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An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS).

https://arctichealth.org/en/permalink/ahliterature260667
Source
Lancet. 2014 Dec 13;384(9960):2164-71
Publication Type
Article
Date
Dec-13-2014
Author
Robert Marten
Diane McIntyre
Claudia Travassos
Sergey Shishkin
Wang Longde
Srinath Reddy
Jeanette Vega
Source
Lancet. 2014 Dec 13;384(9960):2164-71
Date
Dec-13-2014
Language
English
Publication Type
Article
Keywords
Brazil
China
Delivery of Health Care - economics - organization & administration
Health Care Reform - organization & administration
Healthcare Financing
Humans
India
Russia
South Africa
Universal Coverage - economics - organization & administration - statistics & numerical data
Abstract
Brazil, Russia, India, China, and South Africa (BRICS) represent almost half the world's population, and all five national governments recently committed to work nationally, regionally, and globally to ensure that universal health coverage (UHC) is achieved. This analysis reviews national efforts to achieve UHC. With a broad range of health indicators, life expectancy (ranging from 53 years to 73 years), and mortality rate in children younger than 5 years (ranging from 10·3 to 44·6 deaths per 1000 livebirths), a review of progress in each of the BRICS countries shows that each has some way to go before achieving UHC. The BRICS countries show substantial, and often similar, challenges in moving towards UHC. On the basis of a review of each country, the most pressing problems are: raising insufficient public spending; stewarding mixed private and public health systems; ensuring equity; meeting the demands for more human resources; managing changing demographics and disease burdens; and addressing the social determinants of health. Increases in public funding can be used to show how BRICS health ministries could accelerate progress to achieve UHC. Although all the BRICS countries have devoted increased resources to health, the biggest increase has been in China, which was probably facilitated by China's rapid economic growth. However, the BRICS country with the second highest economic growth, India, has had the least improvement in public funding for health. Future research to understand such different levels of prioritisation of the health sector in these countries could be useful. Similarly, the role of strategic purchasing in working with powerful private sectors, the effect of federal structures, and the implications of investment in primary health care as a foundation for UHC could be explored. These issues could serve as the basis on which BRICS countries focus their efforts to share ideas and strategies.
PubMed ID
24793339 View in PubMed
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As much as 20% of Newfoundland's health budget may be inappropriately spent.

https://arctichealth.org/en/permalink/ahliterature281835
Source
CMAJ. 2017 Feb 13;189(6):E255
Publication Type
Article
Date
Feb-13-2017

Association between U.S. state AIDS Drug Assistance Program (ADAP) features and HIV antiretroviral therapy initiation, 2001-2009.

https://arctichealth.org/en/permalink/ahliterature106044
Source
PLoS One. 2013;8(11):e78952
Publication Type
Article
Date
2013
Author
David B Hanna
Kate Buchacz
Kelly A Gebo
Nancy A Hessol
Michael A Horberg
Lisa P Jacobson
Gregory D Kirk
Mari M Kitahata
P Todd Korthuis
Richard D Moore
Sonia Napravnik
Pragna Patel
Michael J Silverberg
Timothy R Sterling
James H Willig
Ann Collier
Hasina Samji
Jennifer E Thorne
Keri N Althoff
Jeffrey N Martin
Benigno Rodriguez
Elizabeth A Stuart
Stephen J Gange
Author Affiliation
Johns Hopkins University, Baltimore, Maryland, United States of America ; Albert Einstein College of Medicine, Bronx, New York, United States of America.
Source
PLoS One. 2013;8(11):e78952
Date
2013
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - drug therapy - economics
Anti-Retroviral Agents - administration & dosage - economics
Canada
Female
Government Programs
Healthcare Financing
Humans
Male
Retrospective Studies
United States
Abstract
U.S. state AIDS Drug Assistance Programs (ADAPs) are federally funded to provide antiretroviral therapy (ART) as the payer of last resort to eligible persons with HIV infection. States differ regarding their financial contributions to and ways of implementing these programs, and it remains unclear how this interstate variability affects HIV treatment outcomes.
We analyzed data from HIV-infected individuals who were clinically-eligible for ART between 2001 and 2009 (i.e., a first reported CD4+
Notes
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PubMed ID
24260137 View in PubMed
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Barriers to and facilitators for implementing quality improvements in palliative care - results from a qualitative interview study in Norway.

