Health policy
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Review Comparative Study
A systematic review and comparison of HIV contact tracing laws in Canada.
Public health officials and health providers need to be aware of the legislation documenting contact tracing in their jurisdiction to advise HIV positive clients of their rights, and to systematically perform their duties. The objective is to outline and compare the contact tracing laws in 13 jurisdictions in Canada, and to provide policy recommendations. ⋯ Public health officials should ensure that contact tracing practices and policies accurately reflect the current regulations without compromising their patients' confidentiality. It is recommended that each province/territory would benefit from standardized contact tracing regulations which are imbedded in communicable disease legislation. Regulations with provisions for informed consent, confidentiality, multiple counselling sessions, clear procedures in duty to warn cases, and domestic violence screening would be considered best practice.
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To develop culturally appropriate and effective strategies to reduce the risk from pandemic influenza (H1N109) in rural and remote Australian Aboriginal and Torres Strait Islander communities. ⋯ The essential work of reducing risk of pandemic influenza with Aboriginal and Torres Strait Islander communities is not straightforward, but this project has highlighted a number of useful pathways to continue to journey along with communities. A number of strategies to reduce the spread of pandemic influenza in Aboriginal and Torres Strait Islander communities were identified. These strategies would make a good starting point for conversations with communities and health services. In Aboriginal and Torres Strait Islander communities the environment, community structures and traditions vary. Respectful engagement with communities is needed to develop effective policy.
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To propose an operational framework for assessing the completeness and consistency of the stewardship function of national health ministries. ⋯ Challenges in the implementation of stewardship relate to: limitations to the role of health ministries; and to governance, operational and change implementation issues. The framework proposed seems flexible enough to help assess the health system stewardship function; however it should be further tested in practice.
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Only limited empirical studies reported own-price elasticity of demand for health care in rural China. Neither research on income elasticity of demand for health care nor cross-price elasticity of demand for inpatient versus outpatient services in rural China has been reported. However, elasticity of demand is informative to evaluate current policy and to guide further policy making. ⋯ First, no significant difference is detected between sensitivity of outpatient services and sensitivity of inpatient services, responding to own-price change. Second, inpatient services are substitutes to outpatient services. Third, the growth of inpatient services is faster than the growth in outpatient services in response to income growth. The major findings from this paper suggest refining insurance policy in rural China. First, from a cost-effectiveness perspective, changing outpatient price is at least as effective as changing inpatient price to adjust demand of health care. Second, the current national guideline of healthcare reform to increase the reimbursement rate for inpatient services will crowd out outpatient services; however, we have no evidence about the change in demand for inpatient service if insurance covers outpatient services. Third, a referral system and gate-keeping system should be established to guide rural patients to utilize outpatient service.
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This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. ⋯ This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality.