2,500 research outputs found

    \ud Tanzania Health Insurance Regulatory Framework Review\ud

    Get PDF
    Make sure that current policy objectives – achieving universal coverage, social health protection, good governance and cost-containment – are reflected in the relevant legislative documents, and provide the requisite legal tools, reflecting the chosen policy options and the institutional consequences of those options. Consider reducing the fragmentation of the health financing legislation which reflects the current fragmentation in health financing and in governance and oversight of the health financing and insurance systems. Develop an explicit policy on competition in health financing to close the current gaps in legislation and to prevent the possibly negative side effects for Tanzania citizens of such competition in the event that the Government of Tanzania (GOT) opts for a competition-based model of health financing. The model ultimately chosen will have consequences not only for health financing practise, but also for the relevant legislation. Consider the establishment of an independent accreditation body for external assessment and gradual improvement of the quality of care of all health services providers, regardless of their sources of financing. Plug the identified gaps in single enactments which can be done without embarking on any big policy changes. The latter can be included in the development of a planned National Health Financing Strategy. During this development process, it will be possible to focus on specific areas of interest and make detailed recommendations. After national adoption of the strategy, new legislation will have to be drawn up.\ud \u

    Leveraging System Context to Understand Collaborative Systems in Modern Public Management

    Get PDF
    Complex and boundary-spanning problems like overpopulation, hunger, pandemics, homelessness, and environmental degradation occur more frequently now than ever (Bynander & Nohrstedt, 2019; Criado & Guevara-Gómez, 2021; Huang, 2020; Kapucu, 2015; Getha-Taylor, 2007; Jayasinghe et al., 2022). Policymakers increasingly address these challenges through interorganizational collaboration (Isett et al., 2011). Countries worldwide now use collaborative governance to respond to such wicked problems (Jayasinghe et al., 2022; Huang, 2020; Megawati et al., 2020). Despite growing in popularity, gaps remain in understanding collaborative governance at scale. In this dissertation, I present research on the interconnected nature of collaborative governance initiatives in the United States by studying the units that carry out collaborative governance in modern public management: collaborative governance regimes (CGRs). A CGR is “a particular mode of, or system for, public decision-making in which cross-boundary collaboration represents the prevailing pattern of behavior and activity” (Emerson et al., 2015, p. 18). Collaborative systems occur when multiple CGRs operate within or across policy arenas in a defined geography or jurisdiction (Annis et al., 2020). I explore the contexts that collaborative systems operate within. System context refers to “the broad and dynamic set of surrounding conditions that create opportunities and constraints for initiating and sustaining CGRs (Emerson & Nabatchi, 2015a, p. 232). Studying the system context is essential because collaboration does not occur in a vacuum. System context factors can create opportunities for or constraints on CGRs that influence their processes and performance. I show the existence of collaborative systems in the U.S. and ask, what leverage can be gained by exploring the broader system contexts of collaborative systems? I present studies of collaborative systems consisting of hundreds of interconnected CGRs in practice today to uncover lessons about collaborative governance at scale. In Chapter One, I detail a collaborative system operating in Oregon in a facilitative system context for collaborative governance. Oregon’s system context features state support and legislation that supports the CGRs there (Cochran et al., 2019). In Chapter Two, I examine the context of the COVID-19 pandemic to understand collaborative governance when an unexpected crisis occurs. I analyze adaptation in two community referral networks whose system context is unstable due to the pandemic’s onset. In Chapter Three, I do not examine the characteristics of a collaborative system; instead, I study the association between states’ broader system contexts and formal CGR registration to that state. I find that collaborative systems exist and can be measured. Chapter One explores representation in a collaborative system in Oregon. The results reveal a high amount of membership overlap among CGRs, even across sectors. This high level of membership overlap has resulted in a tightly interconnected collaborative system in Oregon. It should alert leaders to probe whether a diverse set of actors are substantively represented across the system because the same actors appear in CGRs repeatedly. In Chapter Two, I examine what leverage analysts can gain from looking at collaborative systems in a system context impacted by a crisis. I do this by studying two community referral networks in a U.S. state where the system context was unstable due to the onset of the COVID-19 pandemic. I document that community referral networks adapted to changes in supply and demand for services during the pandemic’s emergence. I find organizational tenure and resource munificence contributed to CGR\u27s adaptability during the crisis. Rather than going through the lead organization governance model with the coordination center directing ties, organizations saw greater returns to modifying the governance structure for faster service delivery to locate and serve clients directly and more quickly during the early days of the pandemic. I find flexible governance structures can buffer CGR member exit during crises. In Chapter Three, I analyze collaborative governance in Medicare to show how researchers can understand CGRs’ broader system context. Chapter Three demonstrates how leaders and managers can use data analytics to understand CGRs, system context factors, and outcomes. I draw four conclusions from the three essays. First, I conclude that researchers and practitioners can gain leverage by examining the system context of collaborative systems, including public management insights on steering collaborative systems for large-scale policy implementation. Second, my results indicate that studying collaborative systems and their contexts allows scholars to contribute to a concise theory of collaborative governance that transcends disciplines. Third, I find that managers can enhance the success of CGRs by focusing on their governance structures and the entities that support them. Fourth, my results show that scholars can gain leverage in understanding collaborative systems and broader system contexts using various data types and methodologies, including qualitative methods, network analysis, and econometrics. The broad range of data types and methodologies available to understand collaborative governance is good for scholarship and practice. When leaders know system context conditions, they become better equipped to manage the current and changing conditions that influence their work (Emerson & Nabatchi, 2015a)

