WorldWideScience

Sample records for european healthcare reforms

  1. Narrative medicine and healthcare reform.

    Science.gov (United States)

    Lewis, Bradley E

    2011-03-01

    Narrative medicine is one of medicine's most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context.

  2. Board Governance: Transformational Approaches Under Healthcare Reform.

    Science.gov (United States)

    Zastocki, Deborah K

    2015-01-01

    Previous successes of healthcare organizations and effective governance practices in the pre-reform environment are not predictive of future success. Healthcare has been through numerous phases of growth and development using tried-and-true strategies. The challenge is that our toolbox does not contain what is needed to build the future healthcare delivery systems required in the post-reform world. Healthcare has had a parochial focus at the local level, with some broadening of horizons at the state and national levels. But healthcare delivery is now a global issue that requires a totally different perspective, and many countries are confronting similar issues. US healthcare reform initiatives have far-reaching implications. Compounding the reform dynamics are the simultaneously occurring, gamechanging accelerants such as enabling information technologies and mobile health, new providers of healthcare, increased consumer demands, and limited healthcare dollars, to name a few. Operating in this turbulent environment requires transformational board, executive, and physician leadership because traditional ways of planning for incremental change and attempting to time those adjustments can prove disastrous. Creating the legacy healthcare system for tomorrow requires governing boards and executive leadership to act today as they would in the desired future system. Boards need to create a culture that fosters.innovation with a tolerance for risk and some failure. To provide effective governance, boards must essentially develop new skills, expertise, and ways of thinking. The rapid rate of change requires board members to possess certain capabilities, including the ability to deal with ambiguity and uncertainty while demonstrating flexibility and adaptability, all with a driving commitment to metrics and results. This requires development plans for both individual members and the overall board. In short, the board needs to function differently, particularly regarding the

  3. Healthcare beyond reform: doing it right for half the cost

    National Research Council Canada - National Science Library

    Flower, Joe

    2012-01-01

    .... In Healthcare Beyond Reform: Doing It Right for Half the Cost, Joe Flower, a well respected healthcare futurist and industry thought leader, lays out his compelling practical vision of how healthcare can work better, and how we can get...

  4. Healthcare beyond reform: doing it right for half the cost

    National Research Council Canada - National Science Library

    Flower, Joe

    2012-01-01

    .... In Healthcare Beyond Reform: Doing It Right for Half the Cost, Joe Flower, a well respected healthcare futurist and industry thought leader, lays out his compelling practical vision of how healthcare can work better, and how we...

  5. Welfare reform in European countries

    DEFF Research Database (Denmark)

    Immervoll, Herwig; Kleven, Henrik Jacobsen; Kreiner, Claus Thustrup

    2007-01-01

    microsimulation model to estimate current marginal and participation tax rates. We quantify the equity-efficiency trade-off for a range of elasticity parameters. In most countries, because of large existing welfare programmes with high phase-out rates, increasing traditional welfare is undesirable unless......This article compares the effects of increasing traditional welfare to introducing in-work benefits in the 15 (pre-enlargement) countries of the European Union. We use a labour supply model encompassing responses to taxes and transfers along both the intensive and extensive margins, and the EUROMOD...

  6. The changing face of European healthcare education: the Hungarian experience.

    Science.gov (United States)

    Betlehem, Jozsef; Kukla, Aniko; Deutsch, Krisztina; Marton-Simora, Jozsef; Nagy, Gabor

    2009-02-01

    Throughout Europe, higher education is undergoing great changes in order to establish what is being called the European Higher Education Area (EHEA) based on the Bologna process. The goal being the establishment of a uniform, transparent and efficient development of professionals in a higher education system that can react in a flexible way to the changes in the labor market, and to the challenges presented by increasing globalization. The aim of this article is to provide an overview of the Bologna process and to give a summary of the implemented initial stages in the health care higher education of Hungary. As a consequence, the Hungarian higher education in healthcare has undergone considerable reforms to facilitate transition into this new system. The results indicate that the new structure in health sciences is not compatible with other way of European countries of introducing Bologna reforms, although the content of the former BSc curriculum still remained the same. MSc programs are still being discussed.

  7. Environmental sustainability in European public healthcare.

    Science.gov (United States)

    Chiarini, Andrea; Vagnoni, Emidia

    2016-01-01

    Purpose - The purpose of this paper is to enlarge the debate concerning the influence of leadership on environmental sustainability implementation in European public healthcare organisations. Design/methodology/approach - This paper is a viewpoint. It is based on preliminary analysis of European standards dedicated to environmental sustainability and their spread across Europe in public healthcare organisations. Viewpoints concerning leadership are then discussed and asserted. Findings - This paper found a limited implementation of standards such as Green Public Procurement criteria, Eco-Management and Audit Scheme and ISO 14001 in public healthcare. Some clues indicate that the lack of implementation is related to leadership and management commitment. Originality/value - For the first time, this paper investigates relationships between leadership and environmental sustainability in European public healthcare opening further avenues of research on the subject.

  8. The Rise of a European Healthcare Union

    DEFF Research Database (Denmark)

    Vollaard, Hans; Martinsen, Dorte Sindbjerg

    2017-01-01

    Healthcare has only slowly appeared on the European Union’s (EU) policy agenda. EU involvement in policies concerning the organization, financing and the provision of diagnosis, care and cures to ill people developed along three fragmented tracks: (a) EU public health policies concerning the well......-being of all people; (b) the application of the free movement principle to national healthcare systems in particular by the EU’s Court of Justice (CJEU); and (c) the austerity packages and the stricter EU surveillance of national budgets since the debt crises. The key questions of this special issue...... are whether this fragmented EU involvement has now developed into a distinct European healthcare union, and if so what its driving forces have been. Thus, it explores how European integration in healthcare has moved forward despite widespread reluctance. It also examines the underexplored political dynamics...

  9. The making of a European healthcare union

    DEFF Research Database (Denmark)

    Vollaard, Hans; van de Bovenkamp, Hester M.; Martinsen, Dorte Sindbjerg

    2016-01-01

    that federalism offers the most fruitful way to do so because of its sensitivity to the EU’s institutional settings and to the territorial dimension of politics. The division of competences and national diversity of healthcare systems have been major obstacles for the formation of a healthcare union. However......, the EU obtained a role in healthcare through the impact of non-healthcare legislation, voluntary co-operation, court rulings, governments’ joint-decision traps, and fiscal stress of member states. The emerging European healthcare union is a system of cooperative federalism without much cost......-sharing. The healthcare union’s robustness is limited, also because it does not generate much loyalty towards the EU....

  10. Lessons to apply to national comprehensive healthcare reform.

    Science.gov (United States)

    Conrad, Douglas A

    2009-12-01

    Fragmentation, insufficient coordination of care, and absence of unified accountability for patient care has resulted in medical errors, rehospitalizations, and preventable complications, all of which increase costs and negatively affect patient outcomes. The current US healthcare system is unsustainable and the national healthcare reform package must address cost containment and quality improvement. Four innovative healthcare models--integrated delivery systems, pay for performance, value-based insurance design, and the medical home--strive to improve quality of care and contain costs. None of these models will solve all healthcare problems alone, nor will they all work everywhere. Different regions, patient populations, and purchaser/payer/provider coalitions may respond to different innovations and modified combinations of the models may eventually predominate. Initial evidence from the Centers for Medicare & Medicaid Services and private sector demonstrations suggests that payment system changes and other innovations would do more than help control runaway healthcare costs. If widely implemented, value-based reforms might achieve long-term improvements in public health. Congress will soon decide whether changing the entire system would be the most value-based reform of all.

  11. Choice of healthcare provider following reform in Vietnam

    Directory of Open Access Journals (Sweden)

    Lindholm Lars

    2008-07-01

    Full Text Available Abstract Background In Vietnam, the health-sector reforms since 1989 have lead to a rapid increase in out-of-pocket expenses. This paper examines the choice of medical provider and household healthcare expenditure for different providers in a rural district of Vietnam following healthcare reform. Methods The study consisted of twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample – Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002. Results The use of private health providers and self-treatment are quite common for both episodes (60% and 23% of all illness episodes and expenditure (60% and 12.8% of healthcare expenditure The poor tend to use self-treatment more frequently than wealthier members of the community (31% vs. 14.5% of illness episodes respectively. All patients in this study often use private services before public ones. The poor use less public care and less care at higher levels than the rich do (8% vs.13% of total illness episodes, which decomposes into 3% vs. 7% at district level, and 1% vs. 3% at the provincial or central level, respectively. The education of the patients significantly affects healthcare decisions. Those with higher education tend to choose healthcare providers rather than self-treatment. Women tend to use drugs or healthcare services more often than men do. Patients in two highest quintiles use health services more than in the lowest quintile. Moreover, seriously ill patients frequently use more drugs, healthcare services, public care than those with less severe illness. Conclusion The results are useful for policy makers and healthcare professionals to (i formulate healthcare policies-of foremost importance are methods used to reduce self-treatment and no treatment; (ii the management of private practices and maintaining public healthcare providers at all levels

  12. Towards evidence-based reform of European universities

    NARCIS (Netherlands)

    van der Ploeg, F.; Veugelers, R.

    2008-01-01

    After the Bologna agreement and the Lisbon Agenda, reform of European university systems has been higher on the political agenda. This is necessary, since most European universities have been suffering from stifling blankets of government regulation, having to make do with much less funds than their

  13. The role of institutional entrepreneurs in reforming healthcare.

    Science.gov (United States)

    Lockett, Andy; Currie, Graeme; Waring, Justin; Finn, Rachael; Martin, Graham

    2012-02-01

    We draw on institutional entrepreneurship theory to analyse the dynamics of institutional change in a healthcare context. The focus of our interest is in the relationship between an institutional entrepreneur's 'subject position', defined in terms of their structural and normative legitimacy within the existing institutional landscape, and the nature of the change enacted. We develop this approach through an examination of the implementation of new pathways for cancer genetic services within the English National Health Service. Employing comparative case analysis we show that those who have limited structural legitimacy under prevailing conditions are most willing to engender change, but also least able; whereas those who have strong structural legitimacy are most able, but often least willing. However, those who are able rhetorically to combine a balance of structural and normative legitimacy are most able to produce change. In doing so, we demonstrate the importance of the concept of institutional entrepreneurship to understand healthcare reform. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Administrative Reform in Romania and the European Union

    OpenAIRE

    Călin HINŢEA; Sorin Dan ŞANDOR; Veronica JUNJAN

    2002-01-01

    The issue of public administration reform is an old one for the professional literature. It has always been at the basis of a significant theoretical debate that started with the idea of compatibility between the concepts of “public administration” and “reform”. Central and Eastern European countries have been faced with the acute need of reform after the crash of communist regimes and painful disclosure of the inefficiency of previous bureaucratic models.

  15. Health sector reforms for 21 st century healthcare

    Directory of Open Access Journals (Sweden)

    Darshan Shankar

    2015-01-01

    Full Text Available The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India′s health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India′s Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21 st century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India′s public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  16. Reforming the European Commission – A (missed? Academic Opportunity

    Directory of Open Access Journals (Sweden)

    Michael W. Bauer

    2002-07-01

    Full Text Available The desire to reform the European Commission is a recurrent theme on the agenda. Has the political failure to reach an appropriate restructuring of this institution a parallel in academic neglect of that institution? To answer this question the article looks into current research efforts on the reform of the European Commission. It calls for (more systematic investigation into the Commission's managerial strengths and weaknesses and does plead for a reassessment of the Commission's potential in the context of the ongoing governance changes.

  17. Theory and reform in the European Union

    OpenAIRE

    Chryssochoou, Dimitris N.; Tsinisizelis, Michael J.; Stavridis, Stelios; Ifantis, Kostas

    2003-01-01

    This substantially updated and revised edition offers a comprehensive overview of the challenges confronting the political system as well as the international politics of the European Union. It draws from a rich spectrum of regional integration theories to determine what the Union actually is and how it is developing. The book examines constitutional politics of the European Union, from the Single European Act to the Treaty of Nice and beyond. The ongoing debate on the future of Europe links ...

  18. Reforming primary healthcare: from public policy to organizational change.

    Science.gov (United States)

    Gilbert, Frédéric; Denis, Jean-Louis; Lamothe, Lise; Beaulieu, Marie-Dominique; D'amour, Danielle; Goudreau, Johanne

    2015-01-01

    Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec. An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis. The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of "intermediate change" and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery. This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation. The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes. This research is one of few studies to examine a primary care reform from emergence to implementation

  19. Dilemma of healthcare reform and invention of new discipline of health fiscalogy.

    Science.gov (United States)

    Liu, Jitong; Miao, Jianchun; Zhang, Dongqi

    2016-01-01

    China's Reform and Open up Policy in 1980s has brought rapid economic development to Chinese society. With the deepening of economic reform, the withdrawal of the state in China has had visible and worrisome consequences for health and for the functioning of health services. The new round of healthcare reform after 2009 has made significant achievements on improving fundamental health and bringing back the nature of welfare of health. However, the financing mechanism of health system has not been established, and the underlying reason behind the healthcare reform dilemma and the theoretical solution need to be found. This study used the methods of literature review, theoretical research and comparative research to summarize and analyze the reasons and solutions of current dilemma in healthcare reform, and created the new discipline of health fiscalogy through theoretical analysis and vertical and horizontal comparison of healthcare system, especially health financing. Dilemma in healthcare system emerged from the circumstances of rapid process of industrialization, urbanization and population aging, including the profit-driven phenomena, tendency of excessive marketization in public hospitals, strained doctor-patient relationship, high disease burden on individuals and families, and so on. It can be concluded that the theoretical basis of healthcare system and the nature of health resources are crucial in solving the dilemma of healthcare reform. The theoretical basis of healthcare reform should be health fiscalogy focusing on government as the main body of health care responsibility rather than health economics focusing on anti-monopoly. There are two key differences between health economics and health fiscalogy: responsible person/department of disease and health welfare, and nature of resource. The new discipline of health fiscalogy has universal and important implications on both China's healthcare reform and the healthcare reform in the world. China

  20. 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

  1. Healthcare inequality issues among immigrant elders after neoliberal welfare reform: empirical findings from the United States.

    Science.gov (United States)

    Yeo, Younsook

    2017-06-01

    Even with the increasing importance being placed on research into immigrant elders' healthcare use as countries change their policies to reflect their increasing immigrant and aging populations, little research has examined changes in healthcare use disparities between immigrant and native elders in relation to these policy changes. To fill this gap in the literature, this study examined healthcare disparities in relation to the welfare reform that the US implemented in 1996 and then compared significant indicators of immigrants' healthcare use during the pre- and post-reform periods. The difference-in-difference (DD) analyses and post hoc probing of the DD analyses were used in multivariate logistic regression of the National Health Information Survey data that were pooled for the pre- and post-reform periods. The results revealed that while inequalities in healthcare existed before the reform, they significantly increased after the reform. A further test showed that the changes in the inequalities were significant among relatively long-stay immigrants, but not significant among immigrants who entered the US before the reform and thus were exempted from the reform restrictions. During the pre-reform period, insurance, employment, sex, and race/ethnicity were related to healthcare use; however, the enabling factors (i.e., insurance, income, and education) and social structural factors (i.e., marital status, family structure, length of US residency, race/ethnicity, and geographical region) explained the post-reform immigrants' healthcare use, while controlling for healthcare needs factors. These findings suggest that welfare reform may be the driving force of inequalities in healthcare.

  2. 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

    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......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...... 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....

  3. Beyond patient care: the impact of healthcare reform on job satisfaction in the Ethiopian public healthcare sector.

    Science.gov (United States)

    Manyazewal, Tsegahun; Matlakala, Mokgadi C

    2017-02-03

    While healthcare reform has been a central attention for local governments, its impact on job satisfaction is poorly understood. This study aimed to determine the impact of healthcare reform on job satisfaction in the public healthcare sector in Ethiopia. The study was designed as a facility-based cross-sectional survey of healthcare professionals and carried out in all public hospitals in central Ethiopia which have been implementing healthcare reform (n = 5). All healthcare professionals in the hospitals who were involved in the reform from the inception (n = 476) were purposively sourced to complete a self-administered questionnaire adapted from a framework proposed for measuring job satisfaction of health professionals in sub-Saharan Africa. Kaiser-Meyer-Olkin and Bartlett's tests were conducted to measure sampling adequacy and sphericity for factor analysis. Likert's transformation formula was used to numerically analyse the satisfaction level of the respondents and to determine the cut-off value of satisfaction levels. Non-parametric and multiple logistic regression analysis were conducted to determine predictors of job satisfaction. A total of 410 healthcare professionals completed the survey, representing an 88% response rate. The median and mean job satisfaction scores were 50 and 49, respectively, on a scale 1-100, which was equivalent to 'Job dissatisfied' on the Likert scale. Only 25% of respondents perceived job satisfaction due to implementation of the reform. Moral satisfaction (adjusted odds ratio (aOR), 177.65; 95% confidence interval (CI), 59.54-530.08), management style (aOR, 4.02; 95% CI, 1.49-10.83), workload (aOR, 2.42; 95% CI, 0.93-6.34), and task (aOR, 5.49; 95% CI, 2.31-13.07) were the most significant predictors. Job satisfaction results were significantly different among the study hospitals (χ (2) = 30.56, p public healthcare professionals' job satisfaction and its overall impact on job satisfaction was poor, which would

  4. 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.

  5. THE CONCEPT OF REFORMING THE HEALTHCARE INDUSTRY USING A PROJECT-BASED APPROACH

    Directory of Open Access Journals (Sweden)

    Владлен Володимирович ЛЕПСЬКИЙ

    2016-03-01

    Full Text Available The strategic goal of the state policy in the field of health Ukraine is to improve human health through providing the population with affordable and quality health care, and the development of a healthy lifestyle and expansion of preventive measures. The main problem with the current health system is called the low level of public health services. So, it is necessary to use modern innovation management technology to reform the healthcare industry. The author is invited to consider the applicability of strategic management to the management of the healthcare industry reforms through the application of innovative medical technologies and management, focusing on the development of innovations in the industry, as improving the existing health care system, and developing projects to reform and the creation of new approaches based on project management tools. The necessity of the organization of the healthcare industry focused on the development of innovations in the field of health and improvement of existing processes has been proved. A new look at the planning and implementation of Ukraine healthcare industry reforms through the integration strategic and project management has been proposed. It is shown how can be related vision, mission, goals and relevant reform programs. Further studies will be subject to the classification of projects that constitute the program, development structure programs and portfolios of projects, implementation of which will achieve the strategic goals of reforming the industry

  6. tEACH - European network for teaching communication in healthcare

    DEFF Research Database (Denmark)

    Nielsen, Annegrethe

    (efteruddannelse af læger) & Annegrethe Nielsen (jordemoderuddannelsen), Danmark – alle medlemmer af tEACH Baggrund European Association of Communication in Healthcare (EACH, www.each.eu) blev stiftet i 2001 som et fælles europæisk samarbejde omkring kommunikation på sundhedsområdet. Kommunikationsundervisning er...

  7. Five years of EACH (European Association for Communication in Healthcare).

    NARCIS (Netherlands)

    Dulmen, S. van; Finset, A.; Langewitz, W.; Zimmermann, C.; Peltenburg, M.; Visser, A.; Bensing, J.

    2006-01-01

    Five years after launching EACH (European Association for Communication in Healthcare) we look back at what EACH achieved so far and announce new ideas and activities EACH plans to carry out in the near future. During the past five years several scientific, educational as well as societal changes

  8. Five years of EACH (European Association for Communication in Healthcare)

    NARCIS (Netherlands)

    Dulmen, S. van; Finset, A.; Langewitz, W.; Zimmermann, C.; Peltenburg, M.; Visser, Adriaan; Bensing, J.

    2006-01-01

    Five years after launching EACH (European Association for Communication in Healthcare) we look back at what EACH achieved so far and announce new ideas and activities EACH plans to carry out in the near future. During the past five years several scientific, educational as well as societal changes

  9. Redefining the Core Competencies of Future Healthcare Executives under Healthcare Reform

    Science.gov (United States)

    Love, Dianne B.; Ayadi, M. Femi

    2015-01-01

    As the healthcare industry has evolved over the years, so too has the administration of healthcare organizations. The signing into law of the Patient Protection and Affordable Care Act (ACA) has brought additional changes to the healthcare industry that will require changes to the healthcare administration curriculum. The movement toward a…

  10. Healthcare beyond reform: doing it right for half the cost

    National Research Council Canada - National Science Library

    Flower, Joe

    2012-01-01

    ... can get there by utilizing the resources we already have. The author provides a comprehensive, positive, and intriguing vision of the future of healthcare for professionals, employers and investors...

  11. 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.

  12. Healthcare reform from the inside: A neurosurgical clinical quality program

    OpenAIRE

    Afsar-Manesh, Nasim; Martin, Neil A.

    2012-01-01

    During the past decade, the U.S. health care system has faced increasing challenges in delivering high quality of care, ensuring patient safety, providing access to care, and maintaining manageable costs. While reform progresses at a national level, health care providers have a responsibility and obligation to advance quality and safety. In 2009, the authors implemented a department-wide Clinical Quality Program. This Program comprised of an inter-disciplinary group of providers and staff wor...

  13. Reforming the culture of healthcare: the case for intelligent kindness

    Science.gov (United States)

    Campling, Penelope

    2015-01-01

    There has been increasing interest in the culture of healthcare in the light of the two reports by Robert Francis into the care at Mid Staffordshire. This editorial encourages a comprehensive exploration of the conditions that promote a benign caring culture and make outbreaks of cruel neglect and abuse of patients less likely. Creating and sustaining such a culture is dependent on being honest and realistic about the forces that threaten to undermine it. The editorial argues that being able to confidently articulate the positive values that should define healthcare culture is particularly important at this time. The case is made for a conscious focus on the concept of intelligent kindness. PMID:26191415

  14. Reforming the culture of healthcare: the case for intelligent kindness.

    Science.gov (United States)

    Campling, Penelope

    2015-02-01

    There has been increasing interest in the culture of healthcare in the light of the two reports by Robert Francis into the care at Mid Staffordshire. This editorial encourages a comprehensive exploration of the conditions that promote a benign caring culture and make outbreaks of cruel neglect and abuse of patients less likely. Creating and sustaining such a culture is dependent on being honest and realistic about the forces that threaten to undermine it. The editorial argues that being able to confidently articulate the positive values that should define healthcare culture is particularly important at this time. The case is made for a conscious focus on the concept of intelligent kindness.

  15. 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.

  16. Getting the Foundations Right: Alberta's Approach to Healthcare Reform

    OpenAIRE

    Duckett, Stephen

    2011-01-01

    Alberta's abolition of its health regions and the creation of Alberta Health Services in 2008 has integrated previously disparate providers of healthcare services. The long-term benefits of this “second-wave” approach to health systems structuring include lower administrative costs, greater equity of access, improved intraprovincial learning and economies of scale. Some benefits have begun to be realized but, as with any merger, performance should be judged over a multi-year time frame.

  17. A critical assessment of the European approach to financial reforms

    Directory of Open Access Journals (Sweden)

    Mario Tonveronachi

    2011-01-01

    Full Text Available The paper offers a critical assessment of the financial reforms adopted or proposed at the European level. The reshaping of the EU institutional architecture and the adoption of the new Basel 3 rules should reduce the national margins of discretion that have up to now characterised supervisory practices, often leading to light touch supervision, and restrain the growth of bankarisation, hence excessive systemic leveraging. However, the limitations of a purely prudential approach to regulation may not be overcome by setting up new institutions and make prudential requirements more stringent. In addition, given unavoidable national banking specificities, more severe rulebooks homogenously applied across the EU countries could further worsen the inconsistencies of a one-size-fits-all rule. The criticisms directed at the new regulatory framework assume particular relevance in the EU, whose peculiar construction requires that the financial sector should not be permitted to jeopardise its critical fiscal equilibrium. This opens the way to the adoption of structural measures, as the one presented by the Vickers Commission on ring-fencing. Looking at the financial system as a whole, we argue that even these measures do not offer effective protection for the economy and tax-payers, and that much more radical interventions are needed.

  18. 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

    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 introdu......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...... 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......-up to the 2013 CAP reform when institutional and political circumstances changed....

  19. Enhanced security services for enabling pan-European healthcare networks.

    Science.gov (United States)

    Blobel, B; Pharow, P; Engel, K

    2001-01-01

    Establishing the Shared Care environment, communication and co-operation between healthcare establishments involved must be provided in a trustworthy way. This challenge is even more important for health networks using the Internet. In that context, services assuring both communication security and application security must be provided. Especially in the e-health environment, additionally to identity-related services certifying data or properties of principals, trustworthiness or authorisation for objects, components and functions must be established by Trusted Third Parties (TTP). Within the European Commission's Information Society Technologies (IST) Programme, the HARP project provides the "HARP Cross-Security Platform (HCSP)" needed in the open Web environment of pan-European networks. The solutions are under implementation and evaluation in the German ONCONET enabling a trustworthy framework for both health professionals and patients as well as supporting clinical studies.

  20. Motivational Interviewing: Creating a Leadership Role for Social Work in the Era of Healthcare Reform.

    Science.gov (United States)

    Stanhope, Victoria; Tennille, Julie; Bohrman, Casey; Hamovitch, Emily

    2016-10-01

    To better address the needs of individuals with a range of complex health conditions, the Affordable Care Act has shifted the focus from acute care to prevention through behavior change and promoted the integration of physical and behavioral healthcare systems. Central to healthcare reform is delivering person-centered care, which means actively engaging people in their treatment decisions and managing their wellness. Motivational Interviewing (MI) is perhaps the most widely used intervention to promote behavior change. Although MI is utilized across most health disciplines, social workers are uniquely positioned to lead dissemination and on-going training efforts in this area.

  1. Dental healthcare reforms in Germany and Japan: A comparison of statutory health insurance policy

    Directory of Open Access Journals (Sweden)

    Mayumi Nomura

    2008-10-01

    Full Text Available This article aims to compare statutory health insurance policy during the dental healthcare reforms in Germany and Japan. Germany and Japan have categorized their statutory health insurance systems. People in both countries have been provided with a wide coverage of dental treatment and prosthetics. To compare the trends of the indicators of oral healthcare systems over time, it has been suggested that the strategic allocation of dental expenditure is more important than the amount of expense. German dental healthcare policy has shifted under political and socio-economic pressures towards a cost-effective model. In contrast, Japanese healthcare reforms have focused on keeping the basic statutory health insurance scheme, whereby individuals share more of the cost of statutory health insurance. As a result, Germany has succeeded in dramatically decreasing the prevalence of dental caries among children. On comparing the dental conditions of both countries, the rate of decline in replacement of missing teeth among adults and the elderly in Germany and Japan has been interpreted as indicating the price-conscious demands of prosthetics. The difference in the decline of DMFT in 12-year-olds in Germany and Japan could be described as being due to the dental health insurance policy being shifted from treatment-oriented to preventive-oriented in Germany. These findings suggest that social health insurance provides people with equal opportunity for dental services, and healthcare reforms have improved people's oral health. A mixed coverage of social health insurance coverage for dental care should be reconsidered in Japan.

  2. European registration process for Clinical Laboratory Geneticists in genetic healthcare.

    Science.gov (United States)

    Liehr, Thomas; Carreira, Isabel M; Aktas, Dilek; Bakker, Egbert; Rodríguez de Alba, Marta; Coviello, Domenico A; Florentin, Lina; Scheffer, Hans; Rincic, Martina

    2017-05-01

    Tremendous progress in genetics and genomics led to a wide range of healthcare providers, genetic tests, and more patients who can benefit from these developments. To guarantee and improve the quality of genetic testing, a unified European-based registration for individuals qualified in biomedicine was realized. Therefore a Europe-wide recognition of the profession 'European registered Clinical Laboratory Geneticist (ErCLG)' based on a syllabus of core competences was established which allows for harmonization in professional education. The 'European Board of Medical Genetics division - Clinical Laboratory Geneticist' provides now since 3 years the possibility to register as an ErCLG. Applicants may be from all European countries and since this year also from outside of Europe. Five subtitles reflect the exact specialty of each ErCLG, who can reregister every 5 years. A previously not possible statistics based on ~300 individuals from 19 countries as holders of an ErCLG title provides interesting insights into the professionals working in human genetics. It could be substantiated that there are around twice as many females than males and that a PhD title was achieved by 80% of registered ErCLGs. Also most ErCLGs are still trained as generalists (66%), followed by such ErCLGs with focus on molecular genetics (23%); the remaining are concentrated either on clinical (6%), tumor (4%) or biochemical genetics (1%). In conclusion, besides MDs and genetic counselors/nurses an EU-wide recognition system for Clinical Laboratory Geneticist has been established, which strengthens the status of specialists working in human genetic diagnostics in Europe and worldwide.

  3. Reforming the System of Public Procurements in the Context of the European Integration Processes

    Directory of Open Access Journals (Sweden)

    Sevostjanova Ganna S.

    2015-09-01

    Full Text Available The article analyzes reforming the system of public procurements in Ukraine in the context of the European integration processes and provides proposals for further directions of reforming, taking into account successful international practices. As result of research, the system of public procurements and its development in the independent Ukraine, phases of reforming in the context of the European integration processes, as well as compliance of the law of Ukraine of 10.04.2014 No.1197-VII «On fulfillment of public procurements» with standards of the European Union in the field of public procurements were analyzed; the main directions of reforming the public procurement system in accordance with the Association Agreement between Ukraine and the EU has been summarized. It is displayed that, despite a number of shortcomings in the system of public procurements, an active reforming and implementing in the legislation of the main requirements for public procurement in the EU is going on currently. Directions of further reforms of the public procurements system have been suggested. Prospects of the further research will be studying and analyzing international experience in implementing the electronic public procurements with a view to formulating proposals as to the best model for a native procurements system.

  4. The political economy of healthcare reform in China: negotiating public and private.

    Science.gov (United States)

    Daemmrich, Arthur

    2013-01-01

    China's healthcare system is experiencing significant growth from expanded government-backed insurance, greater public-sector spending on hospitals, and the introduction of private insurance and for-profit clinics. An incremental reform process has sought to develop market incentives for medical innovation and liberalize physician compensation and hospital finance while continuing to keep basic care affordable to a large population that pays for many components of care out-of-pocket. Additional changes presently under consideration by policymakers are likely to further restructure insurance and the delivery of care and will alter competitive dynamics in major healthcare industries, notably pharmaceuticals, medical devices, and diagnostic testing. This article describes the institutional history of China's healthcare system and identifies dilemmas emerging as the country negotiates divisions between public and private in healthcare. Building on this analysis, the article considers opportunities for public-private partnerships and greater systems integration to reconcile otherwise incommensurable approaches to rewarding innovation and improving access. The article concludes with observations on the public function of health insurance and its significance to further development of China's healthcare system.

  5. Reform of the European Court of human rights

    OpenAIRE

    Mojsilović Marijana

    2013-01-01

    The European Court of Human Rights is the crown in the international system for protecting human rights. In recent years the Court has become a victim of its own success. In response to growing backlog of individual complaints, the Council of Europe has, over the last five years, considered numerous proposals to restructure the European human rights regime and redesign the European Convention on Human Rights. The aim of this article is just to show the most important innovations introduced pr...

  6. ABOUT THE ATTITUDE OF FEDERAL HEALTHCARE INSTITUTIONS EMPLOYEES TO ONGOING REFORMS

    Directory of Open Access Journals (Sweden)

    O. V. Kudelina

    2013-01-01

    Full Text Available During studying of opinion of physicians and heads of Tomsk oblast federal healthcare institutions' departments it was revealed that stuff of institutions have a positive attitude to current changes only in case of being informed enough about territorial program of state guarantees of providing of free medical care to population and about main directions of reforms. On the basis of received results of survey suggestions were formed, which are directed to improving the awareness of employees and formation of personnel policy of institutions.

  7. Pricing and reimbursement of innovative pharmaceuticals in France and the new healthcare reform

    Directory of Open Access Journals (Sweden)

    Alexander Natz

    2012-06-01

    Full Text Available Over the last years, many cost-containment measures were implemented by the government leading to drastic price-cuts. New paradigms and healthcare models are emerging and health technology assessments are increasingly taken into consideration. France has the second biggest rank in terms of healthcare spending after the US. Pharmaceuticals represented around 19% of the budget of the Health Insurance funds in 2009. In France, innovative pharmaceuticals have been subject for a long-time to price-control and cost-containment measures. The present review provides a general description of the French health care system, analyzing the developments and changes by the recent French health care reform.http://dx.doi.org/10.7175/fe.v13i2.270

  8. What direction for the European Council? Institutional reforms and counter-reforms in EU

    Directory of Open Access Journals (Sweden)

    Gheorghe Ciascai

    2012-12-01

    Full Text Available The aim of this paper is to analyse the political and institutional impact of the juridical consecration of the European Council that official institution of European Union by the Lisbon Treaty. Until 1 December 2009, the European Council was a political body with a strong informal role within the european decision making process, but with ambiguous institutional and legal powers. After entry in force of the Lisbon Treaty, European Council becomes an institution that try to exercise a collective leadership in EU.

  9. Policy entrepreneurship and policy networks in healthcare systems - the case of Israel's pediatric dentistry reform.

    Science.gov (United States)

    Cohen, Nissim; Horev, Tuvia

    2017-01-01

    Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting. Our goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process. Historical circumstances and the Israeli public's longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who

  10. Policy entrepreneurship and policy networks in healthcare systems - the case of Israel's pediatric dentistry reform.

    Science.gov (United States)

    Cohen, Nissim; Horev, Tuvia

    2017-04-21

    Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting. Our goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process. Historical circumstances and the Israeli public's longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who

  11. Changing social organizations of care: a comparison of European policy reforms encouraging paid domestic work.

    Science.gov (United States)

    Kvist, Elin

    2012-06-01

    In many European countries different types of policy reforms intending to encourage growth in the domestic service sector have been introduced. The methods and reforms differ but mainly the reforms intend to stimulate growth of a 'new' legal labour market sector within private households. This potential growth sector in combination with insufficient or declining welfare states, inclining female labour market participation and ageing populations could be viewed as explanatory factors to the increased demand for domestic services. A growing amount of those performing paid domestic work in European homes are migrant women with or without papers. The aim of this article is to create a model that enables comparisons of these reforms, with a special focus on changing social organizations of care for elders, children and other dependent persons. Included in the analysis are European countries that have introduced wide domestic service policy reforms as measurement to encourage growth in the domestic service sector, i.e. Austria, Belgium, Denmark, Finland, France, Germany and Sweden.

  12. Proposing evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings: a summative analysis.

    Science.gov (United States)

    Manyazewal, Tsegahun; Oosthuizen, Martha J; Matlakala, Mokgadi C

    2016-09-20

    Many resource-limited countries have adopted and implemented healthcare reform to improve the quality of healthcare, but few have had much impact and strategies in support of these efforts remain limited. We aimed to explore and propose evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings. Descriptive and exploratory designs in two phases. Phase I involved assessing the effectiveness of the healthcare reform implemented in Ethiopia in the form of business process reengineering, with evidence compiled from healthcare professionals through a self-administered questionnaire; and phase II involved proposing strategies and seeking consensus from experts using Delphi method. Public hospitals in central Ethiopia. 406 healthcare professionals and 10 senior health policy experts. The healthcare reform that we evaluated was able to restructure hospital departments into case teams, with the goal of adopting a 'one-stop shopping' approach. However, shortages of critical infrastructure, furniture and supplies and job dissatisfaction continued to hamper the system. The most important predictors that influenced implementation of the reform were financial resources, top management commitment and support, collaborative working environment and information technology (IT). Five strategies with 14 operational objectives and 67 potential interventions that could strengthen the reform are proposed based on their strategic priority, which are as follows: reinforce patient-centred quality of care services; foster a healthy and respectful workforce environment; efficient and accountable leadership and governance; efficient use of hospital financing and maximise innovations and the use of health technologies. Effective implementation of healthcare reform remained a challenge for governments in resource-limited settings. Resilient operational, clinical and governance functions of health systems, as well as a motivated and committed health

  13. A Decade of Reforms at Compulsory Education Level in the European Union (1984-94).

    Science.gov (United States)

    EURYDICE European Unit, Brussels (Belgium).

    This report focuses on the compulsory education reforms introduced throughout the European Union from 1984-1994. Compulsory education that stage of education established formally by a government for the education of all children and young people, usually institutionalized on a full- or part-time basis, and compulsory for a certain number of years.…

  14. The Limits of Europeanization: Regulatory Reforms in the Spanish and Portuguese Telecommunications and Electricity Sectors

    Directory of Open Access Journals (Sweden)

    Jordana

    2005-07-01

    Full Text Available The creation of an EU-level regulatory regimes for telecommunications and electricity was a highly successful political initiative of the European Commission. In promoting market liberalization for telecommunications (a key sector in the creation of the ‘information economy’ and electricity (one of the sectors most resistant to change the European Commission asserted the political importance of European project. Indeed, the two new regimes are commonly cited as successful cases of ‘Europeanization‘. However, this paper argues that the causal link between European initiatives and national policy change is weak. Building on an emerging tradition of cross-sector research of these two sectors, and considering two most-similar European countries, the paper examines commonalities and variations in the regulatory reforms of telecommunications and electricity in Spain and Portugal in the last two decades. It applies a series of comparisons, including a stepwise comparative analysis of two countries (one a reluctant liberalizer, the other an enthusiastic one, of two sectors (a pace-setter and a foot-dragger and of two time periods (before and after the regulatory reforms. We suggest that processes of Europeanization can impinge on the strategic capacities of European member states only to a limited degree. Spain and Portugal were able to shape their sectors according to the preferences of their national policy communities and in a context of a global shift in the way countries both within Europe and outside it defined their interests.

  15. The Limits of Europeanization: Regulatory Reforms in the Spanish and Portuguese Telecommunications and Electricity Sectors

    Directory of Open Access Journals (Sweden)

    Imma Puig

    2005-07-01

    Full Text Available The creation of an EU-level regulatory regimes for telecommunications and electricity was a highly successful political initiative of the European Commission. In promoting market liberalization for telecommunications (a key sector in the creation of the information economy and electricity (one of the sectors most resistant to change the European Commission asserted the political importance of European project. Indeed, the two new regimes are commonly cited as successful cases of Europeanization. However, this paper argues that the causal link between European initiatives and national policy change is weak. Building on an emerging tradition of cross-sector research of these two sectors, and considering two most-similar European countries, the paper examines commonalities and variations in the regulatory reforms of telecommunications and electricity in Spain and Portugal in the last two decades. It applies a series of comparisons, including a stepwise comparative analysis of two countries (one a reluctant liberalizer, the other an enthusiastic one, of two sectors (a pace-setter and a foot-dragger and of two time periods (before and after the regulatory reforms. We suggest that processes of Europeanization can impinge on the strategic capacities of European member states only to a limited degree. Spain and Portugal were able to shape their sectors according to the preferences of their national policy communities and in a context of a global shift in the way countries both within Europe and outside it defined their interests.

  16. Constructing a European healthcare market: the private healthcare company Capio and the strategic aspect of the drive for transparency.

    Science.gov (United States)

    Blomgren, Maria; Sundén, Eva

    2008-11-01

    This article analyses the private healthcare company Capio and its participation in the drive for transparency in the European healthcare field. An important point of departure for the paper is that technologies for transparency, such as accounting and auditing, are not neutral devices for increased openness, but carry with them programmatic dimensions that affect our norms and rules of how healthcare is to be organized and controlled. The drive for transparency engages different actors with various motives. To investigate this we carried out semi-structured interviews with 11 persons, mainly management members of Capio. We show that transparency in healthcare has been put forward by a private actor for strategic reasons. We argue that Capio's involvement in the drive for transparency should be seen as a 'second-order strategy' with the aim to create advantageous opportunities in a future European healthcare market. We show that Capio, through its propagation of various transparency technologies, has put forward programmatic ideals of industrialisation, marketisation and Europeanisation in healthcare. The main conclusion is that although Capio has engaged in the drive for transparency for business reasons, the company has also furthered certain political ideals in the field. This study contributes to the literature which problematizes the division between private and public, and between business and politics in healthcare, and is of interest to a broad health policy audience.

  17. Spatial illustration of health-care workforce accessibility index in China: How far has our 2009 health-care reform brought us?

    Science.gov (United States)

    Wong, Ho Ting; Guo, Ying Qi; Chiu, Marcus Yu Lung; Chen, Si; Zhao, Yong

    2016-02-01

    The objective of the study was to evaluate the effectiveness of China's health-care reform from 2009 to 2011 by examining China's annual health-care workforce statistics of 2008 and 2011. The design of the study was a secondary data analysis. The main outcome measure used was the Primary Health Care Worker Accessibility Index (PHCWA). The statistics illustrated the impact health-care reform had on the provision of primary health care in rural areas. The results showed that the health-care reform of 2009 generally improved access to the primary health-care workforce in all 28 areas (range of increase: 13.18-324.0%). However, an increasing disparity in regional health care based on the increase of the standard deviations of PHCWA (range of increase: 36.44-77.10%) may be an issue that policy-makers and analysts will have to face. Concerted policy efforts from both the provincial and central governments are needed to narrow the gaps. Regional development should not only focus on the economic aspect, but also account for the fact that the adequate provision of primary health care is part of the infrastructure that makes development possible and sustainable. © 2015 National Rural Health Alliance Inc.

  18. The European influence on workers' compensation reform in the United States

    Directory of Open Access Journals (Sweden)

    LaDou Joseph

    2011-12-01

    Full Text Available Abstract Workers' compensation law in the United States is derived from European models of social insurance introduced in Germany and in England. These two concepts of workers' compensation are found today in the federal and state workers' compensation programs in the United States. All reform proposals in the United States are influenced by the European experience with workers' compensation. In 2006, a reform proposal termed the Public Health Model was made that would abolish the workers' compensation system, and in its place adopt a national disability insurance system for all injuries and illnesses. In the public health model, health and safety professionals would work primarily in public health agencies. The public health model eliminates the physician from any role other than that of privately consulting with the patient and offering advice solely to the patient. The Public Health Model is strongly influenced by the European success with physician consultation with industry and labor.

  19. Peer Pressure: Comments on the European Educational Reform

    Science.gov (United States)

    Liesner, Andrea

    2012-01-01

    This article reports on the growing influence of informal and not democratically legitimised authority within the educational field in Europe. The Programme for International Student Assessment (PISA), the Bologna Process and the European Qualifications Framework are discussed as instances of neoliberal strategies of modernisation that change the…

  20. Reform of the European Court of human rights

    Directory of Open Access Journals (Sweden)

    Mojsilović Marijana

    2013-01-01

    Full Text Available The European Court of Human Rights is the crown in the international system for protecting human rights. In recent years the Court has become a victim of its own success. In response to growing backlog of individual complaints, the Council of Europe has, over the last five years, considered numerous proposals to restructure the European human rights regime and redesign the European Convention on Human Rights. The aim of this article is just to show the most important innovations introduced primarily by Protocol no. 14, and then the Declarations adopted at the Conference in Interlaken, Izmir and at the end in Brighton, this year. Some of the solutions provided will help to reduce the work load of the Court in the future, while others are introduced for practical reasons, or a well-known political. However, adopted proposals should be given time to show some results. But in the other way, the frequent changes in the Court's work system and in the Convention system may prove to be a new problem. An institution such as the Court, the protector of human rights at the European level should not be allowed to suffer frequent 'eartquakes'. It should be let alone to work quietly and without 'turbulence'.

  1. Physician payment schemes and physician productivity: Analysis of Turkish healthcare reforms.

    Science.gov (United States)

    Erus, Burcay; Hatipoglu, Ozan

    2017-05-01

    Following healthcare reforms in Turkey, inpatient and outpatient care provided in public hospitals more than doubled from 2003 to 2006. An important component of the reforms has been a shift from a salary based physician compensation scheme to one where fee-for-service component is dominant. The change did not only incentivize physicians to provide a higher volume of services but also encouraged them to practice full-time, rather than dual-time, in public hospitals. Lacking figures on full-time equivalent figures at hospital level, earlier research used head-counts for physician workforce and found technological change and scale economies to be important determinants. We employ data envelopment analysis and find that, under plausible scenarios regarding the number of dual vs full-time physician numbers, most of the change in hospital services may be explained only by the shift to full-time practice. Our estimations find the change in technology and scale economies to play a relatively minor role. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Healthcare financing reform in Latvia: switching from social health insurance to NHS and back?

    Science.gov (United States)

    Mitenbergs, Uldis; Brigis, Girts; Quentin, Wilm

    2014-11-01

    In the 1990s, Latvia aimed at introducing Social Health Insurance (SHI) but later changed to a National Health Service (NHS) type system. The NHS is financed from general taxation, provides coverage to the entire population, and pays for a basic service package purchased from independent public and private providers. In November 2013, the Cabinet of Ministers passed a draft Healthcare Financing Law, aiming at increasing public expenditures on health by introducing Compulsory Health Insurance (CHI) and linking entitlement to health services to the payment of income tax. Opponents of the reform argue that linking entitlement to health services to the payment of income tax does not have the potential to increase public expenditures on health but that it can contribute to compromising universal coverage and access to health services of certain population groups. In view of strong opposition, it is unlikely that the law will be adopted before parliamentary elections in October 2014. Nevertheless, the discussion around the law is interesting because of three main reasons: (1) it can illustrate why the concept of SHI remains attractive - not only for Latvia but also for other countries, (2) it shows that a change from NHS to SHI does not imply major institutional reforms, and (3) it demonstrates the potential problems of introducing SHI, i.e. of linking entitlement to health services to the payment of contributions. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. Primary healthcare reform in the United Nations Relief and Works Agency for Palestine Refugees in the Near East.

    Science.gov (United States)

    Santoro, A; Abu-Rmeileh, N; Khader, A; Seita, A; McKee, M

    2016-09-25

    Palestinian refugees served by the United Nation Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) are experiencing increasing rates of diagnosis of non-communicable diseases. In response, in 2011 UNRWA initiated an Agency-wide programme of primary healthcare reform, informed by the Chronic Care Model framework. Health services were reorganized following a family-centred approach, with delivery by multidisciplinary family health teams supported by updated technical advice. An inclusive clinical information system, termed e-Health, was implemented to collect a wide range of health information, with a focus on continuity of treatment. UNRWA was able to bring about these wide-ranging changes within its existing resources, reallocating finances, reforming its payment mechanisms, and modernizing its drug-procurement policies. While specific components of UNRWA's primary healthcare reform are showing promising results, additional efforts are needed to empower patients further and to strengthen involvement of the community.

  4. [Cross-border healthcare in European Union and Czech Republic].

    Science.gov (United States)

    Barták, Miroslav; Rogalewicz, Vladimír; Jílková, Jiřina; Jeřábková, Silvie

    Currently, the cross-border healthcare still represents a marginal part of the Czech healthcare system's performance, though. Compared to the total healthcare expenditures in the Czech Republic that accounted for CZK 299.9 billion in 2014, the costs of the treatment provided to Czech patients abroad constitute mere 0.27%, and the (subsequently refunded) costs of the treatment provided to foreign patients in the Czech Republic 0.24%.Although data on changes in the volume and reimbursements of healthcare due to the Directive 2011/24/EU have not been published yet, we can expect rather evolutionary than revolutionary development of cross-border healthcare volumes. Taking into account all available data, we can conclude that the cross-border healthcare, as specified by the directive currently in force, is important in our conditions above all in relation to our neighbours, i. e. Germany, Austria, Slovakia and Poland.Key words: cross-border healthcare, patient mobility, international reimbursements EU health policy, Directive 2011/24/EU.

