Economic Tools for Rural Health Planning

The full contribution of hospitals, clinics, pharmacies, etc to the rural economy often goes unrecognized. Quality health services are needed to attract businesses, and required for rural populations with a high proportion of elderly. This paper will share economic tools which can be used in any country to assist rural leaders in maintaining and advancing their health services. More specifically: 1. Health impact model to measure the economic impact of the health sector on a local economy 2. Community engagement tool to evaluate local health services; and 3. Health budget tools to determine the feasibility of a specific health service.Health Economics and Policy,

Barnes Hospital Bulletin

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Barnes Hospital Bulletin

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Barnes Hospital Bulletin

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Agonizing Choices: Syrian Refugees in Need of Health Care in Lebanon

The crisis in Syria, which entered its fourth year in March 2014, continues to take a devastating toll on the country's civilian population. More than 100,000 people have lost their lives, hundreds of thousands have suffered injuries, and civilian property and livelihoods are destroyed on a daily basis. The conflict has led to mass displacement. An estimated 6.5 million people are displaced within Syria, and 2.8 million refugees have fled to neighbouring countries and North Africa.Lebanon hosts over 1 million registered Syrian refugees, more than any other country, making it the largest per capita recipient of refugees in the world. This is in addition to hundreds of thousands of Syrians living in Lebanon without UN assistance and over 50,000 Palestinian refugees from Syria who have fled to Lebanon. Turkey hosts the second largest number of Syrian refugees, around 735,888 people, followed by Jordan, Iraq and Egypt. A small number of those fleeing Syria, some 81,000 people, have claimed asylum in the European Union (EU), Norway and Switzerland.The UN estimates that there will be over 1.5 million Syrian refugees in Lebanon by the end of 2014, which would constitute more than one third of Lebanon's population prior to the conflict in Syria.The social, economic and security strain on Lebanon resulting from hosting such a large number of people from Syria -- particularly given the country's already stressed infrastructure -- has been acknowledged by the international community. However, this has not translated into sufficient support for Lebanon. Health care, water and sanitation facilities, shelter, and other resources that were already strained have been put under further pressure due to the huge and rapid increase in population. Poverty and unemployment are expected to increase, putting financial pressure on a country which already faces one of the highest debt ratios globally.The political and security situation in Lebanon has also been deeply affected by the fighting in Syria with an upsurge in violence in border areas including Arsal in northeast Lebanon, in Tripoli in the north of the country, and in Beirut, Lebanon's capital.To help support the vast number of refugees in the country, the UN has appealed for US$1.7 billion for Lebanon in 2014, as part of a US$4.2 billion UN appeal for Syrian refugees.Yet at the time of writing, only 17% of the funding requirements for Lebanon for 2014 have been met. As a result of the lack of funding, many refugees from Syria are being left without adequate access to health care, food, shelter, water and sanitation, and education

Largest Mergers and Acquisitions by Corporations in 2005

[Excerpt] Mergers and acquisitions activity increased in 2004 over 2003 and 2005 looks to be an even bigger year for m&a. This report provides a listing of the largest mergers (announced value of at least two billion U.S. Dollars) or acquisitions during 2005 through November 18, 2005. Completion dates for the mergers or acquisitions are included and merger or acquisition failures noted. These data have been drawn from publicly available sources and have not been otherwise verified by CRS. This report will be updated monthly

The Association Between Health Literacy and Diet Adherence Among Primary Care Patients with Hypertension

This study examines the association between health literacy and adherence to low-salt diet practices among individuals with hypertension. Health literacy is the ability of individuals to understand and utilize health information. We surveyed 238 patients with hypertension from a primary care clinic in Charlotte, NC. We assessed health literacy and self-reported low-salt diet. Logistic regression was used to model the relationship between health literacy and low-salt diet adherence. Respondents were primarily female (67.3%) and black (80%). Black Americans were less likely to have adequate health literacy as compared to white Americans (21.8% vs. 55.8%). The study found no association between adequate health literacy and adherence to a low-salt diet (OR = 1.06, 95% CI: 0.36-3.10) after adjusting for confounders. This study addresses the conflicting findings for health literacy in two related areas: chronic illness self-care, and nutrition/diet skills. Additional research is warranted among black Americans given their increased risk of hypertension, low rates of diet adherence and previous findings of positive associations between health literacy and nutrition skills

Barnes Hospital Bulletin

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Barnes Hospital Record

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Spending Health Care Dollars Wisely: Can Cost-Effectiveness Analysis Help? 16th Annual Herbert Lourie Memorial Lecture on Health Policy

Are we getting the most health improvement possible for our money. In other words, are all the things that we do in medicine really worth it? That is where cost-effectiveness comes in. As a nation, we have been unwilling, at least publicly, to look explicitly at the value, in terms of improved health outcome, that we get for our health care dollars. With advances in medical technology putting unsustainable pressure on health care costs, our historical reluctance to measure value for health care may have to change. I start this brief by describing cost-effectiveness analysis as a method of determining the value, measured in Quality-Adjusted Life Years, of medical technologies as they are applied to treat, diagnose, or prevent various conditions. Based on this information, I then argue that some highly beneficial, low-cost procedures are significantly underutilized, and that other medical technologies may be overutilized based on the amount of health benefit they yield in relation to their cost. Next, I give examples from current research, my own and that of colleagues, illustrating how cost-effectiveness analysis can be used to guide the use of new diagnostic testing technologies (such as DNA or RNA typing of infectious agents or identification of genomic or proteinomic markers in cancer patients).