Pay-for-performance and tools for quality assurance in health care

Ongoing health care reforms in the countries of Southeast Europe (SEE) to modernise and promote the health sector include the introduction of innovative payment methods for health care providers in hospitals and outpatient services. The idea of remunerating health workers according to the work they do and the results they achieve has been present in the countries of SEE for more than four decades. This includes the need to develop and implement objective measures and criteria to regulate the work of health facilities and health professionals. Implementing the "Pay-for-performance" (P4P) model is a major challenge with the risk of compromising the quality of health services in all countries, and positive experiences for quality assurance have been modest in many countries around the world. Standards and norms (S/N), clinical pathways (CPW) and checklists (CL) are necessary regulatory tools that complement each other to protect the quality of health services and implement the "Payment for success" (P4S) model. The absence of S/N, CPW and CL in the implementation of the P4P model leads to inefficiencies, inadequate/unrealistic numbers, and poor quality of health services, as well as more frequent medical errors. With the development, introduction and implementation of S/N, CPW and CL in the application of the P4S model, everyone benefits: patients, healthcare organisations and their employees, health insurance companies, ministries of health and the state

Foundations of Health Education

The module covers principles and concepts of health education, different approaches to health education, assessing population health needs, health education methods and tools, as well as how to work with individuals (counselling methods), with small groups (including self-help groups), and with population. Health education is an important tool in overall promotion of health. Health education principles are directed to healthy life style and strengthening defense mechanisms by efficient contribution of individuals in the social life. Health education is important for entire population regardless of age, educational level, gender, health and other determinants. Health education should be adjusted to the local culture needs and possibilities. Health promotion program of the World Health Organization from 1984 and Declaration from Ottawa from 1986 represent a basis for an innovative approach toward health education based on the social concept of health and healthy life styles. The new broader approach ”Education for Health” beside relevant and precise information includes all spontaneous and organized actions directed toward health. An essential precondition for those actions is to provide such healthy environment where a healthy choice would be the easiest choice. In this way the control and responsibility for someone’s health are becoming an integrative part of everyday life of the individual, family, community and society through adopting healthy life styles, and creating supportive environments for health

Elizabeth Wager. GETTING RESEARCH PUBLISHED – An A to Z of Publication Strategy, Third Edition. Boca Raton, New York, London: CRC Press, Taylor & Francis Group, LLC, 2015. 188 pages; ISBN-13:978-1-78523-138-4 (Paperback) - CAT# K28669

PURPOSE: This book provides step-by-step guidance on developing a sound publication strategy for how to prepare and get research papers published. The book is a user-friendly guide, a route map for publishing that covers many topics, ranging from abstracts and blogs, tables and trial registration to ethical principles and conventions for writing scientific papers. Publishing the results of scientific research in the form of a scientific paper is the ultimate goal and the final stage of the research of each scientist. To write and publish papers is never going to be an easy task. With this book as their guide, researchers will be better informed and therefore should have an easier and altogether more pleasant path to publication with clear direction on how to choose the right journal, avoid publication delays, and resolve authorship disputes and many other problems associated with scientific publishing.CONTENTS: The 188 pages of the book are distributed in 5 chapters in Part I and 249 entries ordered by the letters of Alphabet in Part II creating an A to Z of publication strategy. In the Appendices there are four sections covering further reading, organizations, guidelines and principles of good publication practice for company-sponsored medical research. The book also contains key references and useful websites within many entries where it seemed helpful. The last ten pages of the book present an index to help users to find the information of interest in the book.CONCLUSION: The book is intended to help all authors, young and old, novice and experienced, to plan their research and publications effectively and prepare manuscripts for journals and other publications, increasing the likelihood that their work will be published. Providing essential information on publishing strategy and process, the book should be extremely useful to everyone who wants to publish research results

Contemporary Concept and Definition of Health Care

Paper gives a historical and theoretical overview of understanding and contemporary concept of health care and various levels of prevention (primary, secondary and tertiary prevention) in terms of the natural course / history of disease. Special emphasize is given to the primary prevention and preventive medicine, what is disease, how to prevent it, to cure it, and to make its consequences less harmful. Specific examples and practices are presented for the specific measures for prevention of disease, control of risk factors, prevention of mental disorders in susceptible individuals or populations, protective procedures for communicable diseases control, as well as monitoring and regulation of environmental pollutants. Primary prevention is to be distinguished from secondary prevention, which is the prevention of complications or after-effects of a drug or surgical procedure, and tertiary prevention, the amelioration of the after-effects of a disease

Patronage Nurses: The Outreach Nursing System a Milestone of Health Promotion

In the health systems of countries of South-East Europe, the public health services have maybe suffered the most during the last fifteen years, with depreciated infrastructure and in some cases outmoded public health interventions. Recent positive trend has been visible in rehabilitation and reinforcement of population based public health interventions. Health staff profile likely best to accomplish function of the community based health education and health promotion are nurses. The patronage outreach nurses have received comprehensive training on methodology and techniques of adult-learning. They have knowledge of epidemiology, community assessment, programme planning and evaluation, biostatistics, research, nursing theory, public health administration and history and politics. They are the milestone in achieving the main principles of community health with its’ participatory process to improve population health and the health promotion empowerment process to reduce social inequalities in health. Additionally, their scope of work helps in readdressing the injustice in health, identifies a complex and mutually interrelated problems that involves individuals, family and community and link them with the local culture, wider policy decisions, economic and socio-cultural forces