  5. Health system reform in peri-urban communities: an exploratory study of policy strategies towards healthcare worker reform in Epworth, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Bernard Hope Taderera

    2016-12-01

    Full Text Available Background: Human resources for health (HRH remains a critical challenge, according to the Kampala Declaration and Agenda for Global Action of 2008 and the 2030 Sustainable Development Agenda. Available literature on health system reforms does not provide a detailed narrative on strategies that have been used to reform HRH challenges in peri-urban communities. This study explores such strategies implemented in Epworth, Zimbabwe, during 2009–2014, and the implications these strategies might have on other peri-urban areas. Design: Qualitative and quantitative methods were used in an exploratory and cross-sectional design. Purposive sampling was used to select key informants, a sample of healthcare workers that participated in in-depth interviews and community members who took part in focus group discussions. Secondary data were collected through a documentary search. Qualitative data were analysed through thematic analysis. Quantitative secondary data were examined using descriptive statistics and then compared with qualitative data to reinforce analysis. Results: The HRH reform policy strategies that were identified included ministerial intervention; policy review; and revival of the human resource for health planning, financial planning, multi-sector collaboration, and community engagement. These had some positive effects; however, desired outcomes were undermined by financial, material, human resource, and social constraints. Conclusions: Despite constraints, the strategies helped revive the health delivery system in Epworth. In turn, this had a favourable outlook on post-2008 efforts by the Global Health Alliance towards healthcare worker reform and the 2030 Sustainable Development Agenda in peri-urban communities.

  6. Newspaper advertising by health maintenance organizations during the reform of healthcare services in Israel.

    Science.gov (United States)

    Reuveni, H; Shvarts, S; Meyer, J; Elhayany, A; Greenberg, D

    2001-06-01

    On 1 January 1995 a new mandatory National Health Insurance Law was enacted in Israel. The new law fostered competition among the four major Israeli healthcare providers (HMOs or sick funds) already operating in the market due to the possibility that an unlimited number of patients and the relative budget share would shift among the HMOs. This led them to launch advertising campaigns to attract new members. To examine newspaper advertising activities during the early stages of healthcare market reform in Israel. Advertising efforts were reviewed during a study period of 24 months (July 1994 to June 1996). Advertisements were analyzed in terms of marketing strategy, costs and quality of information. During the study period 412 newspaper advertisements were collected. The total advertising costs by all HMOs was approximately US$4 million in 1996 prices. Differences were found in marketing strategy, relative advertising costs, contents and priorities among the HMOs. The content of HMOs' newspaper advertising was consistent with their marketing strategy. The messages met the criteria of persuasive advertising in that they cultivated interest in the HMOs but did not provide meaningful information about them. Future developments in this area should include consensus guidelines for advertising activities of HMOs in Israel, instruction concerning the content of messages, and standardization of criteria to report on HMO performance.

  7. Reforming the court management system of Romania in the European Union integration process

    Directory of Open Access Journals (Sweden)

    Nicolae Elvis Cioabă

    2014-11-01

    Full Text Available The Superior Council of Magistracy represent a cornerstone of the Romanian court management system. This responsibility is partly shared with the Ministry of Justice. The reform of the court management system in Romania has been and still is disputable, the main actors being on one hand the magistrates and on the other the Ministry of Justice. While observing this „dispute“ we may discover a third actor, namely the European Union, who has entered scene in the context of Romania’s European integration. This research is looking to plausibly explain which was the part played by the EU and how did it influence the above mentioned reform, with special emphasis on the Superior Council of Magistracy.

  8. How social policies can improve financial accessibility of healthcare: a multi-level analysis of unmet medical need in European countries.

    Science.gov (United States)

    Israel, Sabine

    2016-03-05

    The article explores in how far financial accessibility of healthcare (FAH) is restricted for low-income groups and identifies social protection policies that can supplement health policies in guaranteeing universal access to healthcare. The article is aimed to advance the literature on comparative European social epidemiology by focussing on income-related barriers of healthcare take-up. The research is carried out on the basis of multi-level cross-sectional analyses using 2012 EU-SILC data for 30 European countries. The social policy data stems from EU-SILC beneficiary information. It is argued that unmet medical needs are a reality for many individuals within Europe - not only due to direct user fees but also due to indirect costs such as waiting time, travel costs, time not spent working. Moreover, low FAH affects not only the lowest income quintile but also the lower middle income class. The study observes that social allowance increases the purchasing power of both household types, thereby helping them to overcome financial barriers to healthcare uptake. Alongside healthcare system reform aimed at improving the pro-poor availability of healthcare facilities and financing, policies directed at improving FAH should aim at providing a minimum income base to the low-income quintile. Moreover, categorical policies should address households exposed to debt which form the key vulnerable group within the low-income classes.

  9. Electricity sector liberalization in the European Union: The political economy of regulatory reform

    Science.gov (United States)

    Infante Durana, Maria Dolores

    This dissertation looks into the reasons that pushed European countries to liberalize their electricity industries. The analysis of the political process leading to that decision in the areas pioneers of regulatory reform in this sector (United Kingdom, Sweden and the European Commission) shows that the liberalization of the European power sectors does not conform to the traditional theoretical explanations for regulatory reform that put interests and industry-specific considerations at the forefront of the explanation. The central argument of this dissertation is that, contrary to what most of the literature assumes and the theories predict, the primary impetus for the reforms in European electricity sectors did not come from industrial or economic worries, but rather from a neo-liberal turn to the ideas shared by European intellectual and political elites. The reform followed a political spill-over process by which the liberalization policy was emulated and introduced as a direct result of the international and sectoral diffusion of the new "efficiency regime" and the belief in the economic superiority of free markets over any form of government intervention. As an idea-driven policy, liberalization was not always coherent with the stated goals and, with means and ends that were not always consistent with each other, the reforms were often hampered and their results ambiguous. Liberalization transformed energy policy priorities in member states by adding the promotion and development of market-based mechanisms to the previous two of ensuring that security of supply, was adequate and of achieving ambitious environmental targets. By adding economic efficiency (and its political corollary, low prices) to its policy goals, governments effectively rendered the realization of the other two goals all the more difficult. As a result, liberalization did not entail the expected government disengagement from the affairs of the industry. On the contrary, it became

  10. Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries

    DEFF Research Database (Denmark)

    Lukasse, Mirjam; Schroll, Anne-Mette; Karro, Helle

    2015-01-01

    OBJECTIVES: To assess the prevalence and current suffering of experienced abuse in healthcare, to present the socio-demographic background for women with a history of abuse in healthcare and to assess the association between abuse in healthcare and selected obstetric characteristics. DESIGN: Cross......-sectional study. SETTING: Routine antenatal care in six European countries. POPULATION: In total 6923 pregnant women. METHODS: Cross-tabulation and Pearson's chi-square was used to study prevalence and characteristics for women reporting abuse in healthcare. Associations with selected obstetric factors were...... estimated using multiple logistic regression analysis. MAIN OUTCOME MEASURES: Abuse in healthcare, fear of childbirth and preference for birth by cesarean section. RESULTS: One in five pregnant women attending routine antenatal care reported some lifetime abuse in healthcare. Prevalence varied significantly...

  11. The healthcare system and the provision of oral healthcare in European Union member states. Part 8: Italy.

    Science.gov (United States)

    Bindi, M; Paganelli, C; Eaton, K A; Widström, E

    2017-05-26

    In Italy healthcare is provided for all Italian citizens and residents and it is delivered mainly by public providers, with some private or private-public entities. Italy's public healthcare system - the Servizio Sanitario Nazionale (SSN) - is organised by the Ministry of Health and administered on a devolved regional basis. It is financed by general taxation that provides universal coverage, largely free of charge at the point of service. The central government establishes the basic national health benefits package, which must be uniformly provided throughout the country, through services guaranteed under the NHS provision called LEA - (Livelli Essenziali di Assistenza [Essential Level of Assistance]) and allocates national funds to the regions. The regions, through their regional health departments, are responsible for organising, administering and delivering primary, secondary and tertiary healthcare services as well as preventive and health promotion services. Regions are allowed a large degree of autonomy in how they perform this role and regarding decisions about the local structure of the system. Complementary and supplementary private health insurance is also available. However, as in most other Mediterranean European countries, in Italy oral healthcare is mainly provided under private arrangements. The public healthcare system provides only 5-8% of oral healthcare services and this percentage varies from region to region. Oral healthcare is included in the Legislation on Essential levels of care (LEAs) for specific populations such as children, vulnerable people (medically compromised and those on low income) and individuals who need oral healthcare in some urgent/emergency cases. For other people, oral healthcare is generally not covered. Apart from the national benefits package, regions may also carry out their own initiatives autonomously, but must finance these themselves. The number of dentists working in Italy has grown rapidly in the last few years

  12. Ukrainian Economic Reforms: Current Status and Perspectives in the Face of Competition on European Union Markets

    Directory of Open Access Journals (Sweden)

    Greta Marianna

    2016-06-01

    Full Text Available The conflict in Ukraine since the beginning of 2014 has been the important in the history of Ukraine as an independent state. Despite the danger of economic collapse, the loss of Crimea, and war in its most industrialized region, Ukraine is still trying to conduct reforms and implement Western standards. Through persistent work Ukraine has been moving forward, despite all the difficulties. The society is staying together with the government to save the economy and defend the integrity of the whole country. This article outlines key processes in the Ukrainian reforms during 2014 and describes the cooperation of Ukraine with the European Union and international organizations in the field of financial support and reforms. The main goal of the article is to present the situation in various spheres of the country’s development, but it is also an attempt to present a wider perspective on both the achievements and shortcomings in the process of reforms. The authors focus on those aspects having a significant impact on the Ukrainian economy after February 2014.

  13. From National Enclaves to Supporting Offices: an Analysis of the 1999 Reform of European Commissioners’ Cabinets

    Directory of Open Access Journals (Sweden)

    Renke Deckarm

    2016-08-01

    Full Text Available This article analyses the transformation of European commissioners’ private offices (cabinets from national enclaves to supporting offices. Structural changes were caused by a reform by then-Commission President Prodi in 1999. To analyse this reform, a typology based on management literature is developed. The reform is characterised as ‘big bang’: it was strategically planned by a leader, transformational and affected the entire cabinet system. The most important measures were that at least three nationalities and three Commission officials were required in cabinets. These and other measures anticipated changing demands towards cabinets caused by the 2004/7 enlargement and the Kinnock reforms. This article closes a gap in research on the Commission, in which cabinets are seldom analysed in their own right. It complements earlier evidence on change in cabinets by explaining why and how structural changes evoked a functional transformation. This contributes to the broader research agenda on change in the functioning of the Commission. Content analysis of primary sources (Prodi’s speeches and publications, expert interviews and a biographic database and recent academic publications contribute to the analysis.

  14. European railway reforms and efficiency: Review of evidence in the literature

    Directory of Open Access Journals (Sweden)

    Fitzová Hana

    2017-06-01

    Full Text Available The objective of the European railway reforms which started in the 1990s was to enable the entry of competition to raise the efficiency of railway transport. This was undertaken because the level of services, particularly in former Eastern Bloc countries, was very low due to neglected investment, and so railway transport market share was in decline. The primary goal of this text is to determine based on available empirical studies whether the reforms affected the efficiency of the railway sector positively, and the secondary aim is to identify the factors which complicate evaluation of the reforms’ impact. According to empirical studies, the effect of competition on efficiency is unclear. The reforms have brought the most benefit to consumers, but their overall effect depends on many other factors. Competition for the market appeared to be a better way of implementing competition than competition in the market. In addition, comprehension of the problems complicating the analysis and their inclusion in the evaluation process constitutes an important point in evaluating the reforms’ effects and could be inspiring for countries that have not yet implemented all reforms.

  15. Impact of Québec's healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up.

    Science.gov (United States)

    Pineault, Raynald; Borgès Da Silva, Roxane; Prud'homme, Alexandre; Fournier, Michel; Couture, Audrey; Provost, Sylvie; Levesque, Jean-Frédéric

    2014-05-21

    Healthcare reforms initiated in the early 2000s in Québec involved the implementation of new modes of primary healthcare (PHC) delivery and the creation of Health and Social Services Centers (HSSCs) to support it. The objective of this article is to assess and explain the degree of PHC organizational change achieved following these reforms. We conducted two surveys of PHC organizations, in 2005 and 2010, in two regions of the province of Québec, Canada. From the responses to these surveys, we derived a measure of organizational change based on an index of conformity to an ideal type (ICIT). One set of explanatory variables was contextual, related to coercive, normative and mimetic influences; the other consisted of organizational variables that measured receptivity towards new PHC models. Multilevel analyses were performed to examine the relationships between ICIT change in the post-reform period and the explanatory variables. Positive results were attained, as expressed by increase in the ICIT score in the post-reform period, mainly due to implementation of new types of PHC organizations (Family Medicine Groups and Network Clinics). Organizational receptivity was the main explanatory variable mediating the effect of coercive and mimetic influences. Normative influence was not a significant factor in explaining changes. Changes were modest at the system level but important with regard to new forms of PHC organizations. The top-down decreed reform was a determining factor in initiating change whereas local coercive and normative influences did not play a major role. The exemplar role played by certain PHC organizations through mimetic influence was more important. Receptivity of individual organizations was both a necessary condition and a mediating factor in influencing change. This supports the view that a combination of top-down and bottom-up strategy is best suited for achieving substantial changes in PHC local organization.

  16. Impact of Québec’s healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up

    Science.gov (United States)

    2014-01-01

    Background Healthcare reforms initiated in the early 2000s in Québec involved the implementation of new modes of primary healthcare (PHC) delivery and the creation of Health and Social Services Centers (HSSCs) to support it. The objective of this article is to assess and explain the degree of PHC organizational change achieved following these reforms. Methods We conducted two surveys of PHC organizations, in 2005 and 2010, in two regions of the province of Québec, Canada. From the responses to these surveys, we derived a measure of organizational change based on an index of conformity to an ideal type (ICIT). One set of explanatory variables was contextual, related to coercive, normative and mimetic influences; the other consisted of organizational variables that measured receptivity towards new PHC models. Multilevel analyses were performed to examine the relationships between ICIT change in the post-reform period and the explanatory variables. Results Positive results were attained, as expressed by increase in the ICIT score in the post-reform period, mainly due to implementation of new types of PHC organizations (Family Medicine Groups and Network Clinics). Organizational receptivity was the main explanatory variable mediating the effect of coercive and mimetic influences. Normative influence was not a significant factor in explaining changes. Conclusion Changes were modest at the system level but important with regard to new forms of PHC organizations. The top-down decreed reform was a determining factor in initiating change whereas local coercive and normative influences did not play a major role. The exemplar role played by certain PHC organizations through mimetic influence was more important. Receptivity of individual organizations was both a necessary condition and a mediating factor in influencing change. This supports the view that a combination of top-down and bottom-up strategy is best suited for achieving substantial changes in PHC local

  17. Reforming voluntary drug insurance in Russian healthcare: does social solidarity matter?

    Science.gov (United States)

    Gerry, Christopher J; Kaneva, Maria; Zasimova, Liudmila

    2017-11-01

    With low take-up of both private health insurance and the existing public drug reimbursement scheme, it is thought that less than 5% of the Russian population have access to free outpatient drug treatment. This represents a major policy challenge for a country grappling with reforms of its healthcare system and experiencing low or no economic growth and significant associated reductions in spending on social services. In this paper, we draw on data from a 2011 Levada-Center survey to examine the attitudes and social solidarity of the Russian population towards drug policies in general and towards the introduction of a proposed voluntary drug insurance system in particular. In addition to being among the first to explore these important questions in the post-Communist setting, we make three important contributions to the emerging policy debates. First, we find that, if introduced immediately and without careful planning and preparation, Russia's voluntary drug insurance scheme is likely to collapse financially due to the over-representation of high-risk unhealthy individuals opting in to the scheme. Second, the negative attitude of higher income groups towards the redistribution of wealth to the poor may further impede government efforts to introduce voluntary drug insurance. Finally, we argue that Russia currently lacks the breadth and depth of social solidarity necessary for implementing this form of health financing. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. The Impact of Healthcare Reform Plan on the Rate of Vaginal Delivery and Cesarean Section in Shiraz (Iran) in 2015.

    Science.gov (United States)

    Rooeintan, Faranak; Borzabad, Parviz Aghaei; Yazdanpanah, Abbas

    2016-10-01

    The uncontrolled increase in the rate of cesarean section is one of the most controversial issues, and is a primary challenge among health policy makers. This study was conducted to examine the impact of the Iranian health evolution plan on vaginal delivery rate and cesarean section. This cross-sectional study was carried out in 2014. Maternal health data for 2013 and 2014 were used in this study and changes in vaginal delivery and cesarean section were compared before and after the reform, using t-test and Wilkinson test. According to the findings of this study, 64.7% of deliveries in 2013 were performed using cesarean section while it was 58.6% in 2014 (p= 0.772), of which no significant changes were observed. In addition, the percentage of vaginal delivery in 2013 and 2014 were 35.3% and 41.4% respectively (p= 0.00), so a significant increase was found for vaginal delivery. Healthcare reform has led to an increase in the number of vaginal deliveries in hospitals affiliated to Shiraz University of Medical Sciences (SUMS). Due to the limited number of hospitals adhering to the healthcare reform plan to increase vaginal delivery (using private midwife and implementing painless delivery), the reform for decreasing the cesarean rate was not effective enough.

  19. Support for National Health Insurance Seven Years Into Massachusetts Healthcare Reform: Views of Populations Targeted by the Reform.

    Science.gov (United States)

    Saluja, Sonali; Zallman, Leah; Nardin, Rachel; Bor, David; Woolhandler, Steffie; Himmelstein, David U; McCormick, Danny

    2016-01-01

    Before the Affordable Care Act (ACA), many surveys showed majority support for national health insurance (NHI), also known as single payer; however, little is currently known about views of the ACA's targeted population. Massachusetts residents have had seven years of experience with state health care reform that became the model for the ACA. We surveyed 1,151 adults visiting safety-net emergency departments in Massachusetts in late 2013 on their preference for NHI or the Massachusetts reform and on their experiences with insurance. Most of the patients surveyed were low-income and non-white. The majority of patients (72.0%) preferred NHI to the Massachusetts reform. Support for NHI among those with public insurance, commercial insurance, and no insurance was 68.9%, 70.3%, and 86.3%, respectively (p insurance plan (83.3% vs. 68.9%, p = .014), who delayed medical care (81.2% vs. 69.6%, p health reform, a reappraisal of the ACA's ability to meet the needs of underserved patients is warranted. © The Author(s) 2015.

  20. The European Commission for the Efficiency of Justice (CEPEJ - Reforming European Justice Systems - "Mission Impossible?"

    Directory of Open Access Journals (Sweden)

    Jon T. Johnsen

    2012-12-01

    Full Text Available My paper concerns the Council of Europe’s work to improve justice in Europe. It explains and exemplifies a type of policy that the Council applies in its strive for implementing the demands of the European Human Rights Convention on the judicial systems in Europe.The Convention obliges all member states to put up efficient systems for remedying violations within their own national legal systems. If such systems are missing or do not provide sufficient redress, member states now accept that everyone is free to bring their case before the European Court of Human Rights ECtHR. Over the years the Court has produced extensive case law on violations of the provisions that protect people’s access to justice that develops and concretizes the general wordings used in the text of the ECHR. However, international complaint mechanisms are only one type of instrument for disseminating human rights. In addition to judicial instruments like the ECtHR, CoE also uses policy vehicles for implementation of human rights like the one I will focus upon; namely the European Commission for the Efficiency of Justice – usually abbreviated CEPEJ – from the French version of its name. As one of several committees of CoE, it focuses on the development of the judicial systems of the member states.

  1. Comparative studies on the administrative convergence revealed by national strategies of administrative reform in some South-Eastern European states

    OpenAIRE

    Matei, Lucica; Matei, Ani; Zanovschi, Diana; Stoian, Oana

    2010-01-01

    The paper has as main topic the administrative convergence and its reflection in the national strategies of administrative reform in some states in South Eastern Europe. Having a complex content, sometimes even ambigous, the administrative convergence will have as finality the integration in the European Administrative Space and the administrative reforms as support. From this prospect, the South-Eastern Europe has a certain specificity emphasised by: different positions of the states under d...

  2. [Primary Healthcare Reform in Portugal on two fronts: autonomous family healthcare units and management of groupings of Health Centers].

    Science.gov (United States)

    Pisco, Luis

    2011-06-01

    In 2005, Portugal began a reform of Primary Health Care. This reform process through to April 2010 is described and analyzed. During this period the Mission for Primary Health Care was responsible for conducting a profound reconfiguration. The main objectives for this reform were to improve accessibility, efficiency, quality and continuity of care and increase the satisfaction of professionals and citizens. The main features are voluntary adhesion, teamwork, mandatory information system, performance-sensitive payment, contracting and evaluation. The reconfiguration of health centers was two pronged. First, there was the formation of small autonomous functional units, known as Family Health Units (USF) providing services with proximity and quality. The second measure involved the aggregation of resources and management structures, groups of health centers (ACES), seeking to achieve efficiency and economies of scale. The FHU proved to offer simultaneously more efficiency, accessibility, better working environment, greater citizen satisfaction, namely better quality. The importance of strong political support, the creation of a structure responsible for the design and implementation of reform and good liaison with the media are stressed.

  3. Growth potential of energy sector reforms: new evidence on EU and Southeast European countries by exploring impact on electricity generation

    Directory of Open Access Journals (Sweden)

    Nela Vlahinić Lenz

    2015-12-01

    Full Text Available The aim of this research is to investigate the impact of energy sector reforms on electricity generation and thus economic growth in EU and Southeast European countries. The paper aims at clarifying whether the impact of energy sector reforms on generation efficiency differs among countries according to their level of development and regional characteristics. Our hypothesis is that the EU reform model is not appropriate for all Member States and Southeast European countries since it does not improve efficiency in electricity generation in all countries and therefore, it can hamper economic growth. For testing the defined hypothesis the panel regression model with fixed effects has been used. The research results show that unlike in the EU-15 (old Member States, energy sector reforms in the EU-12 (new Member States, and selected Southeast European countries (Energy Community contracting parties have no significant impact on electricity transmission and distribution losses. These evidences imply that the uniform EU reform model does not improve efficiency of electricity generation in less developed countries. On the contrary it can even hamper economic growth and therefore it cannot be appropriate for all Member States. The reason lies in the fact that successful reform model requires adequate level of institutional resources that are missing in most transition and post-transition countries.

  4. 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.

  5. [Health-care reforms and insurees' preferences: a cluster analysis with data from the representative KBV survey 2010].

    Science.gov (United States)

    Schnitzer, S; Grittner, U; Balke, K; Kuhlmey, A

    2013-12-01

    This study examines insurees' knowledge of and attitudes towards a number of recent reforms of the German healthcare system (electronic health insurance card, reimbursement tariff, etc.). It further examines whether it is possible to identify groups of respondents with similar patterns of preferences and knowledge. The analysis draws on a representative survey conducted by the German National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, KBV, 2010), in which 6 065 respondents aged between 18 and 79 years were interviewed. 4 groups of respondents can be distinguished: the "quality oriented," the "uninformed," the "internet savvy," and the "informed." The most striking finding is that members of the "uninformed" group, who knew the least about recent reforms, tended to be employed middle-aged men with a high level of formal education. To foster the successful implementation of reforms in the health-care system and their communication to specific target groups, it is recommended to take into account not only specific social determinants, but the full personal circumstances and situation of insurees. © Georg Thieme Verlag KG Stuttgart · New York.

  6. The role of healthcare system in dental check-ups in 27 European countries: multilevel analysis.

    Science.gov (United States)

    Kino, Shiho; Bernabé, Eduardo; Sabbah, Wael

    2017-06-01

    To examine whether public expenditure on health and Euro Health Consumer Index (EHCI) are associated with dental check-ups in European countries. Individual data were from Eurobarometer 72.3, 2009 a cross-national survey of 27 European countries. Eligible participants were those aged 18 years and older in 27 European countries. Dental check-ups reflected dental visits for oral examination and getting advice on oral health in the last 12 months. Individual factors included age, gender, marital status, urbanisation, education, subjective social status, and difficulty in paying bills. Public expenditure on health as a percentage of gross domestic product (GDP) and EHCI were used as contextual factors. A set of multilevel logistic regression models was used to examine the relationship between dental check-ups and each of healthcare expenditure and EHCI adjusting for demographic factors, GDP per capita and socioeconomic indicators. Total number included in the analysis was 23,842. Participants in countries with greater healthcare expenditure and higher score of EHCI were significantly 1.17 (95% CI: 1.03, 1.32) and 1.30 times (95% CI: 1.04, 1.64) more likely to report dental check-ups within the past 12 months after accounting for demographic characteristics, GDP per capita, and all socioeconomic indicators. The findings suggest that greater governmental support for the healthcare and better characteristics of healthcare system are positively associated with routine dental attendance. © 2017 American Association of Public Health Dentistry.

  7. 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.

  8. Public administration reform in the context of European integration: Continuing problems of the civil service in Romania

    NARCIS (Netherlands)

    Ioniţa, A.L.; Freyberg-Inan, A.

    2008-01-01

    This article examines the role played by European integration in the public administration reform process in Romania, with a focus on the relations between elected political elites and the civil service. It addresses the question whether the constant interaction between EU institutions and the

  9. The healthcare system and the provision of oral healthcare in European Union Member States. Part 6: Poland.

    Science.gov (United States)

    Malkiewicz, K; Malkiewicz, E; Eaton, K A; Widström, E

    2016-10-21

    Poland is one of the largest European countries in terms of area and population. The country's economic situation does not allow for the allocation of sufficient public funds for healthcare in general and oral healthcare in particular. The health policy of the state focuses primarily on prophylaxis and treatment of diseases, directly threatening the health and lives of the inhabitants. Currently, expenditure on oral health accounts for only 2.7% of the public funds allocated to healthcare. In this context, providing oral care financed from public funds at an appropriate level constitutes a challenge for state institutions, centres providing medical and dental services and private practices. Despite difficult financial conditions in Poland, therapeutic and prophylactic programmes are implemented, aimed at improving the oral health of the society, especially children and adolescents, pregnant women and patients with disabilities or developmental disorders such as cleft palate. In Poland, apart from the oral care system financed by the state, there is also an extremely well developed system of private practices and clinics providing clinical services on a commercial basis. In 2014, oral services, financed by the state, were utilised by about 30% of the population of children and youths aged 0-18 years (2,212,792 patients) and about 15% of the adult population (5,026,383 patients). Training of Polish dentists is conducted in ten state-owned universities, from which 700 graduate each year. Dentists work mainly in private practices or medical centres, some of which provide services guaranteed by the public insurer - the National Health Fund. The other dentists find employment in state clinics, hospitals, and universities and their associated clinics. In Poland dentistry is a predominantly female profession and 75% of the just over 40,000 Polish dentists are female. Accession of Poland to the European Union meant that some Polish dentists have taken up employment abroad

  10. The provincial health office as performance manager: change in the local healthcare system after Thailand's universal coverage reforms.

    Science.gov (United States)

    Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai

    2012-01-01

    This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Cancer registration, public health and the reform of the European data protection framework: Abandoning or improving European public health research?

    Science.gov (United States)

    Andersen, Mette Rye; Storm, Hans H

    2015-06-01

    The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in

  12. [A proposal for reforming psychologists' training in France and in the European Union].

    Science.gov (United States)

    Bouchard, J-P

    2009-02-01

    In France, as in the European Union, the number of psychologists continues to increase and constitutes by far the most important source of professionals in this field. The requests for services of psychologists in many various domains have also increased in an unprecedented way over a number of years. In spite of this development, which should continue to increase considerably, the initial training of psychologists remains uneven and disparate and often remote from, even unsuitable to, the legitimate expectations of users. It is therefore important to reform this training by extending, updating, homogenising and adapting it to current knowledge and needs, and by marking it by a single and specific degree: that of a doctorate. This new eight-year doctoral curriculum would be at the same time more complete and simpler than the European Diploma in Psychology model (EuroPsy), for instance. This latter is a very complicated and insufficient subject and would not completely resolve the great problems of psychologists' training and the competences they need to gain in order to access professional practise, research and teaching. This extension of the psychologists' training would make it possible to integrate new data concerning traditional fields of psychology and data concerning new fields of application of psychology and should obviously include the essential training for psychotherapies referred to the great theoretical and practical models, since their interest is clinically acknowledged (psychoanalysis and psychoanalytical therapies, cognitive and behavioural therapies, systemic therapies, therapies for individuals, couples, families, groups...). This polyreferred training would make it possible to go from a culture still too often axed on orientation and deficiencies of the therapist, to a culture of indication, opening and competence, focused on the patient's interest. Teaching of psychophysiology and neurosciences should be updated and harmonised by taking into

  13. Healthcare Reform and Preparing the Future Clinical Child and Adolescent Psychology Workforce.

    Science.gov (United States)

    Janicke, David M; Fritz, Alyssa M; Rozensky, Ronald H

    2015-01-01

    The healthcare environment is undergoing important changes for both patients and providers, in part due to the Patient Protection and Affordable Care Act (ACA). Ultimately the healthcare delivery system will function very differently by the end of this decade. These changes will have important implications for the education, training, scientific inquiry, and practice of clinical child and adolescent psychologists. In this article we provide a brief description of the fundamental features of the ACA, with a specific focus on critical components of the act that have important, specific implications for clinical child and adolescents psychologists. We then provide recommendations to help position our field to thrive in the evolving healthcare environment to help facilitate further awareness and promote discussion of both challenges and opportunities that face our field in this evolving health care environment.

  14. Analysing a Chinese Regional Integrated Healthcare Organisation Reform Failure using a Complex Adaptive System Approach.

    Science.gov (United States)

    Tang, Wenxi; Wei, Lai; Zhang, Liang

    2017-06-19

    China's organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS) provides a new perspective and methodology for analysing the health system and policy implementation. We observed the typical case of Qianjiang's Integrated Health Organization Reform (IHO) for 2 years to analyse integrated care reforms using CAS theory. Via questionnaires and interviews, we observed 32 medical institutions and 344 professionals. We compared their cooperative behaviours from both organisational and inter-professional levels between 2013 and 2015, and further investigated potential reasons for why medical institutions and professionals did not form an effective IHO. We discovered how interested parties in the policy implementation process influenced reform outcome, and by theoretical induction, proposed a new semi-organised system and corresponding policy analysis flowchart that potentially suits the actual realisation of CAS. The reform did not achieve its desired effect. The Qianjiang IHO was loosely integrated rather than closely integrated, and the cooperation levels between organisations and professionals were low. This disappointing result was due to low mutual trust among IHO members, with the main contributing factors being insufficient financial incentives and the lack of a common vision. The traditional organised health system is old-fashioned. Rather than being completely organised or adaptive, the health system is currently more similar to a semi-organised system. Medical institutions and professionals operate in a middle ground between complete adherence to administrative orders from state-run health systems and completely adapting to the market

  15. Analysing a Chinese Regional Integrated Healthcare Organisation Reform Failure using a Complex Adaptive System Approach

    Directory of Open Access Journals (Sweden)

    Wenxi Tang

    2017-06-01

    Full Text Available Introduction: China’s organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS provides a new perspective and methodology for analysing the health system and policy implementation.  Methods: We observed the typical case of Qianjiang’s Integrated Health Organization Reform (IHO for 2 years to analyse integrated care reforms using CAS theory. Via questionnaires and interviews, we observed 32 medical institutions and 344 professionals. We compared their cooperative behaviours from both organisational and inter-professional levels between 2013 and 2015, and further investigated potential reasons for why medical institutions and professionals did not form an effective IHO. We discovered how interested parties in the policy implementation process influenced reform outcome, and by theoretical induction, proposed a new semi-organised system and corresponding policy analysis flowchart that potentially suits the actual realisation of CAS.  Results: The reform did not achieve its desired effect. The Qianjiang IHO was loosely integrated rather than closely integrated, and the cooperation levels between organisations and professionals were low. This disappointing result was due to low mutual trust among IHO members, with the main contributing factors being insufficient financial incentives and the lack of a common vision.  Discussion and Conclusions: The traditional 'organised health system' is old-fashioned. Rather than being completely organised or adaptive, the health system is currently more similar to a s'emi-organised system'. Medical institutions and professionals operate in a middle ground between complete adherence

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

    Science.gov (United States)

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

    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), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The CIndex for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage. PMID:25749319

  17. Interconnections between economic subsystems and the IT innovation in avoiding unpredictable effects of finance reforms in East-European Countries

    Directory of Open Access Journals (Sweden)

    Teodora ALECU

    2009-07-01

    Full Text Available The tax measures are rapidly changing in East-European countries. The permanence is a concept rarely put in practice. The changes of fiscal policy are usually important, affecting the whole finance system and the investors need to adapt to these various changes. Under such circumstances, the management of information of any kind regarding the activity of investors becomes very important, the information gathered represent a statistic proof of the effects of the economic and finance reforms.

  18. References of the Fiscal System’s Adaptation in the Context of Reforming the European Social Models

    Directory of Open Access Journals (Sweden)

    Marius Frunza

    2011-05-01

    Full Text Available The purpose and the objectives of this approach circumscribe to the highlighting and thedelineation of the representative markers as milestones in the uneven dynamics, both in time and space, of thecomplex process of adaptation of the fiscal systems in the context of reforming the European Social Models.In this respect, the statistical analysis made on a sample grouping countries with different types of capitalistsocial economic systems, forefront and retrospectively outlines, a series of steps in the reforming of theEuropean Social Models, and it is to be noticed the fact that the adaptation of the national fiscal subsystems,related to the requirements of the social and economic development on each step, was to be distinctivelyconceived and differentiated applied, through their main components. The neglect of the interdependencesbetween the components of each fiscal system can lead to making unrealistic assessments and proposalsregarding their adaptation process to the requirements of European Social Models reform. Even more, in thecontext of producing destabilizing phenomena (recession, crisis, unemployment which disrupt social andeconomic processes, the issue of fiscal sustainability may have most unwanted consequences.

  19. The impact of regulatory compliance behavior on hazardous waste generation in European private healthcare facilities.

    Science.gov (United States)

    Botelho, Anabela

    2013-10-01

    This study empirically evaluates whether the increasingly large numbers of private outpatient healthcare facilities (HCFs) within the European Union (EU) countries comply with the existing European waste legislation, and whether compliance with such legislation affects the fraction of healthcare waste (HCW) classified as hazardous. To that end, this study uses data collected by a large survey of more than 700 small private HCFs distributed throughout Portugal, a full member of the EU since 1986, where 50% of outpatient care is currently dominated by private operators. The collected data are then used to estimate a hurdle model, i.e. a statistical specification in which there are two processes: one is the process by which some HCFs generate zero or some positive fraction of hazardous HCW, and another is the process by which HCFs generate a specific positive fraction of hazardous HCW conditional on producing any. Taken together, the results show that although compliance with the law is far from ideal, it is the strongest factor influencing hazardous waste generation. In particular, it is found that higher compliance has a small and insignificant effect on the probability of generating (or reporting) positive amounts of hazardous waste, but it does have a large and significant effect on the fraction of hazardous waste produced, conditional on producing any, with a unit increase in the compliance rate leading to an estimated decrease in the fraction of hazardous HCW by 16.3 percentage points.

  20. [Health behavior of healthcare personnel: The European Presst-Next Study].

    Science.gov (United States)

    Estryn-Behar, Madeleine; le Nezet, Olivier; Bonnet, Nicole; Gardeur, Patrick

    2006-10-01

    The objective of the NEXT (Nurses' Early Exit) study was to identify the organizational and health factors in the 10 participating countries associated with job satisfaction of nurses and nurses' aides or with their desire to change occupation or stop working prematurely. Questions about health were somewhat more detailed in the French version of the questionnaire and allowed us to determine health behaviors of this representative sample of French caregivers (PRESST: Promotion of Health and Job Satisfaction of European Healthcare Workers [www.next-study.net; www.presst-next.fr]). Of the 6980 (796 men and 6184 women) nurses and nurses' aides studied in late 2002 and early 2003, 32.6% reported that they smoked at least occasionally and 24.3% regularly. Only 24.4% of the staff in our sample exercised at least weekly. Overweight was observed in 27,6% of the sample, mostly women (42% of men and 24.7% of women), and obesity affected 6,4% of men and 7% of women. Overweight was slightly less frequent than among the general adult population of France, 39.8% according to the CREDES SPS survey in 2002, but these healthcare workers were younger. On the whole, burnout was higher among French caregivers than among those from other European nations in the Next study. This study demonstrates the need to conduct and assess interventions for the dual purpose of (1) reducing the morbidity and mortality associated with the conditions most sensitive to these risk factors in healthcare personnel and (2) improving their knowledge, motivations and credibility in providing health education to patients.

  1. 'Fruit of the accords': healthcare reform and civil participation in Highland Guatemala.

    Science.gov (United States)

    Maupin, Jonathan Nathaniel

    2009-04-01

    Governmental-contracting of non-governmental organizations (NGOs) is a central strategy of neoliberal health reforms in Central America. More than improving the equity, efficiency, and quality of health services, contracting presents a potential mechanism to redefine antagonistic relationships between the state and civil society, particularly in countries ravaged by political violence. In this paper I examine the process of heath reform in Guatemala through the implementation of the Sistema Integral de Atención en Salud (SIAS) in the municipality of San Martín Jilotepeque. Mandated in the 1996 Peace Accords, SIAS potentially facilitates decentralization and civil participation through governmental-contracting of NGOs to provide health services to underserved populations. Drawing on ethnographic interviews with NGO representatives, Ministry of Health (MOH) workers, and community health workers and midwives, I examine the contracting process and then address issues of equity, efficiency, and quality of services, as well as the process of decentralization. I argue that contracted NGOs are largely restricted to serve as administrators, removed from the delivery of services, and are heavily dependent upon the traditional MOH structure, which limits the ability of SIAS to improve health services or foster the processes of decentralization and democratization.

  2. Narrating health and scarcity: Guyanese healthcare workers, development reformers, and sacrifice as solution from socialist to neoliberal governance.

    Science.gov (United States)

    Walker, Alexis

    2017-08-01

    In oral history interviews, Guyanese healthcare workers emphasize continuity in public health governance throughout the late twentieth century, despite major shifts in broader systems of governance during this period. I argue that these healthcare workers' recollections reflect long-term scarcities and the discourses through which both socialist politicians and neoliberal reformers have narrated them. I highlight the striking similarities in discourses of responsibility and efficiency advanced by socialist politicians in 1970s Guyana and by World Bank representatives designing the country's market transition in the late 1980s, and the ways these discourses have played out in Guyana's health system. Across diverging ideologies, politicians and administrators have promoted severe cost-control as the means to a more prosperous future, presenting short-term pains as necessary to creating new, better, leaner ways of life. In the health sector this has been enacted through a focus on self-help, and on nutrition as a tool available without funds dedicated for pharmaceuticals, advanced medical technologies, or a fully staffed public health system. I argue that across these periods Guyanese citizens have been offered a very similar recipe of ongoing sacrifice. I base my analysis on oral histories with forty-six healthcare workers conducted between 2013 and 2015 in Guyana in Regions 3, 4, 5, 9, and 10, as well as written records from World Bank and Guyanese national archives; I analyze official discourses as well as recollections and experiences of public health governance by those working in Guyana's health system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Generation Y in healthcare: leading millennials in an era of reform.

    Science.gov (United States)

    Piper, Llewellyn E

    2012-01-01

    The healthcare workforce has grown with the addition of a new group of physicians, nurses, allied health professionals, administrators, and support staff who belong to America's youngest generation now in the workforce-generation Y, or the millennials. This generation consists of more than 70 million people, the oldest of whom are now in their late 20s and early 30s. With traits and workplace expectations that differ from those observed in other generations, and with a size that threatens to overtake the total number of baby boomers, generation Yers are positioned to influence (if not drastically change) current leadership approaches. The common traits that define or are associated with generation Y workers are often regarded as barriers yet provide healthcare leaders with a clear guide to understanding these employees and drawing out their best qualities and performance. For the organization to fulfill its social contract to provide high-quality, cost-effective, and safe healthcare, it must satisfy the needs and manage the expectations of those who directly deliver these services. This is especially important in today's environment, which is marked by the still-fluid stipulations of the Affordable Care Act (ACA), changed consumer expectations, and public demands for transparency and accountability.

  4. Healthcare

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

  5. The electoral feedback effects of welfare reform in mature European welfare states

    DEFF Research Database (Denmark)

    Arndt, Christoph

    2012-01-01

    The electoral hazard of welfare state reforms in mature welfare states has been a widely acknowledged feedback effect in the literature. However, the literature does typically no distinct between party families when it comes to the electoral consequences of welfare state reforms and treats...... electorates as unity. This paper analysis the feedback effects of social policy retrenchment under Third Way social democracy since 1994. The paper argues that Third Way reforms resulted in lasting electoral setback for social democracy since these reforms went against the social policy preferences of social...... democracy’s core constituency. Using survey data and election studies, the empirical analysis shows that the reforms have been particularly unpopular among social democracy’s core constituency and that these voters now align with competitors that defend core welfare schemes in a credible manner...

  6. Connectivity for Healthcare and Well-Being Management: Examples from Six European Projects

    Science.gov (United States)

    Kamel Boulos, Maged N.; Lou, Ricardo Castellot; Anastasiou, Athanasios; Nugent, Chris D.; Alexandersson, Jan; Zimmermann, Gottfried; Cortes, Ulises; Casas, Roberto

    2009-01-01

    Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in), CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be. PMID:19742164

  7. Connectivity for Healthcare and Well-Being Management: Examples from Six European Projects

    Directory of Open Access Journals (Sweden)

    Ulises Cortes

    2009-07-01

    Full Text Available Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in, CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be.

  8. Risk contracting and operational capabilities in large medical groups during national healthcare reform.

    Science.gov (United States)

    Mechanic, Robert E; Zinner, Darren

    2016-06-01

    Little is known about the scope of alternative payment models outside of Medicare. This study measures the full complement of public and private payment arrangements in large, multi-specialty group practices as a barometer of payment reform among advanced organizations. We collected information from 33 large, multi-specialty group practices about the proportion of their total revenue in 7 payment models, physician compensation strategies, and the implementation of selected performance management initiatives. We grouped respondents into 3 categories based on the proportion of their revenue in risk arrangements: risk-based (45%-100%), mixed (10%-35%), and fee-for-service (FFS) (0%-10%). We analyzed changes in contracting and operating characteristics between 2011 and 2013. In 2013, 68% of groups' total patient revenue was from FFS payments and 32% was from risk arrangements (unweighted average). Risk-based groups had 26% FFS revenue, whereas mixed-payment and FFS groups had 75% and 98%, respectively. Between 2011 and 2013, 9 groups increased risk contract revenue by about 15 percentage points and 22 reported few changes. Risk-based groups reported more advanced implementation of performance management strategies and were more likely to have physician financial incentives for quality and patient experience. The groups in this study are well positioned to manage risk-based contracts successfully, but less than one-third receive a majority of their revenue from risk arrangements. The experience of these relatively advanced groups suggests that expanding risk-based arrangements across the US health system will likely be slower and more challenging than many people assume.

  9. Health Reform and its Impact on Healthcare Workers: A Case Study of the National Clinical Hospital of Cordova, Argentina

    Directory of Open Access Journals (Sweden)

    Carlos Álvarez

    2007-10-01

    Full Text Available Since the mid 1990’s, health in Argentina has no longer been considered a social function of the State but was transformed into a market commodity. Neoliberal decentralization favored the introduction of corporate methods and incentivized privatization. In practice, this led to self-management for hospitals, deregulation of social services and incorporation of private capital to the public health business. This exploratory study looks at the impact of these reforms in the public health services sector. It analyzes living and working conditions, changes produced in the organization of work and their effect on labor relations and on participation in union, political and social activities by workers at the National Clinical Hospital of Cordoba, Argentina. Data was primarily collected through an interview survey of a convenience sample of 68 workers from the non-teaching staff; this represents 10% of the total professional, administrative and maintenance staff of the hospital. The interviews demonstrate deterioration in income and living conditions. Hospital self-management for these workers led to increased competition, the fragmentation in the work spaces, tension and the distrust between co-workers, as well as increased intensity in the workload of some employees. The profile of these healthcare workers is structured and marked by silence, the resolution of the conflicts by means of individual action in the workplace, and minimal participation in social-political-union or community organizations.

  10. Ethical issues in human reproduction: Protestant perspectives in the light of European Protestant and Reformed Churches.

    Science.gov (United States)

    Birkhäuser, Martin

    2013-11-01

    Protestantism is not a centralized religion. It is composed by many independent Churches having different moral and ethical standards. This review concentrates on the ethical principles prevalent in most modern European Reformed Churches. It does not intend to discuss the ethical principles of many other Protestant Churches present mainly in the USA. The common foundations of Protestant theology are the "five sola ("Sola scriptura", Sola fide", "Sola gratia", Solus Christus or Solo Christo", "Soli deo gloria"). In opposition to the Catholic Church, no intermediary is needed between the Bible and the believer. As a consequence, Protestant Churches have no Magisterium, such as the Catholic Church. Therefore Protestant Churches cannot declare a certain position to be the "official position". Each Christian is personally responsible for all his acts, including his ethical behaviour. There is no complete unanimity among all Protestants on ethics or on any other issue. Human dignity, personal rights and self-determination have to be respected in each ethical consideration. The supersession of the Old Mosaic Covenant (including traditional Jewish law or Halakhah, maintained in Catholicism) by the New Covenant and by Christian Theology has an important impact on Protestant ethics in reproductive medicine. In the New Covenant, the Protestants Churches did not maintain the mandatory obligation from the old Mosaic Covenant to be fruitful and to multiply: there is no divine obligation by God to procreate. As a consequence, contraception is not a sin and not unethical. The status of the embryo is the key for the ethical consideration of all methods used in reproductive medicine. Most representatives of modern Protestant theology and bioethics defend the opinion that the embryo is not an independent human being as is the newborn child. For most Protestant bio-ethicists, as long as an embryo has no nervous system, no organs and no pain receptors, it cannot be seen as a human

  11. Did Socioeconomic Inequality in Self-Reported Health in Chile Fall after the Equity-Based Healthcare Reform of 2005? A Concentration Index Decomposition Analysis

    Science.gov (United States)

    Espinoza, Manuel; Santorelli, Gillian; Delgado, Iris

    2015-01-01

    Objective Chile, a South American country recently defined as a high-income nation, carried out a major healthcare system reform from 2005 onwards that aimed at reducing socioeconomic inequality in health. This study aimed to estimate income-related inequality in self-reported health status (SRHS) in 2000 and 2013, before and after the reform, for the entire adult Chilean population. Methods Using data on equivalized household income and adult SRHS from the 2000 and 2013 CASEN surveys (independent samples of 101 046 and 172 330 adult participants, respectively) we estimated Erreygers concentration indices (CIs) for above average SRHS for both years. We also decomposed the contribution of both “legitimate” standardizing variables (age and sex) and “illegitimate” variables (income, education, occupation, ethnicity, urban/rural, marital status, number of people living in the household, and healthcare entitlement). Results There was a significant concentration of above average SRHS favoring richer people in Chile in both years, which was less pronounced in 2013 than 2000 (Erreygers corrected CI 0.165 [Standard Error, SE 0.007] in 2000 and 0.047 [SE 0.008] in 2013). To help interpret the magnitude of this decline, adults in the richest fifth of households were 33% more likely than those in the poorest fifth to report above-average health in 2000, falling to 11% in 2013. In 2013, the contribution of illegitimate factors to income-related inequality in SRHS remained higher than the contribution of legitimate factors. Conclusions Income-related inequality in SRHS in Chile has fallen after the equity-based healthcare reform. Further research is needed to ascertain how far this fall in health inequality can be attributed to the 2005 healthcare reform as opposed to economic growth and other determinants of health that changed during the period. PMID:26418354

  12. Did Socioeconomic Inequality in Self-Reported Health in Chile Fall after the Equity-Based Healthcare Reform of 2005? A Concentration Index Decomposition Analysis.

