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Welfare Reform on the Web (November 2005): Healthcare - Overseas

An approach to estimating human resource requirements to achieve the Millennium Development Goals

N. Dreesch and others

Health Policy and Planning. Vol. 20, 2005, p.267 - 275

In the context of the Millennium Development Goals, human resources represent a critical constraint on achieving targets. It is therefore vital for health planners to identify the human resources needed to meet the targets. Human resource planning is complex for health decision makers who need to estimate the numbers, skills and distribution of health personnel required to meet population needs, while also considering resource constraints. This paper examines methods of human resource planning for health, drawing from a service-target approach, and functional job analysis to propose a methodology for estimating personnel required to achieve the goals set out in the Millennium Declaration.

Comparative quality of private and public health services in rural Vietnam

T. Tuan and others

Health Policy and Planning. Vol 20, 2005, p. 319 - 327

While cost and user satisfaction are similar in both sectors, private health service providers in Vietnam, of which fewer than 20% are government registered, outnumber public providers despite offering significantly poorer quality and infrastructure. Both fall below national standards. This study offers a first quality comparison of the two systems using a community-based survey of communes in Hung Yen selected by PPS sampling.

Health care reform and change in public-private mix of financing: a Korean case

H.-S. Jeong

Health Policy, vol.74, 2005, p.133-145

Until 2000, doctors in Korea both prescribed and sold drugs. A reform was then introduced that separated the roles of medical institutions/doctors from those of pharmacies, so that doctors prescribed drugs that were sold solely by pharmacies. Article explores the change in the mix of publicly financed and out-of-pocket health care expenditure triggered by the reform. The reform significantly increased publicly funded expenditure on health, because it drew most previously uncovered drugs into the National Insurance scheme.

Illuminating cases: understanding the economic burden of illness through case study household research

S. Russell

Health Policy and Planning, vol. 20, 2005, p.277 - 289

While social protection policy can benefit from understanding illness linked household poverty, research and methods are lacking. This paper looks at the limitations of quantitative approaches, which miss some policy relevant dimensions such as household level coping strategies for illness costs, and, drawing from research experiences in Sri Lanka, sets out the advantages of a case study approach.

Implementing global knowledge in local practice: a WHO lung health initiative in Nepal

A. Ten Asbroek and others

Health Policy and Planning, Vol. 20, 2005, p. 290 - 301

Aimed facilitating the local application of global scientific knowledge in low-income countries, clinical practice guidelines initiatives such as the WHO's Practical Approach to Lung Health (PAL) are often developed internationally. On the basis of an assessment of the feasibility of implementing a pilot PAL programme in Nepal, this paper concludes that for more successful local application, primary health care workers should contribute to the improvement of national guidelines and implementation strategies, and that sustained interventions aimed at specific cultures and health systems should be developed.

Investigating international health markets: methodological problems and challenges

C. Holden

Social Policy and Society, vol. 4, 2005, p.427-435

Processes of privatisation and liberalisation around the world have resulted in an increase in the private provision of health and social services and also in the growth in the international trading of such services. However, the available data are not adequate to allow us to develop a clear and comprehensive picture of the scope and nature of this emerging market. The article discusses the methodological problems and challenges of attempting to integrate diverse forms of data and levels of analysis.

Medical savings and medical cost: healthcare and age in a changing Singapore

D.A. Reisman

International Journal of Sociology and Social Policy, vol.25, no.9 2005, p.1-26

Singapore devotes less than 4% of its GDP to healthcare in part because its average citizen is young and fit. However, as the country has become developed, the birth rate has fallen and life expectancy has increased, leading to the prospect of population ageing. As the population ages demand for healthcare, and its cost, will rise. Government will come under pressure from older voters for more generous public provision, the cost of which will push up taxes. The threat of healthcare cost inflation is also being increased by the rise of health tourism due to Singapore's attempts to position itself as a regional treatment hub, and because of a shortage of doctors and nurses, which is driving wages up.

State policy affecting pain management: recent improvements and the positive impact of regulatory health policies

A.M. Gilson, M.A. Maurer and D.E. Joranson

Health Policy, vol.74, 2005, p.192-204

Study aimed to: 1) evaluate changes in US state policies between 2000 and 2003 that could affect use of controlled drugs, including opioid analgesics, for pain relief; 2) describe content differences for statutes, regulations, guidelines and policy statements; 3) evaluate differences between policies specific to pain management and policies governing general health care practice; and 4) compare content of policies specific to pain management created by healthcare regulatory boards to those created by state legislatures. Results show that more current policies, especially those regulating health professionals, tend to encourage pain management and avoid use of language that restricts professional decision-making about use of controlled drugs for pain relief. In addition, pain policies from healthcare regulatory boards were generally less restrictive than statutes or policies governing general healthcare practice. Findings suggest that positive policy change derives from state medical, pharmacy and nursing boards adopting policies promoting pain management and the use of opioids, while containing few, if any, restrictions.

The unexpected growth of the private health sector in Greece

Y. Tountas and others

Health Policy, vol.74, 2005, p.167-180

Private health care in Greece has grown significantly in the last ten years in spite of legislative restrictions and the development of the National Health System since 1983. Private expenditure accounted for 43% of total spending on health care in 2000. This growth is attributed to widespread dissatisfaction with low quality of publicly funded health services, the rapid increase in private health insurance coverage, and factors associated with improved living standards.

Use of multiple opportunities for improving feeding practices in under-twos within child health programmes

N. Bhandari and others

Health Policy and Planning, Vol, 20, 2005, p.328 - 336

Reducing nutrition related childhood deaths depends on effective promotion of positive child feeding behaviours. Increasing the number of channels (home visits, immunization sessions etc) through which counselling on child feeding is given to care givers positively changed behaviour without disrupting ongoing services according to this report of a controlled effectiveness trial based in rural India. Average supplementation levels of vitamin A and folic acid increased in the trial group.

Why illness causes more serious economic damage than crop failure in rural Cambodia

Y. Kenjiro

Development and Change, vol.36, 2005, p.759-783

Data show that Cambodian households can cope with crop failure by earning additional income. However, to cover the costs of medical treatment, they have to borrow money or sell their assets as they cannot earn additional income quickly enough to cover high one-off costs. The combination of harsh credit terms (high interest rates, strict debt collection and credit rationing) and weak risk-sharing among households results in illness causing a large number of land sales in the surveyed villages.

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