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PubMed1985

Organ procurement in Munich: financial and organizational aspects.

The Transplantation Center at the University of Munich is like all other German centers financially supported by the Insurance Companies via a non-profit organization (Kuratorium für Heimdialyse e.V.). The financial modalities are based on the arrangement that the Insurance Companies pay a certain amount for each transplantation to the non-profit organization. This institution, in cooperation with the University, uses this money to cover all extra expenses arising in the field of organ procurement as well as clinical transplantation (providing additional staff, equipment, etc). This model of a transplant center (ie, cooperation between University and non-University institutions) proved to be successful in the past 9 years. There was a steady increase of donor nephrectomies (200 donor kidneys in 1984) as well as kidney transplantations (171 transplantations in 1984).

Cadaver↗

PubMed1993

Developments in alcoholism treatment.

Alcohol treatment systems expanded and diversified considerably over the past decade. This reflects adaptation to a variety of forces, including developments in national health care financing and policy, changes in other health care systems with which alcohol treatment had strong ties, the more diffuse effects of social movements and a "drying trend" in American public opinion, as well as agitation by advocacy and provider groups within the alcohol field. Drawing on national monitoring data, this chapter reviews developments at the levels of financing policy, organizations, client populations, and treatment modalities, documenting expansion in private sector alcohol treatment units, a growing emphasis on providing outpatient treatment, a merger between services for alcohol and drugs at the organizational and conceptual levels, increases in service delivery to coerced populations, as well as demographic change in alcohol treatment caseloads during the 1980s.

Adult↗

PubMed2006

Defining and implementing a national policy for science, technology, and innovation in health: lessons from the Brazilian experience.

The need for clearly-defined health research policies and priorities has been emphasized in the international scenario. In Brazil, this process began in 2003, when a group appointed by the National Health Council proposed 20 sub-agendas to account for the various health research specificities. The second step was to identify research priorities for each sub-agenda during national seminars involving 510 researchers and policymakers. The 2nd National Conference on Science, Technology, and Innovation in Health was held in July 2004. During the preparatory phase, 307 cities and 24 States organized local conferences, involving 15,000 participants. Some 360 health sector delegates were appointed during the local conferences, in addition to those from the education and science and technology sectors. During the Conference, the national policy was approved and 3 other sub-agendas were introduced and approved. The national policy and the priority agenda are currently guiding investments by the Ministry of Health for research and development, and to a certain extent those from the Ministry of Science and Technology as well. From 2003 to 2005, 24 calls for proposals were launched; as a result, 3,962 research projects were submitted and 1,300 financed.

Biomedical Research↗

PubMed2000

Progress and peril: examining antibiotic resistance and systemic contaminants.

As part of its ongoing mission to inform and support trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH), in conjunction with the Health and Environmental Funders Network (HEFN), held a day-long Issue Dialogue on two important environmental health issues: antibiotic resistance and systemic contaminants. Experts and advocates from many organizations came together to discuss concerns and opportunities, as well as current and potential roles for health philanthropy. This Issue Brief brings together key points from the day's discussion with factual information on environmental health drawn from a background paper prepared for the participants.

Agrochemicals↗

PubMed1997

Local cost sharing in Bamako Initiative systems in Benin and Guinea: assuring the financial viability of primary health care.

The fourth in a series of five, this article presents and analyses data on cost recovery and community cost-sharing, two key aspects of the Bamako Initiative which have been implemented in Benin and Guinea since 1986. The data come from approximately 400 health centres and result from the six-monthly monitoring sessions conducted from 1989 to 1993. Community involvement in the financing of local operating costs in the two national scale programmes is also described. In Benin and Guinea, a user fee system generates the community financed revenue with the aim of covering local operating costs including drugs. Health worker salaries remain the responsibility of the government and donor funding covers vaccine and investment costs. Village health committees manage and control resources and revenue. The community is also involved in decision making, strategy definition and quality control. In Benin in 1993, community financing revenue amounted to about US$0.6 per capita per year and generally covered all local recurrent non salary costs except vaccines and left a surplus. Although total costs and revenues were slightly lower in Guinea for the same period, over-all user fee revenue (around US$0.3 per capita per year) covered local recurrent costs (not including salaries or vaccines). A comparison of costs and revenue between regions and individual health centres revealed important differences in cost recovery ratios. In Benin, some centres recovered more than twice the local costs targeted for community financing. Twenty-five per cent of centres in Guinea did not manage to cover their designated local recurrent costs. The longitudinal analysis showed that the level of cost recovery remained stable over time even as preventive care (and especially EPI) coverage rose significantly. To better understand the most important characteristics affecting cost recovery levels, best performing health centres in terms of cost-recovery levels in 1993 were compared to worst performing centres. This analysis showed that the size of the target population of the health centre is a key determinant of cost-recovery in both countries. In addition, in Guinea the utilization of curative care linked to geographical access and in Benin the average revenue per case linked to the number of deliveries proved to be additional factors of importance. In best performing centres, financial viability improved over time in both countries between 1990 and 1993. Finally, the implications of these conclusions for the planning of health centre revitalization in West Africa are discussed.

