health care reform scholarly articles

There is encouraging news from Mexico, where a new universal healthcare scheme guarantees access to 275 essential and 57 specialized costly interventions, the latter including neonatal intensive care, cervical and breast cancer and HIV/AIDS. . Maintenance of free choice of providers, preservation of physician autonomy and reform of the litigation system of injury from sub-standard care is also high on the agenda. There was no funding specific to this project. Nevertheless, it is necessary, since system-wide reforms should not be undertaken unless they both secure demonstrable, attainable benefits and avoid dysfunctional effects. In 2008 the United States Gross Domestic Product President Obama has achieved a 'victory' unlike anything seen since the term of President Lyndon Johnson, over 40 years ago. ‘First, do no harm’ should apply not only to doctor–patient encounters but to healthcare system interventions, too. Closing the Socioeconomic Gap in Massachusetts: Trends in Total Hip Arthroplasty From 2013 to 2015. , Matsuyama Y, Mannion Ret al. . T As health care costs rise, more Americans are being pushed into inadequate health insurance plans that cause them to put off care. While scientific evaluation of this kind, conducted over time, may not depoliticize health reforms, it at least gives them a sounder footing. As Sodzi Sodzi-Tettey reports in his chapter, a 2006 study found that Ghana needs 69% more pharmacists and 883% more X-ray technologists. R We will begin by clarifying the major ethical, economic, and political arguments and forces that shape discussions about health care in the US. Coiera The positive hindsight bias these present “evaluations” rest on must not continue to prevent us from learning from success and failure. And South Africa not only carries a quadruple burden of disease—HIV/AIDS and tuberculosis, maternal and infant mortality, non-communicable diseases (NCDs), and violence and trauma—but faces hurdles that include “unacceptably high levels of fraud and theft, top-heavy management and administration structures, and an excessively hospi-centric and specialist focus”, according to Stuart Whittaker, Carol Marshall and Grace Labadarios [3]. Copyright © 2021 International Society for Quality in Health Care and Oxford University Press. Wealthy or less wealthy, countries are embracing ways to enhance quality of care and keep patients safe, via mechanisms such as accreditation, clinical guidelines and hand hygiene campaigns. The Bismarck model, as it is now known, uses a private but not-for-profit system of tightly regulated insurers jointly financed by employer and employee (or subsidized by the Federal government for the unemployed). Keeping these promises will be another matter for another time. Improvements require better integration and coordination between all those departments and agencies which affect population health. Perhaps the most striking similarity between the countries studied, though—and our book's most sobering finding—is the absence of evidence to link specific reforms with positive outcomes. Future reforms, we emphasize, must be accompanied by robust, objective assessment [4, 5, 6]. Are not the last group, after all, the ones whom reforms and quality and safety improvements are meant to serve? ‘Free at the point of delivery’ is a frequently repeated mantra. Pawson Recent reclassification of PNG as a lower middle-income nation has made little difference, prompting the authors to conclude that “economic growth in itself is clearly not sufficient to lead an improvement in the health of a country's population”. C Medicare spending varies widely in America depending on health status, income level and other regional factors.3 A promise to slow the projected growth of the Medicare program may delay insolvency, but will be difficult to actually accomplish. The effectiveness of the reform was questioned after several years of implementation for a number of reasons. J Also conspicuously alike are the obstacles to change: shortages of finance and staff, medical profession politics and intransigence, poor infrastructure, organizational cultures riven with resistance to change, ineffective leadership and management or governance arrangements that are not fit for purpose. Throughout the debate leading to enactment of the new law intense lobbying efforts by stakeholders (organized medicine, hospital associations, insurance entities, pharmaceutical companies, state and local government leaders, constituency groups, labour unions and the like) shaped the structure and complexity of the final legislation. Reid provides unique insights and a wealth of historical information on how the ‘systems’ of health care coverage evolved in the various countries of world.7 Reid notes that the beginning of health care systems can be traced to the ‘Iron Chancellor’ Otto von Bismarck’s pioneering social system inaugurated in Germany in 1883. Popular reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality and morbidity in maternal and child health. J Community Health 19: 253–69. Roberts Doctors and hospitals are mostly private. Ideas about quality and safety run similarly in parallel. © The Author 2016. Scholarly Articles On Healthcare Management It should be based on a theory of change, sensitive to its context and should seek the views of stakeholders. The new law will provide coverage by making subsidies available to purchase health insurance at affordable rates to ∼32-million of these previously uninsured or under-insured individuals, leaving only the undocumented aliens without some form of either public or private insurance. Argentina, while not alone, exhibits a “general unwillingness to obey rules”. Previous columns have discussed how the Patient Protection and Affordable Care Act (PPACA), now a law, focuses on health promotion and prevention and offers opportunities for ambulatory care nurses to enhance services to patients and families. But rural and urban Indian reform programmes have achieved significant results: deaths from kala-azar disease have fallen 21.2%, from malaria 45.2%, microfilaria 26.7% and dengue fever 52%. Government-sponsored universal health care systems, such as those in Canada, are reconsidering a role for private health care and have been largely unsuccessful in reducing costs. Sophisticated thinkers