on equity, governance and financing after health care reform in Mexico: lessons for Latin American countries

    Directory of Open Access Journals (Sweden)

    Armando Arredondo

    2015-06-01

    Full Text Available This article includes evidence on equity, governance and health financing outcomes of the Mexican health system. An evaluative research with a cross-sectional design was oriented towards the qualitative and quantitative analysis of financing, governance and equity indicators. Taking into account feasibility, as well as political and technical criteria, seven Mexican states were selected as study populations and an evaluative research was conducted during 2002-2010. The data collection techniques were based on in-depth interviews with key personnel (providers, users and community leaders, consensus technique and document analysis. The qualitative analysis was done with ATLAS TI and POLICY MAKER softwares. The Mexican health system reform has modified dependence at the central level; there is a new equity equation for resources allocation, community leaders and users of services reported the need to improve an effective accountability system at both municipal and state levels. Strategies for equity, governance and financing do not have adequate mechanisms to promote participation from all social actors. Improving this situation is a very important goal in the Mexican health democratization process, in the context of health care reform. Inequality on resources allocation in some regions and catastrophic expenditure for users is unequal in all states, producing more negative effects on states with high social marginalization. Special emphasis is placed on the analysis of the main strengths and weaknesses, as relevant evidences for other Latin American countries which are designing, implementing and evaluating reform strategies in order to achieve equity, good governance and a greater financial protection in health.

  14. Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

    Directory of Open Access Journals (Sweden)

    Harris MF

    2016-01-01

    Full Text Available Mark F Harris,1 Jenny Advocat,2 Benjamin F Crabtree,3 Jean-Frederic Levesque,1,4 William L Miller,5 Jane M Gunn,6 William Hogg,7 Cathie M Scott,8 Sabrina M Chase,9 Lisa Halma,10 Grant M Russell11 1Center for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, VIC, Australia; 3Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; 4Bureau of Health Information, NSW Government, Sydney, NSW, Australia; 5Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA, USA; 6Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia; 7The CT Lamont Primary Care Research Center, The University of Ottawa, Ottawa, ON, 8Alberta Centre for Child, Family, and Community Research, University of Calgary, AB, Canada; 9Rutgers University, Rutgers School of Nursing, Rutgers, NJ, USA; 10Alberta Health Services, Lethbridge, AB, Canada; 11School of Primary Health Care, Monash University, Notting Hill, VIC, Australia Context: A key aim of reforms to primary health care (PHC in many countries has been to enhance interprofessional teamwork. However, the impact of these changes on practitioners has not been well understood.Objective: To assess the impact of reform policies and interventions that have aimed to create or enhance teamwork on professional communication relationships, roles, and work satisfaction in PHC practices.Design: Collaborative synthesis of 12 mixed methods studies.Setting: Primary care practices undergoing transformational change in three countries: Australia, Canada, and the USA, including three Canadian provinces (Alberta, Ontario, and Quebec.Methods: We conducted a synthesis and secondary analysis of 12 qualitative and quantitative studies conducted by the authors in order to understand the impacts and how they

  15. Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa

    Directory of Open Access Journals (Sweden)

    Meier Benjamin

    2012-08-01

    Full Text Available Abstract Background Amidst an evolving post-apartheid policy framework for health, policymakers have sought to institutionalize community participation in Primary Health Care, recognizing participation as integral to realizing South Africa’s constitutional commitment to the right to health. With evolving South African legislation supporting community involvement in the health system, early policy developments focused on Community Health Committees (HCs as the principal institutions of community participation. Formally recognized in the National Health Act of 2003, the National Health Act deferred to provincial governments in establishing the specific roles and functions of HCs. As a result, stakeholders developed a Draft Policy Framework for Community Participation in Health (Draft Policy to formalize participatory institutions in the Western Cape province. Methods With the Draft Policy as a frame of analysis, the researchers conducted documentary policy analysis and semi-structured interviews on the evolution of South African community participation policy. Moving beyond the specific and unique circumstances of the Western Cape, this study analyzes generalizable themes for rights-based community participation in the health system. Results Framing institutions for the establishment, appointment, and functioning of community participation, the Draft Policy proposed a formal network of communication – from local HCs to the health system. However, this participation structure has struggled to establish itself and function effectively as a result of limitations in community representation, administrative support, capacity building, and policy commitment. Without legislative support for community participation, the enactment of superseding legislation is likely to bring an end to HC structures in the Western Cape. Conclusions Attempts to realize community participation have not adequately addressed the underlying factors crucial to promoting

  16. Reforma ou contra-reforma na proteção social à saúde Reform or contra-reform in health policy

    Directory of Open Access Journals (Sweden)

    Paulo Eduardo Elias

    1997-08-01

    Full Text Available Discutem-se as mudanças no sistema de saúde brasileiro em período recente da ótica das políticas sociais. A partir do enunciado da exclusão social como questão central a ser enfrentada pelas políticas sociais e da noção de contra-reforma em oposição à reforma virtuosa e necessária do Estado, analisam-se as políticas de saúde, privilegiando a denominada Reforma Sanitária e a implementação do SUS. O artigo sustenta a exigência de se promover a articulação das reformas do sistema de saúde com as políticas econômicas de modo a apontar para um novo padrão de desenvolvimento, com sólidas bases sociais e orientado ética e politicamente para a inclusão.Changes in the Brazilian health system are discussed from the point of view of social policies. Taking social exclusion as the central question to be faced by social policies and contra-reform as the opposite of the virtuous and necessary reform of the State, the article analyzes Brazilian health policies, chiefly regarding the so-called Sanitary Reform and the National Health Service (SUS. It is argued that the articulation between the reforms of the health system and economic policies should be promoted having in view a new development pattern, with strong social foundations and ethically and politically oriented towards social inclusion.

  17. THE ROLE OF POLICY ENTREPRENEURS AND ADVOCACY NETWORKS IN PUBLIC POLICY PROCESS (STUDY CASE OF BRAZIL WATER POLICY REFORM)

    OpenAIRE

    KOVERZNEVA S.A.; KULAKOVA T.A.

    2015-01-01

    The diversity in social demands does expand the quantity of possible alternative policies and requires the changes in public governance. New strategy of governance involves dialogue among stakeholders. Various social and professional networks, united shared values, interests and beliefs could have more motivational potential for innovations, than traditional administrative approach. Key question is the role of informal advocacy groups and policy entrepreneurs in such shift. The paper examines...

  18. Grassroots health care reform should pay equal attention to health care%基层医改应与医疗并重

    Institute of Scientific and Technical Information of China (English)

    王登强

    2014-01-01

    医改给老百姓带来了福利,但是基层医疗机构承载的医疗任务重大,基层医院缺设备、缺人才的现状还很严重,不平等的医疗现象在基层显现出来,这都是改革前进中的问题。基层医改应该从基层老百姓的想法入手,老百姓所想、所需的就是我们要改的,使基层医疗改革取信于民,重视基层医改与基层医疗并重。%Health care reform brought benefits to people, but the medical task of grassroots medical institutions was significant. The lack of equipment of basic-level hospitals and the lack of talent were still very serious.Unequal medical phenomenon appeared at the grassroots level.These were all the problems of reform forward.Grassroots health care reform should start from the grassroots people's idea.The people thinking and requirement is that we want to reform.It make that the grassroots health care reform can attain the people's trust.Grassroots health care reform should pay equal attention to grassroots health care.

  19. [Medicine on mission: The international health reform of Seventh-Day Adventists and their health care facilities in Sweden].

    Science.gov (United States)

    Eklöf, Motzi

    2008-01-01

    The international non-conformist denomination, Seventh-day Adventists, have since their foundation in 1863, had a distinctive health care model for their members. The life-style has included vegetarian diet, abstinence from alcohol, tobacco and other drugs and the observance of a day of rest once a week. The health policy has striven to care for God's creation in the hope of resurrection at the Day of Judgment and to reform the conventional medical practice. The Adventists have pursued an extensive international health care system--from the start based on dietary and physical treatment methods, such as hydrotherapy, massage and physiotherapy--in line with the Christian mission. Health care establishments have been inaugurated around the world as a vehicle for enabling the Christian health care message to reach the upper classes. With Adventist and Doctor, John Harvey Kellogg's Battle Creek Sanatorium in Michigan as both inspirational source and educational institution, the health care mission--including a vegetarian health food industry, following in the footsteps of cornflakes--spread to the Nordic countries by the turn of the century, 1900. Skodsborgs Badesanatorium near Copenhagen became the model institution for several health care establishments in Sweden during the 1900's, such as Hultafors Sanatorium. The American-Nordic link has manifested itself through co-publication of papers, exchange of health care personnel and reporting to the central Adventist church. The American non-conformist domain as well as a private sphere of activity, aiming mainly from the outset at society's upper classes, has encountered certain difficulties in maintaining this distinction in Sweden's officially increasing secularised society, and in relation to a state health insurance and a publicly financed health care system. With the passing of time, the socioeconomic composition of patients at Hultafors became more heterogeneous, and conventional medical procedures were increasingly

  20. Does Integrated Water Resources Management Support Institutional Change? The Case of Water Policy Reform in Israel

    Directory of Open Access Journals (Sweden)

    Tanya Heikkila

    2010-03-01

    Full Text Available Many international efforts have been made to encourage integrated water resources management through recommendations from both the academic and the aid and development sectors. Recently, it has been argued that integrated water resources management can help foster better adaptation of management and policy responses to emerging water crises. Nevertheless, few empirical studies have assessed how this type of management works in practice and what an integrated water management system implies for institutional adaptation and change. Our assessment of the Israeli water sector provides one view of how they can be shaped by an integrated structure in the water sector. Our analysis of recent efforts to adapt Israel's water management system to new conditions and uncertainties reveals that the interconnectedness of the system and the consensus decision-making process, led by a dominant actor who coordinates and sets the policy agenda, tends to increase the complexity of negotiations. In addition, the physical integration of water management leads to sunk costs of large-scale physical infrastructure. Both these factors create a path dependency that empowers players who receive benefits from maintaining the existing system. This impedes institutional reform of the water management system and suggests that integrated water resources management creates policy and management continuity that may only be amenable to incremental changes. In contrast, real adaptation that requires reversibility and the ability to change management strategies in response to new information or monitoring of specific management outcomes.

  1. Reform of China’s Food Security Policies: Central Government Decentralizing Autonomous Management Right

    Institute of Scientific and Technical Information of China (English)

    Ming; LI

    2015-01-01

    Guaranteeing the food security is a fundamental state policy of China. Food security needs overall planning of central government,economic benefit allocation of local government,and increase of grain farmers’ income. Through analysis on current situations and causes of China’s food security,and comparative study on purposes and functions of foreign and domestic grain reserves,it came up with recommendations that central government should decentralize rights of grain production,reserve,sales,and management to grain producing areas and major sales provinces. It is not appropriate for central enterprises to take charge of national food security reserves. And it is required to make a new round of reform in autonomous management right of major grain producing areas and the capacity of the state purchasing social grain reserves.

  2. POLICY DEVELOPMENT TRAINING AND EDUCATION RESOURCES TO REFORM THE LOCAL GOVERNMENT DISTRICT OF MAKASSAR SIDENRENG RAPPANG

    Directory of Open Access Journals (Sweden)

    Syamsuddin Maldun

    2015-02-01

    Full Text Available This research aims to know and study the strategy of resource development policy reform of local government district of Makassar Sidenreng Rappang. The research method used is descriptive qualitative study type, while the phenomenological approach is used. This is intended to give description in a systematic, factual and actual response object is examined. Results of the research implementation of education and training is not conducted in a planned and timely to get quality apparatus of the abilities, knowledge, skills, expertise, and job skills, as well as a good mental attitude, and optimal performance. Whereas in the era of regional autonomy, it takes the resources of local government apparatus that is intelligent and responsive to the needs of an increasingly complex society services. 

  3. Reform of the EU's climate policy. Small step or big hit?

    International Nuclear Information System (INIS)

    Emissions trading listed as a flexible mechanism under the Kyoto Protocol is regarded as a market economy way in climate protection. Since 2005 the European Emissions Trading System (EU ETS) is the central climate policy instrument for reducing the emissions of greenhouse gases, in particular for carbon dioxide (CO2). For years, however, the CO2 price is too low to direct the politically and socially targeted technical innovations in the electricity sector and the industry. The article analyses the temporary and structural causes of this problem, highlights the EU's reform efforts and points to areas of activity, the basis of which the EU ETS may act in the future as a central instrument for climate protection in the European Union.

  4. Achieving universal health coverage in France: policy reforms and the challenge of inequalities.

    Science.gov (United States)

    Nay, Olivier; Béjean, Sophie; Benamouzig, Daniel; Bergeron, Henri; Castel, Patrick; Ventelou, Bruno

    2016-05-28

    Since 1945, the provision of health care in France has been grounded in a social conception promoting universalism and equality. The French health-care system is based on compulsory social insurance funded by social contributions, co-administered by workers' and employers' organisations under State control and driven by highly redistributive financial transfers. This system is described frequently as the French model. In this paper, the first in The Lancet's Series on France, we challenge conventional wisdom about health care in France. First, we focus on policy and institutional transformations that have affected deeply the governance of health care over past decades. We argue that the health system rests on a diversity of institutions, policy mechanisms, and health actors, while its governance has been marked by the reinforcement of national regulation under the aegis of the State. Second, we suggest the redistributive mechanisms of the health insurance system are impeded by social inequalities in health, which remain major hindrances to achieving objectives of justice and solidarity associated with the conception of health care in France. PMID:27145707

  5. Medicaid and the labor supply of single mothers: Implications for health care reform

    OpenAIRE

    Pohl, Vincent

    2015-01-01

    The Patient Protection and Affordable Care Act expands Medicaid and in-troduces health insurance subsidies, thereby changing work incentives for single mothers. To undertake an ex ante policy evaluation of the employment effects of the PPACA, I structurally estimate a model of labor supply and health in-surance choice exploiting existing variation in Medicaid policies. Simulations show that single mothers increase their labor supply at the extensive and the intensive margin by six and five pe...

  6. Teaching Excellence through Professional Learning and Policy Reform: Lessons from around the World. International Summit on the Teaching Profession

    Science.gov (United States)

    Schleicher, Andreas

    2016-01-01

    If the quality of an education system can never exceed the quality of its teachers, then countries need to do all they can to build a high-quality teaching force. "Teaching Excellence through Professional Learning and Policy Reform: Lessons from around the World," the background report to the sixth International Summit on the Teaching…

  7. Efficiency and competition in the Dutch non-life insurance industry: Effects of the 2006 health care reform

    NARCIS (Netherlands)

    Bikker, Jaap; Popescu, Adelina

    2014-01-01

    This paper investigates the cost efficiency and competitive behaviour of the non-life – or property and casualty – insurance market in the Netherlands over the period 1995-2012. We focus on the 2006 health care reform, where public health care insurance has been included in the non-life insurance se

  8. Primary care reform in Central and Eastern Europe: can Belarus be taken as the control group in international comparison?

    NARCIS (Netherlands)

    Boerma, W.G.W.; Rousovich, V.S.; Schellevis, F.G.; Egorov, K.

    2005-01-01

    Background: Health care reform proceeds differently in Belarus. The country has not followed trends visible in most other countries. Financing and provision of health care is still in the hands of the state. Health insurance funds are unknown, private practices are rare and operating outside the sys

  9. Ex-Ante Impact Assessment of water policy reform in Southeastern of Tunisia: A CGE Approach

    Directory of Open Access Journals (Sweden)

    Abdeladhim Mohamed Arbi

    2011-12-01

    water policy reforms. Despite of the early public intervention, since 80s, the ex-ante integrated impact assessment (IIA of water policies reform needs more investigation in Tunisian arid regions. Using a Computable general equilibrium model we have assessed the economywide impact of water policies reform that consists of providing higher quantity water to the diferente economic sectors. The central aims are to outline the Social Accounting Matrix (SAM building procedure, describe the policy options and present the preliminary results. Model results show that providing more non-conventional water to tourism and agriculture sectors has positive impacts on regional economy. Meanwhile, the results should be analysed with caution given the various limitations of the work that should be enhanced. This work was carried out in the framework of Land Use Policies and Sustainable Development on developing countries (LUPIS project (Reidsma et al., 2011.

  10. Problem Drug Use, Marijuana, and European Projects: How Epidemiology Helped Czech Policy Reformers

    Directory of Open Access Journals (Sweden)

    Jan Morávek

    2008-12-01

    Full Text Available I examine the transfer of the Problem Drug Use (PDU concept into Czech scientific discourse through European institutions’ projects, and view PDU’s utilization by Czech researchers in relation to marijuana decriminalization efforts.PDU is defined as intravenous and/or long-term and regular use of opiates, cocaine, or amphetamines. Out of a vast array of illicit drug use patterns, this concept isolates a relatively small population with the riskiest use patterns to become the focus of public policies. A series of European Union and Council of Europe projects in 1990’s helped bring PDU into European research mainstream. The new common standard, promoted by the European Monitoring Centre for Drugs and Drug Addiction, was utilized by Czech authors in a 2001 policy analysis entitled “Impact Analysis Project of the New Drug Legislation in the Czech Republic” (PAD. PDU played a crucial role in PAD’s drug problem modeling, focusing on a “hard core” of opiate and methamphetamine users, while diverting attention from a large group of cannabis users.By using the new European methodological standard, PAD’s authors constructed marijuana as a non-problem. This helped drug policy reformers in the Czech Government legitimize their focus on “harder” drugs, and subsequently propose more lenient sanctions for the possession and cultivation of marijuana. I argue that continued ignorance of marijuana problems might jeopardize the tolerant expert-driven drug policy in the Czech Republic. Measurement of problem cannabis use should be introduced.

  11. A Review of Visiting Policies in Intensive Care Units.

    Science.gov (United States)

    Khaleghparast, Shiva; Joolaee, Soodabeh; Ghanbari, Behrooz; Maleki, Majid; Peyrovi, Hamid; Bahrani, Naser

    2016-01-01

    Admission to intensive care units is potentially stressful and usually goes together with disruption in physiological and emotional function of the patient. The role of the families in improving ill patients' conditions is important. So this study investigates the strategies, potential challenges and also the different dimensions of visiting hours' policies with a narrative review. The search was carried out in scientific information databases using keywords "visiting policy", "visiting hours" and "intensive care unit" with no time limitation on accessing the published studies in English or Farsi. Of a total of 42 articles, 22 conformed to our study objectives from 1997 to 2013. The trajectory of current research shows that visiting in intensive care units has, since their inception in the 1960s, always considered the nurses' perspectives, patients' preferences and physiological responses, and the outlook for families. However, little research has been carried out and most of that originates from the United States, Europe and since 2010, a few from Iran. It seems that the need to use the research findings and emerging theories and practices is necessary to discover and challenge the beliefs and views of nurses about family-oriented care and visiting in intensive care units. PMID:26755480

  12. Who pays for health care in the United States? Implications for health system reform.

    Science.gov (United States)

    Holahan, J; Zedlewski, S

    1992-01-01

    This paper examines the distribution of health care spending and financing in the United States. We analyze the distribution of employer and employee contributions to health insurance, private nongroup health insurance purchases, out-of-pocket expenses, Medicaid benefits, uncompensated care, tax benefits due to the exemption of employer-paid health benefits, and taxes paid to finance Medicare, Medicaid, and the health benefit tax exclusion. All spending and financing burdens are distributed across the U.S. population using the Urban Institute's TRIM2 microsimulation model. We then examine the distributional effects of the U.S. health care system across income levels, family types, and regions of the country. The results show that health care spending increases with income. Spending for persons in the highest income deciles is about 60% above that of persons in the lowest decile. Nonetheless, the distribution of health care financing is regressive. When direct spending, employer contributions, tax benefits, and tax spending are all considered, the persons in the lowest income deciles devote nearly 20% of cash income to finance health care, compared with about 8% for persons in the highest income decile. We discuss how alternative health system reform approaches are likely to change the distribution of health spending and financing burdens.

