Health policy
-
Using published data about consumption, economic aspects, and legislation, this paper analyzes tobacco control in Indonesia, a major consumer and producer of tobacco products. Given its large population and smoking prevalence, Indonesia ranks fifth among countries with the highest tobacco consumption globally. Over 62% of Indonesian adult males smoke regularly, contributing to a growing burden of non-communicable diseases and enormous demands on the health care system. ⋯ Today, few restrictions exist on tobacco industry conduct, advertising, and promotion in Indonesia. We examine the relevance and prospects of advancing in Indonesia four cost-effective tobacco control strategies: price and tax measures, advertising bans, clean air legislation, and public education. We conclude with several suggestions for action for the public health community.
-
Italian pharmaceutical policy has recently moved towards a "two lanes" approach, with regulation differing according to a drug's patent status. This study analyses the Italian regulatory framework, focusing on policies related to "off-patent" drugs. ⋯ The recent reforms are already producing some worthwhile results, at least in terms of competitive pressure on the (few) substances that run out of patent protection. However, further intervention could be required to achieve long-term sustainability.
-
Multicenter Study Comparative Study
A comparison of patient characteristics and rehabilitation treatment content of chronic low back pain (CLBP) and stroke patients across six European countries.
So far no studies have been conducted on the issue of comparability of rehabilitation treatment profiles and patient characteristics across countries. These aspects might have implications for the feasibility of treating patients abroad but also for the comparison of treatment outcome on an international level. ⋯ International treatment and outcome assessment of CLBP patients is not possible unless standardisation is considered of treatment content and patient selection. For stroke treatment international traffic and multi-centre outcome assessment might be more feasible.
-
Review
Evaluating and planning ICUs: methods and approaches to differentiate between need and demand.
In all western countries the demand for ICU-services is increasing and complaints about a lack of ICU-beds arise--independent of the actual density of ICU-services. The demand for more ICU-beds triggered a debate on whether it is possible to define an "objective" need. It was the aim of the assessment to analyze conventional as well as innovative approaches to plan and to evaluate ICU-services. ⋯ In countries with a high density of ICU-services--such as Austria and Germany--not an expanding of the capacities, but a better use of the existing resources is recommended. For a fair comparison, participation in national databases, in registers as well as benchmarking and quality-assurance programs should be enforced.
-
To quantify the clinical consistency of expert panelists' ratings of appropriateness of pre-operative and post-operative chemotherapy plus radiation for rectal cancer. ⋯ The RAND/UCLA appropriateness method can produce ratings for cancer treatment that are highly clinically consistent. Modifications to the structure of rating manuals to facilitate direct assessment of consistency at the time of rating may reduce inconsistency further.