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This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
Bringing together contributions from diplomats, UN agency officials, lawyers and academics, this book provides insight into the evolution of international environmental law, diplomacy and negotiating techniques. Based on first-hand experiences and extensive research, the chapters offer a blend of practice and theory, history and analysis, presenting a range of historical episodes and nuances and drawing lessons for future improvements to the processes of law-making and diplomacy. The book represents a synthesis of the most important messages to emerge from the annual course on Multilateral Environmental Agreements, delivered to diplomats and negotiators from around the world for the last decade by the University of Eastern Finland and the United Nations Environment Programme. The book will be of interest as a guide for negotiators and as a supplementary textbook and a reference volume for a wide range of students of law and environmental issues.
Road asset management is one of the top priorities of the Central Asia Regional Economic Cooperation (CAREC) Transport and Trade Facilitation Strategy 2020. The implementation of performance-based road maintenance contracts (PBCs)—an essential element of road asset management—promotes effective and efficient maintenance of road networks. Well-designed PBCs keep roads in predefined good condition at relatively low cost. This guide aims to help policy makers in CAREC member countries understand and implement PBCs. After a brief history of the development of PBCs, it discusses the various types of PBCs and their relative advantages and disadvantages. It highlights PBC implementation in selected developed, developing, and transitional countries, including CAREC member countries, to illustrate best practices.
The 2006 World Health Report focuses on the chronic shortages of doctors, midwives, nurses and other health care support workers in the poorest countries of the world where they are most needed. This is particularly true in sub-Saharan Africa, which has only four in every hundred global health workers but has a quarter of the global burden of disease, and less than one per cent of the world's financial resources. Poor working conditions, high rates of attrition due to illness and migration, and education systems that are unable to pick up the slack reflect the depth of the challenges in these crisis countries. This report considers the challenges involved and sets out a 10-year action plan designed to tackle the crisis over the next ten years, by which countries can strengthen their health system by building their health workforces and institutional capacity with the support of global partners.
New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting.
Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.
Promoting regional cooperation in the health sector is an operational priority of the Central Asia Regional Economic Cooperation (CAREC) Strategy 2030. This scoping study assesses the potential of CAREC to promote regional cooperation and integration in the health sector to mitigate risks and develop national health systems. The study specifically reviews the burden of communicable and noncommunicable diseases and their risk factors, along with the progress and challenges in health systems development in the CAREC region. Based on the assessment, the study recommends strengthening regional health security; developing health systems through regional cooperation; and improving health services for migrants, mobile populations, and border communities.
Innovation for Sustainable Development Review of Kyrgyzstan contains the outcomes of a policy advisory exercise that drew on the experience accumulated by the UNECE in the identification of good practices and policy lessons in the area of knowledge-based development, with particular reference to the problems of countries with economies in transition. It provides a set of recommendations and policy options to stimulate innovation activity in the country, enhance its innovation capacity and improve the overall efficiency of the national innovation system.