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Health Systems in Transition 2015This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health... (Review)
Review
This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending.
Topics: Delivery of Health Care; France; Health Policy; Health Status; Healthcare Disparities; Healthcare Financing; Humans; Quality of Health Care; Socioeconomic Factors
PubMed: 26766545
DOI: No ID Found -
Eastern Mediterranean Health Journal =... Oct 2011The government of Saudi Arabia has given high priority to the development of health care services at all levels: primary, secondary and tertiary. As a consequence, the... (Review)
Review
The government of Saudi Arabia has given high priority to the development of health care services at all levels: primary, secondary and tertiary. As a consequence, the health of the Saudi population has greatly improved in recent decades. However, a number of issues pose challenges to the health care system, such a shortage of Saudi health professionals, the health ministry's multiple roles, limited financial resources, changing patterns of disease, high demand resulting from free services, an absence of a national crisis management policy, poor accessibility to some health care facilities, lack of a national health information system, and the underutilization of the potential of electronic health strategies. This paper reviews the historical development and current structure of the health care system in Saudi Arabia with particular emphasis on the public health sector and the opportunities and challenges confronting the Saudi health care system.
Topics: Delivery of Health Care; Financing, Government; Health Care Reform; Health Care Sector; Health Policy; Health Services Accessibility; Health Workforce; Humans; Life Expectancy; Population Dynamics; Public Health; Saudi Arabia
PubMed: 22256414
DOI: 10.26719/2011.17.10.784 -
Annals of Internal Medicine Feb 2002
Topics: Clinical Competence; Codes of Ethics; Conflict of Interest; Delivery of Health Care; Ethics, Medical; Health Resources; Health Services Accessibility; Humans; Patient Rights; Physician-Patient Relations; Quality of Health Care; Social Justice
PubMed: 11827500
DOI: 10.7326/0003-4819-136-3-200202050-00012 -
Journal of Health Organization and... May 2019The purpose of this paper is to identify the lean production (LP) practices applied in healthcare supply chain and the existing barriers related to their implementation. (Review)
Review
PURPOSE
The purpose of this paper is to identify the lean production (LP) practices applied in healthcare supply chain and the existing barriers related to their implementation.
DESIGN/METHODOLOGY/APPROACH
To achieve that, a scoping review was carried out in order to consolidate the main practices and barriers, and also to evidence research gaps and directions according to different theoretical lenses.
FINDINGS
The findings show that there is a consensus on the potential of LP practices implementation in healthcare supply chain, but most studies still report such implementation restricted to specific unit or value stream within a hospital.
ORIGINALITY/VALUE
Healthcare organizations are under constant pressure to reduce costs and wastes, while improving services and patient safety. Further, its supply chain usually presents great opportunities for improvement, both in terms of cost reduction and quality of care increase. In this sense, the adaptation of LP practices and principles has been widely accepted in healthcare. However, studies show that most implementations fall far short from their goals because they are done in a fragmented way, and not from a system-wide perspective.
Topics: Cost Control; Delivery of Health Care; Efficiency, Organizational; Humans; Quality of Health Care
PubMed: 31122116
DOI: 10.1108/JHOM-06-2018-0176 -
Health Systems in Transition 2013This analysis of the Lithuanian health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health... (Review)
Review
This analysis of the Lithuanian health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance since 2000.The Lithuanian health system is a mixed system, predominantly funded from the National Health Insurance Fund through a compulsory health insurance scheme, supplemented by substantial state contributions on behalf of the economically inactive population amounting to about half of its budget. Public financing of the health sector has gradually increased since 2004 to 5.2 per cent of GDP in 2010.Although the Lithuanian health system was tested by the recent economic crisis, Lithuanias counter-cyclical state health insurance contribution policies (ensuring coverage for the economically inactive population) helped the health system to weather the crisis, and Lithuania successfully used the crisis as a lever to reduce the prices of medicines.Yet the future impact of cuts in public health spending is a cause for concern. In addition, out-of-pocket payments remain high (in particular for pharmaceuticals) and could threaten health access for vulnerable groups.A number of challenges remain. The primary care system needs strengthening so that more patients are treated instead of being referred to a specialist, which will also require a change in attitude by patients. Transparency and accountability need to be increased in resource allocation, including financing of capital investment and in the payer provider relationship. Finally, population health,albeit improving, remains a concern, and major progress can be achieved by reducing the burden of amenable and preventable mortality.
