964 resultados para health reform


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

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In this thesis, the researcher shares their own personal journey as an Aboriginal researcher walking the borderlands between academic and Indigenous worldviews.  Indigenous Methodologies and Talking Circles provided a culturally safe environment for urban Aboriginal women to collectively develop and share their strategies to enable health care providers, educators, and policy makers to provide respectful non-racist, non-disciminatory health care.

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With all the discussion around about health care reform in Australia we are missing a fundamental issue about health and illness. They are not the same! There is a disconnect between the rhetoric of reform, the apparent political support for prevention and health promotion, and the realities of decisions being taken and understanding of the underlying assumptions of health determinants.Preventing ill health and promoting health have been seen as the point of departure for good health care, at least rhetorically, ever since the Alma Ata Declaration (1978) and the Ottawa Charter (1986). Australia along with other member states of the WHO is signatories to both and they have underpinned official health policy with a rhetorical flourish in many a document since.

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Health literacy is a multi-dimensional concept comprising a range of cognitive, affective, social, and personal skills and attributes. This paper describes the research and development protocol for a large communities-based collaborative project in Victoria, Australia that aims to identify and respond to health literacy issues for people with chronic conditions. The project, called Ophelia (OPtimising HEalth LIterAcy) Victoria, is a partnership between two universities, eight service organisations and the Victorian Government. Based on the identified issues, it will develop and pilot health literacy interventions across eight disparate health services to inform the creation of a health literacy response framework to improve health outcomes and reduce health inequalities.

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"February 6, 1992."

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Since 2001, Mexico has been designing, legislating, and implementing a major health-system reform. A key component was the creation of Seguro Popular, which is intended to expand insurance coverage over 7 years to uninsured people, nearly half the total population at the start of 2001. The reform included five actions: legislation of entitlement per family affiliated which, with full implementation, will increase public spending on health by 0.8-1.0% of gross domestic product; creation of explicit benefits packages; allocation of monies to decentralised state ministries of health in proportion to number of families affiliated; division of federal resources flowing to states into separate funds for personal and non-personal health services; and creation of a fund to protect families against catastrophic health expenditures. Using the WHO health-systems framework, we used a wide range of datasets to assess the effect of this reform on different dimensions of the health system. Key findings include: affiliation is preferentially reaching the poor and the marginalised communities; federal non-social security expenditure in real per-head terms increased by 38% from 2000 to 2005; equity of public-health expenditure across states improved; Seguro Popular affiliates used more inpatient and outpatient services than uninsured people; effective coverage of 11 interventions has improved between 2000 and 2005-06; inequalities in effective coverage across states and wealth deciles has decreased over this period; catastrophic expenditures for Seguro Popular affiliates are lower than for uninsured people even though use of services has increased. We present some lessons for Mexico based on this interim evaluation and explore implications for other countries considering health reforms.

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A horvátországi egészségügyi reform célja a decentralizáció elvén alapuló egészségügyi rendszer létrehozása volt. Az egészségügyi szolgáltatások költségnövekedése által okozott terheket a központi költségvetés helyett egyre nagyobb mértékben a lakosság viseli, miközben kiegészítő biztosítás létrehozásával megkísérelték csökkenteni a változások nemkívánatos következményeit. A gyógyszer-finanszírozási rendszer átalakításával a költségcsökkentés mellett el akarták érni, hogy a betegek nagyobb arányban jussanak hozzá a modern, innovatív gyógyszerekhez. ________ The Croatian health care system faced great challenges during the1990s. The aim of the paper is to review some important aspects of the Croatian health care reform. Establishing a decentralized health care system was an important section of the reform. As a new element of the health insurance system, burdens generated by the increase of costs of health services have fallen on the society increasingly, while complementary health insurance tried to decrease the undesirable consequences of the changes. The objective of the drug-financing reform was to reduce the costs and improve access to innovative medicines as well. As regards the success of the reforms, besides increasing incomings, the method and result of the spending of the health insurance funds is crucial.

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The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care.

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We are pleased to present the papers from the Australasian Health Informatics and Knowledge Management (HIKM) conference stream held on 20 January 2011 in Perth as a session of the Australasian Computer Science Week (ASCW) 2011. Formerly HIKM was named Health Data and Knowledge Management, however the inclusion of the health informatics term is timely given the current health reform. The submissions to HIKM 2011 demonstrated that Australasian researchers lead with many research and development innovations coming to fruition. Some of these innovations can be seen here, and we believe further recognition will accomplish by continuation to HIKM in the future. The HIKM conference is a review of health informatics related research, development and education opportunities. The conference papers were written to communicate with other researchers and share research findings, capturing each and every aspect of the health informatics field. They are namely: conceptual models and architectures, privacy and quality of health data, health workflow management patient journey analysis, health information retrieval, analysis and visualisation, data integration/linking, systems for integrated or coordinated care, electronic health records (EHRs) and personally controlled electronic health records (PCEHRs), health data ontologies, and standardisation in health data and clinical applications.