  13. Waiting Time Policies in the Health Care Sector. What Works?

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Bech, Mickael

    2013-01-01

    choice of hospital for somatic and psychiatric patients, short maximum waiting time guarantee for life-threatening diseases coupled with care packages for cancer and heart diseases and extra-activity targeted hospital grants. There are good reasons to believe that these policies have reduced waiting...... times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

  14. The new medical reform policy maternal and child health work to develop new ideas%新医改政策下妇幼卫生工作发展新思路

    Institute of Scientific and Technical Information of China (English)

    赵金萍

    2013-01-01

    目的:探讨新医改政策下妇幼卫生工作发展新思路。方法:结合我区实施新医改政策4年来的妇幼卫生工作现状,提出妇幼卫生事业适应新的医改政策下如何发展的一些方法。结果:切实贯彻落实新医改政策,才能促进妇幼卫生事业的有序发展。结论:以政府为主导,坚定不移地执行妇幼卫生工作方针,保障妇幼卫生事业在新医改政策下良好运行和发展,才能不断满足人民群众日益增长的保健需求。%Objective: to study the new medical reform policy maternal and child health work to develop new ideas. Methods: according to the implementation of the reform of our new policy in four years maternal and child health work situation, this paper proposes to cause of maternal and child health reform, how to adapt to the new policy of the development of some methods. Results: the practical implementation of the new medical reform policies, to promote the cause of maternal and child health and orderly development. Conclusion: the government as the leading, unswervingly implement the maternal and child health work policy, security maternal and child health undertakings in the new medical reform policy under a good operation and development, the ability to continuously meet the people's growing health care needs.

  15. Policy and Practice Model of Public-Private Partnership in Public Hospitals during the New Medical Reform Period.

    Science.gov (United States)

    Zhang, Ju-Yang; Long, Ru-Yin; Yan, Hai; Yang, Qing; Yang, Bo

    2016-01-01

    Purpose: Since the beginning of the new health care reform in 2009, the state has illustrated the top design and health care improvement strategy of "encouraging social capital to participate in the reform of public hospitals", in accordance with the program's general objective. All areas have been explored on this matter and the results obtained are very interesting, not to mention the acquisition of significant experience. At present, the existing business models in China are mainly the following: Rebuild-Operate-Transfer (ROT), franchise business model, Build-Own-Operate-Transfer (BOOT) model, mixed ownership model and business insurance model. This paper introduces a variety of alternative models, and provides a simple analysis of the advantages and disadvantages. Moreover, for the reform of public hospitals, the government shares should go into franchise mode or mixed ownership, and all property rights should be transferred to the government to ensure the conservation and proliferation of state-owned assets. PMID:27273961

  16. Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations

    Directory of Open Access Journals (Sweden)

    Jenkins Rachel

    2010-06-01

    Full Text Available Abstract Background Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. Results The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines

  17. Public Finance Policy Strategies to Increase Access to Preconception Care

    OpenAIRE

    Johnson, Kay A.

    2006-01-01

    Policy and finance barriers reduce access to preconception care and, reportedly, limit professional practice changes that would improve the availability of needed services. Millions of women of childbearing age (15–44) lack adequate health coverage (i.e., uninsured or underinsured), and others live in medically underserved areas. Service delivery fragmentation and lack of professional guidelines are additional barriers. This paper reviews barriers and opportunities for financing preconception...

  18. Policy trends and reforms in the German DRG-based hospital payment system.

    Science.gov (United States)

    Klein-Hitpaß, Uwe; Scheller-Kreinsen, David

    2015-03-01

    A central structural point in all DRG-based hospital payment systems is the conversion of relative weights into actual payments. In this context policy makers need to address (amongst other things) (a) how the price level of DRG-payments from one period to the following period is changed and (b) whether and how hospital payments based on DRGs are to be differentiated beyond patient characteristics, e.g. by organizational, regional or state-level factors. Both policy problems can be and in international comparison often are empirically addressed. In Germany relative weights are derived from a highly sophisticated empirical cost calculation, whereas the annual changes of DRG-based payments (base rates) as well as the differentiation of DRG-based hospital payments beyond patient characteristics are not empirically addressed. Rather a complex set of regulations and quasi-market negotiations are applied. There were over the last decade also timid attempts to foster the use of empirical data to address these points. However, these reforms failed to increase the fairness, transparency and rationality of the mechanism to convert relative weights into actual DRG-based hospital payments. PMID:25638648

  19. From coordinated care trials to medicare locals: what difference does changing the policy driver from efficiency to quality make for coordinating care?

    Science.gov (United States)

    Gardner, Karen; Yen, Laurann; Banfield, Michelle; Gillespie, James; McRae, Ian; Wells, Robert

    2013-02-01

    The terms coordination and integration refer to a wide range of interventions, from strategies aimed at coordinating clinical care for individuals to organizational and system interventions such as managed care, which contract medical and support services. Ongoing debate about whether financial and organizational integration are needed to achieve clinical integration is evident in policy debates over several decades, from a focus through the 1990s on improving coordination through structural reform and the use of market mechanisms to achieve allocative efficiencies (better overall service mix) to more recent attention on system performance to improve coordination and quality. We examine this shift in Australia and ask how has changing the policy driver affected efforts to achieve coordination? Care planning, fund pooling and purchasing are still important planks in coordination. Evidence suggests that financial strategies can be used to drive improvements for particular patient groups, but these are unlikely to improve outcomes without being linked to clinical strategies that support coordination through multidisciplinary teamwork, IT, disease management guidelines and audit and feedback. Meso level organizational strategies might align the various elements to improve coordination. Changing the policy driver has refocused research and policy over the last two decades from a focus on achieving allocative efficiencies to achieving quality and value for money. Research is yet to develop theoretical approaches that can deal with the implications for assessing effectiveness. Efforts need to identify intervention mechanisms, plausible relationships between these and their measurable outcomes and the components of contexts that support the emergence of intervention attributes.

  20. From coordinated care trials to medicare locals: what difference does changing the policy driver from efficiency to quality make for coordinating care?

    Science.gov (United States)

    Gardner, Karen; Yen, Laurann; Banfield, Michelle; Gillespie, James; McRae, Ian; Wells, Robert

    2013-02-01

    The terms coordination and integration refer to a wide range of interventions, from strategies aimed at coordinating clinical care for individuals to organizational and system interventions such as managed care, which contract medical and support services. Ongoing debate about whether financial and organizational integration are needed to achieve clinical integration is evident in policy debates over several decades, from a focus through the 1990s on improving coordination through structural reform and the use of market mechanisms to achieve allocative efficiencies (better overall service mix) to more recent attention on system performance to improve coordination and quality. We examine this shift in Australia and ask how has changing the policy driver affected efforts to achieve coordination? Care planning, fund pooling and purchasing are still important planks in coordination. Evidence suggests that financial strategies can be used to drive improvements for particular patient groups, but these are unlikely to improve outcomes without being linked to clinical strategies that support coordination through multidisciplinary teamwork, IT, disease management guidelines and audit and feedback. Meso level organizational strategies might align the various elements to improve coordination. Changing the policy driver has refocused research and policy over the last two decades from a focus on achieving allocative efficiencies to achieving quality and value for money. Research is yet to develop theoretical approaches that can deal with the implications for assessing effectiveness. Efforts need to identify intervention mechanisms, plausible relationships between these and their measurable outcomes and the components of contexts that support the emergence of intervention attributes. PMID:23175532

  1. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

    OpenAIRE

    Lígia Giovanella; Klaus Stegmüller

    2014-01-01

    The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, r...

  2. Effects of an implemented care policy on patient and personnel experiences of care.

    Science.gov (United States)

    Lövgren, Gunvor; Eriksson, S; Sandman, P-O

    2002-03-01

    A care policy was implemented within health care in the county of Västerbotten, Sweden. A questionnaire was administered before and after the implementation of the care policy to assess its effects. Patients within hospital care and primary health care described their experiences in a base-line study (n=3950) in 1994 and a follow-up study (n=2941) in 1996. On the same occasions personnel (n=2362 and 2310, respectively) answered the same questionnaire assessing what they thought their patients experienced. No significant positive effects of the implementation were seen by the patients. Fewer patients felt that they were understood when they talked about their problems, dared to express criticism or denied they were treated nonchalantly in the follow-up study. The experiences of the personnel were in line with those of the patients concerning nonchalant treatment in the follow-up study. Furthermore, fewer staff members thought that their patients felt they had adequate help with hygiene whilst more thought that their patients felt they were responded to in a loving way. One interpretation of the negative outcome is that organizational changes, strained resources and cuts in staffing during the 90s may have reduced the possibility of integrating the care policy in spite of an ambitious and extensive intervention. PMID:11985743

  3. [Changes in psychiatric care. Reform or revolution? The experience of the Swedish model].

    Science.gov (United States)

    Kullgren, G; Penayo, U

    1992-03-01

    Reforms to psychiatric practice in Sweden are discussed, expecting that the Scandinavian experience be of assistance as regards changes that are being implemented for a re-structuration of psychiatric care in Latin America. The following points are enhanced: (a) epidemiological studies as an important basis for planning and action in mental health; (b) a progressive closing of mental hospitals while, at the same time, more institutionalization capacities are being created at general health services, and (c) organizing non-hospital care by sectors with community mental health teams being in charge of. As far as negative aspects are concerned, a tendency towards a "psychologization" so to speak of social issues, and a certain lack of attention of patients with severer disorders are pointed out. PMID:1305353

  4. 医保改革面临挑战%Challenges Faced by Health Care Reform

    Institute of Scientific and Technical Information of China (English)

    桑吉·古普塔; 本尼迪克特·克莱门茨; 戴维·科迪; 王宇(译)

    2015-01-01

    当前,许多国家仍存在医疗服务可得性差、医疗成本高昂、公共卫生支出效率低下等问题,医保改革面临重大挑战。医保改革目标存在两难—既要改善人们的健康状况,又要控制支出成本,因而提高公共卫生支出效率是改善社会健康状况的最优选择。各国政府的干预形式和公共卫生支出水平因国别、时间等的不同而变化。财政状况较好的新兴经济体需在保证财政可持续的前提下扩大基本医保覆盖面;发达经济体则应注重提升公共卫生支出的效率并限制支出增长速度。%At present, poor medical service availability, high health care costs and inefficient of public health spending are exsiting in many countries, and health care reform still faces big challenges. To improve people's health and to make a control of the costs are dilemma of health-care reform, and thus improving the efficiency of public health expenditure is the optimal choice to improve social health. The forms of government intervention and the level of public health expenditure are different due to different countries and period. Emerging economies should expand basic health care coverage on the premise of fiscal sustainable development while developed economies should pay attention to improve the public health spending efficiency and limit the spending growth.

  5. [The interface of nursing care with the aged attention policies].

    Science.gov (United States)

    Darder, Juan José Tirado; Carvalho, Zuila Maria de Figueiredo

    2012-01-01

    The objective was to make an explanation on the interface of nursing care with the elder care policies. It is presented the aging phenomenon as a global reality and a victory of modern society; the situation of elderly people and the social consequences of aging in Spain; the dependence and assistance needs; the situation of elderly people in Brazil; comparison between Spain and Brazil; dependency levels; and the solutions that nurses provide and home care as a basis for a better future. The considerations given are: meeting the dependency must be addressed immediately, considering the failures in other countries, to avoid the same mistakes, and to urge the elder population to maintain their independence with health promotion. PMID:23338574

  6. Religious Groups as Interest Groups: The United States Catholic Bishops in the Welfare Reform Debate of 1995–1996 and the Health Care Reform Debate of 2009–20101

    Directory of Open Access Journals (Sweden)

    Anne Marie Cammisa

    2016-02-01

    Full Text Available The United States has a long history of religious influence on public policy: the anti-slavery movement, progressivism, prohibition, civil rights, abortion, school vouchers, school prayer and nuclear disarmament are all issues that have involved religion and religious groups in policymaking. In recent decades, the number of religious interest groups (as well as interest groups in general has greatly expanded, but the role that the religious organizations play as interest groups in the policy arena has received relatively little attention. How are they similar to and different from other interest groups? What tactics do they use? How successful are they? Under what conditions is success or failure more likely? This article examines Roman Catholic religious groups as interest groups in the congressional policymaking process. First, it places Catholic interest groups in the context of the interest group literature, and second, it examines Catholic interest groups’ activity in the passage of welfare reform in 1996 and in the passage of health care reform in 2010. In both cases, they played a greater role in context-setting than in actually changing provisions.

  7. Las políticas de salud reproductiva en el Perú: reformas sociales y derechos ciudadanos Reproductive health policies in Peru: social reforms and citizenship rights

    Directory of Open Access Journals (Sweden)

    Stéphanie Rousseau

    2007-08-01

    Full Text Available El artículo analiza el caso del proceso de elaboración de políticas de salud reproductiva en el Perú, en el contexto de las reformas de las políticas sociales implementadas durante los últimos 15 años. Las reformas en el sector de la salud sólo han reparado en forma parcial el acceso desigual de las mujeres a la planificación familiar, a los derechos reproductivos y a la atención materna. Las fuentes principales de desigualdad están relacionadas con la naturaleza segmentada del sistema de la atención de la salud que ocasiona, entre otros temas, que la mayoría de las mujeres sin seguro provenientes de las clases populares dependan de qué y cómo sean provistos los servicios públicos de la atención médica. Por otra parte, el continuo papel de sectores conservadores en los debates sobre políticas de salud reproductiva sigue teniendo un impacto sobre los servicios públicamente disponibles de planificación familiar.The article analyzes the case of reproductive health policy-making in Peru in the context of recent social policy reforms. Health-sector reforms have only partially redressed Peruvian women's unequal access to family planning, reproductive rights and maternal care. The main sources of inequalities are related to the segmented character of the health-care system, with the highest burden placed on the public sector. The majority of women from popular classes, who are not protected by an insurance plan, are dependent upon what and how public services are provided. Simultaneously, the continuing role of conservative sectors in public debates about reproductive health policy has a strong impact on public family planning services and other reproductive rights.

  8. Responses of Canada's health care management education programs to health care reform initiatives.

    Science.gov (United States)

    Angus, D E; Lay, C M

    2000-01-01

    Canada's provincial health care systems have been experiencing significant changes, mostly through horizontal integration achieved by merging hospitals, and, in a few cases, through vertical integration of public health, long term care, home care and hospital services. The government motivation for forcing these changes seems to have been primarily financial. In a few cases, the integration seems to have resulted in a stable and successful outcome, but, in most others, there has been destabilization, and in some, there has been chaos. The question posed in this research was how the five accredited Canadian graduate programs in health care management were responding to these changes. Two of the programs have recently made major changes in structure and/or delivery processes, following careful examination of their perceived environments. One has rationalized by subdividing courses. Another is repatriating courses from the business school in order to achieve more health-related content. Four of the five programs have added a number of courses in the last few years, or plan to do so in the next year or two, either because of accreditation criteria or student or faculty interest. The program directors viewed the educational requirements for clinicians and non-clinicians as being identical. In spite of the major structural changes, and the resulting destabilization of the health care organizations (and even governments), none of the programs emphasized the changes as factors in their plans for program changes. They expressed some concern about the possibility of fads as opposed to significant changes. It may be that these changes are dealt with in the content of individual courses. This aspect was not examined by the survey nor by interviews with the directors. Each of the programs has emphasized its own niche, with no consensus about changes required.

  9. The effect of immigration and welfare reform legislation on immigrants' access to health care, Cuyahoga, and Lorain Counties.

    Science.gov (United States)

    Loue, S; Faust, M; Bunce, A

    2000-01-01

    This study examined the effect of the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 on immigrants' ability to access health care in two counties in Northeastern Ohio. Semistructured interviews were conducted with 251 individuals of varying immigration status and ethnicity. Data collected included type of recent illness, type and location of care received, type of health insurance, if any, and problems encountered. Significant associations were found between birth in a former Soviet-controlled area and use of public insurance. We did not detect an adverse effect of the welfare and immigration reform laws on ability to access care, most likely because a large proportion of respondents were permanent residents or asylees and were eligible for publicly funded medical care under the reform laws. The most common problems in obtaining medical care included lack of insurance and/or money, transportation, language, dissatisfaction with the doctor's care, and long waits. Individuals born in former Soviet-controlled areas as well as those who spoke Spanish or Slavic languages at home or work reported more difficulties in accessing care. Many undocumented individuals indicated that they would delay or refrain from seeking care due to fear of immigration consequences. PMID:16228729

  10. Telecom Reform

    DEFF Research Database (Denmark)

    , as well as expertise in the new technologies, industries, economics, policy development, and law to present and critique the principles, policies and regulatory practices associated with telecom reform. Twenty six international experts address thirty two topics that are essential to successful telecom......Telecom Reform: Principles, Policies and Regulatory Practices, provides a comprehensive and definitive review and assessment of the unfolding telecom reform process, and its implications for information society development. It is an invaluable resource and authoritative reference on telecom reform...... and information infrastructure issues - for people in government, academia, industry and the consulting community. This book addresses the process of policy and regulatory reform in telecom that is now in its formative stage. It draws on detailed knowledge of industry development and regulatory experience...

