scholarly journals Efficiency Analysis of Public Health Spending in Brazilian Capitals Using Network Data Envelopment Analysis (DEA)

2017 ◽  
Vol 1 (4) ◽  
pp. 147
Author(s):  
Maria Stella de Castro Lobo ◽  
Edson Correia Araujo
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Design Research ◽  
Health Spending ◽  
Dynamic Network ◽  
Network Models ◽  
Health Coverage ◽  
Levels Of Care ◽  
Link Variable

Aim:In 1988, Brazil implemented profound changes in the organization and financing of its public health system, with the creation of the Unified Health System (Sistema Unico de Saúde – SUS), establishing universal health coverage. The gradual expansion of the health system and entitlements to services has been accompanied by the debate about the appropriate level of government spending and health system efficiency. Design / Research methods: The study uses VRS - output oriented, Dynamic Network SBM DEA model, period 2008-2013, to depict the relationships that take place between diverse levels of care (primary health care/PHC and secondary-tertiary health care/STC). DMUs are Brazilian state capitals, which implement key health policies and assist patients from smaller surrounding municipalities, especially for STC. Inputs are PHC and STC budgets; outputs are their respective services provided and avoidable deaths. The link variable is PHC medical consultation, entrance door to the system and gatekeeper for more complex levels of care. Dynamic model evaluates efficiency across time. Conclusions / findings:Overall performance was 0.86; for PHC, 0.90; for STC, 0.85 (SD=0.15). 8 out of 27 capitals were fully efficient. Capitals increased average scores in both levels of care, but only STC had a positive technological change (frontier shift >1). Link variable behavior denotes a bottleneck between levels of care. Projections onto the frontier enable establish own management diagnosis and goals for financing and development. Originality / value of the article: Network models mimic hierarchically organized health systems. The appliance of results aids health policy.

scholarly journals Examining the Potential of Blockchain Technology to Meet the Needs of 21st-Century Japanese Health Care: Viewpoint on Use Cases and Policy

10.2196/13649 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e13649 ◽  
Author(s):  
Tim Mackey ◽  
Hirofumi Bekki ◽  
Tokio Matsuzaki ◽  
Hiroshi Mizushima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care Access ◽  
Urban Areas ◽  
Public Health System ◽  
Innovation Policy ◽  
Health Coverage ◽  
Term Care ◽  
Blockchain Technology

Japan is undergoing a major population health transition as its society ages, and it continues to experience low birth rates. An aging Japan will bring new challenges to its public health system, highlighted as a model for universal health coverage (UHC) around the world. Specific challenges Japan’s health care system will face include an increase in national public health expenditures, higher demand for health care services, acute need for elder and long-term care, shortage of health care workers, and disparities between health care access in rural versus urban areas. Blockchain technology has the potential to address some of these challenges, but only if a health blockchain is conceptualized, designed, localized, and deployed in a way that is compatible with Japan’s centralized UHC-centric public health system. Blockchain solutions must also be adaptive to opportunities and barriers unique to Japan’s national health and innovation policy, including its regulatory sandbox system, while also seeking to learn from blockchain adoption in the private sector and in other countries. This viewpoint outlines the major opportunities and potential challenges to blockchain adoption for the future of Japan’s health care.

scholarly journals Progress of health care in rural India: a critical review of National Rural Health Mission

2017 ◽  
Vol 5 (1) ◽  
pp. 4 ◽  
Author(s):  
S. Gopalakrishnan ◽  
A. Immanuel
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Rural Health ◽  
Public Health System ◽  
National Rural Health Mission ◽  
Rural India ◽  
Health Coverage ◽  
The Public ◽  
Public Health Infrastructure

National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.

scholarly journals Examining the Potential of Blockchain Technology to Meet the Needs of 21st-Century Japanese Health Care: Viewpoint on Use Cases and Policy (Preprint)

2019 ◽  
Author(s):  
Tim Mackey ◽  
Hirofumi Bekki ◽  
Tokio Matsuzaki ◽  
Hiroshi Mizushima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care Access ◽  
Urban Areas ◽  
Public Health System ◽  
Innovation Policy ◽  
Health Coverage ◽  
Term Care ◽  
Blockchain Technology

UNSTRUCTURED Japan is undergoing a major population health transition as its society ages, and it continues to experience low birth rates. An aging Japan will bring new challenges to its public health system, highlighted as a model for universal health coverage (UHC) around the world. Specific challenges Japan’s health care system will face include an increase in national public health expenditures, higher demand for health care services, acute need for elder and long-term care, shortage of health care workers, and disparities between health care access in rural versus urban areas. Blockchain technology has the potential to address some of these challenges, but only if a health blockchain is conceptualized, designed, localized, and deployed in a way that is compatible with Japan’s centralized UHC-centric public health system. Blockchain solutions must also be adaptive to opportunities and barriers unique to Japan’s national health and innovation policy, including its regulatory sandbox system, while also seeking to learn from blockchain adoption in the private sector and in other countries. This viewpoint outlines the major opportunities and potential challenges to blockchain adoption for the future of Japan’s health care.

scholarly journals LA FINANCIACIÓN DE LA SANIDAD PÚBLICA ESPAÑOLA. ESPECIAL REFERENCIA A LA CRISIS SANITARIA GENERADA POR COVID-19.

