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PubMed2001

Research, health policies and health care in the Caribbean. The role of the University of the West Indies.

The University of the West Indies has had a major impact on the provision of health care and the health of Caribbean nations over the last 50 years, through undergraduate, postgraduate and continuing medical education, research, outreach and public service. These roles are fully accepted, and the Faculties of Medical Sciences and School of Clinical Medicine and Research have provided most of the doctors now serving the English-speaking Caribbean, including academic leaders and chief medical officers. The design of a curriculum to produce doctors "designed" for the region has been a well-articulated goal, and the need to carry out relevant and essential national health research is now accepted. But the broader roles of ensuring translation of research into policy and practice, and developing effective ways of promoting on-going continuing training and behaviour change are far from understood or seriously attempted. Communication of research findings and evidence-based practice is crucial. The West Indian Medical Journal clearly has a valuable role to play here and this requires expansion and support. But a multi-faceted approach to communicating research findings and translating evidence into policy, planning and care is necessary. One possible approach would be a University Unit of Health Policy Research and Development.

Delivery of Health Care↗
PubMed2006

Learning from the best: the benefits of a structured health policy fellowship in developing nursing health policy leaders.

This article describes the experience of a nurse leader engaged in a state Health Policy Fellowship instituted in North Carolina by the North Carolina Center for Nursing (NCCN). This Health Policy Fellowship is designed to provide a focused practicum in major aspects of state-level health policy with emphasis on the role of the nurse leader. The program design includes exposure to experienced mentors with diverse areas of focus to learn from observation and interaction. This article describes the experience of a state Health Policy Fellow and includes discussion of understandings derived from interacting with key state stakeholders in the health policy arena and pearls of wisdom from the policy fellowship experience.

Attitude of Health Personnel↗
PubMed1991

Health policies and Health For All strategies in the Nordic countries.

In the 1980s all five Nordic countries expressed, at the highest political level, their commitment to WHO's program Health for All (HFA) by the Year 2000. This program aims at improving the prerequisites for a healthier and longer life by changing lifestyles, decreasing environmental hazards and by shifting the emphasis in health care from specialized services towards primary health care. Following their policy statements all the Nordic countries formulated national HFA strategies during the latter half of the 1980s. This paper looks at the background and the formulation and implementation of these strategies, covering the period up until the end of the 1980s. The implementation of national strategies seems to be a slow and difficult process. The monitoring of progress toward accepted healthy policy goals is not easy, because measurable objectives or targets are mostly missing.

Demography↗
PubMed2005

Can education policy be health policy? Implications of research on the social determinants of health.

Research on the social determinants of health has demonstrated robust correlations between several social factors, health status, and life expectancy. Some of these factors could be modified through policy intervention. National-level public policies explicitly based on population health research are in various stages of development in many Western countries, but in spite of evident need, seemingly not at all in the United States. Because research shows such a strong association between education and good health, we offer evidence to show that at least two pressing problems in American society, namely the uneven distribution of educational attainment and health disparities linked to socioeconomic position, may be ameliorated through policy initiatives that link quality early childhood care, child development programs, and parental training in a seamless continuum with strengthened K-12 education.

Educational Status↗
PubMed1997

[Complementary medicine--health policy and health care costs].

Complementary medical methods are increasingly offered by physicians as well as other members of the health services and numerous therapists and they are sought and used by a majority of the population. From the point of view of health care authorities the question of acceptance or admission of methods and offering persons is raised. Unfortunately Switzerland lacks an uniform federal curriculum for practitioners of natural cures of other therapists in complementary medicine. Therefore, in order to control the steadily increasing wild growth of complementary medical offerings, several states (Kantone) have introduced examinations for the registration of such paramedical practitioners. Whether complementary (paramedical) medicine will really reduce costs of health care remains unproven so far. According to several surveys most alternative methods are used in addition to "school medicine" (academic medicine). Health insurance companies should subject reimbursement of costs to the fulfillment of standards regarding efficacy, appropriateness and economy equal to all other medications and therapies.

Complementary Therapies↗
PubMed1981

Medicare program; Medigap--certification of Medicare supplemental health insurance policies: Health Care Financing Administration. Proposed rule.

This proposal would establish a program of certification, by the Secretary, of Medicare supplemental health insurance policies (so-called Medigap policies) voluntarily submitted by insurers for review. It would implement, in part, section 507 of the Social Security Disability Amendments of 1980. HCFA will administer the certification program. The voluntary certification program would go into effect July 1, 1982, and would apply only to policies issued in those States that do not have in effect a program for regulating Medigap policies equal to or more stringent than the one to be described in these regulations. A Supplemental Health Insurance Panel, consisting of the Secretary or a designee and four State Commissioners of Superintendents of Insurance appointed by the President, will determine the adequacy of a State's program in relation to the standards contained in the regulations. These regulations would: (1) set standards for policies voluntarily submitted to HCFA for certification, (2) establish procedures for the certification program, and (3) promulgate the statutory requirements that the Supplemental Health Insurance Panel would use to approve State regulatory programs.

Certification↗
PubMedDate not supplied

[Is the patient's charter a tool for the implementation of health policies promoting health care quality? Results of a survey on Italian local health units over the period 1995-98].

Patient's Charter was introduced in Italy in the last decade with the aim of increasing community participation to the quality of health care. The Charter with reference to primary care services, should include information about the admission and standards of service that people can expect to receive. The purpose of the study was to assess, on the basis of a series of indicators, the presence of differences among different organisational model of Local Health Unit Districts. As regards Prevention Department, the association between quality indicators and geographic location was studied. We evaluated 112 Charters, 49.3% on the total amount of Italian Local Health Unit (LHU) that were issued during the period 1996-1998, using a data form with multiple choice questions. 104 out of 112 Charters showed quality items for Districts and Prevention Departments. Significant differences among the different groups of district organization model were shown for three indicators (waiting time, administrative details and chief in charge) respectively in General Practitioner area and in Psychiatric one. As regards Prevention Departments, no association was shown between geographic area and frequency of quality indicators, although a trend of higher frequence was found in Northern Area versus Central Area and Southern one. This study emphasizes the fact that data drawn from Patient's Charter can show the impact of different organisational and geographic conditions on quality of healthcare.

Catchment Area, Health↗
PubMed2003

Human resources for health policies: a critical component in health policies.

In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM.There are three broad arguments for modernizing the ways in which human resources for health are managed:bullet; the central role of the workforce in the health sector;bullet; the various challenges thrown up by health system reforms;bullet; the need to anticipate the effect on the health workforce (and consequently on service provision) arising from various macroscopic social trends impinging on health systems.The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs.Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH):bullet; to move beyond the traditional approach of personnel administration to a more global concept of HRM;bullet; to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy;bullet; to foster a more proactive attitude among human resources (HR) policy-makers and managers;bullet; to promote the full commitment of all professionals and sectors in all phases of the process.The development of explicit human resources policies is a crucial link in health policies and is needed both to address the imbalances of the health workforce and to foster implementation of the health services reforms.

Editorial↗
PubMed1982

The University Health Policy Consortium's Center for Health Policy Analysis and Research.

In 1978, the University Health Policy Consortium, composed of Boston University, Brandeis University and the Massachusetts Institute of Technology, established the Center for Health Policy Analysis and Research for the purpose of conducting relevant policy analyses and short-term research projects for the Health Care Financing Administration. The center has completed more than fifty analytical works since its inception and concentrates its research in three major health care areas: the financing and organization of long-term care, medical care quality, and acute care financing. The flexibility of the Center's organizational structure allows the staff of the three cooperating universities to pursue new topics while maintaining an interdisciplinary approach to emerging public policy problems.

Health Policy↗
PubMed2000

[Ethics in health policy and public health].

The author explains and illustrates by historical references terms such as health policy, public health, health. Next he deals with ethical principles of the health policy in the following sections: a) respecting people and their rights, b) maximalization of benefit and minimalization of damage, c) legal aspects.

Ethics↗
PubMed2006

Utilization of the medical librarian in a state Medicaid program to provide information services geared to health policy and health disparities.

OBJECTIVE: The role of two solo medical librarians in supporting Medicaid programs by functioning as information specialists at regional and state levels is examined. SETTING: A solo librarian for the Massachusetts Medicaid (MassHealth) program and a solo librarian for the New England States Consortium Systems Organization (NESCSO) functioned as information specialists in context to support Medicaid policy development and clinical, administrative, and program staff for state Medicaid programs. BRIEF DESCRIPTION: The librarian for MassHealth initially focused on acquiring library materials and providing research support on culturally competent health care and outreach, as part of the United States Department of Health and Human Services Culturally and Linguistically Appropriate Services in Health Care Standards. The NESCSO librarian focused on state Medicaid system issues surrounding the implementation of the Health Insurance Portability and Accountability Act. The research focus expanded for both the librarians, shaping their roles to more directly support clinical and administrative policy development. Of note, the availability and dissemination of information to policy leaders facilitated efforts to reduce health disparities. In Massachusetts, this led to a state legislative special commission to eliminate health disparities, which released a report in November 2005. On a regional level, the NESCSO librarian provided opportunities for states in New England to share ideas and Medicaid program information. The Centers for Medicaid and Medicare are working with NESCSO to explore the potential for using the NESCSO model for collaboration for other regions of the United States. RESULTS/OUTCOMES: With the increased attention on evidence-based health care and reduction of health disparities, medical librarians are called on to support a variety of health care information needs. Nationally, state Medicaid programs are being called on to provide coverage and make complex medical decisions regarding the delivery of benefits. Increasing numbers of beneficiaries and shrinking Medicaid budgets demand effective and proactive decision making to provide quality care and to accomplish the missions of state Medicaid programs. In this environment, the opportunities for information professionals to provide value and knowledge management are increasing.

Health Policy↗