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What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).
How are public health services in Europe organized and financed? With European health systems facing a plethora of challenges that can be addressed through public health interventions there is renewed interest in strengthening public health services. Yet there are enormous gaps in our knowledge. How many people work in public health? How much money is spent on public health? What does it actually achieve? None of these questions can be answered easily. This volume brings together current knowledge on the organization and financing of public health services in Europe. It is based on country reports on the organization and financing of public health services in nine European countries and an in-depth analysis of the involvement of public health services in addressing three contemporary public health challenges (alcohol obesity and antimicrobial resistance). The focus is on four core dimensions of public health services: organization financing the public health workforce and quality assurance. The questions the volume seeks to answer are: o How are public health services in Europe organized? Are there good practices that can be emulated? What policy options are available? o How much is spent on public health services? Where do resources come from? And what was the impact of the economic crisis? o What do we know about the public health workforce? How can it be strengthened? o How is the quality of public health services being assured? What should quality assurance systems for public health services look like? This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications: Organization and financing of public health services in Europe: country reports and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance.
European public health was a playing field for deeply contradictory impulses throughout the twentieth century. In the 1920s, international agencies were established with great fanfare and postwar optimism to serve as the watchtower of health the world over. Within less than a decade, local-level institutions began to emerge as seats of innovation, initiative, and expertise. But there was continual counterpressure from nation-states that jealously guarded their policymaking prerogatives in the face of the push for cross-national standardization and the emergence of original initiatives from below. In contrast to histories of twentieth-century public health that focus exclusively on the local, national, or international levels, Shifting Boundaries explores the connections or "zones of contact" between the three levels. The interpretive essays, written by distinguished historians of public health and medicine, focus on four topics: the oscillation between governmental and nongovernmental agencies as sites of responsibility for addressing public health problems; the harmonization of nation-states' agendas with those of international agencies; the development by public health experts of knowledge that is both placeless and respectful of place; and the transportability of model solutions across borders. The volume breaks new ground in its treatment of public health as a political endeavor by highlighting strategies to prevent or alleviate disease as a matter not simply of medical techniques but political values and commitments. Contributors: Peter Baldwin, Iris Borowy, James A. Gillespie, Graham Mooney, Lion Murard, Dorothy Porter, Sabine Schleiermacher, Susan Gross Solomon, Paul Weindling, and Patrick Zylberman. Susan Gross Solomon is professor of political science at the University of Toronto. Lion Murard and Patrick Zylberman are both senior researchers at CERMES (Centre de Recherche Médecine, Sciences, Santé et Société), CNRS-EHESS-INSERM, Paris.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
The 2020 edition of Health at a Glance: Europe focuses on the impact of the COVID‐19 crisis. Chapter 1 provides an initial assessment of the resilience of European health systems to the COVID-19 pandemic and their ability to contain and respond to the worst pandemic in the past century.
Health at a Glance: Europe 2018 presents comparative analyses of the health status of EU citizens and the performance of the health systems of the 28 EU Member States, 5 candidate countries and 3 EFTA countries.
A team of world-leading policy experts and clinicians analyse the changing role of the hospital across Europe.
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 crisisThe 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.--
This fourth edition of Health at a Glance: Europe presents key indicators of health and health systems in the 28 EU countries, 5 candidate countries to the EU and 3 EFTA countries.
People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.