2020 ◽  
Vol 5 (2) ◽  
pp. 356-372
Author(s):  
Nuria Benítez Llamazares
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health System ◽  
National Health System ◽  
Health Spending ◽  
Public Health Spending ◽  
Spanish Constitution ◽  
Definition Of Health ◽  
Definition Of

Health population is considered as a fundamental right according to the Spanish Constitution, and public administrations have the duty to guarantee such benefits. National Health System in Spain is configurated by public structures and Health services at all levels of government. The definition of health care benefits as non-contributory implies that the most appropriate alternative is the tax financing of a high percentage of public health spending. Additionally, other financing mechanisms are possible, such as income from donations to the COVID-19 State, an alternative that has given good results to finance the costs associated with the management of the current pandemic.

scholarly journals Social exclusion and the perspectives of health care providers on migrants in Gauteng public health facilities, South Africa

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244080
Author(s):  
Janine A. White ◽  
Duane Blaauw ◽  
Laetitia C. Rispel
Keyword(s):  
Public Health ◽  
South Africa ◽  
Health Care ◽  
Social Exclusion ◽  
Health Care Providers ◽  
Health Facilities ◽  
Health Coverage ◽  
Care Providers ◽  
Public Health Facilities ◽  
Levels Of Care

Background Universal health coverage (UHC) for all people, regardless of citizenship, is a global priority. Health care providers are central to the achievement of UHC, and their attitudes and behaviour could either advance or impede UHC for migrants. Using a social exclusion conceptual framework, this study examined the perspectives of health care providers on delivering health services to migrants in public health facilities in Gauteng Province, South Africa. Methods We used stratified, random sampling to select 13 public health facilities. All health care providers working in ambulatory care were invited to complete a self-administered questionnaire. In addition to socio-demographic information, the questionnaire asked health care providers if they had witnessed discrimination against migrants at work, and measured their perspectives on social exclusionary views and practices. Multiple regression analysis was used to identify predictors of more exclusionary perspectives for each item. Results 277 of 308 health care providers participated in the study–a response rate of 90%. The participants were predominantly female (77.6%) and nurses (51.9%), and had worked for an average of 6.8 years in their facilities. 19.2% of health care providers reported that they had witnessed discrimination against migrants, while 20.0% reported differential treatment of migrant patients. Exclusionary perspectives varied across the different items, and for different provider groups. Enrolled nurses and nursing assistants were significantly more exclusionary on a number of items, while the opposite was found for providers born outside South Africa. For some questions, female providers held more exclusionary perspectives and this was also the case for providers from higher levels of care. Conclusion Health care providers are critical to inclusive UHC. Social exclusionary views or practices must be addressed through enabling health policies; training in culture-sensitivity, ethics and human rights; and advocacy to ensure that health care providers uphold their professional obligations to all patients.

scholarly journals 20.F. Workshop: Dental care – coverage and access across countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
North America ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Dental Care ◽  
Financial Protection ◽  
Health Coverage ◽  
Universal Health

Abstract Oral health is a central element of general health with significant impact in terms of pain, suffering, impairment of function and reduced quality of life. Although most oral disease can be prevented by health promotion strategies and routine access to primary oral health care, the GBD study 2017 estimated that oral diseases affect over 3.5 billion people worldwide (Watt et al, 2019). Given the importance of oral health and its potential contribution to achieving universal health coverage (UHC), it has received increased attention in public health debates in recent years. However, little is known about the large variations across countries in terms of service delivery, coverage and financing of oral health. There is a lack of international comparison and understanding of who delivers oral health services, how much is devoted to oral health care and who funds the costs for which type of treatment (Eaton et al., 2019). Yet, these aspects are central for understanding the scope for improvement regarding financial protection against costs of dental care and equal access to services in each country. This workshop aims to present the comparative research on dental care coverage in Europe, North America and Australia led by the European Observatory on Health Systems and Policies. Three presentations will look at dental care coverage using different methods and approaches. They will compare how well the population is covered for dental care especially within Europe and North America considering the health systems design and expenditure level on dental care, using the WHO coverage cube as analytical framework. The first presentation shows results of a cross-country Health Systems in Transition (HiT) review on dental care. It provides a comparative review and analysis of financing, coverage and access in 31 European countries, describing the main trends also in the provision of dental care. The second presentation compares dental care coverage in eight jurisdictions (Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States) with a particular focus on older adults. The third presentation uses a vignette approach to map the extent of coverage of dental services offered by statutory systems (social insurance, compulsory insurance, NHS) in selected countries in Europe and North America. This workshop provides the opportunity of a focussed discussion on coverage of dental care, which is often neglected in the discussion on access to health services and universal health coverage. The objectives of the workshop are to discuss the oral health systems in an international comparative setting and to draw lessons on best practices and coverage design. The World Conference on Public Health is hence a good opportunity for this workshop that contributes to frame the discussion on oral health systems in a global perspective. Key messages There is large degree of variation in the extent to which the costs of dental care are covered by the statutory systems worldwide with implications for oral health outcomes and financial protection. There is a need for a more systematic collection of oral health indicators to make analysis of reliable and comparable oral health data possible.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Comparative analysis between prevention and treatment costs for gestational diabetes mellitus in primary and tertiary health care in a city in Southern Brazil