Health Promotion in Prevention of Drug Abuse: Guideliness for Primary Prevention of Drug Abuse, Attitude and Behaviour of Youngsters – Case Study Macedonia

Many countries in the world are facing the problem of drug use. The problem affects not just the user, but also his family and wider society. Different factors make youngsters particularly vulnerable towards drugs. Republic of Macedonia is facing significant increase in number of drug users during the last 15 years. Basic results of ESPAD survey are presented for Macedonia and other European countries. Few health education models for drug use prevention and the impact of those programs are discussed (SMART; DARE; Mia’s Diary; Just say no; WHO). Principles, based on the lessons learned from the previous experiences in different health education programs are presented

Social-economic Inequalities and Risk Groups Vulnerability in SEE Countries

The aim of this module is to explore the connection between certain social and economic factors and conditions as determinants of vulnerability and social exclusion of some risk groups and possible main changes in the health status of the population in South Eastern European countries within the last almost twenty years of post-communist transition. The available data regarding the demographics, economic and health statistics of the morbidity and causes of death, as well as the expected influence of various social-economic factors to certain risk and vulnerable groups and their possible health consequences, were analyzed. Based on the observations and conclusions, directions and suggestions are given for appropriate strategies and programmes directed toward mitigating and overcoming the adverse conditions and problems related to the health status and health protection of the vulnerable groups and the total population in the SEE countries

Level of Education and Health Status of the Different Social Groups: Case Study Macedonia

The educational level is an important indicator within the socioeconomical status for health evaluation and a powerful instrument in promotion of population’s health. In 2000 a study conducted in R. Macedonia, in 15 municipalities with different gross national product per capita, encompassing 1129 examinees older than 18 years. The results of the conducted research showed statistically significant association of the educational level with the morbidity. Higher morbidity emerges in persons that are illiterate (78,57%) and in those who have completed only 1-3 elementary school grades (77,08%). There is also an interaction between the mortality and the educational level. Persons with lower educational level have higher mortality rate. What kind of interaction is there between the educational level and the positive health? People with lower educational level are more susceptible to diseases; they are less informed which leads to a poor health. Morbidity and mortality rates are lower in people with higher educational level, who also have high level of self-informing that augments their health awareness and culture, leading towards positive health. According to many research studies, the mechanisms that link education to positive health are the employment and self-satisfaction with the job, healthy lifestyle, psycho-social resources etc. There is a mutual negative effect between poverty and lack of education that provides skills and information needed for managing the stress situations life brings with itself. Education, employment and incomes increase the capacity of self-control, and that condition strengthen the health in relation to the environment The social support, which is most frequent in persons with higher educational level, promotes health and decreases mortality through physiological mechanisms of the environment. People with higher educational level most likely will look for preventive health care (yearly check-ups for health control, immunization and other preventive examinations) and will probably not abuse alcohol and drugs. Preparation of various programs for applying the health education will contribute in the process of directing the individual to correct behavior that leads towards positive health, opposite the hostile influences of the social environment, which leads to bad quality in health (based on the education)

Macedonian Medical Association – Seventy Years from Its Establishment, 1945-2015

AIM: To present the phases of development and activities over the 70-year period of existence and work of the Macedonian Medical Association, from its establishment in 1945 to 2015.METHODS: A retrospective study based on available archive materials, encyclopaedias and other sources of information and reviews of the relevant literature, and personal experiences and observations of the author.RESULTS: Macedonian Medical Association was established on August 12, 1945, with science and health educational mission and program. Dr Boris Spirov was elected as the first president of the Association, one of the main initiators and facilitators of activities in health care sector, including the establishment of the Faculty of Medicine in Skopje in March 1947. Over the past 70 years, the Association is the main carrier and has a key role and contribution in continuing medical education, vocational and scientific advancement of medical staff and improvement the dignity and reputation of the medical profession. The journal of the Association Macedonian Medical Review has contributed to spreading and advancement of knowledge and skills of modern medicine, as well as presenting professional and scientific achievements of physicians in the past 70 years. Macedonian Medical Association is a member of the World Medical Association and many other international associations and organisations contributing to international collaboration in education and science and promoting the Republic of Macedonia in Europe and worldwide.CONCLUSION:Macedonian Medical Association over the 70-year period of its existence has been one of the pillars and lighthouse in the healthcare system in the Republic of Macedonia with great contribution to the advancement of medical and related sciences and continuing medical education, strengthening of health services and health care for the population and overall socio-economic development of the Republic of Macedonia during the past 70 years.Â

Social-economic Inequalities and Risk Groups Vulnerability in SEE Countries

The aim of this module is to explore the connection between certain social and economic factors and conditions as determinants of vulnerability and social exclusion of some risk groups and possible main changes in the health status of the population in South Eastern European countries within the last almost twenty years of post-communist transition. The available data regarding the demographics, economic and health statistics of the morbidity and causes of death, as well as the expected influence of various social-economic factors to certain risk and vulnerable groups and their possible health consequences, were analyzed. Based on the observations and conclusions, directions and suggestions are given for appropriate strategies and programmes directed toward mitigating and overcoming the adverse conditions and problems related to the health status and health protection of the vulnerable groups and the total population in the SEE countries