Monday, May 10, 2010

[EQ] Health Systems Institutional Characteristics

Health Systems Institutional Characteristics:
a survey of 29 OECD Countries

Valerie Paris, Marion Devaux and Lihan Wei

OECD HEALTH WORKING PAPERS No. 50, 2010-05-10
Organisation for Economic Co-operation and Development OECD 28-Apr-2010

Available online PDF [140p.] at:

http://www.olis.oecd.org/olis/2010doc.nsf/LinkTo/NT000029DA/$FILE/JT03282545.PDF

“…..This paper presents the informaton provided by 29 of these countries in 2009. It describes country-specific arrangements to organise the population coverage against health risks and the financing of health spending.

It depicts the organisation of health care delivery, focusing on the public/private mix of health care provision, provider payment schemes, user choice and competition among providers, as well as the regulation of heallth care suppply and prices.


Finally, this document provides information on governance and resource allocation in health systems. (decentralisation in decisionmaking, nature of budget constraints and priority setting)….”

TABLE OF CONTENTS

1 INTRODUCTION

2 HEALTH FINANCING AND COVERAGE ARRANGEMENTS

2.1 Characteristics of basic primary health care coverage

2.2 Regulation of health insurance markets in countries with multiple insurance funds

2.3 Consumer choice and competition between health insurers offering basic primary health care coverage

2.4 Interventions of the public sector to ensure coverage of high-risk or low-income people in non-NHS systems

2.5 Protection against excessive out-of-pocket payments

2.6 “Over the basic” health care coverage

2.7 Financing health care

3 HEALTH CARE DELIVERY

3.1 Organisation of health care supply

3.1.1 The provision of outpatient physician services: organisation and public/private mix

3.1.2 The public/private mix in the provision of acute hospital care

3.2 Payment of health care providers

3.2.1 Predominant modes of physician payment

3.2.2 Payment of hospitals for acute inpatient care

3.2.3 Bonuses or penalties in relation to performance targets

3.3 User choice and competition among providers

3.3.1 Patient choice among providers

3.3.2 Gate-keeping

3.3.3 Information on quality and prices of providers services

3.4 Regulation of health care supply

3.4.2 Regulation and density and distribution of physicians in OECD countries

3.4.3 Regulation of hospital supply and of the diffusion of high-cost medical technologies

3.4.4 Hospital autonomy for staff recruitment and remuneration

3.5 Price/fee regulation

3.6 Regulation and monitoring of health provider activity

3.7 Co-ordination of care

 

4 GOVERNANCE AND RESOURCE ALLOCATION

4.1 Degree of decentralisation of decision-making

4.2 Definition of health care budget and pressure for cost-containment

4.3 Priority setting and public health targets

4.3.1 The use of health technology assessment

4.3.2 The definition of the health benefit basket

4.3.3 The definition of public health objectives

4.4 Patient’s rights and involvement in health care systems

4.4.1 Patient rights

4.4.2 The tort system and the possibility to engage class actions  

4.4.3 Patients’ representation and involvement in decision-making


5 CONCLUSION

6 ANNEXES

7 REFERENCES


 *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] Costs of HIV Prevention Among Out-of-Treatment Drug-Using Women

Costs of HIV Prevention Among Out-of-Treatment Drug-Using Women:

Results of a Randomized Controlled Trial

Jennifer Prah Ruger,a; Arbi Ben Abdallah, b; Linda Cottler, b

A Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT

B Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
Association of Schools of Public Health

Public Health Reports / 2010 Supplement 1 / Volume 125

Available online at: http://publichealthreports.org/archives/issueopen.cfm?articleID=2353

 

Objectives.
We developed a micro-costing methodology to estimate the real resource costs consumed by delivery of the National Institute on Drug Abuse

(NIDA) Cooperative Agreement Standard Intervention (SI) for human immunodeficiency virus (HIV) prevention, plus two enhanced modules, in a three-arm

randomized controlled trial (RCT) among drug-using women. To our knowledge, this is the first micro-costing study of the SI and enhanced modules and

the first of its kind targeting drug-using women.

Methods.
We conducted a micro-costing study alongside a three-arm RCT to estimate costs of (1) the modified NIDA SI; (2) the SI and a well woman exam

(SI1WWE); and (3) the SI, WWE, and four educational sessions (SI1WWE14ES) to prevent HIV and sexually transmitted diseases in at-risk, drug-using women

in St. Louis, Missouri.

Results.
The cost of the SI that all 501 participants received was approximately $227 per person. The additional costs for the WWE and 4ES were approximately

$145 and $942 per person, respectively. Total program costs for the SI (n5501) were $113,869; additional costs for the SI1WWE (n5342) were $49,403 and for the SI1WWE14ES (n5170) were $160,189. The main cost component for the SI (64% of total costs) was testing costs, whereas building and facilities costs were the main cost component for the SI1WWE14ES (75% of total costs).

Conclusions.
This study provides accurate estimates of the real costs for standard and enhanced HIV interventions for policy makers seeking to implement targeted HIV-prevention programs with scarce resources.

 


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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] World Health Statistics 2010

World Health Statistics 2010

WHO - World Health Oganization - May 10, 2010

Available online at:  http://www.who.int/whosis/whostat/2010/en/index.html

“……World Health Statistics 2010 contains WHO's annual compilation of data from its 193 Member States, and includes a summary of progress towards the health-related Millennium Development Goals and targets.

As with previous versions, World Health Statistics 2010 has been compiled using publications and databases produced and maintained by the technical programmes and regional offices of WHO. Indicators have been included on the basis of their relevance to global public health; the availability and quality of the data; and the reliability and comparability of the resulting estimates.

Taken together, these indicators provide a comprehensive summary of the current status of national health and health systems in the following nine areas:
- mortality and burden of disease;
- cause-specific mortality and morbidity;
- selected infectious diseases;
- health service coverage;
- risk factors;
- health workforce, infrastructure and essential medicines;
- health expenditure;
- health inequities; and
- demographic and socioeconomic statistics.

The estimates in this book are derived from multiple sources, depending on each indicator and the availability and quality of data. In many countries, statistical and health information systems are weak and the underlying empirical data may not be available or may be of limited quality. Every effort has been made to ensure the best use of country-reported data – adjusted where necessary to deal with missing values, to correct for known biases, and to maximize the comparability of the statistics across countries and over time. In addition, statistical techniques and modelling have been used to fill data gaps.

Because of the weakness of the underlying empirical data in many countries, a number of the indicators are associated with significant uncertainty. It is WHO policy on statistical transparency to make available to users the methods of estimation and the margins of uncertainty for relevant indicators. However, because of space restrictions, printed versions of the World Health Statistics series include uncertainty ranges for only a few indicators. Further information on the margins of uncertainty for additional indicators will be made available at the Global Health Observatory web site.[ www.who.int/gho ]….”

:: Progress on the health-related Millennium Development Goals (MDGs)  Fact sheet N°290


DOWNLOAD THE FULL REPORT

Available in 6 languages

Arabic [pdf 6.40Mb] | Chinese [pdf 5.58Mb] | English [pdf 4.84Mb] | French [pdf 4.98Mb] | Russian [pdf 5.11Mb] | Spanish [pdf 4.95Mb]


DOWNLOAD THE REPORT AND ASSOCIATED TABLES IN ENGLISH, BY SECTION


Table of contents and introduction [pdf 231kb]
Part I. Health-related Millennium Development Goals [pdf 669kb]
Part II. Global health indicator tables and footnotes [pdf 3.82Mb]
 

 


 *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho





IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.