Benin↗

PubMed1975

HMOs and health education.

HMOs, by their stated purpose and nature, have a necessary and central involvement with health education. The specific characteristics of any HMO determine the extent and quality of health education. An HMO has the responsibility to identify its educational objectives, as well as the educational components of any of its other objectives. The more professional the educational guidance, the better it is integrated into the organization, and the greater its financial and administrative support, the more likely will be the success in achieving objectives. In brief, every HMO has the need and potential for a health education effort. The extent and quality of that effort will reflect the mix of administrative philosophy, organizational characteristics, the degree to which professional educators are involved, and the amount and stability of financial support.

California↗

PubMed2002

Self-organized complexity in economics and finance.

This article discusses some of the similarities between work being done by economists and by physicists seeking to contribute to economics. We also mention some of the differences in the approaches taken and seek to justify these different approaches by developing the argument that by approaching the same problem from different points of view, new results might emerge. In particular, we review two newly discovered scaling results that appear to be universal, in the sense that they hold for widely different economies as well as for different time periods: (i) the fluctuation of price changes of any stock market is characterized by a probability density function, which is a simple power law with exponent -4 extending over 10(2) SDs (a factor of 10(8) on the y axis); this result is analogous to the Gutenberg--Richter power law describing the histogram of earthquakes of a given strength; and (ii) for a wide range of economic organizations, the histogram shows how size of organization is inversely correlated to fluctuations in size with an exponent approximately 0.2. Neither of these two new empirical laws has a firm theoretical foundation. We also discuss results that are reminiscent of phase transitions in spin systems, where the divergent behavior of the response function at the critical point (zero magnetic field) leads to large fluctuations.

Journal Article↗

PubMed1981

Priorities and practices of continuing medical education program directors.

A survey of program directors in continuing medical education (CME) was conducted to determine the priorities and practices of the persons who develop CME programs. Respondents from community hospitals, medical schools, specialty societies, state medical societies, and other organizations thought that the most important issues related to the measurement of educational needs and outcomes. A high degree of congruence between program directors' ideal priorities and those they thought were actually being attained in their organizations was notes. Differences between groups of CME providers were infrequent, but medical schools were significantly more concerned than other groups about funding and accountability; community hospitals, about needs assessment and training for program directors; and specialty societies, about methods for adult learning. The majority of directors thought that CME credits, recertification, and relicensure (but not reexamination) should be mandatory.

Attitude↗

PubMedDate not supplied

Investigating the potential for students to provide dental services in community settings.

Some dental educational institutions in North America have incorporated community-oriented programs into their curriculum. The purpose of this study was to investigate the potential for the clinical placement of Ontario's dental and dental hygiene students in community-based settings. Key informant interviews were used to collect data. The study group consisted of 15 key informants from 9 potential placement sites and 4 educational institutions in Toronto and London, Ontario. The textual data were analyzed qualitatively to identify important issues regarding a clinical placement program. Results showed that there is strong support for the placement of students in community-based clinics; however, the degree to which health centres can accommodate students varies. The majority would not set any limit on the types of dental services that students could provide as long as the services were within the students' competencies. Funding was identified as a barrier to the implementation of such a program, with most of the organizations not able to contribute financially. None would be able to provide sufficient supervision without additional funding. These results indicate that a clinical placement program would be a welcome addition to the training of dental and dental hygiene students, but that external funding for supervision and operational expenses must be available before a program can be instituted.

Administrative Personnel↗

PubMedDate not supplied

Private sector support of nursing research.

Members of the American Nurses' Association Council of Nurse Researchers were surveyed for information about their nursing research funding activity within the private sector: their submission of proposals to private organizations, the outcomes, and effective funding strategies. Results indicated that 51% of applications submitted to private organizations and 78% of intramural applications were funded. However, 65% of proposals funded by private organizations and 59% of intramurally supported projects were for $3,000 or less. A variety of strategies led to private sector support of successful nursing research proposals. These included making direct, personal contact with funding agencies, matching proposals with the needs and interests of the funding agency, networking with other professionals to obtain funding information, and submitting well-written proposals consistent with agency guidelines.

Financing, Organized↗

PubMedDate not supplied

The value of microgrants for community-based health promotion: two models for practice and policy.

In 2001, the Office of Disease Prevention and Health Promotion in the US Department of Health and Human Services announced its intention to (1) identify innovative ways to increase public awareness and focus on Healthy People 2010 objectives and (2) broaden the participation of community-based organizations, including agencies new to public health. The mechanism selected, microfinancing, was modeled after small venture loans for economic stimulus in developing countries. The Office of Disease Prevention and Health Promotion selected one state health department and one academic research organization from 80 applicants to test models of awarding "microgrants" of 2,010 dollars to community agencies. This article describes the two models, the types of agencies that were funded, the primary Healthy People 2010 objectives targeted, examples of how the monies were used and leveraged by grantees, and the implications of microgrants for public health practice and policy.