    Science.gov (United States)

    Cabieses, Baltica; Cookson, Richard; Espinoza, Manuel; Santorelli, Gillian; Delgado, Iris

    2015-01-01

    Chile, a South American country recently defined as a high-income nation, carried out a major healthcare system reform from 2005 onwards that aimed at reducing socioeconomic inequality in health. This study aimed to estimate income-related inequality in self-reported health status (SRHS) in 2000 and 2013, before and after the reform, for the entire adult Chilean population. Using data on equivalized household income and adult SRHS from the 2000 and 2013 CASEN surveys (independent samples of 101 046 and 172 330 adult participants, respectively) we estimated Erreygers concentration indices (CIs) for above average SRHS for both years. We also decomposed the contribution of both "legitimate" standardizing variables (age and sex) and "illegitimate" variables (income, education, occupation, ethnicity, urban/rural, marital status, number of people living in the household, and healthcare entitlement). There was a significant concentration of above average SRHS favoring richer people in Chile in both years, which was less pronounced in 2013 than 2000 (Erreygers corrected CI 0.165 [Standard Error, SE 0.007] in 2000 and 0.047 [SE 0.008] in 2013). To help interpret the magnitude of this decline, adults in the richest fifth of households were 33% more likely than those in the poorest fifth to report above-average health in 2000, falling to 11% in 2013. In 2013, the contribution of illegitimate factors to income-related inequality in SRHS remained higher than the contribution of legitimate factors. Income-related inequality in SRHS in Chile has fallen after the equity-based healthcare reform. Further research is needed to ascertain how far this fall in health inequality can be attributed to the 2005 healthcare reform as opposed to economic growth and other determinants of health that changed during the period.

  13. Did Socioeconomic Inequality in Self-Reported Health in Chile Fall after the Equity-Based Healthcare Reform of 2005? A Concentration Index Decomposition Analysis.

    Directory of Open Access Journals (Sweden)

    Baltica Cabieses

    Full Text Available Chile, a South American country recently defined as a high-income nation, carried out a major healthcare system reform from 2005 onwards that aimed at reducing socioeconomic inequality in health. This study aimed to estimate income-related inequality in self-reported health status (SRHS in 2000 and 2013, before and after the reform, for the entire adult Chilean population.Using data on equivalized household income and adult SRHS from the 2000 and 2013 CASEN surveys (independent samples of 101 046 and 172 330 adult participants, respectively we estimated Erreygers concentration indices (CIs for above average SRHS for both years. We also decomposed the contribution of both "legitimate" standardizing variables (age and sex and "illegitimate" variables (income, education, occupation, ethnicity, urban/rural, marital status, number of people living in the household, and healthcare entitlement.There was a significant concentration of above average SRHS favoring richer people in Chile in both years, which was less pronounced in 2013 than 2000 (Erreygers corrected CI 0.165 [Standard Error, SE 0.007] in 2000 and 0.047 [SE 0.008] in 2013. To help interpret the magnitude of this decline, adults in the richest fifth of households were 33% more likely than those in the poorest fifth to report above-average health in 2000, falling to 11% in 2013. In 2013, the contribution of illegitimate factors to income-related inequality in SRHS remained higher than the contribution of legitimate factors.Income-related inequality in SRHS in Chile has fallen after the equity-based healthcare reform. Further research is needed to ascertain how far this fall in health inequality can be attributed to the 2005 healthcare reform as opposed to economic growth and other determinants of health that changed during the period.

  14. The effects of health care reforms on health inequalities: a review and analysis of the European evidence base.

    Science.gov (United States)

    Gelormino, Elena; Bambra, Clare; Spadea, Teresa; Bellini, Silvia; Costa, Giuseppe

    2011-01-01

    Health care is widely considered to be an important determinant of health. The health care systems of Western Europe have recently experienced significant reforms, under pressure from economic globalization. Similarly, in Eastern Europe, health care reforms have been undertaken in response to the demands of the new market economy. Both of these changes may influence equality in health outcomes. This article aims to identify the mechanisms through which health care may affect inequalities. The authors conducted a literature review of the effects on health inequalities of European health care reforms. Particular reference was paid to interventions in the fields of financing and pooling, allocation, purchasing, and provision of services. The majority of studies were from Western Europe, and the outcomes most often examined were access to services or income distribution. Overall, the quality of research was poor, confirming the need to develop an appropriate impact assessment methodology. Few studies were related to pooling, allocation, or purchasing. For financing and purchasing, the studies showed that publicly funded universal health care reduces the impact of ill health on income distribution, while insurance systems can increase inequalities in access to care. Out-of-pocket payments increase inequalities in access to care and contribute to impoverishment. Decentralizing health services can lead to geographic inequalities in health care access. Nationalized, publicly funded health care systems are most effective at reducing inequalities in access and reducing the effects on health of income distribution.

  15. The Role of Public Discourse in European Social Democratic Reform Projects

    Directory of Open Access Journals (Sweden)

    Schmidt

    2005-06-01

    Full Text Available Public discourse, understood both as ideas about public action and interactive processes that serve to 'coordinate' the construction of those ideas and to 'communicate' them to the public, has been central to the success (or failure of the reform projects of social democratic parties. Certain background factors, including countries' policy legacies, problems, preferences, and capacity set the stage for reform while good ideas which are cognitively sound and normatively appropriate as well as relevant, coherent, and consistent contribute to reform success. But institutional context also matters with regard to how ideas are conveyed to whom, with 'simple' polities emphasizing the 'communicative' discourse to the general public and more 'compound' polities the 'coordinative' discourse among policy actors. This is demonstrated with examples from Germany, France, Britain, Italy, the Netherlands, Denmark, and Sweden.

  16. Laboratories of Reform? The Europeanization and Internationalization of Higher Education in Central and Eastern Europe

    Science.gov (United States)

    Dakowska, Dorota; Harmsen, Robert

    2015-01-01

    This introductory article deals with higher education (HE) transformations in Central and Eastern Europe in the context of democratization and globalization. The authors first briefly survey the wider canvas of reform since 1989, particularly probing the extent to which the countries of the region may be treated as a distinctive or a cohesive…

  17. Effects of healthcare reform on health resource allocation and service utilization in 1110 Chinese county hospitals: data from 2006 to 2012.

    Science.gov (United States)

    Fang, Pengqian; Hu, Ruirong; Han, Qiuxia

    2017-10-01

    The central government of China launched a large-scale, expensive health reform in April 2009 because of the serious health-related problems in the country. This reform aims to re-establish a universal healthcare system, which is expected to provide affordable basic healthcare. Independent two-sample t-test, one-way ANOVA and chi-squared test were conducted to analyze the effect of the health reform on health resource allocation and service utilization in Chinese county hospitals. First, we described the hospitals' financial performance in terms of funding sources, balances and fiscal compensations (for personnel expenditure). Second, we discussed the total number of health personnel as well as the structure (number of medical personnel per thousand population and ratio of doctors and nurses) and quality of the health personnel. Lastly, we investigated the county hospitals' health resource utilization, bed occupancy and average medical expense per visit. Then, we probed different reasons and provided multiple approaches to existing problems. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Political change, disease and healthcare reform: the response to the Toxic Oil Syndrome (Spain, 1981-1998

    Directory of Open Access Journals (Sweden)

    Hernández Martín, Gregoria

    2011-12-01

    Full Text Available In 1981 Spain was threatened by the sudden appearance of an epidemic-like disease, one which was unknown to that date. The Toxic Oil Syndrome, as it was later named after the oil that caused it, thus demanded a response that became conditioned by the fact that the biological nature of the disease was unknown, but also, significantly by the complex situation in the country at that time. Spain was immersed in process of great political change, as well as a difficult economic situation, the authorities were obliged to react in not ideal conditions and in accordance with the very values that the new model of social relations that was being developed. This paper aims to look at the way in which the Toxic Oil Syndrome acted as a catalyst and accelerated the healthcare reform that, already prior to the outbreak of the epidemic, had been deemed necessary. This work focuses mainly on the response of the health system regarding those affected by the epidemic, as it was forced to treat a group of people with severe physical side effects which would lead to disability within a new framework of social relations. It thus aims to illustrate how many of the measures adopted were in accordance with the main ideas behind the reform, and also how these measures were precursors of those which were later applied to the population as a whole.

    En 1981, España se vio amenazada por la súbita aparición en forma de epidemia de una enfermedad desconocida hasta entonces. El Síndrome del Aceite Tóxico, como acabó denominándose en atención al que se ha considerado su agente causal, exigió así una respuesta que se vio condicionada por el desconocimiento de sus características biológicas, pero también, y de forma relevante, por la compleja coyuntura por la que atravesaba la nación. Inmersa como estaba en un profundo proceso de cambio de régimen político, que había de realizarse además en unas condiciones económicas difíciles, los Poderes Públicos se

  19. Enhanced Cooperation, EMU Reforms and Their Implications for Differentiation in the European Union

    Directory of Open Access Journals (Sweden)

    Kubin Tomasz

    2017-10-01

    Full Text Available Initially, before the entry into force of the Maastricht Treaty, differences in integration between members of the European Communities (EC; later the European Union were relatively few and usually temporary in nature. The Schengen Agreement, the Maastricht Treaty and the Treaty of Amsterdam, and the possibility of establishing enhanced cooperation meant that the problem was becoming more and more important in the functioning of the EU—both in theory and in practice.

  20. The search for the criteria in reforming health care: evaluation of the spatial accessibility of primary healthcare service.

    Science.gov (United States)

    Peciūra, Rimantas; Jankauskiene, Danguole; Gurevicius, Romualdas

    2006-01-01

    This article analyzes the spatial accessibility of primary healthcare services, i.e. the population's possibilities to receive healthcare services within an acceptable period of time in healthcare institutions situated in a certain territorial-administrative unit--the municipality. The aim of the study was to develop the technique for the quantitative evaluation of the spatial accessibility of primary healthcare services in different territories. The object of the study was the network of primary healthcare institutions and their subdivisions in the municipalities of Klaipeda, Taurage, and Vilnius districts. The methods of the study were geometrical modeling and applied graphics used for the quantitative determination of the ratios between the total zone area of the accessible primary healthcare institutions and the area of the respective municipal territory. The result of the study was the developed and proposed technique allowing for the evaluation of the spatial accessibility of primary healthcare institutions. The proposed technique of the evaluation of the spatial accessibility of primary healthcare services may be valuable in solving the problems of the development of primary healthcare institutions primarily in the rural regions of Lithuania. The quantitative expression of the evaluation could be used in decision-making related to investments into the development of the primary healthcare institution network in different administrational units of the country. The method of geometrical modeling involving the application of digital graphics may create preconditions for the creation of the geographical information system of the primary healthcare institution network in Lithuania.

  1. Understanding frailty: a qualitative study of European healthcare policy-makers' approaches to frailty screening and management.

    Science.gov (United States)

    Gwyther, Holly; Shaw, Rachel; Jaime Dauden, Eva-Amparo; D'Avanzo, Barbara; Kurpas, Donata; Bujnowska-Fedak, Maria; Kujawa, Tomasz; Marcucci, Maura; Cano, Antonio; Holland, Carol

    2018-01-13

    To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. Thematic analysis of semistructured qualitative interviews. European healthcare policy departments. Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role. Seven themes were identified. Our findings reveal a 'knowledge gap', around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care , the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management. There is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the

  2. European conditionality, ethnic control or electoral disarray? The 2011 controversial territorial reform attempt in Romania

    Directory of Open Access Journals (Sweden)

    Dragoş DRAGOMAN

    2014-02-01

    Full Text Available Though much criticized, especially for its inability of spending European subsidies, the current regional administration in Romania remained unchanged until the communist times. The sudden rush in totally reshaping the regional administration in 2011 triggered an intense debate on the matter. Though brief, it shed light on political constraints operating when it comes to reshape regional design. Whereas official arguments pointed at a severe European conditionality, electoral calculations seem to be at stake. Yet the decisive opposition to the project by the Hungarian party in government unravels a more profound conditionality, namely ethnic balance, related to the political geography of Transylvania.

  3. Romania in the Complex Mosaic of Reform Formulas of the European Enlargement Project

    Directory of Open Access Journals (Sweden)

    Georgiana Ciceo

    2012-12-01

    Full Text Available In a period of hectic diplomatic activity for breathing a new life into the project of European integration and bouncing it back after the economic crisis came to threaten its credibility, Romania is bound to take an active role in the ongoing discussions on the future of Europe. The deliberations that have been going on for the past few months advance now along several lines and aim at creating a banking union, a fiscal union, an economic union and a political union. Each of them taken separately and all of them taken together will alter fundamentally the governance structures of the European Union.

  4. Analysis of government investment in primary healthcare institutions to promote equity during the three-year health reform program in China

    Science.gov (United States)

    2013-01-01

    Background The World Health Report 2000 stated that increased public financing for healthcare was an integral part of the efforts to achieve equity of access. In 2009, the Chinese government launched a three-year health reform program to achieve equity of access. Through this reform program, the government intended to increase its investment in primary healthcare institutions (PHIs). However, reports about the outcome and the improvement of the equity of access have yet to be presented. Methods Stratified sampling was employed in this research. The samples used for the study comprised 34 community health service centers (CHSCs) and 92 township hospitals (THs) from six provinces of China. Collected data, which were publicly available, consisted of the total revenue, financial revenue, and the number of people for the periods covering January 2010 to September 2010 and January 2011 to September 2011. Revenue information for 2009 and 2010 was obtained from China’s Health Statistics Yearbook. By using indicators such as government investment, government finance proportion and per capita revenue, t-tests for paired and independent samples were used to analyze the changes in government investment. Results Government invest large amount of money to the primary healthcare institutions. Government finance proportion in 2008 was 18.2%. This percentage increased to 38.84% in 2011, indicating statistical significance (p = 0.000) between 2010 and 2011. The per capita financial input was 20.92 yuan in 2010 and 31.10 yuan in 2011. Compared with the figures from 2008 to 2010, the gap in different health sectors narrowed in 2011, and differences emerged. The government finance proportion in CHSCs revenue was 6.9% higher than that of THs, while the per capita revenue of CHSCs was higher. In 2011, the highest and lowest government finance proportions were 48.80% (Shaanxi) and 19.36% (Shandong), respectively. In that same year, the per capita revenue of Shaanxi (40.69 Yuan) was

  5. The limitations of some European healthcare databases for monitoring the effectiveness of pregnancy prevention programmes as risk minimisation measures

    DEFF Research Database (Denmark)

    Charlton, R A; Bettoli, V; Bos, H J

    2018-01-01

    availability on contraception to estimate compliance with contraception requirements was variable and no data were available on pregnancy tests. CONCLUSION: Current electronic healthcare databases do not contain all the data necessary to fully monitor the effectiveness of PPP implementation, and thus, special......PURPOSE: Pregnancy prevention programmes (PPPs) exist for some medicines known to be highly teratogenic. It is increasingly recognised that the impact of these risk minimisation measures requires periodic evaluation. This study aimed to assess the extent to which some of the data needed to monitor...... the effectiveness of PPPs may be present in European healthcare databases. METHODS: An inventory was completed for databases contributing to EUROmediCAT capturing pregnancy and prescription data in Denmark, Norway, the Netherlands, Italy (Tuscany/Emilia Romagna), Wales and the rest of the UK, to determine...

  6. Addressing information security training and awareness within the European healthcare community.

    Science.gov (United States)

    Furnell, S; Sanders, P; Warren, M

    1997-01-01

    This paper discusses the need to promote information security issues within modern healthcare establishments and the consequent need for appropriate training and awareness initiatives. Security is an area of extreme significance in healthcare information systems but, whilst the need is generally recognised, many personnel are not familiar with even basic concepts and procedures. As such, adequate promotion of security through training and awareness initiatives is viewed as a vital first step. The paper highlights a series of basic factors that healthcare establishments (HCEs) should consider in setting up a training and awareness framework. The discussion then examines a number of ways in which relevant information may be disseminated to staff, including security guidelines, training seminars and world-wide web based services. The paper is largely based upon work that is currently being conducted as part of the Health Telematics ISHTAR (Implementing Secure Healthcare Telematics Applications in euRope) project.

  7. 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.

  8. WHAT TO REFORM IN THE EUROPEAN BUDGET? SOME REFLECTIONS ON THE STAKES OF THE CURRENT BUDGET REVIEW PROCESS

    Directory of Open Access Journals (Sweden)

    Dragoş Negrescu

    2008-04-01

    Full Text Available The EU budget is the financial tool supporting European integration. The way it has developed over decades, both as concerns revenues and expenditure, superposed to a complex decision-making process, where member states retain veto rights in crucial respects, means that it currently displays a significant inertia, while its size and structure are not the most appropriate for endowing the Union with the means allowing it to best react to the present-day challenges. Tensions are also rising between the national interests of individual members and the common interest, which previous attempts to reconcile by way of special treatments granted to some countries are clearly unsustainable, while inducing additional rigidities to the budgetary construction. This obviates the need for a comprehensive reform, which the 2008/2009 budget review that the Commission was mandated to undertake may set in motion. The following paper attempts at taking stock of the most significant problems in need of a solution and to explore the most appropriate ways available for tackling them.

  9. Unemployment, public-sector health-care spending and breast cancer mortality in the European Union: 1990-2009.

    Science.gov (United States)

    Maruthappu, Mahiben; Watkins, Johnathan A; Waqar, Mueez; Williams, Callum; Ali, Raghib; Atun, Rifat; Faiz, Omar; Zeltner, Thomas

    2015-04-01

    The global economic crisis has been associated with increased unemployment, reduced health-care spending and adverse health outcomes. Insights into the impact of economic variations on cancer mortality, however, remain limited. We used multivariate regression analysis to assess how changes in unemployment and public-sector expenditure on health care (PSEH) varied with female breast cancer mortality in the 27 European Union member states from 1990 to 2009. We then determined how the association with unemployment was modified by PSEH. Country-specific differences in infrastructure and demographic structure were controlled for, and 1-, 3-, 5- and 10-year lag analyses were conducted. Several robustness checks were also implemented. Unemployment was associated with an increase in breast cancer mortality [P unemployment rises (P unemployment and breast cancer mortality remained in all robustness checks. Rises in unemployment are associated with significant short- and long-term increases in breast cancer mortality, while increases in PSEH are associated with reductions in breast cancer mortality. Initiatives that bolster employment and maintain total health-care expenditure may help minimize increases in breast cancer mortality during economic crises. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10.  Railway Reforms

    DEFF Research Database (Denmark)

    Asmild, Mette; Holvad, Torben; Hougaard, Jens Leth

    This paper considers railway operations in 23 European countries during 1995-2001, where a series of reform initiatives were launched by the European Commission, and analyses whether these reform initiatives improved the operating efficiency of the railways. Efficiency is measured using Multi......-directional Efficiency Analysis, which enables investigation of how railway reforms affect the inefficiencies of specific cost drivers. The main findings are that the reform initiatives generally improve operating efficiency but potentially differently for different cost drivers. Specifically, the paper provides clear...... empirical evidence that accounting separation is important for improving operating efficiency for both material and staff costs, whereas other reforms only influenced one of these factors...

  11. A critique of the regulation of data science in healthcare research in the European Union.

    Science.gov (United States)

    Rumbold, John M M; Pierscionek, Barbara K

    2017-04-08

    The EU offers a suitable milieu for the comparison and harmonisation of healthcare across different languages, cultures, and jurisdictions (albeit with a supranational legal framework), which could provide improvements in healthcare standards across the bloc. There are specific ethico-legal issues with the use of data in healthcare research that mandate a different approach from other forms of research. The use of healthcare data over a long period of time is similar to the use of tissue in biobanks. There is a low risk to subjects but it is impossible to gain specific informed consent given the future possibilities for research. Large amounts of data on a subject present a finite risk of re-identification. Consequently, there is a balancing act between this risk and retaining sufficient utility of the data. Anonymising methods need to take into account the circumstances of data sharing to enable an appropriate balance in all cases. There are ethical and policy advantages to exceeding the legal requirements and thereby securing the social licence for research. This process would require the examination and comparison of data protection laws across the trading bloc to produce an ethico-legal framework compatible with the requirements of all member states. Seven EU jurisdictions are given consideration in this critique.

  12. Education in the Wake of Healthcare Reform: Increasing Primary Care Usage by Individuals Currently Reliant upon Emergency Departments for Care

    Science.gov (United States)

    Tannebaum, Michael; Wilkin, Holley A.; Keys, Jobia

    2014-01-01

    Background: The Affordable Care Act (ACA) was introduced, in part, to increase access to primary care, which has been shown to provide patients with myriad health benefits. Objective: To increase primary care usage by understanding the beliefs about primary and emergency care most salient to those whose healthcare-seeking practices may be impacted…

  13. EUROPEAN UNION REGULATION ON PREVENTION FROM SHARPS INJURIES IN HOSPITAL AND HEALTHCARE SECTOR

    Directory of Open Access Journals (Sweden)

    Mariela Yaneva-Deliverska

    2012-12-01

    Full Text Available Healthcare personnel, especially those involved in some specific departments and activities (emergency care, intensive care, surgical interventions, etc. and non-healthcare personnel linked to this sector are often face the risk of infection due to injuries caused by needlesticks and other sharps injuries (scalpels, suture equipment, etc.. Health care workers may also incur injuries from improper procedures, such as passing sharps hand-to-hand between team members, placing sharps in a disposal container, or failing to use a safer sharps device. In the community strategy for health and safety at work (2007-2012, the Commission announced its intention to continue its work to improve risk prevention, among other things, relative to needlestick infections. Council Directive 2010/32/EU of 10 May 2010 implementing the Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector provides a framework to put in place and implement practical preventative measures before the publication of the required national legislation in each country.

  14. Position statement on the role of healthcare professionals, patient organizations and industry in European Reference Networks

    NARCIS (Netherlands)

    Hollak, C.E.M.; Biegstraaten, M.; Baumgartner, M.R.; Belmatoug, N.; Bembi, B.; Bosch, A.; Brouwers, M.; Dekker, H.; Dobbelaere, D.; Engelen, M.; Groenendijk, M.C.; Lachmann, R.; Langendonk, J.G.; Langeveld, M.; Linthorst, G.; Morava, E.; Tien Poll-The, B.; Rahman, S.; Rubio-Gozalbo, M.E.; Spiekerkoetter, U.; Treacy, E.; Wanders, R.; Zschocke, J.; Hagendijk, R.

    2016-01-01

    A call from the EU for the set-up of European Reference Networks (ERNs) is expected to be launched in the first quarter of 2016. ERNs are intended to improve the care for patients with low prevalent or rare diseases throughout the EU by, among other things, facilitating the pooling and exchange of

  15. Position statement on the role of healthcare professionals, patient organizations and industry in European Reference Networks

    NARCIS (Netherlands)

    C.E.M. Hollak (Carla); M. Biegstraaten (Marieke); M.R. Baumgartner (Matthias R.); N. Belmatoug (Nadia); B. Bembi (Bruno); A.M. Bosch (Annet); M.C.G.J. Brouwers (M. C G J); H. Dekker (Hanka); D. Dobbelaere (Dries); M. Engelen (Marc); M.C. Groenendijk (Marike C.); R.H. Lachmann (Robin); J.G. Langendonk (Janneke); M. Langeveld (Mirjam); G. Linthorst (Gabor); E. Morava (Eva); B.T. Poll-The; S. Rahman (Shamima); M.E. Rubio-Gozalbo (Estela); U. Spiekerkoeter (Ute); E. Treacy (Eileen); R.J.A. Wanders (Ronald); J. Zschocke (Johannes); R. Hagendijk (Rob)

    2016-01-01

    textabstractA call from the EU for the set-up of European Reference Networks (ERNs) is expected to be launched in the first quarter of 2016. ERNs are intended to improve the care for patients with low prevalent or rare diseases throughout the EU by, among other things, facilitating the pooling and

  16. Something is amiss in Denmark: A comparison of preventable hospitalisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente

    DEFF Research Database (Denmark)

    Schiøtz, Michaela Louise; Price, Mary; Frølich, Anne

    2011-01-01

    As many other European healthcare systems the Danish healthcare system (DHS) has targeted chronic condition care in its reform efforts. Benchmarking is a valuable tool to identify areas for improvement. Prior work indicates that chronic care coordination is poor in the DHS, especially in comparis...

  17. The evolution of administrative law in Albania and the impact of the decisions of the European Court of Justice in the Albanian legal reforms in administrative justice

    Directory of Open Access Journals (Sweden)

    Monika MEÇA

    2014-12-01

    Full Text Available The selection of the thesis was generally motivated by the lack of legal treatise focused in the arguments of Administrative Court importance in Albanian Judicial system as a new judicial structure, whose role would be to check the legality of decisions of the state administration with the aim to guarantee effective protection of human rights and legitimate interests of private persons through a regular, conform, fast and reasonable judicial process. The aim of this study is to describe the institutional steps taken from Albanian Government in administrative justice evolution, enormous differences between the administrative law before and after 1990, and the impact of European Court of Justice case law and EU law in the Albanian legal reforms in administrative justice. By analyzing the development of the administrative law in Albania is highlighted that the factors which influenced the transformation processes of this branch of law are the level of political culture, the heritage of the paste and the European Union , which has long been engaged in direct support for the modernization of public administration in Albania . In conclusion studying and analyzing the recent reform undertaken in the establishment of administrative court in Albania is necessary to make an evaluation of the impact of this reform in amending the legal framework for administrative procedures and adoption of a new Code of Administrative Procedure.

  18. Crowding and delivery of healthcare in emergency departments: the European perspective.

    LENUS (Irish Health Repository)

    Jayaprakash, Namita

    2009-11-01

    Emergency department (ED) crowding is a multifactorial problem, resulting in increased ED waiting times, decreased patient satisfaction and deleterious domino effects on the entire hospital. Although difficult to define and once limited to anecdotal evidence, crowding is receiving more attention as attempts are made to quantify the problem objectively. It is a worldwide phenomenon with regional influences, as exemplified when analyzing the problem in Europe compared to that of the United States. In both regions, an aging population, limited hospital resources, staff shortages and delayed ancillary services are key contributors; however, because the structure of healthcare differs from country to country, varying influences affect the issue of crowding. The approach to healthcare delivery as a right of all people, as opposed to a free market commodity, depends on governmental organization and appropriation of funds. Thus, public funding directly influences potential crowding factors, such as number of hospital beds, community care facilities, and staffing. Ultimately ED crowding is a universal problem with distinctly regional root causes; thus, any approach to address the problem must be tailored to regional influences.

  19. Willingness of European healthcare workers to undergo vaccination against seasonal influenza: current situation and suggestions for improvement

    Directory of Open Access Journals (Sweden)

    George Kassianos

    2015-01-01

    Full Text Available Uptake of vaccination against seasonal influenza in healthcare workers (HCWs is, in general, low (vaccine coverage of 6–54%, as is awareness of its importance, and has been decreasing in most European Union (EU countries in recent years. By virtue of their working environment, HCWs are at an increased risk of influenza infection and of subsequently transmitting the virus to vulnerable patients, in whom disease burden is significant. It could be argued that a similar or higher target vaccination rate to that recommended for older age groups and people with chronic medical conditions (75% should be applied to HCWs, and the European Council recommends Member States to improve vaccination coverage in this population. In this context, better education of HCWs is needed to increase awareness and highlight the importance of HCW vaccination for the benefit of public health, particularly for their patients, who may be at risk of serious complications that could lead to disability or death. Secondary to these professional responsibilities, personal benefits (as well as benefits to close family and friends should also be emphasised. Misconceptions that create barriers to vaccination need to be discussed openly and objections placed in the context of public health.

  20. Health promotion interventions and policies addressing excessive alcohol use: a systematic review of national and global evidence as a guide to health-care reform in China.

    Science.gov (United States)

    Li, Qing; Babor, Thomas F; Zeigler, Donald; Xuan, Ziming; Morisky, Donald; Hovell, Melbourne F; Nelson, Toben F; Shen, Weixing; Li, Bing

    2015-01-01

    Steady increases in alcohol consumption and related problems are likely to accompany China's rapid epidemiological transition and profit-based marketing activities. We reviewed research on health promotion interventions and policies to address excessive drinking and to guide health-care reform. We searched Chinese- and English-language databases and included 21 studies in China published between 1980 and 2013 that covered each policy area from the World Health Organization (WHO) Global Strategy to Reduce the Harmful Use of Alcohol. We evaluated and compared preventive interventions to the global alcohol literature for cross-national applicability. In contrast with hundreds of studies in the global literature, 11 of 12 studies from mainland China were published in Chinese; six of 10 in English were on taxation from Taiwan or Hong Kong. Most studies demonstrated effectiveness in reducing excessive drinking, and some reported the reduction of health problems. Seven were randomized controlled trials. Studies targeted schools, drink-driving, work-places, the health sector and taxation. China is the world's largest alcohol market, yet there has been little growth in alcohol policy research related to health promotion interventions over the past decade. Guided by a public health approach, the WHO Global Strategy and health reform experience in Russia, Australia, Mexico and the United States, China could improve its public health response through better coordination and implementation of surveillance and evidence-based research, and through programmatic and legal responses such as public health law research, screening and early intervention within health systems and the implementation of effective alcohol control strategies. © 2014 Society for the Study of Addiction.

  1. Can vouchers make a difference to the use of private primary care services by older people? Experience from the healthcare reform programme in Hong Kong

    Directory of Open Access Journals (Sweden)

    Yeoh EK

    2011-10-01

    Full Text Available Abstract Background As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. Methods This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. Results 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4% and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Conclusions Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The

  2. Cultural Variation in Healthcare Consumption in 16 European Countries: National and Individual Drivers in the Case of Mild Medical Conditions: An Abstract

    NARCIS (Netherlands)

    Leijen, I.J.C.; van Herk, H.; Rossi, Patricia; Krey, Nina

    2017-01-01

    With this research we investigate the impact of individual- and country-level characteristics on personal healthcare preferences in mild medical conditions. Using a multilevel approach, we use data from 23,312 individuals from 16 European countries (including emerging economies), together with data

  3. Investing in amnesia, or fantasy and forgetfulness in the World Bank's approach to healthcare reform in sub-Saharan Africa.

    Science.gov (United States)

    Epprecht, M

    1997-01-01

    "Investing in Health," the World Bank's 1993 World Development Report, and a follow-up report, "Better Health in Africa," advocate investments in Third World health sectors as a means of increasing individual productivity and strengthening economic growth. Both reports maintain that structural adjustment policies have enhanced the physical health of low-income populations by improving the fiscal health of business elites. This essay critiques the World Bank's approach through a historical analysis of health care problems in sub-Saharan Africa with an emphasis on the devastating effects of colonialism, patriarchy, and imperialism. Although these documents contain many useful recommendations for Western donors (e.g., recognition of the destructive potential of alcohol and tobacco, the need for state regulation over key parts of the health sector, and the effects of gender on health status), they reflect an "investment in amnesia" regarding historical evidence on health care reform in Africa and an erroneous assumption that Western biomedicine is politically neutral. Foreign aid has tended to serve the needs of multinational corporations rather than African populations. Recommended, in place of structural adjustment policies, are measures such as a massive rebuilding of Africa's urban infrastructure, the enforcement of minimum wage laws, the preservation of ecosystems that supply traditional medicines, attention to the ecologic and health consequences of economic growth, and a feminist-led reproductive rights movement.

  4. Talking about quality: exploring how 'quality' is conceptualized in European hospitals and healthcare systems.

    Science.gov (United States)

    Wiig, Siri; Aase, Karina; von Plessen, Christian; Burnett, Susan; Nunes, Francisco; Weggelaar, Anne Marie; Anderson-Gare, Boel; Calltorp, Johan; Fulop, Naomi

    2014-10-11

    Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study. This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics). The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient

  5. 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.

  6. Changes in government spending on healthcare and population mortality in the European union, 1995-2010: a cross-sectional ecological study.

    Science.gov (United States)

    Budhdeo, Sanjay; Watkins, Johnathan; Atun, Rifat; Williams, Callum; Zeltner, Thomas; Maruthappu, Mahiben

    2015-12-01

    Economic measures such as unemployment and gross domestic product are correlated with changes in health outcomes. We aimed to examine the effects of changes in government healthcare spending, an increasingly important measure given constrained government budgets in several European Union countries. Multivariate regression analysis was used to assess the effect of changes in healthcare spending as a proportion of total government expenditure, government healthcare spending as a proportion of gross domestic product and government healthcare spending measured in purchasing power parity per capita, on five mortality indicators. Additional variables were controlled for to ensure robustness of data. One to five year lag analyses were conducted. European Union countries 1995-2010. Neonatal mortality, postneonatal mortality, one to five years of age mortality, under five years of age mortality, adult male mortality, adult female mortality. A 1% decrease in government healthcare spending was associated with significant increase in all mortality metrics: neonatal mortality (coefficient -0.1217, p = 0.0001), postneonatal mortality (coefficient -0.0499, p = 0.0018), one to five years of age mortality (coefficient -0.0185, p = 0.0002), under five years of age mortality (coefficient -0.1897, p = 0.0003), adult male mortality (coefficient -2.5398, p = 0.0000) and adult female mortality (coefficient -1.4492, p = 0.0000). One per cent decrease in healthcare spending, measured as a proportion of gross domestic product and in purchasing power parity, was both associated with significant increases (p < 0.05) in all metrics. Five years after the 1% decrease in healthcare spending, significant increases (p < 0.05) continued to be observed in all mortality metrics. Decreased government healthcare spending is associated with increased population mortality in the short and long term. Policy interventions implemented in response to the financial crisis may be associated with worsening

  7. Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules.

    Science.gov (United States)

    MacRae, Rhoda; Rooney, Kevin D; Taylor, Alan; Ritters, Katrina; Sansoni, Julita; Lillo Crespo, Manuel; Skela-Savič, Brigita; O'Donnell, Barbara

    2016-07-01

    Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise. This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules. A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted. The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. The Curricular Reform of Art Education in Primary School in Slovenia in Terms of Certain Components of the European Competence of Cultural Awareness and Expression

    Directory of Open Access Journals (Sweden)

    Rajka Bračun Sova

    2012-01-01

    Full Text Available One of the important positions of the last curricular reform in Slovenia, which included systemic issues of education (White Paper on Education, 2011 and curricula for compulsory subjects in primary school, is the fact that Slovenia has been integrated into Europe, and thus education should also include the development of core European competences. One such competence is cultural awareness and expression, which until now has been an issue more in the context of cultural policies than school policies in Slovenia. The purpose of the present article is to critically analyse the curricular reform of art education (i.e., visual art education, through which, in terms of certain components of the competence of cultural awareness and expression, it is foreseen that the student will gain a knowledge of art, develop an ability to experience works of art and develop a creative attitude towards art and heritage. Because the starting point and goal of curricular change is the curriculum, our analysis is derived from curriculum theories, and not from the art theories and pedagogical theories that have predominantly framed previous attempts at curriculum analysis. Critical consideration of the curricular reform of art education in primary school in terms of certain components of the competence of cultural awareness and expression was undertaken by comparing curricula in the field of aesthetic education. We compared art education with music education and literature within the Slovenian language curriculum. Qualitative analysis showed that, despite the reform, the curriculum for arts education does not realise selected components of the competence of cultural awareness and expression, largely due to the curriculum’s conceptual structure. Art education is centred principally on art-making activities, with an obvious neglect of appreciation. The integration of arts subjects at school, as proposed by the White Paper, is therefore not possible, due to the existing

  9. Trends and correlates of the public’s perception of healthcare systems in the European Union: a multilevel analysis of Eurobarometer survey data from 2009 to 2013

    Science.gov (United States)

    AlSaud, AlJohara M; Taddese, Henock B; Filippidis, Filippos T

    2018-01-01

    Objective The aim of the study is to assess trends in public perceptions of health systems in 27 European Union (EU) member states following the financial crisis (2009–2013), in order to discuss observed changes in the context of the financial crisis. Design Repeated cross-sectional studies. Setting 27 EU countries. Participants EU citizens aged 15 years and older. Methods The study mainly uses the Eurobarometer Social Climate Survey, conducted annually between 2009 and 2013, thereby analysing 116 706 observations. A multilevel logistic regression was carried out to analyse trends over time and the factors associated with citizens’ perceptions of their healthcare systems. Results Europeans generally exhibit positive perceptions of their national healthcare systems, 64.0% (95% CI 63.6% to 64.4%). However, we observed a significant drop in positive perceptions in the years following the crisis, especially within countries most affected by the crisis. Concerning fiscal characteristics, wealthier countries and those dedicating higher proportion of their national income to health were more likely to maintain positive perceptions. At the individual level, perceptions of healthcare systems were significantly associated with respondents’ self-perceptions of their social status, financial capacity and overall satisfaction in life. Conclusions Our finding confirms previous observations that citizens’ perceptions of their healthcare systems may reflect their overall prospects within the broader socioeconomic systems they live in; which have in turn been affected by the financial crisis and the policy measures instituted in response. PMID:29317413

  10. Privatization and management development in the healthcare sector of Georgia.

    Science.gov (United States)

    West, Daniel J; Costello, Michael; Ramirez, Bernardo

    2011-01-01

    Healthcare reforms in Georgia parallel some of the major changes made by other Central and Eastern European countries. This is especially true of efforts to privatize the health sector and secure capital investments from Western Europe. Privatization of Georgian healthcare requires an understanding of the Soviet-era healthcare system and ideological orientation. Many of the issues and problems of privatization in Georgia require new knowledge to enhance equity outcomes, improve financial performance, increase access to care and encourage healthcare competition. Training existing and future healthcare leaders in modern management theory and practice is paramount. A university based health-management education partnership model was developed and implemented between several universities in the United States and Europe, along with two Georgian universities, to address workforce demands, changing market conditions, management knowledge and leadership competencies. Health-management education concentrations were developed and implemented along with several short courses to meet market demand for trained leaders and managers.

  11. The development of a consensus definition for healthcare improvement science (HIS) in seven European countries: A consensus methods approach.

    Science.gov (United States)

    Skela-Savič, Brigita; Macrae, Rhoda; Lillo-Crespo, Manuel; Rooney, Kevin D

    2017-06-01

    There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and 'change making' should become an intrinsic part of everyone's job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy. This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania. A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: 'Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.' The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science.

  12. Contribution of the spanish agency for medicines and healthcare products to the European committee for the evaluation of medicinal products for human use.

    Science.gov (United States)

    Alonso-Gutiérrez, A; Díaz-Ramos, P; Sulleiro-Avendaño, E; de Miguel-Marañón, M; Padilla-Gallego, M E; Sancho-López, A; Ruiz-Antúnez, S; Prieto-Yerro, C

    2015-05-01

    The centralized procedure for registering medicinal products involves a joint assessment by all regulatory agencies of European Union member states, which are coordinated by the European Medicines Agency. Since its implementation in 1995, the Spanish Agency for Medicines and Healthcare Products (AEMPS) has actively contributed to the committee on medicinal products for human use. The therapeutic areas in which AEMPS has the greatest presence are cardiovascular, sensory organs (mainly ophthalmology) and genitourinary/sexual hormones. The technical staff of AEMPS contributes their expertise and extensive experience to this task, as do the practitioners of the Spanish healthcare system who act as external experts, providing their clinical vision and bringing the daily clinical practice to the evaluation of medicinal products. As with other European decision spaces, the joint participation of the member states is not homogeneous, with a minority of countries still heading the majority of assessments for the committee on medicinal products for human use, although all member countries take part in the final decision. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  13. Competitiveness effects of environmental tax reforms (COMETR). Final report to the European Commission, DG Research and DG TAXUD

    Energy Technology Data Exchange (ETDEWEB)

    Skou Andersen, M.; Speck, S. (Univ. of Aarhus, National Environmental Research Institute, Dept. of Policy Analysis (Denmark)); Barker, T.; Junankar, S.; Pollitt, H. (Cambridge Econometrics (United Kingdom)); Fitz Gerald, J.; Scott, S. (Economic and Social Research Institute (Ireland)); Jilkova, J. (Univ. of Economics Prague, Institute for Economic and Environmental Policy (Czech Republic)); Salmons, R.; Ekins, P. (Policy Studies Institute (United Kingdom)); Christie, E.; Michael Landesmann, M. (Vienna Institute for International Economic Studies (Austria))

    2007-12-15

    COMETR provides an ex-post assessment of experiences and competitiveness impacts of using carbon-energy taxes as an instrument of an Environmental Tax Reform (ETR), which shifts the tax burden and helps reduce the carbon emissions that cause global warming. COMETR: reviews the experience in ETR in seven EU Member States (Denmark, Germany, Netherlands, Finland, Slovenia, Sweden and UK); analyses world market conditions for a set of energy-intensive sectors, as a framework for considering competitiveness effects; analyses the effects of ETR on sector-specific energy usage and carbon emissions in Member States with carbon-energy taxes introduced on industry; presents a macroeconomic analysis of the competitiveness effects of ETR for individual Member States as well as for the EU as a whole; provides ex-post figures for environmental decoupling and assesses carbon leakage; reviews mitigation and compensation mechanisms for energy-intensive industries. (au)

  14. Trends and correlates of the public's perception of healthcare systems in the European Union: a multilevel analysis of Eurobarometer survey data from 2009 to 2013.

    Science.gov (United States)

    AlSaud, AlJohara M; Taddese, Henock B; Filippidis, Filippos T

    2018-01-08

    The aim of the study is to assess trends in public perceptions of health systems in 27 European Union (EU) member states following the financial crisis (2009-2013), in order to discuss observed changes in the context of the financial crisis. Repeated cross-sectional studies. 27 EU countries. EU citizens aged 15 years and older. The study mainly uses the Eurobarometer Social Climate Survey, conducted annually between 2009 and 2013, thereby analysing 116 706 observations. A multilevel logistic regression was carried out to analyse trends over time and the factors associated with citizens' perceptions of their healthcare systems. Europeans generally exhibit positive perceptions of their national healthcare systems, 64.0% (95% CI 63.6% to 64.4%). However, we observed a significant drop in positive perceptions in the years following the crisis, especially within countries most affected by the crisis. Concerning fiscal characteristics, wealthier countries and those dedicating higher proportion of their national income to health were more likely to maintain positive perceptions. At the individual level, perceptions of healthcare systems were significantly associated with respondents' self-perceptions of their social status, financial capacity and overall satisfaction in life. Our finding confirms previous observations that citizens' perceptions of their healthcare systems may reflect their overall prospects within the broader socioeconomic systems they live in; which have in turn been affected by the financial crisis and the policy measures instituted in response. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Tailor-made finance versus tailor-made service : Can the state improve consumer choice in healthcare by reforming the financial structure?

    NARCIS (Netherlands)

    K.J. Grit (Kor); A.A. de Bont (Antoinette)

    2010-01-01

    textabstractABSTRACT Background: Policy instruments based on the working of markets have been introduced to empower consumers of healthcare, however it is not easy to become a critical consumer in healthcare. Objectives: The aim of this study is to analyze the possibilities of the state to

  16. Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study.

    Directory of Open Access Journals (Sweden)

    Alessandro Cassini

    2016-10-01

    Full Text Available Estimating the burden of healthcare-associated infections (HAIs compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of Communicable Diseases in Europe (BCoDE project and 2011-2012 data from the European Centre for Disease Prevention and Control (ECDC point prevalence survey (PPS of HAIs and antimicrobial use in European acute care hospitals, we estimated the burden of six common HAIs.The included HAIs were healthcare-associated pneumonia (HAP, healthcare-associated urinary tract infection (HA UTI, surgical site infection (SSI, healthcare-associated Clostridium difficile infection (HA CDI, healthcare-associated neonatal sepsis, and healthcare-associated primary bloodstream infection (HA primary BSI. The burden of these HAIs was measured in disability-adjusted life years (DALYs. Evidence relating to the disease progression pathway of each type of HAI was collected through systematic literature reviews, in order to estimate the risks attributable to HAIs. For each of the six HAIs, gender and age group prevalence from the ECDC PPS was converted into incidence rates by applying the Rhame and Sudderth formula. We adjusted for reduced life expectancy within the hospital population using three severity groups based on McCabe score data from the ECDC PPS. We estimated that 2,609,911 new cases of HAI occur every year in the European Union and European Economic Area (EU/EEA. The cumulative burden of the six HAIs was estimated at 501 DALYs per 100,000 general population each year in EU/EEA. HAP and HA primary BSI were associated with the highest burden and represented more than 60% of the total burden, with 169 and 145 DALYs per 100,000 total population, respectively. HA UTI, SSI, HA CDI, and HA primary BSI ranked as the third to sixth syndromes in terms of burden of disease. HAP and HA primary BSI were

  17. Flexible Labour, Flexible Production and Innovation-by-Agreement: International Comparisons Contesting the Lindbeck-Snower Insider-Outsider Thesis and 'Structural Reforms' in the European Union

    Directory of Open Access Journals (Sweden)

    Teresa Carla Oliveira

    2017-09-01

    Full Text Available This paper critiques the case for flexibilisation of labour markets. It evidences that influential claims for this in terms of an insider-outsider thesis by former Nobel economics committee member Assar Lindbeck and the British economist Dennis Snower were purely theoretical without offering any evidence, or recognising contrary evidence. It cites a recent admission by the IMF that there is no basis for claiming that protection of employee rights inhibits economic efficiency and cites also a questioning of structural reforms and an obsession with competitiveness by Benoît Cœuré, an Executive Director of the ECB. It illustrates that the achievement of some of the most competitive companies in the world, in Japan, has been based on reinforcing insider rights through commitment to lifetime employment for core employees and how this has enabled high levels of efficiency and process innovation through continuous improvement. It relates this to theories of psychological and social contracts, and evidences the influence of this flexible production rather than flexible labour market model on the recommendation of innovation-by-agreement in the 2000 Lisbon Agenda of the European Council including the right to work-life balance which has not been integral to flexible production in Japan. It then summarises some implications.

  18. Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries.

    Science.gov (United States)

    den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Payne, Sheila; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

    2018-02-01

    Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Qualitative group interview design. A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%). The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.

  19. Anyone for Social Security Reform?

    OpenAIRE

    Sen, Partha

    2016-01-01

    A reform of a pay-as-you-go social security makes the pensioners worse off and the working generations better off in the period of the reform (in a dynamically efficient economy without altruism). The observed reluctance across all age groups to support such reforms is usually explained by the insurance properties of these schemes. I propose an alternative in a two sector setting. Since the old consume labor-intensive goods like healthcare etc., the reform causes labor demand to fall and redu...

  20. Medical education in pharmacogenomics-results from a survey on pharmacogenetic knowledge in healthcare professionals within the European pharmacogenomics clinical implementation project Ubiquitous Pharmacogenomics (U-PGx).

    Science.gov (United States)

    Just, Katja Susanne; Steffens, Michael; Swen, Jesse Joachim; Patrinos, George P; Guchelaar, Henk-Jan; Stingl, Julia Carolin

    2017-10-01

    Due to the diversity within Europe, the implementation of pharmacogenomic testing in clinical practice faces specific challenges. In the context of the European pharmacogenomics implementation project "Ubiquitous Pharmacogenomics" (U-PGx; funded by the European Commission), we studied the current educational background. We developed a questionnaire including 29 questions. It was spread out to healthcare professionals working at the future implementation sites (in Austria, Greece, Italy, Netherlands, Slovenia, Spain and Great Britain) of the U-PGx project in preparation of an educational programme. Aim of the survey was to analyse the current educational situation at the implementation sites. In total, 70 healthcare professionals participated in the survey. Of participants, 84.3% found pharmacogenomics relevant to their current practice, but experience was still rare. More than two-thirds (65.7%) did not order nor recommend a pharmacogenomic test in the past year. This was mainly attributed to not having enough knowledge on pharmacogenomics (40.0%). Needs were identified in application of pharmacogenomics (identifying drugs 41.4%, interpreting test results 37.2%) as well as in underlining mechanisms (better knowledge on drug metabolism 67.1%, better knowledge on basic principles of pharmacogenomics 60.0%). This study analysed the specific attitudes, experience and education on pharmacogenomics of future users. There was a general positive attitude and interest towards pharmacogenomic testing. However, the grade of own experience, and knowledge about application and interpretation of pharmacogenomics caused uncertainty. Thus, education and training programmes may be helpful for implementation of pharmacogenomics at a homogenous level within Europe.

