Health service delivery profiles

노트 : Compiled in collaboration between WHO and Ministry of Health and Welfare, Republic of Kore

New Zealand regions, 1986 – 2001: Hospitalisation and some related health facts

Once age and gender composition is controlled for, regional health differentials are a function of problems of health service delivery, of socio-economic variance, and overall Māori Pakeha health differences. They indicate relative levels of exclusion and of inequality. This paper shows that these differentials follow in general the patterns seen in other papers in this series

Implications of the National Disability Insurance Scheme for health service delivery

Executive summary The National Disability Insurance Scheme (NDIS) is not a health scheme. The NDIS funds disability support and a range of related services designed to maximise the independence of a person with a disability. Health care is a specific exclusion. The NDIS is organisationally separate from both the health system and the aged care sector. At the national level, the NDIS is the responsibility of the Minister for Social Services (and not the Minister for Health) and is being administered by the National Disability Insurance Agency (NDIA), which is an independent statutory agency. While the NDIS is not a health scheme, and health care is a specific exclusion, it will intersect with the health system on a number of levels. To ensure the NDIS does not lead to fragmented care for participants, the Department of Health, the Department of Social Services and the NDIA will need to work closely to monitor and resolve any issues that arise during the implementation phase. This will require active, joint collaboration to develop appropriate policy responses.   Recommendations for action 1. Establish formal Department of Health, Department of Social Service and National Disability Insurance Agency tripartite working group with the following roles and responsibilities: Education and information for key targeted audiences regarding eligibility requirement and other key implications of the NDIS and the National Injury Insurance Scheme (NIIS) Workforce implications monitored and addressed in a coordinated manner Patient inequity issues monitored and coordinated policy responses undertaken Permanent and fluctuating impairment required coordinated care and active policy responses Mental health implications need to be better understood and coordinate actions to be taken to overcome barriers Service prevision boundary disputes between health and disability sectors require a resolution mechanism through negotiation rather than determined solely by the NDIA Timely access issues monitored and a fast track system for hospital referrals to/from the NDIS developed Inconsistency with the 2011 National Health Reform Agreement monitored and addressed as appropriate 2. While it is the responsibility of the Department of Social Services and the NDIA to work toward a nationally consistent approach as the scheme moves to full roll-out, the Department of Health should monitor roll-out to ensure health services are not negatively impacted. 3. Review the NDIS evaluation in order to inform the health system with applicable lessons. At the system level, the NDIS presents opportunities to learn more about individualised service planning and funding, and better ways to measure need and outcomes

Agency Discretion and Public Health Service Delivery

To study how changes in law shape the public health system. Data Sources . State newborn screening laws and the National Newborn Screening and Genetics Resource Center (NNSGRC). Study Design . A time-series, quasi-experimental design spanning the years 1990–2006 for all states and the District of Columbia was conducted. Analysis proceeded using a multinomial logit with a dependent variable of whether agencies lagged behind, were on target with, or led their newborn screening law. Explanatory variables of three different types of limitations on agency discretion plus relevant controls were included in the model. Data Collection . State laws were coded for three types of discretion: whether an agency can choose a state's newborn screening panel conditions, whether an agency can charge and change newborn screening fees, and whether the agency can define their own newborn screening criteria. Each state's newborn screening law for each year in the dataset was coded with respect to the mandated number of conditions on a panel and compared with the NNSGRC dataset of actual newborn screening implemented in the state. Principal Findings . States that lack condition discretion have 6.02 greater odds of lagging behind newborn screening law, but the presence of criteria discretion results in 7.50 higher odds of lagging behind the law. Condition discretion and fiscal discretion are associated with successful implementation. The presence of criteria discretion is a barrier for successful implementation. Conclusions . Agency discretion can both hinder and facilitate program implementation. Thus, type of discretion determines implementation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73813/1/j.1475-6773.2009.01010.x.pd

Between Communities and Health Facilities in Health Service Delivery: Reality or Myth?

Summary Health service delivery remains a challenge for rural Kenya. Health sector reforms have come in at a time when different models are being tried to improve access and utilisation of health services being offered by various providers, such as NGOs, government and private for?profit practitioners. This article will examine a model that World Neighbours has been trying out. It explores questions raised by this model such as: can community voices influence quality and type of service? Can communities access and use services being offered from a facility where they do not decide on management, staffing or supplies? Can the more vulnerable members access these services where they have to pay? What institutional arrangements spur the energy of a community to influence health service delivery? The article analyses the above questions in light of trends of health service delivery from 1990s to date in terms of policy environment versus reality on the ground, using the example of Mukuyuni Health Centre where World Neighbours has been operating

A Compendium of Existing Mechanisms for Meeting Health Needs in the Philippines

health sector, health management, health service delivery

Editorial: Conflict devastates health service delivery in South Sudan

No Abstrac