On Geographic Inequality in Japanese Regional Health Insurance

In Japan, economic stagnation due to the lack of aggregate demand has hit the regional health insurance system and this affects most retired pensioners. The fiscal state of insurers in rural areas deteriorated. This paper aims to investigate whether the regional disparities in medical levies per household make a contribution to income-related geographic inequalities in health care financing. Data of the central two regions of the Japanese National Health Insurance in 2005 were extracted. Their share of population was about 41.5 percent. Retired employees and self-employed individuals are covered by this insurance system. We conducted the geographic decomposition using the concentration index. The within-area inequality in medical levies mainly accounted for geographic inequality in medical levies per household. The hypothesis that there was no between-area inequality in medical levies was not rejected. We revealed the differences in the within-area inequality in medical levies in the central Kanto. This means such proportionality was not built into the NHI system through near constant contribution rates across the distribution of living standards. It can be considered that the differences in the within-area inequality were caused by the inequality in income per household and the multiplier of income levies. We found that income per household, the standard land price of residential districts and the size of an insurer are major determinants of the multiplier of income levies. The higher land price tends to greater the multiplier of income levies. The expansion of insurer's size increases the multiplier of income levies in most of districts. The inequality in the multiplier of income levies will reduce if local governments raise per-household levy in proportion to the size of an insurer and lower the multiplier of income levy.Decomposition, Inequality, Japan, Medical Levies, National Health Insurance

The Workforce Needs of New Jersey's Pharmaceutical and Medical Technology Industry

This report is based on an online survey conducted in spring 2006 of pharmaceutical and medical technology companies in New Jersey. It identifies the current and future workforce needs of the pharmaceutical and medical technology industry in New Jersey

Towards sustainable health care systems: Strategies in health insurance schemes in France, Germany, Japan and the Netherlands ; a comparative study

In all four countries health care expenditures grow while the revenue remains at the same level or even shrinks in many cases. Due to medical progress, ageing and many other factors the gap is widening over time. The pay-as-you-go approach is running against limits either with rising employer and employee contribution rates as is the case in the so-called Bismarck-Systems or with higher taxes in the so-called Beveridge-systems. There are differences regarding the solutions of each country to tackle the described challenge and they might be able to learn from each other if they are compared. Therefore the study compares the health care systems of France, Germany, Japan and the Netherlands. Due to the complexity of the different institutional settings it seems necessary to select certain criteria in order to make a comparison at all possible. The comparison is divided into three different sections. The institutional and organizational framework as first section compares the general organization of social health insurance in all four countries. It comprises the benefit structure, the enrolment, ownership issues and other criteria. The second section focuses on the funding of social health insurance comparing the different approaches according to criteria like contribution rates, contribution assessment bases, burden of contributions and others. The final section analyses different strategies in the provision and purchasing of health services in the four countries. Next to other hospital ownership infrastructure characteristics play an important role in this section. In the last part of the study certain lessons are drawn from the comparison of the four countries. Furthermore certain developments are described which can be anticipated for the future of social health insurance systems. -- Sowohl die demographische Entwicklung als auch vielfältige medizinische und medizinisch-technische Fortschritte führten in den letzten Jahren zu starken Ausgabensteigerungen in den sozialen Krankenversicherungssystemen. Neben Deutschland sind von dieser Entwicklung auch andere Länder mit sozialen Krankenversicherungssystemen betroffen. Die vorliegende Studie nimmt einen systematischen Vergleich zwischen verschiedenen Ländern vor, deren Gesundheitssystem auf einer sozialen Krankenversicherung aufbaut: Deutschland, Frankreich, Japan und die Niederlande. Anhand definierter Kriterien werden die unterschiedlichen Ausprägungsformen im Hinblick auf den organisatorischen und institutionellen Rahmen, die Mittelaufbringung sowie die Leistungserbringung bzw. die Mittelverwendung der einzelnen Länder verglichen. Anschließend werden mögliche Handlungsstrategien aus dem Vergleich abgeleitet, um den zukünftigen Herausforderungen zu begegnen und eine nachhaltige Entwicklung der sozialen Krankenversicherungssysteme sicherzustellen. Abschließend werden bestimmte Entwicklungen beschrieben, die für die sozialen Krankenversicherungssysteme antizipiert werden können.

International Profiles of Health Care Systems, 2011

This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views

Knowledge management and organizational culture

This paper explores the relationship between organisational knowledge, organisational culture, and Process Based Systems (PBS), in the U.K. National Health Service (NHS). Links between PBS and organisational culture have been observed before(Perry, 2003); the contribution made by PBS to organisational knowledge has also been suggested (Perry, 2004). However, links between organisational knowledge and organisational culture in the NHS have not been widely studied. A qualitative study of these links across clinical functions has been used in conjunction with a literature review to consider in particular the use of tacit knowledge and the role that might be played by PBS in mediating and sharing this "embedded" or experiential form of knowledge. While there may be some opportunity for "externalisation" (Nonaka, 1994) - the conversion of tacit to explicit knowledge, this paper argues that PBS may also contribute to "socialisation" - the direct generation of tacit knowledge by tacit knowledge.Process Based Systems, knowledge management, organisational culture

Philanthropy on the Road to Nationhood in Singapore Philanthropy in Asia: Working Paper No. 1

This paper attempts to address the gap in knowledge on the contributions by philanthropic players to national development in Singapore. Using grounded research, it explores the evolution of giving by individuals, the community and the private sector in Singapore from the end of World War II in 1945 to today. It looks at how each group gives towards prevailing social needs, unexpected events and crises as well as government calls for community support across fve key phases in Singapore's journey to nationhood. To provide context to the giving, the political and socio-economic situation of each time frame and concurrent government social welfare provisions in each phase are also described

An Exploratory Study of Patient Falls

Debate continues between the contribution of education level and clinical expertise in the nursing practice environment. Research suggests a link between Baccalaureate of Science in Nursing (BSN) nurses and positive patient outcomes such as lower mortality, decreased falls, and fewer medication errors. Purpose: To examine if there a negative correlation between patient falls and the level of nurse education at an urban hospital located in Midwest Illinois during the years 2010-2014? Methods: A retrospective crosssectional cohort analysis was conducted using data from the National Database of Nursing Quality Indicators (NDNQI) from the years 2010-2014. Sample: Inpatients aged ≥ 18 years who experienced a unintentional sudden descent, with or without injury that resulted in the patient striking the floor or object and occurred on inpatient nursing units. Results: The regression model was constructed with annual patient falls as the dependent variable and formal education and a log transformed variable for percentage of certified nurses as the independent variables. The model overall is a good fit, F (2,22) = 9.014, p = .001, adj. R2 = .40. Conclusion: Annual patient falls will decrease by increasing the number of nurses with baccalaureate degrees and/or certifications from a professional nursing board-governing body

Boston Hospitality Review: Spring 2014

Going to School on University Hotels by Matthew Arrants -- The Food Photography Trend: A Discussion of the Popular Trend and Tips on Taking Great Pictures by Laurel Greenfield -- Back to the Front: Improving Guest Experiences at The Langham, Hong Kong by Michael Oshins -- The Healthy Hotel by John D. Murtha -- Southern New England’s Middle-Skill Gap: Dilemma for the Hospitality Industry by Erinn D. Tucke