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Welfare Reform on the Web (October 2000): Health Care - Overseas

AMERICAN BOOTY

H. Berliner

Health Service Journal, vol. 110, July 6th 2000, p. 34

Explores the background of an agreement between Columbia-HCA, the largest proprietary hospital chain in the US, and the Department of Justice for compensation of 745m to be paid to settle allegations of fraud and abuse of the Medicare programme.

BERLIN IN CLASH WITH GPs ON OVERSPENDS

C. Tutt and R. Atkins

Financial Times, Aug. 2nd 2000, p.8

The German government is to impose financial penalties on general practitioners who have exceeded budgets for prescription drugs.

THE EVIDENCE-BASED APPROACH IN HEALTH POLICY AND HEALTH CARE DELIVERY

L. W. Niessen, E. W. M. Grijsecls and F. F. H. Rutten

Social Science and Medicine, vol. 51, 2000, p. 859-869

Papers first sketches general developments in the way in which health policy is informed by the results from health research. Then summarises evidence-based approaches in health at three impact levels: intersectoral assessment, national health care policy and evidence-based medicine in everyday practice.

POPULATION AGEING IN DEVELOPED AND DEVELOPING REGIONS: IMPLICATIONS FOR HEALTH POLICY

P. Lloyd-Sherlock

Social Science and Medicine, vol. 51, 2000, p. 887-895

Paper seeks to highlight some key issues arising from population ageing. It begins with a brief overview of international trends in demographic ageing and considers the health needs of different groups of older people. It sketches out some implications for policy, paying particular attention to the financing and organisation of health services. Finally discusses how older people have been affected by, and adapted to, processes of social, economic and political change.

PRIORITY-SETTING IN NEW ZEALAND: TRANSLATING PRINCIPLES INTO PRACTICE

T. Ashton, J. Cumming and N. Devlin

Journal of Health Service Research and Policy, vol. 5, 2000, p. 170-175

Describes a principles-based approach to setting purchasing priorities proposed by the New Zealand Health Funding Authority in May 1998. The proposed priority-setting process involved identifying the extent to which services contributed to the policy goals of maximising effectiveness, minimising cost, promoting equity of outcomes and improving the health of the Maori whilst being broadly acceptable to the public. The approach incorporated the economic methods of programme budgeting and marginal analysis, and cost-utility analysis.

PRIVATE HEALTH CARE

M. W. Uplekar

Social Science and Medicine, vol. 51, 2000, p. 897-904

Distinct advantages of privatisation have been well demonstrated in other sectors. Private sector principles may also be applied to some aspects of health care delivery. But if health is considered as a public good and not a market commodity, and if equity is not to be compromised, a lot of regulatory checks and balances may be required. If these can be jointly developed by local, national and international public health and medical institutions and enforced effectively, the organisation and day to day management of health care services may be handed over to whichever of the public or private sectors performs better.

REFORMING HEALTH CARE IN EUROPE

R. Freeman and M. Moran

West European Politics, vol. 23, Apr. 2000, p. 35-58

Begins by examining the fiscal imperatives for health care reform, and traces responses to them. Then describes associated changes to the organisation and management of health systems, assessing the extent to which many of them have become more alike. Through an account of the reform process in different countries, discusses the strengthening position of the state in the regulation of health care. Finally explores the implications of the globalisation of the health care industry.

SCIENCE IN PRACTICE: CAN HEALTH CARE REFORM PROJECTS IN CENTRAL AND EASTERN EUROPE BE EVALUATED SYSTEMATICALLY?

S. J. Grielen et al

Health Policy, vol. 53, 2000, p. 73-89

Since the beginning of the 1990s, health care reform projects have taken place in many of the former communist countries, but these projects are rarely evaluated systematically. Evaluation, however, is an important tool for increasing their rationality and continuity. The aim of the paper is to identify the difficulties in the efforts towards systematic evaluation and draw lessons for the future.

TARGETS AS A TOOL IN HEALTH POLICY.

PART 1: LESSONS LEARNED

L. M. Van Herten and L. J. Gunning-Schepers

Health Policy, vol. 52, 2000, p. 1-11

Balancing benefits and drawbacks, article concludes that target setting can be a worthwhile tool in health policy. Targets set should be SMART, ie specific, measurable, achievable, realistic and time-bound. Target setting should be undertaken in a climate of political will and daring. Without political commitment and the will to execute a health target approach, a policy will be doomed to fail.

TARGETS AS A TOOL IN HEALTH POLICY.

PART 2: GUIDELINES FOR APPLICATION

L. M. van Herten and L. J. Gunning-Schepers

Health Policy, vol. 52, 2000, p. 13-23

Article reviews the health policy development cycle in relation to health target setting. First there should be an understanding of the problem and a clear picture of the health status of the population. Then a solution can be selected. Chosen solution are then implemented by government and stakeholders. This is then followed by a monitoring and evaluation phase, which again provides insight into the health status of the population. At every stage of the health policy cycle, authors discuss the questions which should be addressed when using targets as a policy tool.

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