  11. Explaining health care professionals' resistance to implement Diagnosis Related Groups: (No) benefits for society, patients and professionals

    NARCIS (Netherlands)

    L.G. Tummers (Lars); S.G.J. Van de Walle (Steven)

    2012-01-01

    textabstractBackground: Effective health system reform requires support from health care professionals. However, many studies show an increasing discontent among health care professionals toward certain government policies. When professionals resist implementing policies, this may have serious conse

  12. Point Climat no. 22 'Reform of the Common Agricultural Policy is laying the initial foundations for a European agricultural climate policy'

    International Nuclear Information System (INIS)

    Among the publications of CDC Climat Research, 'Climate Briefs' presents, in a few pages, hot topics in climate change policy. This issue addresses the following points: The Common Agricultural Policy (CAP) has had a very small climate component since 1992. The recent inclusion of green payments and the climate risk management tools proposed for the CAP for the period beyond 2013 illustrate the European Commission's willingness to expand this climate component. Furthermore, there is little mention of the agricultural sector in the tools rolled out by the European climate policy, particularly those derived from the 2009 'Climate and Energy' Package. Therefore, even if this autumn's parliamentary debate results in the reform proposals being diluted, the post-2013 CAP could nevertheless become a principal tool for a common EU climate policy in the agricultural sector

  13. Health care policy issues in the drug abuser treatment field.

    Science.gov (United States)

    McAuliffe, W E

    1990-01-01

    As we enter the 1990s drug abuse has once again become a major health concern, and for the first time the drug treatment field has had to address many of the policy, regulation, and planning issues resulting from cost inflation that have become commonplace in other parts of the health care field. To avoid serious errors and confusion, drug abuse health policies must recognize the very different needs of the public and private sectors. The public sector, where poor addicts receive drug treatment provided or purchased by the government, has long suffered from chronically inadequate funding. Although responses to several epidemics (heroin, crack, and AIDS) have produced periods of increased allocations for drug abuse treatment, more often than not long waiting lists at programs have rationed treatment to lower-income addicts seeking care. Low salary levels have limited the quality of public treatment services, and the absence of resources has hindered the development of programs that respond to new technical developments and drug abuse problems, such as the crack epidemic. Despite severe resource shortages, the public drug treatment system has sometimes used resources inefficiently, with little attention to appropriateness of admissions, lengths of stay, ambulatory treatment modalities, or varying levels of care. Public sector goals for the 1990s should include filling current shortages in drug treatment services, developing adequate long-term funding for treating addicts who lack third-party coverage, modernizing the treatment system, developing new patterns of practice that use existing resources more efficiently, and developing a plan for treating intravenous drug users infected with the AIDS virus. In the private sector, the advent of working- and middle-class demand for drug treatment in the 1970s and 1980s has produced a new drug treatment system that suffers from many of the policy problems common to the rest of health care. Drug abuse in the workplace has

  14. The impact of market-based 'reform' on cultural values in health care.

    Science.gov (United States)

    Curtin, L L

    1999-12-01

    The many issues managed care poses for providers and health networks are crystallized in the moral problems occasioned by its shifting of the financial risks of care from insurer to provider. The issues occasioned by market-based reform include: the problems presented by clashes between public expectations and payer restrictions; the corporatization of health service delivery and the cultural shift from humanitarian endeavor to business enterprise the depersonalization of treatment as time and money constraints stretch resources, and the culture rewards efficient "business-like" behavior the underfunding of care for the poor and uninsured, even as these populations grow the restructuring of care and reengineering of healthcare roles as the emphasis shifts from quality of care to conservation of resources rapid mergers of both health plans and institutional providers with all the inherent turmoil as rules change, services are eliminated, and support services are minimized to save money the unhealthy competition inherent in market-based reform that posits profit taking and market share as the measures of successful performance the undermining of the professional ethic of advocacy the use of incentives that pander to greed and self-interest. The costs of sophisticated technologies and the ongoing care of increasingly fragile patients have pulled many other elements into what previously were considered "privileged" professional interactions. The fact that very few citizens indeed could pay out-of-pocket for the treatment and ongoing care they might need led to social involvement (few people remember that both widespread health insurance and public programs are relatively recent phenomena--only about 30 years old). However, whether in tax dollars or insurance premiums, other people's money is being spent on the patient's care. Clearly, those "other people" never intended to give either the patient or the professional open-ended access to their collective pocketbooks

  15. The impact of market-based 'reform' on cultural values in health care.

    Science.gov (United States)

    Curtin, L L

    1999-12-01

    The many issues managed care poses for providers and health networks are crystallized in the moral problems occasioned by its shifting of the financial risks of care from insurer to provider. The issues occasioned by market-based reform include: the problems presented by clashes between public expectations and payer restrictions; the corporatization of health service delivery and the cultural shift from humanitarian endeavor to business enterprise the depersonalization of treatment as time and money constraints stretch resources, and the culture rewards efficient "business-like" behavior the underfunding of care for the poor and uninsured, even as these populations grow the restructuring of care and reengineering of healthcare roles as the emphasis shifts from quality of care to conservation of resources rapid mergers of both health plans and institutional providers with all the inherent turmoil as rules change, services are eliminated, and support services are minimized to save money the unhealthy competition inherent in market-based reform that posits profit taking and market share as the measures of successful performance the undermining of the professional ethic of advocacy the use of incentives that pander to greed and self-interest. The costs of sophisticated technologies and the ongoing care of increasingly fragile patients have pulled many other elements into what previously were considered "privileged" professional interactions. The fact that very few citizens indeed could pay out-of-pocket for the treatment and ongoing care they might need led to social involvement (few people remember that both widespread health insurance and public programs are relatively recent phenomena--only about 30 years old). However, whether in tax dollars or insurance premiums, other people's money is being spent on the patient's care. Clearly, those "other people" never intended to give either the patient or the professional open-ended access to their collective pocketbooks

  16. 奥巴马医改三问%Analysis of Obam's Health Care Reform

    Institute of Scientific and Technical Information of China (English)

    汤晓莉

    2014-01-01

    奥巴马医改一波三折,既有党派政治、市场理念、二元联邦制等外在因素的影响,也有改革本身的一些问题。本文从目标定位、筹资机制和实施能力三个方面对此进行了深入分析。%There are many obstacles standing on the way to formulate and implement the Patient Protection and Affordable Act. Some of the obstacles resulted from the external factors, such as partisan politics, market orientated conception and bi-federalism, etc.;some of them were caused by the imperfection of Obam's Health Care Reform itself. This article makes a comprehensive analysis of these problems from three aspects:universal coverage targeting, funds-raising mechanism and executive capacity.

  17. To adopt or not to adopt an abortion policy : A case study of the abortion reform processes in Spain and Portugal

    OpenAIRE

    Norberg, Angelica

    2016-01-01

    This thesis analyzes two attempts at restricting women’s access to abortion with different outcomes. In 2014 a policy proposal seeking to criminalize abortion in Spain was withdrawn after a ten month long debate, while a policy proposal introducing obstacles for women to have an abortion was adopted in Portugal in 2015 after a quiet reform process. Process tracing is used to uncover the factors conducive for the adoption of the Portuguese reform proposal and the withdrawal of the Spanish refo...

  18. Trade Policy Reform and the Textile, Clothing and Footwear Industry, Australia: 1993-97

    OpenAIRE

    Jayanthakumaran, K.

    1999-01-01

    Textiles, clothing and footwear (TCF) industries in Australia experienced extensive trade reforms in the 1990s, which were expected to promote a competitive TCF activities. This paper examines two hypotheses (1) trade reforms have had a positive impact on TCF industries and (2) trade reforms have had an adverse impact on Small and Medium Enterprises (SMEs). Selected growth performance variables were intensively analysed. The results of the study are consistent with hypothesis (1) but are inco...

  19. The human perspective on health care reform: coping with diabetes in Kyrgyzstan.

    Science.gov (United States)

    Hopkinson, Botagoz; Balabanova, Dina; McKee, Martin; Kutzin, Joseph

    2004-01-01

    Health systems world wide are confronted by the challenge of rising levels of chronic diseases. Yet existing approaches to health system analysis often fail to capture the complexity of the responses required to address this challenge. In this paper we describe the results of a pilot study using a rapid appraisal technique to assess the performance of the health care system in Kyrgyzstan, a former Soviet central Asian republic. The study focuses on diabetes, a condition whose effective management requires a coordinated response involving many components of the health care system. The study sets out a conceptual framework in which the system is seen from the perspectives of users, health professionals and policy-makers. It sees the effective delivery of health care as dependent on appropriate investment in human, physical, intellectual and social resources. The study reveals important weaknesses in all of these areas, although it also notes that current policies, while constrained by the legacy of the past and by limited resources, are beginning to tackle them. This pilot study indicates that rapid appraisal, using a condition such as diabetes, where those affected can be easily identified, offers a means of gaining important insights into a health care system.

  20. Balancing equity and efficiency through health care policies in Slovenia during the period 1990-2008

    NARCIS (Netherlands)

    T. Albreht; N.S. Klazinga

    2010-01-01

    Background: Slovenia's 1992 health reform set the following five goals: introduction of social health insurance system and a system of co-payment for a range of health care services; introduction of private practice in health care; devolution of planning and control functions from the State to profe

  1. Competition Policy And Organizational Fragmentation In Health Care

    Directory of Open Access Journals (Sweden)

    Thomas (Tim Greaney

    2009-04-01

    Full Text Available Once upon a time . . . and a very good time it was, advocates for marketbased approaches to health policy had a coherent story to tell. Cost and quality would remain suboptimal as long as fee-for-service medicine persisted and the myriad market imperfections that impede efficiency went unchecked. However, things could be righted by adopting principles associated with managed care, together with pursuing sensible antitrust enforcement and government deregulation to clear away the private and regulatory underbrush obstructing market forces. Economic theorists and policy experts agreed that these steps would effectively address information, agency, and moral hazard problems and begin to glue together the pieces of our fragmented delivery system. And, for a while, things seemed to work out as promised. Providers began to reorganize into firms and other integrating arrangements and health insurers adopted financial and contractual measures designed to align provider incentives with consumer needs. Regulators directed policies at removing obstacles to competition and antitrust enforcers sought to encourage efficient consolidation while blocking cartels and provider oligopolies. Spiraling costs leveled off for a while and both payment systems and provider organizations began to adapt to market forces.

  2. Public policy update. Welfare reform and teen parents: are we missing the point?

    Science.gov (United States)

    Wacker, B L; Gambrell, A E

    1994-01-01

    The aim of teenage pregnancy prevention initiatives should be to provide sexuality education that is age-appropriate, medically accurate, and available at each grade level with a positive view of sexuality and information and skills that contribute to sexual health and the ability to make decisions. Abstinence should be included as long as it is not fear-based and is part of the promotion of responsible sexuality. Contraceptive information must be available to those already sexually active. Subsidized day care for children of poor adolescent mothers must be at the top of the agenda of services integrated with job programs and school-to-work initiatives. Quality child care can provide a solid foundation in personal health, negotiation, self-esteem, and individual rights and responsibilities. Quick-fix and punitive measures are out of place in programs that rely on growth in individual responsibility. An innovative approach to social welfare programming would include comprehensive sexuality education, reproductive health services, child care, health insurance, and job training. The Clinton welfare reform drafts combine elements of teen pregnancy prevention with punitive action. What is needed is greater investment in programs enhancing sexuality education, acceptance and understanding of sexuality, and access to affordable reproductive health services. The Clinton plan focuses primarily on the National Mobilization for Youth Opportunity and Responsibility, which is a national media campaign to educate youth about responsibility and the benefits of staying in school and delaying childbearing. About 1000 middle and high schools in high-poverty areas would be targeted. Opportunities would be offered to go to college or have access to job training. Controls would be placed on adolescents by requiring minor parents to live with a responsible adult, minor mothers to stay in school, and to limit disbursements for additional children while on Aid to Families with Dependent

  3. The Initiative to extend Medicare into Mexico: a case study in changing U.S. Health Care Policy

    Directory of Open Access Journals (Sweden)

    Roberto A. Ibarra

    2011-10-01

    Full Text Available This study examines the geo-political activities of interest groups, governments and multinational corporations involved in an initiative to extend Medicare to U.S. retirees residing in Mexico.  If the initiative to change the current Medicare policy succeeds, the relocation of Medicare-eligible populations from the U.S. to Mexico is likely to increase; the U.S. is expected to gain cost-savings for taxpayers on Medicare; Mexico can develop senior-housing and options for long-term care it currently lacks; and foreign-led multinational corporations will increase their profits and dominance, fostering even more privatization in Mexico’s health care sector. By exploring new issues about retirement migration and health this study seeks to gain knowledge about the phenomena in a number of areas.  First, the retirement migration of North Americans to Latin America is an under-studied phenomenon in the fields of social gerontology, migration research, and health policy studies.  Second, the Medicare in Mexico initiative is even less well-known among health policy scholars than the retirement migration phenomenon into Mexico. Yet this initiative is inherently international in scope and involves a number of US-based institutions and interest groups actively promoting the project from within Mexico. Thus, the initiative has important geo-political and socio-economic implications for reforming health care systems in the U.S. and Mexico.

  4. How Health Reform is Recasting Public Psychiatry.

    Science.gov (United States)

    Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V

    2015-09-01

    This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.

  5. Reform of the College Entrance Examination: Ideology, Principles, and Policy Recommendations

    Science.gov (United States)

    Liu, Haifeng

    2013-01-01

    Reform of the College Entrance Examination is trending toward simultaneous unification and diversification. The objective of reforming the entrance exam is to establish a college enrollment examination system that is primarily based on a unified test, which would assess students' abilities, appraise them on multiple levels, and classify them.…

  6. Social simulation and polycentric policy making: ex ante assessment of administrative reform in the region Rotterdam

    OpenAIRE

    Vissers, G.; Meer, Frans-Bauke

    2000-01-01

    textabstractAdministrative reform is often practiced as solution for perceived problems. However, frequently results are disappointing. The authors relate this phenomenon to the multi-centered nature of administrative processes and propose a social simulation method to gain more insight in potential impact of administrative reforms considered by ex ante assessment. Their analysis is supported by a specific example.

  7. The Use (and Misuse) of PISA in Guiding Policy Reform: The Case of Spain

    Science.gov (United States)

    Choi, Álvaro; Jerrim, John

    2016-01-01

    In 2013 Spain introduced a series of educational reforms explicitly inspired by the Programme for International Student Assessment (PISA) 2012 results. These reforms were mainly implemented in secondary education--based upon the assumption that this is where Spain's educational problems lie. This paper questions this assumption by attempting to…

  8. School Reforms in England, Japan, Korea and the U.S.: Policy Variation and Educational Convergence.

    Science.gov (United States)

    Lee, Jaekyung

    Education reform during the last 2 decades has been shaped by the forces of growing public distrust of educational bureaucracies in a climate of rapid political change and growing international competition in the context of a global economy. Major school reforms in four selected industrial countries that differ significantly in terms of…

  9. Compact reformer for the solid polymer fuel cell policy and best

    Energy Technology Data Exchange (ETDEWEB)

    Goulding, P.S.; Deegan, M.; Gough, A. [Newcastle University (United Kingdom)

    1998-07-01

    This report summarises the results of a study investigating the feasibility of the Compact Reformer concept, and examining its design and manufacture. The development and testing of a hybrid reformer and thin coat catalyst systems are described, and details of the modeling of the reactor, and the optimisation and costing of the solid polymer fuel cell are given. (UK)

  10. Towards a Theory of the Reform of the Common Agricultural Policy

    Directory of Open Access Journals (Sweden)

    Adrian Kay

    2000-07-01

    Full Text Available This paper sets up two competing frameworks to assess the evidence of the CAP reforms of the 1980s and 1990s. The two frameworks differ in the degree of prominence given to interest groups in affecting CAP decisions. The paper concludes that the most important mechanism behind CAP reforms is the interaction of EU institutions and member state governments. Interest groups, at national or EU-level, have limited influence on the reform process. The paper does not claim to have developed a new theory of CAP reform but rather aims to suggest a direction for the development of a high content theory that is able to account for the differences between episodes of CAP reform as well as the similarities.

  11. Mental health policy and integrated care: global perspectives.

    Science.gov (United States)

    Zolnierek, C D

    2008-09-01

    Although omitted from the World Health Organization's eight Millennium Development Goals, mental illness ranks fourth of the 10 leading causes of disability in the world and is expected to approach second place by 2020. Scarce resources challenge responses to mental health needs. Effective approaches must consider existing healthcare delivery networks, nurses as care providers, as well as social, cultural, political and historical contexts. This paper reviews policy development and care approaches to address mental health needs around the world. Challenges, successes and further needs are discussed. Selected articles were reviewed to represent varied approaches to address mental health needs in countries with diverse resources and infrastructures. Integrated systems offer one model for addressing mental health needs along with physical health needs within a population. While potentially an efficient strategy, caution is advised to ensure services are integrated and not merely added on top of an already overburdened system. As the largest group of healthcare professionals worldwide, nurses play a key role in the delivery of mental health services. Nurses have an opportunity, if not a responsibility, to collaborate across borders sharing education and innovative approaches to care delivery. PMID:18768008

  12. Exploiting Policy Obscurity for Legalising Water Grabbing in the Era of Economic Reform: The Case of Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Subodh Wagle

    2012-06-01

    Full Text Available Since the last two decades, economic reform in India is exerting pressure on limited land and water resources. This article argues that sectoral reforms underway in different areas such as water, electricity, and the export sector are giving rise to a new form of water grabbing in the state of Maharashtra, India. This water grabbing is legitimised by the use, application and redefinition of reform instruments such as the sectoral policy statements and laws. Maharashtra, like many other Indian states, has been a theatre for the play of power among different interest groups over control and access to water resources developed through state funding. Dams were built at the cost of depriving the upland riparian communities of their land, water and other resources. The water provided by the dams – which strengthened the political power of the leaders representing the irrigated plains – is now at the core of a shift in regional power equations. Based on case studies of three dams the paper presents these contemporary developments around water allocation and re-appropriation. These developments pertain to the shift from the erstwhile focus on securing water for irrigation to the new focus of securing water to facilitate international and domestic private investments. The paper concludes by arguing that the state is able to legitimise this form of water grabbing due the emergence of a new and grand political coalition and nexus that has emerged at the behest of the ongoing economic reforms.

  13. What lessons have been learned in reforming the Renewables Obligation? An analysis of internal and external failures in UK renewable energy policy

    International Nuclear Information System (INIS)

    Despite operating a delivery programme for RES-E since 1990, UK targets and policy goals have not been achieved. In response, the Government reformed the RO. This article re-examines UK renewable energy policy by analysing the internal and external failures of the various mechanisms to determine if Government has learnt from previous experience in reforming the RO. Government did not learn from their own actions during the NFFO/RO transition, evidenced by high-levels of similarity in internal/external failures. The reformed-RO is expected to significantly increase deployment, has provided a 'renewables package' by comprehensively addressing both internal/external failures but major internal failures (price/financial risk) still remain, resulting in contiguous failures over two decades and two mechanism changes (NFFO, RO, RO/reformed-RO). Success will again be heavily dependent on a select few technologies and new/untested measures to combat external failures. Mechanism-extension to 2037 is probably the single most important factor underlying potential deployment increases. However, introducing a FIT-like system via the sheer number of 'bolt-on' reforms to counter policy failures indicates loss of direction and clarity. Overall, although Government appears to have learnt some of its lessons from the past two-decades, significant doubt remains whether renewable energy policy objectives will be met via the latest mechanism change. - Research highlights: → Review of UK renewable energy policy learning behaviour via the 2009 Renewable Obligation reform. → Applies key lessons and analysis of NFFO/RO, RO reform and possible FIT schemes. → Finds UK Government has learnt some lessons from the past but some failures remain contiguous over two decades. → In contrast to previous changes, 2009 reform provided a comprehensive reform package. → Significant doubt remains whether objectives will be met via latest mechanism change.