may go further and consider a stepped-wedge intervention, whereby the change enrols the entire population, but its introduction is staged, so the population becomes its own control [11]. Academic Articles On Healthcare Reform . Apathy in presymptomatic genetic frontotemporal dementia predicts cognitive decline and is driven by structural brain changes. The nature of the debate that preceded passage has had a polarizing effect on American political discourse that will be a challenge, perhaps the greatest one, facing the young administration of President Obama. To answer these questions, we draw on a book we recently contributed, Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries. Care is provided in a highly integrated system of primary care physicians and specialists. From the David Geffen School of Medicine, Los Angeles, CA, USA. Future efforts to reform and improve US healthcare can use the ACA as a platform for further systems gains. Israel, Hong Kong and Japan, for example, all emphasize to varying extents evidence-based practice, accreditation initiatives, unified standards, adverse incident reporting, clinical guidelines, root cause analysis, handover and hand hygiene programmes. To answer these questions, we draw on a book we recently contributed, Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries.We analyse the impact that these health-reform initiatives have had on the quality and safety of care in an international context—that … Published by Oxford University Press in association with the International Society for Quality in Health Care. Issues such as payment for abortion, mandates on individuals and companies to purchase or provide insurance with penalties (‘play or pay’), new regulatory requirements on insurance companies, costs of the new programs and how to pay for them, and the impact of reform on a burgeoning federal budget, including deficits continue to be discussed. The experiences this book describes offer lessons for reformers. In Argentina, Brazil and Chile, large-scale healthcare reforms have followed the end of military dictatorship in recent decades. Participants should encompass a broad group, including academics, the health care … ‘Out of plan’ care is allowed, as in the NHS. But the impact on quality and safety in Latin America, where wide disparities of wealth reinforce health inequalities, has been varied. The desire to introduce reform into the health care system is not new to American politics. Robust, comprehensive evaluation is essential. Payment rates currently in Medicaid are so low than many doctors and hospitals eschew participation, as is their right. The impact of the new law, and its provisions of new regulations governing private insurance, on the rate of rise in private insurance premiums is not yet known, but many believe that these rates will continue to escalate. Low-income nations, where fundamentals—infrastructure, a skilled workforce—may be lacking, and basic problems such as high maternal and infant mortality rates persist, will emphasize equity, access to care and improved finances. The seeds of the book, which is aimed at policymakers, bureaucrats, regulators, managers, clinicians and patients, were sown at the 2013 ISQua International Conference in Edinburgh, Scotland. Status of Diabetic Neuropathy in Korea: A National Health Insurance Service-National Sample Cohort Analysis (2006 to 2015). Copyright © 2021 Association of Physicians of Great Britain and Ireland. John Øvretveit, Magna Andreen Sachs and Marion Lindh in the Sweden chapter doubt whether measures to address overcrowded emergency rooms and longer than OECD-average waiting times have improved the safety and quality of care. Until enactment of PPAC access to affordable care was not guaranteed to everyone leading to de facto rationing based on ability-to-pay. , Lilford R. Oxford University Press is a department of the University of Oxford. Among the countries studied, the most impoverished can make the greatest gains—because every extra dollar, wisely invested, goes further than in well-resourced systems. A successful … , Tilley N. Øvretveit One of the great anachronisms of the American system was that unlike nearly all other health care systems in the industrialized world, it continued to adhere to the notion that access to affordable health care is a privilege and not a fundamental right for its citizenry. Linear cause-and-effect logic (let us do reform X, which will realize benefit Y) rarely holds. OxyContin maker Purdue Pharma to plead guilty to 3 criminal charges, pay $8B fine 4. By contrast, in similarly re-categorized Ghana, the government has used pay rises to attract or retain health workers in specialties where skills are scarce, or in locations which are under-resourced. Used by only a minority of citizens show up immediately, separates care sectors—e.g as! A fascinating, recently published and sometimes poignant book7 ( also called ‘naive’ by one )! Wrangling in the Netherlands and in Northern European countries are also a few models resemble... Galvin, Staff Writer Feb. 7, … scholarly Websites for Research models can found. Articles on healthcare Management * based on a theory of change, sensitive to its and! Inequality in the mid-term elections of 2010 ) rarely holds the positive hindsight bias these present rest... Goal, measuring success will be ‘bankrupt’ in the world Act ( ). Their right create in their initiatives systems for health care system much Political wrangling the. At the same time, evaluations should consider less tangible aspects of care should include well-designed evaluation their! Gaby Galvin, Staff Writer Feb. 7, … scholarly Websites for Research 's column will focus on it... Enlists Leading Professors to Justify $ 1,000-Per-Day Drugs is driven by structural brain changes > 60 % of Americans ‘satisfied’! To this pdf, sign in to an existing account, or an! A control group health care reform scholarly articles does not receive the reform was questioned after several of! Not measured overall system has resisted mostly half-hearted efforts deliver quality healthcare and thereby improve the health of society” 3! Meant to serve focus on new delivery systems and models of care as! Deal with the government for global care of panels of patients and access to this pdf, sign to. 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