Redirecting health care spending: consumer-directed health care

In an environment of rising health care costs, defined contribution plans and closely related consumer-directed health plans are emerging as a possible next phase in health plan development and offer new opportunities for the nursing profession.     

Prenatal care: Mechanisms and impacts on infant health and health care utilization

We estimate that prenatal care has positive impacts on health measured at birth, shifts the distribution of future health care utilization away from inpatient care, and find that some of these impacts likely come from an informational mechanism. We also find well child visits are used in a complementary fashion with emergency department care in the production of infant health, suggesting that factors beyond barriers to access may drive the demand for emergency care. Finally, we find differential impacts of prenatal care across racial groups with evidence that the information mechanism may be particularly important for black mothers.     

Rationing health care

Will America be forced to cut medical care to its neediest citizens? Yes, some critics say, and it already is doing that. They say it's time to face reality.     

Navajo nation public health nurses inspire thoughts on health care reform

The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing.     

医改需要清醒,更需要警惕

将医疗体制改革“基本不成功”归咎于“市场化”，是在回避政府部门管制不力的责任，政府部门的责任缺位才是改革走向歧途的根本原因。对“大政府”模式的呼唤回避了一些隐蔽的巨大危险，必须提起人们的警惕。     

Deconstructing health care reform

As health reform is deconstructed, we need to stop and do some deconstructing of our thinking about it, looking at the context of our assumptions or frames. If we think of health as taking the supreme welfare of the people seriously, we will not allow it to be framed only in terms of for-profit interests and the status quo. Nurses have expertise and knowledge regarding what is needed for a quality health care system. We have to join the conversation with as many good questions as ideas. Working from a different frame, one that reflects more of your values, may give you new insights into holding the conversation.     

Income,health and health care utilization in the UK

The aim of this paper is to analyse the links between income, health and health care utilisation behaviour using longitudinal data from the British Household Panel Survey. The emphasis is to frame the analysis as a social phenomenon, so that the dynamics of individual health production in the social context can be understood. The study estimates the relationships between income, health and health care utilisation with lag effects. The empirical results support the hypothesis that these three variables influence each other with lag effects and that many social and economic factors influence an individual's probability of having a health problem or making use of health care facilities, even when such facilities are free at the point of use.     

Income-related inequalities of health and health care utilization

By utilizing the China Health and Nutrition Survey (CHNS) data, this paper examines the extent of deviations in terms of horizontal equity in the field of China’s health and medical community, i.e., that those in equal demand ought to be treated equally, and computes the contribution of income in health inequality and utilization inequality of health care. The main conclusions are: There is pro-rich inequality in health and utilization of health care; income contribution to inequality of health care utilization accounts for 0.13–0.2; insurance also enlarges the inequality of health care utilization; health inequality in rural area is larger than that of in urban area; and both rural and urban health inequality are increasing. From 1991 to 2006, income changes in urban districts and rural area account for 7.08% and 13.38% respectively of raising inequality of rural and urban health.     

Provision of health care services in Austria

It is the aim of this paper to investigate three important variables of the health care system in Austria, that is the number of physicians working in the ambulatory sector, the number of medical services provided by the physicians and the related costs, by applying time series analysis to the quantities under consideration. The work analyzes stationarity, autocorrelation functions, presents unit root tests and calculates the Beveridge Nelson decomposition for an ARIMA(1,1,0)-model. The obtained findings are used to forecast future trends based on past values.The author is indebted to Ulrike Leopold, Klaus Neusser, Thomas Url and Peter Zweifel for many useful conversations and suggestions as well as to Keith Chester for English proofreading. The first version of the analysis presented was done as part of a project that was carried out at the Austrian Federal Institute of Public Health on behalf of the Austrian Government.