  1. The Economy of Healthcare: Disparity of Insured/Uninsured Profiles among European Immigrants in the United States

    Directory of Open Access Journals (Sweden)

    Rohitha Goonatilake

    2016-01-01

    Full Text Available Immigration over the last seven years has been the highest for any seven-year period in the history of the United States (US, totaling 10.3 million immigrants. Of which, it is estimated that more than 50% are accounted as immigrants without legal status, according to the Center for Immigration Studies in Washington (Camarota, 2002. Data gathered in early 2000 provides a glimpse of the situation to bring in the disparity of insured and uninsured among European immigrants in the United States as the 9/11 attacks, the Obama care (the Patient Protection and Affordable Care Act (PPACA, or Affordable Care Act (ACA for short, and the (DREAM Act of 2010 the Development, Relief and Education for Alien Minors Act have significantly changed the patterns and profiles of this phenomenon as someone would shed light on the situation. This paper compares and contrasts the extent of health insurance coverage for the citizens, naturalized citizens, and non-citizens as identified in terms of the world regions of birth, of course, for the European descendants. Finally, the analysis is concluded by examining the extent of health insurance coverage among all foreign born population based on race, educational attainment, and family income in 2005.

  2. Tailor-made finance versus tailor-made care. Can the state strengthen consumer choice in healthcare by reforming the financial structure of long-term care?

    Science.gov (United States)

    Grit, K; de Bont, A

    2010-02-01

    Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care institutions. With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of 'need' is transformed into the principle of 'economic demand'. Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care.

  3. Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China: a Cross-sectional Survey 3 Years after the Healthcare Reform.

    Science.gov (United States)

    Li, Yuan; Wang, Jing Lei; Zhang, Xiao Chang; Liu, Dan; Shi, Wen Hui; Liang, Xiao Feng; Wu, Jing

    2016-12-01

    The standardized hypertension management provided by primary health care workers is an important part of China's recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  4. Addressing multimorbidity to improve healthcare and economic sustainability

    Science.gov (United States)

    Colombo, Francesca; García-Goñi, Manuel; Schwierz, Christoph

    2016-01-01

    Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level – something that is now supported within the framework of the European Union’s Stability and Growth Pact. PMID:29090168

  5. Key priorities in the prevention and control of healthcare-associated infection: a survey of European and other international infection prevention experts.

    Science.gov (United States)

    Dettenkofer, Markus; Humphreys, Hilary; Saenz, Henri; Carlet, Jean; Hanberger, Håkan; Ruef, Christian; Widmer, Andreas; Wolkewitz, Martin; Cookson, Barry

    2016-12-01

    Prevention and control of healthcare-associated infection (HCAI) are important within and beyond Europe. However, it is unclear which areas are considered important by HCAI prevention and control professionals. This study assesses the priorities in the prevention and control of HCAI as judged by experts in the field. A survey was conducted by the European Society of Clinical Microbiology and Infectious Diseases focussing on seven topics using SurveyMonkey(®). Through a newsletter distributed by email, about 5000 individuals were targeted throughout the world in February and March 2013. Participants were asked to rate the importance of particular topics from one (low importance) to ten (extraordinary importance), and there was no restriction on giving equal importance to more than one topic. A total of 589 experts from 86 countries participated including 462 from Europe (response rate: 11.8 %). Physicians accounted for 60 % of participants, and 57 % had ten or more years' experience in this area. Microbial epidemiology/resistance achieved the highest priority scoring with 8.9, followed by surveillance 8.2, and decolonisation/disinfection/antiseptics with 7.9. Under epidemiology/resistance, highly resistant Gram-negative bacilli scored highest (9.0-9.2). The provision of computerised healthcare information systems for the early detection of outbreaks was accorded the top priority under surveillance. The prevention of surgical site and central line infections ranked highest under the category of specific HCAI and HCAI in certain settings. Differences between regions are described. These findings reflect the concerns of experts in HCAI prevention and control. The results from this survey should inform national and international agencies on future action and research priorities.

  6. 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

  7. Healthcare financing in Croatia

    Directory of Open Access Journals (Sweden)

    Nevenka Kovač

    2013-12-01

    Full Text Available Healthcare financing system is of crucial importance for the functioning of any healthcare system, especially because there is no country in the world that is able to provide all its residents with access to all the benefits afforded by modern medicine. Lack of resources in general and rising healthcare expenditures are considered a difficult issue to solve in Croatia as well. Since Croatia gained its independence, its healthcare system has undergone a number of reforms, the primary objective of which was to optimize healthcare services to the actual monetary capacity of the Croatian economy. The objectives of the mentioned re - forms were partially achieved. The solutions that have been offered until now, i.e. consolidation measures undertaken in the last 10 years were necessary; however, they have not improved the operating conditions. There is still the issue of the deficit from the previous years, i.e. outstanding payments, the largest in the last decade. Analysis of the performance of healthcare institutions in 2011 shows that the decision makers will have to take up a major challenge of finding a solution to the difficulties the Croatian healthcare system has been struggling with for decades, causing a debt of 7 billion kuna. At the same time, they will need to uphold the basic principles of the Healthcare Act, i.e. to provide access to healthcare and ensure its continuity, comprehensiveness and solidarity, keeping in mind that the National Budget Act and Fiscal Responsibility Act have been adopted.

  8. The Curricular Reform of Art Education in Primary School in Slovenia in Terms of Certain Components of the European Competence of Cultural Awareness and Expression

    Science.gov (United States)

    Bracun Sova, Rajka; Kemperl, Metoda

    2012-01-01

    One of the important positions of the last curricular reform in Slovenia, which included systemic issues of education (White Paper on Education, 2011) and curricula for compulsory subjects in primary school, is the fact that Slovenia has been integrated into Europe, and thus education should also include the development of core European…

  9. The Interface of School, Community, and Health Care Reform: Organizational Directions toward Effective Services for Children and Youth.

    Science.gov (United States)

    Knoff, Howard M.

    1996-01-01

    Three areas of reform have been under national scrutiny: school reform, community services reform, and health-care reform. Few have discussed how these three areas interface and can be organized toward more effective services for children and youth. Describes organizational and planning methodology that coordinates these three reform areas into a…

  10. Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries

    DEFF Research Database (Denmark)

    Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund

    2013-01-01

    Abstract Purpose: Hypoglycemia is a frequent side effect induced by insulin treatment of type 1 (T1DM) and type 2 diabetes (T2DM). Limited data exist on the associated healthcare resource use and patient impact of hypoglycemia, particularly at a country-specific level. This study investigated...... the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Methods: Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics...... be interpreted with caution because of different definitions of hypoglycemia severity, duration of the studies, and methods of data collection. Conclusions: NSHE were associated with use of extra healthcare resources and work-time loss in all countries studied, suggesting that NSHE have considerable impact...

  11. Teasing apart "the tangled web" of influence of policy dialogues: lessons from a case study of dialogues about healthcare reform options for Canada.

    Science.gov (United States)

    Mulvale, Gillian; McRae, Samantha A; Milicic, Sandra

    2017-07-28

    The knowledge exchange literature suggests that policy dialogues are intended to enhance short-, medium- and long-term capacities of individuals, organizations and health systems to use evidence to inform policy-making. Key features of effective dialogues have been suggested, but the linkages between these features and the realization of improved capacities for evidence-informed policy-making among dialogue attendees and the subsequent influence on policy-making activities are not well understood. We conducted a qualitative case study of a series of four policy dialogues that were convened in Canada among national, provincial and regional stakeholders on topics pertaining to healthcare financing and funding in 2011. Data sources included videos of participant perspectives captured during or immediately following each event and follow-up key informant interviews among dialogue participants held 4 years later in 2015. Three conceptual frameworks pertaining to (i) policy dialogues and capacities for evidence use, (ii) factors shaping policy-making across the policy cycle and (iii) factors shaping implementation of evidence guided the thematic analysis. We then synthesized the findings across the three frameworks. The results suggest the potential benefits of policy dialogues described in the literature were developed among the participants at these dialogues. Informants elaborated on how dialogue features influenced their capacities to use evidence, the ideas, interests and institutions during the agenda-setting and policy formulation stages of policy-making and how implementation was affected by characteristics of policy options, individuals, organizations, the external environment and processes. We present a conceptual framework that furthers our understanding of the potential influence of policy dialogues on the content and mechanisms of policy development and illustrate pathways of influence on various stages of the policy cycle from agenda setting through

  12. Telecom Reform

    DEFF Research Database (Denmark)

    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......, 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...

  13. O processo de Bolonha no espaço europeu e a reforma universitária brasileira/The Bologna process in the european space and the brazilian higher education reform

    Directory of Open Access Journals (Sweden)

    Carmen Célia Barradas Correia Bastos

    2007-01-01

    Full Text Available Este artigo aborda questões que envolvem o movimento de reformas educacionais na educação superior, a partir do final do Século XX, como a Declaração de Bolonha assinada em 1999, por ministros da Educação europeus, e que promove, atualmente, a reforma chamada Processo de Bolonha. Outros documentos como a Declaração Mundial sobre Educação Superior, 1998, representam marco referencial das reformas a que se refere este texto. Em sua essência, os documentos europeus vinculam o movimento reformista da educação superior às necessidades contextualizadas pelo padrão de globalização da economia. São articulações que têm como base o incentivo à competitividade, mobilidade discente, adaptação ao mercado de trabalho. No Brasil, em que sentido é possível situar os reflexos desse movimento? Na busca desse entendimento, focalizamos o movimento empreendido pelo Ministério da Educação para discutir a reforma universitária para o país, em especial destacamos o Seminário Internacional Universidade XXI e a Declaração de Brasília. Resguardadas as especificidades de cada situação, vislumbramos refletir sobre possíveis intersecções dos movimentos reformistas na educação superior contemporânea. This article approaches questions that involve the movement of educational reforms in the higher education, from the end of Century XX, until the Declaration of Bologna signed in 1999, by European ministers of Education that promoted the reform called Bologna Process. Other documents as the World-wide Declaration on Higher Education, 1998, represent referential landmark of the reforms that this text is related to. In its essence, the European documents tie the reformist movement of the higher education to the necessities contextualized by the economy globalization standard. They are have as base the competitiveness encouragement, learning mobility, and adaptation to the work market. In Brazil, where is possible to point out the

  14. Reforms and Challenges of Post-conflict Kosovo Health System.

    Science.gov (United States)

    Mustafa, Mybera; Berisha, Merita; Lenjani, Basri

    2014-04-01

    Before its collapse, Kosovo's healthcare system was an integrated part of the Former Yugoslav Republics System (known as relatively well advanced for its time). Standstill had begun in the last decade of the twentieth century as the result of political disintegration of the former state. The enthusiasm of the healthcare professionals and the people of Kosovo that at the end of the conflict healthcare services will consolidate did not prove just right. Although we can claim that reorganization of Kosovo healthcare was a serious push (especially in the first years after the conflict), the intensity of development begun to fall at the latter stages. Although the basic legislation for the operation of the Healthcare System today in Kosovo does exist, the largest cause for the reform stagnation is where the law is not implemented properly and measures are not set as to a meaningful system of accountability. Twelve years have passed by since the 1999 war-conflict and, although, Kosovo has made progress in many other spheres, it has not yet reached to consolidate a health system comparable to those of other European countries. Intending to get out of difficult situation, several healthcare strategic plans have been developed in the past decade in Kosovo, but attempts in this direction have not been particularly fruitful. This script describes the actual Healthcare complexity of a situation in Kosovo 12 years after the end of the 1999 war-conflict. Interconnection and historical background is also looked upon and is described in the flow of events. Finally, the description of transfer competencies from international administrators to the local authorities as well as the flow of strategic planning that took place since 1999 has also been analyzed.

  15. Administrative Reform

    DEFF Research Database (Denmark)

    Plum, Maja

    Through the example of a Danish reform of educational plans in early childhood education, the paper critically addresses administrative educational reforms promoting accountability, visibility and documentation. Drawing on Foucaultian perspectives, the relation between knowledge and governing......, implied in the reform, is analysed as a technology of accounting. A technology producing ‘the professional nursery teacher' as a reflective daily researcher, who outlives her pedagogical desire as an analytical care of the optimisation of ‘the learning child'. Thus, the paper analyses the micro physics......, in this way, can be seen as a practice which mobilises and optimises this humanistic legacy, reproducing and transforming it into a new pedagogical desire....

  16. Engineering the system of healthcare delivery

    National Research Council Canada - National Science Library

    Rouse, William B; Cortese, Denis A

    2010-01-01

    "As the United States continues to debate reform of its healthcare system, this book argues that providing health insurance for all without improving the delivery system will not improve the current...

  17. Reform and Backlash to Reform

    DEFF Research Database (Denmark)

    Hougaard Jensen, Svend E.; Hagen Jørgensen, Ole

    Using a stochastic general equilibrium model with overlapping generations, this paper studies (i) the effects on both extensive and intensive labor supply responses to changes in fertility rates, and (ii) the potential of a retirement reform to mitigate the effects of fertility changes on labor...... supply. In order to neutralize the effects on effective labor supply of a fertility decline, a retirement reform, designed to increase labor supply at the extensive margin, is found to simultaneously reduce labor supply at the intensive margin. This backlash to retirement reform requires the statutory...

  18. Reform requires resilience: a holistic model for success.

    Science.gov (United States)

    Giniat, Edward J; Farrell, John M

    2010-07-01

    Ten initiatives associated with healthcare reform may alter the way healthcare organizations operate. Implementing a governance, risk, and compliance (GRC) model can help healthcare leaders deliver performance and compliance and enable enterprise resilience. Implementing GRC effectively requires a vision that's clearly supported by the management team.

  19. Work motivation among healthcare professionals.

    Science.gov (United States)

    Kjellström, Sofia; Avby, Gunilla; Areskoug-Josefsson, Kristina; Andersson Gäre, Boel; Andersson Bäck, Monica

    2017-06-19

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

  20. The Current Reforms Of The Labour Markets And Of The Related Social Policies At European Union Level – Are They The Best Solutions To Solve The Problems Which Appeared During The Crisis?

    Directory of Open Access Journals (Sweden)

    Alina Georgeta AILINCĂ

    2012-06-01

    Full Text Available The global economic and financial crisis seems to have unfortunate residual effects materialised in the increase of the budget deficits and of the public debt within the European Union, situation observed mostly in the old member states. Among the major effects of the crisis we can notice more serious fiscal-budgetary problems, as well as social and labour market problems, with a strong impact on the restoration of the present and future macroeconomic balance. Actually, the measures meant to restore the public finances on their floating line, thus ensuring the fiscal-budgetary sustainability, were the starting line for the economic and social reforms, which many times had rather adverse effects than beneficial effects on the analysed economies. In this paper we will present the measures proposed by the governments of some EU (European Union countries for the labour market, health systems, education and social protection, highlighting the criticisable aspects, such as the lack of concrete results of the employment programs and of the social policies aiming to ameliorate and compensate the effects of population ageing.

  1. Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control.

    Science.gov (United States)

    Magiorakos, A P; Burns, K; Rodríguez Baño, J; Borg, M; Daikos, G; Dumpis, U; Lucet, J C; Moro, M L; Tacconelli, E; Simonsen, G Skov; Szilágyi, E; Voss, A; Weber, J T

    2017-01-01

    Infections with carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are "at-risk" may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E).The purpose of this guidance is to raise awareness and identify the "at-risk" patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE. The guidance was created by a group of experts who were functioning independently of their organisations, during two meetings hosted by the European Centre for Disease Prevention and Control. A list of epidemiological risk factors placing patients "at-risk" for carriage with CRE was created by the experts. The conclusions of a systematic review on the prevention of spread of CRE, with the addition of expert opinion, were used to construct lists of core and supplemental infection prevention and control measures to be implemented for "at-risk" patients upon admission to healthcare settings. Individuals with the following profile are "at-risk" for carriage of CRE: a) a history of an overnight stay in a healthcare setting in the last 12 months, b) dialysis-dependent or cancer chemotherapy in the last 12 months, c) known previous carriage of CRE in the last 12 months and d) epidemiological linkage to a known carrier of a CRE.Core infection prevention and control measures that should be considered for all patients in healthcare settings were compiled. Preliminary supplemental measures to be implemented for "at-risk" patients on admission are: pre-emptive isolation, active screening for CRE, and contact precautions. Patients who are confirmed positive for CRE will need additional supplemental measures. Strengthening the microbiological capacity, surveillance and reporting of new cases of CRE in healthcare settings and countries

  2. Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control

    Directory of Open Access Journals (Sweden)

    A. P. Magiorakos

    2017-11-01

    Full Text Available Abstract Background Infections with carbapenem-resistant Enterobacteriaceae (CRE are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are “at-risk” may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E. The purpose of this guidance is to raise awareness and identify the “at-risk” patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE. Methods The guidance was created by a group of experts who were functioning independently of their organisations, during two meetings hosted by the European Centre for Disease Prevention and Control. A list of epidemiological risk factors placing patients “at-risk” for carriage with CRE was created by the experts. The conclusions of a systematic review on the prevention of spread of CRE, with the addition of expert opinion, were used to construct lists of core and supplemental infection prevention and control measures to be implemented for “at-risk” patients upon admission to healthcare settings. Results Individuals with the following profile are “at-risk” for carriage of CRE: a a history of an overnight stay in a healthcare setting in the last 12 months, b dialysis-dependent or cancer chemotherapy in the last 12 months, c known previous carriage of CRE in the last 12 months and d epidemiological linkage to a known carrier of a CRE. Core infection prevention and control measures that should be considered for all patients in healthcare settings were compiled. Preliminary supplemental measures to be implemented for “at-risk” patients on admission are: pre-emptive isolation, active screening for CRE, and contact precautions. Patients who are confirmed positive for CRE will need additional supplemental measures. Conclusions Strengthening the microbiological

  3. National Healthcare Reform: Implications for the Military Healthcare System

    Science.gov (United States)

    2010-05-16

    Education of the Middle State Association of Colleges and Schools , 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher...Higher Education of the Middle States Association of Colleges and Schools , 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission...the Lead in Paperless Care,‖ Washington Post, April 10, 2007, p 4. These and other studies suggest that the health care cost per patient or

  4. Environmental fiscal reforms

    Directory of Open Access Journals (Sweden)

    Ashish Chaturvedi

    2014-09-01

    Full Text Available The paper presents concepts and instruments of environmental fiscal reforms (EFR and their application in the Indian context. EFR can lead to environmental improvement more efficiently and cost effectively than traditional regulation. There is substantial experience of successful EFR implementation in the European Union. India has also adopted some EFR measures such as deregulation of petrol prices, coal cess, and subsidy for setting up common effluent treatment plants. The challenges of implementing EFR measures in India are also discussed, including inadequate analysis, policy framework and institutional capacity, as well as conflict with poverty reduction and building political support.

  5. Slab reformer

    Science.gov (United States)

    Spurrier, Francis R.; DeZubay, Egon A.; Murray, Alexander P.; Vidt, Edward J.

    1984-02-07

    Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot comubstion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.

  6. Global Citizenship and National (Re)formations: Analysis of Citizenship Education Reform in Spain

    Science.gov (United States)

    Engel, Laura C.

    2014-01-01

    In recent years, many European education systems have embarked on a process of education policy and curriculum reform related to citizenship education. This article explores citizenship education reform in the context of Spain. It considers how and to what extent Spain's 2006 citizenship education addressed issues of national and global…

  7. Healthcare 2025 : buildings for the future

    NARCIS (Netherlands)

    2008-01-01

    Healthcare in Europe is changing. Many countries are introducing reforms, and creating more competition and an open healthcare market. Product pricing is becoming normal; in some cases, such as the Netherlands, capital costs are becoming a component of charges. Experiments with public/private

  8. Financial re-regulation at a crossroads: How the European experience strengthens the case for a radical reform built on Minsky’s approach

    Directory of Open Access Journals (Sweden)

    Elisabetta Montanaro

    2012-12-01

    Full Text Available The current financial and sovereign crisis is pushing European politicians and EU bureaucrats to devise new institutional and policy solutions. However, the new EU institutional framework and stricter regulatory requirements do not introduce significant changes in the laissez-faire nature of the regulatory approach. Our opinion is that the entire re-regulation process does not go to the roots of how financial fragility endogenously accumulates, and how finally it produces a crisis each time starting from the weakest part of the financial system. Analysing the European banking sectors from this perspective, we show how domestic specificities add to the limits due to risk-based regulation and supervision. We then build on Minsky’s regulatory proposals to present the skeleton of a simple alternative to the existing regulatory approach.

  9. Reforming Catalysts

    Directory of Open Access Journals (Sweden)

    Simon Penner

    2017-11-01

    Full Text Available Steam and dry reforming of hydrocarbons (e.g., methane, ethane or propane, alcohols (e.g., methanol, ethanol or glycerol or bio-compounds is one of the most promising and effective routes to enhanced hydrogen production and for the production of synthesis gas likewise.[...

  10. Healthcare service delivery: a literature review

    CSIR Research Space (South Africa)

    Arhete, LE

    2016-05-01

    Full Text Available . These features can be traced back to the days in South African history where healthcare facilities were racially segregated and both curative and preventive healthcare services were separated by the Public Health Amendment act of 1897 (Coovadia et al. 2009... was greeted with enormous reform measures to redress the discrimination, disempowerment, underdevelopment and ill-health service delivery that had greatly weakened the healthcare system. Although the government has implemented bold initiatives to strengthen...

  11. Healthcare mergers and acquisitions: strategies for consolidation.

    Science.gov (United States)

    Zuckerman, Alan M

    2011-01-01

    The passage of federal healthcare reform legislation, in combination with other factors, makes it likely that the next few years will be a major period of consolidation for healthcare organizations. This article examines the seven key forces reshaping healthcare delivery--from insurance industry consolidation to cost inflation to the increasing gap between financially strong and struggling providers--and provides advice for organizations on both sides of an acquisition.

  12. Burden of Six Healthcare-Associated Infections on European Population Health : Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study

    NARCIS (Netherlands)

    Cassini, Alessandro; Plachouras, Diamantis; Eckmanns, Tim; Abu Sin, Muna; Blank, Hans-Peter; Ducomble, Tanja; Haller, Sebastian; Harder, Thomas; Klingeberg, Anja; Sixtensson, Madlen; Velasco, Edward; Weiß, Bettina; Kramarz, Piotr; Monnet, Dominique L; Kretzschmar, Mirjam|info:eu-repo/dai/nl/075187981; Suetens, Carl

    2016-01-01

    BACKGROUND: Estimating the burden of healthcare-associated infections (HAIs) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of

  13. Undergraduate nursing education reform in France: from vocational to academic programmes.

    Science.gov (United States)

    Debout, C; Chevallier-Darchen, F; Petit dit Dariel, O; Rothan-Tondeur, M

    2012-12-01

    France is currently implementing a number of reforms to the healthcare and education systems. Within this context, a comprehensive reform of undergraduate nurse education was launched in 2009, bringing nurse education closer to the higher education environment. It is likely in future to move from being vocational towards becoming an academic educational programme. In this paper, the 2009 reform of the French pre-registration nursing curriculum will be analysed in light of the European framework. The pedagogical approach, methods and content of nursing education in France are undergoing an in-depth reorganization. The main innovation that the reforms introduce is a competency-based approach. France is joining the group of countries that require first degree-level entry to the nursing profession. There are still many unanswered questions regarding the competencies and qualifications required by both the academic and clinical educators many of whom have not been previously involved in research or publications. The future status of nursing science is unclear, as is the way in which the nursing profession will be able to retain control over its educational mechanisms. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

  14. Healthcare is primary.

    Science.gov (United States)

    Kumar, Raman

    2015-01-01

    India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2(nd) National Conference on Family Medicine and Primary Care 2015 (FMPC) brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care), the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  15. Healthcare is primary

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2015-01-01

    Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  16. Prevalence of healthcare-associated infections in Polish adult intensive care units: summary data from the ECDC European Point Prevalence Survey of Hospital-associated Infections and Antimicrobial Use in Poland 2012-2014.

    Science.gov (United States)

    Deptuła, A; Trejnowska, E; Dubiel, G; Żukowski, M; Misiewska-Kaczur, A; Ozorowski, T; Hryniewicz, W

    2017-06-01

    Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals. From this initial database, data for adult ICU patients (N=945) were filtered for further analyses. HAIs were present in 370 patients (39%) and 430 HAI episodes were recorded. The most common HAIs were respiratory tract infections (45%), usually caused by Enterobacteriaceae and Gram-negative non-fermenters. The majority (87%) of these infections were likely to be device associated. Out of 61 cases of bloodstream infection, 51% were catheter associated. These bloodstream infections were mainly caused by coagulase-negative staphylococci. Among 57 cases of surgical site infection, 42% were classified as organ/space, 33% were classified as deep incisional, and 25% were classified as superficial. The predominant micro-organisms were Enterobacteriaceae and Staphylococcus aureus. Out of 50 cases of urinary tract infection, 96% were device associated. The prevalence of HAI among Polish adult ICU patients is higher than described in similar studies, but may be partially affected by methodological differences. The proportion of device-associated infections was very high, so there is an urgent need to introduce countrywide, targeted surveillance and prevention programmes. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. Arbitration Reform

    Directory of Open Access Journals (Sweden)

    Svetlana Stepurina

    2017-01-01

    Full Text Available УДК 347.73:341.63Subject. This informational article highlights recent changes to the Russian legislation on arbitration.Purpose. To highlight the most important aspects of arbitration law reform, and examines the effects they will have on the development of arbitration in RussiaMethodology. The author uses a formal-legal method.Results, scope of application. The author distinguishes the difference between constantly acting arbitration courts and arbitration courts ad hoc. The special status of a number of arbitration institutions (the ICAC and MAC at the Russian Chamber of Commerce and Industry, is contrary to the constitutional principle of equality under the law. A major achievement of the new legislation on arbitration courts is expanding the range arbitrarily disputes.Conclusions. The new legislation more clearly prescribed the interaction of arbitration and state courts, including requiring the latter to promote the arbitrators, acting under the regulations of the permanent arbitration institutions in obtaining evidence.In addition, the reform of the arbitration law have left aside the problem of improving the quality of judicial control over arbitration decisions.The arbitration law will still be able to improve the arbitration, to enhance its credibility and attractiveness for the participants of civil turnover.

  18. Healthcare information technology and economics.

    Science.gov (United States)

    Payne, Thomas H; Bates, David W; Berner, Eta S; Bernstam, Elmer V; Covvey, H Dominic; Frisse, Mark E; Graf, Thomas; Greenes, Robert A; Hoffer, Edward P; Kuperman, Gil; Lehmann, Harold P; Liang, Louise; Middleton, Blackford; Omenn, Gilbert S; Ozbolt, Judy

    2013-01-01

    At the 2011 American College of Medical Informatics (ACMI) Winter Symposium we studied the overlap between health IT and economics and what leading healthcare delivery organizations are achieving today using IT that might offer paths for the nation to follow for using health IT in healthcare reform. We recognized that health IT by itself can improve health value, but its main contribution to health value may be that it can make possible new care delivery models to achieve much larger value. Health IT is a critically important enabler to fundamental healthcare system changes that may be a way out of our current, severe problem of rising costs and national deficit. We review the current state of healthcare costs, federal health IT stimulus programs, and experiences of several leading organizations, and offer a model for how health IT fits into our health economic future.

  19. European Banking Union

    OpenAIRE

    Breuss, Fritz

    2013-01-01

    The ongoing Euro crisis and the worse economic development in Europe than in the USA are grounded, not the least in the delayed implementation of reforms of the banking sector. Whereas the leaks in economic governance of EMU have been fixed the banking sector is still not stabilised, even five years after Lehman Brothers. From the grand solution of a "European Banking Union" (EBU) only the first pillar, the European Bank Supervision with the single supervisory mechanism (SSM) will come into e...

  20. Mobile healthcare.

    Science.gov (United States)

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

    Mobile technology's presence in healthcare has exploded over the past five years. The increased use of mobile devices by all segments of the US population has driven healthcare systems, providers, and payers to accept this new form of communication and to develop strategies to implement and leverage the use of mobile healthcare (mHealth) within their organizations and practices. As healthcare systems move toward a more value-driven model of care, patient centeredness and engagement are the keys to success. Mobile healthcare will provide the medium to allow patients to participate more in their care. Financially, mHealth brings to providers the ability to improve efficiency and deliver savings to both them and the healthcare consumer. However, mHealth is not without challenges. Healthcare IT departments have been reluctant to embrace this shift in technology without fully addressing security and privacy concerns. Providers have been hesitant to adopt mHealth as a form of communication with patients because it breaks with traditional models. Our healthcare system has just started the journey toward the development of mHealth. We offer an overview of the mobile healthcare environment and our approach to solving the challenges it brings to healthcare organizations.

  1. Steepest Ascent Tariff Reform

    DEFF Research Database (Denmark)

    Raimondos-Møller, Pascalis; Woodland, Alan

    2014-01-01

    The policy reform literature is primarily concerned with the construction of reforms that yield welfare gains. By contrast, this paper’s contribution is to develop a theoretical concept for which the focus is upon the sizes of welfare gains accruing from policy reforms rather than upon their signs....... In undertaking this task, and by focusing on tariff reforms, we introduce the concept of a steepest ascent policy reform, which is a locally optimal reform in the sense that it achieves the highest marginal gain in utility of any feasible local reform. We argue that this reform presents itself as a natural...... benchmark for the evaluation of the welfare effectiveness of other popular tariff reforms such as the proportional tariff reduction and the concertina rules, since it provides the maximal welfare gain of all possible local reforms. We derive properties of the steepest ascent tariff reform, construct...

  2. Getting European universities into shape

    NARCIS (Netherlands)

    Jacobs, B.; van der Ploeg, F.

    2006-01-01

    Most European universities lag behind the best universities in the Anglo-Saxon world. A key challenge is to raise resources per student in Europe to US levels. The Lisbon agenda demands fundamental reform of the European university system in order to enhance efficiency, yet avoid grade inflation, to

  3. Reforming Again: Now Teachers

    Science.gov (United States)

    Marx, Ronald W.

    2014-01-01

    Background: Educational reform responds to local and national pressures to improve educational outcomes, and reform efforts cycle as similar pressures recur. Currently, reform efforts focus on teachers, even though confidence in a host of American social institutions is dropping. One of the most widespread reforms regarding teachers is the…

  4. Reforming America's health system through innovation and entrepreneurship.

    Science.gov (United States)

    Reece, Richard L

    2005-01-01

    America's attempts for healthcare reform are gridlocked. Healthcare special interests are reluctant to abandon profitable activities, and American culture-distrust of centralized federal power, belief in self-improvement, desire for choice, and belief in equal access to medical technologies-is slow to change. Physician entrepreneurship and innovation, coupled with consumer-driven healthcare and public-private partnerships, may break the present gridlock.

  5. Mutuality and solidarity in healthcare in South Africa | McLeod ...

    African Journals Online (AJOL)

    This paper uses Wilkie's definitions of mutuality and solidarity to review the history of private healthcare in South Africa. The vision for a future unified national healthcare system is given and the phases of reform are outlined. The first phase of reforms has been completed and these are contextualised in terms of a return to ...

  6. Analyzing the Romanian Healthcare Bureaucracy Using a Tree Diagram

    Directory of Open Access Journals (Sweden)

    Ruxandra Dinulescu

    2016-01-01

    Our paper tries to analyze the main problem, along with its root causes, in order to proposeviable solutions that could be adopted so our healthcare system could be among the otherEuropean healthcare systems.

  7. Tax reform Ukraine: implementation mechanisms and consequences

    Directory of Open Access Journals (Sweden)

    J.Lebedzevіch

    2015-06-01

    Full Text Available In the article the main shortcomings of the existing domestic tax systems, which were the main reasons for the need for its reform in the context of integration into the European Community. Determined the first stage of reforming tax systems Ukraine, which is associated with the adoption of the Law of Ukraine «On Amendments to the Tax Code of Ukraine and laws of Ukraine». The main provisions of this legal act, revealing the essence of the mechanism for implementing tax reform. Analyzed the mechanism of implementation of tax reform by analyzing the major innovations of the Tax Code of Ukraine and their comparison with the tax «standards» that operated the implementation of tax reform 2015. Thesis there is determined a number of tax loopholes and nedoopratsyuvan conducted tax reform and their implications for payers of taxes and duties, and the need for further research and improvement. The experience of European countries towards the introduction of electronic filing and processing of tax returns.

  8. Citizen participation and discontent in three Southern European health systems.

    Science.gov (United States)

    Serapioni, Mauro; Matos, Ana Raquel

    2014-12-01

    Participation has featured in political agendas in recent decades and the domain of healthcare has not been indifferent to its appeal. Although emerging later than in other European regions, the involvement of civil society in healthcare decision-making procedures has proved one of the biggest challenges facing Southern European health systems. The health systems of the countries considered in this analysis - Italy, Portugal and Spain - underwent reforms that brought citizen participation to the forefront of the health system. Through national laws or health plans, each of these countries has recognised the need to promote participation in order to 'give a voice' to citizens in the health sector. Accordingly, a range of significant activities have been implemented in the region, although they have been developed unequally within national territories, at different paces and involving the mobilisation of different actors. This article focuses on the most relevant experiences of citizen participation designed and implemented in the three selected countries, describing their key features and potential, as well as the main critical issues and contradictions that have emerged over time. Particular emphasis is given to the impact of the current financial crisis on Southern European national health systems, especially in terms of participatory methods, the way in which citizen participation is progressing and civil society's reaction to these important changes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Results of the market-oriented reform in the Netherlands: a review

    NARCIS (Netherlands)

    Maarse, H.; Jeurissen, P.P.T.; Ruwaard, D.

    2016-01-01

    The market-oriented reform in the Dutch health care system is now in its 10th year. This article offers a concise overview of some of its effects thus far on health insurance, healthcare purchasing and healthcare provision. Furthermore, attention is given to its impact on healthcare expenditures,

  10. Hydrodeoxygenation of bio-oils from Thermo-Catalytic Reforming - high energy efficient route to renewable gasoline and diesel: Paper presented at 24th European Biomass Conference and Exhibition, EUBCE 2016, Amsterdam, 6-9 June 2016

    OpenAIRE

    Neumann, Johannes; Hornung, Andreas; Schmitt, Nina; Jäger, Nils; Conti, Roberto; Apfelbacher, Andreas; Daschner, Robert

    2016-01-01

    The agricultural production of energy crops is in competition to food production and discussed controversial. Therefore the academic and commercial research is focused on waste or residual biomass. A promising conversion technology for the production of high quality bio-oil, syngas and biochar from residual biomass is the Thermo-Catalytic Reforming process (TCR®); intermediate pyrolysis and integrated reforming. With an additional focus on biofuels for transportation, the downstream processin...

  11. Health insurance coverage, income distribution and healthcare quality in local healthcare markets.

    Science.gov (United States)

    Damianov, Damian S; Pagán, José A

    2013-08-01

    We develop a theoretical model of a local healthcare system in which consumers, health insurance companies, and healthcare providers interact with each other in markets for health insurance and healthcare services. When income and health status are heterogeneous, and healthcare quality is associated with fixed costs, the market equilibrium level of healthcare quality will be underprovided. Thus, healthcare reform provisions and proposals to cover the uninsured can be interpreted as an attempt to correct this market failure. We illustrate with a numerical example that if consumers at the local level clearly understand the linkages between health insurance coverage and the quality of local healthcare services, health insurance coverage proposals are more likely to enjoy public support. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Drug pricing reform in China: analysis of piloted approaches and potential impact of the reform.

    Science.gov (United States)

    Chen, Yixi; Hu, Shanlian; Dong, Peng; Kornfeld, Åsa; Jaros, Patrycja; Yan, Jing; Ma, Fangfang; Toumi, Mondher

    2016-01-01

    In 2009, the Chinese government launched a national healthcare reform programme aiming to control healthcare expenditure and increase the quality of care. As part of this programme, a new drug pricing reform was initiated on 1 June 2015. The objective of this study was to describe the changing landscape of drug pricing policy in China and analyse the potential impact of the reform. The authors conducted thorough research on the drug pricing reform using three Chinese databases (CNKI, Wanfang, and Weipu), Chinese health authority websites, relevant press releases, and pharmaceutical blogs and discussion forums. This research was complemented with qualitative research based on targeted interviews with key Chinese opinion leaders representing the authorities' and prescribers' perspectives. With the current reform, the government has attempted to replace its direct control over the prices of reimbursable drugs with indirect, incentive-driven influence. Although the exact implementation of the reform remains unclear at the moment, the changes introduced so far and the pilot project designs indicate that China is considering adaptation of some form of internal and external reference pricing policies, commonly used in the Organisation for Economic Co-operation and Development countries. Several challenges related to the potential new mechanism were identified: 1) the risk of hospital underfunding, if hospital funding reform is not prioritised; 2) the risk of promoting the use of cheap, low-quality drugs, if a reliable quality control system is not in place and discrepancy between the available drugs is present; 3) the risk of increasing disparity in access to care between poor and rich regions, in case of country-wide price convergence; and 4) the risk of industry underinvestment, resulting in reduced competition, issues with quality and sustainability of supply, and potentially negative social impact. Foreign pricing policies cannot be transferred to China without

  13. 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.

  14. Relations between professional medical associations and the health-care industry, concerning scientific communication and continuing medical education: a policy statement from the European Society of Cardiology.

    Science.gov (United States)

    2012-06-01

    Physicians have an ethical duty to keep up-to-date with current knowledge. Professional medical associations such as the European Society of Cardiology (ESC) support these obligations. In Europe, the costs of continuing medical education (CME) are insufficiently supported from governments and employers; however, medical associations have been criticized for accepting alternative financial support from industry. Medical education and training in research include learning how to assess the quality and reliability of any information. There is some risk of bias in any form of scientific communication including intellectual, professional, and financial and it is essential that in particular, the latter must be acknowledged by full disclosure. It is essential that there is strong collaboration between basic and clinical researchers from academic institutions on the one hand, with engineers and scientists from the research divisions of device and pharmaceutical companies on the other. This is vital so that new diagnostic methods and treatments are developed. Promotion of advances by industry may accelerate their implementation into clinical practice. Universities now frequently exhort their academic staff to protect their intellectual property or commercialize their research. Thus, it is not commercial activity or links per se that have become the target for criticism but the perceived influence of commercial enterprises on clinical decision-making or on messages conveyed by professional medical organizations. This document offers the perspective of the ESC on the current debate, and it recommends how to minimize bias in scientific communications and CME and how to ensure proper ethical standards and transparency in relations between the medical profession and industry.

  15. Relations between professional medical associations and healthcare industry, concerning scientific communication and continuing medical education: a policy statement from the European Society of Cardiology.

    Science.gov (United States)

    2012-01-01

    Physicians have an ethical duty to keep up-to-date with current knowledge. Professional medical associations such as the European Society of Cardiology (ESC) support these obligations. In Europe, the costs of continuing medical education (CME) are insufficiently supported from governments and employers; however, medical associations have been criticized for accepting alternative financial support from industry. Medical education and training in research include learning how to assess the quality and reliability of any information. There is some risk of bias in any form of scientific communication including intellectual, professional, and financial and it is essential that in particular, the latter must be acknowledged by full disclosure. It is essential that there is strong collaboration between basic and clinical researchers from academic institutions on the one hand, with engineers and scientists from the research divisions of device and pharmaceutical companies on the other. This is vital so that new diagnostic methods and treatments are developed. Promotion of advances by industry may accelerate their implementation into clinical practice. Universities now frequently exhort their academic staff to protect their intellectual property or commercialize their research. Thus, it is not commercial activity or links per se that have become the target for criticism but the perceived influence of commercial enterprises on clinical decision-making or on messages conveyed by professional medical organizations. This document offers the perspective of the ESC on the current debate, and it recommends how to minimize bias in scientific communications and CME and how to ensure proper ethical standards and transparency in relations between the medical profession and industry. Copyright © 2012. Published by Elsevier España.

  16. Time for TIGER to ROAR! Technology Informatics Guiding Education Reform.

    Science.gov (United States)

    O'Connor, Siobhan; Hubner, Ursula; Shaw, Toria; Blake, Rachelle; Ball, Marion

    2017-11-01

    Information Technology (IT) continues to evolve and develop with electronic devices and systems becoming integral to healthcare in every country. This has led to an urgent need for all professions working in healthcare to be knowledgeable and skilled in informatics. The Technology Informatics Guiding Education Reform (TIGER) Initiative was established in 2006 in the United States to develop key areas of informatics in nursing. One of these was to integrate informatics competencies into nursing curricula and life-long learning. In 2009, TIGER developed an informatics competency framework which outlines numerous IT competencies required for professional practice and this work helped increase the emphasis of informatics in nursing education standards in the United States. In 2012, TIGER expanded to the international community to help synthesise informatics competencies for nurses and pool educational resources in health IT. This transition led to a new interprofessional, interdisciplinary approach, as health informatics education needs to expand to other clinical fields and beyond. In tandem, a European Union (EU) - United States (US) Collaboration on eHealth began a strand of work which focuses on developing the IT skills of the health workforce to ensure technology can be adopted and applied in healthcare. One initiative within this is the EU*US eHealth Work Project, which started in 2016 and is mapping the current structure and gaps in health IT skills and training needs globally. It aims to increase educational opportunities by developing a model for open and scalable access to eHealth training programmes. With this renewed initiative to incorporate informatics into the education and training of nurses and other health professionals globally, it is time for educators, researchers, practitioners and policy makers to join in and ROAR with TIGER. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Health care reform: preparing the psychology workforce.

    Science.gov (United States)

    Rozensky, Ronald H

    2012-03-01

    This article is based on the opening presentation by the author to the Association of Psychologists in Academic Health Centers' 5th National Conference, "Preparing Psychologists for a Rapidly Changing Healthcare Environment" held in March, 2011. Reviewing the patient protection and affordable care act (ACA), that presentation was designed to set the stage for several days of symposia and discussions anticipating upcoming changes to the healthcare system. This article reviews the ACA; general trends that have impacted healthcare reform; the implications of the Act for psychology's workforce including the growing focus on interprofessional education, training, and practice, challenges to address in order to prepare for psychology's future; and recommendations for advocating for psychology's future as a healthcare profession.

  18. Failure of the Croatian Higher Education Reform

    Directory of Open Access Journals (Sweden)

    Zoran Kurelić

    2012-01-01

    Full Text Available The authors analyse the reasons for Croatian higher education reformsince 2003, as well as its consequences. The main proposition of the paper is that the implementation of the Bologna Process in Croatia has failed due to a fundamental misunderstanding of the goals of the process, a lack of correspondence between the cycles of higher education and the European Qualifications Framework, and a lack of international pressure, resulting from the nature of the open method of coordination. The authors present the internal market rules of the European Union and how they affect the national regulation of higher education. The paper deals with the main characteristics of the higher education reform and how it has affected the structure of higher education programmes, the comparability of degrees and qualifications, and student mobility. The authors propose an agendafor a “reform of the reform” that could bring the Croatian system of higher education back onto the European track.

  19. The European Model Company Act

    DEFF Research Database (Denmark)

    Cleff, Evelyne Beatrix

    2011-01-01

    European Company Law regulation is currently undergoing a reform. These reforms raise a number of regulatory questions, such as what should be the aims of companies' legislation, and how these aims should best be met by regulation. Many of the reforms and discussions (both on EU and national level......) on the organisation of company laws reflect an interesting paradigm shift. Whereas, previously company law was primarily focused on preventing abuse, there is now a trend towards legislation that promote commerce and satisfy the needs of business. This means that the goal of economic efficiency is having...... an increasing influence on the framing of company legislation, such as the choice between mandatory or default rules. This article introduces the project 'European Company Law and the choice of Regulatory Method' which is carried out in collaboration with the 'European Model Company Act Group'. The project aims...

  20. Anchors for Education Reforms

    Science.gov (United States)

    Alok, Kumar

    2012-01-01

    Education reforms, considering their significance, deserve better methods than mere "trial and error." This article conceptualizes a network of six anchors for education reforms: education policy, education system, curriculum, pedagogy, assessment, and teacher education. It establishes the futility to reform anchors in isolation and…

  1. Reforming Special Education.

    Science.gov (United States)

    Fishkin, Anne S.; Sullivan, Michael

    This paper describes education reform as an integrated effort to modify not only the structure and elements of the education system but also the culture or belief structure of that system. Central to any discussion of school reform are the elements of restructuring, empowerment, and change. Current reform efforts in restructuring revolve around a…

  2. The potential advantages and disadvantages of introducing interprofessional education into the healthcare curricula in Spain.

    Science.gov (United States)

    Pumar Méndez, María J; Armayor, Navidad Canga; Díaz Navarlaz, María Teresa; Wakefield, Ann

    2008-04-01

    The complexity of contemporary clinical practice demands that increasingly skilled high quality health and social care is provided to individuals. However, the failure of health and social care professionals to work collaboratively has been widely reported in the international literature. Hence, interprofessional education has been suggested as a means of improving both interprofessional understanding and respect across a diverse range of practice disciplines. In this way, functional barriers can be challenged or broken down; teamwork enhanced and healthcare outcomes improved. Lack of conclusive evidence to substantiate the above healthcare benefits has been attributed to weak methodological approaches when evaluating such educational initiatives. In Spain barriers to implementing interprofessional education are potentially less challenging. Recent legislative demands following the Bologna Agreement on European Higher Education is compelling Spanish higher education institutes to engage in radical educational reforms. Consequently, this paper examines some of the advantages and disadvantages of introducing interprofessional education into health and social care curricula in Spain to see when and how interprofessional initiatives might be assimilated into the health care curricula. In this way lessons learned from a thorough review of the relevant literature might help to inform such educational reforms across mainland Europe and beyond.

  3. Healthcare Fraud Investigations

    Directory of Open Access Journals (Sweden)

    Adrian Victor Vevera

    2015-12-01

    Full Text Available Tax healthcare fraud and tax evasion affects us all. It occurs within a country and across countries both within the EU,USA and globally. That is why a single country cannot solve the problem on its own. The EU and Member States need to work more together and internationally to combat the problem at home and abroad. Open dialogue involving the European Commission, stakeholders and interested parties helps ensure that existing rules and proposals for new rules are designed to keep pace with the reality of rapid change. This dialogue helps to achieve the regulatory efficiency we need to foster best administrative and legislative practice tailored to meet the needs of business in the European Union in the third millennium

  4. Steepest Ascent Tariff Reforms

    DEFF Research Database (Denmark)

    Raimondos-Møller, Pascalis; Woodland, Alan D.

    2006-01-01

    a theoretical concept where the focus is upon the size of welfare gains accruing from tariff reforms rather than simply with the direction of welfare effects that has been the concern of theliterature.JEL code: F15.Keywords: Steepest ascent tariff reforms; piecemeal tariff policy; welfare; market access; small...... for the evaluation of the welfare effectiveness of other well known tariff reform rules, as e.g. the proportional and the concertina rules. We develop the properties of this tariff reform, characterize the sources of the potential welfare gains from tariff reform, use it to establish conditions under which some...... existing reforms are locally optimal, provide geometric illustrations and compare welfare effectiveness of reforms using numerical examples. Moreover, being a general concept, we apply it to the issue of market access and examine its implications. Overall, the paper's contribution lies in presenting...

  5. Health Reform and the Obama Administration: Reflections in Mid-2010

    Science.gov (United States)

    Marmor, Theodore R.

    2010-01-01

    The reforms that finally emerged from the Obama administration's initiative were the result of a year of nasty, demagogic and misleading claims in the US public forum, coupled with the complexities of crafting legislation that stood a chance of passing both the House of Representatives and the Senate. The resulting “hybrid” approach to healthcare reform produced a conservative strategy that ignores the experience of other wealthy democracies. More significantly, its long period of implementation, given a possible change of administration in 2012, increases uncertainty regarding whether and how reforms will be rolled out by 2014 and after. PMID:21804835

  6. Payment systems and incentives in primary care: implications of recent reforms in Estonia and Romania.

    Science.gov (United States)

    Dan, Sorin; Savi, Riin

    2015-01-01

    Since the early 1990s, major reform in healthcare has been adopted in former communist countries in Central and Eastern Europe. More than 20 years after, reform in healthcare still draws much interest from policy makers and academics alike. One of the dynamic components of reform has been the reform of payment systems in primary care. This article looks at recent developments in payment systems and financial incentives in Estonia and Romania. We conclude that finding the appropriate mix in paying and incentivizing primary care providers in a transitional context is no easy solution for healthcare policy makers who need to carefully weigh in the advantages and inherent problems of various payment arrangements. In a transitional, rapidly changing healthcare system and society, and a context of financial stringency, the theoretical effects of payment mechanisms may be more difficult to predict and manage than it is expected. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Local Public Administration Reform. The Romanian Case

    Directory of Open Access Journals (Sweden)

    Tudorel Andrei

    2006-02-01

    Full Text Available The existence of an efficient and democratic administration is one of the main criteria of defining the modernity of a country. At this moment, Romania has not such an administration. That is why a major priority of Romania is to achieve, in a few years, a real reform through which the public administration in our country to achieve the European standards and to be defined by transparency, predictability, responsability, adaptability and effectiveness. As a fact, this is a profound reform. It is obvious that, in order to be successful, this reform cannot be performed exclusively through the effort and political will of more Governments. A joint and structural effort at the level of the entire society is necessary.

