Health policy
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Both public and private health and social care services are facing increased and changing demands to improve quality and reduce costs. To enable local services to respond to these demands, governments and other organisations have established large scale improvement programmes. ⋯ The purpose of this paper is to provide an empirical description of how one organisation coordinated ten national improvement programmes between 2004 and 2010. It provides details which may be useful to others seeking to plan and implement such programmes, and also contributes to the understanding of knowledge translation and of network governance.
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To demonstrate the utility of rates of change in measuring country performance in health using the rate of decline of adult mortality for 22 countries in the OECD as an illustration. ⋯ Examining the rates of change of health indicators at the country level enables finding transition times in performance, and provides a more time-sensitive measure of country performance than does assessing performances in levels of health. The effects of changes in potential determinants of health can then be assessed in terms of their relation to transition times in performance.
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Public procurement is generally an important sector of the economy and, in most countries, is controlled by the introduction of regulatory and policy mechanisms. In the Greek healthcare sector, recent legislation redefined centralized procurement through the reestablishment of a state Health Procurement Committee (EPY), with an aim to formulate a plan to reduce procurement costs of medical devices and pharmaceuticals, improve payment time, make uniform medical requests, transfer redundant materials from one hospital to another and improve management of expired products. ⋯ The procurement practices and policies set forth by EPY and the first measurable outcomes, in terms of cost savings, resulting from these policies are presented. The importance of these measures is discussed in light of the worst economic crisis faced by Greece since the restoration of democracy in 1974, as a result of both the world financial crisis and uncontrolled government spending.
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EU enlargement has facilitated the mobility of EU citizens, including health professionals, from the 2004 and 2007 EU accession states. Fears have been raised about a mass exodus of health professionals and the consequences for the operation of health systems. However, to date a systematic analysis of the EU enlargement's effects on the mobility of health professionals has been lacking. The aim of this article is to shed light on the changes in the scale of movement, trends and directions of flows pre and post 2004 and 2007 EU enlargements. ⋯ A mass exodus of health professionals has not taken place after the 2004 and 2007 EU enlargements. The estimated annual outflows from the EU-12 countries have rarely exceeded 3% of the domestic workforce. This is partly due to labour market restrictions in the destination countries, but also to improvements in salaries and working conditions in some source countries. The overall mobility of health professionals is hence relatively moderate and in line with the overall movement of citizens within the EU. However, for some countries even losing small numbers of health professionals can have impacts in underserved regions.
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This paper investigates the determinants of generic entry in the regulated Taiwanese prescription drug market, where physicians both prescribe and dispense drugs. ⋯ The negative effect of large buyers on generic entry implies that rent-seeking behavior appears to create a barrier for generic manufacturers to enter into the Taiwanese prescription drug market.