scholarly journals Advice to purchasing authorities

1993 ◽  
Vol 17 (3) ◽  
pp. 164-165
Author(s):  
Peter Urwin
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Health Care Needs ◽  
Care Needs ◽  
District Health ◽  
Professional Advice ◽  
Health Authorities ◽  
Provision Of Services ◽  
Second Year

We are now well into the second year of the separation of purchaser and provider functions in the National Health Service. District health authorities as purchasers of services are required to assess the health care needs of their population (NHS Management Executive, 1991a) and seek professional advice regarding both the need for, and the provision of, services. The NHS Management Executive acknowledges that local clinicians in provider units will continue to make a major contribution to this advice (NHS Management Executive, 1991b).

FROM WEDNESBURY UNREASONABLENESS TO ACCOUNTABILITY FOR REASONABLENESS

2017 ◽  
Vol 76 (3) ◽  
pp. 642-670 ◽  
Author(s):  
Daniel Wei L. Wang
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Social Policy ◽  
Health Service ◽  
Medical Treatment ◽  
Judicial Review ◽  
Accountability For Reasonableness ◽  
Health Authorities ◽  
Care Policies ◽  
Health Care Policies

AbstractOver the last decades, rationing of medical treatment in the National Health Service (NHS) has moved from implicit to being increasingly explicit about what is being denied and about the procedures and reasons for such decisions. This article argues that the courts have had an important role in this process. By applying a heightened scrutiny of rationing decisions, courts have forced health authorities to make better-informed decisions and to take procedural justice more seriously to comply with, respond to and avoid judicial review. The analysis in this article reveals that litigation has contributed to incremental, but significant and enduring, changes in a social policy. It also offers insights to the paradoxes of judicial accountability in health care policies.

scholarly journals Health Services Development Resource Assumptions and Planning Guidelines 1990/1991

1990 ◽  
Vol 14 (5) ◽  
pp. 316-316
Author(s):  
M. M. Tannahill
Keyword(s):  
Public Health ◽  
Health Care ◽  
Community Care ◽  
White Paper ◽  
Health Care Needs ◽  
Health Issues ◽  
Care Needs ◽  
Department Of Health ◽  
Health Authorities ◽  
Development Resource

In August 1989 the NHS Management Executive of the Department of Health issued Health Authorities with Circular HC(89)24 which lays down planning guidelines and resource assumptions for 1990/91. In five terse pages, the document sets the scene for the Government's priority health issues over the next two years. Several of these issues are of interest and importance to psychiatrists, as they are concerned with the implementation of the White Paper Caring for People: Community Care in the Next Decade and Beyond. Health Authorities are asked to “identify the health care needs of their populations” and to set targets, based on reports of their Directors of Public Health, to improve the overall health of their population.

scholarly journals The National Health Service (NHS) in ‘crisis’: the role played by a shift from horizontal to vertical principles of equity

2018 ◽  
Vol 15 (1) ◽  
pp. 1-17
Author(s):  
Sheena Asthana ◽  
Alex Gibson
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Health Inequalities ◽  
National Health ◽  
Access To Health Care ◽  
Horizontal Equity ◽  
Equal Access ◽  
Care Needs ◽  
The Way

AbstractExplanations of the state of ‘crisis’ in the English National Health Service (NHS) generally focus on the overall level of health care funding rather than the way in which funding is distributed. Describing systematic patterns in the way different areas are experiencing crisis, this paper suggests that NHS organisations in older, rural and particularly coastal areas are more likely to be ‘failing’ and that this is due to the historic underfunding of such areas. This partly reflects methodological and technical shortcomings in NHS resource allocation formulae. It is also the outcome of a philosophical shift from horizontal (equal access for equal needs) to vertical (unequal access to equalise health outcomes) principles of equity. Insofar as health inequalities are determined by factors well beyond health care, we argue that this is an ineffective approach to addressing health inequalities. Moreover, it sacrifices equity in access to health care by failing to adequately fund the health care needs of older populations. The prioritisation of vertical over horizontal equity also conflicts with public perspectives on the NHS. Against this background, we ask whether the time has come to reassert the moral and philosophical case for the principle of equal access for equal health care need.

scholarly journals The psychiatric secretary: a key player in the ‘new’ health service

1993 ◽  
Vol 17 (12) ◽  
pp. 755-756
Author(s):  
Sally A. Foster ◽  
Philip S. Davison
Keyword(s):  
General Practitioner ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Potential Role ◽  
District Health ◽  
Health Authorities

