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At least 1,135 records · Page 63Linked to original sources
PubMed1993

Access to obstetric care.

Initially, this article examines the relationship between access to components of obstetric care and birth outcomes. It goes on to describe the significant decline in physician participation in obstetrics and its possible relationship to increasing rates of late or no prenatal care in the United States. The limitations of obstetric capacity and future access to providers of obstetric care in the United States versus Canada are explored. The article concludes with a discussion of strategies for improving access to obstetric care.

Female↗
PubMed1977

Beyong the cities.

Explore the source record for details and available documents.

Communication↗
PubMed1977

Referrals and demand for specialist care in the Netherlands.

Three independent sets of data are analyzed to investigate the determinants of referrals from general practitioners to specialists, the demand for specialist care, and the rapid increase in referrals and use of specialists in the Netherlands. Individual determinants of demand are examined with data from a three-man group practice; macroanalyses are conducted on cross-section data from all service areas of the Dutch Sickness Fund Organization for 1971 and 1973 and cross-section time-series data from all provinces for the period from 1960 to 1972. Regression coefficients are estimated for the number of referrals to specialists and the amount of care given by specialists, with respect to explanatory variables that induce both socioeconomic and care-supply factors. Results are discussed in light of M. Feldstein's classification of three types of care, in which for some types the physician is seen as generating the demand for care. The authors conclude that demand for specialist outpatient care is in large part supply-determined and that general practitioners substitute for specialists; they also suggest that the dual physician-payment system in the Netherlands (capitation for legally insured patients and fee-for-service for privately insured patients) contributes to increased use of specialist care.

Ambulatory Care↗
PubMed1998

[School health in France: evolution and perspectives].

The school health service in France was attached to the Ministry of national education from 1945-1964, then to the Ministry of health until 1984, and has since returned to the Ministry of national education. From a global service in its beginnings, including physicians, nurses and social workers, it progressively grew into a social service on one hand, as well as a medical service and nursing service on the other, that act in close collaboration. Health and social personnel insure the technical advising of administrative heads of the Ministry of national education, at each level (ministerial, academic, and departmental). The strong coherence of the fundamental texts of the Ministry of national education allows the health and social service personnel to take health into account in the daily lives of establishments. They act as technical advisors in public health among school directors and heads of establishments. School medical centres are organised in districts of more than 5,000 inhabitants. The medical files of students are regrouped in these centres. The provision of personnel remains insufficient. The funds for functioning are sparse. The initial training of nurses and social workers depends on academic initiatives, while doctors benefit from a statuary initial training, either for eight weeks or a year. The school health teams implement new work procedures based on the methods of public health, the systematic health exams having been put into question. The March, 1998 "plan for relaunching school health" focuses on health education and prevention in schools.

Education↗
PubMed1995

Forecasting physician workforce requirements in Minnesota.

The existing oversupply, specialty imbalance, and geographic maldistribution of clinicians are inconsistent with the goals of health system reform in Minnesota. Health professional workforce projections can help the private and public sectors make informed decisions to assure that the future supply of health professionals reasonably approximates requirements. Appropriate methodologies for projecting national health professional requirements, based on existing HMO staffing patterns, should be applied to Minnesota. In the absence of workforce projections, a variety of assumptions about changes in Minnesota's health care system that will affect workforce supply and requirements can, nonetheless, be made. Limitations on the state's ability to influence the health professional workforce within its borders are noted.

Cost-Benefit Analysis↗
PubMed2003

Assessing human resources for health: what can be learned from labour force surveys?

BACKGROUND: Human resources are an essential element of a health system's inputs, and yet there is a huge disparity among countries in how human resource policies and strategies are developed and implemented. The analysis of the impacts of services on population health and well-being attracts more interest than analysis of the situation of the workforce in this area. This article presents an international comparison of the health workforce in terms of skill mix, sociodemographics and other labour force characteristics, in order to establish an evidence base for monitoring and evaluation of human resources for health. METHODS: Profiles of the health workforce are drawn for 18 countries with developed market and transitional economies, using data from labour force and income surveys compiled by the Luxembourg Income Study between 1989 and 1997. Further descriptive analyses of the health workforce are conducted for selected countries for which more detailed occupational information was available. RESULTS: Considerable cross-national variations were observed in terms of the share of the health workforce in the total labour market, with little discernible pattern by geographical region or type of economy. Increases in the share were found among most countries for which time-trend data were available. Large gender imbalances were often seen in terms of occupational distribution and earnings. In some cases, health professionals, especially physicians, were overrepresented among the foreign-born compared to the total labour force. CONCLUSIONS: While differences across countries in the profile of the health workforce can be linked to the history and role of the health sector, at the same time some common patterns emerge, notably a growing trend of health occupations in the labour market. The evidence also suggests that gender inequity in the workforce remains an important shortcoming of many health systems. Certain unexpected patterns of occupational distribution and educational attainment were found that may be attributable to differences in health care delivery and education systems; however, definitional inconsistencies in the classification of health occupations across surveys were also apparent.

Journal Article↗