ISSN:0749-6753    

DOI:10.1002/hpm.4740100102

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

年代:1995

数据来源: WILEY

摘要:

AbstractLike other advanced market economies, Israel has been engaged in a reform of its health care system, more intensely so since 1994. The first two sections describe the key features of the Israeli health care system before the reform, and their strengths and weaknesses. A State Commission of Inquiry, established by the government in 1988, proposed in its 1990 report two different reform strategies, respectively developed by the majority and the minority in it. The Commission diagnoses, recommendations and strategies are assessed and explained in the next sections. Legislators and policy makers opted for the incremental, evolutionary reform strategy, proposed by the minority in the Commission. The essence of the reform strategy being implemented as from 1995 is presented and examined in the penultimate section. In the concluding part, the Israeli experience with the formulation and implementation of a health care reform is discussed.

ISSN:0749-6753    

DOI:10.1002/hpm.4740100103

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee‐for‐service, and case‐based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low‐income countries should avoid complex payment systems requiring higher levels of institutional deve

ISSN:0749-6753    

DOI:10.1002/hpm.4740100104

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe health of a population is related to more than the volume and quality of health services available. Ischaemic heart diseases and cancers are the main causes of death for adults in most developed countries. Partly, these diseases are related to diet and other life style variables. The purpose of this article is to discuss some prevention possibilities related to health practices. Empirical data were collected by means of a questionnaire on health status and ‘life style’ among long‐standing members of a Swedish popular movement for physical culture. The principal question was what could be learned for health planning and management. Genetic factors have lately come more in focus as an explanation of untimely death and disease while, for example, life style has been de‐emphasized. There is a risk, thereby, that a purchaser—provider approach, where short‐sighted returns are in focus, will give too low a priority to healt

ISSN:0749-6753    

DOI:10.1002/hpm.4740100105

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

年代:1995

数据来源: WILEY

摘要:

AbstractUrban hospital outpatient clinics in developing countries are said to be overburdened and some policy experts are proposing a new intermediate tier of advanced health centres between hospitals and health centres to solve this problem (termed ‘reference centres’ by the World Health Organization). In Maseru, Lesotho, hospital congestion led the Ministry of Health to decide to build reference centres. To delineate precisely how these centres should operate, research was carried out on the existing system comparing utilization, quality and cost between health centre and hospital outpatient care. The study showed that throughput per clinician at the hospital and the city health centres was similar; that the hospital service saw a greater proportion of adults and more men; that the technical care quality was similar; and, that health centre staff took longer with patients and had higher interpersonal consultation scores. Average costs at the hospital were 39 per cent greater, but, the calculated net costs to the provider at the hospital and at government centres were very similar once user fees had been taken into account. The results questioned the assumptions underlying the decision to build reference centres in Maseru, and also the relevance of a new tier to solve health service delivery problems in the city. The study highlights the need for national and municipal planners to examine carefully existing health services with respect to utilization, quality and cost before adopting urban reference centres as a standard solution to congested hospit

ISSN:0749-6753    

DOI:10.1002/hpm.4740100106

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

年代:1995

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740100107

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

年代:1995

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740100108

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

年代:1995

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740100109

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

年代:1995

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740100110

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

年代:1995

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740100111

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

年代:1995

数据来源: WILEY