  8. Local Public Administration Reform. The Romanian Case

    Directory of Open Access Journals (Sweden)

    Marius Profiroiu

    2006-04-01

    Full Text Available The existence of an efficient and democratic administration is one of the main criteria of defining the modernity of a country. At this moment, Romania has not such an administration. That is why a major priority of Romania is to achieve, in a few years, a real reform through which the public administration in our country to achieve the European standards and to be defined by transparency, predictability, responsability, adaptability and effectiveness. As a fact, this is a profound reform. It is obvious that, in order to be successful, this reform cannot be performed exclusively through the effort and political will of more Governments. A joint and structural effort at the level of the entire society is necessary.

  9. Demonstration of direct internal reforming for MCFC power plants

    Energy Technology Data Exchange (ETDEWEB)

    Aasberg-Petersen, K.; Christensen, P.S.; Winther, S.K. [HALDOR TOPSOE A/S, Lynby (Denmark)] [and others

    1996-12-31

    The conversion of methane into hydrogen for an MCFC by steam reforming is accomplished either externally or internally in the stack. In the case of external reforming the plant electrical efficiency is 5% abs. lower mainly because more parasitic power is required for air compression for stack cooling. Furthermore, heat produced in the stack must be transferred to the external reformer to drive the endothermic steam reforming reaction giving a more complex plant lay-out. A more suitable and cost effective approach is to use internal steam reforming of methane. Internal reforming may be accomplished either by Indirect Internal Reforming (DIR) and Direct Internal Reforming (DIR) in series or by DIR-only as illustrated. To avoid carbon formation in the anode compartment higher hydrocarbons in the feedstock are converted into hydrogen, methane and carbon oxides by reaction with steam in ail adiabatic prereformer upstream the fuel cell stack. This paper discusses key elements of the desire of both types of internal reforming and presents data from pilot plants with a combined total of more than 10,000 operating hours. The project is being carried out as part of the activities of the European MCFC Consortium ARGE.

  10. Mental health reforms in Eastern Europe.

    Science.gov (United States)

    Tomov, T

    2001-01-01

    To describe the background in general culture, public and professional discourse against which mental health care reform initiatives in Eastern Europe need to be seen. An account of some key aspects of sociopolitical and cultural transition in Eastern European countries is given, and core results of a research project on attitudes and needs assessment in psychiatry in six Eastern European countries are reported. In post-totalitarian cultures mental health reforms impinge on imagination in ways which are not easy to predict. Some of the reasons for this are traced to the psychiatric practices under the system of total control, e.g. dispensary care, political abuse, reification of classificatory terms. Data on a study of attitudes suggest that institutions had replaced community life in those parts of Europe. It is predicted that with time trust in the capacity of community to contain mental illness will be regained.

  11. Lesotho - Land Administration Reform

    Data.gov (United States)

    Millennium Challenge Corporation — Michigan State University was assigned to design the impact evaluation (IE) of the Land Administration Reform Project (LARP) funded under the Millennium Challenge...

  12. Health care in China: improvement, challenges, and reform.

    Science.gov (United States)

    Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

    2013-02-01

    Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

  13. Reforma da Atenção Primária em Portugal em duplo movimento: unidades assistenciais autónomas de saúde familiar e gestão em agrupamentos de Centros de Saúde Primary Healthcare Reform in Portugal on two fronts: autonomous family healthcare units and management of groupings of Health Centers

    Directory of Open Access Journals (Sweden)

    Luis Pisco

    2011-06-01

    Full Text Available Analisa-se o processo de reforma da atenção primária à saúde (APS em Portugal de 2005 a abril de 2010, período em que a Missão para os Cuidados de Saúde Primários teve a responsabilidade de conduzir essa profunda reconfiguração da APS Portuguesa. Os principais objectivos da reforma foram: melhorar a acessibilidade, eficiência, qualidade e continuidade dos cuidados e aumentar a satisfação dos profissionais e cidadãos. Suas principais características são a adesão voluntária, trabalho em equipa, existência obrigatória de sistema de informação, pagamento por desempenho, contratualização e avaliação. A reconfiguração dos centros de saúde obedeceu a um duplo movimento: por um lado, formação de pequenas unidades funcionais autónomas, as Unidades de Saúde Familiar (USF, prestando serviços com proximidade e qualidade; por outro lado, a agregação de recursos e estruturas de gestão, os agrupamentos de Centros de Saúde (ACES visando a eficiência e economia de escala. As USF conseguiram simultaneamente mais eficiência, acessibilidade, melhor clima laboral, maior satisfação dos cidadãos, numa palavra, mais qualidade. Salienta-se a importância de um forte apoio político, da criação de uma estrutura responsável pelo desenho e implementação da reforma e de uma boa comunicação social.In 2005, Portugal began a reform of Primary Health Care. This reform process through to April 2010 is described and analyzed. During this period the Mission for Primary Health Care was responsible for conducting a profound reconfiguration. The main objectives for this reform were to improve accessibility, efficiency, quality and continuity of care and increase the satisfaction of professionals and citizens. The main features are voluntary adhesion, teamwork, mandatory information system, performance-sensitive payment, contracting and evaluation. The reconfiguration of health centers was two pronged. First, there was the formation

  14. International publication trends and collaboration performance of China in healthcare science and services research.

    Science.gov (United States)

    Chen, Kai; Yao, Qiang; Sun, Ju; He, Zhi-Fei; Yao, Lan; Liu, Zhi-Yong

    2016-01-01

    In recent years, China's healthcare reforms and related studies have drawn particular global attention. The main objective of this study is to evaluate quantitatively the publication trends and collaboration performance of China in healthcare science and services (HSS) research. Scientometric methods and visualization technology were used to survey the growth and development trends of HSS research based on the Web of Science publications during the past 15 years. China's international publications on HSS research increased rapidly compared to those of the global HSS and Chinese scientific studies. Growth trends indicate that collaboration among countries, institutions and authors has also increased. China's leading partners were all developed countries, such as the US, the UK, Australia and Canada, which have contributed to the majority of the joint publications. The academic impact of publications involving partners from European and American countries was relatively higher than those involving partners from Asian countries. Prominent institutions were universities that could be primarily classified into two groups, namely, Mainland China on the one hand and Hong Kong universities and foreign universities on the other. The most prominent actors were elite institutions, such as Peking University, Fudan University, Chinese University of Hong Kong, University of Hong Kong. The papers published by the Chinese Ministry of Health had relatively high academic impact, whereas those published by Mainland China universities alone had a lower academic impact compared to foreign cooperation papers. Issues related to the Chinese healthcare reform, priority diseases (e.g., breast cancer, HIV/AIDS, tuberculosis, etc.), health systems performance, quality of life and measurement tools, aging problems and research methods have been the most popular HSS topics in China in recent years. Despite the extensive achievement of the Chinese HSS reforms and research, gaps and challenges

  15. Contact Allergy in Danish Healthcare Workers

    DEFF Research Database (Denmark)

    Schwensen, Jakob F; Menné, Torkil; Sommerlund, Mette

    2015-01-01

    Contact dermatitis in healthcare workers is a pan-European problem. We conducted a retrospective observational study of the patch-test results of 1402 healthcare workers and 1402 matched controls with contact dermatitis who were treated at 3 hospitals departments in Denmark between 2007 and 2014....... The primary objective was to determine whether healthcare work was associated with contact allergy to thiuram mix. Unadjusted univariate analyses revealed that healthcare work was significantly associated with occupational contact dermatitis and hand dermatitis. Contact allergy to thiuram mix was more common...... in healthcare workers was significantly associated with having occupational contact dermatitis, hand dermatitis and older age. In conclusion, we report here a potential problem of contact allergy to thiurams in healthcare workers with contact dermatitis. Legislative authorities may in the future focus...

  16. Methods of responding to healthcare security incidents.

    Science.gov (United States)

    Furnell, S; Gritzalis, D; Katsikas, S; Mavroudakis, K; Sanders, P; Warren, M

    1998-01-01

    This paper considers the increasing requirement for security in healthcare IT systems and, in particular, identifies the need for appropriate means by which healthcare establishments (HCEs) may respond to incidents. The main discussion focuses upon two significant initiatives that have been established in order to improve understanding and awareness of healthcare security issues. The first is the establishment of a dedicated Incident Reporting Scheme (IRS) for HCEs, enabling the level and types of security incidents faced within the healthcare community to be monitored and advice appropriately targeted. The second aspect presents a description of healthcare security World Wide Web service, which provides a comprehensive source of advice and guidance for establishments when trying to address and prevent IT security breaches. The discussion is based upon work that is currently being undertaken with the ISHTAR (Implementing Secure Healthcare Telematics Applications in Europe) project, as part of the Telematics Applications for Health programme of the European Commission.

  17. Perceived Impact of Health Sector Reform on Motivation of Health ...

    African Journals Online (AJOL)

    Background: Literature on the impact of health sector reform (HSR) on motivation of healthcare workers (HWs) and performance in health service provision in developing countries is still limited. Objective: To describe the impact of HSR on HW motivation and performance in providing quality health care in Tanzania.

  18. [Networks, disease management programs, GP coordinator: analysis of recent ambulatory reforms in Germany].

    Science.gov (United States)

    Giovanella, Ligia

    2011-01-01

    Strengthening the role of the general practitioner in the conduction and coordination of specialized, inpatient and social care to ensure the continuity is a trend observed in recent health reforms in European countries. In Germany, from the second half of the 1990s, driven by economic pressures, a specific legislation and initiatives of the providers themselves have developed new organizational structures and care models for the purpose of the integration of the health care system and the coordination of health care in the form of: physicians networks, practitioner coordinator model, diseases management programs and integrated care. From a literature review, document analysis, visits to services and interviews with key informants, this paper analyzes the dynamics of these organizational changes in the German outpatient sector. The mechanisms of integration and coordination proposed are examined, and the potential impacts on the efficiency and quality of new organizational arrangements are discussed. Also it is analyzed the reasons and interests involved that point out the obstacles to the implementation. It was observed the process of an incremental reform with a tendency of diversification of the healthcare panorama in Germany with the presence of integrated models of care and strengthening the role of general practitioners in the coordination of patient care.

  19. Connecting statewide health information technology strategy to payment reform.

    Science.gov (United States)

    Toussaint, John S; Queram, Christopher; Musser, Josephine W

    2011-03-01

    To develop an effective way to link statewide healthcare information technology strategy to payment reform. Investigation of what Wisconsin did to develop and publicly share provider performance data and then use those data to drive payment reform. We examine 2 statewide organizations (Wisconsin Collaborative for Healthcare Quality and Wisconsin Health Information Organization) and 1 integrated health system (ThedaCare) to evaluate how they pool data and use those data to measure provider performance. When aggregated data regarding health outcomes are shared, a clearer picture emerges of provider performance baselines and improvements with which payment models can be developed. Aggregating commercial and Medicare claims data will help states to better measure provider performance and to compare providers on quality and cost. The ability to compare performance using broad databases is necessary if the current payment system in the United States is to be reformed.

  20. Land Reform and Sustainable Development

    OpenAIRE

    Elizabeth Stanton; Peter Rosset; James Boyce

    2005-01-01

    Land reform, equitable distribution, economic development, environmental quality, land reform strategies, Brazil, Landless Workers’ Movement, East Asia, rural poverty, land productivity, sustainable agriculture, comparative advantage, small farms.

  1. Multicultural healthcare: a transatlantic project.

    Science.gov (United States)

    Koskinen, Liisa; Jokinen, Pirkko

    2007-01-01

    Healthcare is increasingly multicultural, posing a challenge for nurse educators in both Europe and the United States. Nursing education faculties are responding to the challenge of internationalization, for instance, by participating in international student exchange projects to foster students' intercultural competence. The authors describe an educational model constructed during a transatlantic project between European and American universities. The benefits of the project from the Finnish partner's perspective are also reported.

  2. The Danish Police Reform

    DEFF Research Database (Denmark)

    Degnegaard, Rex; Mark, Sofie

    2013-01-01

    , the reform process was problematic and the following years were challenging and filled with changes and turbulence. Media, politicians and the police itself directed heavy criticism towards the effects of the reform and reviews of the reform as well as of the work of the police were carried out resulting...... for organisations to work with transparency and involvement with the aim of upholding and further developing a social responsibility to their environment. This case on the other hand takes an inside-out perspective on social responsibility by illustrating how social responsibility is necessary for public...... and private organisations doing business-in-society. The case concerns the reformation of the Danish Police. In 2007 the Danish Police started implementing an extensive reform that affected all parts of the organisation. Despite thorough planning of the process including several change management initiatives...

  3. Healthcare Firms and the ERP Systems

    Directory of Open Access Journals (Sweden)

    A. Garefalakis

    2016-04-01

    Full Text Available With the continuous and drastic changes due to the economic crisis, along with the increasing market demands, major reforms are initiated in the healthcare sector in order to improve the quality of healthcare and operational efficiency, while reducing costs and optimizing back-end operations. ERP systems have been the basic technological infrastructure to many sectors as well as healthcare. The main objective of this study is to discuss how the adoption of ERP systems in healthcare organizations improves their functionality, simplifies their business processes, assure the quality of care services and helps their management accounting and controlling. This study presents also the stages required for the implementation of ERP system in healthcare organizations. This study utilizes a literature review in order to reach the research conclusions. Specifically, through related case studies and research, it examines how ERP systems are used to evaluate the better functionality of the healthcare organizations, addressing in parallel important problems, and possible malfunctions. The implementation of ERP systems in healthcare organizations promises to evolve and align strictly to the organizations’ corporate objectives and high-levels of healthcare quality. In order to accomplish this goal, the right decisions should be made by the managers of the healthcare organization regarding the choice of the appropriate ERP system following its installation and its application. Limited research exists on the significance ERP systems implementation in healthcare organizations, while possible dysfunctions and challenges during its installation and implementation are recorded. Therefore, new evidence in the significance of ERP systems in healthcare organization is provided.

  4. The telecom reform process in Europe and the upcoming challenges

    DEFF Research Database (Denmark)

    Henten, Anders

    2013-01-01

    of the whole information communications technology (ICT) area requiring new policy and regulatory answers. Originality/value – The paper provides a brief introduction to the European telecommunication reform process, its achievements, present challenges, and the policy responses of the European Union......Purpose – The purpose of this paper is to provide a brief introduction to the telecommunication reform process in Europe, its status, and upcoming policy issues. Furthermore, it also aims to provide an overview of the papers in this special issue. Design/methodology/approach – The paper provides...

  5. ANALYSIS OF PENSION REFORMS IN EU MEMBER STATES

    Directory of Open Access Journals (Sweden)

    ELENA LUCIA CROITORU

    2012-01-01

    Full Text Available The demographic situation in the European Union is changing. Demographic trends have a significant impact on social policies in each state and in particular on social security pensions. By 2050, the number of young active population will decrease dramatically. Meanwhile, the older population will triple. And so, the pension expenditure will increase and regarding this many countries reform they pension systems. Pension systems in the European Union are very different, due to the fact, that there is a tradition regarding the way that pensions are granted and the various phases of the reform process.

  6. [Governance and health: the rise of the managerialism in public sector reform].

    Science.gov (United States)

    Denis, Jean L; Lamothe, Lise; Langley, Ann; Stéphane, Guérard

    2010-01-01

    The article examines various healthcare systems reform projects in Canada and some Canadian provinces and reveals some tendencies in governance renewal. The analisis is based on the hypothesis that reform is an exercise aiming at the renewal of governance conception and practices. In renewing governance, reform leaders hope to use adequate and effective levers to attain announced reform objectives. The article shows that the conceptions and operational modalities of governance have changed over time and that they reveal tensions inherent to the transformation and legitimation process of public healthcare systems. The first section discusses the relationships between reform and change. The second section defines the conception of gouvernance used for the analisis. Based on a content analisis of the various reform reports, the third section reveals the evolution of the conception of governance in healthcare systems in Canada. In order to expose the new tendencies, ideologies and operational principles at the heart of the reform projects are analysed. Five ideologies are identified: the democratic ideology, the "population health" ideology, the business ideology, the managerial ideology and the ideology of equity and humanism. This leads to a discussion on the dominant influence of the managerial ideology in the current reform projects.

  7. Open Business Model Innovation in Healthcare Sector

    DEFF Research Database (Denmark)

    Lindgren, Peter; Rasmussen, Ole Horn; Poulsen, Helle

    2012-01-01

    The Open Innovation and Open Business Model Innovation (OBMI) approach (Chesbrough 2005, 2008) has been one of the most discussed innovation frameworks in the 2000s, and probably one of the most important contributions to business model innovations (BMIs) since 2005. Managers in the healthcare...... sector responsible for innovations have also tried to adapt the OBMI approach as a tool among the numerous other innovation tools. The aim of the paper is to present an initial study of the implementation of the framework of OBMI in the European healthcare sector. The study is naturally inspired...... from the European and US healthcare sectors. The paper focuses on the following research questions: • How can OBMI be defined? • How is OBMI used in the healthcare sector? The paper concludes by proposing a definition of open and close business models, and open and close business model innovations....

  8. Reforming Educational Reform: A Democratic Perspective

    Science.gov (United States)

    Green, J.

    2005-05-01

    This essay examines the status of educational reform in the United States as represented by the current Bush administration's program titled "No Child Left Behind" (NCLB). Employing the techniques of critical theory and logical analysis, contemporary reform efforts are compared with other, more progressive, educational reform movements in an effort to gain perspective and conceptual "traction" as it were, in differentiating such movements. Criteria are established for the assessment and evaluation of reform movements. These are employed in judging the efficacy of NCLB's aim, content, and methods, as well as the results of its program following four years of implementation. The merits of the centrality of standardized testing, pre-ordained curricular content, and exclusively didactic teaching methodologies are criticized, along with the extra-school societal forces which ordain these and determine their prominence in the NCLB program. The essentialism adopted by NCLB is, moreover, evaluated in the light of pragmatic, phenomenological, and postmodern educational theory. Arguing that the school is always and inevitably an instrument of societal forces, interests, and groups, it is contended that these not only be acknowledged, but that avenues be formalized for a thorough going and continuous educational "conversation," to borrow Rorty's term, for an amicable resolution of the issues of education's aim(s), content, and methods.

  9. Drug pricing reform in China: analysis of piloted approaches and potential impact of the reform

    Science.gov (United States)

    Chen, Yixi; Hu, Shanlian; Dong, Peng; Kornfeld, Åsa; Jaros, Patrycja; Yan, Jing; Ma, Fangfang; Toumi, Mondher

    2016-01-01

    Objectives In 2009, the Chinese government launched a national healthcare reform programme aiming to control healthcare expenditure and increase the quality of care. As part of this programme, a new drug pricing reform was initiated on 1 June 2015. The objective of this study was to describe the changing landscape of drug pricing policy in China and analyse the potential impact of the reform. Methods The authors conducted thorough research on the drug pricing reform using three Chinese databases (CNKI, Wanfang, and Weipu), Chinese health authority websites, relevant press releases, and pharmaceutical blogs and discussion forums. This research was complemented with qualitative research based on targeted interviews with key Chinese opinion leaders representing the authorities’ and prescribers’ perspectives. Results With the current reform, the government has attempted to replace its direct control over the prices of reimbursable drugs with indirect, incentive-driven influence. Although the exact implementation of the reform remains unclear at the moment, the changes introduced so far and the pilot project designs indicate that China is considering adaptation of some form of internal and external reference pricing policies, commonly used in the Organisation for Economic Co-operation and Development countries. Several challenges related to the potential new mechanism were identified: 1) the risk of hospital underfunding, if hospital funding reform is not prioritised; 2) the risk of promoting the use of cheap, low-quality drugs, if a reliable quality control system is not in place and discrepancy between the available drugs is present; 3) the risk of increasing disparity in access to care between poor and rich regions, in case of country-wide price convergence; and 4) the risk of industry underinvestment, resulting in reduced competition, issues with quality and sustainability of supply, and potentially negative social impact. Conclusions Foreign pricing policies

  10. Interpreting ethnic inequalities in healthcare consumption: a conceptual framework for research

    NARCIS (Netherlands)

    Essink-Bot, Marie-Louise; Lamkaddem, Majda; Jellema, Petra; Nielsen, Signe Smith; Stronks, Karien

    2013-01-01

    The increasing diversity of the Western-European population demands identification of potential ethnic healthcare inequities. We developed a framework that helps researchers in interpreting ethnic inequalities in healthcare consumption in equity terms. From this framework, we develop recommendations

  11. Regulatory reform for services of general interest and trends in citizen satisfaction (Deliverable 4.1)

    NARCIS (Netherlands)

    J. Clifton (Judith); D. Diaz Fuentes (Daniel); M. Fernandez Guttierrez (Marcos); O. James (Oliver); S.R. Jilke (Sebastian); S.G.J. Van de Walle (Steven)

    2012-01-01

    textabstractAbstract In the European Union (EU), as in most of the developed and also developing world, reforms and particularly liberalization of public services were introduced during the last decades, aiming to increase citizen and consumer satisfaction. However, the reforms have not achieved

  12. Catalytic reforming methods

    Science.gov (United States)

    Tadd, Andrew R; Schwank, Johannes

    2013-05-14

    A catalytic reforming method is disclosed herein. The method includes sequentially supplying a plurality of feedstocks of variable compositions to a reformer. The method further includes adding a respective predetermined co-reactant to each of the plurality of feedstocks to obtain a substantially constant output from the reformer for the plurality of feedstocks. The respective predetermined co-reactant is based on a C/H/O atomic composition for a respective one of the plurality of feedstocks and a predetermined C/H/O atomic composition for the substantially constant output.

  13. Reading Augustine in the Reformation: the flexibility of intellectual authority in Europe, 1500-1620

    NARCIS (Netherlands)

    Visser, A.S.Q.

    2011-01-01

    This book explores the reception of Augustine of Hippo in the European Reformations. In this religious revolution Augustine was a highly contested authority, with different parties assimilating his thought in contrasting ways. This flexible reception raises fundamental questions about the

  14. Atuarfitsialak: Greenland's Cultural Compatible Reform

    Science.gov (United States)

    Wyatt, Tasha R.

    2012-01-01

    In 2002, Greenlandic reform leaders launched a comprehensive, nation-wide reform to create culturally compatible education. Greenland's reform work spans the entire educational system and includes preschool through higher education. To assist their efforts, reform leaders adopted the Standards for Effective Pedagogy developed at the Center for…

  15. Understanding reform in Latin America

    OpenAIRE

    Alvaro Forteza; Mario Tommasi

    2005-01-01

    This paper provides an overview of the pro-market reform process in eight Latin American countries, based on country studies undertaken within the Understanding Reform project of the Global Development Network. After a brief presentation of the reform in Latin America and in the eight countries in the project, the paper addresses some key themes on the political economy of reform. We review the initial conditions of reform; the role played by technocrats and stakeholders; political participat...

  16. Reform of the Stability and Growth Pact

    Directory of Open Access Journals (Sweden)

    Ana Šabić

    2006-09-01

    Full Text Available In conditions of the single monetary policy and the decentralised fiscal policy in the European Monetary Union (EMU it is necessary for the coordination of macroeconomic policy to be strengthened. The Treaty on European Union imposes conditions that relate to the size of the budgetary deficit and the public debt as criteria for the introduction of the euro in a given country. The Stability and Growth Pact (SGP sets the fiscal framework of the European Monetary Union based on rules underpinned by these criteria. Thus the SGP, as a kind of economic policy-coordination mechanism, has the task of ensuring fiscal discipline among the Member States of the EMU. The objective of this paper is to describe the recent reform of the Stability and Growth Pact that arose as a result of deficiencies observed in the original version of the Pact of 1997.

  17. Reforming the financing of the EU budget: Outlook

    Directory of Open Access Journals (Sweden)

    D’Alfonso Alessandro

    2016-10-01

    Full Text Available This paper provides a general overview of the EU’s own resources system, and of the debate on its possible reform within the current legal framework. Two alternative reforms are discussed, along with their possible advantages and drawbacks: 1 a simplified system based only on a resource related to gross national income; and 2 the introduction of new genuine own resources and the possible elimination of some current own resources. The second option, which has long been called for by the European Parliament, is explored in further detail, with an overview of the potential candidates for new own resources analysed by the European Commission prior to its 2011 reform proposal. The current outlook for a possible reform focuses on the ongoing work of the high-level group on own resources chaired by Professor Mario Monti, presenting the main obstacles to change and possible ways forward. This paper updates the author’s in-depth analysis How the EU budget is financed: The “own resources” system and the debate on its reform (European Parliamentary Research Service, Brussels.

  18. HEALTHCARE INFORMATION SYSTEM MANAGEMENT IN THE KYRGYZ REPUBLIC

    Directory of Open Access Journals (Sweden)

    R. Bokushev

    2016-01-01

    Full Text Available Despite the active reformation and informatization of healthcare, healthcare establishments of different levels feature a different degree of access to information resources. The situation is also characterized by parallel development of information collection flows, different level of development of different regions, poorly developed infrastructure. These aspects complicate operative information exchange for the purposes of managerial decision-making. We need to determine the degree of compliance of healthcare information systems and subsystems with user needs, as well as assess the capabilities of information systems to provide timely and quality healthcare information to all users of all levels for the purposes of managerial decision-making. The article presents results of a comprehensive assessment of the current state of healthcare informatization in the Kyrgyz Republic using HMN-developed (Health Metrics Network analytical tools. We demonstrate significant differences in healthcare information system management in the Kyrgyz Republic and note the heterogenous use thereof, especially in regions and districts.

  19. Electronic healthcare information security

    CERN Document Server

    Dube, Kudakwashe; Shoniregun, Charles A

    2010-01-01

    The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

  20. 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.

  1. The Europeanization of Health Care Governance

    DEFF Research Database (Denmark)

    Martinsen, Dorte Sindbjerg; Vrangbæk, Karsten

    2008-01-01

    The paper examines the Europeanization process and the impact of the European Union (EU) on national healthcare policies, using the example of Denmark. The analysis reveals that although health policy formally falls within the competence of member states, the impact of the EU is becoming increasi......The paper examines the Europeanization process and the impact of the European Union (EU) on national healthcare policies, using the example of Denmark. The analysis reveals that although health policy formally falls within the competence of member states, the impact of the EU is becoming...... increasingly conspicuous and has contributed to a gradual restructuring of healthcare boundaries as well as of some of its organizing principles. Furthermore, the process and impact have a de-structuring effect on the more traditional governance tools used in relation to healthcare. The paper concludes...

  2. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  3. Transnational healthcare practices of Romanian migrants in Ireland: inequalities of access and the privatisation of healthcare services in Europe.

    Science.gov (United States)

    Stan, Sabina

    2015-01-01

    This article deals with the transnational healthcare practices of Central and Eastern European migrants in Europe, taking the case of Romanian migrants in Ireland. It explores the implications of migrants' transnational healthcare practices for the transformation of citizenship in Europe, more particularly in terms of access to free public healthcare. The article places these practices in the larger perspective of global care chains, seen as including transnational flows of healthcare seekers and healthcare workers that link distant healthcare systems in an emerging European healthcare assemblage. The study adopted a holistic perspective, taking into account both formal and informal practices, as well as the use of healthcare services in both the host and the origin countries of migrants. These were explored during multi-sited fieldwork in Romania and Ireland, conducted between 2012 and 2013, and combining a variety of sources and methods (semi-structured interviews, informal conversations, documentary analysis, etc.). The article explores the links between migrants' transnational healthcare practices and two other important processes: 1) inequalities in access to healthcare services in migrants' countries of origin and of destination; and 2) the contribution of healthcare privatisation to these inequalities. It shows that Romanian migrants' transnational healthcare practices function as strategies of social mobility for migrants, while also reflecting the increasing privatisation of healthcare services in Ireland and Romania. The article argues that these processes are far from specific to Ireland, Romania, and the migration flows uniting them. Rather, they draw our attention to the rise of an unevenly developed European healthcare assemblage and citizenship regime in which patients' movements across borders are closely interlinked with diminishing and increasingly unequal access to public healthcare services. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Healthcare system information at language schools for newly arrived immigrants

    DEFF Research Database (Denmark)

    Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

    2017-01-01

    Objective: In most European countries, immigrants do not systematically learn about the host countries’ healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Method: Immigrants attending...... a language school in Copenhagen in 2012 received either a course or written information on the Danish healthcare system and subsequently evaluated this quantitatively. Results: The evaluation revealed a positive appraisal of the course/information provided. Conclusion: In times of austerity, incorporating...... healthcare information into an already existing language programme may be pertinent for providing immigrants with knowledge on the healthcare system....

  5. How to Reform the EU Budget? A Multidisciplinary Approach

    NARCIS (Netherlands)

    Figueira, F.

    The European Commission is currently drafting a proposal for a review of the EU budget, which could lead to its most significant reform to date. This paper proposes a method for restructuring the EU budget, based on a multidisciplinary approach. The insights of public sector economics, fiscal

  6. Does sequencing matter? regulation and privatization in telecommunications reforms

    OpenAIRE

    Wallsten, Scott

    2002-01-01

    The question of the most effective order of reforming state-owned enterprises has been hotly debated over the years. In the early 1990s, many western advisers encouraged Eastern European countries, and the former Soviet Union, to privatize firms quickly under the assumption that market institutions would develop once firms were privately owned. The thinking since then has emphasized the importance ...

  7. Workplace bullying among healthcare workers.

    Science.gov (United States)

    Ariza-Montes, Antonio; Muniz, Noel M; Montero-Simó, María José; Araque-Padilla, Rafael Angel

    2013-07-24

    This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations--subgroup 22--(ISCO-08). The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers.

  8. Workplace Bullying among Healthcare Workers

    Science.gov (United States)

    Ariza-Montes, Antonio; Muniz, Noel M.; Montero-Simó, María José; Araque-Padilla, Rafael Angel

    2013-01-01

    This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations—subgroup 22—(ISCO-08). The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers. PMID:23887621

  9. Workplace Bullying among Healthcare Workers

    Directory of Open Access Journals (Sweden)

    María José Montero-Simó

    2013-07-01

    Full Text Available This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations—subgroup 22—(ISCO-08. The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers.

  10. Understanding competition between healthcare providers : Introducing an intermediary inter-organizational perspective

    NARCIS (Netherlands)

    Westra, Daan; Angeli, F.; Carree, Martin; Ruwaard, Dirk

    Pro-competitive policy reforms have been introduced in several countries, attempting to contain increasing healthcare costs. Yet, research proves ambiguous when it comes to the effect of competition in healthcare, with a number of studies highlighting unintended and unwanted effects. We argue that

  11. Healthcare beyond reform: doing it right for half the cost

    National Research Council Canada - National Science Library

    Flower, Joe

    2012-01-01

    ... of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in...

  12. Leveraging National Healthcare Reform to Improve Army National Guard Readiness

    Science.gov (United States)

    2010-03-01

    April 21, 2009) in LexisNexis Academic (accessed November 5, 2009). 110 Patrick, “Lose Weight or Lose Out,” 270. 111 Glied, “Mandates and Affordability... LexisNexis Academic (accessed November 5, 2009). 123 U.S. Congress, Senate, Committee on Finance, Chairman’s Mark: America’s Healthy Future Act of 2009...September 22, 2009) in LexisNexis Academic (accessed November 5, 2009). 124 U.S. Congress, Senate, Committee on Finance, Financing Comprehensive Health

  13. The pension reform: foreign experience for Ukraine

    Directory of Open Access Journals (Sweden)

    O. A. Vyshnevska

    2016-09-01

    Full Text Available Problem setting. Pension provision of citizens is among the priority tasks of social policy that is constantly on the agenda of public administration in developed countries. Under current conditions, the formation of the optimal pensions model that takes into account social and economic aspects of society is an important task for the state. Recent research and analysis of publications. There are certain theoretical and scientific achievements in the area under consideration. A significant contribution have been made by researchers and scientists in various fields, including V.Bessarab, I.Hnybidenko, M.Kravchenko, O.Krentovska, E. Libanova, B.Nadtochiy, A.Nechay, V.Skurativskyy, V.Tolub and others. However, some issues related to reforming of the pension system require further study with due regard for further modernization of state social policy. The paper objective is to review the European experience in reforming the pension system in the context of its possible application in the realities of current Ukraine. The main body of paper. Reforming of pension systems in Europe relied on the rapid aging of the population and increased pension burden on employees. Thus, in 2010, the EU population over 60 years made up about 24%, up to 2040, according to the experts, it could reach the figure of 35%, an increase by more than 10%. Thus, the population of working age (20-59 years will decrease from 54% to 47%, or by 7% during the same period. Currently, pension systems in most European countries are based on the three-level models that include unfunded pension scheme with the provision of basic pension and funded one (mandatory and voluntary scheme and are combined in different options. Analysis of pension systems in some European countries, including Great Britain, Germany, Denmark, the Netherlands, Finland, Sweden, shows that their reforms were carried out in the following directions: increasing the retirement age (for men -  to 65, women - 60 years

  14. Health care reforms.

    Science.gov (United States)

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

    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 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.

  15. 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.

  16. Rorty the Reformer?

    Directory of Open Access Journals (Sweden)

    Harvey Cormier

    2008-12-01

    Full Text Available Rorty should be read as a reformer, rather than a revolutionary transformer. While the reformer aims to improve what is already good, the revolutionary transformer seeks to dispense with the merely good in a quest for the absolutely best. For Rorty this choice was a bad choice. In order to make the case that Rorty was a reformer,we explicate Rorty’s views on truth. These views argue that we can obtain consensus about what is worth preserving and improving without reference to either rightness, truth, or objectivity. For after all, there is no way for philosophers to get outside the circle of language within which we debate about what we take to be authoritative and aceptable.

  17. Post-Reformation Reformed sources and children | Neele | HTS ...

    African Journals Online (AJOL)

    ... education and parenting of children. This interest not only continued, but intensified during the sixteenth-century Protestant Reformation when much thought was given to the subject matter. This article attempts to appraise the aim of post-Reformation Reformed sources on the topic “children.” HTS Theological Studies Vol.

  18. It's all about the money? A qualitative study of healthcare worker motivation in urban China.

    Science.gov (United States)

    Millar, Ross; Chen, Yaru; Wang, Meng; Fang, Liang; Liu, Jun; Xuan, Zhidong; Li, Guohong

    2017-07-07

    China's healthcare reform programme continues to receive much attention. Central to these discussions has been how the various financial incentives underpinning reform efforts are negatively impacting on the healthcare workforce. Research continues to document these trends, however, qualitative analysis of how these incentives impact on the motivation of healthcare workers remains underdeveloped. Furthermore, the application of motivational theories to make sense of healthcare worker experiences has yet to be undertaken. The purpose of our paper is to present a comparative case study account of healthcare worker motivation across urban China. It draws on semi structured interviews (n = 89) with a range of staff and organisations across three provinces. In doing so, the paper analyses how healthcare worker motivation is influenced by a variety of financial incentives; how motivation is influenced by the opportunities for career development; and how motivation is influenced by the day to day pressures of meeting patient expectations. The experience of healthcare workers in China highlights how a reliance on financial incentives has challenged their ability to maintain the values and ethos of public service. Our findings suggest greater attention needs to be paid to the motivating factors of improved income and career development. Further work is also needed to nurture and develop the motivation of healthcare workers through the building of trust between fellow workers, patients, and the public. Through the analysis of healthcare worker motivation, our paper presents a number of ways China can improve its current healthcare reform efforts. It draws on the experience of other countries in calling for policy makers to support alternative approaches to healthcare reform that build on multiple channels of motivation to support healthcare workers.

  19. Lunar Organic Waste Reformer Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Lunar Organic Waste Reformer (LOWR) utilizes high temperature steam reformation to convert all plastic, paper, and human waste materials into useful gases. In...

  20. Transfers, Taxes, and Welfare Reform

    OpenAIRE

    Haveman, Robert; Scolex, John Karl

    1994-01-01

    Discusses the need inability of past administrations to pass any welfare reform and gives an overview of an antipoverty policy. Shows that the poverty problem goes beyond tax reform and includes education, crime and violence.

  1. The influence of power in the Canadian healthcare system.

    Science.gov (United States)

    Seenandan-Sookdeo, Kendra-Ann I

    2012-01-01

    This article presents a review of the literature as it relates to the influence of the word power in the context of the Canadian healthcare system. The concept of power is used to explore issues of gender and the evolution of advanced nurse practice in the development of the Canadian healthcare system. Furthermore, issues related to the call for interprofessional collaboration are addressed. Healthcare workers, in particular nurses, are trusted in a society that seeks, promotes, and aspires for power and control. In addition, societal norms continue to shape our healthcare reform. As a consequence, the discussion centers on a call for true collaboration among our healthcare providers and concludes with implications for nursing.

  2. Healthcare and healthcare systems: inspiring progress and future prospects.

    Science.gov (United States)

    Durrani, Hammad

    2016-01-01

    Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population

  3. Teacher Education Reforms in Albania.

    Science.gov (United States)

    Whitehead, Joan

    2000-01-01

    Drawing on insights from Albanian teacher educators and government representatives, this paper examines processes of change and types of reform (modernization, structural, and systemic reform) in Albania. It also discusses the initial implementation of one of the reforms, which was directed at the balance and role of school experiences, analyzing…

  4. Prospects for Health Care Reform.

    Science.gov (United States)

    Kastner, Theodore

    1992-01-01

    This editorial reviews areas of health care reform including managed health care, diagnosis-related groups, and the Resource-Based Relative Value Scale for physician services. Relevance of such reforms to people with developmental disabilities is considered. Much needed insurance reform is not thought to be likely, however. (DB)

  5. THE CONSTITUTIONAL CONCEPTS OF THE REFORM TREATY (THE LISBON TREATY

    Directory of Open Access Journals (Sweden)

    Emilian Ciongaru

    2017-12-01

    Full Text Available The Lisbon Treaty also known as the Reform Treaty provides only an amendment of the treaties considered as fundamental, namely the Treaty on the European Union and the Treaty on the functioning of the European Union and is the result of the constitutional process triggered by the Laeken Declaration adopted by the European Council. The Lisbon Treaty is still built on the content of the European Constitution from which they eliminated the most controversial provisions, first of all the title of Constitution that might produce concern and panic among the European Union population through the symbolic power it contained, and for Romania this new treaty was the first it signed in quality of a Union member state. Even if does not bear the name of European Constitution, the Lisbon Treaty is a European Constitution for the following reasons: first it is a Constitution because it gathers together most of the fundamental elements of the Constitutional Treaty, even if it does not have the structure or the name thereof, and second the treaties after the Lisbon reform have become small constitutions from the operational viewpoint, they develop the functions of a constitution, limit power and organize the operation of the organization.

  6. Does patient choice of healthcare providers lead to better patient experiences in the Netherlands? A cross-sectional questionnaire study .

    NARCIS (Netherlands)

    Victoor, A.; Reitsma-van Rooijen, M.; Jong, J. de; Delnoij, D.; Friele, R.; Rademakers, J.

    2014-01-01

    Background: Various European healthcare systems encourage patients to make an active choice of healthcare provider, both as a worthwhile effort for patients and an instrument to encourage competition between providers. In previous research, patient groups were distinguished

  7. Curriculum Reform in Romania.

    Science.gov (United States)

    Crisan, Alexandru

    This document defines curriculum reform in Romania as the elaboration and progressive setting up of a new educational paradigm unaltered by the outlooks and consequences of the Communist era. Although the strategic and technical aspects of implementing the new reality are still at the stage of advanced working hypotheses, the essential objective…

  8. Teenagers and Welfare Reform.

    Science.gov (United States)

    Offner, Paul

    This report examines the extent to which welfare reform is changing adolescent behaviors that lead to welfare dependency. It begins by discussing the provisions in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 that require teenagers to stay in school and live with a parent, concluding that relatively little can be…

  9. Reforming Underperforming High Schools

    Science.gov (United States)

    MDRC, 2013

    2013-01-01

    Urban high schools are in trouble--high dropout rates, low student academic achievement, and graduates who are unprepared for college are just some of the disappointing indicators. However, recent research points to a select number of approaches to improving student outcomes and reforming underperforming schools--from particular ways of creating…

  10. Accomplishing Districtwide Reform

    Science.gov (United States)

    Sharratt, Lyn; Fullan, Michael

    2006-01-01

    This is a mystery story. It is about a district that apparently did the right things but seemed not to get commensurate results across all classrooms and schools. In this article, we look closely at the details and discover an important lesson about districtwide reform. The district is York Region District School Board, which is a large…

  11. Defense Spending and Reform

    Science.gov (United States)

    2012-04-02

    Budget; Finance Reform; Military Spending ; Defense Spending; Budget Cuts 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...global military spending is China with 7 percent, and United Kingdom comes in a distant third with 4 percent (see Table 2).8 Table 1 Adjusted

  12. Sex and School Reform.

    Science.gov (United States)

    Cuban, Larry

    1986-01-01

    Predicts that reformers will not attack sex education as an inappropriate addition to otherwise rigorous academic programs. Examines (1) some of the political, social, and practical reasons behind this avoidance and (2) the ineffectiveness of existing programs in preventing teenage pregnancies. Suggests that sex education programs may even hinder…

  13. Need for Electoral Reform

    African Journals Online (AJOL)

    Need for Electoral Reform . Botswana. 'Mph0 G. Molomo *. Abstract. Botswana has been operating a First—Past-The-Post (FPTP) electoral system since her independence from Britain in 1965. Unlike other African countries, this system has not led to electoral violence or, political instability. The system is not without its ...

  14. Reforming Ethiopia's Expropriation Law

    African Journals Online (AJOL)

    Muradu_Abdo

    Reforming Ethiopia's Expropriation Law. Muradu Abdo ♧. Abstract. Ethiopia is increasingly using expropriation as the single most important device to take land particularly from small landholders to supply it to corporate farmers and industrialists with a declared intention of boosting economic growth. This is happening in the ...

  15. nigeria's banking sector reforms

    African Journals Online (AJOL)

    NESG PUBLICATIONS

    the Banks and Other Financial. Institutions Act of (BOFIA)1 1991 as amended, the CBN anchored the banking sector reform on a 13-point agenda involving (CBN, 2005: 16). Minimum bank capital base of N25 billion that must be met on or before 31st December, 2005: ♢. Consolidation through mergers and acquisition,.

  16. The Reform Game.

    Science.gov (United States)

    Whitlock, Kelli

    2001-01-01

    A 3-year study of welfare reform in Ohio's 29 Appalachian counties surveyed human services agencies, county commissioners, poor families, and employers and found that rural barriers to employment included lack of jobs, lack of child care, poor health, lack of education and job skills, and transportation problems. Many former welfare recipients…

  17. The 'reformation' of counselling

    Directory of Open Access Journals (Sweden)

    G.A. Lotter

    2001-08-01

    Full Text Available Although the Reformation took place some four hundred years ago, one area in which reformation is really needed today is the counselling of people. Since Wilhelm Wundt started the “study of the mind” in 1879, William James and Sigmund Freud followed and secular psychology gradually has developed to take the “front seat”; hence moving Biblical counselling, which has been practised since the times of the New Testament, to the “back burner”. This development had been going on for the greater part of the 20th century, up to the publication of Competent to Counsel by Jay E. Adams in 1970. In the model for counselling suggested by Adams, the principles of the Reformation of the sixteenth century, Soli Deo Gloria, Soli Scriptura, Soli Fidei, Sola Gratia, etc. were again implemented in assisting and counselling people with personal and interpersonal problems. The epistomological and anthropological approach of secular psychology differs radically from that of Biblical principles, thus necessitating a new “reformation” of counselling. Within this new form counselling, inter alia, implies the following: the Word of God has its rightful place, sin has to be taken seriously and the work of the Holy Spirit should be recognised. In this article it is proposed that the “reformation” of counselling was started by scholars with a Biblical Reformational approach and that this method of counselling followed the parameters of the Reformation of the sixteenth century. This “reformation” developed into a new direction in counselling and still continues today with fascinating new frontiers opening up for Biblical counselling.

  18. Plasma devices for hydrocarbon reformation

    KAUST Repository

    Cha, Min Suk

    2017-02-16

    Plasma devices for hydrocarbon reformation are provided. Methods of using the devices for hydrocarbon reformation are also provided. The devices can include a liquid container to receive a hydrocarbon source, and a plasma torch configured to be submerged in the liquid. The plasma plume from the plasma torch can cause reformation of the hydrocarbon. The device can use a variety of plasma torches that can be arranged in a variety of positions in the liquid container. The devices can be used for the reformation of gaseous hydrocarbons and/or liquid hydrocarbons. The reformation can produce methane, lower hydrocarbons, higher hydrocarbons, hydrogen gas, water, carbon dioxide, carbon monoxide, or a combination thereof.

  19. Sustainable healthcare: how to assess and improve healthcare structures' sustainability.

    Science.gov (United States)

    Buffoli, M; Capolongo, S; Bottero, M; Cavagliato, E; Speranza, S; Volpatti, L

    2013-01-01

    Sustainability is a broad and debated subject, often difficult to be defined and applied into real projects, especially when dealing with a complex scenario as the one of healthcare. Many research studies and evaluation systems have handled this topic from different perspectives, but many limits and criticalities still have to be overcome to properly cope with actual needs. The Sustainable Healthcare project has been developed through three main phases: a deep study of the state of the art, unraveling pros and cons of available sustainability scoring systems; an accurate analysis of the stakeholders network and their needs; the realization of an objective evaluation framework, through scientific methods, as the ANP. The newly developed evaluation system takes into consideration all the three pillars of sustainability, analyzing social, environmental and economic sustainability through a set of criteria, specified by measurable indicators. So the system identifies both global sustainability and specific critical areas, pointing out possible strategic solutions to improve sustainability. The evaluation is achieved through technical analyses and qualitative surveys, which eventually allow to quantitatively assess sustainability, through a sound scoring method. This study proposes an innovative evaluation method to determine the sustainability of a hospital, already existing or in the design phase, within the European context. The Sustainable Healthcare system overcomes some of the current evaluation systems' limits by establishing a multidisciplinary approach and being an easy-to-use tool. This protocol is intended to be of support in the identification of the main hospital's weaknesses and in setting priorities for implementation of the solutions.

  20. Finance reform under local integration

    Directory of Open Access Journals (Sweden)

    S. S. Seryohin

    2016-06-01

    Full Text Available Abstract Revealed the essence of local finance manifested in economic relations, and their structure is a combination of local budgets, special purpose budget funds; budget funds of local governments; public funds of funds banks if their share capital formed at the expense of local governments; fund municipal enterprises, institutions and organizations. The analysis on fundamental scientific research on local budgets.Defined-purpose local governments.Systematized theoretical definition of municipal finances. Formed impact of reform of local finance to ensure the improvement of socio-economic status of the region to the European Union for more confident of Ukraine’s integration into Europe. Found that implementing fiscal policy in terms of spending, local authorities are guided by the priorities of socio-economic development of the region or administrative unit in line with national principles defined government policy document. Discovered topical issues of local budgets as the existence of significant differences in the regulatory and legislative framework - the excessive centralization of local budgets unstable sources of local revenues inadequacy of intergovernmental relations. It was found that to radically change the existing system of functioning of local budgets, as required considerable time gap and improving the theoretical and methodological and regulatory framework of the local budgets.

