Tag Archives: Health care

Health Policy Analysis Institutes: India, Thailand, and Vietnam Case Studies

11 Dec

Each country, especially the emerging ones, have to back their health policy on the evidence brought by the research focused on health systems in order to implement  sound, balanced health services for their citizens. Thailand Vietnam and India present in the video below their national institutes devoted to health systems research.

 

International Health Policy: Comparative Health Care Systems

10 Dec

How to explain the differences across North America and Western Europe regarding the policies of health coverage (mandatory in one hand, private initiative in the other hand)? The response has to be searched in the past history on both side of the Atlantic Ocean. Feudalism in Europe made government to be considered by people as a good thing which liberated them from oppression of the King and feudal lords while in North America, Government rules are associated in people’s mind with the oppression of the English government which imposed taxes before the independence. At least it is the theory exposed by Henry J. Kaiser Jr. Professor of Health and Research Policy Emeritus at Stanford.

Health services research

21 Oct

Recently I found a definition of the field I am interested in:  ie the health services research. Wikipedia defines it as ” to examine how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care.” quoting Academyhealth in the references.

Putted more simply, and according to Academyhealth, HSR tries to give responses to 4 questions in the field of health care in a community:

What works?
For whom?
At what cost?
Under what circumstances?

Read more here

 

A health services author blog

12 May

I would like to share an interesting Blog written by a French physician adviser of the French Social Security.

Drug companies use direct-to-prescriber advert...

Drug companies use direct-to-prescriber advertising in an effort to convince prescribers to dispense as written with brand-name products rather than generic drugs. (Photo credit: Wikipedia)

Written in French it gives good advises to insured people but also to care providers for dealing with the administrative rules which, as every body knows, are some times indubitably complicated. I congratulate this health services author for giving a consequent part of his time to the writing of this useful website accessible to the lay person as well as to the professional.
As often when the author of a blog belongs to an administration or a company under the supervision of the government, the blogger seems to prefer to stay anonymous since I was unable to find the name of the author. But nevertheless the content is noticeable since it addresses such sensitive topics as work loss compensation, pay for performance, off label prescription, psycho social disorders at work, disability, generic drugs, new drug approval etc…

More content:

A scientific speech addressed to medical journalists

21 Apr

When Gary Schwitzer talks at a health care journalists congress the result is the below brilliant course of medical research methodology.

The way health care journalists report the lowering of risk linked to a medical or pharmaceutical intervention has an impact on the size of the interest the public will give to the so-called innovative therapy. The example chosen by Gary with Nolvadex and breast cancer risk is very striking (see slide 36).

Thank you Gary Schwitzer for this very informative lecture which benefits not only to journalists but also to health care consumers (i.e. all of us).

The hospital CEO was an infiltrated FBI agent

19 Mar

In the suburbs of Chicago, the gangsters are chased by a 61 year old woman, CEO of the Edward Hospital.

Gov. "Hot Rod" Blagojevich @ Illinoi...

Gov. "Hot Rod" Blagojevich @ Illinois State University (Photo credit: Wikipedia)

Congrats to the courageous CEO of Edward Hospital, Naperville, Illinois who helped the FBI to nail a high ranked state politician for corruption. Like in spy movies Pamela Davis wore a recording device in her bra and gave the rendez-vous for tapes transfers to the FBI agent in her preferred make-up and perfume shop (she nevertheless kept being a women in addition to being a spy). The enquiry lasted two endless years during which Pamela incurred a high level of psychological stress. She putted herself in danger in the aim to defend the health services on behalf of the Illinois population from dragging in the sludge of corruption and kickbacks. She feared for her physical integrity once when she crossed the precise man she was on the way to record on the tape while she was hooking her microphone in a parking-lot. Indeed in exchange of the administrative authorization for building a new premise for the hospital need, the governor’s board (the Illinois Health Facilities Planning Board) wanted absolutely a friend of him (Jacob Kiferbaum), construction entrepreneur, being hired. But now that the governor Rod Blagojevich has been convicted and sent in jail for 14 years in Colorado she is relieved. The conclusion of the story could be that a career in health services can lead to play spy games.
The Edward Hospital serves the Chicago area and its western suburbs. It employs 4400 employees including 1000 physicians. It is a regional healthcare provider of complex medical and surgical specialties.
This woman of 61 years of age should be a model and an example for all the health services servants.

Press releases:

http://www.fiercehealthcare.com/story/hospital-ceo-whistleblower-takes-down-corrupt-governor/2012-03-16?utm_medium=nl&utm_source=internal

http://qctimes.com/news/state-and-regional/illinois/wearing-an-fbi-wire-she-brought-down-a-governor/article_5c0c2d7b-9e0e-524d-b379-2a0cafcd5148.html

http://triblocal.com/naperville/2012/03/14/edward-ceo-proud-of-role-in-corruption-probe/

http://heraldnews.suntimes.com/news/11273506-418/edward-ceo-finds-vindication-as-blago-heads-to-prison.html

http://triblocal.com/naperville/files/cache/2012/03/Pam-Davis.jpg/460_345_resize.jpg

Europe is the theater of a Greek tragedy

14 Feb

When egoism strikes men, it is also contagious for nations.