  14. Policy Reform Efforts and Equal Opportunity – An Evidence-Based Link? An Analysis of Current Sector Reforms in the Austrian School System

    Directory of Open Access Journals (Sweden)

    Corinna Geppert

    2012-01-01

    Full Text Available The main focus of the present paper is to answer two different questions: From the perspective of Austrian education policy, which core areas of schooling are linked to the demand for equal opportunity? Can these reform efforts sustain the current state of research, and what are the consequences for schooling? The paper draws on an analysis by Hopmann, Geppert & Bauer (2010. Fifteen official self-presentations (political programmes of Austrian political parties were analysed for statements concerning the improvement of the education system. This resulted in about seventy different statements, which were aggregated into eight core areas.We conducted a systematic analysis of four of these core areas, dealing with the topics of equal opportunity: comprehensive school, all-day schooling, school autonomy and standardisation of students’ achievements. The aim was not to judge the legitimacy or the political content of the claims made. In line with evaluative discourse, we asked whether the combination of political demands and their associated expectations met the current state of research. In many policy programmes, it is assumed that comprehensive schooling, all-day schooling, education standards, standardised general certification for university attendance, school autonomy or language surveys go hand in hand with more equality of opportunity, justice andquality in education, but an analysis of the current state of research could not confirm this. The analysis showed that, with regard to education policy demands, statements having empirically little or nothing to do with each other are often linked.

  15. Health care reform through the eyes of patients: a qualitative look at Medicaid redesign.

    Science.gov (United States)

    Walsh, Michael F; Fitzgerald, M Paula

    2012-01-01

    This research examines consumer choice in Medicaid insurance plans. As part of the 2005 Federal Deficit Reduction Act, a number of states have implemented new Medicaid programs targeted to a subset of the Medicaid population. These programs offer consumers a choice of plans and this research examines consumer choice in one state's program. As part of a broader survey, participants were given the opportunity to explain, in their own words, why they selected their plan. We systematically interpret this qualitative data and then develop a series of propositions relating to Medicaid health care plan choice and marketing/public policy issues surrounding this choice. PMID:22416923

  16. Inpatient psychiatric care in the 21st century: the need for reform.

    Science.gov (United States)

    Glick, Ira D; Sharfstein, Steven S; Schwartz, Harold I

    2011-02-01

    Driven by financial pressures, the sole focus of psychiatric inpatient treatment has become safety and crisis stabilization. Data are lacking on outcomes of ultrashort-stay hospitalizations; however, such stays may diminish opportunities for a sustained recovery. In the absence of an evidence base to guide clinicians and policy makers, mental health professionals have an ethical obligation to promote what they consider to be best practice. This Open Forum focuses on the need to reconsider the current model of inpatient hospitalization in order to maximize positive outcomes and emphasize appropriate transition to the community and less intensive levels of care. A model of care is presented based on rapid formulation of diagnosis, goals, and treatment modalities before treatment begins. Three phases are described--assessment, implementation, and resolution--with specific principles to guide length-of-stay decisions and requirements for staffing.

  17. Taxation reform as a component of tobacco control policy in Australia

    OpenAIRE

    Scollo, Michelle; Borland, Ron; World Health Organization,

    2004-01-01

    In 1998, the Australian Government announced a major reform of Australia’s overall tax system. The previous system was characterized as out of date (it included a range of historically justified but now anachronistic taxes), unfair, discouraging of exports and investment, ineffective and complex. The proposed reforms included the introduction of a Goods and Services Tax (GST) and the abolition of a raft of state taxes and charges. The aim was to bring the service economy into the tax net, pro...

  18. The Reform of International Financial System and China’s Policy Options

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The reform of international financial system is focused on the following aspects: international monetary system, international financial institutions (IFIs), and international financial regulatory system. The US, European Union, Japan, and the Emerging Market Countries all have different stances concerning the reforms in these fields. There is also an obvious deviation in the interests and demands of Emerging Powers and the US and EU. In addition, the G20 has become the major forum for economic coordination...

  19. Rare disease policies to improve care for patients in Europe.

    Science.gov (United States)

    Rodwell, Charlotte; Aymé, Ségolène

    2015-10-01

    Rare diseases are those with a particularly low prevalence; in Europe, diseases are considered to be rare when they affect not more than 5 in 10000 persons in the European Union. The specificities of rare diseases make the area a veritable public health challenge: the limited number of patients and scarcity of knowledge and expertise single rare diseases out as a distinctive domain of high European added-value. The Orphan Medicinal Product Regulation of 1999 was the first European legislative text concerning rare diseases, followed by many initiatives, including recommendations by the Council of Ministers of the European Union in 2009. These initiatives contributed to the development of rare diseases policies at European and national level aimed at improving care for patients with rare diseases. A review of the political framework at European level and in European countries is provided to demonstrate how legislation has created a dynamic that is progressively improving care for patients with rare diseases. This article is part of a Special Issue entitled: "Current Research on the Neuronal Ceroid Lipofuscinoses (Batten Disease)".

  20. Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience

    Science.gov (United States)

    2016-01-01

    Abstract Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes—all core attributes of a medical home. This qualitative study looked at 4 different PHCO models—3 from the United States and 1 from Australia—with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system. PMID:26636485

  1. The Yokes of Gender and Class: The Policy Reforms and Implications for Equitable Access to Education in Kenya

    Directory of Open Access Journals (Sweden)

    Njoki Nathani Wane

    2003-09-01

    Full Text Available Kenya, a former British colony, attained its political independence in 1963. Despite its political independence, Kenya inherited a colonial education system that was based on segregation and exclusion because of race, culture, class, and gender. This is a qualitative analysis examining the education system in Kenya. In the analysis, we explore gender and class barriers that may inhibit education for women in Kenya. We review existing secondary literature on policy documents; reflect on our experiences and observations; and also reflect on interviews with Njeri and Nyokavi, who live in the 21st century ‘post-colonial’ Kenya. As Kenyan women from subsistence-farming backgrounds, we, the authors, seemed destined to remain at the very bottom of the hierarchical education structure established during the colonial period. We explore the impact of contemporary, globally and locally mandated education policy reforms and emerging social service provision partnerships. These are often packaged as policy reforms and viable strategies of a just, equitable, and fair distribution of opportunities for all, meant to correct the colonial disparities. Our arguments are informed by the system's discursive framework (Wane 2000b and the anti-colonial discursive framework (Amadiume 1989, 1997; Dei 1999, 2000; Oyewumi 1997; Wane 2002. The analysis authenticates that, since independence, Kenya has realized tremendous educational growth at all levels. However, such educational reforms have resulted in the exclusion of many children who are from low socio-economic groups, in essence replacing the racial segregation of the colonial system with cultural and class-based inequities of the post-colonial society.

  2. Water Policy Reform in China’s Fragmented Hydraulic State: Focus on Self-Funded/Managed Irrigation and Drainage Districts

    Directory of Open Access Journals (Sweden)

    James Nickum

    2010-10-01

    Full Text Available This essay explores the nature of China’s unique decentralised 'authoritarian' regime and its various origins; the continuous dialectic between state-directed and market-directed approaches to the economy (including water; the economic and budgetary drivers of water policy change; whether the concept of integrated water resources management (IWRM is overly 'loaded' with liberal ideas or even if not, whether it provides any insights beyond concepts more widely accepted in China; whether the state-society dichotomy makes sense in China’s guanxi (personal relations culture; and the course of the World Bank-sponsored Self-funded/managed Irrigation and Drainage District (SIDD reforms.

  3. Expanded, but not regulated: ambiguity in home-care policy in Ireland.

    Science.gov (United States)

    Timonen, Virpi; Doyle, Martha; O'Dwyer, Ciara

    2012-05-01

    This article argues that home-care policy in Ireland was ambiguous throughout the first decade of the 21st century: policy-makers expanded home care, but failed to develop policies to govern this expanded provision. As a result, home care became more widely available in the absence of a framework to govern access to services and to regulate care providers. We analysed official policy documents, statistics and policy critiques published between 2000 and 2010 in order to understand this incongruity between the expansion of home-care services and the failure to develop policies to govern access to and quality of services. The key factors that motivated home-care expansion in the Irish case were: (1) problems in the acute hospital sector and the perception of home care as a partial solution to these (political blame avoidance) and (2) significant GDP growth (until 2007) that provided politicians with the means to fund expansion in home-care services (political credit claiming). The key factors that inhibited the development of a policy framework to govern home-care services were: (1) weak governance structures in health services and decision-making at national level based on short-term political gain; (2) Ireland's adherence to the liberal welfare state model and concern about uncontrollable care costs in the face of population ageing; (3) until 2010, paucity of attention to home-care issues in the Irish media and (4) weak provider interest representation. The recent budgetary cutbacks in Ireland bring into sharp relief the political expediency of an unregulated domiciliary care sector and absence of entitlements to home care. We conclude that the forces that drive expanded provision are different from drivers of policy to govern home care and that weakness of governance structures and political advantages of the absence of regulation are the main reasons for the lack of standards and entitlement rules. PMID:22168468

  4. Not-so-new public management and the denial of geography: Ontario health-care reform in the 1990s

    OpenAIRE

    N T Hanlon; Rosenberg, M. W.

    1998-01-01

    New public management (NPM) has become the mantra for public sector restructuring in OECD nations. We critically examine NPM in the context of recent public sector restructuring initiatives in the province of Ontario, Canada. Two NPM-inspired reform mechanisms employed by the Ontario government -- the benchmarking of hospital-utilization indicators and the offloading of a greater share of patient-care responsibilities to the private sector -- are examined as they impact on the economically di...

  5. Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009

    OpenAIRE

    Marco Cornejo-Ovalle; Guillermo Paraje; Felipe Vásquez-Lavín; Glòria Pérez; Laia Palència; Carme Borrell

    2015-01-01

    The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004–2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20–39, 40–59, 60–63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), a...

  6. 新医改背景下的医药企业战略转型研究%Strategic Transformation of Pharmaceutical Companies Under the New Health Care Reform Background

    Institute of Scientific and Technical Information of China (English)

    马永鹍; 姜斌

    2015-01-01

    The new medical reform program will be incorporated into the medical reform pharmaceutical industry category, which is the difference between the new and previous health care reform health reform policies. The launch and implementation of the new health reform program will increase the capacity of China ’ s pharmaceutical market, promote reconstruction pharmaceutical distribution market structure and increase the concentration of the pharmaceutical industry, which makes pharmaceutical business development opportunities and challenges exist. In the new context of health care reform , the implementation of strategic transformation is wise for pharmaceutical companies to obtain long-term development. Making enterprises to adapt their own conditions and environment is the core issue of strategic transformation.%新医改方案将医药产业纳入医改范畴,这是新医改与以往医改政策的区别。新医改方案的推出与实施将增加我国医药市场容量,促进医药流通市场结构的重构,提高医药产业集中度。医药企业的发展契机与挑战将同时存在[1]。在新医改的背景下,医药企业要想获得长远发展,实行战略转型是明智之举。企业的自身条件与环境相适应是战略转型的核心问题[2]。

  7. Reforma, responsabilidades e redes: sobre o cuidado em saúde mental Reform, responsibilities and networks: about mental health care

    Directory of Open Access Journals (Sweden)

    Martinho Braga Batista e Silva

    2009-02-01

    Full Text Available Tendo em vista o processo paulatino de responsabilização de atores e instâncias sociais pelo cuidado no contexto da Reforma Psiquiátrica brasileira, percebe-se que familiares e vizinhos de pacientes psiquiátricos têm sido instigados a " participar" da política pública, principalmente no lugar de " suporte social" , embora oficialmente considerados " parceiros" . Essa reconfiguração da relação entre Estado e sociedade civil é consagrada pela diretriz governamental de tomada de responsabilidade dos serviços pelo território, uma mudança da lógica de demanda e oferta de atendimento no sentido de estimular serviços extra-hospitalares - como os Centros de Atenção Psicossocial, campo desse estudo - a se encarregarem pela população adscrita a uma área geográfica. O objetivo desse texto é investigar as tecnologias psicossociais produzidas nesse contexto político, institucional e histórico específico, tais como a mediação de trocas sociais e a arbitragem de conflitos. Um dos materiais analisados são os registros em prontuário, que podem constituir os atores e instâncias sociais citados como envolvidos no campo da saúde mental, enredando-os na malha administrativa construída como rede de suporte social.In the context of the Brazilian Psychiatric Reform family members and neighbors of psychiatric patients have been urged to " participate" in the public policies, mainly as " social support" although officially considered " partners" . This reconfiguration of the relationship between State and civil society is reflected in the directive that the services have to take over the responsibility for territories, a change in the logic of supply and demand aimed at stimulating extra-hospital services such as Psychosocial Care Centers, the object of this study, to provide care to the population of a certain geographical area. The purpose of this article is to investigate the psychosocial technologies produced in this specific

  8. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Science.gov (United States)

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  9. Decolonizing the Evidence-Based Education and Policy Movement: Revealing the Colonial Vestiges in Educational Policy, Research, and Neoliberal Reform

    Science.gov (United States)

    Shahjahan, Riyad Ahmed

    2011-01-01

    There is a growing body of literature discussing evidence-based education, practice, policy, and decision-making from a critical perspective. In this article, drawing on the literature and policy documents related to evidence-based education in the USA, Britain, and Canada, I join this critique and offer an anticolonial perspective. I argue that…

  10. Policy and Practice in Education Reform in Mongolia and Uzbekistan during the First Two Decades of the Post-Soviet Era

    Directory of Open Access Journals (Sweden)

    John C. Weidman

    2010-12-01

    Full Text Available This article describes the social, economic, and political processes that have influenced educational reform in two countries of Central Asia since the fall of the Soviet Union in 1991. It compares and contrasts the various educational reform initiatives that have occurred in each country, including legal and policy frameworks, curriculum change, decentralization, privatization, finance, structure, and emphasis of educational systems, and the fit between what is taught in educational institutions and demands of the labor market. A sector-wide framework for education reform is presented to facilitate understanding of the very complex set of processes involved.

  11.  Analysis on Opportunities and Challenges of Chinese Medical Device Industry under New Health Care Reform :  Reference of Sweden, USA and UK

    OpenAIRE

    Wu, Xiaotong; Luo, Zhe

    2010-01-01

    Purpose and Execution –The purpose of this paper is to seek feasible suggestions and recommendations to the Chinese medical device industry under the new current market situation—Chinese health care system reform. In order to achieve this aim, we will start with introducing the background of current status of related issues. The next part will be the preparation of further analysis, which contains the theory and descriptions of the health care system reform histories of China, Sweden, the USA...

  12. Post-Crisis Economic Reform in Indonesia:Policy for Intervening in Ownership in Historical Perspective

    OpenAIRE

    Sato, Yuri; 佐藤, 百合

    2003-01-01

    Introduction : Economic reform in Indonesia after the Asian currency crisis is often discussed in parallel with Thailand and South Korea, which were alike hit by the crisis. It should however be noted that what happened in Indonesia was a change of political regime from authoritarianism to democracy, not just a change of government as seen in Thailand and South Korea. Indonesia’s post-crisis reform should be understood in the context of dismantling of the Soeharto regime to seek a new democra...

  13. Estimating the Effect of Student Aid on College Enrollment: Evidence from a Government Grant Policy Reform

    DEFF Research Database (Denmark)

    Nielsen, Helena Skyt; Sørensen, Torben; Taber, Christopher

    and a reform of the student aid scheme to identify the effect of direct costs on college enrollment. To allow for heterogeneous responses due to borrowing constraints, we use detailed information on parents' assets. We find that enrollment is less responsive than found in other studies and that the presence......In this paper, we investigate the responsiveness of the demand for college to changes in student aid arising from a Danish reform. We separately identify the effect of aid from that of other observed and unobserved variables such as parental income. We exploit the combination of a kinked aid scheme...... of borrowing constraints only deters college enrollment to a minor extent....

  14. Tax Reforms and "Modell Deutschland": Lessons from Four Years of Red-Green Tax-Policy

    OpenAIRE

    Truger, Achim; Jacoby, Wade

    2002-01-01

    When the red-green (SPD-Bündnis90/DieGrünen) coalition took over the federal government from the Christian-Democrat/Free-Democrat (CDU/CSU/FDP) coalition in 1998, tax reforms had a very high political priority. And, in fact, the government pushed through an astonishing number of far-reaching tax reforms/tax changes within a period of little more than two years. This paper follows two aims. First, it gives a short description of the measures taken and evaluates them with respect to tax theory ...

  15. Developing New Mexico Health Care Policy: An application of the Vital Issues Process

    Energy Technology Data Exchange (ETDEWEB)

    Engi, D. [Sandia National Labs., Albuquerque, NM (United States); Icerman, L. [Icerman & Associates, Santa Fe, NM (United States)

    1995-06-01

    The Vital Issues Process, developed by the Sandia National Laboratories Strategic Technologies Department, was utilized by the Health Care Task Force Advisory Group to apply structure to their policy deliberations. By convening three expert panels, an overarching goal for the New Mexico health care system, seven desired outcomes, nine policy options, and 17 action items were developed for the New Mexico health care system. Three broadly stated evaluation criteria were articulated and used to produce relative rankings of the desired outcomes and policy options for preventive care and information systems. Reports summarizing the policy deliberations were submitted for consideration by the Health Care Task Force, a Joint Interim Committee of the New Mexico Legislature, charged with facilitating the development and implementation of a comprehensive health care delivery system for New Mexico. The Task Force reported its findings and recommendations to the Second Session of the 41st New Mexico State Legislature in January 1994.

  16. 军队医疗保障制度改革的思考%Reform of Military Health Service Policy

    Institute of Scientific and Technical Information of China (English)

    刘敏; 贺桢; 潘景光; 胡安恒; 张献志

    2012-01-01

    Since 2004 Chinese military health care system reform has started to change the health service mode of military personnel with the socialized reform of logistic services, which has achieved good effect. Now combining with the fact of military medical support, we should deepen the reform, enlarge the medical socialized support range, with which to improve the support level of the military personnel and promote the development of modern logistics system.%2004年我军开始实行的新型医疗保障制度,进行军队成员社会化医疗保障的有益探索,收到良好成效,得到了普遍支持和认可.结合军队医疗保障实际,深化医疗保障制度改革,扩大医疗保障社会化范围,对提高系统内军队成员医疗保障水平、全面建设现代后勤有着重要意义.

  17. Gender Policies Meet VET Practices--The Case of Health and Social Care in Norway

    Science.gov (United States)

    Høst, Håkon; Seland, Idunn; Skålholt, Asgeir

    2015-01-01

    Could the labour market gender balance be improved by introducing new types of apprenticeship-trained workers? This article investigates what happened in the wake of the Norwegian VET programme for health and social care, a new approach introduced via the 1994 educational reform. By upgrading this traditionally female-dominated area of education,…

  18. Health reform's impact on federally qualified community health centers: the unintended consequence of increased Medicaid enrollment on the primary care medical home.

    Science.gov (United States)

    Kulesher, Robert R

    2013-01-01

    The impact of recently passed health reform legislation may cause substantial changes in community health center (CHC) operations. The new legislation provides federal funding for center expansion, increased Medicaid enrollment, enhanced Medicare payments, training to increase primary care providers, and incentives to develop CHCs as accountable care organizations. Health reform could place CHCs in a vulnerable financial situation. Newly insured patients may seek care at private providers, whereas CHCs are left caring only for the uninsured. Thus, CHCs are unable to benefit from enhanced insurance payments needed to offset care given to the uninsured. Conversely, if CHCs participate in developing comprehensive care networks for low-income populations by strengthening referral networks, developing primary medical care homes and accountable care organizations, and investing in infrastructure, then health center medical care will be a desired option for the newly insured, and a robust safety-net system may result.

  19. Disintegrated care: the Achilles heel of international health policies in low and middle-income countries

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Unger

    2006-09-01

    Full Text Available Purpose: To review the evidence basis of international aid and health policy. Context of case: Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. We review this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries. Data sources: National policies, international programmes and pilot experiments are examined in both scientific and grey literature. Conclusions and discussion: We document how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control. Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored. We conclude by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care.

  20. The 2011 Estonian High School Language Reform in the Context of Critical Language Policy and Planning

    Science.gov (United States)

    Skerrett, Delaney Michael

    2014-01-01

    This paper seeks to situate Estonian language use and policy within the emerging field of critical language policy and planning (CLPP) by investigating the discourses that frame linguistic behaviour. This done by way of an analysis of a series of interviews carried out with key actors in language policy in Estonia. The discourses framing language…

  1. Farm growth and exit: consequences of EU dairy policy reform for Dutch dairy farming

    NARCIS (Netherlands)

    Peerlings, J.H.M.; Ooms, D.L.

    2008-01-01

    The purpose of this paper is to analyse farm growth and exit and its interaction in Dutch dairy farming as consequences of the 2003 CAP reform and 2008 CAP Health Check. Results indicate that the decision to exit dairy farming is largely determined by household characteristics as age and the size of

  2. A Legal Guide to State Pension Reform. Education Sector Policy Briefs

    Science.gov (United States)

    Herriot-Hatfield, Jennie; Monahan, Amy; Rosenberg, Sarah; Tucker, Bill

    2012-01-01

    Just 18 minutes before the midnight signing deadline on May 15, 2010, Minnesota state legislators breathed a sigh of relief. Their bipartisan pension reform legislation, which passed both chambers by large margins and aimed to help shore up a potentially failing pension system, had just escaped a veto threat. Under pressure from his Republican…

  3. Success for All and Comprehensive School Reform: Evidence-Based Policies for Urban Education.

    Science.gov (United States)

    Slavin, Robert E.; Madden, Nancy A.

    This paper discusses comprehensive school reform (CSR), which accepts the importance of standards and accountability but adds to these strategies for introducing innovations in curriculum, instruction, school organization, governance, parent interactions, and other core features of practice. The paper reviews research on the nature and quality of…

  4. Teacher Education Policies, Practices, and Reform in Scotland: Implications in the Indian Context

    Science.gov (United States)

    Misra, Pradeep Kumar

    2015-01-01

    India, a country of 1.27 billion, nowadays needs reforms, improvements, and new approaches in teacher education to cater to the demands of changing economy and society. This call to improve teacher education becomes more significant considering the fact that 50% of India's current population is below the age of 25 and over 65% below 35. There are…

  5. Bulgaria's Policy for Regulatory Reform in the European Union : Converging with Europe's Best Regulatory Environments

    OpenAIRE

    World Bank

    2007-01-01

    Bulgaria's entry into the EU Single Market raises new opportunities and new risks for the national economy. As shown in the rest of Europe, a program of regulatory reform offers an effective strategy for managing the risks of more intense competition while preparing Bulgarian companies to prosper within the largest economy in the world. Bulgaria has already made significant progress in reg...

  6. Regulatory and Financial Reform of Federal Research Policy: Recommendations to the NRC Committee on Research Universities

    Science.gov (United States)

    Association of American Universities, 2011

    2011-01-01

    At the request of the National Research Council (NRC) Committee on Research Universities, the Council on Governmental Relations (COGR), the Association of American Universities (AAU), and the Association of Public and Land-grant Universities (APLU) have assembled a set of ten recommendations for regulatory reform that would improve research…

  7. Soil fertility decline and economic policy reform in Sub-Saharan Africa

    NARCIS (Netherlands)

    Heerink, N.B.M.

    2005-01-01

    Two decades of economic reforms in Africa have not resulted in the anticipated growth in per capita agricultural production. Declining output-fertiliser price ratios, particularly for food crops, contributed to soil fertility depletion and agricultural stagnation. Current prices of agricultural prod

  8. Interactions of selected policy-stakeholder groups implementing middle school science standards-based systemic reform

    Science.gov (United States)

    Boydston, Theodore Lewis, III

    1999-12-01

    This research is an interpretive inquiry into the views and interactions of stakeholders in a district office of a large school system responsible for implementing science systemic reform. Three major sources of data were used in this research: surveys, stakeholder interviews, and autobiographical reflection on experiences as part of the reform initiative. This is an emergent research that is evident in the shift in the focus of research questions and their supporting assumptions during the research. The literature review describes standards-based reform, arguments about reform, and the major dimensions of reform research. The results of the survey of stakeholders revealed that the views among the stakeholder groups followed the system hierarchy and could be separated into two large groups; staff responsible for implementing the reform initiative and the other stakeholder groups. Each of these groups was composed of identifiable subgroups. The interviews with stakeholders revealed how their different attitudes, values, and beliefs frame the context of stakeholder interactions. An over reliance on an authoritarian view of decision-making leaves many stakeholders feeling disempowered and critical of others. This atmosphere promotes blaming, which inhibits collegial interaction. Work experiences in the district office revealed how stakeholders' unaddressed assumptions, attitudes, and beliefs promote fragmentation and competition rather than cooperation. Hidden assumptions about management by control and mandate, competition, and teaching and learning appear to restrain the interactions of stakeholders. Support of the National Science Education Standards was identified as a unifying view among the stakeholders, yet the professional development program focused on content and pedagogical knowledge without addressing stakeholder concerns and beliefs about the intended constructivist framework of the program. Stakeholders' attitudes about the issue of equity demonstrated

  9. Central and Eastern European Social Policy and European Union Accession: Time for Reform

    Directory of Open Access Journals (Sweden)

    Noemi Lendvai

    2005-03-01

    Full Text Available European Union enlargement and accession are reflexive of both EU and post-communist social policies. There is a unique “dialogue“ going on, indicative of fundamental aspects of post-communist, post-transitional social policy. It is also a 'mirror' that reflects shortcomings of governance, and often presents a neglected institutional landscape. Therefore, the Europeanisation of social policy is an essential transformation process for post-communist countries whereby a new language and new concepts are introduced, the outlines of new social-policy governance emerge and enter the space in which social policy is formulated and considered.

  10. The politics of pharmaceutical reform: the case of the Philippine National Drug Policy.

    Science.gov (United States)

    Lee, M B

    1994-01-01

    A national drug policy was formulated in the Philippines after the rise of the Aquino government in 1986. In this article, the author discusses the pharmaceutical situation before the policy was announced, and argues that the major push for a policy came from the confluence of four factors: a change in the structures of political power, especially the rise of a new government and the empowerment of health non-governmental organizations as new participants in the policy process; members of the Department of Health who pushed for a policy; a more conductive social and political climate, both locally and internationally; and a growing body of knowledge about the drug issue. The author discusses the policy's achievements as well as the limitations that have beset the policy from 1987 to 1992.

  11. Adult safeguarding policy and law:a thematic chronology relevant to care homes and hospitals

    OpenAIRE

    Manthorpe, Jill; Stevens, Martin

    2014-01-01

    Elder abuse is a ‘social problem’, as illustrated by the production of policy documents and legislation that define and revise the scope and nature of the problem. This article synthesises and discusses the policy documents and legal changes that have taken place in England since 2000, when the first policy guidance to address adult safeguarding as a whole was produced. The focus of this article is on particular locations, namely care home and hospital settings, and the applicable policy and ...

  12. Did capitation payment reform make a difference in Chinese rural primary health care?

    Directory of Open Access Journals (Sweden)

    Jing Sun

    2014-02-01

    Full Text Available This paper evaluated the effect of capitation payment reform in New Rural Cooperative Medical Scheme designating primary facilities in Qianjiang 2007-2009. Retrospective administrative claims were analyzed. Intercepts changes of cost per visit in facilities started the reform in different stages and of overall Qianjiang were compared. Referral rate, prescribing indicators, hospitalization rate, income of facility and individuals were compared pre- and post- the reform. Growth rate of cost per visit in health centers was contained in 2008, kept unchanged in 2009. Cost containment effect on village clinics was observed in each starting stage of reforms, but vanished later on. Except for the fact the proportion of essential medicines used in health centers significantly increased (X2 test, P<0.05, prescription indicators were not improved significantly in all facilities. After a slight increase in 2007, the hospitalization rate continuously dropped. The monthly income and outpatient revenue continuously increased in 2006-2009. Cost containment objective of the capitation reform was achieved immediately following the reform, but was not sustainable. Provider behaviors were partially improved with limited effects on prescriptions behaviors. The reform brought no financial loss to both the facilities and individuals.

  13. A governance model for integrated primary/secondary care for the health-reforming first world – results of a systematic review

    Science.gov (United States)

    2013-01-01

    Background Internationally, key health care reform elements rely on improved integration of care between the primary and secondary sectors. The objective of this systematic review is to synthesise the existing published literature on elements of current integrated primary/secondary health care. These elements and how they have supported integrated healthcare governance are presented. Methods A systematic review of peer-reviewed literature from PubMed, MEDLINE, CINAHL, the Cochrane Library, Informit Health Collection, the Primary Health Care Research and Information Service, the Canadian Health Services Research Foundation, European Foundation for Primary Care, European Forum for Primary Care, and Europa Sinapse was undertaken for the years 2006–2012. Relevant websites were also searched for grey literature. Papers were assessed by two assessors according to agreed inclusion criteria which were published in English, between 2006–2012, studies describing an integrated primary/secondary care model, and had reported outcomes in care quality, efficiency and/or satisfaction. Results Twenty-one studies met the inclusion criteria. All studies evaluated the process of integrated governance and service delivery structures, rather than the effectiveness of services. They included case reports and qualitative data analyses addressing policy change, business issues and issues of clinical integration. A thematic synthesis approach organising data according to themes identified ten elements needed for integrated primary/secondary health care governance across a regional setting including: joint planning; integrated information communication technology; change management; shared clinical priorities; incentives; population focus; measurement – using data as a quality improvement tool; continuing professional development supporting joint working; patient/community engagement; and, innovation. Conclusions All examples of successful primary/secondary care integration reported in

  14. Split-Award Tort Reform, Firm's Level of Care and Litigation Outcomes

    OpenAIRE

    Maxim Nikitin; Claudia M. Landeo

    2004-01-01

    In an attempt to reduce the liability insurance costs of firms, several US states have implemented many different kinds of tort reform. Some reforms take the form of caps or limits on punitive damage awards while others have mandated that a proportion of the award be allocated to the plaintiff with the remainder going to the state. These latter reforms, called “split-awards†have recently been implemented in Georgia, Illinois, Indiana, Iowa, Missouri, Oregon, and Utah. It is important to n...

  15. Reform of the EU's climate policy. Small step or big hit?; Reform der EU-Klimapolitik. Kleiner Schritt oder grosser Wurf?

    Energy Technology Data Exchange (ETDEWEB)

    Janssen, Matthias; Peichert, Patrick; Perner, Jens; Riechmann, Christoph [Frontier Economics Ltd., Koeln (Germany)

    2015-11-15

    Emissions trading listed as a flexible mechanism under the Kyoto Protocol is regarded as a market economy way in climate protection. Since 2005 the European Emissions Trading System (EU ETS) is the central climate policy instrument for reducing the emissions of greenhouse gases, in particular for carbon dioxide (CO{sub 2}). For years, however, the CO{sub 2} price is too low to direct the politically and socially targeted technical innovations in the electricity sector and the industry. The article analyses the temporary and structural causes of this problem, highlights the EU's reform efforts and points to areas of activity, the basis of which the EU ETS may act in the future as a central instrument for climate protection in the European Union. [German] Der im Kyoto-Protokoll als flexibler Mechanismus aufgefuehrte Emissionshandel gilt als marktwirtschaftlicher Weg in den Klimaschutz. Das Europaeische Emissionshandelssystem (EU ETS) ist seit 2005 das zentrale klimapolitische Instrument zur Senkung des Ausstosses von Treibhausgasen, insbesondere fuer Kohlenstoffdioxid (CO{sub 2}). Seit Jahren ist der CO{sub 2}-Preis jedoch zu gering, um die politisch und gesellschaftlich angestrebten technischen Innovationen im Stromsektor und der Industrie zu lenken. Der Artikel untersucht die temporaeren und strukturellen Ursachen dieses Problems, beleuchtet die Reformbestrebungen der EU und zeigt Handlungsfelder auf, anhand derer das EU ETS auch in Zukunft als zentrales Instrument fuer Klimaschutz in der Europaeischen Union fungieren kann.

  16. Models to Guide System Reform for At-Risk Youth

    Science.gov (United States)

    McCarter, Susan A.; Haber, Mason G.; Kazemi, Donna

    2010-01-01

    Policy reform for at-risk youth is complicated by involvement of various service sectors. Issues related to coordinating systems of care in a dynamic policy environment are not new, but surprisingly little has been written to guide practitioners and policymakers in addressing them (Friedman in "Journal of Emotional and Behavioral Disorders"…

  17. Analysis of Ukrainian legislation on state anti-corruption policy at the present stage of the reform

    Directory of Open Access Journals (Sweden)

    Liliia Bakunchyk

    2015-11-01

    Full Text Available In this article the state of implementation of anti-corruption policy in Ukraine has been analyzed. The basic legal and regulatory backgrounds of the country’s anti-corruption activities are examined. Based on analysis of the ways of improving the state anticorruption policy, improve the efficiency of its practical implementation in Ukraine. Corruption remains a major problem in Ukraine and continues to threaten its economic development, political stability, reputation (confidence level of the public authorities. Analyzing the phenomenon of corruption, it is necessary to emphasize that corruption is reformed in a reliable instrument to implement or achieve certain goals not only in individual format, but like leverage in the form of inter-state relations. This article shows the Ukraine’s achievement in the field of development the legislating basis for anticorruption policy, the practical instruments of its implementation on the institutional level. Steps made by the new elected authority involving publicity in order to improve the transparency and integrity building are reviewed as well as main tasks of the country to combat the corruption and the recommendations for its capability development. Combating corruption, our country has made considerable progress through the adoption of the anti-corruption legislation. It also covers reform of relevant government institutions that are unconditional guarantee of performance and implementing the rules. Many changes occurred and continue to occur with the support and under the close supervision of the foreign community, as well as a number of international organizations and institutions. At the same time, while preparing this materiel the influence of the international lessons learned experience had been taking in to consideration, which found its reflection and was actively implemented in the creating of anticorruption programs of governmental establishments as well as in Ministry of Defence.

  18. Policy Brief: Petroleum product pricing reforms in India. Are we on the right track?

    Energy Technology Data Exchange (ETDEWEB)

    Agarwal, Pravin Kumar; Soni, Anmol

    2013-03-15

    The path to petroleum product pricing reforms in India has been full of undulations. Even though Administered Pricing Mechanism (APM) was dismantled during 1 April 1998 to 31 March 2002, the government continued to regulate the prices of petrol, diesel, Public distribution System (PDS) kerosene, and domestic LPG, except for over a year, when oil marketing companies (OMCs) revised the consumer prices of petrol and diesel in line with the international prices. In June 2010, petrol pricing was deregulated, but government control continued to an extent. This control of petroleum product prices has not only severely affected the fiscal balance of the economy, but has also adversely impacted the oil companies (both upstream and downstream), eventually affecting the overall development of the sector. In fact, the impact of petroleum product subsidies has compelled the government to announce certain reforms in the past few months.

  19. Educational Policy Reform and its Impact on Equity Work in Ontario: Global Challenges and Local Possibilities

    Directory of Open Access Journals (Sweden)

    Goli M. Rezai-Rashti

    2003-12-01

    Full Text Available In this article I discuss the effects of global policy discourses on the educational restructuring of the work of equity workers in Ontario, Canada. Research in two school boards with those directly involved in equity work revealed that the restructuring process had uneven and unexpected effects on the activities of equity workers. Using the critical policy analysis framework, the analysis moves into a discussion of the complexities of policy studies. I argue that the policies introduced at the government level are implemented and practiced on the basis of the historical specificities found at each local site. (Note 1

  20. Agricultural Policy and Structural Reforms in the Baltics: Prospects for the Environmental Benefits

    OpenAIRE

    Natalija Kazlauskiene; William H. Meyers

    1993-01-01

    The Baltic countries of Estonia, Latvia, and Lithuania are undertaking rapid economic and structural reforms affecting the food and agricultural sectors. The environmental problems related to agriculture now and in the recent past are more in the area of chemical and animal waste runoff than in soil erosion. The radical change in economic incentives and progressing structural change in farming systems have already reduced chemical use and the intensity of livestock production. Some effects of...

  1. Welfare Reform in Frisian Towns: Between Humanist theory, Pious Imperatives and Government Policy

    OpenAIRE

    Spaans, J.W.

    2008-01-01

    Ole Peter Grell has challenged us to examine how, in an age dominated by faith, religion shaped public and private approaches to poor relief. His thesis is twofold. Ideologically, Protestantism changed the purpose of charity — from a benefit to the souls of donors in the hereafter to the relief of the indigent in the present. In terms of practice, without the Reformation the speed and extent to which poor relief was centralized in the seventeenth century would have been unimaginable. The role...

  2. Surviving success : policy reform and the future of industrial pollution in China

    OpenAIRE

    Dasgupta, Susmita; Hua Wang; Wheeler, David

    1997-01-01

    China's recent industrial growth, a remarkable success story, has been clouded by hundreds of thousands of premature deaths and incidents of serious respiratory illness caused by exposure to industrial air pollution. Seriously contaminated by industrial discharges, many of China's waterways are largely unfit for direct human use. This damage could be substantially reduced at modest cost. Industrial reform combined with stricter environmental regulation has reduced organic water pollution in m...

  3. [The Development of Long-Term Care Policies and the Impact on Nursing].