  1. Nursing leadership and health sector reform.

    Science.gov (United States)

    Borthwick, C; Galbally, R

    2001-06-01

    The political, technological and economic changes that have occurred over the past decade are increasingly difficult to manage within the traditional framework of health-care, and the organisation of health-care is seen to need radical reform to sweep away many of the internal barriers that now divide one form of health-care, and one profession, from another. Nursing must equip itself with skills in advocacy and political action to influence the direction the system will take. Nursing currently suffers from a weakness in self-concept that goes hand in hand with a weakness in political status, and nursing leadership must build the foundations for both advocacy for others and self-advocacy for the nursing movement. The profession faces tensions between different conceptions of its role and status, its relationship to medicine, and its relationship to health. Health indices are tightly linked to status, and to trust, hope, and control of one's own life. Can nurses help empower others when they are not particularly good at empowering themselves? What will the role of the nurse be in creating the information flows that will guide people toward health? Nursing's long history of adaptation to an unsettled and negotiated status may mean that it is better fitted to make this adaptation than other more confident disciplines.

  2. Healthcare. Executive Summary

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This executive summary highlights several findings about healthcare. These are: (1) Healthcare is 18 percent of the U.S. economy, twice as high as in other countries; (2) There are two labor markets in healthcare: high-skill, high-wage professional and technical jobs and low-skill, low-wage support jobs; (3) Demand for postsecondary education in…

  3. The quality of healthcare

    African Journals Online (AJOL)

    The quality of healthcare provided by a healthcare system is not always easily assessed. How can one assess the smile of reassurance from a nursing sister or the feeling of satisfaction of a patient when visiting a doctor in a resource-limited setting? There are, however, some objective measures of healthcare activity.

  4. Methanol partial oxidation reformer

    Science.gov (United States)

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  5. The Danish school reform

    DEFF Research Database (Denmark)

    Bager, Ann; Mølholm, Martin; Horsbøl, Anders

    The paper presents a methodological framework for the study of the discursive emergence of the recent Danish School reform (2014). The framework will enable discourse scholars to hold an actively involved position in changing and furthering plurivocal processes of translations, negotiations...... and implementation of the reform. The framework is operationalized through research-based participatory collaborative processes involving local actors in two Danish public schools. It interlinks diverse discourse strategies and perceptive distances that traditionally belong to separate branches within discourse...... (Latour), e.g. civil service and municipal practices and texts, into the organizational practices of two local schools. On the basis of these analyses, we will establish a participatory process in which local actors are involved in the co-creation of new plurivocal and egalitarian dialogue designs...

  6. Methanol partial oxidation reformer

    Science.gov (United States)

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-24

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  7. ESSENTIALS OF PUBLIC SECTOR REFORM: A CASE STUDY OF CROATIA

    Directory of Open Access Journals (Sweden)

    Farhad Analoui

    2008-09-01

    Full Text Available This paper explores the challenges faced by developing countries and countries in transition in their attempt at reforming the inherited bureaucratic public service. The paper explores how the public sector in Croatia has managed to come this far after the turbulent years of political and technocratic dislocation. Croatia is determined to reform its public sector to become eligible for joining the European Union (EU in near future. This has posed a major challenge for top senior officials and consultants alike. Adopting ‘action research’ as both a methodology and a strategy, a programme of intervention for change was designed and implemented in the Ministry of Finance. The overall results suggest that for the successful implementation of public sector reforms in the 21st century, attention should focus on strategic issues including systems thinking, HRMD, behavioural and attitudinal change, skills and competencies development and, above all, honest and responsible transformational leadership.

  8. Public satisfaction with the healthcare system performance in South Korea: Universal healthcare system.

    Science.gov (United States)

    Park, Kisoo; Park, Jumin; Kwon, Young Dae; Kang, Yoonjeong; Noh, Jin-Won

    2016-06-01

    An awareness of the public's level of satisfaction with health professionals is becoming more important as steps are being taken to improve quality, reduce costs, and implement reform. The purpose of this study is to assess public satisfaction with the healthcare system and to examine the relationship between satisfaction and socio-demographic factors in the context of the health care environment in the Republic of Korea. The data were obtained from 1573 adults aged 20-69 in three major areas - Seoul, Gyeonggi, and Busan - by the Ministry of Health and Welfare during June and July 2011 in South Korea. Satisfaction with the healthcare system was evaluated by using 13 items in three sections: access to care, cost of care, and quality of care. A confirmatory factor analysis (CFA) was conducted to examine the validity of satisfaction with a healthcare system performance questionnaire. A structural equation model (SEM) was estimated to assess the relative impact of demographic and socio-economic variables on satisfaction. The study proposed a comprehensive three-factor model of healthcare system performance satisfaction. Among the three factors, the quality of care had the largest impact on satisfaction with the healthcare system, suggesting that is the most important determinant of consumers' satisfaction with their healthcare system. Regarding the relationships between public satisfaction and demographic and socio-economic variables, residence and marital status were significant predictors of the satisfaction level. It is important to be aware of the potential significance of background variables in determining satisfaction with the healthcare system. An understanding of the characteristics of the sample enables healthcare managers and/or policymakers to inform targeted follow-up actions. Copyright © 2016. Published by Elsevier Ireland Ltd.

  9. European communion

    DEFF Research Database (Denmark)

    Manners, Ian James

    2013-01-01

    Political theory of European union, through an engagement between political concepts and theoretical understandings, provides a means of identifying the EU as a political object. It is argued that understanding the projects, processes and products of European union, based on ‘sharing’ or ‘communion......’, provides a better means of perceiving the EU as a political object rather than terms such as ‘integration’ or ‘co-operation’. The concept of ‘European communion’ is defined as the ‘subjective sharing of relationships’, understood as the extent to which individuals or groups believe themselves to be sharing...... relations (or not), and the consequences of these beliefs for European political projects, processes and products. By exploring European communion through an engagement with contemporary political theory, using very brief illustrations from the Treaty of Lisbon, the article also suggests that European...

  10. The proportion of unmet costs considering inpatients billing of selected hospitals, after 2014 Health System reform implementation in Isfahan Province.

    Science.gov (United States)

    Naghdi, Parnaz; Mohammadi, Mahan; Jahangard, Mohammad Ali; Yousefe, Alireza; Rafiee, Noora

    2017-01-01

    Since 2013, in Iran's health care, the contribution of direct payments for health-care services was estimated more than 50 % of all expenditures. In May 2014, Iran's health-care reform was established to improve health services quality and reduce patients' out-of-pocket payments reform coverage mentioned in Sections 1.2.2 and 1.2.1, Article 6 of the Health Minister Reform Guideline) in the inpatient billings within the first 5 months from the reform implementation. This study was conducted as a cross-sectional research in the second half of 2014 on the selected hospitals in Isfahan Province. Data were collected by investigating 97,000 inpatients' billing records issued by 28 hospitals affiliated to Isfahan University of Medical Sciences using census method. Findings of the study showed that the average of unmet costs paid by the inpatients constituted 21.8% of the total billing costs in 28 hospitals, and the average unmet costs paid by each patient was 1,903,832 Rials. Considering the definition of unmet cost in the context of health-care reform guideline and hospitals' problems in providing some costly services, drugs, and medical equipment (that were not covered by insurance organizations and the reform scheme) within the obligations of the reform, it is necessary to review these obligations and further interact with insurance companies about expanding the coverage to some costly services required by the patients.

  11. The development of intelligent healthcare in China.

    Science.gov (United States)

    Zheng, Xiaochen; Rodríguez-Monroy, Carlos

    2015-05-01

    Intelligent healthcare (IH) is proposed with the fast application of Internet of Things technology in the healthcare area in recent years. It is considered as an expansion of e-health and telemedicine. As the largest developing country, China is investing large amounts of resources to push forward the development of IH. It is one of the centerpieces of the country's New Healthcare Reform, and great expectation is placed on it to help solve the conflict between limited healthcare resources and the large patient population. Essential policies, milestones, standards, and specifications from the Chinese government since the 1990s were reviewed to show the brief development history of IH in China. Some typical cases and products have been analyzed to present the current situation. The main problems and future development directions have been summarized. The IH industry in China has great potential and is growing very fast, but a lot of challenges also exist. In the future both government support and the active participation of nongovernmental capital are needed to push forward the whole industry.

  12. Security Sector Reform in Albania

    OpenAIRE

    Abazi, Enika; Bumci, Aldo; Hide, Enri; Rakipi, Albert

    2009-01-01

    International audience; This paper analyses security sector reform (SSR) in Albania. In all its enterprises in reforming the security sector,Albania is assisted by different initiatives and projects that provide expertise and financial support. To assesswhether reforms improved the overall security environment (national and human) of the country, it is necessaryto measure the effectiveness of the various initiatives and projects. This is gauged by how well the initiatives andprojects achieved...

  13. Who benefits from government healthcare subsidies? An assessment of the equity of healthcare benefits distribution in China.

    Science.gov (United States)

    Chen, Mingsheng; Fang, Guixia; Wang, Lidan; Wang, Zhonghua; Zhao, Yuxin; Si, Lei

    2015-01-01

    Improving the equitable distribution of government healthcare subsidies (GHS), particularly among low-income citizens, is a major goal of China's healthcare sector reform in China. This study investigates the distribution of GHS in China between socioeconomic populations at two different points in time, examines the comparative distribution of healthcare benefits before and after healthcare reforms in Northwest China, compares the parity of distribution between urban and rural areas, and explores factors that influence equitable GHS distribution. Benefit incidence analysis of GHS progressivity was performed, and concentration and Kakwani indices for outpatient, inpatient, and total healthcare were calculated. Two rounds of household surveys that used multistage stratified samples were conducted in 2003 (13,564 respondents) and 2008 (12,973 respondents). Data on socioeconomics, healthcare payments, and healthcare utilization were collected using household interviews. High-income individuals generally reap larger benefits from GHS, as reflected by positive concentration indices, which indicates a regressive system. Concentration indices for inpatient care were 0.2199 (95% confidence interval [CI], 0.0829 to 0.3568) and 0.4445 (95% CI, 0.3000 to 0.5890) in 2002 (urban vs. rural, respectively), and 0.3925 (95% CI, 0.2528 to 0.5322) and 0.4084 (95% CI, 0.2977 to 0.5190) in 2007. Outpatient healthcare subsidies showed different distribution patterns in urban and rural areas following the redesign of rural healthcare insurance programs (urban vs. rural: 0.1433 [95% CI, 0.0263 to 0.2603] and 0.3662 [95% CI, 0.2703 to 0.4622] in 2002, respectively; 0.3063 [95% CI, 0.1657 to 0.4469] and -0.0273 [95% CI, -0.1702 to 0.1156] in 2007). Our study demonstrates an inequitable distribution of GHS in China from 2002 to 2007; however, the inequity was reduced, especially in rural outpatient services. Future healthcare reforms in China should not only focus on expanding the coverage

  14. Education Reform in Hong Kong

    Directory of Open Access Journals (Sweden)

    Chris Dowson

    2000-05-01

    Full Text Available Since the early 1990s, the pace of educational reform in Hong Kong has accelerated and broadened to incorporate almost all areas of schooling. The reforms introduced during this period can be subsumed under what has generally been labelled the quality movement. In this paper, we review and comment on a number of policy reform initiatives in the four areas of "Quality Education," English Language Benchmarking, Initial Teacher Training and the Integration of Pupils with Special Needs into Ordinary Classrooms. Following a brief description of each policy initiative, the reforms are discussed in terms of their consistency, coherence and cultural fit.

  15. Hidden problems in current health-care financing and potential changes.

    Science.gov (United States)

    Kerrey, B; Hofschire, P J

    1993-03-01

    Health-care costs in the United States have risen significantly in the past 10 years, markedly affecting access to quality medical and mental health care. Deficit financing of our federal health-care expenditures adds billions of dollars annually to our national debt. Health-care reform is being hindered by both the inability of the government to pay for the uninsured and the unremitting spiral of the Medicare and Medicaid entitlement programs. The reasons for the total health-care cost increases include higher provider charges, overutilization of services, and the burgeoning technology; problems of malpractice, overspecialization, and consumer demands have also fueled the higher costs.

  16. One of many lessons from the European Mental Health Integration Index.

    Science.gov (United States)

    Murawiec, Sławomir; Krysta, Krzysztof

    2015-09-01

    The Mental Health Integration Index developed by the Economist Intelligence Unit describes and explores the challenges of European countries of integrating people with mental illness into society and employment, within the European Union's 28 Member States, plus Norway and Switzerland. Countries have been ranked according to estimation based on indicators of their degree of commitment to support those living with mental illness into society and employment. The Index is based on a list of indicators including the environment for those with mental illness, their access to medical help and services, their opportunities--specifically job-related--and the governance of the system, including human rights issues and efforts to combat stigma. The indicators were developed in consultation with a panel of independent experts on mental health. Key findings of the research are that Germany's strong healthcare system and generous social provision put it at the top of the Index, with the UK and Scandinavian states not far behind. However, examples of best practice "islands of excellence" in integration are not limited to the leading countries and exists in all European Countries. The Index reveals also the discrepancy between perfect legislation and poor implementation of it in practice in many European countries. It proposes that the investment figure is a proxy for seriousness in establishing good policy and practice. According to the Index some reform plans including entire national mental health programmes are largely aspirational and are grossly under-funded. Moreover various levels of government responsible for the implementation of its component parts are largely ignoring its implementation. When we consider the legislation as an promise to professionals and people with mental health problems, this promise is largely unfulfilled. The is a need for strong leadership in mental health changes process, policy capacity and real financial investments in the way of The European

  17. Towards an international health market with the European Court

    DEFF Research Database (Denmark)

    Martinsen, Dorte Sindbjerg

    2005-01-01

    This article examines the process through which a European healthcare dimension has been established and which has gradually extended the rights of European patients to cross-border healthcare. The integrative course has been charted by the legal activism of the European Court of Justice, whereas...... by national authorities can be challenged. Through the indeterminacy of European rules, open to continuous contestation and clarification, healthcare institutionalisation has proceeded and the European Union has extended into the core of the welfare state....... evolution of Community law has increasingly challenged the national instrument to retain health supply within own borders. Furthermore, the position of the European patient has been empowered by new individual rights, emanating from a supranational locus of rights against which the discretion exerted...

  18. Reform Drivers and Reform Obstacles in Natural Resource Management

    DEFF Research Database (Denmark)

    Gezelius, Stig S.; Raakjær, Jesper; Hegland, Troels Jacob

    2010-01-01

    ABSTRACT: The ability to transform historical learning into institutional reform is a key to success in the management of common pool natural resources. Based on a model of institutional inertia and a comparative analysis of Northeast Atlantic fisheries management from 1945 to the present....... Institutional inertia entails that large-scale management reform tends to be crisis driven....

  19. Cultivating curricular reform.

    Science.gov (United States)

    Guze, P A

    1995-11-01

    Since the 1960s there has been pressure to reform medical education in a more humanistic direction. One reason this has been difficult is that most medical schools have been forced to maintain themselves on resources allocated to support research and the technology of specialized tertiary care. Nevertheless, many people believe that medical education can still change because of changes taking place outside the sciences, such as a redefinition of the meaning of health and the need to provide better health care to the U.S. population at a lower cost. Taking this optimistic view will help strengthen reformers' resolve for curricular change and the incorporation of important areas such as family violence into medical students' education. There are numerous barriers to curricular change. Yet there are useful principles that can guide reform efforts, such as having an explicit rationale for the desired change, focusing on educational goals rather than on resources for their implementation, recruiting support from the departmental and school leadership, anticipating negative reactions, and recognizing the need for negotiation. There are also principles to foster successful implementation, the most important of which is to have everyone involved agree on the goals of the new program and participate in the process. The way to increase an emphasis on family violence issues is to find areas in the curriculum where these issues can be integrated with current teaching. Finally, a medical school curriculum on family violence does not need to be all-inclusive, but instead should prepare a good foundation so that students can expand their knowledge and skills during residency training and medical practice.

  20. Challenges for delivering healthcare education through telematics.

    Science.gov (United States)

    Alpay, L; Murray, P

    1998-06-01

    Within the context of the education of professional healthcare providers, the authors give an overview of the challenges faced by those wishing to introduce telematics as both a mechanism for content delivery and as subject content itself. After presenting a brief overview of the current state of telematics applications to healthcare education, focusing on the European sphere, the authors outline the challenges before discussing the collaborative and communicative issues in detail. The authors conclude by suggesting that, while the authors believe that telematics is a necessary direction for the future development of healthcare education for professionals, the collaboration and communication challenges are of greater importance than the technical and policy challenges and that there is a need to educate the majority of educators, based in the experiences of the enthusiasts.

  1. Novel Reforming Catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Pfefferle, Lisa D; Haller, Gary L

    2012-10-16

    Aqueous phase reforming is useful for processing oxygenated hydrocarbons to hydrogen and other more useful products. Current processing is hampered by the fact that oxide based catalysts are not stable under high temperature hydrothermal conditions. Silica in the form of structured MCM-41 is thermally a more stable support for Co and Ni than conventional high surface area amorphous silica but hydrothermal stability is not demonstrated. Carbon nanotube supports, in contrast, are highly stable under hydrothermal reaction conditions. In this project we show that carbon nanotubes are stable high activity/selectivity supports for the conversion of ethylene glycol to hydrogen.

  2. European Institutions?

    NARCIS (Netherlands)

    Meacham, Darian

    2016-01-01

    The aim of this article is to sketch a phenomenological theory of political institutions and to apply it to some objections and questions raised by Pierre Manent about the project of the European Union and more specifically the question of “European Construction”, i.e. what is the aim of the

  3. Selective Europeanization

    DEFF Research Database (Denmark)

    Hoch Jovanovic, Tamara; Lynggaard, Kennet

    2014-01-01

    political contexts at the European level. We further show how the “translation” of international norms to a domestic context has worked to reinforce the original institutional setup, dating back to the mid-1950s. The translation of European-level minority policy developed in the 1990s and 2000s works most...

  4. Survey of Attitudes towards Curriculum Reforms among Medical Teachersin Different Socio-economic and Cultural Environments

    DEFF Research Database (Denmark)

    Dahl, Mads Ronald

    2007-01-01

    Curriculum reforms in medical schools require cultural and conceptual changes from the faculty. We assessed attitudes towards curriculum reforms in different academic, economic, and social environments among 776 teachers from 2 Western European medical schools (Belgium and Denmark) and 7 medical...... had more positive attitude towards reforms of medical curriculum (mean score 36.8 out of maximum 50 [95% CI 36.1 to 37.3]) than those from medical schools in Croatia or Slovenia (30.7 [29.8 to 31.6]) or Western Europe (27.7 [27.1 to 28.3]) (PSignificant predictors of positive attitudes...

  5. Improving Healthcare Logistics Processes

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes

    provision whilst providing high quality care. Logistics activities in hospitals provide a significant opportunity for cost containment in healthcare through the implementation of best practices. Literature provides little guidance on how to improve healthcare logistics processes. This study investigates...... at hospitals in Denmark and the US investigating three different types of processes: bed logistics, hospital cleaning, and pharmaceutical distribution. Based on an analysis and comparison of the case studies, a set of factors were identified influencing the decision on how to improve healthcare logistics......Healthcare costs are increasing due to an ageing population and more sophisticated technologies and treatments. At the same time, patients expect high quality care at an affordable cost. The healthcare industry has therefore experienced increasing pressures to reduce the cost of healthcare...

  6. Healthcare financing in Malaysia.

    Science.gov (United States)

    Kananatu, K

    2002-01-01

    This paper presents an overview of the Malaysian healthcare system and its method of financing. The development of the healthcare delivery system in Malaysia is commendable. However, the strength and weaknesses of the public healthcare system and the financing problems encountered are also discussed. Cost of healthcare and funding of both the public and private sectors were also revealed. One must optimise the advantages of operating a health financing scheme which is affordable and controllable which contribute towards cost-containment and quality assurance. Thus, there is a need for the establishment of a National Healthcare Financing, a mechanism to sustain the healthcare delivery network and operate it as a viable option. A model of the National Health Financing Scheme (NHFS) was proposed.

  7. Medical Education and Curriculum Reform: Putting Reform Proposals in Context

    Directory of Open Access Journals (Sweden)

    Daniel Kam Yin Chan, MD, MB.BS, MHA

    2004-01-01

    Full Text Available The purpose of this paper is to elaborate criteria by which the principles of curriculum reform can be judged. To this end, the paper presents an overview of standard critiques of medical education and examines the ways medical curriculum reforms have responded to these critiques. The paper then sets out our assessment of these curriculum reforms along three parameters: pedagogy, educational context, and knowledge status. Following on from this evaluation of recent curriculum reforms, the paper puts forward four criteria with which to gauge the adequacy medical curriculum reform. These criteria enable us to question the extent to which new curricula incorporate methods and approaches for ensuring that its substance: overcomes the traditional opposition between clinical and resource dimensions of care; emphasizes that the clinical work needs to be systematized in so far as that it feasible; promotes multi-disciplinary team work, and balances clinical autonomy with accountability to non-clinical stakeholders.

  8. National Public Opinion on School Health Education: Implications for the Health Care Reform Initiatives.

    Science.gov (United States)

    Torabi, Mohammad R.; Crowe, James W.

    1995-01-01

    This study investigated national public opinion on school health education and the implications for health-care reform initiatives. Telephone surveys of 1,005 adults nationwide indicated that the public at large believes in the importance of health education to reduce health problems among children, considering it the responsibility of parents and…

  9. Marketing in Healthcare Unit

    OpenAIRE

    Mariana BIRSA

    2011-01-01

    Healthcare marketing is a part of public services marketing. In developed countries, healthcare marketing can be applied to a microeconomic as well as to a macroeconomic level. The main feature of healthcare marketing is that there are products, markets, but there is no cash equivalent. For both traditional marketing and public healthcare marketing, the user of a product or service is called “consumer” and a group of consumers is mentioned as a “market”. Acceptance of marketing by USA heath s...

  10. Healthcare in the UK: understanding continuity and change

    National Research Council Canada - National Science Library

    Greener, Ian

    2009-01-01

    ... of the 1960s The 1970s The 1980s The 1990s The 2000s Conclusion 39 39 39 50 57 58 60 63 66 71 four the double-bed Introduction The relationship between the state and the medical profession The deelopment of the double-bed relationship Deelopments in the 1950s The 1960s and the first organisational reform of the NHS 75 75 77 81 81 84 Healthcar...

  11. Governing Collaborative Healthcare Improvement: Lessons From an Atlantic Canadian Case

    Directory of Open Access Journals (Sweden)

    Meghan Rossiter

    2017-12-01

    Full Text Available The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC Quality Improvement Collaborative (QIC in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements.

  12. The Danish Regulatory Reform of Telecommunications

    DEFF Research Database (Denmark)

    Skouby, Knud Erik

    1998-01-01

    An overview of the liberalisation process and regulatory reform of telecommunications in Denmark......An overview of the liberalisation process and regulatory reform of telecommunications in Denmark...

  13. Healthcare students as innovative partners in the development of future healthcare services: An action research approach.

    Science.gov (United States)

    Norbye, Bente

    2016-11-01

    Health care systems in Norway and the western world have experienced extensive changes due to patients living longer with complex conditions that require coordinated care. A Norwegian healthcare reform has led to significant restructuring in service delivery as a devolution of services to municipalities. Partners from three rural healthcare services, students from four professional programmes, and one lecturer from each of the professional programmes used a collaborative approach to obtain new knowledge through interprofessional practice. Using an action research design, the research group facilitated democratic processes through dialogues with healthcare services and students. The design is visualised as a cyclical process in which each cycle contributes to improvements, innovations, and increased understanding. A total of 32 students and 3 supervisors were interviewed before and after the clinical practice experiences. Fieldwork was conducted during three clinical periods. Interprofessional student groups formed small healthcare teams and assessed patients with chronic and long-term conditions. Students prepared and negotiated patient follow-up. The teams' responsibilities led to reflective practices that enhanced their professional knowledge. The teams achieved a new understanding of patient situations, which influenced "second opinions" for patients with complex conditions and led to innovative practices. The change in perception of patient needs led to a changed professional approach. The students' perceptions changed as they learned from and about each other and in collaboration with the health service; this led to more coordinated care of patients with complex conditions. Interprofessional learning in community settings provided a platform to improve both healthcare education and rural healthcare services. This research contributes to knowledge of how students' placement in interprofessional teams can enhance students learning from, with and about each other

  14. Recent University Reform in Mexico.

    Science.gov (United States)

    Ornelas, Carlos; Post, David

    1992-01-01

    Examination of recent reforms at three Mexican public universities suggests that university administrators have had little will or power to regulate expansion in the face of growing social demand for higher education. Discusses "populist" and "modernist" conceptions of university reform, which focus on social needs and economic…

  15. Ageing-Driven Pension Reforms

    NARCIS (Netherlands)

    Bonenkamp, J.; Meijdam, Lex; Ponds, Eduard; Westerhout, Ed

    This paper stems from the observation that there are two world-wide trends, pension reform and population ageing, and asks whether the two may be related. Exploring the cases of pension reform in different countries, we find that, although they are very different, the cases share a common

  16. Education Finance Reform in Tennessee.

    Science.gov (United States)

    Green, Harry A.

    1999-01-01

    The Education Improvement Act instigated funding allocation reform, equalization and equity, system accountability, systemwide report cards, value-added assessment, and governance reform. The most dissatisfied educators are those in large, wealthier urban systems. Horizontal equity, accountability, and test results have improved throughout the…

  17. George's Complaint: Reforming the Dragon

    Science.gov (United States)

    Buxton, Bruce

    2007-01-01

    The evangelical tone and history of American culture has long been identified as a force for anti-intellectualism. The metaphors of educational reform are a demonstration of how this plays out. The very nature of the positivist social science research used to support proposed reform is anti-intellectual and feeds a debate that favors extremes over…

  18. Ageing-driven pension reforms

    NARCIS (Netherlands)

    Bonenkamp, J.; Meijdam, Lex; Ponds, Eduard; Westerhout, Ed

    This paper stems from the observation that there are two world-wide trends, pension reform and population ageing, and asks whether the two may be related. Exploring the cases of pension reform in different countries, we find that, although they are very different, the cases share a common

  19. Pension Reform in China.

    Science.gov (United States)

    Liu, Tao; Sun, Li

    2016-01-01

    This article analyzes China's pension arrangement and notes that China has recently established a universal non-contributory pension plan covering urban non-employed workers and all rural residents, combined with the pension plan covering urban employees already in place. Further, in the latest reform, China has discontinued the special pension plan for civil servants and integrated this privileged welfare class into the urban old-age pension insurance program. With these steps, China has achieved a degree of universalism and integration of its pension arrangement unprecedented in the non-Western world. Despite this radical pension transformation strategy, we argue that the current Chinese pension arrangement represents a case of "incomplete" universalism. First, its benefit level is low. Moreover, the benefit level varies from region to region. Finally, universalism in rural China has been undermined due to the existence of the "policy bundle." Additionally, we argue that the 2015 pension reform has created a situation in which the stratification of Chinese pension arrangements has been "flattened," even though it remains stratified to some extent.

  20. Small School Reform

    Directory of Open Access Journals (Sweden)

    Carroll E. Bronson

    2013-05-01

    Full Text Available This qualitative ethnographic case study explored the evolution of a public urban high school in its 3rd year of small school reform. The study focused on how the high school proceeded from its initial concept, moving to a small school program, and emerging as a new small high school. Data collection included interviews, observations, and document review to develop a case study of one small high school sharing a multiplex building. The first key finding, “Too Many Pieces, Not Enough Glue,” revealed that the school had too many new programs starting at once and they lacked a clear understanding of their concept and vision for their new small school, training on the Montessori philosophies, teaching and learning in small schools, and how to operate within a teacher-cooperative model. The second key finding, “A Continuous Struggle,” revealed that the shared building space presented problems for teachers and students. District policies remain unchanged, resulting in staff and students resorting to activist approaches to get things done. These findings offer small school reform leaders suggestions for developing and sustaining a small school culture and cohesion despite the pressures to revert back to top-down, comprehensive high school norms.

  1. Ecological tax reform

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    An environmental tax reform is seen by many as a possible solution to some crucial problems of modern society - pollution, excessive resource consumption and unemployment. Changes in the system of taxation are here seen as a long term process, one that must cheapen the costs of labour and make the costs of resource use more expensive - a process which can also create major changes in our society as to conceptions of quality, work, consumption etc. The conference presented proposals for an ecological tax and duty system that would contribute to: Changing technology so that it becomes more resource and energy effective. Changing the economic mechanisms so that resource consumption and pollution become more expensive while human resources become cheaper. Changing personal life styles and values so that material consumption becomes less decisive for our choices and priorities. An environmental tax reform is neither without problems nor painless. An economy and an industrial sector based on increasing consumption of energy and raw materials will, in the long run, lead to drawbacks that far outweigh those that are connected with an economic re-orientation whose driving force is another conception of nature. (EG)

  2. Public Administration reforms and results

    Directory of Open Access Journals (Sweden)

    Gunnar Helgi Kristinsson

    2014-12-01

    Full Text Available Research on administrative reforms during the past thirty years indicates that reform efforts of countries differ. The Anglo Saxon states were at the forefront of the New Public Management movement while countries on mainland Europe were more hesitant and moved further towards the Neo-Weberian state. Academics have tried to explain different reform efforts within countries by looking at political, historical and cultural issues, values and economic factors to name just a few. Three hypotheses are put forward to explain reform efforts in different states. This research involves analysing the implementation of two different reform trends, New Public Management and the Neo-Weberian tradition. The analysis indicates that countries vary in their commitment to reform rather than in the emphasis on either New Public Management or the Neo-Weberian State. Decentralization, clear objectives and consultation with communities and experts are closely related to national reform efforts. However, Iceland does distinguish itself from Europe and the Nordic countries. The analysis reveals that although decentralization is high in the Icelandic system, autonomy of agencies does not have a strong relation to a varied use of administrative instruments. The second part of the article focuses on the results and achievements of reform programmes. The achievement of reform programmes are examined in relation to theories of bounded rationality, street level bureaucracy (bottom up and consensus decision making. Three hypotheses are presented and tested to explain what causes reforms programmes to be successful in some countries and not in others. The analysis reveals that countries are more likely to succeed if bounded rationality is applied with careful preparation and when stakeholders are consulted.

  3. European Whiteness?

    DEFF Research Database (Denmark)

    Blaagaard, Bolette

    2008-01-01

    Born out of the United States’ (U.S.) history of slavery and segregation and intertwined with gender studies and feminism, the field of critical whiteness studies does not fit easily into a European setting and the particular historical context that entails. In order for a field of European...... critical whiteness studies to emerge, its relation to the U.S. theoretical framework, as well as the particularities of the European context need to be taken into account.. The article makes a call for a multi-layered approach to take over from the identity politics so often employed in the fields of U...

  4. Elite Decision Makers’ Strategic Use of European Integration and Globalisation Discourses

    DEFF Research Database (Denmark)

    Lynggaard, Kennet

    2013-01-01

    This article investigates decision makers’ strategic use of European integration and globalisation discourses to justify and coordinate national sector reforms. This is done using the example of banking sector reforms in two small European Union (EU) member states, Ireland and Denmark. Two key...... to make credible claims about their influence on European financial integration, an option not available to Danish decision makers since Denmark is not a Eurozone member; (2) Globalisation comprises a particularly compelling set of discourses which enables decision makers to carry through sector reforms...... in line with European integration measures, even in the absence of national commitment to the latter. Discourses of globalisation have thus become ‘the last resort’ for Danish decision makers in justifying and coordinating reforms that are in line with EU regulations and recommendations....

  5. Who Benefits from Public Healthcare Subsidies in Egypt?

    Directory of Open Access Journals (Sweden)

    Ahmed Shoukry Rashad

    2015-11-01

    Full Text Available Direct subsidization of healthcare services has been widely used in many countries to improve health outcomes. It is commonly believed that the poor are the main beneficiaries from these subsidies. We test this hypothesis in Egypt by empirically analyzing the distribution of public healthcare subsidies using data from Egypt Demographic and Health Survey and Egypt National Health Accounts. To determine the distribution of public health care subsidies, we conducted a Benefit Incidence Analysis. As a robustness check, both concentration and Kakwani indices for outpatient, inpatient, and total healthcare were also calculated. Results show some degree of inequality in the benefits from public healthcare services, which varied by the type of healthcare provided. In particular, subsidies associated with University hospitals are pro-rich and have inequality increasing effect, while subsidies associated with outpatient and inpatient care provided by the Ministry of Health and Population have not been pro-poor but have inequality reducing effect (weakly progressive. Results were robust to the different analytical methods. While it is widely perceived that the poor benefit the most from health subsidies, the findings of this study refute this hypothesis in the case of Egypt. Poverty reduction measures and healthcare reforms in Egypt should not only focus on expanding the coverage of healthcare benefits, but also on improving the equity of its distribution.

  6. Healthcare. State Report

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report projects education requirements linked to forecasted job growth in healthcare by state and the District of Columbia from 2010 through 2020. It complements a larger national report which projects educational demand for healthcare for the same time period. The national report shows that with or without Obamacare, the United States will…

  7. The European Union's Eastward Enlargement

    Directory of Open Access Journals (Sweden)

    Hanns-D. Jacobsen

    1997-08-01

    Full Text Available In July 1997 the Commission of the European Union presented its Agenda 2000. This document not only suggested to start accession talks with some East and Central European countries (CEEC in early 1998 but it also provided proposals for a restructuring of EU expenditures. On this background this contribution discusses the state of readiness of the Central and East European countries to become EU members over the next few years and the Union's capacity to absorb up to ten CEEC over the next decade or so. This study concludes that the European Union has become an anchor of stability to the CEEC that guarantees both democracy and economic security--much more than could be expected only a couple of years ago. The Union's readiness to accept the membership of CEEC has, in a decisive way, contributed to their societal, political and economic stabilization. There is almost a contest among the CEEC on which one is going to meet the accession criteria first and best. The enlargement process, however, is connected to problems the resolution of which realistically postpone its successful conclusion at least into the year 2005. The main reasons are (1 the welfare gap between the EU area and the CEEC, (2 the need for more institutional and economic changes in the CEEC to make them ready for acces-sion, and, most importantly, (3 the necessity for the European Union to prepare herself for accession by a comprehensive financial reform and fundamental institutional changes.

  8. European Security

    DEFF Research Database (Denmark)

    Møller, Bjørn

    Theoretical chapters on "Security", "Organisations" and "Regions," Historical Chapters on "Europe and Its Distinguishing Features" and on "The United Nations," "NATO," "The CSCE/OSCE and the Council of Europe" and "The European Union"......Theoretical chapters on "Security", "Organisations" and "Regions," Historical Chapters on "Europe and Its Distinguishing Features" and on "The United Nations," "NATO," "The CSCE/OSCE and the Council of Europe" and "The European Union"...

  9. Early Results of Massachusetts Health Care Reform on Racial, Ethnic and Socioeconomic Disparities in Cardiovascular Care

    Science.gov (United States)

    Albert, Michelle A.; Ayanian, John Z.; Silbaugh, Treacy S.; Lovett, Ann; Resnic, Fred; Jacobs, Aryana; Normand, Sharon-Lise T.

    2017-01-01

    Background Insured adults receive invasive cardiovascular procedures more frequently than uninsured adults. We examined the impact of Massachusetts’s healthcare reform on use of coronary revascularization procedures, in–hospital and 1-year mortality by race/ethnicity, education, and sex. Methods and Results Using hospital claims data, we compared differences in coronary revascularization rates [coronary artery bypass grafting or percutaneous coronary intervention] and in-hospital mortality by race/ethnicity, education, and sex among Massachusetts residents age 21–64 hospitalized with a principal discharge diagnosis of ischemic heart disease pre (November 1, 2004 to July 31, 2006) and post (December 1, 2006 to September 30, 2008) reform; 1-year mortality was calculated for those undergoing revascularization. Adjusted-logistic regression assessed 24,216 discharges pre-reform and 20,721 discharges post-reform. Blacks had 30% lower odds of receiving coronary revascularization than whites in the pre-reform period. Compared to whites in the post-reform period, blacks (OR=0.73, 95%CI 0.63–0.84) and Hispanics (OR= 0.84, 95%CI 0.74–0.97) were less likely and Asians (OR=1.29, 95%CI 1.01–1.65) more likely to receive coronary revascularization. Patients living in more educated communities, males, and persons with private insurance were more likely to receive coronary revascularization pre and post-reform. Compared to pre-reform, the adjusted odds of in-hospital mortality were higher in patients living in less educated communities in the post-reform period. No differences in 1-year mortality by race/ethnicity, education, or sex for revascularized patients were observed pre- or post-reform. Conclusion Reducing insurance barriers to receipt of coronary revascularization procedures has not yet eliminated pre-existing demographic and educational disparities in access to these procedures. PMID:24727094

  10. [Good governance in the Burundi health sector financial reform].

    Science.gov (United States)

    Peerenboom, Peter Bob; Basenya, Olivier; Bossuyt, Michel; Ndayishimiye, Juvénal; Ntakarutimana, Léonard; van de Weerd, Jennie

    2014-01-01

    Burundi introduced free healthcare for children under five and pregnant women in 2006. In 2010, this was linked to the Performance-Based Financing (PBF) approach. This article is designed to identify factors in these health financing reforms that have contributed to good governance in the health sector. Six criteria of good governance were used as an analytical framework. Results were derived from official reports and the international literature. The main contributions of these reforms to good governance in Burundi were the separation of functions, transparency in management and a meticulous description of administrative procedures. Scrupulous monitoring resulted in several corrective measures. Several unresolved questions remain, concerning the integration of vertical programmes and the sustainability of the system given the considerable costs, since funding is not yet fully ensured by the State and its partners.

  11. The European Trademark Reform. An Overview from a Danish Perspective

    DEFF Research Database (Denmark)

    Wallberg, Knud

    2015-01-01

    The article analyzes the proposed changes to the EU trademarks directive and the Community Trademark regulation......The article analyzes the proposed changes to the EU trademarks directive and the Community Trademark regulation...

  12. Reforming European universities: Scope for an evidence-based process

    NARCIS (Netherlands)

    Veugelers, R.; van der Ploeg, F.; Dewatripont, M.; Thys-Clément, F.; Wilkin, L.

    2008-01-01

    Universities are key players in the successful transition to a knowledge-based economy and society. However, this crucial sector of society needs restructuring if Europe is not to lose out in the global competition in education, research and innovation. To allow a more evidence based process of

  13. Reformation of Tax Procedures along the European Integration Process

    Directory of Open Access Journals (Sweden)

    Genta Bungo-Tafa

    2012-06-01

    Full Text Available Social insurance is part of social security which consists as well as of social assistance and services, health services and health care insurance. Everyone has the right for social insurance when retired or in case of incapacity of work under a certain system established by a law. The right of social insurance is part of labor rights. In Albania the mandatory social insurance scheme is based on the pay-as-you-earn principle, on the awareness of the individual about the risks in social field in its future and in the principle of agreement between generations. This is a scheme financed out of contributions from the employers, the employed persons and self-employed. The benefits are provided in case of sickness, maternity, old-age, disability, loss of breadwinner, employment accidents/occupational diseases and unemployment.

  14. A Comparative Study of Defense Reforms in Eastern European Nations

    Science.gov (United States)

    2010-12-01

    many agreed that the recovery would be a slow and prolonged process.205 In September 2010, billionaire investor Warren Buffett commented that the U.S...recession-economics. 206. Jonathan Stempel, “ Warren Buffett : We’re Still In a Recession,” Reuters, last modified September 23, 2010, accessed November 15...General Conference, August 18–24, 2002. Stempel, Jonathan. Reuters. “ Warren Buffett : We’re Still In a Recession.” Last modified September 23, 2010

  15. Local government reform: problematic aspects

    Directory of Open Access Journals (Sweden)

    Y. P. Sharov

    2014-06-01

    Full Text Available In the article the actual problems aspects of realization of reform of local self-government are worked up, namely: reformation of institute of local state administrations, creation of executive branches of local Rada, «technology» of realization of administrative-territorial device, place and role of strategic and project approaches, statutory and regulatory support of integrative forms of territorial communities activity, modern forms of professional communication of local government’s personal, using the potential of associations of local government’s practitioners; directions of development of human factor of reform and administrative system are analyzed in local self-government on principles of management achievements.

  16. The Economists of the Reformation

    Directory of Open Access Journals (Sweden)

    David H. Eaton

    2013-07-01

    Full Text Available This article provides an overview of the teaching of the Protestant Reformers (Luther, Calvin, and the Puritans toward issues of wealth, work, interest, and calling. The purpose is to highlight some of the teachings that could be said to lead to a “Protestant Work Ethic.” The Reformers were not uniform in their views of economic matters and in some cases their views of economic matters were influenced by the society around them. While much of the teaching continued in the Catholic tradition, the reformers did elevate the views of calling and work; what had been toil was elevated to Divine calling and service to God.

  17. Pension reform in Latin America : quick fixes or sustainable reform?

    OpenAIRE

    Aiyer, Sri-Ram

    1997-01-01

    Because of better health and higher standards of living, people are living longer. By 2030, more than 16 percent of the world's population will be older than 60, compared with 9 percent today. As a result, pension systems will need reform. Most current systems have substantial unfunded liabilities that will impose significant financial burdens onfuture generations without providing adequate protection for older individuals and lower-income workers. Pension reform is inevitable because of demo...

  18. Factors influencing healthcare service quality

    OpenAIRE

    Ali Mohammad Mosadeghrad

    2014-01-01

    Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production o...

  19. Stormy weather in healthcare

    DEFF Research Database (Denmark)

    Clemensen, Jane; Jakobsen, Pernille; Myhre Jensen, Charlotte

    2017-01-01

    This paper discusses how the roles of patients and health professionals have changed over the years. It also explores how accelerated courses of treatment and busy staff have turned healthcare services and hospitals into “factories”, where care and relationships now exist in very cramped conditions...... and healthcare professionals, by a dominant paradigm. We suggest a shift in focus from valuing the neo-liberal approach, to focus on care by linking an Ecology of Care (EoC) approach to the healthcare context, as EoC can be used as a complementary philosophy to help change the paradigm and thereby secure...

  20. Apps for hearing healthcare.

    Science.gov (United States)

    Paglialonga, Alessia; Tognola, Gabriella; Pinciroli, Francesco

    2015-01-01

    The hearing healthcare scenario is rapidly evolving due to the pervasive use of m-Health solutions, in particular mobile apps. This brings along significant advantages and opportunities (e.g., accessibility, affordability, personalized healthcare, patient empowerment) as well as significant potential risks and threats (e.g., safety, misuse, quality issues, privacy). Our research aims at the identification and assessment of apps in the hearing healthcare domain. In this article we present an overview of the current availability, variety, and penetration of hearing-related apps.

  1. Radiant non-catalytic recuperative reformer

    Energy Technology Data Exchange (ETDEWEB)

    Khinkis, Mark J.; Kozlov, Aleksandr P.

    2017-10-31

    A radiant, non-catalytic recuperative reformer has a flue gas flow path for conducting hot exhaust gas from a thermal process and a reforming mixture flow path for conducting a reforming mixture. At least a portion of the reforming mixture flow path is positioned adjacent to the flue gas flow path to permit heat transfer from the hot exhaust gas to the reforming mixture. The reforming mixture flow path contains substantially no material commonly used as a catalyst for reforming hydrocarbon fuel (e.g., nickel oxide, platinum group elements or rhenium), but instead the reforming mixture is reformed into a higher calorific fuel via reactions due to the heat transfer and residence time. In a preferred embodiment, a portion of the reforming mixture flow path is positioned outside of flue gas flow path for a relatively large residence time.

  2. Changes in the care of patients with cervical spine fractures following health reform in Massachusetts.

    Science.gov (United States)

    Schoenfeld, Andrew J; Wahlquist, Trevor C; Bono, Christopher M; Lehrich, Jessica L; Power, Robyn K; Harris, Mitchel B

    2015-08-01

    There is a substantial concern among spine surgeons that healthcare reform efforts will alter the processes through which spinal care is delivered and decrease overall quality. We used the Statewide Inpatient Dataset for Massachusetts to evaluate changes in hospital processes and quality of care for patients with cervical fractures following the implementation of health reform. This was a pre-post retrospective analysis of patients (n=9,387) treated for cervical fractures in Massachusetts between 2003-2006 and 2008-2010. Changes in hospital processes (surgical intervention, length of stay (LOS) and environment of care) and quality of care (mortality, complications, reoperation and failure to rescue (FTR)) were the outcomes of interest. FTR is a quality measure that evaluates a hospital's capacity to avoid mortality following the occurrence of a sentinel complication. Patients treated between 2003 and 2006 were considered the pre-reform group. The post-reform cohort consisted of those treated from 2008 to 2010. Baseline differences between cohorts were evaluated using chi-square or Mann-Whitney U tests. Unadjusted comparisons between the dependent variables and the onset of healthcare reform were performed, followed by regression techniques that adjusted for differences in case-mix and whether a surgical intervention was performed. Multivariable logistic regression was used for categorical variables and negative binomial regression was employed for continuous variables. The rates of surgical intervention remained unchanged pre- and post-reform (p=0.25). Hospital length of stay (RC: -0.18, 95% CI: -0.22, -0.14) and the FTR rate following surveillance insensitive complications (OR: 0.49, 95% CI: 0.25, 0.94) were significantly reduced following health reform. Post-reform, academic centers experienced a 22% reduction in mortality (95% CI: 0.61, 0.99) a 40% decrease in FTR (95% CI: 0.40, 0.89), a 30% decrease in surveillance insensitive complications (95% CI: 0.51, 0

  3. European visit

    CERN Multimedia

    2006-01-01

    The European Commissioner for Science and Research, Janez Potočnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez Potočnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez Potočnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...

  4. Do reviews of healthcare interventions teach us how to improve healthcare systems?

    Science.gov (United States)

    Pawson, Ray; Greenhalgh, Joanne; Brennan, Cathy; Glidewell, Elizabeth

    2014-08-01

    Planners, managers and policy makers in modern health services are not without ingenuity - they will always try, try and try again. They face deep-seated or 'wicked' problems, which have complex roots in the labyrinthine structures though which healthcare is delivered. Accordingly, the interventions devised to deal with such stubborn problems usually come in the plural. Many different reforms are devised to deal with a particular stumbling block, which may be implemented sequentially, simultaneously or whenever policy fashion or funding dictates. This paper examines this predicament from the perspective of evidence based policy. How might researchers go about reviewing the evidence when they are faced with multiple or indeed competing interventions addressing the same problem? In the face of this plight a rather unheralded form of research synthesis has emerged, namely the 'typological review'. We critically review the fortunes of this strategy. Separating the putative reforms into series of subtypes and producing a scorecard of their outcomes has the unintended effect of divorcing them all from an understanding of how organisations change. A more fruitful approach may lie in a 'theory-driven review' underpinned by an understanding of dynamics of social change in complex organisations. We test this thesis by examining the primary and secondary research on the many interventions designed to tackle a particularly wicked problem, namely the inexorable rise in demand for healthcare. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Structural Reforms in Latin America under Scrutiny

    OpenAIRE

    Lora, Eduardo; Panizza, Ugo

    2002-01-01

    The future of structural reforms in Latin America is under discussion. The purpose of this document is to synthesize the facts and opinions that underlie this debate. The first section shows that although the reform process has not ground to a halt, it has been incomplete and uneven, both across countries and different areas of reform. The greatest progress has been made in reforming the trade and financial sectors. In terms of tax reform and privatization, the record has been mixed across co...

  6. Welfare Reform & the Health of Single Mothers

    OpenAIRE

    Narain, Kimberly Danae Cauley

    2016-01-01

    Objective: This dissertation explores the relationship between welfare reform and the health of single mothers with less than a high school diploma or GED (LESMS) by addressing six research questions: (1) what impact did welfare reform have on the health insurance coverage of LESMS, (2) what impact did welfare reform have on the annual medical provider contact of LESMS, (3) what impact did welfare reform have on the health outcomes of LESMS, (4) what impact did welfare reform have on the fede...

