MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The International Journal of Health Planning and Management' source. Thu, 09 Feb 2012 10:13:07 +0100 http://www.medworm.com/index.php?rid=5372350&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1108 SUMMARYFragile states need assessment of decentralized management capabilities, not just of the central level, to design capacity‐building efforts focused on improving management. Improving the management capacity of health departments at the provincial or district level is just as critical as strengthening the central ministry in fragile states if a health system that effectively addresses the real health needs of the population is to be formed. This paper describes a management capacity assessment tool developed for use in fragile states. It uses a framework that describes six critical management areas: oversight and coordination; human resources; resource management; health financing; community involvement; and health information management. These core areas of health system managemen... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5372350 Fri, 28 Oct 2011 04:00:00 +0100 5372350 http://www.medworm.com/index.php?rid=5329155&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1105 SUMMARYWhile the primary healthcare (PHC) services in Iran were appropriate to the needs of the population in the late 1970s and 1980s, the changing burden of disease and shifting demand patterns have rendered the existing PHC system no longer suitable for meeting current and emergent needs. This has serious implications for the PHC system in Iran, which has clearly succeeded in addressing high levels of communicable diseases, maternal deaths and infant mortality, but appears less well prepared to address the emerging challenges of noncommunicable diseases (NCD).We conducted a systematic review of the available literature in the past 10 years related to the PHC system in Iran to assess its weaknesses and challenges.This paper categorizes PHC system weaknesses from the studied articles into... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5329155 Tue, 18 Oct 2011 04:00:00 +0100 5329155 http://www.medworm.com/index.php?rid=5663389&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.2098 SUMMARYThe literature on team and inter‐professional care practice describes numerous barriers to the institutionalization of inter‐professional healthcare. Responses to slow institutionalization of inter‐professional healthcare practice have failed to describe change variables and to identify change agents relevant to inter‐professional healthcare practice. The purpose of this paper is to (1) describe individual and organizational level barriers to collaborative practice in healthcare; (2) identify change variables relevant to the institutionalization of inter‐professional practice at individual and organizational levels of analysis; and (3) identify human resource professionals as change agents and describe how the strategic use of the human resource function could transform in... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5663389 Sat, 01 Oct 2011 04:00:00 +0100 5663389 http://www.medworm.com/index.php?rid=5654826&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1110 This article offers a broad overview of the performance of these healthcare systems. The results will enable decision‐makers to know the strengths and weaknesses of their own health care system and also to compare it with those of other countries. Copyright © 2012 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5654826 Sat, 01 Oct 2011 04:00:00 +0100 5654826 http://www.medworm.com/index.php?rid=5556181&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1118 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556181 Sat, 01 Oct 2011 04:00:00 +0100 5556181 http://www.medworm.com/index.php?rid=5556180&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1116 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556180 Sat, 01 Oct 2011 04:00:00 +0100 5556180 http://www.medworm.com/index.php?rid=5556179&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1115 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556179 Sat, 01 Oct 2011 04:00:00 +0100 5556179 http://www.medworm.com/index.php?rid=5556178&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1111 ConclusionsAlthough the performance of BJ‐DRGs was acceptable, further revision and improvement is needed. Comparisons with other mature DRGs versions can assist in identifying the improvement priorities of the local version. Copyright © 2011 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556178 Sat, 01 Oct 2011 04:00:00 +0100 5556178 http://www.medworm.com/index.php?rid=5556177&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1112 SUMMARYTreatment by injection or infusion is widespread in China. Using the common cold as a tracer condition, we explored the reasons for over‐prescription of injections and infusions in Guizhou, China. Interviews with prescribers, patients and key informants were supplemented by focus groups. These revealed how historical ideas encourage unnecessary use of percutaneous treatment: faith in the healing power of needles is locally attributed to association with acupuncture. Many patients and some staff believe that injections per se are therapeutic. However, the structure of health service financing and remuneration now reinforces this irrational faith. Market‐based reforms have attempted to control costs and increase productivity with an incentive scheme which rewards prescribers finan... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556177 Sat, 01 Oct 2011 04:00:00 +0100 5556177 http://www.medworm.com/index.php?rid=5556176&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1113 ABSTRACTThe separation of revenue and expenditure budgets (SREB) is a new financial budgetary system that is being implemented in community health services (CHS) institutions in some areas in China. Through literature review, it was found that, derived from the traditional separation of revenue and expenditure budgets (TSREB) implemented in administrative public services units, SREB and TSREB have something in common and yet many more differences. On the basis of some quantitative and qualitative data that were collected by field survey, it was also found that implementation of SREB in CHS institutions brings positive outcomes in terms of the quantity, quality and efficiency of services; residents' satisfaction; and the behavior of CHS institutions. The conclusion can be suggested that SRE... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556176 Sat, 01 Oct 2011 04:00:00 +0100 5556176 http://www.medworm.com/index.php?rid=5556175&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1117 ConclusionAlthough there have been other policies interacting with the impact of GCP, GCP reforms implemented in the pilot districts at different times (as well as the later, standardized GCP system) have been effective in enabling CHCs to focus on providing quality public health services and appropriate medical treatment, rather than concentrating upon profit and loss. The impact of the standardized GCP system was further confirmed by cross‐sectional comparisons of some broad indicators, in terms of medical cost, quality of medical service, and coverage of public health service, between the pilot districts and control districts.However, uncertainties exit when looking at individual indicators. Some indicators (see pp. 11–13 and Table 5), such as the service contracting rate with CHCs ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556175 Sat, 01 Oct 2011 04:00:00 +0100 5556175 http://www.medworm.com/index.php?rid=5556174&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1114 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5556174 Sat, 01 Oct 2011 04:00:00 +0100 5556174 http://www.medworm.com/index.php?rid=5415774&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1109 ABSTRACTHealth insurance programs have changed rapidly over time in China. Among rural populations, insurance coverage shifted from nearly universal levels in the 1970s to 7% in 1999; it stands at 94% of counties in 2009. This large increase is the result of a series of health reforms that aim to achieve universal access to healthcare and better risk protection, largely through the rollout of the health insurance programs and the gradual increase in subsidies and benefits over time. In this paper, we present the development of the rural and urban health insurance programs, their modes of financing and operation and the benefits and reimbursement schemes at the end of 2009. We discuss some of the problems with the rural and urban residents' schemes including reliance on local government cap... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5415774 Fri, 01 Jul 2011 04:00:00 +0100 5415774 http://www.medworm.com/index.php?rid=5372349&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1107 This study analyzes that strategy and examines the factors associated with the use of maternity waiting homes and institutional birth. To that end, we apply a quantitative approach, by means of an econometric analysis of the data extracted from surveys conducted in 2006 on a sample of women and parteras or traditional birth attendants, as well as a qualitative approach based on interviews with key informants. Results indicate that although the operation of the maternity waiting homes is usually satisfactory, there is still room for improvement along the following lines: (i) disseminating information about the homes to both women and men, as the latter frequently decide the course of women's healthcare, and to parteras, who can play an important role in referring women; (ii) strengthening t... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5372349 Fri, 01 Jul 2011 04:00:00 +0100 5372349 http://www.medworm.com/index.php?rid=5329154&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1106 We present the pattern of informal payments in primary, out‐patient specialist and in in‐patient care in the period before and shortly after the visit fee was introduced. We also analyse whether in the short run, the introduction of visit fee decreased the probability of paying informally. For the analysis, we use a dataset for a representative sample of 2500 respondents collected in 2007 shortly after the introduction of the visit fee, which contains data on informal payments for healthcare services. According to our results, 9% of the patients paid informally during their last visit to GP (2 Euros on average), 14% paid informally for specialist care (35 Euros on average) and 50% paid informally for hospitalisation (58 Euros on average). We find a significant reduction in the probabil... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5329154 Fri, 01 Jul 2011 04:00:00 +0100 5329154 http://www.medworm.com/index.php?rid=5123679&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1094 SUMMARYCommunity participation in local health has assumed a central role in the reforms of public healthcare, being increasingly associated with the issue of decentralization of the health system. The aim of this paper is to raise questions regarding the structural approaches to multicultural social policy in Chile and to analyze the results of its implementation. The article analyzes the case study of Makewe Hospital, one of the pioneering experiences of intercultural health initiative in Chile. The Makewe Hospital, which involves the indigenous community of the Mapuche, provides interesting insights to understand the dynamics of multicultural social policy and presents an example of a successful initiative that has succeeded in involving local communities in multicultural health policy.... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5123679 Thu, 30 Jun 2011 23:00:00 +0100 5123679 http://www.medworm.com/index.php?rid=5115686&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1101 SUMMARYDonor country initiatives for the prevention and mitigation of HIV/AIDS are not a matter of simple burden sharing. Instead, they have brought in their wake many of the complexities and unforeseen effects that have long been associated with more general overseas development assistance. In the case of funding directed toward HIV/AIDS, these effects are by no means either secondary or easily calculable. It is widely acknowledged that there is no consensus framework on how these impacts may be defined, no framework/toolkit for the evaluation of impacts and no longitudinally significant data that could provide the substance for those evaluations.The subject of this study focuses not on the health outcomes of funding but on how donor–recipient relations could be better deliberated, nego... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5115686 Thu, 30 Jun 2011 23:00:00 +0100 5115686 http://www.medworm.com/index.php?rid=5101803&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1100 ConclusionsThe use of the opportunities to overcome barriers depends on the identification of high, medium or low interaction among key stakeholders, integration of coalitions and negotiating skills of all stakeholders involved. Copyright © 2011 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5101803 Thu, 30 Jun 2011 23:00:00 +0100 5101803 http://www.medworm.com/index.php?rid=5093000&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1099 This study contributes to knowledge about improved methods for this type of research, as well as knowledge about developing coordination between public health and welfare services. One lesson for the current policy is that, where full structural integration is not possible, then client‐level coordination roles in each sector are useful to connect sector services for shared clients. Copyright © 2011 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5093000 Thu, 30 Jun 2011 23:00:00 +0100 5093000 http://www.medworm.com/index.php?rid=5075128&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1102 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5075128 Thu, 30 Jun 2011 23:00:00 +0100 5075128 http://www.medworm.com/index.php?rid=5075127&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1103 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5075127 Thu, 30 Jun 2011 23:00:00 +0100 5075127 http://www.medworm.com/index.php?rid=5075126&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1104 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5075126 Thu, 30 Jun 2011 23:00:00 +0100 5075126 http://www.medworm.com/index.php?rid=4930653&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1092 SUMMARYOne of the most significant developments in the quest for quality, transparency, and accountability in healthcare is the construction and the implementation of indicator‐based technologies. In Denmark, this development has been relatively pronounced, and based on an extensive document study supplemented by qualitative interviews, this paper articulates a policy history of the clinical databases for quality from the early 1990s to the present. First, the paper outlines how, in the early 1990s, the National Board of Health and representatives from the medical profession place the clinical databases on the quality agenda in healthcare. Second, the paper shows that, in spite of an initial alignment between governmental and professional interests, the establishment of national clinical... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4930653 Sun, 12 Jun 2011 23:00:00 +0100 4930653 http://www.medworm.com/index.php?rid=4890424&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1091 ConclusionsDeterioration of health services quality, staffing levels and violence against doctors continued from 2003 through 2006, although these may have improved slightly in 2007. In 2009 and 2010, reports suggest that assassinations of doctors and out‐migration have continued. Few have returned. Copyright © 2011 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4890424 Wed, 01 Jun 2011 23:00:00 +0100 4890424 http://www.medworm.com/index.php?rid=4890423&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1088 SUMMARYAs many industrial and third‐world countries recover from the severe economic crisis of a global recession, they continue to struggle with its negative effect on their healthcare systems. Healthcare reform has become a leading policy agenda item for most countries. This is especially true for countries in the developing world who are struggling to allocate very limited resources to meet the growing health needs of their residents and the expectations of global health. In the late 1990s, the Egyptian government, in conjunction with the United States Agency for International Development, initiated a Health Sector Reform Program (HSRP) to completely reform the way healthcare was financed, organized and delivered with the intent to extend healthcare coverage to all of its citizens. Al... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4890423 Wed, 01 Jun 2011 23:00:00 +0100 4890423 http://www.medworm.com/index.php?rid=4890422&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1089 SUMMARYAlthough community pharmacies have been the mainstay for drug distribution in the USA, plan members are encouraged to use mail‐order pharmacies as a cost‐containment strategy. Both channels differ with respect to reimbursement rates, utilization, and costs. We evaluated the differences in reimbursement rates and in ingredient costs between the two dispensing channels.We used pharmacy claims from a large Midwestern retirement system for the period 2000–2005. A representative sample of drug products was selected. We estimated the aggregated gross reimbursement, the ingredient cost, dispensing fee, pharmacy incentives for drug substitution, professional fee for other services, sales tax, and reimbursement per payer.The sample contained 1964 observations—four million claims. The... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4890422 Wed, 01 Jun 2011 23:00:00 +0100 4890422 http://www.medworm.com/index.php?rid=4890421&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1093 SUMMARYThe nature of the local health authorities (LHAs) in the Italian National Health Service has been deeply reformed during the 1990s by new public management (NPM) reforms that introduced decentralization, quasi‐market and managerialism. These reforms implied that the main role of LHA is to govern the production of health services in their area (steer) rather than to only directly produce services (row). After more than 15 years from these reforms of Italian healthcare, we describe how much the steering versus rowing dichotomy made an impact on LHA activity, through an analysis of the management control systems they set up for themselves and the subsequent qualitative analysis of the opinions that a diverse group of managers expressed during 8 days of group discussion. Results s... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4890421 Wed, 01 Jun 2011 23:00:00 +0100 4890421 http://www.medworm.com/index.php?rid=5016088&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1082 SUMMARYGreat progress has been made in achieving universal access to antiretroviral therapy (ART). However, for successful viral suppression, patients must adhere to rigid and complex treatment regimens. With three quarters of antiretroviral (ARV) users in Africa adhering successfully, African countries have achieved extraordinary levels of adherence given the levels of poverty in which many ARV users live. Nevertheless, one quarter of ARV users still struggle to adhere and run the risk of experiencing viral replication, clinical progression or even drug resistance. Much has been written about ART adherence, but little has been done to systematically categorise the spectrum of factors that influence ART. In this paper, we use a Zimbabwean case study to develop a framework for ART programme... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=5016088 Thu, 31 Mar 2011 23:00:00 +0100 5016088 http://www.medworm.com/index.php?rid=4930655&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1097 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4930655 Thu, 31 Mar 2011 23:00:00 +0100 4930655 http://www.medworm.com/index.php?rid=4930654&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1096 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4930654 Thu, 31 Mar 2011 23:00:00 +0100 4930654 http://www.medworm.com/index.php?rid=4930652&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1087 SUMMARYIn this paper, we argue that the dominant role played by governments of the developed countries in global health policies is a critical but often an ignored factor in contributing to the lack of progress in global health. The solution to this challenge lies in efforts to ‘democratise’ global decision making and to argue for a greater say of the poor globally in policies affecting them. Although there are potentially many ways to achieve this, the paper proposes ‘communitarian claims’ as one way to have the voice of people globally involved and to make decisions about how best to allocate resources globally. It is argued that such claims can be advanced at a practical level through ‘citizens' juries’ as evident from the experience in Australia. That experience and with in... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4930652 Thu, 31 Mar 2011 23:00:00 +0100 4930652 http://www.medworm.com/index.php?rid=4530840&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1079 This study aims to evaluate the General Health Insurance System (GHIS) in Turkey implemented since 1 October 2008, in order to assess whether the GHIS will be able to achieve its objective of universal coverage. Both the breadth and depth of coverage will be taken into account.The study notes out that some socio‐economic problems, such as a significant informal economy, high unemployment rate, inefficiency in the creation of adequate employment opportunities, inequitable income distribution, and widespread poverty, are the main problems preventing the GHIS from reaching breadth of coverage in Turkey. Contribution conditions for entitlement to health services prevent the GHIS from providing breadth of coverage too. Out‐of‐pocket payments, which are higher than in European and OECD cou... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4530840 Mon, 28 Feb 2011 00:00:00 +0100 4530840 http://www.medworm.com/index.php?rid=4520969&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1078 AbstractOver the past three decades, the public health landscape in Thailand has shifted remarkably. Currently chronic non‐communicable diseases represent the largest cause of mortality in the Thai population. In light of the current situation, this paper synthesizes what is known about the chronic non‐communicable disease situation in Thailand and analyzes current policy responses. Relevant contextual factors such as socio‐economic transitions, health systems development, and health workforce capacities are also considered. Primary data for this study were collected by a review of policy documents, government statements, and statistics reported by the Thailand Ministry of Public Health. Secondary data were obtained by a thorough review of the existing literature. The paper finds tha... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4520969 Fri, 25 Feb 2011 00:00:00 +0100 4520969 http://www.medworm.com/index.php?rid=4890420&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1095 ConclusionsOverall, organizational culture plays an important role in patient safety activities. Safety behaviors of hospital staff are partly influenced by the prevailing cultural norms in their organizations and work groups. For management implications, constructed patient priority from management commitment to leadership is necessary. For academic implications, research on patient safety should consider leadership, group dynamics and organizational learning. These factors are important for understanding the barriers and the possibilities embedded in patient safety. Copyright © 2011 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4890420 Sat, 01 Jan 2011 00:00:00 +0100 4890420 http://www.medworm.com/index.php?rid=4520973&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1086 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4520973 Sat, 01 Jan 2011 00:00:00 +0100 4520973 http://www.medworm.com/index.php?rid=4520972&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1085 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4520972 Sat, 01 Jan 2011 00:00:00 +0100 4520972 http://www.medworm.com/index.php?rid=4520971&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1083 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4520971 Sat, 01 Jan 2011 00:00:00 +0100 4520971 http://www.medworm.com/index.php?rid=4520970&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1084 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4520970 Sat, 01 Jan 2011 00:00:00 +0100 4520970 http://www.medworm.com/index.php?rid=4248091&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1077 AbstractLittle is known about the organizational factors involved in policy creation and programs implementation aimed at reducing maternal mortality in Madagascar. A qualitative case study was performed to investigate organizational factors influencing the health system's capacity to elaborate and implement maternal mortality reduction programs. Semi‐structured interviews were conducted with 53 participants. A conceptual framework based on Gamson's coalition theory and Hinings and Greenwood's archetypes concept was used. Three major conclusions emerge: the Ministry of Health is a poor leader in the development of national strategies, due to its dependency on external financial resources and expertise, and because of poor transmission of key information from the field; at a meso level (r... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4248091 Fri, 10 Dec 2010 00:00:00 +0100 4248091 http://www.medworm.com/index.php?rid=4240723&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1076 AbstractClinical quality (CQ) and patient satisfaction (PS) are key elements on the agenda of European public healthcare systems. This paper seeks to explore the relationship between CQ and PS, at hospital level, as freedom of hospital choice may lead to a trade‐off between them. In addition, the paper studies the influence of some factors—location, size, case‐mix, length of stay and occupancy rate (OR)—on hospital clinical and perceived quality. Correlation analyses and the linear mixed‐effect methodology are used. The study focuses on the Andalusian Health Service, one of the biggest European public health services, and covers the years from 2002 to 2006. The results indicate that CQ and perceived quality are not related. The ‘volume‐expertise’ effect is not confirmed in ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4240723 Tue, 07 Dec 2010 00:00:00 +0100 4240723 http://www.medworm.com/index.php?rid=4148782&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1072 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4148782 Fri, 01 Oct 2010 00:00:00 +0100 4148782 http://www.medworm.com/index.php?rid=4148781&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1071 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4148781 Fri, 01 Oct 2010 00:00:00 +0100 4148781 http://www.medworm.com/index.php?rid=4148780&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1070 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4148780 Fri, 01 Oct 2010 00:00:00 +0100 4148780 http://www.medworm.com/index.php?rid=4148779&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1069 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4148779 Fri, 01 Oct 2010 00:00:00 +0100 4148779 http://www.medworm.com/index.php?rid=4148778&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1073 AbstractN Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4148778 Fri, 01 Oct 2010 00:00:00 +0100 4148778 http://www.medworm.com/index.php?rid=4148777&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1074 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4148777 Fri, 01 Oct 2010 00:00:00 +0100 4148777 http://www.medworm.com/index.php?rid=3811860&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1049 The importance of monitoring and evaluation for mental health service planning and delivery is indubitable. Notwithstanding, monitoring and evaluation of mental health policy and plans has received only limited attention. This paper presents an approach developed by the World Health Organization for monitoring mental health policy and plans that can be adapted and utilized for evaluation and monitoring of policy and plans in most other health spheres as well. Four critical areas are outlined i.e., evaluation of the policy document and the plan derived from it; monitoring the implementation of the strategic plan; evaluation of the implementation of the plan; and evaluation of whether the objectives of the policy have been achieved. Overcoming difficulties in objective assessment of policy d... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3811860 Mon, 02 Aug 2010 23:00:00 +0100 3811860 http://www.medworm.com/index.php?rid=3797609&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1063 This study aims to examine the spatial accessibility to polyclinics and identify service gaps, and suggest optimal sites using Geographic Information System (GIS) to aid in future planning. A national database containing 3.6 million polyclinic visits in 2006 were geo-analysed using ArcView GIS. Patients' travel impedance to the nearest polyclinic was computed using DriveTime to identify areas with the lowest spatial accessibility and highest volume of under-served population. Jurong West and Sembawang were ranked as top areas with poor spatial accessibility to polyclinic services. ArcGIS was used to identify optimal sites with the minimum accumulated distance impedance to this under-served population. If new facilities were set up at these identified sites, volume of visits by Jurong West ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3797609 Wed, 28 Jul 2010 23:00:00 +0100 3797609 http://www.medworm.com/index.php?rid=3797610&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1050 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3797610 Tue, 27 Jul 2010 23:00:00 +0100 3797610 http://www.medworm.com/index.php?rid=3726120&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1032 Because of the introduction of (regulated) market competition and self-regulation, strategy is becoming an important management field for health care organizations in many European countries. That is why health managers are introducing more and more strategic principles and tools. Especially the SWOT (strengths, weaknesses, opportunities, threats)-analysis seems to be popular. However, hardly any empirical research has been done on the use and suitability of this instrument for the health care sector. In this paper four case studies are presented on the use of the SWOT-analysis in different parts of the health care sector in the Netherlands. By comparing these results with the premises of the SWOT and academic critique, it will be argued that the SWOT in its current form is not suitable as... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3726120 Mon, 05 Jul 2010 23:00:00 +0100 3726120 http://www.medworm.com/index.php?rid=3726122&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1048 During the 1990s, Tanzania like many other developing countries adopted health sector reforms. The most common policy change under the health sector reforms has been decentralization, which involves the transfer of power and authority from the central level to local authorities. Based on the case study of Mbarali district in Tanzania, this paper uses a policy analysis approach to analyse the implementation of decentralized health care priority setting. Specifically, the paper examines the process, actors and contextual factors shaping decentralized health care priority setting processes. The analysis and conclusion are based on a review of documents, key informant interviews, focus group discussion, and notes from non-participant observation. The findings of the study indicate that local i... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3726122 Sun, 04 Jul 2010 23:00:00 +0100 3726122 http://www.medworm.com/index.php?rid=3726121&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1035 This study was designed to elicit the perspectives of a group of health professionals and managers so as to analyse factors affecting the efficiency of hospitals owned by the Iranian Social Security Organization (SSO), which is the second largest institutional source of hospital care in that country. This study also aimed to identify actions that would improve efficiency. Using purposive sampling (to identify key informants), interviews with seventeen health professionals and hospital managers involved in the SSO health system were conducted. The respondents identified a number of organizational factors affecting efficiency, particularly the hospital budgeting and payment system used to fund physicians, and the lack of the managerial skills needed to manage complex facilities such as hospi... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3726121 Sun, 04 Jul 2010 23:00:00 +0100 3726121 http://www.medworm.com/index.php?rid=4131303&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1075 AbstractUsing a unique data set, this study explores how type of ownership (government/private) is related to processes of governance. The findings suggest that the neo‐institutional perspective and the self‐interest rationale of the agency perspective are helpful in explaining processes of governance in both government‐ and privately owned non‐profit organizations. Due to adverse incentives and the quest for legitimacy, supervising governance bodies within local government‐owned non‐profit institutions pay relatively less attention to the development of high quality supervising bodies and delegate little to management. Our findings also indicate that governance processes in private institutions are more aligned with the business model and that this alignment is likely driven b... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4131303 Thu, 01 Jul 2010 00:00:00 +0100 4131303 http://www.medworm.com/index.php?rid=4115400&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1065 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4115400 Wed, 30 Jun 2010 23:00:00 +0100 4115400 http://www.medworm.com/index.php?rid=4080872&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1066 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4080872 Wed, 30 Jun 2010 23:00:00 +0100 4080872 http://www.medworm.com/index.php?rid=4055011&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1068 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4055011 Wed, 30 Jun 2010 23:00:00 +0100 4055011 http://www.medworm.com/index.php?rid=4043790&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1064 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4043790 Wed, 30 Jun 2010 23:00:00 +0100 4043790 http://www.medworm.com/index.php?rid=3840950&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1062 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840950 Wed, 30 Jun 2010 23:00:00 +0100 3840950 http://www.medworm.com/index.php?rid=3840949&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1061 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840949 Wed, 30 Jun 2010 23:00:00 +0100 3840949 http://www.medworm.com/index.php?rid=3840948&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1060 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840948 Wed, 30 Jun 2010 23:00:00 +0100 3840948 http://www.medworm.com/index.php?rid=3840947&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.985 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840947 Wed, 30 Jun 2010 23:00:00 +0100 3840947 http://www.medworm.com/index.php?rid=3840946&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.971 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840946 Wed, 30 Jun 2010 23:00:00 +0100 3840946 http://www.medworm.com/index.php?rid=3840945&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.972 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840945 Wed, 30 Jun 2010 23:00:00 +0100 3840945 http://www.medworm.com/index.php?rid=3840944&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1059 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840944 Wed, 30 Jun 2010 23:00:00 +0100 3840944 http://www.medworm.com/index.php?rid=3840943&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1058 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840943 Wed, 30 Jun 2010 23:00:00 +0100 3840943 http://www.medworm.com/index.php?rid=3702653&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1051 Case-mix classification has made it possible to analyze acute care delivery case volumes and resources. Data arising from observed differences have a role in planning health policy. Aggregated length of hospital stay (LOS) and total charges (TC) as measures of resource use were calculated from 34 case-mix groups at 469 hospitals (1 721 274 eligible patients). The difference between mean resource use of all hospitals and the mean resource use of each hospital was subdivided into three components: amount of variation attributable to hospital practice behavior (efficiency); amount attributable to hospital case-mix (complexity); and amount attributable to the interaction. Hospital characteristics were teaching status (academic or community), ownership, disease coverage, patients, and hospital ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3702653 Sun, 27 Jun 2010 23:00:00 +0100 3702653 http://www.medworm.com/index.php?rid=3702654&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1052 There is a need for nationally representative information on the affordability of health care by disability status to assist in the design of equitable health systems in developing countries. Using the Viet Nam National Health Survey (2001-2002), this paper analyses health care utilization, cost burden and coping strategies for people with disabilities versus the population at large. The results clearly show that the disabled population are more prone to hospitalization, and spend more on inpatient stays and pharmaceuticals. Households with disabled members are at greater risk of catastrophic health expenditures and debt financing, posing a serious threat to economic welfare. Copyright © 2010 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3702654 Sat, 26 Jun 2010 23:00:00 +0100 3702654 http://www.medworm.com/index.php?rid=3689920&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1000 The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Government's rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the repor... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3689920 Wed, 23 Jun 2010 23:00:00 +0100 3689920 http://www.medworm.com/index.php?rid=3664935&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1029 Despite an increase in organizational capacity building efforts by external organizations in low and middle income countries, the documentation of these efforts and their effects on health programs and systems remains limited. This paper reviews key frameworks for considering sustainability of capacity building and applies these frameworks to an evaluation of the sustainability of an AIDS non-governmental organization (NGO) capacity building initiative. From 2004-2007 Bristol-Myers Squibb Foundation's Secure the FutureTM initiative in southern Africa funded a five country program, the NGO Training Institute (NGOTI), to build capacity of NGOs working to address HIV/AIDS. Lessons learned from this project include issues of ownership, the importance of integrating planning for sustainability ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3664935 Tue, 15 Jun 2010 23:00:00 +0100 3664935 http://www.medworm.com/index.php?rid=3664934&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1047 To establish the full costs borne by sub-district health facilities in providing services, we analysed the costs and revenues of 10 sub-district health facilities located in two districts in Ghana. The full costs were obtained by considering staff costs, cost of utilities, cost of using health facility equipment, cost of non-drug consumables, equipment maintenance expenses, amounts spent on training, community information sessions and other outreach activities as well as all other costs incurred in running the facilities.We found that (i) a large proportion of sub-district health facility costs is made up of staff salaries; (ii) at all facilities, internally generated funds (IGFs) are substantially lower than costs incurred in running the facilities; (iii) average IGF is several times high... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3664934 Tue, 15 Jun 2010 23:00:00 +0100 3664934 http://www.medworm.com/index.php?rid=3664933&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1041 The formation of healthcare consortia is a management strategy adopted by a number of cities in Brazil in order to minimize the difficulties the population has in access to services of greater technological complexity. As administrators are the main governmental actors in the promotion of this strategy, the aim of the present study was to identify the motives, expectations and difficulties faced by the mayors, and secretaries of health that make up a healthcare consortium undergoing a formation process in the rural, coastal zone of the state of Pernambuco. A descriptive, qualitative, case study was conducted. Data collection was carried out through semi-structured interviews held with mayors and secretaries of health of the municipalities participating in the consortium. Data were analyzed... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3664933 Tue, 15 Jun 2010 23:00:00 +0100 3664933 http://www.medworm.com/index.php?rid=3647532&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1026 In 1996, the Federal Law on Health Insurance (LAMal) was adopted in order to contain costs in Swiss health care. At the same time, the reform aimed to maintain or even improve solidarity and encourage institutional reform through new public management (NPM) and market mechanisms. More freedom in contractual conditions between insurers and providers and a clearer distinction of responsibilities between federal and regional (cantonal) authorities were stipulated to achieve efficiency, effectiveness, and transparency. The focus of this paper is an analysis of the effects of market reforms and NPM mechanisms introduced with the LAMal on the cost-containment, quality of care and equity objectives in the Swiss health care system. Copyright © 2010 John Wiley & Sons, Ltd. (Source: The Internation... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3647532 Wed, 09 Jun 2010 23:00:00 +0100 3647532 http://www.medworm.com/index.php?rid=3647531&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1030 Our study aimed to explore policy challenges to the quality of child health services in Bulgaria.The study was based on qualitative in-depth interviews, analysis of regulatory documents, and review of the literature. Respondents included policy-makers, providers and users of health services, from both rural and urban areas.Problems identified included insufficient training of general practitioners, medical errors, delays in response to emergencies, inadequate information provided to patients, and underdeveloped child public health. A common view was that paediatricians provide better quality care than general practitioners. Respondents described a lack of clinical guidelines for rational use of pharmaceuticals, overprescribing of antibiotics, reliance on pharmaceutical companies for inform... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3647531 Wed, 09 Jun 2010 23:00:00 +0100 3647531 http://www.medworm.com/index.php?rid=3624259&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1013 In health care, multidisciplinary collaboration is both indispensable and complicated. We discuss organizational problems that occur in situations where multiple health care providers are required to cooperate for patients with complex needs. Four problem categories, labelled as communication, patient safety, waiting times and integration are distinguished. Then we develop a supply chain perspective on these problems in the sense of discussing remedies according to supply chain management (SCM) literature. This perspective implies a business focus on inter-organizational conditions and requirements necessary for delivering health care and cure across organizational borders. We conclude by presenting some strategic and policy recommendations. Copyright © 2010 John Wiley & Sons, Ltd. (Sourc... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3624259 Wed, 02 Jun 2010 23:00:00 +0100 3624259 http://www.medworm.com/index.php?rid=3624258&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1040 This study concluded that the goal of the UHC policy in providing equity of access to PHC to all citizens may not be achieved unless the role of CHDs is supported with training in health management and PHC and is supported by the government. Copyright © 2010 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3624258 Wed, 02 Jun 2010 23:00:00 +0100 3624258 http://www.medworm.com/index.php?rid=3624257&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1034 Africa's distribution of specialized private health services is severely disproportionate. Mismatch between South Africa's excess supply and a huge demand potential in an under-serviced continent represents an entrepreneurial opportunity to attract patients to South Africa for treatment and recuperative holidays. However, effective demand for intra-African medical tourism could be constrained by sub-Saharan poverty. Results from interviewing 320 patients and five staff at the Johannesburg Breast care Centre of Excellence, however, reject this proposition, Africa's middle class women being the target market estimated to grow annually by one million while breast cancer incidence increases with middle-class lifestyles. Uncovering this potential involves an extensive marketing strategy. Copyri... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3624257 Wed, 02 Jun 2010 23:00:00 +0100 3624257 http://www.medworm.com/index.php?rid=3594624&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1033 We compared health managers' judgements of: (1) the time they spent on nine major work activities, (2) the time they thought they should allocate and (3) the importance they attributed to each pursuit. These and managers' reasons for devoting time to activities were examined in an Anglo and a Confucian-Asian country.A questionnaire survey of Australian (n = 251) and Singaporean health managers (n = 340).In both countries, the correlation between judgements of time spent on activities/activities' importance (1 and 3) was significantly less than the correlation between time spent/time that should be spent (1 and 2), which was less than the correlation between time that should be spent/activities' importance (2 and 3). Singaporeans said they devoted more time to some activities but the import... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3594624 Mon, 24 May 2010 23:00:00 +0100 3594624 http://www.medworm.com/index.php?rid=3537021&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1046 We describe the stewardship function, identify existing challenges and issues in the Spanish case, and reflect upon methodological aspects of this exercise. We use reports, documents, articles, and official statistics to complete the analysis. Overall, we find the MoH to give an average performance in its role as the steward of the health system. The MoH has progressed particularly well in generating intelligence as well as formulating a strategic policy framework over recent years. However, it lacks the appropriate authority to efficiently coordinate the health system and to ensure that the Autonomous Communities implement policies that are in-line with overall NHS objectives. Copyright © 2010 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3537021 Wed, 05 May 2010 23:00:00 +0100 3537021 http://www.medworm.com/index.php?rid=3528895&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1039 This study takes advantage of a natural experiment in which 15% of the population - the poor and disabled - was exempted from these co-payments. It used the micro-level panel data of three large health plans on the physician visits of 50 000 members per plan in 1997-2001. The data indicate that, following introduction of the co-payment, specialist visits increased among non-exempt members, relative to exempt members, of two health plans that together account for two-thirds of the population. This paper illustrates how, unlike the Health Insurance Experiment and other US studies of cost sharing, the structure of the co-payment in Israel may have inadvertently limited the incentive to decrease consumer demand and may have created an incentive for the health plans to increase visit rates, esp... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3528895 Mon, 03 May 2010 23:00:00 +0100 3528895 http://www.medworm.com/index.php?rid=3518279&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1037 Recent changes to the system of remuneration and contracting arrangements with Primary Care Trusts (PCTs) has meant that dental practitioners in the UK have experienced several types of incentive and governance arrangements. This paper uses data from a qualitative study of 20 dental practitioners to examine the influence of different systems of incentives and governance on their motivational system. Results show that a perceived reduction in autonomy was the least acceptable aspect of the health reforms. The study also suggests that conflict between self-interested and altruistic motives may occur where medical professionals operate as independent contractors in a small business environment. Whilst dentists appeared to show altruistic motives towards their patients, priorities towards runn... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3518279 Thu, 29 Apr 2010 23:00:00 +0100 3518279 http://www.medworm.com/index.php?rid=3514314&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1038 In conclusion, remuneration rate setting is not just about translating costing results into a price tag, but other factors have to be considered in a low-income country context in order to balance out health sector objectives and provider interests. Inclusion of providers in developing the costing methodology proves important to increase acceptability of results. Copyright © 2010 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3514314 Wed, 28 Apr 2010 23:00:00 +0100 3514314 http://www.medworm.com/index.php?rid=3504328&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1031 Increasing attention, and a concomitant increase in funds, is being devoted to the strengthening of research capacity for health within low- and middle-income countries. Yet approaches to research capacity strengthening (RCS) are still new, and there is much debate about how to strengthen something that is so difficult to define, let alone measure. This paper aims to inform our understanding of how research capacity is being strengthened, and how we might consider the effectiveness of these initiatives. It does this by examining (a) understandings of and approaches to RCS, and (b) different ways in which RCS is monitored and evaluated. The study included a literature review, internet search, and analysis of the web pages and available documents for six donor organizations key to health RCS... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3504328 Sat, 24 Apr 2010 23:00:00 +0100 3504328 http://www.medworm.com/index.php?rid=3440075&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1036 This study took place in 18 Ugandan hospitals. We describe the 49 physicians who participated in 11 focus groups and the 63 physicians who completed questionnaires, out of a larger sample of 641 health workers overall.Only 37% of physicians said they were satisfied with their jobs, and 46% reported they were at risk of leaving the health sector or the country. After compensation, the largest contributors to dissatisfaction among physicians were quality of management, availability of equipment and supplies (including drugs), quality of facility infrastructure, staffing and workload, political influence, community location, and professional development.Physicians in our study were highly dissatisfied, with almost half the sample reporting a risk to leave the sector or the country. The establ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3440075 Mon, 05 Apr 2010 23:00:00 +0100 3440075 http://www.medworm.com/index.php?rid=3440074&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.971 As it moves from a relief to a development phase, the Republic of Tajikistan (RT) needs to attract more external aid and to ensure adequate alignment of this aid with health systems development priorities.A potential response to these two needs is a Sector-Wide Approach (SWAp), a method originating from post-colonial Africa and Asia that is increasingly being introduced in new contexts. However, little is known about whether SWAps are appropriate in the context of the former Soviet Union (FSU). This paper explores SWAps using Tajikistan as a case study.A number of lessons are identified for the Tajik health system, for other FSU countries and for health SWAps in general, covering issues of practical relevance to national and international health policy-makers.We conclude that context-speci... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3440074 Mon, 05 Apr 2010 23:00:00 +0100 3440074 http://www.medworm.com/index.php?rid=3397907&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1028 In 2003, China launched the New Cooperative Medical Scheme (NCMS) as a form of health insurance for rural areas. Counties play an important part in the management of the system, raising issues over the capacity of local government to manage complex health insurance systems. This paper examines the extent and impact of county level managerial capacity to manage the NCMS.The paper is largely based on qualitative data but supported by quantitative data. Policy makers, NCMS administrators, health providers and residents were interviewed in May 2006 in six counties in rural China.Management capacity was defined as the capability to bring together and use resources to carry out responsibilities. The results are grouped into three areas of management capacity: staff, organizational and contextual... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3397907 Tue, 23 Mar 2010 00:00:00 +0100 3397907 http://www.medworm.com/index.php?rid=3184618&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.997 One of the biggest obstacles identified in achieving Millennium Development Goals (MDGs) was the lack of available qualified health personal to meet the health needs of the global population. With nurses being the main workforce component in health systems, the human resource challenge for most countries is to address the reported shortage of nurses. Skill mix is one suggestion.In Australia, workforce projections indicated a shortage of 40,000 nurses by 2010. Toward the reform of the Australian health workforce, one project aimed to develop a nationally consistent framework for nursing and midwifery specialization based on knowledge and skills to generate the first national database iteration for designated specialties. A literature review looked at the way nursing specialty practices were... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3184618 Tue, 19 Jan 2010 00:00:00 +0100 3184618 http://www.medworm.com/index.php?rid=3162841&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.972 This study involves a secondary analysis of micro-data collected from a nationally-representative household survey conducted in Tajikistan in 2003. Three empirical models are employed: binomial logit regression for the admission to the hospital; zero truncated negative binomial (ZTNB) regression for the length of hospital stay; and ordinary least square (OLS) for the amount of out-of-pocket expenditures for hospitalization.Variation in hospital admission is due to the differences in ability to pay, long-standing illness, gender, age, and educational level. Factors explaining out-of-pocket expenditures include ability to pay, having long-standing illness, and having surgery and receiving intensive care. The most important out-of-pocket expenditures are payments for pharmaceuticals and suppl... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3162841 Tue, 12 Jan 2010 00:00:00 +0100 3162841 http://www.medworm.com/index.php?rid=3162845&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1027 This paper presents an overview of the operating theatre planning and scheduling practice of hospitals in Flanders (Belgium). An electronic survey was sent to 95 hospitals in which surgeries are performed, which eventually resulted in a response set of 52 hospitals (55%). The questionnaire did not only focus on issues related to the elective (inpatient and outpatient) planning and scheduling process, but also questioned how hospitals currently deal with the occurrence of non-elective surgeries (urgencies and emergencies). We indicate what goals health managers try to achieve and how this planning is established. We furthermore pay attention to some possible disruptions to the schedule and the corresponding anticipatory methods. Despite the proliferation of computerized planning and schedul... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3162845 Mon, 11 Jan 2010 00:00:00 +0100 3162845 http://www.medworm.com/index.php?rid=3162844&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1025 The aim of the study was to identify the main determinants of grassroots project success among HIV/AIDS NGOs operating in Rakai, Uganda. It was a cross-sectional study using face-to-face interviews in a mixed-methods approach among community members and NGOs involved in providing HIV/AIDS and related health services. The study found that the success of grassroots projects of HIV/AIDS NGOs essentially relies on adequate financial resources, competent human resources, strong organizational leadership, and NGO networking. These data suggest that to increase grassroots project success, HIV and AIDS NGOs in Rakai need to improve not only the budget base and human capacities but as well decision-making processes, organizational vision, mission and strategies, gender allocation in staffing, and b... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3162844 Mon, 11 Jan 2010 00:00:00 +0100 3162844 http://www.medworm.com/index.php?rid=3162843&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1014 In 1988, Brazil became one of the first countries in Latin America to frame access to health care as a constitutional right. However, it would be misleading to call Brazil's Unified Health System (Sistema Único de Saúde, or SUS) a public health system that provides universal access and comprehensive care. This paper reveals a strong contradiction between the re-distribution model set out in the Brazilian Constitution and the inadequate level of public spending on health care. The law states that health care is a basic social right, allocated by need rather than means. Meanwhile, in 2003, Brazil spent US$ 597 per capita on health, or 7.6 per cent of its gross domestic product (GDP), while the average country from the Organization for Economic Cooperation and Development (OECD) spent US$ 3... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3162843 Mon, 11 Jan 2010 00:00:00 +0100 3162843 http://www.medworm.com/index.php?rid=3162842&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.985 This study aims to investigate the patterns in the utilization of infertility services in Iran.We performed a survey of 10 783 women in 28 provinces from 2004 to 2005. We used a systematic sampling method to draw a total of 400 clusters, the probability for selection being proportional to the size of the urban and rural population in each province. The categorization of the woman as "presumed infertile" was based on her own report of infertility at some time during her married life. We also studied the measures taken for the latest episode of presumed infertility. For each of these measures, we recorded the reason(s), the year in which it was taken, and the time interval separating it from contraceptive discontinuation. Data analysis, using the software package STATA 8.0, included descript... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3162842 Mon, 11 Jan 2010 00:00:00 +0100 3162842 http://www.medworm.com/index.php?rid=4055012&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1067 Abstract (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=4055012 Fri, 01 Jan 2010 00:00:00 +0100 4055012 http://www.medworm.com/index.php?rid=3840940&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1047 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840940 Fri, 01 Jan 2010 00:00:00 +0100 3840940 http://www.medworm.com/index.php?rid=3840939&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1051 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840939 Fri, 01 Jan 2010 00:00:00 +0100 3840939 http://www.medworm.com/index.php?rid=3840938&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1039 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840938 Fri, 01 Jan 2010 00:00:00 +0100 3840938 http://www.medworm.com/index.php?rid=3840937&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1031 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840937 Fri, 01 Jan 2010 00:00:00 +0100 3840937 http://www.medworm.com/index.php?rid=3840936&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1032 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840936 Fri, 01 Jan 2010 00:00:00 +0100 3840936 http://www.medworm.com/index.php?rid=3840935&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1063 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840935 Fri, 01 Jan 2010 00:00:00 +0100 3840935 http://www.medworm.com/index.php?rid=3078178&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.1003 This article argues that organizing inter-organizational collaboration in projects tends to be counterproductive, since the purpose of this collaboration is to increase the integration of local authorities. This article is based on case studies of three different collaboration projects. Each project is analyzed in relation to the way collaboration is organized within the project and how the relationship to the local authorities' activities is designed. The outcome of these studies shows that while collaboration projects increase integration between the responsible authorities, the integration stays within the projects. This is due to the fact that the projects were designed as units separate from the responsible authorities. As a result, the collaboration that occurs in the projects is not... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3078178 Fri, 11 Dec 2009 00:00:00 +0100 3078178 http://www.medworm.com/index.php?rid=2833802&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.983 The objective of the study was to project the future demand for physicians in Kuwait for the years 2007-2020 based on the period 1994-2006. Population projections were derived using the average annual natural increase rate of the 1994-2006 populations. The future demand for physicians was predicted using the average physician to population ratio for the years 1994-2006. The average annual growth rate of indigenous physicians during the period 1994-2006 was 4.08% compared to 2.83% for non-native expatriot physicians. There is a gap between the numbers of native and foreign physicians. In 2006, native physicians constituted 36.6% of the physician workforce in Kuwait. The disparity between the total number of physicians needed and the number of native physicians is expected to decline from 62... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2833802 Thu, 24 Sep 2009 23:00:00 +0100 2833802 http://www.medworm.com/index.php?rid=2833801&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.980 The health sector in the Punjab (Pakistan) faces many problems, and the government introduced reforms during 1993-2000 to overcome these problems. This paper explores the policy process for the reforms. A case study method was used and, to assist this, a conceptual framework was developed. Analysis of four initiatives indicated that there were deviations from the government guidelines and that the policy processes used were weak. The progress of different reforms was affected by a variety of factors: the immaturity of the political process and civil society, which together with innate conservatism and resistance to change on the part of the bureaucracy resulted in weak strategic sectoral leadership and a lack of clear purpose underpinning the reforms. It also resulted in weaknesses in prep... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2833801 Thu, 24 Sep 2009 23:00:00 +0100 2833801 http://www.medworm.com/index.php?rid=2694342&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.989 The objective was to estimate the direction, volume, and value of TiHS; analyze country commitments; and assess the challenges and opportunities for health services.Trade liberalization favored an open trade regime and encouraged foreign direct investment. Consumption abroad and movement of natural persons were the two prevalent modes. Yemen and Sudan are net importers, while Jordan promotes health tourism. In 2002, Yemenis spent US$ 80 million out of pocket for treatment abroad, while Jordan generated US$ 620 million. Egypt, Pakistan, Sudan and Tunisia export health workers, while Oman relies on import and 40% of its workforce is non-Omani. There is a general lack of coherence between Ministries of Trade and Health in formulating policies on TiHS.This is the first organized attempt to loo... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2694342 Wed, 12 Aug 2009 23:00:00 +0100 2694342 http://www.medworm.com/index.php?rid=2575536&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.988 In recent years, the central government in China has been leading the re-establishment of its rural health insurance system, but local government institutions have considerable flexibility in the specific design and management of schemes. Maintaining a reasonable balance of funds is critical to ensure that the schemes are sustainable and effective in offering financial protection to members. This paper explores the financial management of the NCMS in China through a case study of the balance of funds and the factors influencing this, in six counties in two Chinese provinces. The main data source is NCMS management data from each county from 2003 to 2005, supplemented by: a household questionnaire survey, qualitative interviews and focus group discussions with all local stakeholders and pol... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2575536 Mon, 06 Jul 2009 23:00:00 +0100 2575536 http://www.medworm.com/index.php?rid=2445655&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.992 This analysis identifies salient features of team management that were critical to the efficiency of program implementation and the effectiveness of behavior change management to promote essential newborn care practices in Uttar Pradesh, India. In May 2003, the Johns Hopkins Bloomberg School of Public Health and King George Medical University initiated a cluster-randomized, controlled neonatal health research program. In less than 2 years, the trial demonstrated rapid adoption of several evidence-based newborn care practices and a substantial reduction in neonatal mortality in intervention clusters. Existing literature involving research program management in resource-constrained areas of developing countries is limited and fails to provide models for team organization and empowerment. The... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2445655 Sun, 31 May 2009 03:23:20 +0100 2445655 http://www.medworm.com/index.php?rid=2363133&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.982 Pharmaceutical care, meant to complement a proper drug supply system, is a key component of a robust health care system and is the direct, responsible provision of medication-related care designed to achieve definite outcomes that improve a patient's quality of life. Beyond simply dispensing medicine, pharmaceutical care promotes adherence to therapeutic regimens and addresses problems such as overdosage, sub-therapeutic dosage, adverse drug reactions, medication errors, and untreated indications. The dearth of health care workers trained in pharmaceutical care coupled with inadequate access to medications creates multiple disease management challenges in Sub-Saharan Africa (SSA), which has 25% of the world's disease burden but only 1.3% of the world's health workforce. To prevent and trea... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2363133 Fri, 24 Apr 2009 04:00:00 +0100 2363133 http://www.medworm.com/index.php?rid=2352598&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.986 Although accountability drives in the Indian health sector sporadically highlight egregious behaviour of individual health providers, accountability needs to be understood more broadly. From a managerial perspective, while accountability functions as a control mechanism that involves reviews and sanctions, it also has a constructive side that encourages learning from errors and discretion to support innovation. This points to social relationships: how formal rules and hierarchies combine with informal norms and processes and more fundamentally how power relations are negotiated. Drawing from this conceptual background and based on qualitative research, this article analyses the views of government primary health care administrators and workers from Koppal district, northern Karnataka, Indi... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2352598 Tue, 21 Apr 2009 04:00:00 +0100 2352598 http://www.medworm.com/index.php?rid=2294149&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.978 This study evaluated equity of provision of surgery after the introduction of a prioritization system to manage access. Data for people receiving publicly funded elective joint replacement, prostatectomy or cataract surgery between 2000 and 2005 were obtained, as well as most recent data for people receiving privately funded surgery (2001 and 2002). Denominators were derived from the 2001 census for the population of District Health Board regions. NZDep2001, a small-area deprivation index, was used to identify people in poorest deciles. Despite the introduction of a prioritization system aimed at increased equity and fairness, the provision of elective surgery remains inequitable geographically. High private provision was not associated with better access to publicly funded surgery. Moreov... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2294149 Sat, 28 Mar 2009 04:00:00 +0100 2294149 http://www.medworm.com/index.php?rid=2294151&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.981 This study shows that perceived obligations and psychological contracts indicate high degree of relational contracts between the hospital and the physicians. These socio-cultural elements should be recognized as important mechanisms of coordination and communication when policy makers and hospital managers are designing hospital management control systems. Copyright © 2009 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2294151 Wed, 25 Mar 2009 04:00:00 +0100 2294151 http://www.medworm.com/index.php?rid=2181094&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.951 This paper describes performance measurement and its indicators for mental health care services. Performance measurement can serve several goals such as accountability, quality improvement and performance management. For all three purposes structure, process and outcome indicators should be measured. Literature was retrieved from Medline and PsychInfo in order to see which performance indicators were used for the three purposes of performance measurement in mental health care. The indicators were classified in structure, process and outcome indicators. The results show no big differences in the indicators used among studies. Performance management is the performance measurement purpose most referred to, followed by accountability, and quality improvement. Outcome and process indicators are... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2181094 Fri, 13 Feb 2009 05:00:00 +0100 2181094 http://www.medworm.com/index.php?rid=2127907&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.969 Despite a burgeoning literature on global health partnerships (GHPs), there have been few studies of how GHPs, particularly those trying to build a bridge between horizontal and vertical modes of delivering essential health services, operate at global and country levels. This paper will help address this knowledge gap by describing and analyzing the GAVI Alliance's early experience with health systems strengthening (HSS) to improve immunization coverage and other maternal-child health outcomes. To date, the strengths of HSS reside in its potential to optimize GAVI's overall investment in immunization, efforts to harmonize with other initiatives, willingness to acknowledge risk and identify mitigation strategies, engagement of diverse stakeholders, responsiveness to country needs, and effec... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2127907 Sat, 24 Jan 2009 05:00:00 +0100 2127907 http://www.medworm.com/index.php?rid=2127908&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.970 This study aimed to estimate and analyse the "actual" unit cost of providing key clinical services in selected rural district hospitals in the North of Vietnam. It also examined the relationship between actual costs and the levels of cost covered by the corresponding user fees paid by patients.Methods: This was a facility-based costing study which estimates the costs of health care services from the perspective of the service providers. Three rural district hospitals from three provinces in the North of Vietnam were purposively selected for this study. The "step-down" approach was applied.Results: There was little difference in the costs of an outpatient visit across the hospitals, but the costs of an operation and an inpatient day varied considerably. In terms of cost structure, personnel... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2127908 Thu, 22 Jan 2009 05:00:00 +0100 2127908 http://www.medworm.com/index.php?rid=3840941&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.981 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840941 Thu, 01 Jan 2009 00:00:00 +0100 3840941 http://www.medworm.com/index.php?rid=1958837&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.966 Conclusions Considerable operating theatre time is wasted while patients are transferred to and from the operating theatre resulting in both anaesthetists and surgeons having to wait between patients in a high proportion of cases, averaging 1 h during a 4 h operating list. Surgery could be made more time efficient by ensuring that patients arrive in the operating theatre complex early enough (to reduce time wasted for anaesthetists and surgeons), and by having two anaesthetists available at the end of surgery, one to reverse the anaesthetic while the other starts the next induction (to reduce time waste for the surgeon), coupled to adequate recovery area capacity. Copyright © 2008 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1958837 Sat, 15 Nov 2008 05:00:00 +0100 1958837 http://www.medworm.com/index.php?rid=1767806&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.950 This study concludes that services for PMTCT of HIV infection can easily be scaled-up and integrated into RCH services using the already existing staff. In the wake of the human resource crisis in the health sector in developing countries, strategies to address the problem will need to go beyond numbers to address issues of staff productivity and their distribution. Copyright © 2008 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1767806 Sat, 06 Sep 2008 04:00:00 +0100 1767806 http://www.medworm.com/index.php?rid=1767807&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.959 The article explores the concept of clinical leadership in the National Health Service in the UK by seeking to establish a workable definition and by contrasting it with managerial leadership, focussing on the 'disconnected hierarchy' in professional organizations. It proposes that the problems faced by clinical leadership relate to the current nature of general management in the NHS and concludes by suggesting that clinical leadership is the 'elephant in the room' - often ignored or unaddressed. Copyright © 2008 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1767807 Thu, 04 Sep 2008 04:00:00 +0100 1767807 http://www.medworm.com/index.php?rid=1641847&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.958 The Democratic Peoples Republic of Korea (DPRK), under the leadership of the Ministry of Public Health (MOPH), undertook the development of a Health System Strengthening (HSS) proposal through the support of the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to outline the approach to the development of the HSS strategy in DPRK, and describe opportunities and challenges associated with its development and future implementation. Sources of information for this review have included national programme plans, in country social sector reviews, information generated through HSS proposal developments and the international literature.Updated assessments in DPRK indicate some recent improvements in the health situation for women and children, but there remain ongoing... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1641847 Tue, 22 Jul 2008 04:00:00 +0100 1641847 http://www.medworm.com/index.php?rid=1604954&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.938 The study aims to define configurations of factors from local, regional and national levels that, within a context of decentralized health systems, enable or hinder change towards a health care model of promotion and disease prevention as advocated in current Latin American public health discourse. The project developed in-depth case studies of prevention and promotion activities in eight local health systems in rural and urban Brazil and Chile allowing three levels of comparison: national, regional and local. The data are based on interviews, secondary sources, policy documentation and observations. The results are summarized as pathways through configurations of factors leading to what are termed active and basic degrees of activity related to disease prevention and health promotion at t... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1604954 Fri, 11 Jul 2008 04:00:00 +0100 1604954 http://www.medworm.com/index.php?rid=1534414&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.937 This paper suggests a simple framework to estimate the shortage of medical practitioners in rural and urban areas in developing countries. Shortages are defined with respect to four main considerations. The overall numbers and also the different categories of practitioners in the rural and urban areas, the relatively greater difficulties of access in the rural areas (which reduce the number of accessible practitioners) and the greater health hazards in those areas (which lead to greater need for medical treatment).The quantitative effect of these factors is examined by undertaking simulation exercises with data for the Ujjain district in Madhya Pradesh state, India and also data for that state. The simulations turned up the following results. The un-weighted total number of practitioners, ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1534414 Sat, 21 Jun 2008 04:00:00 +0100 1534414 http://www.medworm.com/index.php?rid=1496185&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.947 Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1496185 Fri, 06 Jun 2008 04:00:00 +0100 1496185 http://www.medworm.com/index.php?rid=1496188&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.946 This paper performs an empirical comparison of health systems.Health systems are seen as networks of delegation relationships among principals and agents, subject to agency problems. Following the institutional economics approach, a health system's efficiency is considered to be determined by the existence and treatment of agency problems. Agency problems can be controlled by mechanisms built into the health system, or can also be controlled by an external actor, for example, the government, either by using the instruments available or by conducting institutional reforms. To explain differences in the amenability of a country's health system to external governmental control, I combine the veto player approach and the incentives for societal actors to exert influence, into the concept of in... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1496188 Thu, 05 Jun 2008 04:00:00 +0100 1496188 http://www.medworm.com/index.php?rid=1496187&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.949 This study analyzes Guyana's drug policy and regulation, public financing, and drug procurement and delivery. The study also identifies main barriers to drug access and proposes alternatives to strengthen the country's public health functions. Data were collected from the country's regulatory agencies, public procurement agency, pharmacies, wholesalers, and pharmaceutical companies. The information was supplemented with interviews with a convenient sample of Guyanese health authorities and stakeholders. Data were also compiled from scientific databases, and web pages of the country's Ministries of Health, Commerce and Finance, the Bureau of Statistics, and international organizations. Major barriers to drug access include: (1) lack of national drug policy and regulation, and limited role o... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1496187 Thu, 05 Jun 2008 04:00:00 +0100 1496187 http://www.medworm.com/index.php?rid=1496186&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.948 This study aims to guide costing efforts in Iran and other countries in the region that are pursuing casemix funding, through identifying the main issues facing cost finding approaches and introducing the costing models compatible with their hospitals accounting and management structures. The results show that inadequate financial and utilisation information at the patient's level, poorly computerized 'feeder systems'; and low quality data make it impossible to estimate reliable DRGs costs through clinical costing. A cost modelling approach estimates the average cost of 2.723 million Rials (Iranian Currency) per DRG. Using standard linear regression, a coefficient of 0.14 (CI = 0.12-0.16) suggests that the average cost weight increases by 14% for every one-day increase in average length of... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1496186 Thu, 05 Jun 2008 04:00:00 +0100 1496186 http://www.medworm.com/index.php?rid=2575537&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.948 This study aims to guide costing efforts in Iran and other countries in the region that are pursuing casemix funding, through identifying the main issues facing cost finding approaches and introducing the costing models compatible with their hospitals accounting and management structures. The results show that inadequate financial and utilisation information at the patient's level, poorly computerized 'feeder systems'; and low quality data make it impossible to estimate reliable DRGs costs through clinical costing. A cost modelling approach estimates the average cost of 2.723 million Rials (Iranian Currency) per DRG. Using standard linear regression, a coefficient of 0.14 (CI = 0.12-0.16) suggests that the average cost weight increases by 14% for every one-day increase in average length of... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=2575537 Wed, 04 Jun 2008 23:00:00 +0100 2575537 http://www.medworm.com/index.php?rid=1453456&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.936 This paper outlines the principal institutional factors affecting the slow progress in reaching agreed targets in Africa regarding the prevention and control of HIV/AIDS, TB and malaria. It focuses on three key factors, political analysis, strategic business approach and international inputs.Much analysis tends to look at the technical aspects of disease prevention and control. Of political analysis there is a marked absence. Yet we know that wider contextual or macro factors such as power and political decision-making can make or break a programme.Many senior managers in public sector institutions are preoccupied with the day-to-day. Successful businesses in the private sector have some things in common with each other: outstanding leadership, a strategic and action orientated culture, ve... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1453456 Tue, 20 May 2008 04:00:00 +0100 1453456 http://www.medworm.com/index.php?rid=1425435&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.934 This study examines care provided by obstetricians in all 19 facilities in a typical Russian region. A first set of structured interviews was conducted with 52 obstetricians, with emerging themes explored in a second set of interviews with 36 of the original interviewees. Accounts were compared with quantitative data on patterns of practice.Obstetricians had little access to information, with only limited use of Russian journals and textbooks and minimal access to international evidence.The decisions made by obstetricians largely determined the overall pattern of care, with midwives, nurses and anaesthetists clearly subordinate. Care was highly medicalized, with many interventions long discarded in the west. There was no obvious reason for widespread variations.Obstetric care in Russia is ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1425435 Wed, 07 May 2008 04:00:00 +0100 1425435 http://www.medworm.com/index.php?rid=1404869&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.928 Since the 1993 publication of Disease Control Priorities in Developing Countries and World Development Report: Investing in Health, micronutrient fortification and supplementation interventions have been recognized as being among the most cost-effective public health interventions. This paper reviews nearly 100 studies of the cost of micronutrient interventions. The literature contains enormous variation in the estimated costs of these programs due to differences in program structure, delivery systems and a host of country-specific factors, differences in the studies' objectives, designs and costing methodologies. The most diverse estimates reported are those of vitamin A supplementation programs, where estimates vary by a factor of more than 1000. The costs of fortification programs, too,... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1404869 Tue, 29 Apr 2008 04:00:00 +0100 1404869 http://www.medworm.com/index.php?rid=1404870&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.932 Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries of the local system being examined. This local system - the unit of analysis of the study - was defined as the health district.We developed a standardized set of assessment tools to measure 53 indicators. Data collection was carried out over 4 weeks by a Nepalese agency. Scaling and combining indicators into six component indices provided a map of progress toward sustainable maternal and child, health, and family planning results for the ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1404870 Mon, 28 Apr 2008 04:00:00 +0100 1404870 http://www.medworm.com/index.php?rid=1398756&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.929 Portfolio analysis is a business management tool that can assist health care managers to develop new organizational strategies. The application of portfolio analysis to US hospital settings has been frequently reported. In Europe however, the application of this technique has received little attention, especially concerning public hospitals. Therefore, this paper examines the peculiarities of portfolio analysis and its applicability to the strategic management of European public hospitals. The analysis is based on a pilot application of a multi-factor portfolio analysis in a Dutch university hospital. The nature of portfolio analysis and the steps in a multi-factor portfolio analysis are reviewed along with the characteristics of the research setting. Based on these data, a multi-factor po... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1398756 Fri, 25 Apr 2008 04:00:00 +0100 1398756 http://www.medworm.com/index.php?rid=1398758&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.931 The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, healt... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1398758 Thu, 24 Apr 2008 04:00:00 +0100 1398758 http://www.medworm.com/index.php?rid=1398757&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.930 In the last 20 years, orphan drug legislation (ODL) has been adopted in several countries around the world (USA, Japan, Australia, and the European Union) and has successfully promoted R&D investments to develop new pharmaceutical products for the treatment of rare diseases. Without these incentives, many life-saving new drugs would have not been developed and produced.For economic reasons, the development of medicines for the treatment of diseases prevalent in the developing world (or tropical diseases) is lagging behind. Among several factors, the low average per-capita income makes pharmaceutical markets in developing countries appear relatively unprofitable and therefore unattractive for R&D-oriented companies.The case of ODL may offer some useful insights and perspectives for the figh... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1398757 Thu, 24 Apr 2008 04:00:00 +0100 1398757 http://www.medworm.com/index.php?rid=1274640&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.926 No Abstract. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1274640 Mon, 03 Mar 2008 05:00:00 +0100 1274640 http://www.medworm.com/index.php?rid=1188215&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.919 The study aims to define configurations of factors from local, regional and national levels that, within a context of decentralized health systems, enable or hinder change towards a health care model of promotion and disease prevention as advocated in current Latin American public health discourse. The project made in-depth case studies of prevention and promotion activities in eight local health systems in rural and urban Brazil and Chile allowing three levels of comparison: national, regional and local. The data are based on interviews, secondary sources, policy documentation and observations.The results are summarized as pathways through configurations of factors leading to what are termed active and basic degrees of activity related to disease prevention and health promotion at the loc... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1188215 Wed, 30 Jan 2008 05:00:00 +0100 1188215 http://www.medworm.com/index.php?rid=1156595&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.916 This study focuses on how the inter-organizational collaboration was conducted in the care for drug abusers over a period of 5 years. The study sought to answer the following questions: Which effect does inter-organizational collaboration have on ways-of-working among professionals and which effect does inter-organizational collaboration have on the services provided by the clients?We argue that inter-organizational collaboration is developed through three processes. First, the professionals redefine 'areas of responsibilities' in the different organizations. Second, the professionals 'reconstruct their ways of working' with clients. Third, the professionals 'organize a networking model with the client as citizen in the centre'. This paper describes how the three processes appeared in the ... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1156595 Wed, 16 Jan 2008 05:00:00 +0100 1156595 http://www.medworm.com/index.php?rid=3840942&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.932 (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=3840942 Tue, 01 Jan 2008 00:00:00 +0100 3840942 http://www.medworm.com/index.php?rid=1112573&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.917 To explore the determinants of public satisfaction with the National Health Insurance, this study re-analyzed the 2004 public satisfaction survey with the Korean National Health Insurance (KNHI) conducted by Korean National Health Insurance Corporation (KNHIC). One thousand samples were selected with probability proportional to population size (by region/sex/age). The data collected by home-visit interview were transformed into the final data set by matching them to the insured's benefit database and the qualification database. The results showed that metropolitan residence, insured type, relationship between respondent and householder, subjective health status, benefit-cost ratio, and attitudes toward KNHI were direct determinants of satisfaction with KNHI. In addition, various demographi... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1112573 Sat, 22 Dec 2007 05:00:00 +0100 1112573 http://www.medworm.com/index.php?rid=1112574&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.915 Through health sector reform in developing countries, Ministries of Health have sought to enhance health care through greater community governance and improved management effectiveness in their public hospitals. In this paper, we present a partnership-mentoring model for enhancing management capacity that has been piloted in Ethiopia and may be useful in other developing countries. The model included needs assessment and baseline evaluation using a hospital management indicator checklist, deployment of 24 Fellows (US and international hospital administrators) for 1 year to work as mentors with hospital management teams in 14 Ethiopian hospitals, continuing didactic and practical training in quality improvement methods for hospital management teams, and 24 management improvement projects to... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1112574 Fri, 21 Dec 2007 05:00:00 +0100 1112574 http://www.medworm.com/index.php?rid=1060798&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.914 This paper contributes to analysing and understanding the demand for (social) health insurance of informal sector workers in Kenya by assessing their perceptions and knowledge of and concerns regarding health insurance and the Kenyan National Hospital Insurance Fund (NHIF). It serves to explore how informal sector workers could be integrated into the NHIF.To collect data, focus group discussions were held with organized groups of informal sector workers of different types across the country, backed up by a self-administered questionnaire completed by heads of NHIF area branch offices.It was found that the most critical barrier to NHIF enrolment is the lack of knowledge of informal sector workers about the NHIF, its enrolment option and procedures for informal sector workers. Inability to p... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1060798 Fri, 30 Nov 2007 05:00:00 +0100 1060798 http://www.medworm.com/index.php?rid=1060799&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.911 The present work analyzed the association between hospital costs and patient admission characteristics in a general public hospital in the city of Rio de Janeiro, Brazil. The unit costs method was used to estimate inpatient day costs associated to specific hospital clinics. With this aim, three "cost centers" were defined in order to group direct and indirect expenses pertaining to the clinics. After the costs were estimated, a standard linear regression model was developed for correlating cost units and their putative predictors (the patients gender and age, the admission type (urgency/elective), ICU admission (yes/no), blood transfusion (yes/no), the admission outcome (death/no death), the complexity of the medical procedures performed, and a risk-adjustment index). Data were collected f... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1060799 Thu, 29 Nov 2007 05:00:00 +0100 1060799 http://www.medworm.com/index.php?rid=1027961&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.912 A reward and recognition (RR) system is a tool widely applied by organizations to motivate their employees. Outstanding employees expect their effort to be acknowledged by the organization. However, the variety of rewards and recognitions systems used by organizations may be perceived differently by different employees. The diverse workforce structure in the United Arab Emirates (UAE) poses various challenges for organization managers. Managers need to implement the shrewd RR system which best fits their diverse workforce. This research studied how medical sector employees in the private and public health sector view the RR systems in the UAE. Two lists, comprising 26 major approaches to RR, were prepared and its items prioritized by taking inputs from 250 employees working in more than 30... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1027961 Thu, 15 Nov 2007 05:00:00 +0100 1027961 http://www.medworm.com/index.php?rid=1027962&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.913 To determine, from the perspective of providers, community leaders and users of health services, equity, governance and health financing outcomes of the Mexican health system reform.Cross-sectional study oriented towards the qualitative analysis of financing, governance and equity indicators for the uninsured population. Taking into account feasibility, as well as political and technical criteria, six Mexican states were selected as study populations and a qualitative research was conducted during 2004-2006. Two hundred and forty in-depth interviews were applied, in all selected states, to 60 decision-makers, including medical and administrative personnel; 60 service providers at health centres; 60 representatives of civil organizations, including municipal representatives and, finally, 60... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=1027962 Wed, 14 Nov 2007 05:00:00 +0100 1027962 http://www.medworm.com/index.php?rid=867892&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.899 A simple information system for primary care clinics was designed to support the USAID funded health system strengthening project in the Suez Governorate in Egypt. This system (FACT - Feedback and Analytic Comparison Tool) was implemented in December 2003 in 14 primary care clinics. The MS Access-based system was designed and prototyped in several months, and was easily and cheaply modified several times after implementation. A total of 128 562 persons have been registered in the system (as of June 2005) and 36 083 visits have been documented. A key feature of FACT is the ease with which clinicians can conduct exploratory research about practice patterns, and variations in them across doctors and the other clinics. This analytic feature enables the clinicians to self-diagnose quality probl... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=867892 Thu, 13 Sep 2007 04:00:00 +0100 867892 http://www.medworm.com/index.php?rid=845271&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.901 A questionnaire survey (QS) among stakeholders in Tanzania had shown that in-kind drug donations (DDs) are important to boost the drug supply system. Major problems were their insufficient quantity for sustainable treatment and the discrepancy between the needs of the recipients and the donors' supply. Objectives in this study were to discuss these findings and to learn from key informants (KIs) how to improve the DD process. Data were collected through KI interviews in 2001/2002.A 30% gap in drug supply has to be bridged by DDs. KIs confirmed the importance of the World Health Organisation and Tanzanian DD guidelines as a tool for good donation practice and emphasized the role of the government in their implementation. They requested that donors meet the recipient country's regulatory req... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=845271 Thu, 06 Sep 2007 04:00:00 +0100 845271 http://www.medworm.com/index.php?rid=833081&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.902 Over the last decade, outsourcing has become one of the major issues in health care. Two major concerns are related to public health care outsourcing practice. The first one involves the suitability of the outsourcing strategy in the public sector, principally with reference to the outsourcing of essential clinical services. The second one relates to the actual benefits of the outsourcing practice in health care, in terms of cost reduction and increasing efficiency.This paper aims to contribute to the debate and literature on outsourcing through a national survey carried out in the Italian National Health Service.In order to achieve the research objective, a questionnaire was developed and, after a pilot test, it was mailed to all Italian public providers. The total response rate was aroun... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=833081 Fri, 31 Aug 2007 04:00:00 +0100 833081 http://www.medworm.com/index.php?rid=830619&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.900 This study also identified challenges to implementing integration and the solutions found. These include the importance of focusing on the professional development of disease-specific program staff as their roles change, strengthening specific weakness in the general health system and finding alternative solutions where these are not easily solved, actively engaging senior management at an early stage, continually evaluating the impact of integration and not pushing integration for the sake of integration. Copyright © 2007 John Wiley & Sons, Ltd. (Source: The International Journal of Health Planning and Management) The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=830619 Thu, 30 Aug 2007 04:00:00 +0100 830619 http://www.medworm.com/index.php?rid=829466&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.897 In recent years, primary health care in Uzbekistan has seen dramatic changes in organization, management and financing. The Soviet multi-tiered system of primary care is being replaced by a two-tiered system, consisting in rural areas of rural physician points (SVPs) and outpatient clinics of central rayon hospitals. A state-guaranteed benefits package of primary care services has been introduced and financing is increasingly based on capitation. In addition, a considerable number of physicians and nurses have been trained in general practice. There are, however, a number of challenges that remain. One of them is the considerable regional differences that exist in health financing. Another challenge is that some rural areas have difficulties attracting primary care workers. Overall, the in... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=829466 Wed, 29 Aug 2007 04:00:00 +0100 829466 http://www.medworm.com/index.php?rid=811651&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.898 Community-based health insurance (CBHI) schemes have developed in response to inadequacies of alternate systems for protecting the poor against health care expenditures. Some of these schemes have arisen within community-based organizations (CBOs), which have strong links with poor communities, and are therefore well situated to offer CBHI. However, the managerial capacities of many such CBOs are limited. This paper describes management initiatives undertaken in a CBHI scheme in India, in the course of an action-research project. The existing structures and systems at the CBHI had several strengths, but fell short on some counts, which became apparent in the course of planning for two interventions under the research project. Management initiatives were introduced that addressed four featu... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=811651 Tue, 21 Aug 2007 04:00:00 +0100 811651 http://www.medworm.com/index.php?rid=806373&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.896 This paper outlines the principal institutional factors affecting the slow progress in reaching agreed targets in Africa regarding the prevention and control of HIV/AIDS, TB and Malaria. It focuses on three key factors: political analysis, strategic business approach and international inputs.Most of the analyses tend to look at the technical aspects of disease prevention and control, of political analysis there is a marked absence. Yet, we know that wider contextual or macro factors such as power and political decision making can make or break a programme.Many senior managers in public sector institutions are preoccupied with day-to-day work. Successful businesses in the private sector have some things in common with each other. Outstanding leadership, a strategic and action orientated cul... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=806373 Sat, 18 Aug 2007 04:00:00 +0100 806373 http://www.medworm.com/index.php?rid=668181&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.890 This article reports on a study of one type of HEF, based in Kirivong Operational Health District (KOD) and operated through local pagoda structures, which demonstrates minimal reliance on external funding and low administrative overheads. We utilize an adapted sustainability assessment framework to assess the ability of pagoda structures to enable financial access for the poorest to public sector health services. We further analyse the strengths and limitations of the pagoda-managed equity fund initiative, with a view to assessing not only its sustainability but its potential for replication in other settings.Our study shows that, against key sustainability indicators (health service utilization and health outcomes; management capacity and financial viability; community mobilization and g... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=668181 Sat, 16 Jun 2007 04:00:00 +0100 668181 http://www.medworm.com/index.php?rid=660232&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.882 Knowledge of what constitutes best practice in human resource management (HRM) in public-oriented services is limited and the operational aspects of managing health workers at provision level have been poorly studied. The magnet hospital concept offers some insights into HRM practices that are leading to high commitment. These have been shown to lead to superior performance in not only industrial business firms, but also service industries and the public service. The mechanisms that drive these practices include positive psychological links between managers and staff, organizational commitment and trust. Conditions for successful high commitment management (HiCoM) include health service managers with a strong vision and able to transmit this vision to their staff, appropriate decision spac... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=660232 Wed, 06 Jun 2007 04:00:00 +0100 660232 http://www.medworm.com/index.php?rid=660233&cid=s_33639_51_f&fid=33639&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhpm.880 In a move to achieve a better equity in the funding of access to health care, particularly for the poor, a better efficiency of hospital functioning and a better financial balance, the analysis of hospital costs in Mali brings several key elements to improve the pricing of medical services. The method utilized is the classical step-down process which takes into consideration the entire set of direct and indirect costs borne by the hospital. Although this approach does not allow to estimate the economic cost of consultations, it is a useful contribution to assess the financial activity of the hospital and improve its performance, financially speaking, through a more relevant user fees policy. The study shows that there are possibilities of cross-subsidies within the hospital or within servi... The International Journal of Health Planning and Management journals http://www.medworm.com/rss/comments.php?id=660233 Tue, 05 Jun 2007 04:00:00 +0100 660233