Health policy
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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 develop a national scorecard for assessing health system performance derived from routine data. ⋯ The scorecard offers a useful method for combining a range of data to give an overall picture of health system performance, highlighting strengths, weaknesses and areas for improvement. This initial study provides a baseline for assessing New Zealand's performance over time and, where data permit, a template for other countries to follow.
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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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Tremendous strides have been made in the last two decades with regard to the quality of palliative care available to patients at the end of life. But progress has not been uniform, even among countries in the same region of the world. ⋯ This study's conclusions, based on a synthesis of the research, suggest that despite its well earned reputation as a generally progressive welfare state, Denmark tends to trail well behind its European neighbors when it comes to end-of-life care. Understanding the cultural forces that underlie this reality may help Danish health care professionals and policy makers overcome the barriers that stand in the way of providing state-of-the-art medical care to patients who suffer at the end of life.
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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.