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Biomedical subjects

T Rathwell

Publications and source records attributed to T Rathwell.

At least 19 recordsLinked to original sources
PubMed1999

Looking over the horizon: an Internet-based international course in healthcare management.

The International Course in Healthcare Management is predicated on the belief that comparative benefits can most effectively be 'taught' by enabling students to work directly with colleagues in other countries, sharing views, discussing differences, and checking understandings on how healthcare is structured and managed in different countries. The course focuses on four countries--Canada, Germany, Finland and Ireland--which offer an interesting range and mix of approaches to healthcare, and yet are sufficiently similar to ensure relative ease of understanding. The course, which is delivered and taught jointly by faculty from five participating institutions in the four countries using the Internet as the distance delivery medium, is an integral component of each institution's participating department's graduate program. The aims of the course are: to enable the participants to develop an in-depth understanding of the healthcare systems of each country; to foster a deeper understanding, through comparative analysis, of each participant's own healthcare system; and to facilitate the development of new insights into ways of addressing common concerns in healthcare management. The course is structured around a series of case studies organized under four main themes: financing and funding; delivery issues; impact of health service reforms; and evidence-based management.

Canada↗
PubMed1996

Health care reforms in Bulgaria: an initial appraisal.

Bulgaria is in the process of re-structuring its health care system from one based on command and control to one founded on pluralism. This paper explores the way this transformation is taking place from the comparative perspective of the health care reforms being implemented in Britain and elsewhere. It draws out the lessons that there may be for Bulgaria based on western European experience and concludes with an assessment of the applicability and desirability of relying on the experience of other countries as a precursor for policy development and formulation in another.

Bulgaria↗
PubMed1994

Health care in Canada: a system in turmoil.

Canada, in common with most countries, is re-examining its health care system. The main reasons for the reappraisal are the rising cost of health care and the growing unease that the cost is fast outstripping the capacity of the tax base to support it. This paper examines the way in which Canada's provinces are attempting to meet this health care challenge. It does this from two perspectives: first, through a consideration of the steps taken to control and/or cut costs and, second, by an exploration of the developing debate about rationing. The paper concludes with some comments about the potential policy implications of such issues.

Canada↗
PubMed1994

Stochastic simulation and sensitivity analysis: estimating future demand for health resources in China.

A simulation model has been built to estimate the demand for hospital beds and doctors in China between 1990 and 2010. The model was used to compare deterministic sensitivity analysis and stochastic simulation in assessing inherent uncertainty in health projections. The stochastic simulation method uses information more efficiently, and produces a more reasonable average estimate and a more meaningful range of projections than deterministic sensitivity analysis. However, it may be preferable to combine the use of both approaches because they have different, complementary, advantages and disadvantages. The usefulness of 3 value estimates of input variables and the benefits of the triangular distribution for stochastic simulation should be emphasized in health projections.

China↗
PubMed1993

An analytical framework of physician productivity and variation in utilization.

The utilization of medical services by patients is an important determinant of doctor productivity, but this factor does not appear to have been given much attention in previous studies. In order to answer the question of why is there a wide variation in doctor output at low level medical facilities in China, an analytical framework of doctor productivity and utilization is developed. The simulation model is used to produce data that can be analyzed by such a framework. Great uncertainty about patient flows is one reason for the average lower and varying doctor productivity in lower level health facilities. Until uncertainty can be reduced, more flexibility is needed at the lower level to cope with changing utilization patterns and patient characteristics. The management by doctors of non-patient care activities (preventive programmes, medical research, teaching, and administration) is crucial to any approach to using doctor resources more effectively and efficiently.

Ambulatory Care↗
PubMed1992

Pursuing health for all in Britain--an assessment.

In 1977 the World Health Organisation adopted the strategic goal "Health For All by the Year 2000". The Regional Office for Europe of the World Health Organisation has taken important steps toward the attainment of the goal, with the formulation in 1980 of a common health policy and the adoption by the Regional Committee in 1984 of 38 wide-ranging targets. The targets represent a common view of what could be Health For All in Europe and constitute a major challenge which the 33 member states in the European Region have set for themselves. Thus, the targets offer a different way or approach to the building of a local strategy. This paper reviews the extent to which Health For All and its associated targets constitute part of the planning process at district level. At the core of the paper is the results of a survey of health authorities and boards in the United Kingdom which sought details on the extent to which health planners and policy makers have embraced the concept of Health For All in applying it to a local setting. The findings of the survey are discussed within the context of whether or not Health For All should be a centrally driven or locally derived policy. And how the experience in Britain could be of value to others embarking on such a venture.

Health Planning↗
PubMed1992

Realities of Health For All by the year 2000.

The European Region of the World Health Organisation (WHO) took the global lead on Health For All when the Regional Committee in 1980 approved a European Health For All Strategy. This was an important breakthrough for WHO as it was the first time Member States in a Region endorsed a common health policy and agreed to be monitored on their progress towards attainment of the strategy. The paper reviews the progress of Member States to date towards the Regional Health For All goal. Progress is discussed within the context of the six fundamental principles which underpin the Health For All concept, vis: equity; health promotion; community involvement; multisectoral participation; primary (local) health care; and, international cooperation. The paper argues that the commitment of Member States to the Health For All Strategy has been patchy with only moderate success towards meeting the 38 Regional Targets. Poor progress is attributed to changing national and international political and economic circumstances and limited resources but perhaps most importantly to a lack of political will to take the strategy seriously.

Developing Countries↗
PubMed1989

The effect of health services on mortality: amenable and non-amenable causes in Spain.

Recent work has demonstrated the usefulness of employing 'avoidable' deaths as an outcome measure for assessing and comparing the effectiveness and quality of health care systems. This paper considers the relevance of 'avoidable' deaths as an outcome measure for the Spanish health system. Mortality data for 1960 to 1984, were examined and the results, with the exception of cancer of the cervix, show a marked decline in 'avoidable' deaths, consistent with studies elsewhere. This pattern of 'avoidable' deaths may reflect either a decrease in the incidence of disease or better medical management of disease leading to fewer deaths. The 'avoidable' mortality may well be a sensitive indicator of the efficacy of a country's health care system.

Adolescent↗
PubMed1984

General practice, ethnicity and health services delivery.

This paper explores the inter-relationships between the conventional model of general medical practice, a society undergoing the transition from one essentially homogeneous to one that is heterogeneous in composition, and the effects that these changes may have on the mechanisms for the determination and delivery of health care. It is argued that the changing circumstances highlight the inappropriateness of the conventional medical model to primary health care and that an alternative approach for providing care is required.

Delivery of Health Care↗