https://arctichealth.org/en/permalink/ahliterature279978
Source
BMC Palliat Care. 2016 Jul 15;15:61
Publication Type
Article
Date
Jul-15-2016
Author
Ragni Sommerbakk
Dagny Faksvåg Haugen
Aksel Tjora
Stein Kaasa
Marianne Jensen Hjermstad
Source
BMC Palliat Care. 2016 Jul 15;15:61
Date
Jul-15-2016
Language
English
Publication Type
Article
Keywords
Ambulatory Care Facilities - organization & administration - standards
Attitude of Health Personnel
Clinical Competence - standards
Dementia - nursing
Diffusion of Innovation
Education, Nursing - organization & administration
Health Policy
Health Resources - organization & administration - standards
Healthcare Financing
Hospitalization
Humans
Interprofessional Relations
Leadership
Motivation
Neoplasms - nursing
Norway
Nursing Homes - organization & administration - standards
Organizational Culture
Organizational Policy
Palliative Care - organization & administration - standards
Patient compliance
Professional Role
Qualitative Research
Quality Improvement
Social Responsibility
Abstract
Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increase the knowledge base, was to conduct national studies in PC services. This study aims to identify factors perceived as barriers or facilitators for improving PC in cancer and dementia settings in Norway.
Individual, dual-participant and focus group interviews were conducted with 20 employees working in different health care services in Norway: two hospitals, one nursing home, and two local medical centers. Thematic analysis with a combined inductive and theoretical approach was applied.
Barriers and facilitators were connected to (1) the innovation (e.g. credibility, advantage, accessibility, attractiveness); (2) the individual professional (e.g. motivation, PC expertise, confidence); (3) the patient (e.g. compliance); (4) the social context (e.g. leadership, culture of change, face-to-face contact); (5) the organizational context (e.g. resources, structures/facilities, expertise); (6) the political and economic context (e.g. policy, legislation, financial arrangements) and (7) the implementation strategy (e.g. educational, meetings, reminders). Four barriers that were particular to PC were identified: the poor general condition of patients in need of PC, symptom assessment tools that were not validated in all patient groups, lack of PC expertise and changes perceived to be at odds with staff's philosophy of care.
When planning an improvement project in PC, services should pay particular attention to factors associated with their chosen implementation strategy. Leaders should also involve staff early in the improvement process, ensure that they have the necessary training in PC and that the change is consistent with the staff's philosophy of care. An important consideration when implementing a symptom assessment tool is whether or not the tool has been validated for the relevant patient group, and to what degree patients need to be involved when using the tool.
PubMed ID
27422410 View in PubMed
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Source
Health Syst Transit. 2013;15(1):1-179
Publication Type
Article
Date
2013
Author
Gregory Marchildon
Author Affiliation
University of Regina, Canada.
Source
Health Syst Transit. 2013;15(1):1-179
Date
2013
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - organization & administration
Health Care Reform - organization & administration
Healthcare Financing
Humans
Needs Assessment
State Medicine - organization & administration
Abstract
Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas.
PubMed ID
23628429 View in PubMed
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Cuts without conflict: The use of political strategy in local health system retrenchment in Sweden.

https://arctichealth.org/en/permalink/ahliterature310021
Source
Soc Sci Med. 2019 09; 237:112464
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2019
Author
Mio Fredriksson
Inga-Britt Gustafsson
Ulrika Winblad
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22 Uppsala, Sweden. Electronic address: mio.fredriksson@pubcare.uu.se.
Source
Soc Sci Med. 2019 09; 237:112464
Date
09-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Budgets
Communication
Delivery of Health Care - economics
Health Policy
Healthcare Financing
Humans
Local Government
Politics
Sweden
Abstract
Disinvestment in health services is seen as challenging by decision-makers as the public usually reacts strongly to rationing and retrenchments. Drawing on the literature on welfare state retrenchment - the reduction of public expenditure by cutting costs or spending - this article explores the development and implementation of a comprehensive retrenchment programme in one local health system in Sweden (a so-called region). According to theory, retrenchments are both electorally risky and institutionally difficult. Nonetheless, they take place and in the local health system we investigate, without too extensive public protest and without decision-makers having to resign. The main question in this qualitative study is: why and how was it possible to make such comprehensive retrenchments despite being unpopular and facing many political and institutional barriers? Interviews with 18 local politicians and public servants were carried out between January 18 and April 3, 2017, and analysed from the perspective of political strategy. They showed that the serious budget deficit, and a shared understanding of what the region's problems were, are important explanations for why the retrenchment programme was possible to develop and implement. Based on a thorough internal review of the health system, a crisis discourse developed which partly depoliticized the retrenchment programme. Justification and framing are keys to how it was possible. The retrenchment programme was justified by arguing that current service provision exceeded that in comparable regions, and framed as necessary saving the local health system and enhancing quality. Important strategies were thus to redefine the retrenchments and to blame-share, the latter through politicians and public servants claiming responsibility together after involving the clinic managers. In sum, our study shows that the retrenchment literature and theories on political strategy may be fruitfully applied to the health-care sector as well. By studying the local level, our findings contribute to the retrenchment literature, indicating that political strategy at the local level is more about justification and blame sharing, than blame avoidance.
PubMed ID
31430657 View in PubMed
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Dentistry as a free market in the context of leading policymaking.