    Integration, co-ordination and multidisciplinary care in Australia: growth via optimal governance arrangements

    No full text
    The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

    The role of shared medical appointments in the management of chronic disease: utilising international experiences to design an intervention for peripheral arterial disease in the NHS

    Get PDF
    With over 15 million people living with chronic disease in England alone, patients and healthcare systems face significant burden, in terms of symptoms, quality-of-life and resource costs. One such chronic disease is peripheral arterial disease (PAD), with an estimated UK prevalence of 7%. Patients with PAD often have co-morbidities and require risk factor modification, having increased risk of cardiovascular morbidity and mortality. They utilise primary care, community and hospital resources, requiring multi-disciplinary team input, to provide lifestyle, medical and surgical management. With increasing prevalence of chronic disease and in the current economic climate, there is a need to empower patients to take an active role in their care and improve utilisation of existing healthcare resources. Interventions that streamline patient pathways, integrate the multi-disciplinary team and facilitate self-care are likely to benefit patients and the NHS. Shared medical appointments (SMAs) can improve patient education, self-management and clinical outcomes in those with chronic disease, whilst delivering care more efficiently. Whilst their use has increased in countries such as USA across a variety of settings, research or use within the NHS has mainly been within primary care. To date, SMAs have not been used within vascular surgery, in the UK or abroad. Using the example of PAD, this thesis seeks to investigate the role for SMAs in the NHS. Firstly, it identifies scope for improvement within current care. Through international collaboration, it then examines barriers and facilitators to implementing SMAs and the patient experience of this model of care. It details a co-design process, whereby UK patients and healthcare professionals were brought together to work with qualitative data from the preceding chapters. The final data chapters describe a pilot SMA and discuss experiences of staff and patients involved. Finally, the thesis reflects on implications of this work for clinical practice and healthcare policy.Open Acces

    Local resources and procurement practices in humanitarian supply chains:an empirical examination of large-scale house reconstruction projects