  7. Applications of solar reforming technology

    Energy Technology Data Exchange (ETDEWEB)

    Spiewak, I. [Weizmann Inst. of Science, Rehovoth (Israel); Tyner, C.E. [Sandia National Labs., Albuquerque, NM (United States); Langnickel, U. [Deutsche Forschungsanstalt fuer Luft- und Raumfahrt e.V. (DLR), Koeln (Germany)

    1993-11-01

    Research in recent years has demonstrated the efficient use of solar thermal energy for driving endothermic chemical reforming reactions in which hydrocarbons are reacted to form synthesis gas (syngas). Closed-loop reforming/methanation systems can be used for storage and transport of process heat and for short-term storage for peaking power generation. Open-loop systems can be used for direct fuel production; for production of syngas feedstock for further processing to specialty chemicals and plastics and bulk ammonia, hydrogen, and liquid fuels; and directly for industrial processes such as iron ore reduction. In addition, reforming of organic chemical wastes and hazardous materials can be accomplished using the high-efficiency destruction capabilities of steam reforming. To help identify the most promising areas for future development of this technology, we discuss in this paper the economics and market potential of these applications.

  8. Child Mortality under Chinese Reforms

    OpenAIRE

    Christopher GRIGORIOU; Patrick GUILLAUMONT

    2004-01-01

    This paper looks for the impact of the Chinese economic reforms on its health performance. From an appropriate health outcomes indicator, it appears that while still being one of the most performing countries, China’s relative advance decreased during the reforms. Consistent with the fact that the health system had to rely more and more on private expenditures, we find an increasing impact of income on infant survival. We also show that relative prices matter for infant survival: for a given ...

  9. Misrecognition and science education reform

    Science.gov (United States)

    Brandt, Carol B.

    2012-09-01

    In this forum, I expand upon Teo and Osborne's discussion of teacher agency and curriculum reform. I take up and build upon their analysis to further examine one teacher's frustration in enacting an inquiry-based curriculum and his resulting accommodation of an AP curriculum. In this way I introduce the concept of misrecognition (Bourdieu and Passeron 1977) to open up new ways of thinking about science inquiry and school reform.

  10. Reforming Disaster and Emergency Response

    Science.gov (United States)

    2011-03-24

    St ra te gy R es ea rc h Pr oj ec t REFORMING DISASTER AND EMERGENCY RESPONSE BY COLONEL MARK D. JOHNSON United States Army...From - To) 4. TITLE AND SUBTITLE Reforming Disaster and Emergency Response 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...the Federal Emergency Management Agency (FEMA) has focused too much on day- to-day disasters , from snow storms to forest fires, tripling the number

  11. Indonesia : Budget Reform Strategy Priorities

    OpenAIRE

    Allen, R.; Eckardt, S.; Jacobs, D; Kristensen, J; Lienert, I.; Schiavo-Campo, S.

    2007-01-01

    This report is designed to assist the authorities develop an overall road map for reforming budget preparation. A specific focus is on the steps to be taken to introduce a medium-term framework for the central government's budget and a performance-based budget. These reforms require important preconditions to be in place, and a substantial change in the culture, incentives and behavior of ...

  12. Managing risk selection incentives in health sector reforms.

    Science.gov (United States)

    Puig-Junoy, J

    1999-01-01

    The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

  13. Healthcare Associated Infections - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infection (HAI) measures - provider data. These measures are developed by Centers for Disease Control and Prevention (CDC) and...

  14. Healthcare Associated Infections - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - national data. These measures are developed by Centers for Disease Control and Prevention (CDC) and...

  15. Healthcare Associated Infections - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - state data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected...

  16. Are healthcare workers' intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review

    National Research Council Canada - National Science Library

    Herzog, Raúl; Álvarez-Pasquin, María José; Díaz, Camino; Del Barrio, José Luis; Estrada, José Manuel; Gil, Ángel

    2013-01-01

    The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers' knowledge and beliefs about vaccines, and their attitudes towards them, to increase vaccination coverage...

  17. Information Technology for Healthcare

    OpenAIRE

    Abbas Yazdanpanah

    2016-01-01

    The article produced below hopes to focus on the use of information technology solutions for improving healthcare delivery systems. It explains evolution of IT-Enhanced healthcare from Telemedicine to e-health, including definition and requirements of telemedical systems. It also traces the evolution of contemporary telemedical systems and the challenges faced by future technologies including legal and formal aspects of telemedicine as well as its acceptance among users. It overvi...

  18. Internal Border Controls in the European Union

    DEFF Research Database (Denmark)

    Jørgensen, Carsten Willemoes; Sørensen, Karsten Engsig

    2012-01-01

    Recent events, involving inter alia France and Denmark, have stimulated renewed interest in the introduction of different forms of border controls at the internal borders within the European Union. These border control measures are aimed at checking either persons or goods or both. Against...... the background of these events, this article analyses the existing rules regulating controls of persons and goods, and explores how these rules may or may not stand in the way of introducing border controls at the European Union’s internal borders. These events have resulted in a call for reforms of the current...

  19. Health policy in the concertación era (1990-2010): Reforms the chilean way.

    Science.gov (United States)

    Martinez-Gutierrez, María Soledad; Cuadrado, Cristóbal

    2017-06-01

    The Chilean health system has experienced important transformations in the last decades with a neoliberal turn to privatization of the health insurance and healthcare market since the Pinochet reforms of the 1980s. During 20 years of center-left political coalition governments several reforms were attempted to regulate and reform such markets. This paper analyzes regulatory policies for the private health insurance and health care delivery market, adopted during the 1990-2010 period. A framework of variation in market types developed by Gingrich is adopted as analytical perspective. The set of policies advanced in this period could be expected to shift the responsibility of access to care from individuals to the collective and give control to the State or the consumers vis a vis producers. Nevertheless, the effect of the implemented reforms has been mixed. Regulations on private health insurers were ineffective in terms of shifting power to the consumer or the state. In contrast, the healthcare delivery market showed a trend of increasing payers' and consumers' control and the set of implemented reforms partially steered the market toward collective responsibility of access by creating a submarket of guaranteed services (AUGE) with lower copayments and fully funded services. Emerging unintended consequences of the adopted policies and potential explanations are discussed. In sum, attempts to use regulation to improve the collective dimension of the Chilean health system has enabled some progress, but several challenges had persisted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Patient Centered Medical Home: Creating a Blueprint for Quality Healthcare through Illustrative Simulation

    Science.gov (United States)

    Sheingold, Brenda Helen; Chapa, Deborah W.; Ekmekci, Ozgur; Emard, Esther

    2015-01-01

    The advent of healthcare reform in the U.S. presents an unprecedented challenge to academic institutions that are striving to prepare a workforce to interact with individuals needing care in a variety of new practice settings. Patient-centered care is a core objective of these evolving settings which enhance access to a variety professionals and…

  1. The influence of social challenges when implementing information systems in a Swedish health-care organisation.

    Science.gov (United States)

    Nilsson, Lina; Eriksén, Sara; Borg, Christel

    2016-09-01

    To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation. Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation. An Institutional Ethnography design was used. A deductive content analysis was made influenced by empirically identified social challenges of power, professional identity and encounters. An abstraction was made of the analysis. Nineteen nurses at macro, meso and micro levels were interviewed in focus groups. Organisational levels are lost in different ways in how to control the reformation, how to introduce Information systems as reformation strategies and in how to translate new tools and assumptions that do not fit traditional ways of working in shaping professional identities. Different focus may affect the reformation of health-care organisations and implementation and knowledge processes. An implementation climate is needed where the system standards fit the values of the users. Nursing management needs to be visionary, engaged and work with risk factors in order to reform the hierarchical health-care organisation. © 2016 John Wiley & Sons Ltd.

  2. Steam reforming of ethanol

    DEFF Research Database (Denmark)

    Trane-Restrup, Rasmus; Dahl, Søren; Jensen, Anker Degn

    2013-01-01

    Steam reforming (SR) of oxygenated species like bio-oil or ethanol can be used to produce hydrogen or synthesis gas from renewable resources. However, deactivation due to carbon deposition is a major challenge for these processes. In this study, different strategies to minimize carbon deposition...... on Ni-based catalysts during SR of ethanol were investigated in a flow reactor. Four different supports for Ni were tested and Ce0.6Zr0.4O2 showed the highest activity, but also suffered from severe carbon deposition at 600 °C or below. Operation at 600 °C or above were needed for full conversion...... of ethanol over the most active catalysts at the applied conditions. At these temperatures the offgas composition was close to the thermodynamical equilibrium. Operation at high temperatures, 700 °C and 750 °C, gave the lowest carbon deposition corresponding to 30–60 ppm of the carbon in the feed ending...

  3. An Ethical Analysis of Performance-Based Supplementary Payment in Turkey's Healthcare System.

    Science.gov (United States)

    Kadioglu, Funda Gulay

    2016-07-01

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

  4. Renaissance bookbindings on Slovene reformation prints from the Slovene National Museum in Ljubljana

    Directory of Open Access Journals (Sweden)

    Sonja Svoljšak

    2004-01-01

    Full Text Available Four of these prints: two Dalmatin’s Bibles, Dalmatin’s Lepe karszhanske molitve and Trubar’s Hishna postilla have leather stiff board decorative renaissance bindings while Bohorič’s Arcticae horulae succisivae has a stiff board vellum binding.A short overview of the European renaissance bookbindnig characteristics and decorative motives development is presented in the first part, followed by the codicological census. The second part of the research consists of decorative tools and motives clasiffication and an individual motive analysis. An overview of the decorative motives on four decorative reformation bindings in the context of the European reformation book decoration styles with special emphasis on the Wittemberg reformation book decoration style is given in the final analysis.

  5. European Cinema

    NARCIS (Netherlands)

    Elsaesser, Thomas

    2005-01-01

    In the face of renewed competition from Hollywood since the early 1980s and the challenges posed to Europe's national cinemas by the fall of the Wall in 1989, independent filmmaking in Europe has begun to re-invent itself. European Cinema: Face to Face with Hollywood re-assesses the different

  6. Relations between decision indicators for implementing technology in healthcare logistics – a bed logistics case study

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes; Jacobsen, Peter

    2015-01-01

    The cost of healthcare is rising and reforms have been introduced across Europe to address the cost issue in healthcare. There is potential to improve logistical processes within healthcare to save costs and at the same time provide services that support high quality patient care. Re......-designing processes and implementing technology can improve the efficiency of processes and reduce costs. A relations diagram has been developed that identifies the effects between the constructs Logistics, Technology, Procedure and Structure. Knowledge about how these constructs affect each other is important when...

  7. Study on Environmental Fiscal Reform Potential in 14 EU Member States: Main Report & Appendices

    DEFF Research Database (Denmark)

    Hogg, Dominic; Andersen, Mikael Skou; Elliott, Timothy

    2015-01-01

    Environment Agency between 2010 and 2013 on the potential for environmental fiscal reform in four EU Member States affected by the economic crisis. As with the last study for the European Commission, the intention of this study is to indicate where this potential may lie, and to demonstrate the order...

  8. Duty Calls for Interculturalism: How Do Teachers Perceive the Reform of Intercultural Education in Cyprus?

    Science.gov (United States)

    Hajisoteriou, Christina

    2013-01-01

    In the context of Cyprus's accession to the European Union and a huge wave of immigration towards the country, teachers are called upon to teach within more diverse educational settings. In consideration of the substantial role teachers play in implementing intercultural education, this study explores their perceptions of the reform of…

  9. The Agenda 2000 CAP reform, world prices and GATT-WTO export constraints

    NARCIS (Netherlands)

    Meijl, van H.; Tongeren, van F.W.

    2002-01-01

    This paper examines the compatibility of the Agenda 2000 reform of the Common Agricultural Policy (CAP) of the European Union (EU) with the EU's commitments to reduce export subsidies made under the GATT Uruguay Round Agreement on Agriculture. A multi-region applied general equilibrium model, which

  10. The Agenda 2000 CAP reform, world prices and URAA GATT-WTO export constraints

    NARCIS (Netherlands)

    Meijl, van H.; Tongeren, van F.W.

    2002-01-01

    This paper examines the compatibility of the Agenda 2000 reform of the Common Agricultural Policy (CAP) of the European Union (EU) with the EU's commitments to reduce export subsidies made under the GATT Uruguay Round Agreement on Agriculture. A multi-region applied general equilibrium model, which

  11. The Road to Change? A Case Study Examining Educational Reform in Sibiu County, Romania

    Science.gov (United States)

    Tucker, Stan; Trotman, Dave; Rusu, Horatiu; Mara, Daniel

    2014-01-01

    This article examines processes of educational reform and change in a post-Communist Eastern European country. Focusing on the experiences and challenges facing one geographical community in Sibiu County, Romania, an attempt is made to understand some of the macro and micro factors, influences and external policy drivers, shaping the organization…

  12. Will Gender Equality Ever Fit In? Contested Discursive Spaces of University Reform

    Science.gov (United States)

    Kreissl, Katharina; Striedinger, Angelika; Sauer, Birgit; Hofbauer, Johanna

    2015-01-01

    Similar to other European countries, the introduction of non-academic, especially managerial, criteria in higher education has shaped and altered Austrian universities since over a decade. This paper presents the results of a frame analysis of Austrian higher education debates from 1993 until 2010. It outlines how reforms in higher education were…

  13. A Judicialisation of Healthcare Policies in Denmark and Spain?

    DEFF Research Database (Denmark)

    Martinsen, Dorte Sindbjerg; Mayoral, Juan A.

    2017-01-01

    This paper examines the impact of judicialisation on the right to cross-border healthcare in Denmark and Spain, i.e., the national impact of legal integration as spurred by the Court of Justice of the European Union (CJEU). We expect the national impact of judicialisation to be conditioned by the...

  14. Assistive Robotics in Robotics for healthcare, roadmap study for the EC

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M. de; Cremers, G.; Rensma, A.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  15. Use of Generics—A Critical Cost Containment Measure for All Healthcare Professionals in Europe?

    Directory of Open Access Journals (Sweden)

    F. Cankat Tulunay

    2010-08-01

    Full Text Available Pharmaceutical expenditures in ambulatory care rose rapidly in Europe in the 1990s and early 2000s. This was typically faster than other components of healthcare spending, leading to reforms to moderate future growth. A number of these centered on generic medicines with measures to lower reimbursed prices as well as enhance their prescribing and dispensing. The principal objective of this paper is to review additional measures that some European countries can adopt to further reduce reimbursed prices for generics. Secondly, potential approaches to address concerns with generics when they arise to maximize savings. Measures to enhance the prescribing of generics will also briefly be discussed. A narrative review of the extensive number of publications and associated references from the co-authors was conducted supplemented with known internal or web-based articles. In addition, health authority and health insurance databases, principally from 2001 to 2007, were analyzed to assess the impact of the various measures on price reductions for generic omeprazole and generic simvastatin vs. pre-patent loss prices, as well as overall efficiency in Proton Pump Inhibitor (PPI and statin prescribing. The various initiatives generally resulted in considerable lowering of the prices of generics as well as specifically for generic omeprazole and generic simvastatin vs. pre-patent loss prices. At one stage in the UK, generic simvastatin was just 2% of the originator price. These measures also led to increased efficiency for PPI and statin prescribing with reimbursed expenditure for the PPIs and statins either falling or increasing at appreciably lower rates than increases in utilization. A number of strategies have also been introduced to address patient and physician concerns with generics to maximize savings. In conclusion, whilst recent reforms have been successful, European countries must continue learning from each other to fund increased volumes and new

  16. CONSIDERATION REGARDING TO THE FISCAL REGULATIONS IN SOME EUROPEAN STATES

    Directory of Open Access Journals (Sweden)

    Ardeleanu-Popa Carmen

    2010-12-01

    Full Text Available It can be observed, that the member states of the European Union were guided to implement some reforms in the domain of fiscal politics, the aim of which would constitute in fighting and eliminating the damaging fiscal competition, of the differences regarding to indirect fiscality, etc. Without this political fiscal instrument coordinated by the members of the European Union, the free traffic of capitals could be transformed into a determinant factor of the cross-border fraud.

  17. Reforming Preschools and Schools.

    Science.gov (United States)

    Duncan, Greg J; Magnuson, Katherine; Murnane, Richard J

    2016-04-01

    Compared with their higher-income counterparts, children growing up in low-income families in the United States typically complete less schooling, report worse health, and work and earn less in adulthood. Moreover, changes in the American economy over the last 40 years have raised the level of skills and qualifications that children need to obtain a good middle-class job, as well as making it much more difficult for children from low-income families to attend schools that support their learning of these skills. We first review strategies used in the past to improve K-12 schooling-including investing more money, introducing more accountability, and putting in place new governance structures (eg, charter schools)-and show why these strategies have been relatively ineffective. Drawing on the research literature and case studies, we then describe education reform strategies for prekindergarten programs and for elementary, middle, and high schools that may help meet these challenges. All of the initiatives described in our case studies provide ample opportunities for teachers and school leaders to improve their skills through coaching and other professional development activities; incorporate sensible systems of accountability, including requiring teachers to open their classrooms to the scrutiny of colleagues and school leaders and to work with their colleagues to improve their teaching practices; and incorporate high academic standards, such as those described in the Common Core State Standards. By focusing directly on improving teaching and promoting learning, these successful initiatives have boosted the achievement of low-income children. They show that it is indeed possible to make a real difference in the life chances of low-income children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Temptation of the “Powerful”: The politics of electoral reform in Central Europe in post-transitional period

    OpenAIRE

    Charvát Jakub

    2016-01-01

    The paper explores and analyses processes of electoral reforms in selected Central European countries (the Czech Republic, Hungary, Slovakia, and Slovenia) in post-transitional period. The qualitative analysis focuses “only” on the enacted changes in electoral systems and its purpose is not to evaluate the impact and political consequences of individual changes but rather to concentrate, through a theoretically-informed detailed contextual analysis, on the electoral reform process itself. It ...

  19. Mobile healthcare informatics.

    Science.gov (United States)

    Siau, Keng; Shen, Zixing

    2006-06-01

    Advances in wireless technology give pace to the rapid development of mobile applications. The coming mobile revolution will bring dramatic and fundamental changes to our daily life. It will influence the way we live, the way we do things, and the way we take care of our health. For the healthcare industry, mobile applications provide a new frontier in offering better care and services to patients, and a more flexible and mobile way of communicating with suppliers and patients. Mobile applications will provide important real time data for patients, physicians, insurers, and suppliers. In addition, it will revolutionalize the way information is managed in the healthcare industry and redefine the doctor - patient communication. This paper discusses different aspects of mobile healthcare. Specifically, it presents mobile applications in healthcare, and discusses possible challenges facing the development of mobile applications. Obstacles in developing mobile healthcare applications include mobile device limitations, wireless networking problems, infrastructure constraints, security concerns, and user distrust. Research issues in resolving or alleviating these problems are also discussed in the paper.

  20. How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

    Science.gov (United States)

    Bronkhorst, Babette

    2017-08-01

    Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

  1. Hydrogen Generation Via Fuel Reforming

    Science.gov (United States)

    Krebs, John F.

    2003-07-01

    Reforming is the conversion of a hydrocarbon based fuel to a gas mixture that contains hydrogen. The H2 that is produced by reforming can then be used to produce electricity via fuel cells. The realization of H2-based power generation, via reforming, is facilitated by the existence of the liquid fuel and natural gas distribution infrastructures. Coupling these same infrastructures with more portable reforming technology facilitates the realization of fuel cell powered vehicles. The reformer is the first component in a fuel processor. Contaminants in the H2-enriched product stream, such as carbon monoxide (CO) and hydrogen sulfide (H2S), can significantly degrade the performance of current polymer electrolyte membrane fuel cells (PEMFC's). Removal of such contaminants requires extensive processing of the H2-rich product stream prior to utilization by the fuel cell to generate electricity. The remaining components of the fuel processor remove the contaminants in the H2 product stream. For transportation applications the entire fuel processing system must be as small and lightweight as possible to achieve desirable performance requirements. Current efforts at Argonne National Laboratory are focused on catalyst development and reactor engineering of the autothermal processing train for transportation applications.

  2. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  3. Balancing influence between actors in healthcare decision making.

    Science.gov (United States)

    Kaplan, Robert M; Babad, Yair M

    2011-04-19

    Healthcare costs in most developed countries are not clearly linked to better patient and public health outcomes, but are rather associated with service delivery orientation. In the U.S. this has resulted in large variation in healthcare availability and use, increased cost, reduced employer participation in health insurance programs, and reduced overall population health outcomes. Recent U.S. healthcare reform legislation addresses only some of these issues. Other countries face similar healthcare issues. A major goal of healthcare is to enhance patient health outcomes. This objective is not realized in many countries because incentives and structures are currently not aligned for maximizing population health. The misalignment occurs because of the competing interests between "actors" in healthcare. In a simplified model these are individuals motivated to enhance their own health; enterprises (including a mix of nonprofit, for profit and government providers, payers, and suppliers, etc.) motivated by profit, political, organizational and other forces; and government which often acts in the conflicting roles of a healthcare payer and provider in addition to its role as the representative and protector of the people. An imbalance exists between the actors, due to the resources and information control of the enterprise and government actors relative to the individual and the public. Failure to use effective preventive interventions is perhaps the best example of the misalignment of incentives. We consider the current Pareto efficient balance between the actors in relation to the Pareto frontier, and show that a significant change in the healthcare market requires major changes in the utilities of the enterprise and government actors. A variety of actions are necessary for maximizing population health within the constraints of available resources and the current balance between the actors. These actions include improved transparency of all aspects of medical decision

  4. A atenção em Saúde Mental em municípios de pequeno e médio portes: ressonâncias da reforma psiquiátrica Mental Healthcare in small and medium-sized cities: resonance of the psychiatric reform

    Directory of Open Access Journals (Sweden)

    Cristina Amélia Luzio

    2009-02-01

    Full Text Available A partir da análise da Política Nacional de Saúde Mental formulada nos últimos anos e das experiências desenvolvidas após 1987 no país, procura-se compreender como o Sistema Único de Saúde tem contribuído ao avanço da reforma psiquiátrica nos municípios; verificar como a assistência oferecida nesses municípios está viabilizando os princípios da reforma psiquiátrica e a melhora das condições de vida dos usuários, bem como pesquisar o papel dos trabalhadores e gestores na construção de novas práticas de cuidado em Saúde Mental. A análise das práticas discursivas aponta que os vários segmentos sociais envolvidos na Saúde Mental conhecem os princípios e propostas da reforma psiquiátrica. No entanto, as gestões municipais não assumem integralmente as propostas do Ministério da Saúde para a área, sob a alegação de falta de recursos financeiros para a contrapartida exigida. Os usuários e familiares têm aos poucos assumido as novas propostas de intervenção, mas os mecanismos de participação e organização popular ainda são incipientes. Por fim, deve-se destacar que, para uma efetiva consolidação das propostas atuais da reforma psiquiátrica, é necessário um maior compromisso dos gestores com a atenção em Saúde Mental, maior investimento nas equipes multiprofissionais, o estímulo à organização e à participação dos usuários e familiares e a integralidade dos dispositivos de saúde, de assistência social e de cultura existentes nas cidades.From the analysis of the national Mental Health policy, formulated in the past years, and from the experiences developed after 1987, it is sought to: understand how Brazilian Health System has contributed to the development of the psychiatric reform in towns; verify how the assistance offered in those towns is making the psychiatric reform principles feasible as well as improving the users´ living conditions; and research the role of the workers and managers

  5. Leadership strategies in healthcare.

    Science.gov (United States)

    Menaker, Ronald

    2009-01-01

    Healthcare is one of the largest and most important industries in the United States because it affects every individual in the nation. Numerous parties are stakeholders in healthcare, which contributes to the complexity of change efforts. Physicians and administrators play a significant role by providing direct care and influencing other decisions that impact the delivery of patient care. Success in the healthcare industry is influenced by numerous factors, some of which are controllable and others that are not. Understanding leadership and change management will be increasingly important to overcome resistance to change and to improve relationships, the core of leadership in an environment that will become more challenging. In what follows, different approaches to understanding leadership and change management are presented along with other leadership strategies to enhance the effectiveness of leaders. Raising leader awareness regarding transformational leadership behaviors and developing strategies to increase the use of these behaviors may be helpful to enhance organizational performance.

  6. Conization and healthcare use

    DEFF Research Database (Denmark)

    Frederiksen, Maria E; Vázquez-Prada Baillet, Miguel; Jensen, Pernille T

    2017-01-01

    The aim of this study was to assess whether negative psychological consequences of conization reported in questionnaire studies translated into increased use of the healthcare services that could relieve such symptoms. This was a population-based register study comparing women undergoing conization......, healthcare use increased significantly from the 'before' to the 'after' period. For contacts with GPs and hospitals, the increase was significantly larger for the conization group than for the control group, but this could be attributed to the standard postconization follow-up process. In the 'before' period......, women who later had a conization used fewer drugs than the control-group women, but their drug use increased similarly over time. The conization event did not result in an increased use of the healthcare services that could relieve potential negative side effects. However, women who underwent...

  7. Can consumers cure healthcare?

    Science.gov (United States)

    Gruber, David

    2009-01-01

    The U.S. healthcare delivery system is in crises. Costs are too high and increasingly becoming unaffordable to federal and state governments, employers and consumers. Americans are dissatisfied with the current system and believe it should be fundamentally altered or rebuilt. A solution needs to be found, and it is not the single-payer system espoused by many in Washington and elsewhere. We believe consumers can cure healthcare if (a) professionals, providers and policy experts shift their mindset from treating diseases and conditions to taking a holistic approach to the caring of people, particularly Baby Boomers and their parents; (b) technology becomes widely available to increase engagement, personalize healthcare, share experiences, make better choices and embrace convenience and (c) a cost-effective and reimbursed primary care navigator (coordinator and/or health manager), consistent with the medical home concept espoused by the American Association of Family Practitioners (AAFP) becomes a central component of public policy.

  8. Tough love : the European Union's relations with the Western Balkans

    NARCIS (Netherlands)

    Blockmans, Steven

    2007-01-01

    As part of the international presence in the Western Balkans, the European Union has adopted sanctions, brokered political agreements, launched its first-ever police and military missions and directed economic, legal and administrative reforms to eradicate the root causes of instability. Yet,

  9. Health Care Reform: Out Greatest Opportunity...Ever!

    Science.gov (United States)

    Keigher, Sharon M.

    1993-01-01

    Discusses inevitability of health care reform in United States, considers the reform process itself, and explains the plan of the President's Task Force on National Health Care Reform. Also considers the prospects for Congressional response to reform proposals. (NB)

  10. Advanced healthcare materials

    CERN Document Server

    Tiwari, Ashutosh

    2014-01-01

    Advanced materials are attracting strong interest in the fundamental as well as applied sciences and are being extensively explored for their potential usage in a range of healthcare technological and biological applications. Advanced Healthcare Nanomaterials summarises the current status of knowledge in the fields of advanced materials for functional therapeutics, point-of-care diagnostics, translational materials, up and coming bio-engineering devices. The book highlights the key features which enable engineers to design stimuli-responsive smart nanoparticles, novel biomaterials, nan

  11. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza

    2014-01-01

    The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i.......e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other...... jurisdictions (e.g., clinical coding) to bear on costing practice. These factors contribute to the fragmentation of the jurisdiction of management accounting....

  12. The Emergence of Hybrid Professional Roles: GPs and secondary school teachers in a context of public sector reform

    NARCIS (Netherlands)

    Hendrikx, Wiljan; van Gestel, Nicolette

    2016-01-01

    Responding to recent calls for more context and history in studying (semi-)professionals in the public sector, this article examines the emergence of hybrid professional roles along with large scale reforms of Dutch healthcare and education since 1965. Using a theoretical framework based on public

  13. Teaching the Dragon? The Diffusion of European Union’s Social and Employment Policies to China

    NARCIS (Netherlands)

    van Gerven-Haanpää, Minna Marja-Leena; Weiguo, Yang; Mok, Ka Ho

    2017-01-01

    This chapter analyses the extent to which we can trace the ideational spread of the European Union’s employment and social policies outside European borders, more specifically in China. Based on the analysis of labour market reforms in China between 2000 and 2012 and interview data obtained from

  14. Studies in Business Administration in the European Higher Education Area: A Comparative Analysis in Europe

    Science.gov (United States)

    Cavero Rubio, José Antonio; Mullor, Javier Reig; Martín, Agustín Pérez

    2015-01-01

    On signing the Bologna declaration in 1999, European countries committed themselves to addressing the reforms necessary for adapting their university education to the European Higher Education Area. This modification process culminated in 2010, and this research aims to analyse the degree of divergence that currently exists in each course subject…

  15. Revitalizing the European ‘Neighbourhood Economic Community’: the case for legally binding sectoral multilateralism

    NARCIS (Netherlands)

    Blockmans, S.; van Vooren, B.

    2012-01-01

    The revolutionary upheaval in the southern Mediterranean and the slow reforms in most of the eastern neighbourhood have pushed the European Union to revise its approach to the European Neighbourhood Policy (ENP). In May 2011, the Commission presented a full review of the ENP, introducing an enhanced

  16. UNIVERSITY REFORM AND INTELLECTUAL FREEDOM

    Directory of Open Access Journals (Sweden)

    Antonio Valdecantos Alcaide

    2009-04-01

    Full Text Available The university reforms undertaken after the 1999 Bologna Declaration do not constitute a strictly academic phenomenon, but also a social reform at a high level, that affects the concept itself of society and the role of intellectual freedom in the whole Freedom System of the liberal thought and ideology. Contrary to the basics of this tradition, it is maintained that the intellectual sphere must be included in the economic sphere and that institutions in which intellectual freedom could be practised must be considered -even with a certain amount of independence- as a part of the market. The purpose of this article is to show that present university reform is against what has been the usual way of constructing the idea of society from the 18th century onwards.

  17. Health Inequity and "Restoring Fairness" Through the Canadian Refugee Health Policy Reforms: A Literature Review.

    Science.gov (United States)

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2016-09-02

    Refugees and refugee claimants experience increased health needs upon arrival in Canada. The Federal Government funded the Interim Federal Health Program (IFHP) since 1957, ensuring comprehensive healthcare insurance for all refugees and refugee claimants seeking protection in Canada. Over the past 4 years, the Canadian government implemented restrictions to essential healthcare services through retrenchments to the IFHP. This paper will review the IFHP, in conjunction with other immigration policies, to explore the issues associated with providing inequitable access to healthcare for refugee populations. It will examine changes made to the IFHP in 2012 and in response to the federal court decision in 2014. Findings of the review indicate that the retrenchments to the 2012 IFHP instigated health outcome disparities, social exclusion and increased costs for vulnerable refugee populations. The 2014 reforms reinstated some services; however the policy continued to produce inequitable healthcare access for some refugees and refugee claimants.

  18. Philosophy, medicine and healthcare: insights from the Italian experience.

    Science.gov (United States)

    Adinolfi, Paola

    2014-09-01

    To contribute to our understanding of the relationship between philosophical ideas and medical and healthcare models. A diachronic analysis is put in place in order to evaluate, from an innovative perspective, the influence over the centuries on medical and healthcare models of two philosophical concepts, particularly relevant for health: how Man perceives his identity and how he relates to Nature. Five epochs are identified--the Archaic Age, Classical Antiquity, the Middle Ages, the Modern Age, the 'Postmodern' Era--which can be seen, à la Foucault, as 'fragments between philosophical fractures'. From a historical background perspective, up to the early 1900s progress in medical and healthcare models has moved on a par with the evolution of philosophical debate. Following the Second World War, the Health Service started a series of reforms, provoked by anti-positivistic philosophical transformations. The three main reforms carried out however failed and the medical establishment remained anchored to a mechanical, reductionist approach, perfectly in line with the bureaucratic stance of the administrators. In this context, future scenarios are delineated and an anthropo-ecological model is proposed to re-align philosophy, medicine and health care.

  19. Electronic Healthcare Records: an essential part of Health Telematics Applications.

    Science.gov (United States)

    Engelbrecht, R; Hildebrand, C; Moser, W

    2000-01-01

    A healthcare record should ideally be a repository of data, describing a person's health and how it is being supported; and not, as it is now, describing a person's diseases and treatment only. The healthcare record is the basis for monitoring and decisions. Therefore it should be open and available to all authorized health professionals and to the patient. To make this easier is one of the major advantages of electronic healthcare records (EHCR). The computer-based patient record could make major contributions to improving the healthcare system. This is the motivation to initiatives, projects and routine implementations of electronic patient records. The European Union and national initiatives have put major efforts into the support of this main field of medical information processing.

  20. Greening healthcare at Muskoka Algonquin Healthcare.

    Science.gov (United States)

    Stone, Debra

    2017-03-01

    Waste diversion is fundamental to reducing the ecological footprint. Until 2012, waste generated by Muskoka Algonquin Healthcare (MAHC) was not incorporated into any formal waste diversion efforts. In 2012, the Reduce, Recycle, Waste Diversion Program was initiated. Support for the program was endorsed by the senior leadership team, staff, and the community, and incorporated into the strategic plan, which was instrumental in the program's success. The goal of the waste diversion program was to help MAHC work towards a sustainable future and make MAHC a leading hospital in making responsible environmental choices. By increasing the number of recycle stations at MAHC's two hospital sites and providing education and promotion on the importance of waste diversion, MAHC has been successful in reducing the amount of waste going to the landfill to a 48% level between 2012 and 2015. The following case study illustrates and discusses MAHC's successful waste diversion efforts.

  1. Reforming long-term care in Europe

    National Research Council Canada - National Science Library

    Costa-i-Font, Joan

    2011-01-01

    .... Offers the very latest analysis of long-term care reform agendas in Europe. Compares countries comparatively less studied with the experiences of reform in Germany, the UK, Netherlands and Sweden...

  2. TAX-REFORM - DREAMING ABOUT TOUGH REALITIES

    NARCIS (Netherlands)

    DEKAM, F

    1992-01-01

    This paper discusses four papers concerned with tax reform. It is concluded that tax reform has had a rather limited impact on behaviour so far but that governments should press ahead with gradual improvement and not expect dramatic results.

  3. Intelligence Reform: A Question of Balance

    National Research Council Canada - National Science Library

    Bansemer, John D

    2006-01-01

    .... The 9/11 Report renewed calls for reform of the intelligence community (IC), continuing a long series of intelligence reform efforts that began shortly after the National Security Act of 1947 laid the foundation of the modern IC...

  4. Attrition resistant fluidizable reforming catalyst

    Science.gov (United States)

    Parent, Yves O [Golden, CO; Magrini, Kim [Golden, CO; Landin, Steven M [Conifer, CO; Ritland, Marcus A [Palm Beach Shores, FL

    2011-03-29

    A method of preparing a steam reforming catalyst characterized by improved resistance to attrition loss when used for cracking, reforming, water gas shift and gasification reactions on feedstock in a fluidized bed reactor, comprising: fabricating the ceramic support particle, coating a ceramic support by adding an aqueous solution of a precursor salt of a metal selected from the group consisting of Ni, Pt, Pd, Ru, Rh, Cr, Co, Mn, Mg, K, La and Fe and mixtures thereof to the ceramic support and calcining the coated ceramic in air to convert the metal salts to metal oxides.

  5. Arktisk Reform i Ukraines Skygge

    DEFF Research Database (Denmark)

    Rahbek-Clemmensen, Jon

    2015-01-01

    USA overtager formandskabet for Arktisk Råd ved udenrigsministermødet d. 24.-25. april 2015. Der er behov for nødvendige reformer af Rådets struktur, men Ukraine-konflikten gør det vanskeligt at nå de ambitiøse mål.......USA overtager formandskabet for Arktisk Råd ved udenrigsministermødet d. 24.-25. april 2015. Der er behov for nødvendige reformer af Rådets struktur, men Ukraine-konflikten gør det vanskeligt at nå de ambitiøse mål....

  6. Reel Reform: Documentaries Spur Debate about Educational Reform

    Science.gov (United States)

    Hurley, Stephen

    2011-01-01

    Three new American documentaries including "Waiting for Superman," "The Lottery, Race to Nowhere" and one British entry, "We are the People We've Been Waiting For," have animated school reform debates. Each of these documentaries seeks to disturb the entrenched thinking by claiming that our educational institutions…

  7. 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. Copyright © 2015 by American Society of Clinical Oncology.

  8. Improving Competition: Reforming the Requirements Process

    Science.gov (United States)

    2016-07-01

    45 Defense AT&L: July-August 2016 Improving Competition Reforming the Requirements Process Roy Wood, Ph.D. Wood is the Acting Vice President...professional. T ypical acquisition reform efforts have been focused in the margins, achiev­ ing marginal results. The evidence of decades of...acquisition reform indicates that the marginal reforms typically taken are not making the funda­ mental changes needed by the Department of Defense (DoD

  9. Method of steam reforming methanol to hydrogen

    Science.gov (United States)

    Beshty, Bahjat S.

    1990-01-01

    The production of hydrogen by the catalyzed steam reforming of methanol is accomplished using a reformer of greatly reduced size and cost wherein a mixture of water and methanol is superheated to the gaseous state at temperatures of about 800.degree. to about 1,100.degree. F. and then fed to a reformer in direct contact with the catalyst bed contained therein, whereby the heat for the endothermic steam reforming reaction is derived directly from the superheated steam/methanol mixture.

  10. The Labor Supply Effects of Welfare Reform

    OpenAIRE

    Bartik, Timothy J.

    1998-01-01

    Will welfare reform increase unemployment and reduce wages? The answer depends in part on how much welfare reform increases labor supply. This paper considers the labor supply effects of the welfare reforms that have occurred since 1993, when President Clinton entered office with a promise to "end welfare as we know it." The paper reviews previous estimates, and provides new estimates, of how many additional labor force participants have entered the labor force due to welfare reform. I estima...

  11. Social marketing in healthcare

    Directory of Open Access Journals (Sweden)

    Radha Aras

    2011-08-01

    Full Text Available BackgroundSocial marketing is an important tool in the delivery ofhealthcare services. For any healthcare programme orproject to be successful, community/consumer participationis required. The four principles of social marketing can guidepolicymakers and healthcare providers to successfully planand implement health programmes.AimTo review the existing literature in order to project thebenefits of social marketing in healthcare.MethodA search of periodical literature by the author involvingsocial marketing and marketing concepts in health wascarried out. Items were identified initially through healthorientedindexing services such as Medline, Health STARand Cinahl, using the identifiers “social marketing“ and“marketing in health”. An extensive search was also carriedout on educational database ERIC.ResultsA literature review of various studies on social marketingindicated that the selection of the right product (accordingto the community need at the right place, with the rightstrategy for promotion and at the right price yields goodresults. However, along with technical sustainability(product, price, promotion and place, financialsustainability, institutional sustainability and marketsustainability are conducive factors for the success of socialmarketing.ConclusionThe purpose of this literature review was to ascertain thelikely effectiveness of social marketing principles andapproaches and behaviour change communication towardshealth promotion.It is important for all healthcare workers to understand andrespond to the public’s desires and needs and routinely useconsumer research to determine how best to help thepublic to solve problems and realise aspirations. Socialmarketing can optimise public health by facilitatingrelationship-building with consumers and making their liveshealthier.

  12. Coproduction of healthcare service.

    Science.gov (United States)

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. 49 CFR 260.13 - Credit reform.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Credit reform. 260.13 Section 260.13... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.13 Credit reform. The Federal Credit Reform Act of 1990, 2 U.S.C. 661, requires Federal agencies to set aside the subsidy cost of new credit...

  14. General Education Reform: Opportunities for Institutional Alignment

    Science.gov (United States)

    Fuess, Scott M., Jr.; Mitchell, Nancy D.

    2011-01-01

    General education reform provides strategic opportunities for departments. This article analyzes reform at the University of Nebraska-Lincoln, illustrating how departments could use the reform process to clarify their strategic planning, align with institutional goals, and steer the university closer to departmental objectives. (Contains 1 table.)

  15. Considerations for Education Reform in British Columbia

    Science.gov (United States)

    Santos, Ana

    2012-01-01

    Countries around the world refer to twenty-first century education as essential to maintaining personal and national economic advantage and draw on this discourse to advocate for and embark on educational reform. This paper examines issues around education reform, particularly in British Columbia. It argues that reformers should give careful…

  16. Large-Scale Reform Comes of Age

    Science.gov (United States)

    Fullan, Michael

    2009-01-01

    This article reviews the history of large-scale education reform and makes the case that large-scale or whole system reform policies and strategies are becoming increasingly evident. The review briefly addresses the pre 1997 period concluding that while the pressure for reform was mounting that there were very few examples of deliberate or…

  17. Leadership Lessons from Comprehensive School Reforms.

    Science.gov (United States)

    Murphy, Joseph, Ed.; Datnow, Amanda, Ed.

    This volume explores the role of leadership in comprehensive school reform (CSR). It consists of 12 chapters: (1) "The Development of Comprehensive School Reform" (Joseph Murphy and Amanda Datnow); (2) "Expeditionary Learning Schools: Tenacity, Leadership, and School Reform" (Greg Farrell); (3) "The Modern Red School…

  18. Social marketing in healthcare.

    Science.gov (United States)

    Aras, Radha

    2011-01-01

    Social marketing is an important tool in the delivery of healthcare services. For any healthcare programme or project to be successful, community/consumer participation is required. The four principles of social marketing can guide policymakers and healthcare providers to successfully plan and implement health programmes. To review the existing literature in order to project the benefits of social marketing in healthcare. A search of periodical literature by the author involving social marketing and marketing concepts in health was carried out. Items were identified initially through health-oriented indexing services such as Medline, Health STAR and Cinahl, using the identifiers "social marketing" and "marketing in health". An extensive search was also carried out on educational database ERIC. A literature review of various studies on social marketing indicated that the selection of the right product (according to the community need) at the right place, with the right strategy for promotion and at the right price yields good results. However, along with technical sustainability (product, price, promotion and place), financial sustainability, institutional sustainability and market sustainability are conducive factors for the success of social marketing. The purpose of this literature review was to ascertain the likely effectiveness of social marketing principles and approaches and behaviour change communication towards health promotion. It is important for all healthcare workers to understand and respond to the public's desires and needs and routinely use consumer research to determine how best to help the public to solve problems and realise aspirations. Social marketing can optimise public health by facilitating relationship-building with consumers and making their lives healthier.

  19. Health care reform, 2014: no matter what the question, mission is the answer.

    Science.gov (United States)

    Khatri, Parinda

    2014-06-01

    In this column, the president of the Collaborative Family Healthcare Association (CFHA) addresses the lack of understanding and agreement to the question What is health care reform? It is a daunting task to understand, let alone redesign, the most expensive (but not most effective or most efficient) health care system in the world. In this critical window of opportunity, influencing positive movement through leadership, communication, and teamwork is a strategic priority of the CFHA and its journal, Family Systems & Health. The emphases on comprehensive, coordinated, and cost-effective care, although novel concepts for many, have been core features of CFHA's philosophy for almost two decades (see CFHA's mission statement). As we mark the halfway point in this pivotal year in health care reform, we continue to struggle. CFHA can help illuminate the path of what health care reform can be and what it can do for each citizen in our communities.

  20. Non-healthcare costs of hepatitis C: a systematic review.

    Science.gov (United States)

    Pascual-Argente, Natàlia; Puig-Junoy, Jaume; Llagostera-Punzano, Anna

    2018-01-01

    There is an increasing interest in the indirect (or non-healthcare) costs of hepatitis C virus (HCV). Areas covered: Systematic review of original studies on the non-healthcare costs of HCV published in English or Spanish between January 2000 and March 2017. 19 studies addressing non-healthcare cost of HCV were included in the analysis. All studies but one contain treatments with monotherapy or dual therapy prior to the recent introduction of innovative and highly effective direct acting antivirals (DAAs). Five studies estimate the incremental non-healthcare cost of HCV with a control group, which is regarded as high-quality methodology. The incremental annual non-healthcare costs of HCV in untreated patients compared with non-HCV patients are €4,209 in the US, and taking data from 5 European countries costs range from €280 in the UK to €659 in France. Expert commentary: Available studies may be underestimating the true burden of non-healthcare costs for HCV as they are all partial studies, mainly including absenteeism and premature mortality estimates. Moreover, there is a need for studies addressing non-healthcare costs of HCV in settings where new treatments with DAAs have been implemented, as they are probably changing the current and future burden of the disease.

  1. Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

    Directory of Open Access Journals (Sweden)

    Mauricio Toyama

    2017-09-01

    Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

  2. Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

    Science.gov (United States)

    Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

    2017-01-01

    Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

  3. Factors Influencing Healthcare Service Quality

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2014-07-01

    Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

  4. Development of healthcare waste management in Serbia and challenges in the improvement of the quality of healthcare services

    Directory of Open Access Journals (Sweden)

    Jovanović Verica S.

    2014-01-01

    Full Text Available Proper Healthcare Waste Management (HCWM was introduced in the Republic of Serbia in 2007 with the support of the European Union. Since then, the amounts of waste treated, prior to landfill, have steadily increased and more and more healthcare institutions adopted HCWM systems. In parallel large numbers of healthcare workers were trained in proper HCWM. This study quantifies the progress made. The study analyzed the period 2009 to 2012 using three methods of data collection. On basis of data collected, it has been established that with a population of just over seven million, Serbia generates between 4,500 and 5,000 tones of infectious waste on an annual basis of which some 20% originates from the treatment of out-patients, 75% from the treatment of in-patients and 5% from micro-biological laboratory tests. While in 2009 only one third of this waste was treated prior to disposal, this fraction has increased to two thirds in 2011. The data also show that more than 90% of healthcare facilities have developed individual healthcare waste management plans up from less than 20% in 2009. In every healthcare facility there are at least 2 people trained in healthcare waste management, and in total there are approximately 3000 staff members who received formal HCWM training provided through the Institute for Public Health. Healthcare waste management is continuously improving in the Republic of Serbia and is well established in more than 85% of healthcare facilities. There are still issues to be improved especially regarding treatment on healthcare waste other than infectious waste.

  5. Steam reforming of light oxygenates

    DEFF Research Database (Denmark)

    Trane-Restrup, Rasmus; Resasco, Daniel E; Jensen, Anker Degn

    2013-01-01

    Steam reforming (SR) of ethanol, acetic acid, acetone, acetol, 1-propanol, and propanal has been investigated over Ni/MgAl2O4 at temperatures between 400 and 700 degrees C and at a steam-to-carbon-ratio (S/C) of 6. The yield of H-2 and conversion increased with temperature, while the yield of by...

  6. Tax Reform and Higher Education.

    Science.gov (United States)

    Franck, Gail

    1987-01-01

    The effect of the Tax Reform Act of 1986 on college and university revenues and expenditures is reviewed. Institutional revenues are derived primarily from five sources: tuition, charitable contributions, debt financing, endowment income, and governmental appropriations. The effect of the new law on family and student income, savings, student…

  7. Assessing Institutionalization of Educational Reforms

    Science.gov (United States)

    Aypay, Ahmet; Kalayci, Serpil Sezer

    2008-01-01

    This study aims to assess the institutionalization of a major reform in the faculties of education in Turkey in the 1990s. A survey was administered to faculty members in eight faculties of education in the academic year 2005-2006. Factor analysis, t-tests and ANOVAs, and OLS regressions were used. Findings indicate that the most problematic area…

  8. Forest policy reform in Brazil

    Science.gov (United States)

    S. Bauch; E. Sills; L.C. Rodriguez Estraviz; K. McGinley; F. Cubbage

    2009-01-01

    Rapid deforestation in the Brazilian Amazon, caused by economic, social, and policy factors, has focused global and national attention on protecting this valuable forest resource. In response, Brazil reformed its federal forest laws in 2006, creating new regulatory, development, and incentive policy instruments and institutions. Federal forestry responsibilities are...

  9. Steam Hydrocarbon Cracking and Reforming

    Science.gov (United States)

    Golombok, Michael

    2004-01-01

    The interactive methods of steam hydrocarbon reforming and cracking of the oil and chemical industries are scrutinized, with special focus on their resemblance and variations. The two methods are illustrations of equilibrium-controlled and kinetically-controlled processes, the analysis of which involves theories, which overlap and balance each…

  10. Reforming Dutch occupational pension schemes

    NARCIS (Netherlands)

    Gradus, R.H.J.M.; Bovenberg, A.L.

    2015-01-01

    In many countries, occupational plans are being reformed away from defined-benefit (DB) to defined-contribution (DC) designs. This paper explores the case of the Netherlands, which features a particularly high ratio of occupational pension assets to GDP. Dutch occupational DB plans suffer from a

  11. (milbank) and reformational philosophy (dooyeweerd)

    African Journals Online (AJOL)

    Reformational Philosophy (RP). One of these concerns is their rejection of the dogma of the autonomy of reason. Milbank (2006b:22) investigates the theological critique of Hamann,. Jacobi, Wizenmann and Herder – “of philosophy construed as the autonomy of reason”. In the Introduction to Radical Orthodoxy, Milbank.

