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Welfare Reform on the Web (April 2004): Healthcare - Overseas

CHANGING HEALTH IN CHINA: RE-EVALUATING THE EPIDEMIOLOGICAL MODEL

I.G. Cook and T.J.B. Dummer

Health Policy, Vol. 67, 2004, p.329-343

The article examines whether the improvement to China's health system since 1949 (pre the People's Republic of China) can be explained by the traditional epidemiological transition model or whether it fundamentally reflects state policy.

COMPARATIVE HEALTH POLICY

R.H. Blank and V. Burau

London: Palgrave, 2004

In order to determine the extent to which the problems facing health care systems have common causes, this comparative assessment of health policy focuses on a set of key themes and issues. How do the main types of health systems in the developed world address health care problems, and do different systems make a difference? Or is health policy in these countries converging? The book analyses public/private mixes, policy and funding frameworks, professional organizations, and acute and preventative services from the various health systems. In order to do this, the systems of Australia, Germany, Japan, New Zealand, the Netherlands, Sweden, Singapore, the UK and the USA are systematically covered.

DIFFERENTIAL WILLINGNESS OF HOUSEHOLD HEADS TO PAY COMMUNITY-BASED HEALTH INSURANCE PREMIA FOR THEMSELVES AND OTHER HOUSEHOLD MEMBERS

H. Dong and others

Health Policy and Planning, vol.19, 2004, p.120-126

Household heads' valuation of the benefits of health insurance for themselves was found to differ from their valuation of benefits to other household members. The results imply that the premium for community-based insurance (CBI) needs to be adjusted for economic status and household size, or the poor need to be given exemptions or subsidies. Otherwise the poor will have less access to CBI than the rich. The results also imply that the household might be a better unit of enrolment than the individual if vulnerable household members such as women and the elderly are to be protected.

EQUITY IN RESOURCE ALLOCATION IN THE IRISH HEALTH SERVICE: A POLICY DELPHI STUDY

R. O'Loughlin and A. Kelly

Health Policy, Vol. 67, 2004, p.271-280

The article considers whether resource allocation in the Irish health service is inequitable. It uses a policy Delphi methodology - a multi-round survey in which a variety of experts interact anonymously on a particular topic. Data were collected from three questionnaires, where the views of 52 senior health personnel were sought in order to determine ways to improve equity in resource allocation. Numerous examples of inequity and suggestions for improvements were made and the results reflect concern about lack of transparency in the resource allocation process. There are concerns about the feasibility of change, but the article concludes that this concern should not hinder attempts to begin the process.

FINANCING AND PLANNING OF PUBLIC AND NOT-FOR-PROFIT HOSPITALS IN THE EUROPEAN UNION

C.R. Thompson and M. McKee

Health Policy, Vol. 67, 2004, p.281-291

The article examines how countries in the European Union (EU) invest in their hospital sectors, with particular focus on the methods used to finance major capital investments and approaches to hospital planning, in the hope that exchanging knowledge will help policy makers understand the range of options available to them. Key staff were surveyed regarding hospital planning across the EU, with questions centred around four key areas - the current climate for hospital investment, capital financing options, private sector involvement and the decision-making aspects of the hospital planning process. Results show diversity across Europe, but at the same time an expansion of public-private partnerships as a means of capital development.

GLOBALISATION AND LOCAL POWER: INFLUENCES ON HEALTH MATTERS IN SOUTH AFRICA

T. Gilbert and L. Gilbert

Health Policy, Vol. 67, 2004, p.245-255

The article considers the factors, both local and global, which impact on South African health matters, and the extent to which global patterns have played out in South Africa. Areas examined include health policy, neo-liberal macroeconomic policy, HIV/AIDS and health care pluralism. It concludes that although South Africa is influenced by international organisations such as the World Bank and the WHO and by developments in the global political economy, local issues still dominate. This is particularly evident with regard to HIV/AIDS, where local history has not only shaped the spread and development of the disease, but also access to preventive and curative care.

HEALTH LITERACY, SOCIAL SUPPORT AND HEALTH: A RESEARCH AGENDA

S-Y. D. Lee, A.M. Arozullah and Y.I. Cho

Social Science & Medicine, Vol. 58, 2004, p.1309-1321

The article considers how health literacy affects health status and health service utilisation. It proposes research hypotheses to answer two questions: what links low health literacy to poor health status and a frequent use of health services and what impact does structural and functional social support have on the relationship between health literacy and health utilisation. Empirical studies of health literacy are reviewed to emphasise the limitations of the current literature and promote the need for further research.

INEQUALITIES IN ACCESS TO MEDICAL CARE IN FIVE COUNTRIES: FINDINGS FROM THE 2001 COMMONWEALTH FUND INTERNATIONAL HEALTH POLICY SURVEY

C. Schoen and M.M. Day

Health Policy, Vol. 67, 2004, p.309-322

The article reports on the Commonwealth Fund International Health Policy Survey which examined inequalities in access to and quality of healthcare in Australia, Canada, New Zealand, the United Kingdom, and the United States. Approximately 1,400 adults were surveyed in each country regarding problems accessing medical care, quality ratings and their views on their healthcare system. Key measures, including relative income, health status, ethnicity and education, were also taken into account. Results revealed significant disparities in access and care experience between adults with above and below-average incomes in the US, whereas differences by income in the UK were rare. Australia, Canada and New Zealand fell in the middle of the range. The report concludes that some healthcare systems are better able to minimise financial barriers to access and quality of care than others, but that inequalities can still occur in systems providing basic health coverage for all if private coverage is relied upon as a supplement.

INSURANCE AND THE UTILIZATION OF MEDICAL SERVICES

J. Meer and H.S. Rosen

Social Science & Medicine Vol. 58, 2004, p.1623-1632

Conventional wisdom states that health insurance increases an individual's utilization of healthcare services which, in turn, leads to better health outcomes. The article seeks to confirm the first part of the hypothesis. Data were taken from the 1996-1998 Medical Expenditure Panel Survey (MEPS), where respondents are questioned on a yearly basis about their insurance status, utilization of healthcare and a variety of other related issues. Results confirmed that insurance did have a significant influence on health utilization.

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