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Welfare Reform on the Web (July 2003): Healthcare - Overseas

CALIFORNIA DREAMING IN RURAL LINCOLNSHIRE

D. Bray

Primary Care Report, vol. 5, 14 May 2003, p. 28, 32

The Lincolnshire South West PCT spent a week in California to see how the health care company, Kaiser Permanente, has produced an efficient, quality service that has cut the length of inpatient stays, cut the number of hospital beds needed and improved access to services. Found key features for success included the integrated nature of the primary and secondary care functions, an integrated information system, discharge planning from hospital, intermediate care arrangements and an emphasis on keeping the patient in the primary care setting. Explains how lessons drawn from the visit will be applied to the Lincolnshire South West PCT.

CHANGING THE NATURE OF PHYSICIAN REFERRAL RELATIONSHIPS IN THE US: THE IMPACT OF MANAGED CARE

D. Anthony

Social Science and Medicine, vol. 56, 2003, p. 2033-2044

Managed care in the USA requires primary care providers to refer patients to a closed panel of specialist physicians. Through an in-depth case study of 45 primary care providers who face restricted specialist panels for their managed care patients, but not for their fee-for-service patients, author investigates how the practice of referral is changed by this requirement. Managed care referrals were less likely to be made to consultants with whom the primary care provider had an established relationship, and were characterised by somewhat less communication and somewhat more logistical difficulties. Many primary care providers were unhappy about not being able to use their own professional judgement when making referrals.

A CRITICAL EXAMINATION OF THE HOSPITAL RESTRUCTURING PROCESS IN ONTARIO, CANADA

T. Bryant

Health Policy, vol. 64, 2003, p. 193-205

This paper questions the sole reliance on expert knowledge to develop health policy. Examines different types of knowledge, including lay and critical knowledge. Presents a conceptual framework of health policy change incorporating broad concepts of knowledge and civil society actors contributing to the development of health policy. Looks at a case study of hospital restructuring in Toronto, Canada and examines the selection and use of different types of knowledge to fight the closure of a hospital.

HAS DECENTRALISATION OF PRIMARY CARE FINALLY RUN ITS COURSE?

G. Meads and A. Wild

Primary Care Report, vol. 5, Apr 30th 2003, p. 30-32

Article discusses modernisation of primary care in New Zealand, Canada and Finland, focusing on common themes of decentralisation, privatisation and integration of health and social care.

IMPLEMENTATION OF PROVINCIAL/TERRITORIAL HEALTH GOALS IN CANADA

D. L. Williamson and others

Health Policy, vol. 64, 2003, p. 173-191

In Canada, over the last 25 years, a range of health goals have been developed at provincial level. This paper investigates the implementation and use of these goals. Finds that health goals have not been systematically incorporated into health planning. Instead, business plans have been developed that may reflect some of the goals, but they have not been deliberately built into them. Health care system goals are more likely to be in the business plans than health goals relating to the economic and social environment. Concludes that health goals can be seen as an inspiration for some of the business plans, but not as a basis for them.

INNOVATIONS IN HEALTH SERVICE DELIVERY: THE CORPORATISATION OF PUBLIC HOSPITALS

A. S. Preker and A. Harding

World Bank, 2003

Argues that the efficiency of the acute sector can be enhanced by giving hospitals autonomy and subjecting them to market forces. Giving hospitals greater freedom can lead to efficiency gains if:

  • the autonomy given is genuine;
  • financial surpluses can be retained and reinvested;
  • they are exposed to competition;
  • there is a sound accountability framework;
  • expensive specialised services are subsidised by government.

PUBLIC HEALTH AND SOCIETY

J. Costello and M. Haggart

Basingstoke: Palgrave MacMillan, 2003

Public Health and Society links public health explicitly to sociological theory, and demonstrates the relationship between health care and the social structures that underpin the provision of health services. The book reviews special topic areas such as:

  • health inequalities
  • social diversity
  • social exclusion units
  • care in the community
  • media constructions of health

REFORM AND AUTONOMY: PERCEPTIONS OF THE AUSTRALIAN GENERAL PRACTICE COMMUNITY

T. Majoribanks and J. M. Lewis

Social Science and Medicine, vol. 56, 2003, p. 2229-2239

Using a multi-component model of autonomy which separates out micro, meso and macro levels, authors undertook an analysis of 343 items on autonomy and reform collected from three key Australian general practice journals. There was concern among GPs over a perceived loss of control over earnings and clinical practice following health policy reforms.

SPANISH LAW GIVES HOSPITALS BROADER POWERS

L. Crawford

Financial Times, May 7th 2003, p. 3

Spain has allowed private management companies to take over the running of public hospitals since 1998, although the law that gave hospitals the option of becoming private "foundations" was just as controversial as it is proving to be in Britain today.

STRATEGIC EXPLOITATION OF INFORMATION AND COMMUNICATION TECHNOLOGY IN THE HEALTHCARE SECTOR

T. Y. Liang

Human Systems Management, vol. 21, 2003, p. 241-248

Article looks at the use of information technology in the healthcare sector in Singapore focusing on electronic data interchange, the Internet, e-commerce, and broadband network and wireless technology.

THE STRUGGLE OVER EMPLOYEE BENEFITS: THE ROLE OF LABOR IN INFLUENCING MODERN HEALTH POLICY

D. Rosner and G. Markowitz

Milbank Quarterly, vol. 81, no. 1, 2003, p. 45-73

Offers an assessment of organised labour's role in the development of US health care policies from the late nineteenth century to the present. Elucidates labour's historical role in an array of policy arenas, including workplace safety, occupational health and private and public insurance schemes. Traces labour's declining influence on these matters in recent decades.

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