    Get PDF
    Different procurement decisions taken by relief organizations can result in considerably different implications in regards to transport, storage, and distribution of humanitarian aid and ultimately can influence the performance of the humanitarian supply chain and the delivery of the humanitarian aid. In this article, we look into what resources are needed and how these resources evolve in the delivery of humanitarian aid. Drawing on the resource-based view of the firm, we develop a framework to categorize the impact of local resources on the configuration of humanitarian supply chains. In contrast to other papers, the importance of localizing the configuration of the humanitarian supply chain is not only conceptually recognized, but empirical investigations are also provided. In terms of methodology, this article is based on the analysis of secondary data from two housing reconstruction projects. Findings indicate that the use of local resources in humanitarian aid has positive effects on programs' overall supply chain performance and these effects are not only related to the macroeconomic perspective, but benefits expand to improvements related to the use of knowledge. At the same time, it was found that local sourcing often comes with a number of problems. For example, in one of the cases, significant problems existed, which were related to the scarcity of local supplies. Both housing reconstruction projects have indicated the continuous need for changes throughout the programs as a dynamic supply chain configuration is important for the long-term sustainability of reconstruction aid

    Sindh health sector strategy 2012 – 2020

    Get PDF

    IIMA in HealthCare Management: Abstract of Publications (2000-2010)

    Get PDF
    The Indian Institute of Management, Ahmedabad (IIMA), was established in 1961 as an autonomous institution by the Government of India in collaboration with the Government of Gujarat and Indian industry. IIMA’s involvement in the health sector started with the establishment of the Public Systems Group in 1975. In the initial period, our research focused on the management of primary healthcare services and family planning. We expanded our research activities to include the management of secondary healthcare services in the 80s and to tertiary healthcare services in the 90s. Currently our research interests focus on the governance and management issues in the areas on Rural Health, Urban Health, Public Health and Hospital Management. In June 2004, IIMA Board approved the setting up of a Centre for Management Health Services (CMHS) in recognition of IIMA’s contributions to the health sector in the past and the felt need to strengthen the management of health sector in the context of socio-economic developments of our country. The overall objectives of CMHS are to address the managerial challenges in the delivery of health services to respond to the needs of different segments of our population efficiently and effectively, build institutions of excellence in the health sector, and influence health policies and wider environments. All our research projects are externally funded and we have developed research collaborations with 15-20 international universities in USA, UK, Europe, and Asia. CMHS has also established strong linkages with the Ministry of Health and Family Welfare at the national and state government levels, particularly in the states of Gujarat, Maharashtra, Rajasthan, Madhya Pradesh, Chattisgarh, Orissa, and Bihar. This working paper is a compilation of the abstracts of all our publications in the last 10 years, which include 40 referred journal articles, 54 Working Papers, 19 Chapters in Books and 18 Case Studies.

    More effective social services

    Get PDF
    In June 2014, the Productivity Commission was asked to look at ways to improve how government agencies commission and purchase social services. The final report was released in mid-September 2015. It makes several recommendations about how to make social services more responsive, client-focused, accountable and innovative. The final inquiry report has two key messages. First, system-wide improvement can be achieved and should be pursued. Second, New Zealand needs better ways to join up services for those with multiple, complex needs. Capable clients should be empowered with more control over the services they receive. Those less capable need close support and a response tailored to their needs, without arbitrary distinctions between services and funds divided into “health”, “education”, etc. These are significant, but extremely worthwhile, changes for New Zealand

    Integrating artificial intelligence into an ophthalmologist’s workflow: obstacles and opportunities

    Get PDF
    Introduction: Demand in clinical services within the field of ophthalmology is predicted to rise over the future years. Artificial intelligence, in particular, machine learning-based systems, have demonstrated significant potential in optimizing medical diagnostics, predictive analysis, and management of clinical conditions. Ophthalmology has been at the forefront of this digital revolution, setting precedents for integration of these systems into clinical workflows. Areas covered: This review discusses integration of machine learning tools within ophthalmology clinical practices. We discuss key issues around ethical consideration, regulation, and clinical governance. We also highlight challenges associated with clinical adoption, sustainability, and discuss the importance of interoperability. Expert opinion: Clinical integration is considered one of the most challenging stages within the implementation process. Successful integration necessitates a collaborative approach from multiple stakeholders around a structured governance framework, with emphasis on standardization across healthcare providers and equipment and software developers
    • 

    corecore