Over recent years the National Health Service has undergone many changes, one of the most important being the development of purchaser/provider roles. From April 1993 district health authorities (DHAs) and general practitioner fund holders (GPFHs) have been able to choose from which provider to purchase their adult psychiatric out-patient services. While discussions on how to attract and keep the contracts from DHAs and GPFHs have been underway at a managerial and consultant level, we believe that the potential role of a key player for hospitals, the psychiatric medical secretary, has been overlooked. This paper examines the secretarial role in the context of the ‘new’ health service.

scholarly journals Inequity in health care needs, health service use and financial burden of medical expenditures in China: results from a consecutive household monitoring study in Jiangsu Province

2019 ◽  
Author(s):  
Weixi Jiang ◽  
Xiaolin Xu ◽  
Shenglan Tang ◽  
Ling Xu ◽  
Yaoguang Zhang ◽  
...  
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Expenditure ◽  
Service Use ◽  
Negative Binomial ◽  
Outpatient Service ◽  
Medical Insurance ◽  
Health Care Needs ◽  
Care Needs ◽  
Rural And Urban

Abstract Background: Although public medical insurance covers over 95% of the population in China, disparities in health service use and out-of-pocket (OOP) health expenditure across income groups are still widely observed. This study aims to investigate the socio-economic disparities in perceived health care needs, informal care, formal care and payment for health care and explore their equity implication. Methods: We assessed healthcare needs, service use and payment in 400 households in rural and urban areas in Jiangsu, China, and included only the adult sample (N=925). One baseline survey and 10 follow-up surveys were conducted during the 7-month monitoring period, and the Affordability Ladder Program (ALP) framework was adopted for data analysis. Negative binomial/zero-inflated negative binomial and logit regression models were used to explore factors associated with perceived care needs and with the use of three types of health service (self-treatment, outpatient and inpatient care). Two-part model and logit regression were conducted to explore factors associated with OOP health expenditure and the likelihood of incurring catastrophic health expenditure (CHE). Results: Rural residence was significantly associated with more perceived health care needs, more self-treatments, higher probability of using outpatient and inpatient service, more OOP health expenditure and higher likelihood of incurring catastrophic expenditure (P<0.05), after adjusting for other variables. Compared to Urban Employee Basic Medical Insurance (UEBMI), enrollment in New Rural Cooperative Medical Scheme (NRCMS) or Urban Resident Basic Medical Insurance (URBMI) was correlated with lower possibility of ever using outpatient service, but more times of outpatient visits when people were at risk of using outpatient service (P<0.05). NRCMS/URBMI was also associated with higher likelihood of incurring CHE with reference to UEBM (OR=2.02, P<0.05), and this effect was only significant for the rural population in the separate analysis of the rural and urban sample. Conclusions: The rural population perceived more health care needs, had a higher probability of using both informal and formal health care services, and had more OOP health expenditure and a higher likelihood of incurring CHE in Jiangsu. The inequity mainly exists in health care financing, and may be partially addressed through improving the benefit packages of NRCMS/URBMI.

Meeting the Health Care Needs of Suburban Youth: Review of a Clinical Service

PEDIATRICS ◽  
1988 ◽  
Vol 81 (1) ◽  
pp. 8-13
Author(s):  
Martin Fisher ◽  
Andrea Marks ◽  
Katherine Trieller
Keyword(s):  
Health Care ◽  
Health Service ◽  
Adolescent Health ◽  
Transmitted Disease ◽  
Health Risk Behaviors ◽  
Screening Tests ◽  
Medical Attention ◽  
Health Care Needs ◽  
Care Needs ◽  
Initial Survey

The demographic and medical data from the first 1,000 patients registered at a suburban adolescent health service were reviewed and the findings compared with the results of an initial survey performed in the same community and other health services located in urban communities. Most of the patients were white (92%), girls (82%), and 16 to 18 years of age (63%) and had parents who graduated from high school (59%) or college (28%). They reported higher rates of participation in health-risk behaviors, including smoking (50%), drinking (60%), drug use (67%), and sexual intercourse (83%), than their peers. Seventy-two percent of the patients sought medical attention for sexuality-related or gynecologic concerns, including contraception (39%), pregnancy determination (20%), and evaluation of possible sexually transmitted disease (9%), and 28% sought attention for general medical or emotional needs, including checkups or immunizations (11%), nutritional or weight problems (4%), and emotional issues or substance abuse (4%). Management of sexuality-related issues differed from that reported in urban settings, whereas laboratory screening tests indicated that problems were similar to those in other settings. Many problems described in an initial survey of youth in the community were not seen at the adolescent health service. We conclude that a suburban-based health service may meet certain health care needs of the higher risk youth of the community but that ultimate care for adolescents remains with the private physicians in this setting.

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