Health system design and performance: what can other countries learn from the Nordic experience?

<p class="Abstract"><span lang="EN-GB">Nordic health systems are amongst the strongest in the developed world. This paper discusses their strengths and lessons for other health systems under five headings: sources of finance, provider payment, organization, regulation, and persuasion. It attributes the good performance of Nordic systems to good governance of the institutions of health care, the behaviour and attitude of citizens, and high levels of cooperation in Nordic countries. The paper notes that there is only modest use of competition or payment incentives in the provider market. It suggests that improving information on the performance of providers and other institutions is an important priority for the future.</span></p

Departures from cost-effectiveness recommendations: The impact of health system constraints on priority setting

The methods and application of cost-effectiveness analysis have reached an advanced stage of development. Many decision makers consider cost-effectiveness analysis to be a valid and feasible approach towards setting health priorities, and it has been extensively applied in evaluating interventions and developing evidence based clinical guidelines. However, the recommendations arising from cost-effectiveness analysis are often not implemented as intended. A fundamental reason for the failure to implement is that CEA assumes a single constraint, in the form of the budget constraint, whilst in reality decision-makers may be faced with numerous other constraints. The objective of this paper is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance; and political constraints. Where possible -and if applicable- for each class of constraint, the paper discusses ways in which these constraints can be taken into account by a decision maker wishing to pursue the principles of cost-effectiveness

Matching novel face and voice identity using static and dynamic facial images

Research investigating whether faces and voices share common source identity information has offered contradictory results. Accurate face-voice matching is consistently above chance when the facial stimuli are dynamic, but not when the facial stimuli are static. We tested whether procedural differences might help to account for the previous inconsistencies. In Experiment 1, participants completed a sequential two-alternative forced choice matching task. They either heard a voice and then saw two faces or saw a face and then heard two voices. Face – voice matching was above chance when the facial stimuli were dynamic and articulating, but not when they were static. In Experiment 2, we tested whether matching was more accurate when faces and voices were presented simultaneously. The participants saw two face–voice combinations, presented one after the other. They had to decide which combination was the same identity. As in Experiment 1, only dynamic face–voice matching was above chance. In Experiment 3, participants heard a voice and then saw two static faces presented simultaneously. With this procedure, static face–voice matching was above chance. The overall results, analyzed using multilevel modeling, showed that voices and dynamic articulating faces, as well as voices and static faces, share concordant source identity information. It seems, therefore, that above-chance static face–voice matching is sensitive to the experimental procedure employed. In addition, the inconsistencies in previous research might depend on the specific stimulus sets used; our multilevel modeling analyses show that some people look and sound more similar than others

The effect of inserting an inter-stimulus interval in face-voice matching tasks

Voices and static faces can be matched for identity above chance level. No previous face- voice matching experiments have included an inter-stimulus interval (ISI) exceeding 1 second. We tested whether accurate identity decisions rely on high-quality perceptual representations temporarily stored in sensory memory, and therefore whether the ability to make accurate matching decisions diminishes as the ISI increases. In each trial, participants had to decide whether an unfamiliar face and voice belonged to the same person. The face and voice stimuli were presented simultaneously in Experiment 1, there was a 5 second ISI in Experiment 2, and a 10 second interval in Experiment 3. The results, analysed using multilevel modelling, revealed that static face-voice matching was significantly above chance level only when the stimuli were presented simultaneously (Experiment 1). The overall bias to respond same identity weakened as the interval increased, suggesting that this bias is explained by temporal contiguity. Taken together, the findings highlight that face-voice matching performance is reliant on comparing fast-decaying, high-quality perceptual representations. The results are discussed in terms of social functioning

Defining a Health Benefits Package: What Are the Necessary Processes?

There is immense interest worldwide in the notion of universal health coverage (UHC). A major policy focus in moving toward UHC has been on the key policy question: what services should be made available and under what conditions? In this article we are concerned with how a feasible set of UHC services can be explicitly defined to create what is commonly known as a “health benefits package” (HBP), a set of services that can be feasibly financed and provided under the actual circumstances in which a given country finds itself. We explain why an explicit statement of the HBP is important and then describe a framework that includes ten core elements that are indispensable if a coherent and sustainable process for setting the HBP is to be established

Measuring attitude towards Buddhism and Sikhism : internal consistency reliability for two new instruments

This paper describes and discusses the development and empirical properties of two new 24-item scales – one measuring attitude toward Buddhism and the other measuring attitude toward Sikhism. The scale is designed to facilitate inter-faith comparisons within the psychology of religion alongside the well-established Francis Scale of Attitude toward Christianity. Data were obtained from a multi-religious sample of 369 school pupils aged between 13 and 15 in London. Application of the two scales demonstrated that adolescents had a more positive attitude to Buddhism than Sikhism. The findings confirm the reliability of the scales and commend them for further use