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

ELECTRONIC PRESCRIPTION SYSTEM: DO THE PROFESSIONALS USE IT?

T.A.M. Spil, R.W. Schuring and M.B. Michel-Verkerke

International Journal of Healthcare Technology and Management, Vol.6, 2004, p.32-55

A multiple case study of 56 Dutch GPs revealed that the Electronic Prescription System (EPS) is not used in at least 72% of cases. Low use arose from inadequate resources (e.g. a lack of fast PCs) and failure of the system to meet user needs.

EQUITY IN THE UTILISATION OF HEALTH CARE IN IRELAND

R. Layte and B. Nolan

The Economic and Social Review, Vol. 35, 2004, p.111-134

The article examines the distribution of health care service utilisation in Ireland and explores whether it is equitable across income groups. It sets out a definition of equity - that people with the same health needs should have the same level of treatment, regardless of income - before looking at the use of different levels of health care services, including inpatient and outpatient hospital services, GPs and dental and optician services. Results showed that although hospital services were generally neutral in their distribution across income groups, those with lower incomes used their GPs significantly more than their better off peers and use of dentists and opticians was mainly by more advantaged income groups. The study found that most of these differences could be explained in terms of "need" factors, with the exception of GP services, where utilisation by those with lower incomes was found to be greater than their predicted need.

FOREIGN DIRECT INVESTMENT AND TRADE IN HEALTH SERVICES: A REVIEW OF THE LITERATURE

R.D. Smith

Social Science and Medicine, Vol. 59, 2004, p.2313-2323

The paper seeks to assess the major issues surrounding foreign direct investment in health services through a systematic review of the literature. The perspective taken is one of the protection and promotion of health, most especially in low- and middle-income countries, and the article is therefore concerned with the "import" of FDI. Current research suggests that:

• the extent to which a national health system is commercialised per se is of more significance than whether the investment in it is foreign or domestic;
• the national regulatory environment and its "strength" will significantly determine the economic and health impact of FDI, the effectiveness of safeguard measures, and the stability of GATS commitments;
• any negotiations will depend on parties having a common understanding of what is being negotiated, and the interpretation of key definitions is thus critical.

A GUIDE TO UTILISATION AND SUSTAINMENT OF TELEMEDICINE: ANSWERING THE QUESTION, "WHAT IS IN IT FOR ME?"

D.E. Seale and others

International Journal of Healthcare Technology and Management, Vol.6, 2004, p.91-107

Despite general agreement that many healthcare needs can be met and addressed through telemedicine, most telemedicine systems are underused and provision of services is difficult to sustain. The article outlines five steps for establishing baseline utilisation and assuring long term growth and sustainability along with field-tested techniques for achieving each. The five steps are: identifying strategic partners, developing local champions, engaging the project team, securing executive buy-in and governing community support.

MOVING BEYOND IMPLEMENTATION TO SUSTAINED USE OF COMPUTERS IN GENERAL PRACTICE IN AUSTRALIA

D. Bomba

International Journal of Healthcare Technology and Management, Vol.6, 2004, p.83-90

The article reports on results from a cross-sectional study of GP attitudes towards computerisation in the Illawarra region of New South Wales. Results of a postal survey in 2001 were compared to results gathered in 1999. Results show that GPs have continued to use computers and a software programme called Medical Director (MD) for a range of functions since the Illawarra Coordinated Care Trial in 1999. There is a high use of MD for prescription writing and a low use for patient clinical records. GPs associate the use of computers and MD with improved information management and work practices despite problems with system crashes, viruses and data loss.

PRICING HEALTH SERVICES FOR PURCHASERS - A REVIEW OF METHODS AND EXPERIENCES

H.R. Waters and P. Hussey

Health Policy, Vol.70, 2004, p.175-184

The article explores the costs and pricing of health care services for health care purchasers. It identifies the main factors influencing price setting: provider payment systems (capitation, case-based payment and fee-for-service payment), information available on actual costs, service volumes and outcomes and the characteristics of providers and purchasers. It then presents case studies from countries using one of the different payment systems. The article concludes with advice on developing provider payment systems for low- and middle-income countries.

SOCIAL MOVEMENTS IN HEALTH: AN INTRODUCTION

P. Brown and S. Zavestoski

Sociology of Health and Illness, Vol.26, 2004, p.679-694

The article explores health social movements, and explains their importance. It demonstrates how social movements can engage in scientific knowledge production, thus democratising and reshaping social policy in order to transform the socioeconomic and political conditions that shape the health of society.

WILLINGNESS TO PAY FOR PUBLIC HEALTH CARE: A COMPARISON OF TWO APPROACHES

J.A. Olsen and others

Health Policy, Vol.70, 2004, p.217-228

The article considers whether people are more willing to pay for health care through insurance premiums or taxation contributions. A split sample survey was taken in Denmark in which two groups of respondents were presented with two different versions of a questionnaire. Results showed that more people were willing to pay in the community (taxation) version although respondents gave different reasons for being or not being willing to pay.