Health policy
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Prescribing medications is one of the most important therapeutic activities of a general practitioner (GP) and the quality of such practices is a relevant issue. Our objective was to use regional administrative databases to assess the following: (a) the prevalence of prescription drug use by patient age and gender, (b) different GPs' prescription volumes and average drug expenditure, and (c) how GPs' socio-demographic variables may be considered as predictive factors in their prescribing practices. ⋯ Prescribing decisions are subject to a myriad of external factors. The present study shows how physicians' characteristics might affect drug prescription in terms of prevalence of use, costs and consumption. Using regional administrative databases it has been possible to analyse the association between doctors' prescribing habits, their socio-demographic factors and characteristics of their catchments areas. However, the variability in age groups in terms of prevalence, consumption and expenditure suggests that a sophisticated method of analysis will be needed in order to implement strategies and interventions able to optimise resource use in the health care sector.
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The objective of this study was to evaluate the general practitioners' (GPs') knowledge and perceptions towards generic medicines in a northern state of Malaysia. ⋯ Although it appeared that GPs have largely accepted the use of generic medicines, they still have concerns regarding the reliability and quality of such products. GPs need to be educated and reassured about generic products approval system in Malaysia concerning bioequivalence, quality, and safety. The current findings have important implications in establishing generic medicines policy in Malaysia.
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To describe how Dutch healthcare institutions develop and disseminate institutional practice guidelines on medical end-of-life decisions and policy statements on euthanasia and physician-assisted suicide (EAS) to relevant parties, and to describe supportiveness of EAS guidelines experienced by Dutch physicians. ⋯ It is recommended that more health care institutions pay attention to the dissemination of their policy statements and practice guidelines to relevant parties. This will only lead to improvement in medical practice if this is accompanied by efforts to also stimulate the use of guidelines in practice.
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To review the literature on interventions to improve team effectiveness and identify their 'evidence based'-level. ⋯ There are only some studies available with high quality evidence on interventions to improve team effectiveness. These studies show that team training can improve the effectiveness of multidisciplinary teams in acute (hospital) care.
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Comparative Study
Welfare state regimes and population health: integrating the East Asian welfare states.
Epidemiological studies have consistently shown that population health varies significantly by welfare state regime. However, these studies have focused exclusively on the welfare states of Europe, North America and Australasia. This focus ignores the existence of welfare states in other parts of the world, specifically in East Asia. ⋯ However, when controlling for GDP per capita in the ANCOVA analyses, only Life Expectancy (R(2)=0.58, adjusted R(2)=0.47, p<0.05) and Social Expenditure (R(2)=0.70, adjusted R(2)=0.61, p<0.05) differed significantly by welfare state regime. 47% of the variation in Life Expectancy was explained by welfare state regime type. Further, the East Asian welfare states did not have the worst health outcomes. The study concludes by highlighting the need to expand comparative health analysis both in terms of the range of countries examined and also in terms of incorporating other societal and public health factors-towards a 'public health regime' analysis.