ISSN:0749-6753    

DOI:10.1002/hpm.4740030402

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

年代:1988

数据来源: WILEY

摘要:

AbstractTo assist in the selection of a preferable vitamin A deficiency control policy, a model has been developed to organize information on program costs and program‐related effects. The model was designed to compare three approaches: (1) diet modification; (2) fortification of processed foods; and (3) periodic large doses. Health effects projected are rates of specific eye pathologies associated with vitamin A deficiency (xerophthalmia), and mortalities within age cohorts. Effectiveness is calculated as a function of coverage, biological efficacy, and incidence of vitamin A deficiency. The model was applied to data from the Province of West Java in Indonesia. The results of this application suggest that funding level considerations are an important factor in selecting a preferred control strategy. In addition to determining the relative resource requirements of alternative interventions aimed at reducing the morbidity and mortality effects of vitamin A deficiencies, the model, using marginal cost and marginal effectiveness information, can serve as a guide to the most efficient allocation of resources for each type of interventio

ISSN:0749-6753    

DOI:10.1002/hpm.4740030403

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

年代:1988

数据来源: WILEY

摘要:

AbstractThere are severe methodological problems to be overcome in comparing the effects of different payment methods on general medical practice, not least because there are many factors which affect the pattern of service delivery. Also, the reliability and comparability of data may be poor. This article emphasises that the effects of capitation and fee‐for‐service payment methods on general medical practice should be carefully compared with factual information, especially numerical data. In so doing, it is shown that there are supporting data for the contention that a fee‐for‐service system encourages more consultations, more diagnostic tests, higher drug use, higher surgical rates and higher costs than a capitation system. On the other hand, a capitation system may lead doctors to hastier and less courteous care than a fee‐for‐service system. The geographical distribution of general practitioners (GPs) may be more even, and continuity of care may be better maintained, under a capitation system; but there may be excessive referrals from GPs to specialists under this system of payment. There is no evidence for the contention that a capitation system encourages preventive medicine, but the financial coverage for preventive procedures does encourage such

ISSN:0749-6753    

DOI:10.1002/hpm.4740030404

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

年代:1988

数据来源: WILEY

摘要:

AbstractThe post‐World War II oil boom that transformed the country from a Bedouin trading center to a modern society has brought Kuwaiti citizens one of the world's highest living standards, including a tax‐free economy and a lavish array of welfare state services. Enormous wealth has not, however, sheltered Kuwait from the contemporary public policy dilemma generally encountered in other countries—how to reconcile fast‐rising public expectations for more and better government services with slower‐growing budgetary revenues. Following a review of some of the more prominent national economic and social characteristics, the structure of the Kuwaiti National Health Service is described against the backdrop of new economic realities precipitated by a decline in oil export earnings and a slowing of economic expansion. Government plans to alleviate the pressure on public spending are described which center on cost sharing with consumers and employers. Finally, the implications of cost containment for the future of private medical practice are

ISSN:0749-6753    

DOI:10.1002/hpm.4740030405

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

年代:1988

数据来源: WILEY

摘要:

AbstractThe overall purpose of the research reported in this article is two‐fold: firstly, to describe the efforts of a regional health planning agency in the United States to reduce the size of acute care facilities in its planning area; and, secondly, to frame these events into a general theory of structural problems of state interventions in the American health care sector. Specifically, a case study is presented that documents—over time—the process of decision making, in seeking to close a community hospital against strong, and vocal, local interests. This analysis supports the view that, in the real world of health planning, power is exercised through a process of bargaining between health care providers and government, and between health care providers. Overall, the study illustrates the constraints upon the American health planning agencies to steer a relatively autonomous health care s

ISSN:0749-6753    

DOI:10.1002/hpm.4740030406

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

年代:1988

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740030407

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

年代:1988

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740030408

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

年代:1988

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740030409

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

年代:1988

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740030410

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

年代:1988

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740030411

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

年代:1988

数据来源: WILEY