Health policy
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The objective of this study was to evaluate the intended and unintended impact on pharmaceutical use and sales of three public reimbursement reforms applied to the prescription of statins: a Spanish generic reference pricing system, and two competing policies introduced by the Andalusian Public Health Service. ⋯ RP has been effective at reducing the volume of sales growth of the off-patent statins, yet its overall impact on sales of all statins has been relatively modest.
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The responsibility of healthcare administrators for handling ethically sensitive medical practices, such as medical end-of-life decisions (MELDs), within an institutional setting has been receiving more attention. The overall aim of this paper is to thoroughly examine the prevalence, content, communication, and implementation of written institutional ethics policies on MELDs by means of a literature review. ⋯ With regard to providing support for physicians and nurses, DNR and euthanasia policies expressed support by primarily providing technical and procedural guidelines. Further research is needed whether and in which way written institutional ethics policies on MELDs could contribute to better end-of-life care.
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The European Convention on Human Rights and Biomedicine was adopted by the Committee of Ministers of the Council of Europe on 19 November 1996 and opened for signature in Oviedo, Spain, on 4 April 1997. As of the moment of writing 11 Member States of the EU have ratified the Convention: Cyprus, Czech Republic, Denmark, Estonia, Greece, Hungary, Lithuania, Portugal, Slovakia, Slovenia and Spain. ⋯ We analysed for each ratifying Member State whether and how the ratification of the Convention has influenced patient rights legislation and policies. Finally, we concluded by dividing the 11 Member States into 4 categories depending upon the already existing patient rights legislation at the moment of ratification and the constitutional provisions related to the ratification of an international treaty in general in a given Member State.
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Comparative Study
A comparison of the impact of U.S. and Canadian cigarette pack warning label requirements on tobacco industry profitability and the public health.
Since the early 1980s, neo-liberals have argued that command and control regulation (such as modern tobacco control programs) are costly in supporting corporate markets and profits. Some recent social constructionists have also argued that weak and symbolic command and control policies are necessary to maintain corporate productivity. This paper examines whether the command and control-oriented United States cigarette warning label law is symbolic thus helping to maintain corporate profitability. ⋯ Contrary to the arguments of neo-liberals, symbolic command and control policies can actually support corporate private profit making, which for the tobacco industry occurs at the expense of the public health.
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Over the past few years, students in Germany have been dropping out of medical school at increasing rates, and the number of physicians choosing to work abroad or in non-medical professions has been growing. A recent study (the "Ramboll Study") commissioned by the Health Ministry concluded that German physicians' dissatisfaction with existing monetary and non-monetary incentive systems during training and subsequent practice was the main reason for these trends. Among those physicians who have remained in the workforce, there is a similar dissatisfaction, reflected in part by a general strike in 2006 by German physicians in favour of higher wages and better working conditions. ⋯ This study sheds light to the underlying factors that contribute to physician job satisfaction in Germany, and it provides insights into the reasons for physicians leaving medical practice. In order for a health system to recruit and retain physicians, it may be necessary for a system's physician strategy to shift from focusing primarily on hard, monetary and compensation-related factors to a broader focus that incorporates the soft, non-monetary factors. The implementation of policies and management practices that reduce the time burden on physicians, and enhance physicians' participation in the development of patient care management processes and in managerial decisions that affect patient care appears to be crucial. The result will be increased job satisfaction among physicians, which is important to the future recruitment and retention of doctors, as well as to the productivity and quality of the services provided by this essential component of our medical care systems.