Topics: Delivery of Health Care; Health Care Reform; Health Expenditures; Health Services Accessibility; Health Status; Health Workforce; Healthcare Financing; Humans; Lithuania; Population Dynamics
PubMed: 23902994
DOI: No ID Found -
Health Services Research Dec 2020
Topics: Delivery of Health Care; Economic Competition; Health Planning; Healthcare Disparities; Humans; Learning Health System; Quality of Health Care; United States
PubMed: 33284523
DOI: 10.1111/1475-6773.13595 -
Health Systems in Transition Jan 2016The pace of health reforms in Tajikistan has been slow and in many aspects the health system is still shaped by the countrys Soviet legacy. The country has the lowest... (Review)
Review
The pace of health reforms in Tajikistan has been slow and in many aspects the health system is still shaped by the countrys Soviet legacy. The country has the lowest total health expenditure per capita in the WHO European Region, much of it financed privately through out-of-pocket payments. Public financing depends principally on regional and local authorities, thus compounding regional inequalities across the country. The high share of private out-of-pocket payments undermines a range of health system goals, including financial protection, equity, efficiency and quality. The efficiency of the health system is also undermined by outdated provider payment mechanisms and lack of pooling of funds. Quality of care is another major concern, due to factors such as insufficient training, lack of evidence-based clinical guidelines, underuse of generic drugs, poor infrastructure and equipment (particularly at the regional level) and perverse financial incentives for physicians in the form of out-of-pocket payments. Health reforms have aimed to strengthen primary health care, but it still suffers from underinvestment and low prestige. A basic benefit package and capitation-based financing of primary health care have been introduced as pilots but have not yet been rolled out to the rest of the country. The National Health Strategy envisages substantial reforms in health financing, including nationwide introduction of capitation-based payments for primary health care and more than doubling public expenditure on health by 2020; it remains to be seen whether this will be achieved.
Topics: Delivery of Health Care; Health Care Reform; Health Expenditures; Health Policy; Healthcare Financing; Humans; Tajikistan
PubMed: 27172509
DOI: No ID Found -
Annals of Family Medicine Jan 2019As a result of a large and compelling body of evidence documenting the impacts of social determinants, such as income and education, on health outcomes, health care...
As a result of a large and compelling body of evidence documenting the impacts of social determinants, such as income and education, on health outcomes, health care systems are beginning to incorporate social and economic risk data into health care delivery decisions. But there is a risk that some of these efforts could worsen health and widen health inequities. We highlight 3 examples- including recent policy changes in Medicaid, social needs, informed risk prediction models, and advances in precision medicine-where the inclusion of social risk information threatens to reduce care quality or health care access for some groups of patients. A new dialog is needed about both the opportunities and potential consequences of bringing information about patients' social circumstances into a market-based health care system.
Topics: Delivery of Health Care; Delivery of Health Care, Integrated; Health Policy; Health Status Disparities; Humans; Social Determinants of Health; Social Work
PubMed: 30670400
DOI: 10.1370/afm.2339 -
Health Expectations : An International... Jun 2013Obesity-related stigma likely influences how obese people interact with health-care professionals and access health care. (Review)
Review
BACKGROUND
Obesity-related stigma likely influences how obese people interact with health-care professionals and access health care.
AIM
To undertake a synthesis of studies examining the views and experiences of both obese people in relation to their health-care provision and health-care professionals in providing care to obese patients.
SEARCH STRATEGY
A systematic search of key electronic databases relating to professional or patient experiences of, or perspectives on, obesity was performed in 2008 and updated in 2010. Reference lists of article bibliographies were searched, along with hand searches of relevant journals.
INCLUSION CRITERIA
Studies were screened against explicit inclusion criteria and published between 1990 and 2010. Findings were examined and organized thematically.
DATA EXTRACTION
Data were extracted focusing on obesity, stigma and access to health-care services. All included studies were subject to critical appraisal to assess the quality of the research.
FINDINGS
Thirty studies were identified. All the studies reported obesity impacting on health-care interactions. Key themes identified were experiences of stigma and feelings of powerlessness, treatment avoidance, psycho-emotional functioning, professional attitudes, confidence and training, variations in health contact time and finally, differences in treatment options and preventative measures.
CONCLUSION
Obesity is a stigmatized condition that impacts negatively on the relationship between patients and health-care providers. Given the increasing prevalence of obesity and the range of therapeutic options available, further work is necessary to understand how the presence of obesity affects health-care interactions and decision making.
Topics: Attitude of Health Personnel; Attitude to Health; Delivery of Health Care; Health Services Accessibility; Humans; Obesity; Patient Satisfaction; Physician-Patient Relations; Quality of Health Care; Stereotyping
PubMed: 21645186
DOI: 10.1111/j.1369-7625.2011.00699.x -
BMJ (Clinical Research Ed.)
Topics: Budgets; Canada; Delivery of Health Care; Europe; Fees and Charges; Global Health; Humans; United States
PubMed: 11124164
DOI: 10.1136/bmj.321.7276.1541