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"Overall, the book walks a delicate balance between evidence and advocacy regarding the care of people with chronic conditions. Nolte and McKee conclude the volume with the following: 'A first step is to recognize that something must be done. A second, which we hope will be facilitated by the evidence provided in this book, is to realize that something actually can be done, and that they can do it (p. 240)'. The overarching desire to match the need for evidence with the reality that advocates (including policy-makers) need a reasoned voice makes the book well suited to health policy deliberations." International Journal of Integrated Care The complex nature of many chronic diseases, which affect people many different ways, requires a multifaceted response that will meet the needs of the individual patient. Yet while everyone agrees that the traditional relationship between an individual patient and a single doctor is inappropriate, there is much less agreement about what should replace it. Many countries are now experimenting with new approaches to delivering care in ways that do meet the complex needs of people with chronic disorders, redesigning delivery systems to coordinate activities across the continuum of care. Yet while integration and coordination have an intuitive appeal, policy makers have had little to help them decide how to move forward. The book systematically examines some of the key issues involved in the care of those with chronic diseases. It synthesises the evidence on what we know works (or does not) in different circumstances. From an international perspective, it addresses the prerequisites for effective policies and management of chronic disease. Taking a whole systems approach, the book: Describes the burden of chronic disease in Europe Explores the economic case for investing in chronic disease management Examines key challenges posed by the growing complexity in healthcare including prevention, the role of self-management, the healthcare workforce, and decision-support Examines systems for financing chronic care Analyses the prerequisites for effective policies for chronic care Caring for People with Chronic Conditions is key reading for health policy makers and health care professionals, as well as postgraduate students studying health policy, health services research, health economics, public policy and management. Contributors: Reinhard Busse, Elisabeth Chan, Anna Dixon, Carl-Ardy Dubois, Isabelle Durand-Zaleski, Daragh K Fahey, Nicholas Glasgow, Monique Hejmans, Izzat Jiwani, Martyn Jones, Cécile Knai, Nicholas Mays, Martin McKee, Ellen Nolte, Thomas E Novotny, Joceline Pomerleau, Mieke Rijken, Dhigna Rubiano, Debbie Singh, Marc Suhrcke.
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
This forward-looking volume challenges professionals and interested lay readers to reconsider our ways of looking at health and wellness, illness and disease, and the goals of health/healthcare systems. Reframing health systems as complex adaptive systems, the book identifies health care as a central aspect of social care and security for all people, particularly the most vulnerable. From there, the author outlines necessary organizational, design, medical, and community steps toward building health systems that view and practice health care as a human right and can produce optimum care in the long term. And extensive illustrations display effective collaborative problem solving within these systems, in both intriguing theoretical models and the real world. Highlights of the coverage: · Systems and complexity thinking in health and health care · Redesign based on “first principles” · Redesign from an organizational perspective · Working together effectively and efficiently to achieve a common purpose · Analyzing “the workings” of health systems as complex adaptive systems · Person-centered, equitable, and sustainable health systems: achieving the goal Health System Redesign brings a voice and a vision to the most pressing problems in healthcare service delivery, and offers new goals and purpose to health policymakers, health financiers, organizational leaders, clinicians, and concerned members of the local community
This publication explores some of the key issues, ranging from interpreting the evidence base to assessing the policy context for, and approaches to, chronic disease management across Europe. Drawing on 12 detailed country reports (available in a second, online volume), the study provides insights into the range of care models and the people involved in delivering these; payment mechanisms and service user access; and challenges faced by countries in the implementation and evaluation of these novel approaches.
