The International journal of health planning and management
-
Int J Health Plann Manage · Jan 2019
Inequality trends in the demographic and geographic distribution of health care professionals in China: Data from 2002 to 2016.
China has long been negatively affected by a shortage and maldistribution of health workers. This study aimed to examine the national and regional trends in the demographic and geographic distribution inequality of health care professionals in China from 2002 to 2016. Based on data from the China Health and Family Planning Statistical and China Statistical Yearbooks, we calculated the Gini coefficient and the Theil T and Theil L indices based on the number of health care professionals per capita and per geographic area to measure the inequalities in their demographic and geographic distribution, respectively. ⋯ To conclude, the distribution equality of health care professionals by population was satisfactory, whereas the corresponding distribution inequality by area was severe. Different types of distribution inequality of health care professionals existed regionally and nationally despite their increasing quantities and densities. Factors beyond population size should be considered when the government introduces health workforce allocation policies.
-
Int J Health Plann Manage · Oct 2018
An exploratory case study of the organizational functioning of a decision-making and referral support call center for frontline providers of maternal and new born care in the Greater Accra Region of Ghana.
A call center was designed and started implementation in the Greater Accra Region of Ghana in 2015, to support frontline provider decision-making and referral for maternal and new born care. This study aimed to understand the organizational functioning of the center and lessons for design improvement, implementation, and scale-up. The study design was a single case study. ⋯ Perceptions of lack of involvement of some call center staff in decision-making, and the resource constrained working conditions sometimes hampered the functioning of the center. The locally driven bottom-up process used to establish the center appeared to be an important element in sustaining it despite the resource constraints. More attention to locally driven bottom-up approaches, organizational functioning, and resilience are critical to develop and sustain innovations for health outcome improvement in resource-constrained contexts.
-
Int J Health Plann Manage · Apr 2018
Understanding ED performance after the implementation of activity-based funding.
The aim of this study was to describe emergency department (ED) activities and staffing after the introduction of activity-based funding (ABF) to highlight the challenges of new funding arrangements and their implementation. ⋯ Substantial variation exists across Queensland EDs when resourcing service delivery in an activity-based funding environment. Historical inequity persists in the staffing profiles for regional and outer metropolitan departments. The lack of association between resourcing and performance metrics provides opportunity for further investigation of efficient models of care.
-
Int J Health Plann Manage · Jan 2018
Growing concerns and controversies to Taiwan's National Health Insurance-what are the lessons from mainland China, South Korea and Singapore?
It has been over 20 years since Taiwan's implementation of its National Health Insurance (NHI) program. Under this program, the health insurance coverage rate has reached approximately 99% of the population. Despite guaranteeing the residents of Taiwan equal access regardless of socioeconomic status and background, critical problems and controversies persist, and they continue to challenge the NHI. ⋯ Targeting the needs of the NHI, we have three policy recommendations: separating the NHI scheme into different target populations, strengthening the NHI referral system and regulating the access of overseas citizens to health services while in Taiwan. After two decades in existence, problems persist and there is a continuing need to improve Taiwan's NHI. Copyright © 2016 John Wiley & Sons, Ltd.
-
Int J Health Plann Manage · Jan 2018
Public strategies for improving eHealth integration and long-term sustainability in public health care systems: Findings from an Italian case study.
eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. ⋯ To solve the interoperability issues, the concept of the "platform approach" emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes.