Nevada enacts legislation that limits hospital profits.
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In developed countries, dietary guidelines are more and more often used as a source of binding information not only in public health, food production, nutrition and agricultural policy, but in ecology and economy as well. In view of that, it is imperative to formulate such guidelines that would be supported by relevant population studies and correspond to the European model of WHO/CINDI guidelines. At the turn of the millennium, the Czech guidelines were updated in order that serving sizes of 5 basic food groups were brought closer to contemporary trends emphasizing lower protein intakes and at the same time, by setting limit ranges, they were able to meet specific need of people of different age group, sex, physiological status, physical activity, etc. The conversion of recommended servings to nutrients was compared with the results of the actual food basket of the Czech population and specific recommendations for amendments in proportions of individual food items in food groups and subgroups were given. On the basis of diet guidelines, conclusions describing tasks for the beginning of the third millennium were made. Besides them the most important are: production or health information systems with special emphasis to food intake and nutritional status report, policies to increase the access to vegetables and fruit for vulnerable groups, legislation to curb advertising high-fat energy-dense foods to children, policy to strengthen the operational targets of Innocenti Declaration and to increase the number of Baby Friendly Hospitals, legislation regarding food control systems based on international standards, sustainable campaigns to promote safe healthy diet, policies to ensure sustainable food production.
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There is some evidence in established market economies that health economics is having a positive impact on policy. Although many of the underlying assumptions can be questioned, the predictions made are broadly applicable to a range of relatively wealthy industrialised economies. In low and middle income countries these assumptions are often less applicable. In particular, assumptions about the regulation and functioning of public and private sector activities often fail to account for the operation of the unofficial health care sector. This paper illustrates how unofficial markets might operate in the context of the health care sector in a developing economy. In particular it examines how the motives of practitioners may be influenced by a lack of regulation and under-funding which in turn contribute to the presence of unofficial activities. Unofficial market activities could influence and distort the impact of policies commonly being pursued in many countries. Further research is required into the functioning of these markets in order to align the assumptions of policy with the reality of the developing health care sector.
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STUDY OBJECTIVE: Physicians have an important role in the diagnosis, treatment, and documentation of violence-inflicted injuries. Physicians may also be legally mandated to report these assault-related injuries to law enforcement. Previous studies have shown that physicians may not be aware of the reporting laws in their state. The objective of this study was to review the reporting laws for violence-inflicted injuries in adults in the 50 states and the District of Columbia, with particular emphasis on domestic violence. METHODS: Members of a domestic violence research interest group contacted individual state legislatures regarding mandated reporting by health providers of violence-inflicted injuries in adults. This information was then verified by each state's domestic violence coalition. Statutes regarding child abuse or sexual assault and statutes concerning injuries in incapacitated adults were not included in this study. RESULTS: Five states (Alabama, New Mexico, South Carolina, Washington, and Wyoming) have no specific reporting requirements for health providers treating patients with assault-related injuries. Forty-two states have reporting requirements for injuries resulting from firearms, knives, or other weapons. Twenty-three states have reporting requirements for injuries resulting from crimes. Seven states have statutes that specifically require health providers to report injuries resulting from domestic violence. CONCLUSION: Forty-five states have laws that mandate physician reports of injuries caused by weapons, crimes, or domestic violence. Physicians need to be aware of the existence of these laws and of their state's specific requirements.
Among the healthcare regulations enacted by New York State Health Commissioner Dr. David Axelrod is one requiring a comprehensive compulsory survey of each New York hospital by the state health department. A medical director offers his thoughts on the survey and describes its impact on his hospital.
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