ISSN:0749-6753    

DOI:10.1002/hpm.4740080202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe end of the Apartheid system in South Africa will have a major impact on its public sector, and the health service in particular. The key player in the process of transformation, the African National Congress, has put forward proposals for a National Health Service. The need for a management cadre to bring about and maintain these major changes is slowly being recognized. This article considers the impact of the proposed changes for health service management, and argues that management education has to produce people who possess both strategic and operational competencies to effect the transformation of an unequal and divisive health service into one that offers an equitable and high quality service to all South Africans.

ISSN:0749-6753    

DOI:10.1002/hpm.4740080203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractWith the re‐election of the Conservative Party in the United Kingdom in April 1992, it is now likely that the major reforms of its National Health Service as outlined in the 1989 White Paper—Working for Patients—and embodied in the 1990 National Health Service and Community Care Act will be implemented to completion. This article examines the reforms as a re‐structuring of incentives facing agencies within the internal market for health care, and forecasts how agency behaviour is likely to change as a result of such re‐structuring. Medium‐term implications of the reforms for hospitals, general practitioners and patients are derived. A number of problems in the continued development of the internal market are

ISSN:0749-6753    

DOI:10.1002/hpm.4740080204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractKenya has developed a model of the Bamako Initiative which differs in some respects to that developed in other African countries. It has established a system of community pharmacies in peripheral areas which acts as the locus of a community financing programme, focused on the provision of drugs and disease control activities carried out by Community Health Workers. This model addresses problems of geographical accessibility rather than quality in existing services. While it responds to the most urgent health service problems in Kenya, it ignores the communities felt needs for the extension of services to treat serious illnesses. Nevertheless, the Initiative has been successful in generating community enthusiasm and in establishing an affordable and sustainable services. It is important that the Bamako Initiative is not marginalized from the ‘main’ health service delivery system and is not seen as a substitute for extension of services. In the longer term, the Initiative should be used to support efforts to strengthen qualityandimprove accessibility at higher lev

ISSN:0749-6753    

DOI:10.1002/hpm.4740080205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractDespite itsa prioriattractiveness, health insurance schemes are rare in developing countries. A recent external review of the Bamako Initiative in Burundi considered the extent to which the ‘Carte d'Assurance Maladie’ (CAM) has the potential to improve the quality of, and access to, health services. Although utilization of the CAM was found to be low overall, most of those visiting the health centres were in possession of a card, leading the team to conclude that health service utilization for curative care is extremely low. Focus group discussion revealed that users perceive the quality of health services to be poor, and that frequent shortages of basic drugs and supplies create uncertainty as to whether the CAM will provide good value for money, the shortage of basic drugs, the lack of community participation in the management of health services, and the fact that very little of the revenue from sales of the CAM is spent on health service provision provide possible explanations for the weak uptake of health insurance. Closing the link between thepaymentfor health services and thefinancingof those services would contribute to an improvement in the quality and the confidence of the population in government health servi

ISSN:0749-6753    

DOI:10.1002/hpm.4740080206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractCompulsory health insurance schemes have received attention recently as a means of creating a reliable extra‐budgetary source of health care funding. Yet, the full implications of such schemes in a developing country context are unclear; in particular, the impact on and relationship with private sector providers has infrequently been explored. This study examines patterns of public and private sector utilization under the Civil Servants' Medical Benefit Scheme (CSMBS) in Bangkok, Thailand. The CSMBS currently provides limited reimbursement for private inpatient care, but recent proposals suggest increasing benefit levels for care sought in the private sector. The study shows that despite high level of cost recovery in the public sector, charges were much lower than those in the private sector. Different patterns of diagnosis in the two sectors were found with private hospitals tending to treat a less complex case mix. Within the private sector, there was a limited tendency to specialize in certain types of care. It is concluded that under the current payment mechanism of fee‐for‐service reimbursement, measures to enhance access to private sector care should be approached with caution. In the long run, the scheme should merge with the recently established social security s

ISSN:0749-6753    

DOI:10.1002/hpm.4740080207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740080208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740080209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740080210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740080211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY