Health policy
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In 2011, Member States and the European Parliament brought into force a Directive on the application of patients' rights in cross-border healthcare within the EU. Austria voted against this directive even though its national legislation was already in line with the rulings of the European Court of Justice which had triggered the negotiations on the directive. Why then, in the absence of any legal constraints on adapting to it, did Austria vote against the directive? The article argues that it was the federal structure of financing hospital infrastructure and the subnational level's influence on national position building which led to the rejection of the directive. The article retraces the process of position building by analyzing the interaction between the national and the subnational levels and concludes that Austria's position mirrors the national struggle between both levels of government over control of the hospital sector.
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The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. ⋯ Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types.
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I analyze the relationship between health care institutions and the utilization of outpatient services by individuals aged 50 and above. I use cross-sectional micro data from thirteen European countries. ⋯ I estimate the utilization of private specialist care to be higher in countries where copayments are required for public specialist care, and where the general practitioners have gatekeeper role. These estimated associations with private specialist care utilization are relatively large in magnitude, and are driven by individuals in the top income quartile.
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Historical Article
World Health Assembly agendas and trends of international health issues for the last 43 years: analysis of World Health Assembly agendas between 1970 and 2012.
To analyse the trends and characteristics of international health issues through agenda items of the World Health Assembly (WHA) from 1970 to 2012. ⋯ The WHA agendas cover a variety of items, but not always reflect international health issues in terms of disease burden. The Member States of WHO should take their responsive roles in proposing more balanced agenda items.
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This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the "fair" return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. ⋯ The findings highlight significant problems in current procurement practices and the methodologies by which bids are assessed. To minimise the financial impact of hospital investments on health care systems, a regulatory regime must ensure that expected returns are set at the "fair" rate.