Connecticut↗

PubMed2005

Adapting CDC DEBI list for target audiences is a major issue among CBOs. Translation changes can affect funding.

State and federal funding already was tight, and now it has become tighter for prevention work since most funding sources are requiring HIV organizations to follow strict guidelines regarding the use of evidence-based HIV prevention interventions. So far, the CDC has a list of 12 evidence-based interventions that include training materials for sites that desire to replicate them, but this limited list does not meet all of the target population needs. So behavior scientists say the interventions often need extensive adaptation, which is both expensive and difficult.

Centers for Disease Control and Prevention, U.S.↗

PubMedDate not supplied

Designing and building new local public health agencies in Nebraska.

Prior to 2001, the local public health system in Nebraska was weak, fragmented, and severely under funded. Local public health departments covered only 22 of the state's 93 counties. The Turning Point project provided the impetus for change by allowing a diverse group of public health stakeholders to develop a strategic plan for strengthening and transforming the public health system. The plan acted as a catalyst to use some of the Nebraska Tobacco Settlement Funds to provide dedicated state funding to build the local public health system. By June 2002, 16 new local public health departments had been organized, ultimately covering all of the 93 counties in the state. Some of the keys to long-term sustainability are creating a network of community health partners that support collaborative decision making, continually seeking input from the community, developing and implementing an education and training plan for public health professionals and local board of health members, and demonstrating accountability by documenting results and communicating them to policy makers and the general public.

Community Health Planning↗

PubMedDate not supplied

Profile: Invalid Children's Aid Association.

The Invalid Children's Aid Association is a well-established charity, with its roots in the last century, now taking its place among modern forward-looking voluntary organizations working for children. The Association's aims have remained the same; namely that the handicapped child, seen in the context of the family, should have the best possible chance in life. Methods of achieving these aims have varied, according to need, and state provision, and the Association has always been willing to experiment to find the best ways of meeting problems: it presents a continual challenge to workers and supporters.

Child↗

PubMed2000

Watching the bottom line: enhancing the role and impact of infection control in a managed care environment.

Health care expenditures exceeded $1 trillion in 1997, with projections for $2.2 trillion in expenditures by 2008. Decreasing organizational revenues and efforts to reduce operating costs have had a direct impact on infection control programs. Senior managers in hospitals and other provider organizations are focusing on achieving and maintaining revenues while controlling costs. Infection control professionals must align themselves and their programs with these organizational goals by (1) identifying areas in which the infection control program can support and enhances revenues, (2) facilitating the avoidance of excess costs for care, especially those related to nosocomial infection, (3) identifying opportunities for cost reduction through value analysis, and (4) participating in efforts to measure and prevent other adverse outcomes of care.

Cost Control↗

PubMed1997

Home care, medical care and the new competitive environment.

Health-care organization and financing is rapidly changing in the USA due to competitive pressures. Parallel changes are occurring in other countries. These changes are affecting, and will affect, home care services. Watching these changes, and building on social models, leads one to focus on important developments. These developments include: point of service plans, disease management, outcomes measurement, price and quality competition. These changes will make measured outcomes and demonstrated value essential in home care.

Aged↗

PubMed1998

The commercialization of human genetics: profits and problems.

Private-sector funding is becoming increasingly important to genetic scientists and clinicians, and the number of academic-industry collaborations is growing rapidly. Furthermore, genetics has become an important tool for the healthcare industry, as the genomes of humans and other organisms are mined for new diagnostic tests and drug leads. Potentially, this is a win-win situation: academic research gets a funding boost; industry benefits from academic research; and humankind benefits from the products of these liaisons. But these benefits do not come without cost. This article explores these costs and examines whether the commercialization of academic research is compromising academic freedom, progress in clinical research, and our attitudes to normal good health.

Attitude to Health↗

PubMed2003

[Is continuing medical education under suspicion of corruption? Contribution to the discussion by the Committee for Quality Preservation of the Swiss Society of Gynaecology and Obstetrics].

The requirements laid down by law and by the medical profession itself with regard to continuing medical education have recently been tightened. The cost of good training is high, both in time and money. Sponsoring, especially by the pharmaceutical industry, has helped to keep costs down for individual participants. The question of a tariff system for the payment of compulsory training is now being raised. Rates have been set to ensure that, in the future, indirect costs are covered. In the event of a full tariff-based payment of costs being introduced, various disadvantages could be expected both for participants and the quality of the training. Changes in Swiss criminal law and the new medicines act do not forbid sponsoring, but they do call for rules of professional ethics and of personnel law in public hospitals governing behaviour in respect of funding by sponsors. Various sponsoring models are conceivable with differences in allocation to organizers, individual participants or distribution via a pool system. There are strong arguments in favour of continuing the existing practice of mixed funding by participants and sponsoring, provided that it is subject to certain rules of transparency. What is lacking to date is a political decision on the issue of funding for continuing medical education.

Conflict of Interest↗