2021 ◽  
Vol 13 (1) ◽  
pp. 21-30
Author(s):  
Ricardo Reichenbach ◽  
◽  
Yasmin Reis ◽  
Maria Carolina Gullo ◽  
José Mauro Madi ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health System ◽  
Public Health System ◽  
Economic Valuation ◽  
Southern Brazil ◽  
Economic Context

Objective: The present study’s purpose is to evaluate the economic context in which the Brazilian public health system, the only universal public health system with more than 200 million users, stands out. This evaluation will be made through the lens of the execution of gestational health care services in a city of approximately 500 thousand inhabitants in southern Brazil. The care costs of patients with gestational diabetes mellitus (GDM) will be compared to those of patients without GDM, analyzing the different economic valuation methods. And lastly, there was an intent to explore the generated costs in the context of economic valuation applied to health to comprehend better the complexity of the union of the financial and health areas to optimize the services offered. Methods: For the economic context in health, an analysis of health investments was performed through the Transparency Portal. The costs involved in preventing GDM were raised by the Sistema Único de Saúde (SUS) table of procedures performed ordinarily in low-risk pregnancies. The expenses involved in DMG patients were increased at the High-Risk Pregnancy and Fetal Medicine Clinic of DMG patients. Results: Preventing GDM is more cost-effective, cost-minimizing, and cost-useful than treating patients diagnosed with GDM. Conclusion: The result is an extremely interesting costopportunity, given the economic context in which it is presented

scholarly journals Identification of the Main Elements of Single Payer System; A Comparative Study

2019 ◽  
Author(s):  
Ali Aboutorabi ◽  
Saman Ghasempour ◽  
Behzad Najafi ◽  
Sirous Panahi
Keyword(s):  
Health Care ◽  
Comparative Study ◽  
Health System ◽  
Risk Sharing ◽  
Optimal Allocation ◽  
Insurance Coverage ◽  
Health Sector ◽  
Health Coverage ◽  
Simple Task ◽  
Single Payer

Background: Progress towards universal coverage requires adequate capital in health sector. Investing and optimal allocation of resources in this sector will contribute to the development and reduction of poverty in countries in order to achieve the goals of health system. Therefore, the more people contribute to risk sharing, we have lower financial risks in facing the issue. The single payer system as a public health coverage model seeks to expand the insurance coverage scope at community level. The present study aimed to identify the main elements of S-PS to conduct a comparative study. Methods: A comparative study was conducted to describe the fundamental of financing and the provision of services in selected countries - Germany, Thailand, Turkey, and Colombia, as well as to achieve the main elements of S-PS. In addition, the health system of Iran has been studied. The basis for selection of countries was health system Garden typology. The main criteria for selection or rejection of studies were the separation of health services provider from financial functions; has allowed a single department to purchasing process. Results: single payer system in two functions of health system, namely, financing and providing health care; consolidation resources (reducing fragmentation by creating a single pooled fund and achieve massive purchase of health care through the insurance agent as single purchaser) and ensuring community health (delivery of services by the network of providers represented by Health Promotion Organization) represents 12 main organizational elements. Conclusion: the multiple insurers and payers of health care in Iran are both inequity and ineffective. And its integration is not a simple task. Iranian financing policies should aimed to achieving universal health coverage by creating greater risk pooling and becoming aware of the important tasks of insurance system; take advantage of the strength in numbers, setting the principles of cross-subsidy and preventing adverse reaction. It is important not to put together a long-term, coherent plan to reach the S-PS.

scholarly journals Delays and Unmet Need for Health Care Among Adult Primary Care Patients in a Restructured Urban Public Health System

2004 ◽  
Vol 94 (5) ◽  
pp. 783-789 ◽  
Author(s):  
Allison L. Diamant ◽  
Ron D. Hays ◽  
Leo S. Morales ◽  
Wesley Ford ◽  
Daphne Calmes ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Unmet Need ◽  
Primary Care Patients
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