    Science.gov (United States)

    Wu, Shiao-Chi; Tsai, Yin-Yin; Yeh, Shin-Ting

    2015-10-01

    The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination. PMID:26507622

  4. Public policy and medical tourism: ethical implications for the Egyptian health care system.

    Science.gov (United States)

    Haley, Bob

    2011-01-01

    Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population. PMID:22619867

  5. A New Health Care Prevention Agenda: Sustainable Food Procurement and Agricultural Policy.

    Science.gov (United States)

    Harvie, Jamie; Mikkelsen, Leslie; Shak, Linda

    2009-07-01

    Health care leaders are broadening their awareness to include the need to address the food system as a means to individual, public, and global health, above and beyond basic nutritional factors. Key voices from the health care sector have begun to engage in market transformation and are aggregating to articulate the urgency for engagement in food and agricultural policy. Systemic transformation requires a range of policies that complement one another and address various aspects of the food system. Health care involvement in policy and advocacy is vital to solve the expanding ecological health crises facing our nation and globe and will require an urgency that may be unprecedented. PMID:23144678

  6. Oregon's Coordinated Care Organizations Increased Timely Prenatal Care Initiation And Decreased Disparities.

    Science.gov (United States)

    Muoto, Ifeoma; Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Snowden, Jonathan M

    2016-09-01

    Policies at the state and federal levels affect access to health services, including prenatal care. In 2012 the State of Oregon implemented a major reform of its Medicaid program. The new model, called a coordinated care organization (CCO), is designed to improve the coordination of care for Medicaid beneficiaries. This reform effort provides an ideal opportunity to evaluate the impact of broad financing and delivery reforms on prenatal care use. Using birth certificate data from Oregon and Washington State, we evaluated the effect of CCO implementation on the probability of early prenatal care initiation, prenatal care adequacy, and disparities in prenatal care use by type of insurance. Following CCO implementation, we found significant increases in early prenatal care initiation and a reduction in disparities across insurance types but no difference in overall prenatal care adequacy. Oregon's reforms could serve as a model for other Medicaid and commercial health plans seeking to improve prenatal care quality and reduce disparities. PMID:27605642

  7. Office of Disability, Aging and Long-Term Care Policy

    Science.gov (United States)

    ... Primary and Behavioral Health Integration Disability Dual Eligibles Elder Rights/Adult Protective Services Falls Prevention Housing with Services Informal Caregiving Long-Term Care Financing Long-Term Care Insurance Medicaid Home and ...

  8. Against the odds. The Open Method of Coordination as a selective amplifier for reforming Belgian pension policies

    Directory of Open Access Journals (Sweden)

    Bart Vanhercke

    2009-11-01

    Full Text Available Tackling pensions' problems means engaging with what Pierson (2001 has called 'immovable objects'. Additionally, the EU competence for drafting specific legislation in this area remains unfulfilled potential, while EU legislation in other policy areas creates indirect pressures on national pension policies. Under such circumstances it seems that the room for an effective European intervention in the domain is limited, especially for 'soft' modes of governance such as the Open Method of Coordination on Social Protection and Social Inclusion (SPSI. The pension's strand of the SPSI OMC is often referred to in academic writings as a bureaucratic nightmare which only involves experts and technocrats, even if some cognitive effects have been acknowledged. I take issue against the view of the OMC as mere window dressing. This chapter argues that OMC is 'effective' in that it provides opportunities to create policy windows of opportunity which EU and national policymakers use in their efforts to discuss, manage and reform pension systems. Building on John Kingdon's (1995 theoretical framework and applying it to both the EU level and the (most likely case of Belgium, I conclude that the pension OMC influences, against the odds, three core streams of the policy formation process. First, OMC influences the acceptance of compelling problems so that decision makers pay serious attention to them; secondly, OMC brings about changes in the political stream; and thirdly OMC makes certain ideas 'take hold and grow', so that they matter (more in the policy soup. The core mechanisms through which OMC operates are puzzling, through deliberate learning and de facto socialization, and powering, through usage of the OMC architecture and peer pressure as a result of comparisons with others.

  9. The modernization of American public law: health care reform and popular constitutionalism.

    Science.gov (United States)

    Super, David A

    2014-04-01

    The Patient Protection and Affordable Care Act (ACA) transformed U.S. public law in crucial ways extending far beyond health care. As important as were the doctrinal shifts wrought by National Federation of Independent Business v. Sebelius, the ACA's structural changes to public law likely will prove far more important should they become entrenched. The struggle over the ACA has triggered the kind of "constitutional moment" that has largely replaced Article V's formal amendment procedure since the Prohibition fiasco. The Court participates in this process, but the definitive and enduring character of these constitutional moments' outcomes springs from broad popular engagement. Despite the Court's ruling and the outcome of the 2012 elections, the battle over whether to implement or shelve the ACA will continue unabated, both federally and in the states, until We the People render a clear decision. Whether the ACA survives or fails will determine the basic principles that guide the development of federalism, social insurance, tax policy, and privatization for decades to come. In each of these areas, the New Deal bequeathed us a delicate accommodation between traditionalist social values and modernizing norms of economic efficiency and interest group liberalism. This balance has come under increasing stress, with individual laws rejecting tradition far more emphatically than the New Deal did. But absent broad popular engagement, no definitive new principles could be established. The ACA's entrenchment would elevate technocratic norms across public law, the first change of our fundamental law since the civil rights revolution. The ACA's failure would rejuvenate individualistic, moralistic, pre-New Deal norms and allow opponents to attempt a counterrevolution against technocracy. PMID:24834539

  10. The modernization of American public law: health care reform and popular constitutionalism.

    Science.gov (United States)

    Super, David A

    2014-04-01

    The Patient Protection and Affordable Care Act (ACA) transformed U.S. public law in crucial ways extending far beyond health care. As important as were the doctrinal shifts wrought by National Federation of Independent Business v. Sebelius, the ACA's structural changes to public law likely will prove far more important should they become entrenched. The struggle over the ACA has triggered the kind of "constitutional moment" that has largely replaced Article V's formal amendment procedure since the Prohibition fiasco. The Court participates in this process, but the definitive and enduring character of these constitutional moments' outcomes springs from broad popular engagement. Despite the Court's ruling and the outcome of the 2012 elections, the battle over whether to implement or shelve the ACA will continue unabated, both federally and in the states, until We the People render a clear decision. Whether the ACA survives or fails will determine the basic principles that guide the development of federalism, social insurance, tax policy, and privatization for decades to come. In each of these areas, the New Deal bequeathed us a delicate accommodation between traditionalist social values and modernizing norms of economic efficiency and interest group liberalism. This balance has come under increasing stress, with individual laws rejecting tradition far more emphatically than the New Deal did. But absent broad popular engagement, no definitive new principles could be established. The ACA's entrenchment would elevate technocratic norms across public law, the first change of our fundamental law since the civil rights revolution. The ACA's failure would rejuvenate individualistic, moralistic, pre-New Deal norms and allow opponents to attempt a counterrevolution against technocracy.

  11. Influence of macro-economic growth, CAP reforms and biofuel policy on the Polish agri-food sector in 2007–2020

    NARCIS (Netherlands)

    Tabeau, A.A.

    2009-01-01

    This paper presents the possible development scenario of the Polish agricultural sector till 2020. It also assesses the impact of macroeconomic growth, CAP reforms and worldwide policies towards the agriculture on this development. The scenario is build using an extended version of the Global Trade

  12. Social limitations to livelihood adaptation : responses of maize-farming smallholder households to neoliberal policy reforms in Morelos, Southern Veracruz, Mexico

    NARCIS (Netherlands)

    Groenewald, S.F.

    2012-01-01

    This thesis describes the adaptation of smallholders to market changes shaped by neoliberal policy reforms in the Mexican maize sector. Contrary to expectations about smallholder responses to a liberalised maize market, in the study area maize still is the main source of income. Farmers did not leav

  13. Music plus Music Integration: A Model for Music Education Policy Reform That Reflects the Evolution and Success of Arts Integration Practices in 21st Century American Public Schools

    Science.gov (United States)

    Scripp, Lawrence; Gilbert, Josh

    2016-01-01

    This article explores the special case of integrative teaching and learning in music as a model for 21st century music education policy reform based on the principles that have evolved out of arts integration research and practices over the past century and informed by the recent rising tide of evidence of music's impact on brain capacity and…

  14. Toward a New Era of Policy: Health Care Service Delivery to First Nations

    Directory of Open Access Journals (Sweden)

    Miranda D. Kelly

    2011-05-01

    Full Text Available The disproportionate burdens of ill health experienced by First Nations have been attributed to an uncoordinated, fragmented health care system. This system is rooted in public policies that have created jurisdictional gaps and a long-standing debate between federal, provincial and First Nations governments as to who is responsible for First Nations health care. This article examines: (1 the policies that shape First Nations health care in Canada and in the province of British Columbia (BC specifically; (2 the interests of the actors involved in First Nations health policy; and (3 recent developments in BC that present an opportunity for change to First Nations health policy development and have broader implications for Indigenous health policy across Canada and worldwide.

  15. Fisheries Policy, the World Fisheries Crisis and Policy Reforms of the U.S.A. and the Falkland Islands

    OpenAIRE

    Gleadall, Ian G.

    2004-01-01

    The fishing industries of the world are currently in a crisis brought about mainly by overfishing : the capture of too many fish such that the population cannot recover and so collapses dramatically. This paper considers how overfishing occurs, its wider effects and what might be done to control it. Brief reference is made to the history of attempts to reach agreements on how to control overfishing, and to three recently published commission reports : two on the state of ocean policy in the U...

  16. Health care models guiding mental health policy in Kenya 1965 - 1997

    Directory of Open Access Journals (Sweden)

    Jenkins Rachel

    2010-04-01

    Full Text Available Abstract Background Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors. Methods This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers. Results The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya. Conclusions Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.

  17. Implementation as transfer between policy, research and practice in care.

    NARCIS (Netherlands)

    Heiligers, P.J.M.; Niet, A. van der

    2010-01-01

    Background: Health Services Research is policy related and results have an impact on practices. Implementation of research output into practices is performed with a variety of strategies. Type of policy intentions and research output create a specific context for implementation. The main question he

  18. Earning and caring: demographic change and policy implications

    Directory of Open Access Journals (Sweden)

    Beaujot, Roderic

    2002-01-01

    Full Text Available EnglishSeeking to define families as groups of people who share earning and caringactivities, we contrast theoretical orientations that see advantages to a division of labour orcomplementary roles, in comparison to orientations that see less risk and greater companionship in acollaborative model based on sharing paid and unpaid work, or co-providing and co-parenting. It isimportant to look both inside and outside of families, or at the changing gendered links betweenearning and caring, to understand change both in families and in the work world. It is proposed thatequal opportunity by gender has advanced further in the public sphere associated with education andwork, than in the private family sphere associated with everyday life. Time-use data [from Canada]indicate that, on average, men carry their weight in terms of total productive time (paid plus unpaidwork, but that women make much more of the accommodations between family and work. Fertility islikely to be lowest in societies that offer women equal opportunity in the public sphere but wherefamilies remain traditional in terms of the division of work. Policies are discussed that would reducethe dependency between spouses, and encourage a greater common ground between men and women in earningand caring.FrenchEn cherchant à définir la famille comme étant un groupe de personnes partageant les activités relatives au fait de gagner de l'argent et de prendre soin des autres, nous nous distinguons des théories préconisant la division du travail ou les rôles complémentaires comparativement au modèle collaboratif qui a l'avantage de présenter moins de risque et plus de compagnonnage et qui est fondé sur le partage du travail rémunéré et non rémunéré, le travail à l'extérieur de la maison et le parentage. Il est important de voir ce qui se passe à l'intérieur et à l'extérieur de la famille ou de considérer les liens changeant d'après le sexe entre le rôle de pourvoyeur et

  19. A New Health Care Prevention Agenda: Sustainable Food Procurement and Agricultural Policy

    OpenAIRE

    Harvie, Jamie; Mikkelsen, Leslie; Shak, Linda

    2009-01-01

    Health care leaders are broadening their awareness to include the need to address the food system as a means to individual, public, and global health, above and beyond basic nutritional factors. Key voices from the health care sector have begun to engage in market transformation and are aggregating to articulate the urgency for engagement in food and agricultural policy. Systemic transformation requires a range of policies that complement one another and address various aspects of the food sy...

  20. Practice-Based Discourse Analysis of Information Security Policy in Health Care

    OpenAIRE

    Karlsson, Fredrik; Goldkuhl, Göran; Hedström, Karin

    2014-01-01

    Information security is an understudied area within electronic government. In this study, we examine the quality of information security policy design in health care. Employees cause a majority of the security breaches in health care, and many of them are unintentional. In order to support the formulation of practical, from the employees’ perspective, information security policies, we propose eight tentative quality criteria. These criteria were developed using practice-based discourse analys...

  1. Unemployment protection reform in Belgium, Finland, the Netherlands, and the UK: policy learning through open coordination?

    NARCIS (Netherlands)

    M. van Gerven; M. Beckers

    2009-01-01

    This book examines how and to what extent the European Employment Strategy and the Open Method of Coordination (OMC) on Social Protection and Social Inclusion have influenced national labour market and social welfare policies.

  2. Against the odds: the OMC as a selective amplifier for reforming Belgian pension policies

    NARCIS (Netherlands)

    B. Vanhercke

    2009-01-01

    Tackling pensions' problems means engaging with what Pierson (2001) has called 'immovable objects'. Additionally, the EU competence for drafting specific legislation in this area remains unfulfilled potential, while EU legislation in other policy areas creates indirect pressures on national pension

  3. Barack Obama's Health Care Reform:Motivation,Contents and Inspiration%奥巴马医改的动因、内容及启示

    Institute of Scientific and Technical Information of China (English)

    林莉; 李跃平; 黄子杰

    2011-01-01

    通过对奥巴马医改动因及其医改法案内容的分析,认为我国应在医疗服务市场实行"有管理的竞争",平衡好医改中各利益集团的关系,制定更具有操作性的医改方案,提高医疗卫生服务的公平性和可及性.%Through the analysis of the motivation and main contents of Barack Obama's Health Care Reform.We put forward important inspirations for China's Health Care Reform,such as implementing managed competition in the medical service market balancing the various interest groups in the healthcare reform, drawing up more operable healthcare reform programs, improving equity and availability of health services and so on.

  4. Labor and housing markets as public spaces: 'personal responsibility' and the contradictions of welfare-reform policies

    OpenAIRE

    Daniel Trudeau; Meghan Cope

    2003-01-01

    Recent US welfare-form initiatives affecting employment and housing assistance have promoted more flexible applications of assistance as well as devolving the responsibility of care for the poor from federal levels to the individual. Implicit in these policy changes is the assumption that individuals enter labor and housing markets where open access is the norm and a 'level playing field' exists. In this paper, we use the analogy of seeing labor and housing markets as public spaces to analyze...

  5. Against the odds: the OMC as a selective amplifier for reforming Belgian pension policies

    OpenAIRE

    Vanhercke, B.

    2009-01-01

    Tackling pensions' problems means engaging with what Pierson (2001) has called 'immovable objects'. Additionally, the EU competence for drafting specific legislation in this area remains unfulfilled potential, while EU legislation in other policy areas creates indirect pressures on national pension policies. Under such circumstances it seems that the room for an effective European intervention in the domain is limited, especially for "soft" modes of governance such as the Open Method of Coord...

  6. Informing policy and service development at the interfaces between acute and aged care.

    Science.gov (United States)

    Howe, Anna L

    2002-01-01

    This paper argues that policies to address the interfaces between acute care and aged care should view older people as members of the wider Australian population entitled to a range of health services under Medicare rather than focusing only on supposed "bed blockers". In seeking to explain the current level of policy interest in this area, three areas are canvassed: pressures on acute hospital care, particularly those attributed to population ageing; shrinking provision of residential aged care; and the proliferation of post acute services. If policy development is to maintain a wider rather than narrower perspective, attention needs to be given to improving collection and analysis of critical data that are currently unavailable, to developing system-wide funding arrangements for post acute care, and to reassessing what constitutes appropriate hospital activity for younger and older age groups alike. PMID:12536863

  7. Experience from UK integrated care and the implications for health care reform in China%英国整合型保健发展经验及启示

    Institute of Scientific and Technical Information of China (English)

    谢春艳; 金春林; 王贤吉

    2015-01-01

    This paper summarized the practice and experience about integrated care carried out in UK through qualitative research methods including on-site observation and deep interview,especially the integration and coordination of health service and social service systems in recent years. And then some relevant policy recommendations were put forward on health care reform according to the problems of fragmented health care system in China,including developing primary health care and community health services,strengthening multidisciplinary team,building a gate keeping health care system in which GPs were the core,establishing mechanisms for communication and collaboration between the relevant government departments,and integrating multi-social service resources at the community level.%通过现场观察与深度访谈的定性研究方法,总结了英格兰NHS整合型保健的做法和经验,并针对我国卫生服务体系存在的碎片化问题,提出了相关的政策建议:大力发展初级卫生保健和社区卫生服务,加强以全科医生为核心的多学科服务团队建设,建立全科医生“守门人”制度,建立相关政府部门间的沟通协作机制,在社区层面横向整合多方社会服务资源等。

  8. 英国整合型保健发展经验及启示%Experience from UK integrated care and the implications for health care reform in China

    Institute of Scientific and Technical Information of China (English)

    谢春艳; 金春林; 王贤吉

    2015-01-01

    This paper summarized the practice and experience about integrated care carried out in UK through qualitative research methods including on-site observation and deep interview,especially the integration and coordination of health service and social service systems in recent years. And then some relevant policy recommendations were put forward on health care reform according to the problems of fragmented health care system in China,including developing primary health care and community health services,strengthening multidisciplinary team,building a gate keeping health care system in which GPs were the core,establishing mechanisms for communication and collaboration between the relevant government departments,and integrating multi-social service resources at the community level.%通过现场观察与深度访谈的定性研究方法,总结了英格兰NHS整合型保健的做法和经验,并针对我国卫生服务体系存在的碎片化问题,提出了相关的政策建议:大力发展初级卫生保健和社区卫生服务,加强以全科医生为核心的多学科服务团队建设,建立全科医生“守门人”制度,建立相关政府部门间的沟通协作机制,在社区层面横向整合多方社会服务资源等。

  9. Integrated care: a fresh perspective for international health policies in low and middle-income countries

    OpenAIRE

    Unger, Jean-Pierre; De PAEPE, Pierre; Ghilbert, Patricia; Soors, Werner; Green, Andrew

    2006-01-01

    Abstract Purpose To propose a social-and-democrat health policy alternative to the current neoliberal one. Context of case The general failure of neoliberal health policies in low and middle-income countries justifies the design of an alternative to bring disease control and health care back in step with ethical principles and desired outcomes. Data sources National policies, international programmes and pilot experiments—including those led by the authors—are examined in both scientific and ...

  10. Women-friendly policy paradoxes?! Child Care policies and gender equality visions in Scandinavia

    DEFF Research Database (Denmark)

    Borchorst, Anette

    2006-01-01

    The chapter focuses on the political construction of the equality-difference dilemma in Scandinavian welfare policies. Different policy logics of childcare policies in Sweden, Norway and Denmark are addressed and the visions of gender equality underpinning them are analyzed....

  11. Policies on Women's Health Care: Challenges and Realities

    Directory of Open Access Journals (Sweden)

    Denise de Azambuja Zocche

    2012-11-01

    Full Text Available Report of a workshop on Women's Health Policy held in the third Critical Paths Seminar: extreme situations resulting from gender violence. The participants were ten women, three health students, four health professionals (nursing technician, psychologist, nurse and social worker, an educator and a lawyer. The methodology used was a debate about Women Public Policy and listening of music: Mariana went to the sea. By the end of the debate, we concluded that to understand and cope with the health needs of women who suffer violence is necessary to review not only the women health policy, but also health education and the work processes within the public safety sector.

  12. A Policy Analysis of Child Care Subsidies: Increasing Quality, Access, and Affordability

    Science.gov (United States)

    Moodie-Dyer, Amber

    2011-01-01

    Changing family dynamics over the past four decades, including rises in the numbers of working mothers and single-parent families, have created an increased need for affordable child care. Government response to this need has involved a number of stop-and-start policy approaches, which have led to a fractured child care system that makes it…

  13. The Influence of Trade Unions on Pension Reform in Romania and Hungary: The Role of Ideas, Interests and Institutions in Policy-Making

    Directory of Open Access Journals (Sweden)

    Monica BUCURENCIU

    2009-09-01

    Full Text Available Although both Romania and Hungary have inherited pay-as-you-go defined benefit (PAYG-DB pensions systems, they have both moved towards a three-pillar pensions system, in which PAYG-DB becomes just one of three pillars together with the mandatory and the voluntary private pension funds.Trade unions have had an important influence on pension reform in both countries. The analysis of pension reform in Hungary and Romania brings evidence that trade unions’ influence on policy-making is not uniform, but it is shaped by the international policy discourse, by the institutional setting, by their relationship with other policy actors, by their organisational culture and even material inheritance.

  14. Writing to Learn the Reformation: Or, Who Was Ulrich Zwingli and Why Should I Care?

    Science.gov (United States)

    Jordon, Sherry

    2014-01-01

    This article describes the use of "Writing to Learn" assignments in a course on the Theology of the Protestant and Catholic Reformations. These short, informal assignments promote active learning by focusing on writing as a process for critical thinking and as a way to learn the content of the course. They help students creatively engage…

  15. Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform.

    Science.gov (United States)

    Felland, Laurie E; Grossman, Joy M; Tu, Ha T

    2011-05-01

    Lingering fallout--loss of jobs and employer coverage--from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change's (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Hospitals with significant market clout continued to command high payment rate increases from private insurers, and tighter hospital-physician alignment heightened concerns about growing provider market power. High and rising premiums led to increasing employer adoption of consumer-driven health plans and continued increases in patient cost sharing, but the broader movement to educate and engage consumers in care decisions did not keep pace. State and local budget deficits led to some funding cuts for safety net providers, but an influx of federal stimulus funds increased support to community health centers and shored up Medicaid programs, allowing many people who lost private insurance because of job losses to remain covered. Hospitals, physicians and insurers generally viewed health reform coverage expansions favorably, but all worried about protecting revenues as reform requirements phase in. PMID:21614861

  16. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States

    Directory of Open Access Journals (Sweden)

    Donald Murphy R

    2011-07-01

    Full Text Available Abstract It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs. Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.

  17. The effects of expanding primary care access for the uninsured: implications for the health care workforce under health reform.

    Science.gov (United States)

    Dow, Alan W; Bohannon, Arline; Garland, Sheryl; Mazmanian, Paul E; Retchin, Sheldon M

    2013-12-01

    The Patient Protection and Affordable Care Act seeks to improve health equity in the United States by expanding Medicaid coverage for adults who are uninsured and/or socioeconomically disadvantaged; however, when millions more become eligible for Medicaid in 2014, the health care workforce and care delivery systems will be inadequate to meet the care needs of the U.S. population. To provide high-quality care efficiently to the expanded population of insured individuals, the health care workforce and care delivery structures will need to be tailored to meet the needs of specific groups within the population.To help create a foundation for understanding the use patterns of the newly insured and to recommend possible approaches to care delivery and workforce development, the authors describe the 13-year-old experience of the Virginia Coordinated Care program (VCC). The VCC, developed by Virginia Commonwealth University Health System in Richmond, Virginia, is a health-system-sponsored care coordination program that provides primary and specialty care services to patients who are indigent. The authors have categorized VCC patients from fiscal year 2011 by medical complexity. Then, on the basis of the resulting utilization data for each category over the next fiscal year, the authors describe the medical needs and health behaviors of the four different patient groups. Finally, the authors discuss possible approaches for providing primary, preventive, and specialty care to improve the health of the population while controlling costs and how adoption of the approaches might be shaped by care delivery systems and educational institutions. PMID:24128619

  18. Insurer policies create barriers to health care access and consumer choice.

    Science.gov (United States)

    Hansen-Turton, Tine; Ritter, Ann; Rothman, Nancy; Valdez, Brian

    2006-01-01

    A national survey shows that most insurance companies refuse to credential nurse practitioners in nurse-managed health centers as primary care providers. These prohibitive policies along with weak federal and state laws threaten the long-term sustainability of nurse-managed health centers as safety net health care providers, and the ability for nurse practitioners to become an accepted primary health care source in the United States. PMID:16967891

  19. The Ghosts of Higher Education Reform: On the Organisational Processes Surrounding Policy Borrowing

    Science.gov (United States)

    Brøgger, Katja

    2014-01-01

    The Bologna Process is one of the most extensive examples of policy borrowing processes. Based on qualitative data, this article argues in favour of studying part of this process as "global smallness", centring on the organisational effects of the implementation of a globalised curriculum. Through Derrida's notion on hauntology,…

  20. Public- Private- Partnership Policy: Proposed Nigerian Reform Programme for Electricity Development

    Directory of Open Access Journals (Sweden)

    Samuel Nnamdi Marcus

    2015-03-01

    Full Text Available The study examines the public private partnership policy in Nigeria as a panacea to the development and management of electricity in Nigeria. The study is descriptive and its objective is proposing an alternative policy that will ensure the sustainable development of electricity in Nigeria. The heavy presence of government in energy development did not seem to encourage desirable development in the sector. The SAP, Vision 2010, and NEP 1999 proposed deregulatory approach relying on private sector led development approach for the development of utilities. The NEEDS 2004 clearly and specifically proposes the PPP approach under the deregulatory devices. PPP as a contractual arrangement between the public and private sectors operators constitutes an approach to achieve well defined and shared objectives in a well-managed, cost-effective, efficient and sustainable manner, hence, is con-sidered in the paper. Findings suggest that forms of the PPP are given for consideration to bail Nigeria out of the impacts of poor quality, unreliable and limited availability of power-supply, presumed partly due to government led-development approach. The paper contains some policy issues such as the encouragement of private sector participation in the provision of energy infrastructure within the public- private- partnership policy (PPP framework.

  1. Implementing plant clinics in the maelstrom of policy reform in Uganda

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Matsiko, F.B.; Kjær, A.M.

    2014-01-01

    government commitment and a growing demand for this new type of farmer service, effective implementation of plant clinics turned out to be a challenge.We examine how agricultural policies and institutional setups, and their political context, influenced the implementation of plant clinics from 2010 to 2011...

  2. The Medicalization of Current Educational Research and Its Effects on Education Policy and School Reforms

    Science.gov (United States)

    Tröhler, Daniel

    2015-01-01

    This paper starts from the assumption of the emergence of an educationalized culture over the last 200 years according to which perceived social problems are translated into educational challenges. As a result, both educational institutions and educational research grew, and educational policy resulted from negotiations between professionals,…

  3. Alternatively Certified Teachers in Urban Small Schools: Where Policy Reform Meets the Road

    Science.gov (United States)

    Carter, Julie H.; Keiler, Leslie S.

    2009-01-01

    In this study we explore the experiences of new teachers in urban schools at the intersection of three major policy agendas--alternative certification, new teacher retention, and the small schools movement. We examine alternatively certified teachers' perceptions of the rewards and challenges of teaching in small schools, the support neophyte…

  4. Education Policy and "Friedmanomics": Free Market Ideology and Its Impact on School Reform

    Science.gov (United States)

    Fiala, Thomas J.; Owens, Deborah Duncan

    2010-01-01

    The purpose of this paper is to examine the impact of neoliberal ideology, and in particular, the economic and social theories of Milton Friedman on education policy. The paper takes a critical theoretical approach in that ultimately the paper is an ideological critique of conservative thought and action that impacts twenty-first century education…

  5. An Exploration of E-Learning Benefits for Saudi Arabia: Toward Policy Reform

    Science.gov (United States)

    Alrashidi, Abdulaziz

    2013-01-01

    Purpose: The purpose of this study was to examine policies and solutions addressing (a) improving education for citizens of the Kingdom of Saudi Arabia and (b) providing alternative instructional delivery methods, including e-learning for those living in remote areas. Theoretical Framework: The theoretical framework of this study was based on the…

  6. Rhode Island Pension Reform: Implications and Opportunities for Education. Education Sector Policy Briefs

    Science.gov (United States)

    Herriot-Hatfield, Jennie; Monahan, Amy; Rosenberg, Sarah; Tucker, Bill

    2011-01-01

    On August 24, 2010, the state of Rhode Island received some outstanding news. Its yearlong, bipartisan effort to develop new policies to spur educational improvement was about to pay off. The state, along with eight others and the District of Columbia, was named a winner of the U.S. Department of Education's Race to the Top grant competition. The…

  7. Reflection on the Education Policy Orientation in Post-May 31 Reform in Korea

    Science.gov (United States)

    Lee, Chong Jae; Kim, Yong

    2016-01-01

    For the last 70 years, since the establishment of the Republic of Korea, Korean education has achieved universal expansion of educational opportunity from elementary to secondary to higher education. Planning, centralized policy making, top-down implementation, and administrative control had been the standards of the first few decades of Korean…

  8. Competency-based Training: Evidence of a Failed Policy in Training Reform.

    Science.gov (United States)

    Cornford, Ian R.

    2000-01-01

    Examines whether competency-based training is working in practice in Australian vocational education and whether it is producing superior skill performance. Explores the ideological nature of the competency-based training policy framework and the nature of related research commissioned by government agencies. Reviews the empirical evidence that…

  9. Ideational Leadership in German Welfare State Reform. How Politicians and Policy Ideas Transform Resilient Institutions

    NARCIS (Netherlands)

    Stiller, S.J.

    2010-01-01

    editors of the series Gøsta Esping-Andersen, University of Pompeu Fabra, Barcelona, Spain Anton Hemerijck, the Netherlands Scientific Council for Government Policy (Wetenschappelijke Raad voor het Regeringsbeleid - wrr) Kees van Kersbergen, Free University Amsterdam, the Netherlands Kimberly Morgan,

  10. Analysis of township health center in the distribution system of the new health care reform%乡镇卫生院新医改分配制度现状分析

    Institute of Scientific and Technical Information of China (English)

    洪家文

    2013-01-01

    The township health center is the hub and backbone of the rural three-level health care network. What’s more,it plays a very important role at many aspects,including rural medical,medical prevention and public health service. In the policy of health care reform,the reform of the distribution system, which is directly related to vital interest of the whole medical workers,is a the key to the works of the new health care reform. By taking 10 township health centers of YangDong Town,YangJiang City,GuangDong Province as the object of study,this paper combines the distribution system with many reform measures, such as Two line of income and expenses and Drug zero difference,and so on. To view the data and questionnaire,this paper analyzes the current situation after the reform of distribution system of towns and townships,and tries to understand the cognition and satisfaction of medical workers and the masses to this reform. According to the analysis of existing problems,it puts forward further suggestions for the existing distribution system.%乡镇卫生院是农村三级医疗保健网络的枢纽和中坚,在农村医疗、医疗预防及公共卫生服务等方面起着举足轻重的作用,在新医改政策中,分配制度的改革关系到广大医务工作者的切身利益,也是新医改工作的重点。本文通过以广东省阳江市阳东县10间乡镇卫生院为研究对象,结合分配制度和“收支两条线”、“药物零差价”等改革措施,以查看资料及问卷调查方式,对乡镇卫生院分配制度改革后现状进行剖析,了解卫生院广大医务人员和群众对本次改革的认知和满意度,针对存在的问题进行分析,对现行分配制度更进一步提出建议。

  11. Water Governance Decentralisation and River Basin Management Reforms in Hierarchical Systems: Do They Work for Water Treatment Policy in Mexico’s Tlaxcala Atoyac Sub-Basin?

    Directory of Open Access Journals (Sweden)

    Cesar Casiano Flores

    2016-05-01

    Full Text Available In the last decades, policy reforms, new instruments development, and economic resources investment have taken place in water sanitation in Mexico; however, the intended goals have not been accomplished. The percentage of treated wastewater as intended in the last two federal water plans has not been achieved. The creation of River Basin Commissions and the decentralisation process have also faced challenges. In the case of Tlaxcala, the River Basin Commission exists only on paper and the municipalities do not have the resources to fulfil the water treatment responsibilities transferred to them. This lack of results poses the question whether the context was sufficiently considered when the reforms were enacted. In this research, we will study the Tlaxcala Atoyac sub-basin, where water treatment policy reforms have taken place recently with a more context sensitive approach. We will apply the Governance Assessment Tool in order to find out whether the last reforms are indeed apt for the context. The Governance Assessment Tool includes four qualities, namely extent, coherence, flexibility, and intensity. The assessment allows deeper understanding of the governance context. Data collection involved semi-structured in-depth interviews with stakeholders. The research concludes that the observed combination of qualities creates a governance context that partially supports the implementation of the policy. This has helped to increase the percentage of wastewater treated, but the water quality goals set by the River Classification have not been achieved. With the last reforms, in this hierarchical context, decreasing the participation of municipal government levels has been shown to be instrumental for improving water treatment plants implementation policy, although many challenges remain to be addressed.

  12. The Economic Impact of Child Care Subsidies for Kentucky. Policy Insights. Occasional Policy Brief #3

    Science.gov (United States)

    Hardy, Bradley; Hokayem, Charles; Ziliak, James P.

    2011-01-01

    For parents of young children the decision to work strongly depends on the availability of affordable child care. Child care costs can take up a large portion of a family budget and may serve as an obstacle to work. In 2008 the National Association of Child Care Resource and Referral Agencies (NACCRRA) estimated that Kentucky families recently…

  13. Risks and Opportunities of Reforms Putting Primary Care in the Driver’s Seat; Comment on “Governance, Government, and the Search for New Provider Models”

    Directory of Open Access Journals (Sweden)

    Monica Andersson Bäck

    2016-08-01

    Full Text Available Recognizing the advantages of primary care as a means of improving the entire health system, this text comments on reforms of publicly funded primary health centers, and the rapid development of private forprofit providers in Sweden. Many goals and expectations are connected to such reforms, which equally require critical analyses of scarce resources, professional trust/motivation and business logic in the wake of freedom and control of ownership and management. In line with Saltman and Duran, this article calls for research and a methodologically developed approach to capture everyday practice in-depth and how regulation, market incentives and patient demands are met by professionals and primary care leaders.

  14. Economic crisis and counter-reform of universal health care systems: Spanish case

    OpenAIRE

    Paulo Antônio de Carvalho Fortes; Regina Ribeiro Parizi Carvalho; Marília Cristina Prado Louvison

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, ...

  15. Intensively Promote the Reform of Health Care Providers to Establish Reasonable Graded Health Care System%深入推进供方改革实现合理分级诊疗

    Institute of Scientific and Technical Information of China (English)

    王震

    2015-01-01

    There are two measures needed in the system of graded health care, i.e., establishing relatively stable relationship between patients and doctors, and establishing cooperation and integration among different kinds of health care. The sources of problem in non-graded health care currently in China is the mismatching between diversified and marketized health care demands and the government-deciding medical resources allocation. It is impossible to use governmental "Grading" to achieve the goal of "dispersing patients", otherwise, it brings about more problems. To establish rational graded medical care system, it should firstly change the policy framework, reform the system of health care providers instead of arranging the choice for patients, and establish a patient-orientated health care system. The feasible approach to realize the system of graded health care currently is to establish a community family doctor system based on their private practices.%合理的分级诊疗一是要建立患者与医生之间的稳定关系,二是不同类别医疗服务之间的合作与衔接.当前出现"非"分级诊疗的制度性根源在于用行政化的资源配置方式应对已经多样化、市场化的医疗服务需求.以行政化的"分级"追求患者就医的"分流"不具可行性,且会带来进一步的扭曲.建立合理的分级诊疗,首先需要政策思路上的转变,不是去"安排"患者,而是改革供方,建立"患者中心"的医疗服务体系.建立在医生自由执业基础上的社区家庭医生制度是实现合理的分级诊疗的"抓手".

  16. Policy paper : the place of Northern Ireland within UK human rights reform.

    OpenAIRE

    Murray, Colin R. G.; O'Donoghue, Aoife; Warwick, Ben T.C.

    2015-01-01

    Considerable speculation has surrounded the impact of the Good Friday Agreement’s provisions on human rights upon the Conservative Government’s proposals for repeal of the Human Rights Act 1998. This Policy Paper seeks to demystify this aspect of the debate over the future of the Human Rights Act, examining the terms of the Good Friday Agreement as an international treaty and peace agreement and explaining its interrelationship with both the Human Rights Act and the Devolution Acts. Once some...

  17. The Growth of China and India: Implications and Policy Reform Options for Malaysia

    OpenAIRE

    Ianchovichina, Elena; Ivanic, Maros; Martin, Will

    2010-01-01

    This study explores the trade-related impacts of rapid growth of China and India on the Malaysian economy and evaluates policy options to better position Malaysia to take advantage of these changes. Higher growth in China and India is likely to raise Malaysia's national income and to expand Malaysia's natural resource and agricultural exports, while putting downward pressure on exports from some manufacturing and service sectors. Increases in the quality and variety of exports from China and ...

  18. Exploring Corporate Governance Structures and Practices in Jamaica: Towards Policy Reform

    OpenAIRE

    Kerr, Vindel Leroy

    2010-01-01

    This study explores corporate governance (CG) structures and practices in Jamaica to fill theoretical, practical and public policy gaps. The study is organized into four parts and nine chapters. Part one is an introduction to the thesis and the contextual setting. Part two explores the theoretical and methodological framework via an in-depth review of the social science literature on CG and sets out the research strategy and methodology. Part three analyses and discusses the findings from th...

  19. Effects of decentralisation and health system reform on health workforce and quality-of-care in Indonesia, 1993-2007.

    Science.gov (United States)

    Diana, Aly; Hollingworth, Samantha A; Marks, Geoffrey C

    2015-01-01

    The impact of decentralisation, socioeconomic changes and healthcare reforms in Indonesia on type and distribution of healthcare providers and quality-of-care has been unclear. We examined workforce trends for healthcare facilities from 1993 to 2007 using the Indonesian Family Life Surveys. Each included a sample of public and private healthcare facilities, used standardised interviews for numbers and composition of staffing, and quality-of-care vignettes. There was an increase in multiprovider facilities and shift in profile of solo providers-increasing proportions of midwives and drop in doctors in rural areas (including facilities with doctors) and nurses in urban areas. Quality-of-care scores were low, particularly for nurses as solo providers. Despite increased numbers of healthcare workers and growth of the private sector, outer Java-Bali and rural areas continued to be disadvantaged in workforce capacity and quality-of-care. The results have implications for accreditation and in-service training requirements, the legal status of nurses and private sector regulation. PMID:24825032

  20. Family Models for Earning and Caring: Implications for Child Care and for Family Policy

    Directory of Open Access Journals (Sweden)

    Ravanera, Zenaida

    2009-01-01

    Full Text Available AbstractCanadian families have changed, in part due to an economy that provides more work opportunities for women, and a cultural orientation that values equal opportunity and diversity infamilies. In spite of the change, both quantitative and qualitative evidence suggest a continued preference for mothers to spend considerable time with children, especially in the infant andtoddler years. Thus, in an average couple, the presence of young children in the home brings wives to reduce their paid work and husbands to increase their paid work. Our reading of parentalpreferences suggests an interest in more services for young children in the form of early childhood education and child care, but also an interest in policies that would allow parents to spend more time with children through parental leaves, part-time work with good benefits, and subsidies that supplement market income. Many options available to two-parent families are often less feasible for lone parents, giving a higher priority to child care.RésuméLa famille canadiennes a changé, dû en partie à une économie qui offre plus de possibilités d’emploi pour les femmes, et à une tendance culturelle qui valorise l’égalité des chances et la diversité dans les familles. En dépit de ces changements, les preuves quantitatives et qualitatives suggèrent une préférence continue pour les mères de passer plus de temps avec les enfants, particulièrement quand il s’agit de nouveau-nés ou d’enfants en bas âge. Donc, pour un couple moyen, la présence de jeunes enfants au foyer pousse les femmes à réduire leurs emplois rémunérés et les maris à augmenter les leurs. Notre étude des préférences parentales suggère un intérêt pour un accroissement des services pour jeunes enfants sous la forme d’éducation préscolaire et de garde d’enfants, et aussi un intérêt pour des politiques qui permettraient aux parents de passer plus de temps avec leurs enfants tels que cong

  1. [The list of drugs in the Popular Pharmacy Program and the Brazilian National Pharmaceutical Care Policy].