The book will focus on three key aspects of delivery of child health services: service integration and coordination, public health measures, and enhancing the quality of care for children. Taking a child-centric view on understanding how health services and systems work the book aims to contribute towards improving children’s health through deepening the understanding of children’s health services.Focusing primarily on the western European countries the book draws on research conducted with child health leaders in ten countries: Austria, Britain, Finland, France, Israel, Italy, Netherlands, Norway, Poland, and Sweden. The chapters include clinical scenarios designed to help identify and describe the various ways in which children and their families negotiate health services when dealing with twelve different conditions. Using clinical scenarios in this way allows the book authors to capture the diverse aspects of each health system as well as assessment and analysis of the challenges involved in each, and their successes and failures.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
"The book is very valuable as actual information about the health systems in the Nordic countries and the changes that have been made during the last two decades. It informs well both about the similarities within the 'Nordic Health Model' and the important differences that exist between the countries." Bo Könberg, County Governor, Former Minister of Health and Social Insurance in Sweden (1991-94) "This book is a rich, interesting and very useful document. I have been looking, for example, today for precise information on political governing which is not displayed anywhere else. It will be of importance in many aspects!" Johan Calltorp MD PhD, Professor of Health Policy and Management, The Nordic School of Public Health, Gotenburg "The publishing of this book about the Nordic health care systems is a major event for those interested not only in Nordic health policy and health systems but also for everybody interested in comparative health policy and health systems. It is the first book in its kind. It covers the four 'large' Nordic countries, Denmark, Norway, Sweden and Finland, and does so in a very systematically comparative way. The book is well organized, covers 'everything' and is analytically sophisticated." Ole Berg, nstitute of Health Management and health economics, University of Oslo, Norway This book examines recent patterns of health reform in Nordic health care systems, and the balance between stability and change in how these systems have developed. The health systems in Norway, Denmark, Sweden and Finland are investigated through detailed comparisons along a variety of policy-driven parameters. The following themes are explored: Politicians, patients, and professions Financing, production, and distribution The role of the primary health sector The role of public health Internal management mechanisms Impact of the European Union The book probes the impact of these topics and then contrasts the development across all four, allowing the reader to gain a sense of perspective both on the individual countries as well as on the region as a whole. The editors also explore the extent to which a Nordic Health Care Model exists, and the degree to which that model will continue to help explain the future direction of health policy-making in these four countries. An additional chapter on recent developments in Iceland completes the work. Contributors: Tinna L. Ásgeirsdóttir, Paula Blomquist, Johan Calltorp, Terje P. Hagen, Unto Häkkinen, Peter K. Jespersen, Pia M. Jonsson, Lars Erik Kjekshus, Allan Krasnik, Meri Larivaara, Juhani Lehto, Kalevi Luoma, Jon Magnussen, Dorte S. Martinsen, Pål E. Martinussen, Bård Paulsen, Clas Rehnberg, Ånen Ringard, Richard B. Saltman, Signild Vallgårda, Karsten Vrangbæk, Ulrika Winblad, Sirpa Wrede.
This Open Access book highlights the ethical issues and dilemmas that arise in the practice of public health. It is also a tool to support instruction, debate, and dialogue regarding public health ethics. Although the practice of public health has always included consideration of ethical issues, the field of public health ethics as a discipline is a relatively new and emerging area. There are few practical training resources for public health practitioners, especially resources which include discussion of realistic cases which are likely to arise in the practice of public health. This work discusses these issues on a case to case basis and helps create awareness and understanding of the ethics of public health care. The main audience for the casebook is public health practitioners, including front-line workers, field epidemiology trainers and trainees, managers, planners, and decision makers who have an interest in learning about how to integrate ethical analysis into their day to day public health practice. The casebook is also useful to schools of public health and public health students as well as to academic ethicists who can use the book to teach public health ethics and distinguish it from clinical and research ethics.
Economic shocks pose a threat to health and health system performance by increasing people’s need for health care and making access to care more difficult – a situation compounded by cuts in public spending on health and other social services. But these negative effects can be avoided by timely public policy action. While important public policy levers lie outside the health sector, in the hands of those responsible for fiscal policy and social protection, the health system response is critical. This book looks at how health systems in Europe reacted to pressure created by the financial and economic crisis that began in 2008. Drawing on the experience of over 45 countries, the authors:  analyse health system responses to the crisis in three policy areas: public funding for the health system; health coverage; and health service planning, purchasing and delivery assess the impact of these responses on health systems and population health identify policies most likely to sustain the performance of health systems facing financial pressure explore the political economy of implementing reforms in a crisis The book is essential reading for anyone who wants to understand the choices available to policy-makers - and the implications of failing to protect health and health-system performance - in the face of economic and other forms of shock.