  12. reforming unit using pinch analysis

    African Journals Online (AJOL)

    2012-12-19

    Dec 19, 2012 ... _ i , I _, p ' ABSTRACT, H { __;_~ -_~ Energy Integration of Catalytic Reforming Unit (CRU), of 'KadunalRefin'ery' and Petrochemical , . Company Kaduna Nigeria was carried out usingPinch Technology. The'pinch analysis waishcarried ' out using Maple. Optimum minimum approach temperature of 20 °C ...

  13. Catalytic reforming feed characterisation technique

    Energy Technology Data Exchange (ETDEWEB)

    Larraz Mora, R.; Arvelo Alvarez, R. [Univ. of La Laguna, Chemical Engineering Dept., La Laguna (Spain)

    2002-09-01

    The catalytic reforming of naphtha is one of the major refinery processes, designed to increase the octane number of naphtha or to produce aromatics. The naphtha used as catalytic reformer feedstock usually contains a mixture of paraffins, naphthenes, and aromatics in the carbon number range C{sub 6} to C{sub 10}. The detailed chemical composition of the feed is necessary to predict the aromatics and hydrogen production as well as the operation severity. The analysis of feed naphtha is usually reported in terms of its ASTM distillation curve and API or specific gravity. Since reforming reactions are described in terms of lumped chemical species (paraffins, naphthenes and aromatics), a feed characterisation technique should be useful in order to predict reforming operating conditions and detect feed quality changes. Unfortunately online analyzer applications as cromatography or recently introduced naphtha NMR [1] are scarce in most of refineries. This work proposes an algorithmic characterisation method focusing on its main steps description. The method could help on the subjects previously described, finally a calculation example is shown. (orig.)

  14. Lifelong Learning and Welfare Reform.

    Science.gov (United States)

    Griffin, Colin

    1999-01-01

    An alternative perspective on lifelong learning locates it in culture, civil society, and leisure/consumption lifestyles. Distinctions between education and learning and markets and quasi-markets are used to explore policy models. The relationship to welfare reform policies is discussed. (Author/SK)

  15. [Reform of psychiatry in Spain].

    Science.gov (United States)

    Pedrosa Gil, F; Luderer, H J

    2000-11-01

    Since the 1980's psychiatric care in Spain changed considerably (Reforma psiquiátrica española). In the course of this reform, many positive results were achieved. An extensive community network of mental health centres was build up which resulted in the majority of psychiatric patients being integrated in the Spanish general health care system and making a better organized mental health care structure possible. New legislation also improved the care and civil rights of patients. An analysis of the experiences of the Spanish psychiatric reform shows that the tendency to retain the old mental hospitals, alongside the other institutions still exists. The process of deinstitutionalization and the original aims of the psychiatric reform cannot only be satisfied by the closure of large psychiatric hospitals as during the reform new aspects and problems as well the great complexity of the task have become apparent. This article together with the details of the Spanish sources gives the German public a good overview of the developments in Spanish psychiatry.

  16. Teacher Empowerment and School Reform

    Science.gov (United States)

    Thornburg, Devin G.; Mungai, Anne

    2011-01-01

    Teachers in high-needs settings working with diverse populations are typically cited as a central element for school improvement yet are often described as resistant to such efforts. We sought to investigate the reasons behind teachers' views and beliefs about school reform within the context of collaboration and professional development, rather…

  17. Stakeholders' expectations and perceived effects of the pharmacy ownership liberalization reform in Sweden

    DEFF Research Database (Denmark)

    Wisell, Kristin; Winblad, Ulrika; Sporrong, Sofia Kälvemark

    2016-01-01

    BACKGROUND: Reforms in the health-care sector, including the pharmacy sector, can have different rationales. The Swedish pharmacies were prior to 2009 organized in a state-owned monopoly. In 2009, a liberalization of the ownership took place, in which a majority of the pharmacies were sold...... should lead to, apart from abolishing the monopoly. The perceived effects are quite similar in the different stakeholder groups, and not as positive as were expected....

  18. Does the Accountable Care Act Aim to Promote Quality, Health, and Control Costs or Has It Missed the Mark? ;Comment on “Health System Reform in the United States”

    Directory of Open Access Journals (Sweden)

    Carol Molinari

    2014-02-01

    Full Text Available McDonough’s perspective on healthcare reform in the US provides a clear, coherent analysis of the mix of access and delivery reforms in the Affordable Care Act (ACA aka Obamacare. As noted by McDonough, this major reform bill is designed to expand access for health coverage that includes both prevention and treatment benefits among uninsured Americans. Additionally, this legislation includes several financial strategies (e.g. incentives and penalties to improve care coordination and quality in the hospital and outpatient settings while also reducing healthcare spending and costs. This commentary is intended to discuss this mix of access and delivery reform in terms of its potential to achieve the Triple Aim: population health, quality, and costs. Final remarks will include the role of the US federal government to reform the American private health industry together with that of an informed consumer.

  19. Migrants' access to healthcare.

    Science.gov (United States)

    Norredam, Marie

    2011-10-01

    There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were used to explore differences: 1) cancer stage at diagnosis as a clinical outcome and 2) emergency room (ER) contacts as a utilisation measure. Both informal and formal barriers to access were studied to explore why possible differences existed including: 1) motivation for using ER; and 2) asylum seekers' healthcare entitlements. Different definitions of migration and ethnicity were investigated including: country of birth and residence status. Substudy I showed a tendency towards more advanced stage at diagnosis or unknown stage among most subgroups of migrant women with a history of cancer compared to non-migrant women. Sub-study II found that some migrants (those born in Somalia, Turkey and Ex-Yugoslavia) use ER services more frequently than do non-migrants whereas others have the same or lower utilisation levels. As a consequence, substudy III was undertaken, which documented that more migrant within all subgroups had considered contacting a primary caregiver before visiting the ER compared to non-migrants, but that migrants experienced communication problems herein

  20. The European Narcolepsy Network (EU-NN) database

    DEFF Research Database (Denmark)

    Khatami, Ramin; Luca, Gianina; Baumann, Christian R

    2016-01-01

    Narcolepsy with cataplexy is a rare disease with an estimated prevalence of 0.02% in European populations. Narcolepsy shares many features of rare disorders, in particular the lack of awareness of the disease with serious consequences for healthcare supply. Similar to other rare diseases, only...... a few European countries have registered narcolepsy cases in databases of the International Classification of Diseases or in registries of the European health authorities. A promising approach to identify disease-specific adverse health effects and needs in healthcare delivery in the field of rare...... diseases is to establish a distributed expert network. A first and important step is to create a database that allows collection, storage and dissemination of data on narcolepsy in a comprehensive and systematic way. Here, the first prospective web-based European narcolepsy database hosted by the European...

  1. Healthcare technology in the home

    DEFF Research Database (Denmark)

    Ballegaard, Stinne Aaløkke

    2011-01-01

    The dissertation explores through ethnographic field studies ways in which negotiations and transformations take place when healthcare technology is introduced to the home. With the increased focus on tele-medical solutions and on supporting patient self-care through new healthcare technologies i...... of healthcare technology extends beyond making treatment available outside the hospital. Healthcare technology is not neutral, but transforms practice and entails both challenges and possibilities.......The dissertation explores through ethnographic field studies ways in which negotiations and transformations take place when healthcare technology is introduced to the home. With the increased focus on tele-medical solutions and on supporting patient self-care through new healthcare technologies...... it is relevant to examine the changes induced by this development: How is healthcare technology appropriated and domesticated by users, how does the development affect the role of the patient, and how is the relationship between home patients, family caregivers and healthcare professionals transformed? The role...

  2. Hospital Managers’ Perception of Recent Health Care Reform in Teaching Hospitals of Qazvin, Iran

    Directory of Open Access Journals (Sweden)

    Zakaria Kiaei

    2015-11-01

    Full Text Available Background The main purpose of any government from a healthcare reform is to improve the service quality and raised public satisfaction. Objectives As the important role of managerial human resources in any organizational changes, this paper tried to examine the point of view of this group about the recent reform in governmental hospitals of Qazvin. Patients and Methods This cross-sectional study was conducted in January 2015. The statistical population consisted of 50 executive managers of Qazvin teaching hospitals. The data gathering instrument was a research-made questionnaire with approved reliability and validity (α = 0.84. Data analyse was performed in SPSS version 20 using descriptive and analytic statistics (analysis of variance (ANOVA, Pearson correlation test and one sample t-test. Results A total of 43.2% of managers believed that this reform was a good restrictor for malpractices in healthcare and 31.8% believed that it will not be so useful to improve the society health status. The average score of resource preparation, insurance companies coordination, changing the routine workflows, and finally achieving the goals, had a meaningful difference (P ˂ 0.05 and the average score of these fields were upper than average. Conclusions The findings showed that based on the managers’ point of view, the reform plan was able to achieve its primary goals; however, it could not meet their exceptions in improving the society health status. Therefore, it is necessary to design some interventions for changing this perception.

  3. Study on assessing the environmental fiscal reform potential for the EU28

    DEFF Research Database (Denmark)

    Hogg, Dominic; Elliott, Timothy; Elliott, Laurence

    2016-01-01

    and consumption taxes”. The AGS set out three pillars that it foresaw as underpinning the EU’s economic and social policy for 2015:  A coordinated response to boosting investment;  A renewed commitment to structural reforms; and  The pursuit of fiscal responsibility. Environmental taxes (together......, and the expressed desire to promote more efficient use of both energy and other resources, point towards a role for environmental fiscal reform (EFR) as a means to set the European economy on a trajectory of growth with a strong shade of green....

  4. STRESS MANAGEMENT FOR HEALTHCARE PROFESSIONALS

    OpenAIRE

    Odigie, Anita

    2016-01-01

    Healthcare professionals are exposed to several job stressors that can adversely affect both their mental and physical health, decrease their efficiency at work, for a successful intervention, the causes and management of stress in any healthcare unit or among healthcare professionals must be diligently documented. The aim of this study is to explore issues on specific occupational stress related to job performance, the role of healthcare in stress management and the effects of job resourc...

  5. 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...... of these reforms on public support for the welfare state.......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...

  6. Water Institutional Reforms in Scotland: Contested Objectives and Hidden Disputes

    Directory of Open Access Journals (Sweden)

    Antonio A.R. Ioris

    2008-10-01

    Full Text Available One fundamental limitation of the contemporary debate over water institutional reforms has been the excessive concentration on scientific assessments and management techniques, with insufficient consideration of the underlying politics of decision-making and socio-economic asymmetries. This article examines the 'sociology of water regulation' to demonstrate how the implementation of the European Water Framework Directive (WFD in Scotland is profoundly influenced by broader political and economic circumstances. The ongoing reforms of regulatory institutions became entangled in the reorganisation of a devolved Scottish Administration in the late 1990s, which has directly influenced the channels of representation and the overall decision-making processes. It is claimed here that, despite a discursive construction around sustainability and public participation, the new institutional landscape has so far failed to improve long-term patterns of water use and conservation. The article also analyses how the exacerbation of the economic dimension of water management has permeated the entire experience, serving as a political filter for the assessment of impacts and formulation of solutions. The ultimate conclusion is that formal changes in the legislation created a positive space for institutional reforms, but the effective improvement of water policy and catchment management has been curtailed by political inertia and the hidden balance of power.

  7. Innovation Concepts in Healthcare

    CERN Multimedia

    CERN. Geneva

    2010-01-01

    AbstractDemographic change and advances in medical science pose increased challenges to healthcare systems globally: The economic basis is aging and thus health is becoming more and more a productivity factor. At the same time, with today’s new communication possibilities the demand and expectations of effective medical treatment have been increased. This presentation will illustrate the need for the “industrialization” of healthcare in order to achieve highest results at limited budgets. Thereby, industrialization is not meaning the medical treatment based on the assembly line approach. Rather it is to recognize the cost of medical care as an investment with respective expectations on the return of the investment. Innovations in imaging and pharmaceutical products as well as in processes - that lead to similar medical results, but with lower efforts - are keys in such scenarios.BiographyProf. Dr. Hermann Requardt, 54, is a member of the Managing Board of Siemens AG and Chief Executive Officer of the He...

  8. Patient charges for health services: the opinions of healthcare stakeholders in Bulgaria.

    Science.gov (United States)

    Atanasova, Elka; Pavlova, Milena; Moutafovа, Emanuela; Kostadinova, Todorka; Groot, Wim

    2015-01-01

    The reforms of the Bulgarian healthcare sector have been widely discussed, both nationally and internationally. In spite of the reforms, problems with the efficiency, equity and quality in healthcare provision continue to exist in Bulgaria. Among others, the reforms included the implementation of formal patient charges for the use of healthcare services. These were established in the country in 2000. Formal patient charges are applied to all levels of medical services with the exception of emergency care. The aim of this paper is to describe and analyze the attitudes of Bulgarian healthcare stakeholders toward patient charges. The analysis is based on data collected in focus group discussions and in-depth interviews carried out in Bulgaria in May-June 2009. The paper concludes by recommendations for policies related to patient payments. The social sensitivity of these payments requires broad discussion before policy decisions are implemented. There is also a need of a well-thought communication strategy on the issue of patient payments by the Ministry of Health. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Macroeconomic trends and reforms in Germany

    Directory of Open Access Journals (Sweden)

    Roberto Sabbatini

    2010-01-01

    Full Text Available This paper traces the main macroeconomic developments in the German economy from national unification. Its performance is compared with that of the rest of the euro area and its largest economies. The study documents as GermanyÕs modest growth in the later 1990s was due to the restrictive impact on domestic demand coming from the deep restructuring and modernization of the production system, followed by sweeping reforms after the turn of the century. Rapid productivity increases and prolonged wage moderation, especially in industry, fuelled a large and mounting current account surplus in Germany, that compares with the deficits registered in most European countries. The study retraces the recent debate on how to correct those imbalances, recalling the arguments for and against the thesis that the countries with a current payments surplus, above all Germany, must also play an active role in fostering the adjustment of the deficit countries. A possible synthesis is proposed, based on an analysis of the formation of national income and the use of resources according to the national accounts system. The implication is that Germany may contribute to the correction of imbalances within the euro area not so much by altering the wage formation mechanism as by creating incentives for domestic investment, hence fostering employment creation, in the service sectors that are currently lagging behind the extraordinary perfomance of a number of core activities in the industry.

  10. Quality management in healthcare

    OpenAIRE

    Subhash S Dodwad

    2013-01-01

    Clinical governance and better human resource management practices are important planks in the current health policies emphasizing quality of patient care. There are numerous reasons why it is important to improve quality of healthcare, including enhancing the accountability of health practitioners and managers, resource efficiency, identifying, and minimizing medical errors while maximizing the use of effective care and improving outcomes, and aligning care to what users/patients want in add...

  11. Sociotechnical changing in healthcare.

    Science.gov (United States)

    Petrakaki, Dimitra; Cornford, Tony; Klecun, Ela

    2010-01-01

    This paper discusses a conceptual approach to the study of the implementation of ICTs in healthcare organizations. The paper uses some fundamental concepts from sociotechnical studies to address the complex process of change--the changing--that accompanies ICT innovations. The paper argues for the importance of the perspective of changing as a way to account for the dynamics as technology and people, organizations and institutions co-constitutively work-out their future together.

  12. Advanced practice roles for nurses in tomorrow's healthcare systems.

    Science.gov (United States)

    Berger, A M; Eilers, J G; Pattrin, L; Rolf-Fixley, M; Pfeifer, B A; Rogge, J A; Wheeler, L M; Bergstrom, N I; Heck, C S

    1996-09-01

    Advanced practice nurses (APNs) have traditionally been a diverse group in terms of titles, education, credentials, and roles. The classification of APN usually encompasses the nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS). NP, CRNA, and CNM roles have been more clearly delineated than the CNS roles. In light of healthcare reform, the CNS roles have been critically reviewed and analyzed. Attempts have been made to clarify responsibilities and outcomes, and to quantify the financial impact of this role. In this article, seven APN roles clearly defined in terms of minimal qualifications and competencies critical to accomplishment of the duties, responsibilities, and expected outcomes are presented. Comparison of competency requirements are also presented. The roles presented are designed to facilitate healthcare institutions in meeting the demands for serving patients with increasingly complex needs, as well as cost-containment goals.

  13. Psychology in academic health centers: a true healthcare home.

    Science.gov (United States)

    Rozensky, Ronald H

    2012-12-01

    This article is based on the invited presentation by the author at the American Psychological Association's Annual Convention, August 4-7, 2011, upon his receipt of the Joseph D. Matarazzo Award for Distinguished Contributions to Psychology in Academic Health Centers presented by the Association of Psychologists in Academic Health Centers. This article relates the history, roles, and responsibilities of psychologists in academic health centers to the ultimate survival and success of professional psychology. It describes implications of the Patient Protection and Affordable Care Act (ACA) on the institutional practice of psychology including how psychology's place in academic health centers positions the field well for the future of healthcare reform. The article provides several recommendations to help professional psychology prepare for that future of integrated, interprofessional healthcare.

  14. [Smart Medicine and Healthcare].

    Science.gov (United States)

    Lu, Yen-Chiao Angel; Chen, Li-Chin

    2017-08-01

    Innovation and rapid technological development in Smart Medicine or Smart Healthcare impact profoundly on many aspects of healthcare. It is believed that Health Information Technology (HIT) has the potential to improve integration between care providers, reduce administrative costs and burdens, reduce medical errors, and improve care quality and patient outcomes. However, issues such as interoperability, compatibility, and integration are critical to effectively integrating hardware and software in order to fully realize the benefits of HIT. High-end medical devices and equipment, including medical carts / mobile computer carts and wireless physiological and biomedical monitoring devices, should also be integrated into the hospital information system. Furthermore, the Data, Information, Knowledge, and Wisdom Hierarchy (DIKW) has been gaining popularity in the development of Nursing Information Systems (NIS) since 2013. To create a DIKW-based information system, data must first be defined and analyzed and then transformed into meaningful information. Eventually, this information is transformed into an intelligent system. For example, if evidence-based nursing research results / findings are integrated into the NIS to guide clinical practice, patient outcomes, patient safety, and healthcare quality will be greatly enhanced.

  15. Swiss-model of managerial culture as the basis for forming the competence model of a modern manager in healthcare

    Directory of Open Access Journals (Sweden)

    Olga Aleksandrovna Strakhova

    2015-06-01

    Full Text Available Objective to research the practice of Swissmanagement of healthcare organizations. Methods abstractlogic comparative management benchmarking. Results elaboration o f the mechanism and tools of forming the competence model of the modern manager in healthcare. Scientific novelty the conceptual approach is elaborated to build the system of human resources management in healthcare organization basing on the Swissmodel of managerial culture the innovative model of healthcare managers training in the system of continuous professional education is elaborated the problemoriented approach to training the medical personnel is used with the possibility to correct the curriculum during its implementation. Practical value the issue of efficient resource management in healthcare are discussed at the level of the Russian Ministry of Healthcare Russian Agency for Monitoring in Healthcare Federal Fund for compulsory medical insurance. The existing contradictions in the management and regulatory system of healthcare as a sector of economy the protracted reforms the unbalanced model of healthcare system lead to the search of new managerial mechanisms. Thus the introduction of the Swissmodel of human resources management and the new type of managerial culture in healthcare organizations can be viewed as the mechanism of increasing the efficiency of the Russian healthcare organizationsrsquo functioning. nbsp

  16. Regional Healthcare Effectiveness

    Directory of Open Access Journals (Sweden)

    Olga Vladimirovna Kudelina

    2016-03-01

    Full Text Available An evaluation of healthcare systems effectiveness of the regions of the Russian Federation (federal districts was conducted using the Minmax method based on the data available at the United Interdepartmental Statistical Information System. Four groups of components (i.e. availability of resources; use of resources; access to resources and medical effectiveness decomposed into 17 items were analyzed. The resource availability was measured by four indicators, including the provision of doctors, nurses, hospital beds; agencies providing health care to the population. Use of resources was measured by seven indicators: the average hospital stay, days; the average bed occupancy, days; the number of operations per 1 physician surgical; the cost per unit volume of medical care: in outpatient clinics, day hospitals, inpatient and emergency care. Access to the resources was measured by three indicators: the satisfaction of the population by medical care; the capacity of outpatient clinics; the average number of visits to health facility. The medical effectiveness was also measured by three indicators: incidence with the "first-ever diagnosis of malignancy"; life expectancy at birth, years; the number of days of temporary disability. The study of the dynamics of the components and indexes for 2008–2012 allows to indicate a multidirectional influence on the regional healthcare system. In some federal districts (e.g. North Caucasian, the effectiveness decreases due to resource availability, in others (South, North Caucasian — due to the use of resources, in others (Far Eastern, Ural — due to access to resources. It is found that the effectiveness of the healthcare systems of the federal districts differs significantly. In addition, the built matrix proves the variability the of effectiveness (comparison of expenditures and results of healthcare systems of the federal districts of the Russian Federation: the high results can be obtained at high costs

  17. Energy deprivation dynamics and regulatory reforms in Europe. Evidence from household panel data

    Energy Technology Data Exchange (ETDEWEB)

    Poggi, Ambra [Department of Economics, University of Milan-Bicocca and LABORatorio Revelli, Collegio C. Alberto (Italy); Florio, Massimo [Department of Economics, Business and Statistics, University of Milan, Via Conservatorio 7, 20122 Milan (Italy)

    2010-01-15

    The typical ingredients of energy reforms in the European Union (EU) in the 1990s were full or partial privatization, vertical disintegration and liberalization. This paper analyses the effects of energy reforms on the probability of households experiencing deprivation, defined as difficulty in paying the bills. We use two sets of micro-data. First, the European Community Household Panel (ECHP), a large EU survey, offers evidence on people who report having been unable to pay scheduled utility bills. We consider seven European countries: Denmark, Belgium, France, Ireland, Italy, the Netherlands and Spain, and eight ECHP waves (1994-2001), with around 28,000 observations. Second, we also use micro-data from the European Statistics on Income and Living Conditions survey (EU-SILC) 2004-2005, with around 84,000 observations. The countries included are Belgium, France, Ireland, Italy, Spain, Austria, Finland, Luxembourg, Norway and Sweden. As indicators of regulatory reforms in the same countries and years we use ECTR (formerly REGREF), a database provided by the OECD. In both samples we find evidence that privatization increases the probability of households experiencing deprivation. Vertical disintegration has a similar effect and also increases the persistence in the status of household deprivation. Liberalization has no statistically significant effect. We discuss possible interpretations of these findings. (author)

  18. Energy deprivation dynamics and regulatory reforms in Europe: Evidence from household panel data

    Energy Technology Data Exchange (ETDEWEB)

    Poggi, Ambra [Department of Economics, University of Milan-Bicocca and LABORatorio Revelli, Collegio C. Alberto (Italy); Florio, Massimo, E-mail: massimo.florio@unimi.i [Department of Economics, Business and Statistics, University of Milan, Via Conservatorio 7, 20122 Milan (Italy)

    2010-01-15

    The typical ingredients of energy reforms in the European Union (EU) in the 1990s were full or partial privatization, vertical disintegration and liberalization. This paper analyses the effects of energy reforms on the probability of households experiencing deprivation, defined as difficulty in paying the bills. We use two sets of micro-data. First, the European Community Household Panel (ECHP), a large EU survey, offers evidence on people who report having been unable to pay scheduled utility bills. We consider seven European countries: Denmark, Belgium, France, Ireland, Italy, the Netherlands and Spain, and eight ECHP waves (1994-2001), with around 28,000 observations. Second, we also use micro-data from the European Statistics on Income and Living Conditions survey (EU-SILC) 2004-2005, with around 84,000 observations. The countries included are Belgium, France, Ireland, Italy, Spain, Austria, Finland, Luxembourg, Norway and Sweden. As indicators of regulatory reforms in the same countries and years we use ECTR (formerly REGREF), a database provided by the OECD. In both samples we find evidence that privatization increases the probability of households experiencing deprivation. Vertical disintegration has a similar effect and also increases the persistence in the status of household deprivation. Liberalization has no statistically significant effect. We discuss possible interpretations of these findings.

  19. Using disease management and market reforms to address the adverse economic effects of drug budgets and price and reimbursement regulations in Germany.

    Science.gov (United States)

    Schwermann, Tim; Greiner, Wolfgang; v d Schulenburg, J M Graf

    2003-01-01

    Germany spends the highest share (10.4%) of its gross domestic product on health care among European Union countries. The majority of this financing comes from an earmarked tax on labor earnings. Drug spending, as a share (12.7%), is relatively low, as is per-capita drug spending. Over the past decade, a number of specific budgeting initiatives were introduced to control drug spending-with some success, at least until the 11% increase in the first 6 months of 2001. This article describes and analyzes these governmental initiatives as well as other market reforms. Germany has had a "drug budget silo mentality" throughout this period. But the focus of the mentality moved rapidly from the central budget to regional budgets and to drug budgets per physician based on historical data. These amounts do not correspond to either medical necessity or economic considerations. An analysis of the health-care system as a whole shows that the efforts to constrain spending with budget in one area can lead to higher total costs. This article also considers the impact of introducing other actual or proposed reforms such as a positive list to replace the negative list, generic substitution, retail price competition among pharmacies, and E-health commerce. There is also a new national institute constructing a database of information on health technology assessments. To overcome the strong segmentation of the health system in physician, drug, and hospital budgets, we recommend using this information from proper cost-effectiveness evaluations to develop clear guidelines for disease management programs, reinforced by appropriate financial incentives.

  20. Reform of labour taxes in Latvia 2011-2013

    Directory of Open Access Journals (Sweden)

    Ilmārs Šņucins

    2015-12-01

    Full Text Available The paper analyses the motives for and results of the labour tax reforms undertaken by the Latvian government in 2011-2013 with a special focus on the lowwage sector. The reforms were developed with the goal of overcoming negative effects on the labour market caused by the deep economic crisis in 2008-2010 as well as of coping with an increase in labour tax burdens during consolidation. In 2008-2010, Latvia was seriously affected by the global economic crisis and during these years real gross domestic product (GDP declined by 21 percent. Labour market conditions became worse rapidly and at the beginning of 2010, the unemployment rate reached 21.5 per cent of the economically active population. For the period of 2011-2016, the reforms provide for a reduction in the rates of personal income tax (PIT and social security contributions (SSC as well as for an increase in PIT allowances. Taking into account the changes made in labour tax laws, we employed forecasts of average wages and applied the Eurostat methodology to calculate the tax wedge for different groups of employees depending on income level and on the number of their dependants. The results show that the impact of the reform varies greatly and it is more beneficial for employees with dependants and for low-wage earners. The findings of the paper contribute to policy discussions and decisions on the tax wedge, especially in the Euro area. In the period covered by the paper, about half of the Euro area member states (including Latvia received a country-specific recommendation to address this issue in the context of the European Semester.

  1. The use of deliberative method in educational reform

    Directory of Open Access Journals (Sweden)

    Ivan Buljan

    2016-12-01

    Full Text Available The project named Higher Education Reform was established in 2004 as one of the implementation elements of the European higher education policy. The core activities of the project were executed throughout the formation of National Teams of Bologna Experts who had the task and duty to contribute to the general and real awareness-rising on the topic of the higher education reform among different stakeholders in participating countries of the Bologna Process. The Croatian National Team of Bologna Expert (Hrvatska stručna skupina za Bolonjski proces was established in 2011. Among the diversity of activities executed by the student representatives in the Team, the important place is reserved for the deliberative workshops held during 2013. The target groups of the deliberative workshops were students and other stakeholders in the higher education. This paper presents the process of including the stakeholders in educational reform through the deliberative workshops. During the workshops, the organizers found out how the stakeholders are rethinking on some of the aspects of the Bologna Process, how they perceive and value the work of student representative and volunteering activities, and what they think about the extra-curricular activities of the student and how they value such activities. The form of deliberative workshops encouraged participants to freely and in constructive way express their thoughts and expectances in order to exchange ideas and knowledge about the matter, and to make a decision on common suggestions to solve a particular problem in the context of higher education (introduction of a new practice, modifications and alternations of existing practices, etc. This type of the application of deliberation method is extremely useful, which is the reason for the suggestion of the method’s use in preparing, implementing and evaluating the educational reforms.

  2. Tuberculosis in healthcare workers, Scotland.

    Science.gov (United States)

    Pollock, Kevin G; McDonald, Eisin; Smith-Palmer, Alison; Johnston, Fiona; Ahmed, Syed

    2017-08-01

    In an attempt to explore healthcare worker acquisition of tuberculosis infection, we conducted population-based surveillance of all cases recorded as healthcare workers reported to Enhanced Surveillance of Mycobacterial Infection from 2000 to 2015. Over the study period, the mean incidence rate of tuberculosis among all healthcare workers was 15.4 per 100,000 healthcare workers. However, the incidence rate of tuberculosis amongst those healthcare workers born outside the UK was 164.8 per 100,000 compared with 5.0 per 100,000 UK-born healthcare workers. Fifty-seven per cent of all non-UK-born healthcare workers were diagnosed within five years of their arrival in the UK and would have been new entrants to the NHS. An effective new entrant occupational health screening programme for latent tuberculosis infection may have prevented some of these active cases of infection.

  3. Improving Healthcare through Lean Management

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2011-01-01

    The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...... still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading...

  4. Squaring the circle of healthcare supplies.

    Science.gov (United States)

    Böhme, Tillmann; Williams, Sharon; Childerhouse, Paul; Deakins, Eric; Towill, Denis

    2014-01-01

    The purpose of this paper is to use a systems lens to assess the comparative performance of healthcare supply chains and provide guidance for their improvement. A well-established and rigorous multi-method audit methodology, based on the uncertainty circle model, yields an objective assessment of value stream performance in eight Australasian public sector hospitals. Cause-effect analysis identifies the major barriers to achieving smooth, seamless flows. Potentially high-leverage remedial actions identified using systems thinking are examined with the aid of an exemplar case. The majority of the healthcare value streams studied are underperforming compared with those in the European automotive industry. Every public hospital appears to be caught in the grip of vicious circles of system uncertainty, in large part being caused by problems of their own making. The single exception is making good progress towards seamless functional integration, which has been achieved by elevating supply chain management to a core competence; having a clearly articulated supply chain vision; adopting a systems approach; and, managing supplies with accurate information. The small number of cases limits the generalisability of the findings at this time. Hospital supply chain managers endeavouring to achieve smooth and seamless supply flows should attempt to elevate the status of supplies management within their organisation to that of a core competence, and should use accurate information to manage their value streams holistically as a set of interwoven processes. A four-level prism model is proposed as a useful framework for thus improving healthcare supply delivery systems. Material flow concepts originally developed to provide objective assessments of value stream performance in commercial settings are adapted for use in a healthcare setting. The ability to identify exemplar organisations via a context-free uncertainty measure, and to use systems thinking to identify high

  5. Stakeholders' views on the strengths and weaknesses of maternal care financing and its reform in Georgia.

    Science.gov (United States)

    Shengelia, Lela; Pavlova, Milena; Groot, Wim

    2017-08-08

    The improvement of maternal health has been one of the aims of the health financing reforms in Georgia. Public-private relationships are the most notable part of the reform. This study aimed to assess the strengths and weakness of the maternal care financing in Georgia in terms of adequacy and effects. A qualitative design was used to explore the opinions of key stakeholders about the adequacy of maternal care financing and financial protection of pregnant women in Georgia. Women who had used maternal care during the past 4 years along with health care providers, policy makers, and representatives of international partner organizations and national professional body were the respondents in this study. Six focus group discussions to collect data from women and 15 face-to-face in-depth interviews to collect data from the other stakeholders were conducted. Each focus group discussion consisted of 7-8 women. Two focus group discussions were carried out at each of the target settings (i.e. Tbilisi, Imereti and Adjara). Women were selected in each location through the hospital registry and snowballing method. The evidence shows that there is a consensus among maternal care stakeholder groups on the influence of the healthcare financing reforms on maternal health. Specifically, the privatization of the maternal care services has had positive effects because it significantly improved the environment and technical capacity of the maternity houses. Also, in contrast to other former-soviet republics, there are no informal payments anymore for maternal care in Georgia. However the privatization, which was done without strict regulation, negatively influenced the reform process and provided the possibility to private providers to manipulate the formal user fees in maternal care. Stakeholders also indicated that the UHC programs implemented at the last stage of the healthcare financing reform as well as other state maternal health programs protect women from catastrophic health

  6. Plasma catalytic reforming of methane

    Energy Technology Data Exchange (ETDEWEB)

    Bromberg, L.; Cohn, D.R.; Rabinovich, A. [Massachusetts Inst. of Technology, Cambridge, MA (United States). Plasma Science and Fusion Center; Alexeev, N. [Russian Academy of Sciences, Moscow (Russian Federation). Baikov Inst. of Metallurgy

    1998-08-01

    Thermal plasma technology can be efficiently used in the production of hydrogen and hydrogen-rich gases from methane and a variety of fuels. This paper describes progress in plasma reforming experiments and calculations of high temperature conversion of methane using heterogeneous processes. The thermal plasma is a highly energetic state of matter that is characterized by extremely high temperatures (several thousand degrees Celsius) and high degree of dissociation and substantial degree of ionization. The high temperatures accelerate the reactions involved in the reforming process. Hydrogen-rich gas (50% H{sub 2}, 17% CO and 33% N{sub 2}, for partial oxidation/water shifting) can be efficiently made in compact plasma reformers. Experiments have been carried out in a small device (2--3 kW) and without the use of efficient heat regeneration. For partial oxidation/water shifting, it was determined that the specific energy consumption in the plasma reforming processes is 16 MJ/kg H{sub 2} with high conversion efficiencies. Larger plasmatrons, better reactor thermal insulation, efficient heat regeneration and improved plasma catalysis could also play a major role in specific energy consumption reduction and increasing the methane conversion. A system has been demonstrated for hydrogen production with low CO content ({approximately} 1.5%) with power densities of {approximately} 30 kW (H{sub 2} HHV)/liter of reactor, or {approximately} 10 m{sup 3}/hr H{sub 2} per liter of reactor. Power density should further increase with increased power and improved design.

  7. IMPLEMENTATION OF MODERN FOREIGN APPROACHES TO UKRAINIAN PENSION SYSTEM REFORMING

    Directory of Open Access Journals (Sweden)

    Anna Khemii

    2017-11-01

    Full Text Available A study of the experience of Western European countries in implementing structural reforms of the pension insurance system and the implementation of such experience in Ukraine. The main task of the pension system of any country in the world is to ensure the corresponding stable level of incomes of pensioners and at the same time maintain their financial stability. The increase in the proportion of pensioners increases the burden on pension systems, and mainly measures taken by countries are aimed at reducing pension costs and parametric reforms. Methodology. This article investigates the prerequisites and consequences of reforming the pension systems of the Member States of the Organization for International Cooperation and Development. Considered measures to ensure the financial stability of pension systems of the countries concerned, increased the social and stimulating role of pension insurance in the society. The methodological basis of the article is methods of scientific cognition, which enable to expose basic conformities to the law of development of the pension systems, priority ways to ensure their financial sustainability. Such methods are in particular used: analysis and synthesis – during research of financial indicators of pension systems; systematization – for revealing methods for reforming pension systems, their detailed analysis and the definition of their features; scientific abstraction – with the purpose of forming theoretical generalizations and conclusions. Results. The article investigates the trends of reforming pension insurance systems in some countries. It is established that today the main characteristics of pension reforms in foreign countries are increasing the retirement age, improving the solidary component of the pension system, reducing the role of state pension insurance. Some countries raise their contribution rates; the conditions for early retirement are becoming tougher. Almost nobody decided to

  8. Power sector reforms in India

    Energy Technology Data Exchange (ETDEWEB)

    Bajaj, Harbans L.; Sharma, Deepak

    2007-07-01

    India faces endemic electrical energy and peaking shortages. The Power Sector is plagued with mounting commercial losses due various inefficiencies, colossal commercial and technical losses and increasing subsidy burden on the states. These shortages have had a very detrimental effect on the overall economic growth of the country. In order to re-vitalise the sector and improve the techno-economic performance, the Government of India has initiated the reform process in 1991. This paper analyses the pre-reform era and identifies the key concerns which led to the initiation of the reforms. It also analyses the likely impact of the major policy and regulatory initiatives that have been undertaken since 1991 including the provisions of the new enactments which have come into force eventually in the form of The Electricity Act, 2003. This paper details out the key features of the Act and its likely impact on the Indian electricity industry in the emerging scenario. The paper also discusses major issues like power trading, role of regulator in the new regime, issue of open access, introduction of power markets and role of Appellate Tribunal for Electricity in harmonizing the orders of the various regulators.

  9. EU ECONOMIC GOVERNANCE REFORM: ARE WE AT A TURNING POINT?

    Directory of Open Access Journals (Sweden)

    Daniel Daianu

    2011-03-01

    Full Text Available The sovereign debt crisis is creating enormous anguish in the European Monetary Union (EMU. Not surprisingly, emergency measures continue to be used at a time when a sort of economic recovery seems to be underway. Against this background the European Council summit of last October considered a Task Force report with a telling name: "Strengthening economic governance in the EU". This document is to be examined in conjunction with the governance reform proposals issued by the European Commission at the end of September and related documents. For the depth of this financial crisis and the "Great Recession" have forced EU governments and EU institutions to take a hard look at the governance structure of the Union. But it would be wrong to say that this demarche is an attempt to explore a terra incognita. From the very beginning of the European Monetary Union (EMU there was some discomfort with its institutional underpinnings and there were misgivings regarding its optimality as a currency area. This explains why a train of thought underlines a political rationale, too, for the creation of the EMU. Likewise, criticism regarding the way regulation and supervision have been established in the Union is not of recent vintage. And insufficiencies of the Stability and Growth Pact (SGP, with almost all member states flouting its rules at various points in time, have been repeatedly pointed out. This said, however, the flaws of financial intermediation have been less tackled by policy-makers and central bankers for reasons which, partially, are to be found in a paradigm which has dominated economic thinking in recent decades. This paper focuses on roots of the huge strain in the EU (EMU and main policy issues ensuing from the current crisis. It also looks at the stake NMSs have in a reformed EU economic governance structure. The challenges for EU economic governance reform are to be seen from a broad perspective: the crisis of the financial intermediation

  10. Prospects for Reforming the Organizational and Legal Mechanism for Ensuring Human and Civil Rights and Freedoms

    Directory of Open Access Journals (Sweden)

    Myroslav Kovaliv

    2017-10-01

    Full Text Available The purpose of the article is analyzing the prospect of reforming the organizational and legal mechanism for ensuring the rights and freedoms of individuals and citizens of Ukraine from the systemic approach. Based on the methodology of system analysis, the prospects of reforming the organizational and legal mechanism for ensuring the rights and freedoms of men and citizens of Ukraine in the context of association with the European Union are considered. The key factors that influence the effectiveness of the submitted organizational and legal mechanism are analyzed. The measures aimed at the improvement of normative-legal regulation, which shall promote the maintenance of constitutional rights and freedoms in the conditions of reforming all spheres of society's life, are presented.

  11. Physician leadership: a health-care system's investment in the future of quality care.

    Science.gov (United States)

    Orlando, Rocco; Haytaian, Marcia

    2012-08-01

    The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system.

  12. Understanding healthcare innovation systems: the Stockholm region case.

    Science.gov (United States)

    Larisch, Lisa-Marie; Amer-Wåhlin, Isis; Hidefjäll, Patrik

    2016-11-21

    Purpose There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs). Design/methodology/approach The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed. Findings The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations. Research limitations/implications In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities. Social implications Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring. Originality/value This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public

  13. Reforming Science and Mathematics Education

    Science.gov (United States)

    Lagowski, J. J.

    1995-09-01

    Since 1991, the National Science Foundation has signed cooperative agreements with 26 states to undertake ambitious and comprehensive initiatives to reform science, mathematics, and technology education. Collectively, those agreements are known as the State Systemic Initiatives (SSI's). Two complimentary programs, The Urban and Rural Systemic Initiatives (USI's and RSI's), address similar reforms in the nation's largest cities and poorest rural areas. The SSI Program departs significantly from past NSF practice in several ways. The funding is for a longer term and is larger in amount, and the NSF is taking a more activist role, seeking to leverage state and private funds and promote the coordination of programs within states. The Initiatives also have a stronger policy orientation than previous NSF programs have had. The NSF strategy is a reflection of the growing and widely held view that meaningful reforms in schools are most likely to be achieved through state initiatives that set clear and ambitious learning goals and standards; align all of the available policy levers in support of reform; stimulate school-level initiatives; and mobilize human and financial resources to support these changes. Two premises underlie systemic reform: (1) all children can meet significantly higher standards if they are asked to do so and given adequate opportunities to master the content, and (2) state and local policy changes can create opportunities by giving schools strong and consistent signals about the changes in practice and performance that are expected. Because this is an enormous investment of Federal resources that is intended to bring about deep, systemic improvement in the nation's ability to teach science and mathematics effectively, the NSF has contracted with a consortium of independent evaluators to conduct a review of the program. The first of the SSI's were funded in 1991, sufficiently long ago to begin to formulate some initial impressions of their impact. Take

  14. Stormy Weather in Healthcare

    DEFF Research Database (Denmark)

    Clemensen, Jane; Jakobsen, Pernille Ravn; Myhre Jensen, Charlotte

    2017-01-01

    This paper discusses how the roles of patients and health professionals have changed over the years. It also explores how accelerated courses of treatment and busy staff have turned healthcare services and hospitals into “factories”, where care and relationships now exist in very cramped conditions....... The paper discusses the gap between patients’ need for care and the care received. The analysis and discussion focus on how health professionals can be empowered to re-find care in their daily practice. We reveal how different health paradigms can affect care, and the relationship between patients...

  15. Building National Healthcare Infrastructure

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Thorseng, Anne

    2017-01-01

    This case chapter is about the evolution of the Danish national e-health portal, sundhed.dk, which provides patient-oriented digital services. We present how the organization behind sundhed.dk succeeded in establishing a national healthcare infrastructure by (1) collating and assembling existing...... data resources, (2) repurposing and enhancing current data sources in the health sector, and (3) engaging a multiplicity of stakeholders. We argue that these activities represent three ways of capitalizing on the installed base that has led to the evolution and current situation of the e-health portal...

  16. The contemporary healthcare crisis in China and the role of medical professionalism.

    Science.gov (United States)

    Hui, Edwin C

    2010-08-01

    The healthcare crisis that has developed in the last two decades during China's economic reform has caused healthcare and hospital financing reforms to be largely experienced by patients as a crisis in the patient-healthcare professional relationship (PPR) at the bedside. The nature and magnitude of this crisis were epitomized by the "Harbin Scandal"-an incident that took place in August 2005 in a Harbin teaching hospital in which the family of an elderly patient hospitalized in the intensive care unit (ICU) for 66 days paid over RMB yen6 million. The news was publicized globally and ended in the firing of six top hospital administrators including the hospital president and the ICU director. This paper seeks to show that the Chinese healthcare crisis is ultimately linked to a conflict of interests between patients and healthcare professionals (HCPs), which is inherent in the reformed healthcare system of China. Hence the crisis is, at its core, a crisis of fidelity and confidence that must be restored to the PPR. At the "macro" level, it is simplistic to blame the crisis on the failure of the market system, and at the "micro" level, it is naïve to expect that a contractual understanding of the PPR will effectively restore the confidence of patients. This paper will show that the fiduciary relationship and medical professionalism share similar attributes, with fidelity being the core value of both. It concludes that the loss of medical fidelity implies the dissolution of the PPR and the demise of the medical profession and challenges Chinese HCPs to keep their fidelity as a means to both protect their patients' interests and to preserve their profession's survival.

  17. Refuelling stations for hydrogen or reformate gas

    Energy Technology Data Exchange (ETDEWEB)

    Silversand, Fredrik [CATATOR AB, Lund (Sweden)

    2006-02-15

    A prestudy concerning refuelling stations for reformate gas/hydrogen has been performed on the request of Swedish Gas Centre. The plan is to build a small-scale fuel processor for said application during 2006 as a continuation of the RandD programme in the fuel processing area. Catator has designed and evaluated small-scale fuel processors in a series of SGC-projects. The fuel processor system was abbreviated 'Stur-unit' and contained reactors for steam reforming, water-gas shift and preferential oxidation, tied together in a single train unit. The STUR-unit is operated at atmospheric conditions and will produce reformate gas of fuel cell quality (normally less than 20 ppm of CO). Catator has designed and delivered a number of Stur-units ranging from 1 nm{sup 3} to 50 nm{sup 3}/hr of hydrogen. Different fuels have been evaluated, both gases and liquids. Catator has also designed a pressurised system together with Intelligent Energy (abbreviated 'Hestia-unit'). This unit operates at 5-10 bar(a) and utilizes physical purification by means of fast-cycle PSA to provide essential pure hydrogen. Both units have been subjected to successful long-term testing. The hydrogen demand in Malmoe (the proposed location for the refuelling station) is presently low and irregular since only two buses utilize Hythane (a mixture between natural gas and hydrogen) at the moment. The interest for hydrogen and hydrogen containing fuels is, however, expected to increase in a near future. E.ON Gas (the owner of the existing refuelling station) has forwarded a number of specifications for the fuel processor system. The unit shall operate on natural gas and biogas. Bio-derived liquid fuels (bio ethanol and E85 - a mixture between ethanol and gasoline) could also be interesting alternatives. Depending on the low demand for hydrogen (average of about 1 nm{sup 3}/hr), the production capacity can be rather low - 5-10 nm{sup 3}/hr is probably more than enough for the time being

  18. Measuring healthcare quality: the challenges.

    Science.gov (United States)

    van den Heuvel, Jaap; Niemeijer, Gerard C; Does, Ronald J M M

    2013-01-01

    Current health care quality performance indicators appear to be inadequate to inform the public to make the right choices. The aim of this paper is to define a framework and an organizational setting in which valid and reliable healthcare information can be produced to inform the general public about healthcare quality. To improve health care quality information, the paper explores the analogy between financial accounting, which aims to produce valid and reliable information to support companies informing their shareholders and stakeholders, and healthcare aiming to inform future patients about healthcare quality. Based on this analogy, the authors suggest a measurement framework and an organizational setting to produce healthcare information. The authors suggest a five-quality element framework to structure quality reporting. The authors also indicate the best way to report each type of quality, comparing performance indicators with certification/accreditation. Health gain is the most relevant quality indicator to inform the public, but this information is the most difficult to obtain. Finally, the organizational setting, comparable to financial accounting, required to provide valid, reliable and objective information on healthcare quality is described. Framework elements should be tested in quantitative studies or case studies, such as a performance indicator's relative value compared to accreditation/certification. There are, however, elements that can be implemented right away such as third party validation of healthcare information produced by healthcare institutions. Given the money spent on healthcare worldwide, valid and reliable healthcare quality information's value can never be overestimated. It can justify delivering "expensive healthcare, but also points the way to savings by stopping useless healthcare. Valid and reliable information puts the patient in the driver's seat and enables him or her to make the right decision when choosing their healthcare

  19. Budget reform in Ukraine and the OECD countries

    Directory of Open Access Journals (Sweden)

    Puchko Anna

    2016-09-01

    Full Text Available The article analyzes the fiscal reforms in Ukraine and the OECD countries. It has been proved that the main areas which should undergo changes are the tax reform, regulatory reform and restructuring policies to encourage entrepreneurship, reform of social protection and social security, reform of social sphere constituents, administrative reform, reform of the army and law enforcement, administrative and territorial reform. According to the analysis results, there has been drawn the conclusion about the need to introduce in Ukraine the successful experience of the OECD countries in implementing budget reforms.

  20. Healthcare System Information at Language Schools for Newly Arrived Immigrants: A Pertinent Setting in Times of Austerity

    Science.gov (United States)

    Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

    2017-01-01

    Objective: In most European countries, immigrants do not systematically learn about the host countries' healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Methods: Immigrants attending a language school in Copenhagen in 2012 received…