Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

Background. Taiwan's primary community care network (PCCN) demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals) within individual PCCNs. Methods. The thorough questionnaire items, covering the network working infrastructures - governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003-2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results. Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion. There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at the early stage of network forming in this study, the detailed surveyed items, the concepts proposed by the managerial and theoretical professionals, could be a guide for those health care providers who have willingness to turn their business into multi-organizations. © 2007 Lin; licensee BioMed Central Ltd.published_or_final_versio

Healthy cities and sustainable innovation

In this chapter, the conceptualization of healthy city including its characteristics and societal benefits are discussed. To build and sustain healthy cities, a well-established approach found in literature is reviewed. Furthermore, more recent literature has been calling for more effective city-level systems to deal with constant and fast-changing city health conditions as city-immigration is hitting global record high and thus the challenge is ever more difficult. A particularly debated area is the impact of foreign direct investment (FDI) on health of cities of host countries. Recent emerging trend identifiable in recent literature is the seeking and promotion of building technologically-smart and resource-sustainable cities. The chapter concludes by highlighting some important future considerations for public policy bodies

O Movimento Cidades/Municípios Saudáveis: um compromisso com a qualidade de vida The Healthy Cities Movement: a commitement with quality of life

O Movimento Cidades/Municípios Saudáveis, desde a década de 1970, vem envolvendo cada vez maior número de cidades e atores em vários países e divulgando uma prática que representa uma nova forma de pensar e fazer saúde. O movimento tem como objetivo um produto social, a qualidade de vida da população e pressupõe a existência de problemas concretos de pessoas vivendo em um território. Representa uma nova forma de gestão municipal, baseada na ação intersetorial e exige, ao mesmo tempo, um protagonismo do Estado e a participação da sociedade civil como parceira na consecução dos objetivos. No Brasil há, até o momento, 19 municípios envolvidos com a proposta, mas somente 13 estão com projetos ativos. Os resultados dos esforços estão começando a ser visualizados, trazendo novas perspectivas em termos de desenvolvimento social e sustentado, bem como de melhoria das condições de saúde e qualidade de vida.<br>The Healthy Cities Movement has been involving an increasing number of cities and actors in several countries of the world since the 70's, and has been divulging a practice that represents a new form of thinking and working on health which aims at constructing a social product - quality of life of the population. This new proposal presupposes the existence of people living in a territory with concrete problem. It represents a new form of city administration based on intersectorial action and demands the protagonism of the state, as well as the participation of civil society in the accomplishment of new objectives aiming at changing the city profile. In Brazil there are so far 19 municipal districts involved with Healthy Cities' proposal but only 13 with active projects. The results of the efforts of these municipal districts are beginning to become visible and to bring new perspectives in terms of social and sustained development and the improvement of health conditions and quality of life