https://arctichealth.org/en/permalink/ahliterature295847
Source
Int J Qual Stud Health Well-being. 2018 Dec; 13(1):1484218
Publication Type
Journal Article
Date
Dec-2018
Author
Bengt Franzon
Magnus Englander
Björn Axtelius
Björn Klinge
Author Affiliation
a Faculty of Odontology, Department of Oral Diagnostics , Malmö University , Malmö , Sweden.
Source
Int J Qual Stud Health Well-being. 2018 Dec; 13(1):1484218
Date
Dec-2018
Language
English
Publication Type
Journal Article
Keywords
Administrative Personnel
Adult
Capitalism
Commerce
Culture
Dental Care - economics
Dentist-Patient Relations
Dentistry - organization & administration
Dentists - economics
Health Expenditures
Health Knowledge, Attitudes, Practice
Health Policy
Healthcare Financing
Humans
Personal Autonomy
Politics
Social Welfare
State Medicine
Sweden
Abstract
The purpose of this study was to disclose the psychological meaning structure of dentistry as a free market within the context of leading Swedish policymaking. Following the criteria for the descriptive phenomenological psychological method data was collected from leading policy makers about the experiential aspects of dentistry as a free market within the context of a welfare state. The analysis showed that dentistry as a free market was experienced as a complex business relationship between buyers and sellers that transcended the traditional dentist and patient roles. The lived experience of the proposed business transaction was based on two inherently conflicting views: the belief in the individual's ability to make a free choice versus the understanding that all individuals in a society do not have the ability or the means necessary to make a free choice. Dentistry as a free market within a welfare state, such as Sweden, can thus be seen as a persistent attempt to hold on to a compromise between two very distinctive political ideologies.
Notes
Cites: J Med Philos. 1999 Jun;24(3):243-66 PMID 10472814
Cites: Int J Qual Stud Health Well-being. 2016 Mar 09;11:30682 PMID 26968361
PubMed ID
29912654 View in PubMed
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Depoliticising the political: Market solutions and the retreat of Swedish institutional drug treatment from state management.

https://arctichealth.org/en/permalink/ahliterature287884
Source
Int J Drug Policy. 2016 06;32:93-9
Publication Type
Article
Date
06-2016
Author
Johan Edman
Source
Int J Drug Policy. 2016 06;32:93-9
Date
06-2016
Language
English
Publication Type
Article
Keywords
Financing, Government - trends
Government Regulation
Healthcare Financing
Humans
Politics
Privatization - trends
Public Sector
Substance Abuse Treatment Centers - economics - organization & administration - trends
Substance-Related Disorders - therapy
Sweden
Abstract
This article examines developments in the Swedish drug treatment services in 1982-2000 and explores the ways in which political initiatives and the state administration's management have contributed to the major privatisations of institutional drug treatment during this period.
The empirical basis for the textual analysis lies in official reports, parliamentary material and archived records from the Stockholm County Administrative Board's management of treatment facilities.
The major privatisations of drug treatment services in the 1980s were both unintentional and unwanted and mainly arose from a lack of bureaucratic control and ideological anchorage. The privatisations were, however, reinforced by ideologically driven NPM-oriented political initiatives in the 1990s.
The market-oriented treatment services have failed to fulfil the needs for diversity and availability within a publicly financed sector, which deals with unevenly informed and often socio-economically weak citizens. New management models in this field must ensure that ideological considerations are taken into account to meet politically decided goals and means.
PubMed ID
27184217 View in PubMed
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[Financing of dental care in the outpatient settings in the system of obligatory medical insurance].

https://arctichealth.org/en/permalink/ahliterature267751
Source
Stomatologiia (Mosk). 2015;94(3):70-2
Publication Type
Article
Date
2015
Source
Health Syst Transit. 2019 Aug; 21(2):1-166
Publication Type
Journal Article
Review
Date
Aug-2019
Author
Ilmo Keskimaki
Liina-Kaisa Tynkkynen
Eeva Reissell
Meri Koivusalo
Vesa Syrja
Lauri Vuorenkoski
Bernd Rechel
Marina Karanikolos
Author Affiliation
Finnish Institute for Health and Welfare and Tampere University.
Source
Health Syst Transit. 2019 Aug; 21(2):1-166
Date
Aug-2019
Language
English
Publication Type
Journal Article
Review
Keywords
Delivery of Health Care - methods - organization & administration
Finland
Health Care Reform
Health Policy
Health Services - statistics & numerical data
Healthcare Financing
Humans
Insurance, Health - organization & administration
Politics
Quality of Health Care
Abstract
This analysis of the Finnish health system reviews developments in its organization and governance, financing, provision of services, health reforms and health system performance. Finland is a welfare state witha high standard of social and living conditions and a low poverty rate. Its health system has a highly decentralized administration, multiple funding sources, and three provision channels for statutory services in first-contact care: the municipal system, the national health insurance system, and occupational health care. The core health system is organized by the municipalities (i.e. local authorities) which are responsible for financing primary and specialized care. Health financing arrangements are fragmented, with municipalities, the health insurance system, employers and households all contributing substantial shares. The health system performs relatively well, as health services are fairly effective, but accessibility may be an issue due to long waiting times and relatively high levels of cost sharing. For over a decade, there has been broad agreement on the need to reform the Finnish health system, but reaching a feasible policy consensus has been challenging.
PubMed ID
31596240 View in PubMed
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24 records – page 1 of 3.