Singapore's regional health systems-a data-driven perspective on frequent admitters and cross utilization of healthcare services in three systems

2015 ◽  
Vol 32 (1) ◽  
pp. 36-49 ◽  
Author(s):  
Nakul Saxena ◽  
Alex Xiaobin You ◽  
Zhecheng Zhu ◽  
Yan Sun ◽  
Pradeep Paul George ◽  
...  
Keyword(s):  
Health Systems ◽  
Healthcare Services ◽  
Data Driven ◽  
Regional Health ◽  
Utilization Of Healthcare ◽  
Regional Health Systems

The role of regional health systems on the waiting time inequalities in health care services: Evidences from Italy

2020 ◽  
pp. 095148482092830
Author(s):  
Stefano Landi ◽  
Enrico Ivaldi ◽  
Angela Testi
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Waiting Time ◽  
Health Care Access ◽  
Health Care Services ◽  
Waiting Times ◽  
Healthcare Services ◽  
Regional Health ◽  
Health Authorities ◽  
Regional Health Authorities

Inequalities in effective access to healthcare are present among countries and within the same country. Despite in Italy exist the principle of equity in access to health system, there are evidence of different access rates in the form of unequal waiting time within the country. Waiting times are an instruments to ration healthcare services dealing with resource scarsity. Theoretically, it is a fair tool because waiting times should depend only on health needs and not on the ability to pay. However, a growing literature has pointed out that belonging to a particular socioeconomic status leads to waiting times inequalities for healthcare services. Many countries have socioeconomic disparities among regions, and healthcare organizations need to take into account these differences. The increasing power of Regional Health Authorities in decentralized health systems, as in the case of Italy, has generated different organizational ways to provide health care, possibly leading to different access rates in the form of unequal waiting time within the country. This paper aims to understand if the administrative area (Regional Health Authorities) in charge of health services affects waiting times lowering or strengthening health care access inequalities. Using a series of logistic regression models, this work suggests the presence of two vectors: socioeconomic inequalities and regional inequalities. Health organizations need to implement different kinds of answers for each vectors of inequalities.

Data Transparency as a “Source of Truth” to Support Regional Health Systems Change

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Kristin M. Jenkins ◽  
Judy L. Bezanson ◽  
James R. Edgerton ◽  
W. Steves Ring ◽  
Baron L. Hamman ◽  
...  
Keyword(s):  
Health Systems ◽  
Systems Change ◽  
Regional Health ◽  
Data Transparency ◽  
Regional Health Systems

Abstract 182: The Impact of National and Regional Health Systems Arrangements on Hypertension Awareness, Treatment and Control: a Systematic Literature Review

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Jared Paty ◽  
Will Maimaris ◽  
Pablo Perel ◽  
Helena Legido-Quigley ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Systems ◽  
Insurance Coverage ◽  
Regional Health ◽  
Cross Sectional ◽  
The Us ◽  
Cross Sectional Studies ◽  
Regional Health Systems ◽  
And Control ◽  
The Impact

Background: Around a billion people worldwide have hypertension (HT), a major risk factor for cardiovascular disease. A significant proportion of HT patients remain unaware, untreated, and are uncontrolled, despite the availability of inexpensive and effective medications. Weaknesses in health systems are thought to be a key contributor to the inadequacies in HT care and control globally. We performed a systematic literature review to summarize the effects of national or regional health systems arrangements on HT care and control. Methods: An existing health systems framework was adapted to illustrate the impact of health systems components on HT outcomes (awareness, treatment prescription, treatment adherence and HT control) and guide the conduct of the systematic review. Studies analyzing effects of health systems arrangements at the regional or national level on HT outcomes were included, and Medline, Embase, and Global Health were searched for eligible studies. Two authors independently assessed papers for inclusion, extracted data, and assessed risk of bias using a simple proforma. Pooling of results was deemed inappropriate considering substantial variation in study designs. Results: Fifty studies met our eligibility criteria; 1 randomized controlled trial, 11 cohort, 3 case-control, 30 cross-sectional, 3 ecological, and 2 qualitative studies. Forty-one studies (82%) were set in high income countries, 35 of which were in the US. Most studies examined factors relating to the effect of either health systems financing (35) or health systems governance and delivery (16). Longitudinal studies, supported by some but not all cross-sectional studies, consistently reported a significant association between health insurance coverage in the US and improved HT awareness, medication adherence, and control (10 of 21 studies). There was also a consistent significant association, in both longitudinal and cross-sectional studies, between reduced co-payments for medical care and improved HT outcomes (10 of 11 studies). Although lacking longitudinal studies, we found a significant association in 12 of 14 US studies between having a routine place or physician for HT care, and HT outcomes. Conclusions: A largely consistent association between health insurance status, medication copayments, and routine availability of HT care with HT outcomes was found. Implications for policy are mainly applicable to the US setting, where our findings suggest that expanding insurance coverage and increasing access to routine care may improve HT outcomes. Additionally, minimization of co-payments for medication and care may improve HT outcomes in the US and to a limited extent in other non-US settings. Future research efforts should primarily focus on obtaining high quality longitudinal data and reducing the information gap in low and middle income countries, which bear three quarters of the global HT burden.

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