Click here to skip to content

Welfare Reform on the Web (April 2007): Healthcare - overseas

Decentralisation and convergence in health among the provinces of Spain (1980-2001)

R. Montero-Granados, J. de Dios Jimenez and J. Martin

Social Science and Medicine, vol. 64, 2007, p. 1253-1264

This study measures the process of convergence in population health status among the regions and provinces of Spain from 1980 to 2001 in order to examine the possible influence of the decentralisation of healthcare management to the regions in this period. Sigma and beta convergence models were used, taking Life Expectancy at Birth and Infant Mortality as indicators. Results show that decentralisation either does not affect convergence or leads to greater diversity in population health. Indeed, in the case of infant mortality the so-called change of role scenario seems to have occurred. Thus, certain provinces with initially poor indicators have improved faster than those originally in a better position.

Direct-to-consumer advertising of pharmaceuticals: developed countries' experiences and Turkey

S. Semin, S. Aras and D. Guldal

Health Expectations, vol. 10, 2007, p. 4-15

The authors express concern about direct-to-consumer advertising of pharmaceuticals with particular reference to Turkey. A slowing of growth in the drug market in developed countries has led pharmaceutical companies to seek to expand sales in developing countries such as Turkey. It is suggested that "masked advertising" is playing an increasingly important role in increasing public demand and pharmaceutical consumption. While the health status of the population of Turkey resembles that of developing countries, it has a profile of pharmaceutical consumption characteristic of Western countries. Direct-to-consumer advertising is particularly problematic in Turkey because patients receive little information about their condition and treatment from doctors, and advertising aims to persuade rather than inform.

The drive for transparency: organizational field transformations in Swedish healthcare

M. Blomgren

Public Administration, vol.85, 2007, p. 67-82

This paper provides an account of the rising demand for transparency in Swedish healthcare. Research has identified about 70 bodies involved in monitoring, regulating and holding healthcare organisations to account, but the paper focuses on the most active in the promotion of transparency. It shows how the drive for transparency has opened up the field to new actors and has changed the quality discourse. As a result, the National Registries of Quality are beginning to be opened up to the public.

Public trust in health care: a comparison of Germany, the Netherlands, England and Wales

E. van der Schee and others

Health Policy, vol. 81, 2007, p. 56-67

This article describes differences in public trust in health care in three European countries: Germany, the Netherlands and England and Wales. Data were collected using a postal questionnaire and analysis showed people in Germany had the least trust in health care, while those in England and Wales had the most. The researchers found no indications that differing institutional arrangements, variations in healthcare quality or negative media exposure would explain the different levels of public trust. The explanation may lie in cultural differences and international data has shown that people in Germany are generally less trusting than the Dutch or the English and Welsh. This means that level of public trust cannot safely be used as a performance indicator for healthcare systems.

Reference drug programs: effectiveness and policy implications

S. Schneeweiss

Health Policy, vol. 81, 2007, p. 17-28

Reference drug programmes (RDPs) for pharmaceutical reimbursement are based on the assumption that certain medications within a drug group are clinically interchangeable and that a common reimbursement level can thus be established. If the evidence shows that a higher price for a given drug does not buy greater effectiveness or reduced toxicity, then the cost-conscious drug plan should not cover the extra cost. Thus drug plans implementing RDPs will fully cover only the cost of the least expensive drugs in a therapeutically equivalent group by defining the maximum reimbursable amount called the reference price. Ideally this approach can provide complete coverage for prescription drugs, while reducing expenditure and encouraging pharmaceutical companies to lower prices.

Search Welfare Reform on the Web