    Science.gov (United States)

    Yamauti, Sueli Miyuki; Barberato-Filho, Silvio; Lopes, Luciane Cruz

    2015-08-01

    This study aimed to analyze the list of drugs in the Popular Pharmacy Program in Brazil (PFPB) in relation to the country's pharmaceutical care policy. The list of drugs in the PFPB was compared to the Brazilian and international reference lists of essential medicines, the components of pharmaceutical care in Brazilian Unified National Health System (SUS), and drug production by the country's government pharmaceutical laboratories. The PFPB list includes 119 drugs, of which 19.3% and 47.1% were not selected on the Brazilian and international reference lists, respectively; 16.8% are not used in primary care, and 40.3% are not produced by the country's government laboratories. A revision of the PFPB list based on the essential medicines concept (World Health Organization), alignment of pharmaceutical care policies, and production by government laboratories are essential to improve quality of health care, management, training of prescribers, and information for the population.

  2. [The list of drugs in the Popular Pharmacy Program and the Brazilian National Pharmaceutical Care Policy].

    Science.gov (United States)

    Yamauti, Sueli Miyuki; Barberato-Filho, Silvio; Lopes, Luciane Cruz

    2015-08-01

    This study aimed to analyze the list of drugs in the Popular Pharmacy Program in Brazil (PFPB) in relation to the country's pharmaceutical care policy. The list of drugs in the PFPB was compared to the Brazilian and international reference lists of essential medicines, the components of pharmaceutical care in Brazilian Unified National Health System (SUS), and drug production by the country's government pharmaceutical laboratories. The PFPB list includes 119 drugs, of which 19.3% and 47.1% were not selected on the Brazilian and international reference lists, respectively; 16.8% are not used in primary care, and 40.3% are not produced by the country's government laboratories. A revision of the PFPB list based on the essential medicines concept (World Health Organization), alignment of pharmaceutical care policies, and production by government laboratories are essential to improve quality of health care, management, training of prescribers, and information for the population. PMID:26375644

  3. The Effect of the Common Agricultural Policy Reform by 2013 on Direct Payments in Relation to Animal Welfare in the European Union - Review

    Directory of Open Access Journals (Sweden)

    Marek Angelovič

    2011-10-01

    Full Text Available The primary role of agriculture is to provide food and the European Union should be able to contribute to rising world food demand. The Common Agriculture Policy covers the wide variety of measures used to support and protect the European Union farmers. The most important measure within the Common Agriculture Policy is direct payments paid directly to farmers to protect their income. The Common Agriculture Policy is due to be reformed by 2013. The main object of the Common Agriculture Policy, which is a provision of safe, healthy choice of food at transparent and affordable prices, will remain unchanged, but further changes of the Common Agriculture Policy are necessary to respond to the new challenges such as animal welfare, global food security, natural resources such as water, air, biodiversity and soil, climate changes, increasing globalization and rising price volatility.

  4. Evaluation of policy options to reform the EU Emissions Trading System. Effects on carbon price, emissions and the economy

    Energy Technology Data Exchange (ETDEWEB)

    Verdonk, M.; Brink, C.; Vollebergh, H.; Roelfsema, M.

    2013-04-15

    The EU Emissions Trading System (EU ETS) is a key instrument of EU climate policy, providing a clear reduction pathway for CO2 emissions. The current carbon price (of about 3 euros per tonne of CO2, April 2013) is much lower than previously expected (which was around 30 euros) and is likely to remain low for a long time. This fuels doubts about whether the ETS will remain a key policy instrument in the long term. Such doubts also increase investment uncertainty, which is likely to have a negative impact on further investments in low-carbon technologies needed for a low-carbon economy in 2050. In November 2012, the European Commission put forward six options for a more structural reform of the EU ETS. The proposed options vary from reducing the cap and expanding the ETS to include other sectors, to strengthening the ETS by measures directly affecting allowance prices. The Dutch Ministry of Infrastructure and the Environment (IenM) asked the PBL Netherlands Environmental Assessment Agency to assess the impact of these options. Four categories of options for reforming the ETS were evaluated: (1) reducing the supply of emission allowances; (2) expanding the ETS by including other sectors; (3) a minimum price for auctioned allowances; and (4) combining ETS with a carbon tax. Recently, the European Parliament voted against the European Commission's proposal to temporarily set aside emission allowances. In an earlier assessment of this proposal, PBL concluded that the impact of this backloading proposal on CO2 prices is likely to be limited, because the total amount of allowances up to 2020 would remain unchanged. All options analysed would reduce emissions and cause the emission price to increase. A minimum price on carbon, however, would provide the best opportunity to make the ETS more robust against unforeseen events, such as a further deterioration of the economy. Such a minimum price would result in more emission reductions if abatement proves to be cheaper

  5. Developing public policy to advance the use of big data in health care.

    Science.gov (United States)

    Heitmueller, Axel; Henderson, Sarah; Warburton, Will; Elmagarmid, Ahmed; Pentland, Alex Sandy; Darzi, Ara

    2014-09-01

    The vast amount of health data generated and stored around the world each day offers significant opportunities for advances such as the real-time tracking of diseases, predicting disease outbreaks, and developing health care that is truly personalized. However, capturing, analyzing, and sharing health data is difficult, expensive, and controversial. This article explores four central questions that policy makers should consider when developing public policy for the use of "big data" in health care. We discuss what aspects of big data are most relevant for health care and present a taxonomy of data types and levels of access. We suggest that successful policies require clear objectives and provide examples, discuss barriers to achieving policy objectives based on a recent policy experiment in the United Kingdom, and propose levers that policy makers should consider using to advance data sharing. We argue that the case for data sharing can be won only by providing real-life examples of the ways in which it can improve health care.

  6. Five Policy Levers To Meet The Value Challenge In Cancer Care.

    Science.gov (United States)

    Callahan, Ryan; Darzi, Ara

    2015-09-01

    The burden of cancer on public finances is a serious concern for policy makers. More people are developing cancer, and as standards of care have risen, more are surviving and requiring longer-term care. Precision medicine promises better outcomes but demands commensurately higher payments for care. As both incidence and per case costs rise, we suggest that the task of expanding access to high-quality cancer care poses a "value challenge" that policies in many countries are inadequate to meet. Policy makers should respond with a new approach. We explore questions that policy makers will need to consider regarding objectives, barriers, and levers for policy development. We use transparency and accountability as cornerstones of a new approach to promote value-based decision making. Although barriers to advancing this agenda are formidable, we recommend that governments define common standards for value-based accounting; serve as information brokers for evidence development; pioneer value-based procurement of goods and services; engage in deliberative democracy in cancer care; and educate communities to facilitate knowledge sharing between communities of patients, their caretakers, and researchers. PMID:26355059

  7. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    Directory of Open Access Journals (Sweden)

    Martin Carmel M

    2009-01-01

    themes around chronic illness experience and care needs remained consistent over the 10 year period. Reforms did not appear to alleviate the burden of chronic illness across disease groups, yet some were more privileged than others. Thus in the future, chronic care reforms should build from greater understanding of the needs of people with chronic illness.

  8. Boutique to Booming: Medicare Managed Care and the Private Path to Policy Change.

    Science.gov (United States)

    Kelly, Andrew S

    2016-06-01

    In 2014, Medicare Advantage (MA) enrollment surpassed 30 percent of eligible beneficiaries. Twenty-five years earlier, enrollment hovered at just 3 percent. The expansion of private Medicare plans presents a puzzling instance of policy change within Medicare-a program long held to be a quintessential case of policy stasis. This article investigates the policy features that made Medicare susceptible to this dramatic policy shift, as well as the processes by which the initial policy change remade the politics of Medicare and solidified the MA program. The first enrollment surge occurred in the absence of a proximate legislative or administrative change. Instead, increased spending and expanded benefits were the result of the interaction of new market dynamics with an existing legislative framework-demonstrating an expansionary form of policy drift. The 1982 Tax Equity and Fiscal Responsibility Act created a policy space that gave the new and lightly controlled managed care industry considerable operational discretion. As the interests of the government's private partners changed in response to new market dynamics, a change occurred in the output and performance of the Medicare managed care program. As enrollment and spending increased, Medicare's politics were remade by the political empowerment of the managed care industry and the creation of a new subconstituency of beneficiaries.

  9. Boutique to Booming: Medicare Managed Care and the Private Path to Policy Change.

    Science.gov (United States)

    Kelly, Andrew S

    2016-06-01

    In 2014, Medicare Advantage (MA) enrollment surpassed 30 percent of eligible beneficiaries. Twenty-five years earlier, enrollment hovered at just 3 percent. The expansion of private Medicare plans presents a puzzling instance of policy change within Medicare-a program long held to be a quintessential case of policy stasis. This article investigates the policy features that made Medicare susceptible to this dramatic policy shift, as well as the processes by which the initial policy change remade the politics of Medicare and solidified the MA program. The first enrollment surge occurred in the absence of a proximate legislative or administrative change. Instead, increased spending and expanded benefits were the result of the interaction of new market dynamics with an existing legislative framework-demonstrating an expansionary form of policy drift. The 1982 Tax Equity and Fiscal Responsibility Act created a policy space that gave the new and lightly controlled managed care industry considerable operational discretion. As the interests of the government's private partners changed in response to new market dynamics, a change occurred in the output and performance of the Medicare managed care program. As enrollment and spending increased, Medicare's politics were remade by the political empowerment of the managed care industry and the creation of a new subconstituency of beneficiaries. PMID:26921379

  10. End-of-life care in the United States: policy issues and model programs of integrated care

    Directory of Open Access Journals (Sweden)

    Joshua M. Wiener

    2003-05-01

    Full Text Available Background: End-of-life care financing and delivery in the United States is fragmented and uncoordinated, with little integration of acute and long-term care services. Objective: To assess policy issues involving end-of-life care, especially involving the hospice benefit, and to analyse model programs of integrated care for people who are dying. Methods: The study conducted structured interviews with stakeholders and experts in end-of-life care and with administrators of model programs in the United States, which were nominated by the experts. Results: The two major public insurance programs—Medicare and Medicaid—finance the vast majority of end-of-life care. Both programs offer a hospice benefit, which has several shortcomings, including requiring physicians to make a prognosis of a six month life expectancy and insisting that patients give up curative treatment—two steps which are difficult for doctors and patients to make—and payment levels that may be too low. In addition, quality of care initiatives for nursing homes and hospice sometimes conflict. Four innovative health systems have overcome these barriers to provide palliative services to beneficiaries in their last year of life. Three of these health systems are managed care plans which receive capitated payments. These providers integrate health, long-term and palliative care using an interdisciplinary team approach to management of services. The fourth provider is a hospice that provides palliative services to beneficiaries of all ages, including those who have not elected hospice care. Conclusions: End-of-life care is deficient in the United States. Public payers could use their market power to improve care through a number of strategies.

  11. Science and Policy in Interaction: On practices of science policy interactions for policy-making in health care

    NARCIS (Netherlands)

    C. van Egmond (Stans)

    2010-01-01

    textabstractIn times of crisis, such as in the case of the volcanic ash cloud, the role of science in policy-making processes becomes more apparent than in ‘normal’, less controversial times. There is, however, hardly a policy area imaginable where science is not involved – even though that role, in

  12. Production of norms and securitization in development policies : from "Human Security" to "Security Sector Reform"

    OpenAIRE

    Larzillière, Pénélope

    2012-01-01

    Security has become part and parcel of the objectives of development policies where a particular emphasis is placed on the interlinkages between security and development. The history of approaches to security in the development field sheds light on how this has come about, i.e. on how the notion of ‛human security‛ has evolved into ‛security sector reform‛ (SSR). While development stakeholders first devised the human-security approach as a means of mainstreaming their objectives into the secu...

  13. Lifelong guidance policies in France and in Europe : where reforms are heading ?

    OpenAIRE

    Borras, Isabelle; Berthet Collab., Thierry; Campens Collab., Étienne; Romani, Claudine

    2009-01-01

    Translation of the French text : "Le pilotage de l'orientation tout au long de la vie. Le sens des réformes". Notes emploi formation n° 29, Céreq, juillet 2008 Note de travail LEPII ; 10/2009. Grenoble: LEPII. The transformations occurring in work and employment at the present time are raising new expectations with respect to guidance policies. Public action concerning guidance is challenged by the growing complexity of educational and professional pathways and increasing career mobilit...

  14. Labour Reform in South Africa: Measuring Regulation and a Synthesis of Policy Suggestions

    OpenAIRE

    Haroon Bhorat; Halton Cheadle

    2009-01-01

    Even though the South African economy is formally categorised as an upper-middle income country, it has one of the highest unemployment rates in the world. The economy’s unemployment rate stands officially at 26.7 per cent and 38.8 per cent. This characteristic, more than any other, has placed market regulation high on the agenda of pertinent policy issues in South Africa. This paper, then, in trying to mature the debate on labour regulation and worker protection, has two key objectives. Firs...

  15. The Effects of Alcohol Policies in Reducing Entry Rates and Time Spent in Foster Care

    OpenAIRE

    Sara Markowitz; Alison Evans Cuellar; Conrad, Ryan M.; Michael Grossman

    2011-01-01

    The purpose of this paper is to empirically estimate the propensity for alcohol-related policies to influence rates of entry into foster care and the length of time spent in foster care. Alcohol consumption is believed to be major contributing factor to child maltreatment, associated with an increased likelihood of abuse and longer durations once in foster care. We analyze a panel of state-level foster care entry rates over time, followed by a duration analysis of individual-level cases. The ...

  16. How Major Public Hospital Initiative to Meet the Medical Insurance Reform under New Health-care Reform%大型公立医院如何适应新医改下的医保改革

    Institute of Scientific and Technical Information of China (English)

    李晓平; 余艳红; 许崇伟

    2011-01-01

    Through the study of medical insurance reform measure and trend under the situation, of new medical health-care reform, according to the practice of major public hospital, the paper discusses the influence of medical insurance reform, and provides feasible suggestions for public hospital.%通过研究新医改形势下的医保改革措施及趋势,根据大型公立医院的实践,探讨医保改革对大型公立医院的影响,并对大型公立医院如何主动适应医保改革提出可行性建议.

  17. Building a health care workforce for the future: more physicians, professional reforms, and technological advances.

    Science.gov (United States)

    Grover, Atul; Niecko-Najjum, Lidia M

    2013-11-01

    Traditionally, projections of US health care demand have been based upon a combination of existing trends in usage and idealized or expected delivery system changes. For example, 1990s health care demand projections were based upon an expectation that delivery models would move toward closed, tightly managed care networks and would greatly decrease the demand for subspecialty care. Today, however, a different equation is needed on which to base such projections. Realistic workforce planning must take into account the fact that expanded access to health care, a growing and aging population, increased comorbidity, and longer life expectancy will all increase the use of health care services per capita over the next few decades--at a time when the number of physicians per capita will begin to drop. New technologies and more aggressive screening may also change the equation. Strategies to address these increasing demands on the health system must include expanded physician training.

  18. Big things come in bundled packages: implications of bundled payment systems in health care reimbursement reform.

    Science.gov (United States)

    Delisle, Dennis R

    2013-01-01

    With passage of the Affordable Care Act, the ever-evolving landscape of health care braces for another shift in the reimbursement paradigm. As health care costs continue to rise, providers are pressed to deliver efficient, high-quality care at flat to minimally increasing rates. Inherent systemwide inefficiencies between payers and providers at various clinical settings pose a daunting task for enhancing collaboration and care coordination. A change from Medicare's fee-for-service reimbursement model to bundled payments offers one avenue for resolution. Pilots using such payment models have realized varying degrees of success, leading to the development and upcoming implementation of a bundled payment initiative led by the Center for Medicare and Medicaid Innovation. Delivery integration is critical to ensure high-quality care at affordable costs across the system. Providers and payers able to adapt to the newly proposed models of payment will benefit from achieving cost reductions and improved patient outcomes and realize a competitive advantage.

  19. Redefining Economic Policy and Institutional Reform – Support for Economic Growth

    Directory of Open Access Journals (Sweden)

    Coralia ANGELESCU

    2010-12-01

    Full Text Available The paper addresses the effects of economic crisis fromthe perspective of theoretical developments and how they were reflectedin the economy, both nationally and among the actors of the internationalsystem. Basic economic paradigms such as the role of price as amechanism regulating the operation of free markets and the ability todetermine prices to reflect economic developments have been tested invarious markets. In the context of limited resources available, due toeconomic contraction it is necessary to redefine accepted socialbalances.The example analyzed in the paper is that of social policies. Intimes of economic expansion, modification of such arrangements, even ifsuboptimal, proves to be difficult because it involves implicit costs, lessvisible. Economic crisis brings out such costs. Changing these socialarrangements requires first the solution and coherent regulatorymechanisms and implementation. They depend on the quality ofinstitutions and social coordination system as a whole. If thesemechanisms are complex national, at supranational level we can addadditional layers of decision, which explains the difficulty of coordination. The degree of consistency in decision-making mechanismsand their quality determine the cost of adapting to new conditionsimposed by the balance.Coordination mechanisms, either national or supranationalcontext, are relevant for redefining of a new balance to streamlineexisting policies (eg social that reflects the crisis and the creation of newarrangements to accommodate new engines economic growth.

  20. Medical education in end-of-life care: the status of reform.

    Science.gov (United States)

    Block, Susan D

    2002-04-01

    Deficiencies in education about end-of-life care are widely recognized, both in the "formal" or structured curriculum, and in the "informal" curriculum (the culture in which students are immersed as they learn medicine). Numerous approaches to addressing these deficiencies have been identified. These approaches include developing palliative care leaders; improving curricula; creating standards and a process for certification of competence; creating and enhancing educational resources for end-of-life education; faculty development; growing palliative care clinical programs as venues for education; textbook revision; and creating palliative care fellowship training opportunities. Current efforts in these areas are reviewed, and barriers to their implementation are highlighted. PMID:12006224