182 research outputs found
World Cities Project: New York, Paris, London, Tokyo Fact Sheet
The World Cities Project (WCP) originated as a joint research project between the International Longevity Center-USA and New York University's Robert F. Wagner Graduate School of Public Service. It has since grown to include the active involvement of the ILC-France, ILC-Japan, and ILC-UK. Also the City of Paris Department of Health and Social Affairs, the London Regional Office of the British National Health Service, the Tokyo Metropolitan Government Bureau of Health and Social Welfare, and the New York City Department of Aging and Department of Health have provided important support to the project. The project compares health, social services, and quality of life for persons aged 65 and over in the four largest urban agglomerations in the countries belonging to the Organization for Economic Cooperation and Development (OECD): New York, Paris, Tokyo and London.Although these four cities have been the subject of numerous studies in the fields of architecture and urban planning, there have been few comparative studies of health and social services. Additionally, the WCP introduces a spatial perspective to more conventional economic and demographic analyses of population aging and longevity issues. Most comparative analyses of health systems focus on national averages that mask important variations within smaller jurisdictions. In contrast, the WCP relates smaller, more comparable units providing notable advantages for cross-national learning
Meeting the Challenge of Diabetes in China
China’s estimated 114 million people with diabetes pose a massive challenge for China’s health policy-makers who have significantly extended health insurance coverage over the past decade. What China is doing now, what it has achieved, and what remains to be done should be of interest to health policy-makers, worldwide. We identify the challenges posed by China’s two principal strategies to tackle diabetes: (1) A short-term pilot strategy of health promotion, detection and control of chronic diseases in 265 national demonstration areas (NDAs); and (2) A long-term strategy to extend health promotion and strengthen primary care capacity and health system integration throughout China. Finally, we consider how Chinese innovations in artificial intelligence (AI) and Big Data may contribute to improving diagnosis, controlling complications and increasing access to care. Health system integration in China will require overcoming the fragmentation of a system that still places excessive reliance on local government financing. Moreover, what remains to be done resembles deeper challenges faced by healthcare systems worldwide: the need to upgrade primary care and reduce inequalities in access to health services
Cities and Health: A Response to the Recent Commentaries
We are grateful to our many colleagues who took the time to respond to our analysis of Shanghai’s declining “avoidable mortality.”1 The range of their perspectives across 5 recent commentaries reassures us that the topic is worthy of sustained study. Indeed, the presumption behind our comparative research on healthcare in world cities 2 is that the city is a strategic unit of analysis for understanding the health sector and that world cities share a host of important characteristics
Reduce Avoidable Hospitalisations: A Policy to Increase Value from Health Care Expenditures
An interdisciplinary examination of rates of avoidable hospitalizations in France and England to evaluate access to primary care and identify the extent to which these countries may be able to reduce hospital costs by investing in disease management and primary care
Public health and medical care for the world's factory: China's Pearl River Delta Region
While the growth of urbanization, worldwide, has improved the lives of migrants from the hinterland, it also raises health risks related to population density, concentrated poverty and the transmission of infectious disease. Will megacity regions evolve into socially infected breeding grounds for the rapid transmission of disease, or can they become critical spatial entities for the protection and promotion of population health? We address this question for the Pearl River Delta Region (PRD) based on recent data from Chinese sources, and on the experience of how New York, Greater London, Tokyo and Paris have grappled with the challenges of protecting population health and providing their populations with access to health care services. In some respects, there are some important lessons from comparative experience for PRD, notably the importance of covering the entire population for health care services and targeting special programs for those at highest risk for disease. In other respects, PRD's growth rate and sheer scale make it a unique megacity region that already faces new challenges and will require new solutions
The Health Policy and Management (HPAM) gap - from diagnosis to prescription: a response to recent commentaries
On Health Policy and Management (HPAM): mind the theory-policy-practice gap
We argue that the field of Health Policy and Management (HPAM) ought to confront the gap between theory,
policy, and practice. Although there are perennial efforts to reform healthcare systems, the conceptual barriers are
considerable and reflect the theory-policy-practice gap. We highlight four dimensions of the gap: 1) the dominance
of microeconomic thinking in health policy analysis and design; 2) the lack of learning from management theory and
comparative case studies; 3) the separation of HPAM from the rank and file of healthcare; and 4) the failure to expose
medical students to issues of HPAM. We conclude with suggestions for rethinking the field of HPAM by embracing
broader perspectives, e.g. ethics, urban health, systems analysis and cross-national analyses of healthcare systems
Needed: Global Collaboration for Comparative Research on Cities and Health
Over half of the world’s population lives in cities and United Nations (UN) demographers project an increase of
2.5 billion more urban dwellers by 2050. Yet there is too little systematic comparative research on the practice of
urban health policy and management (HPAM), particularly in the megacities of middle-income and developing
nations. We make a case for creating a global database on cities, population health and healthcare systems.
The expenses involved in data collection would be difficult to justify without some review of previous work,
some agreement on indicators worth measuring, conceptual and methodological considerations to guide the
construction of the global database, and a set of research questions and hypotheses to test. We, therefore, address
these issues in a manner that we hope will stimulate further discussion and collaboration
Shanghai rising: health improvements as measured by avoidable mortality since 2000
Over the past two decades, Shanghai, the largest megacity in China, has been coping with unprecedented
growth of its economy and population while overcoming previous underinvestment in the health system
by the central and local governments. We study the evolution of Shanghai’s healthcare system by analyzing
“Avoidable Mortality” (AM) – deaths amenable to public health and healthcare interventions, as previously
defined in the literature. Based on analysis of mortality data, by cause of death, from the Shanghai Municipal
Center for Disease Control and Prevention, we analyze trends over the period 2000–10 and compare
Shanghai’s experience to other mega-city regions – New York, London and Paris. Population health status
attributable to public health and healthcare interventions improved dramatically for Shanghai’s population
with permanent residency status. The age-adjusted rate of AM, per 1,000 population, dropped from 0.72
to 0.50. The rate of decrease in age-adjusted AM in Shanghai (30%) was comparable to New York City
(30%) and Paris (25%), but lower than London (42%). Shanghai’s establishment of the Municipal Center
for Disease Control and Prevention and its upgrading of public health and health services are likely
to have contributed to the large decrease in the number and rate of avoidable deaths, which suggests
that investments in public health infrastructure and increasing access to health services in megacities –
both in China and worldwide – can produce significant mortality declines. Future analysis in Shanghai
should investigate inequalities in avoidable deaths and the extent to which these gains have benefitted the
significant population of urban migrants who do not have permanent residency status
BRIC Health Systems and Big Pharma: A Challenge for Health Policy and Management
Abstract
BRIC nations – Brazil, Russia, India, and China – represent 40% of the world’s population, including a growing
aging population and middle class with an increasing prevalence of chronic disease. Their healthcare systems
increasingly rely on prescription drugs, but they differ from most other healthcare systems because healthcare
expenditures in BRIC nations have exhibited the highest revenue growth rates for pharmaceutical multinational
corporations (MNCs), Big Pharma. The response of BRIC nations to Big Pharma presents contrasting cases
of how governments manage the tensions posed by rising public expectations and limited resources to satisfy
them. Understanding these tensions represents an emerging area of research and an important challenge for all
those who work in the field of health policy and management (HPAM)
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