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Welfare Reform on the Web (June 2003): Health Care - Overseas

COMPETITION POLICY AND INTRA-PROFESSIONAL CONFLICT: RE-REGULATING GENERAL PRACTICE

K. Dwan and R. A. Boyce

The International Journal of Public Sector Management, vol. 16, 2003, p. 141-152

Examines changes to general practitioner (GP) training in Australia. Shows how conflict amongst GPs, in conjunction with the National Competition Policy (NCP), led to a regulatory system with a more direct role for government and with less autonomy for GPs.

DOES ORGANISATIONAL CULTURE INFLUENCE HEALTH CARE PERFORMANCE? A REVIEW OF THE EVIDENCE

T. Scott and others

Journal of Health Services Research and Policy, vol. 8, 2003, p. 105-117

The proposition that organisational culture and health care performance are linked has enduring intuitive appeal, but is currently supported by little firm empirical evidence. Considerable conceptual and empirical work is needed to clarify the links between culture and performance, and their implications for health care policy and management. It is not enough to know whether or not culture is linked to performance. In order to decide if policies are appropriate, we need to know how and why they are linked (e.g. technically, psychologically, linguistically, politically).

E-BUSINESS IN HEALTH CARE: DOES IT CONTRIBUTE TO STRENGTHEN CONSUMER INTEREST?

E. Kertzman, R. Janssen and M. Ruster

Health Policy, vol. 64, 2003, p. 63-73

Presents the use of E-business in health care in the Netherlands. Examines the application of E-business to the management of waiting lists and of personal health-care budgets. Concludes that E-business is likely to give patients a stronger position, encouraging a more demand-led allocation of care.

THE EUROPEAN COURT OF JUSTICE AND THE FREE MOVEMENT OF PATIENTS IN THE EUROPEAN UNION

E. Mossialos and W. Palm

International Social Security Review, vol. 56, no.2, 2003, p. 3-29

Paper reviews recent European Court of Justice (ECJ) rulings concerning the free movement of patients within the EU, and discusses the implications of these rulings for health and social care systems within member states. The case law of the ECJ potentially pits patient choice against the principle of territoriality and member states' control of their health and social security systems. As a side effect, the rulings could also force member states to open their health care markets to foreign providers, thus increasing capacity.

HEALTH SECTOR REFORMS IN KENYA: AN EXAMINATION OF DISTRICT LEVEL PLANNING

C. O. Oyaya and S. B. Rifkin

Health Policy, vol. 64, 2003, p. 113-127

Investigates Kenya's health sector reforms based on the Health Policy Framework of 1994. States that policy objectives have been based on flawed assumptions. Argues that concentrating on outcomes, rather than on policy processes, has undermined the goals of improved health and sustainable reform. Identifies the major policy processes that need to be managed to achieve these goals.

INDIGENOUS SOCIAL INSURANCE AS AN ALTERNATIVE FINANCING MECHANISM FOR HEALTH CARE IN ETHIOPIA (THE CASE OF EDERS)

D. H. Mariam

Social Science and Medicine, vol. 56. 2003, p. 1719-1726

Eders in Ethiopia are indigenous social institutions originally aimed at helping members bear the financial costs of bereavement. However they are now also involved in various community development activities. Article reports results of a study which explored the feasibility of using eders to run social health insurance schemes. Found that eders are viable mechanisms for running health insurance schemes in rural Ethiopia.

NATIONAL HEALTH INSURANCE AND THE ANTENATAL CARE USE: A CASE IN TAIWAN

C. S. Chen, T. C. Liu and L. M. Chen

Health Policy, vol. 64, 2003, p. 99-112

Compares the use of antenatal care in Taiwan before and after the implementation of National Health Insurance (NHI) in 1995. Identifies conditions resulting in a higher number of antenatal care visits than average. Finds new patterns of antenatal care visits after the implementation of NHI including visits to maternity clinics increasing more than visits to hospitals, visits by those in central Taiwan increasing and government employees and business women seeking care most frequently.

PHYSICIAN ASSISTANTS: DOES THE US EXPERIENCE HAVE ANYTHING TO OFFER OTHER COUNTRIES?

J. F. Cawley and R. S. Hooker

Journal of Health Services Research and Policy, vol. 8, 2003, p. 65-67

Physician assistants could assist industrialised countries in addressing medical workforce shortages. They can both supplement doctors in a wide range of roles, and replace doctors in case of shortage.

SCIENCE, CONSUMERISM AND BUREAUCRACY: NEW LEGITIMATIONS OF MEDICAL PROFESSIONALISM

S. Harrison and R. McDonald

The International Journal of Public Sector Management, vol. 16, 2003, p. 110-121

The way in which the medical profession legitimises itself is changing. Describes the changes in terms of a Weberian shift from substantive to formal rationality. Finds a 'bureaucratised' model of formal assessments, analysis, regulations and tests is replacing the 'traditional' model of professional self-regulation and self-criticism.

SHIFTING BOUNDARIES AND NEGOTIATIONS ON KNOWLEDGE: INTERPROFESSIONAL CONFLICTS BETWEEN NURSES AND NURSING ASSISTANTS IN NORWAY

R. Dahle

International Journal of Sociology and Social Policy, vol. 23, 2003, p.139-158

Examines the ongoing conflict between nurses and nursing assistants in Norway. Nurses found their professional role was threatened by the overlapping work performed by nursing assistants. After the Leon report in 1989 nursing assistants were excluded from caring directly for patients. They oppose this division of labour.

USER FEES WOULD STOP WASTE AND ENSURE BETTER USE OF THE HEALTH CARE SYSTEM

Canadian Health Services Research Foundation

Journal of Health Services Research and Policy, vol. 8, 2003, p. 125-126

There is no evidence that user fees reduce inappropriate use of the health care system overall. They appear to deter people on low incomes from seeking early treatment, leading to sicker patients and more costs later on.

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