English: The logo of Greece's health ministry.

Image via Wikipedia

I have selected for the benefit of my readers some articles issued by The Lancet, a prestigious medical journal, focusing on the consequences of the Greek economic and political crisis on Health Services. Greece is in Europe; nevertheless this country seems abandoned by the Europeans. After the world war two in Europe, starting from ruins, a welfare system was reconstructed. Nowadays it seems like we assist exactly to the reverse: Europe, starting from a well build welfare system is being ruined. In both cases only the will of human beings is at work. After World war two those men in charge were the former resistance fighters while now they are bankers and traders. Even perhaps the latter could be the grand sons of the formers. With their Marshall plan the USA helped Europe in the past. But now it seems that no one would stand up for that purpose.

Greece’s financial crisis dries up drug supply:

Eva Karamanoli; http://www.thelancet.com Vol 379 January 28, 2012

Resume: The pharmacies run short of medicine as important as Parkinson treatment or Epilepsy treatment. International pharmaceutical laboratories hesitate to deliver their product to Greece because of the lowering that government imposed to the price of medicines in the context of health budgets cuts. Patients have to pay in cash pharmacist before holding medicine because social security funds take months to reimburse; if not wholesalers cannot deliver the drug to the pharmacist.

 

Health eects of financial crisis: omens of a Greek tragedy:

Alexander Kentikelenis, Marina Karanikolos, Irene Papanicolas, Sanjay Basu, Martin McKee, David Stuckler; http://www.thelancet.com Vol 378 October 22, 2011

Resume: The rate of suicides has grown during the crisis, as well of the rate of HIV or Sexual Transmissible Infections (secondary to an increase of drug users and prostitution). Criminality rates have also increased (homicide and theft). Primary care practitioner consultations have not been implemented although they were needed while rate of admission in public hospitals has increased.

 

Increased suicidality amid economic crisis in Greece

Marina Economou, Michael Madianos, Christos Theleritis, Lily E Peppou, Costas N Stefanis; http://www.thelancet.com Vol 378 October 22, 2011

Resume: The suicide rate has increased by 40% since the beginning of the crisis. It is highly associated with the economic distress in the surveyed population.

 

IMF and European co-workers attack public health in Greece

Konstantinos Triantafyllou, Chryssi Angeletopoulou ; http://www.thelancet.com Vol 378 October 22, 2011

Resume: At the demand of the International Monetary Fund and the European Central bank, health care spending cuts will lead Greece to lose 26 000 public health workers (of whom up to 9100 doctors). According to the author the inevitable consequence will be the worsening of the health of the population as it has been already observed in all the countries previously “aided” by the IMF in the world. But this latest fact is contested by the IMF.

 

Debt crisis strains Greece’s ailing health system

Eva Karamanoli; http://www.thelancet.com Vol 378 July 23, 2011

Resume: In order to cut spending, clinics will be merged and a special body of primary care will be created to alleviate the public hospital’s burden. Indeed, in one hand public hospitals are lacking or in short supply of elementary material such as gloves, IVs, gazes or medicines and the patients undergoes long waiting times while in the other hand people use public hospitals instead of private practices not to have to advance the money because Social security reimbursements have to be waited for months.

To say it short, the overall situation is: Health insurance fund owes money to health providers who themselves owes money to wholesalers who owes money to pharmaceutical industry. The health services strongly have to be rebooted in Greece.

 

Greek academic psychiatry and neurology before the firing squad?

Thomas Paparrigopoulos, Ioannis Liappas; http://www.thelancet.com Vol 378 July 23, 2011

The most important psychiatric hospital in Greece whose chiefs of departments are also keys opinion leaders in their speciality experience a 30 % budget cut. Greek academic psychiatrists are now an endangered specie which need urgently to be preserved.

 

Works consulted (in the same order):

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673612601299.pdf

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611615560.pdf

 

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611616383.pdf

 

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611616395.pdf

 

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611611525.pdf

 

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611611586.pdf

 

Le quotidien du médecin

10 Jan

Today is a celebration day. One of the most read daily medical news-paper in France, especially by general practitioners, has just quoted, in its January 9th, 2012 issue, the Health Services Authors blog.


The author of a letter published by the Quotidien du Médecin, Dr Olivier Guilhot, a general practitioner giving primary cares in a disadvantaged suburb of Marseilles, made a reference to two posts of the Health Services Authors blog: this one and this one.
I’m very pleased that this blog could be used as a material in an interesting debate about the risk of moral hazard attached to the declarative side of the financial incentives attribution procedure in the brand new P4P implemented in France last summer. This is the mission statement of health services authors blog to participate and fuel all the discussions in the health services policy provided that they are grounded on sound research results. If I do not endorse the entire contents of the letter nevertheless I was sensitive to some very stylish excerpts like for example the evocation of the ghosts of fathers of the social security system in 1945 (now all dead), victorious of the Nazis, inheriting the solidarity spirit from the concentration camps, assisting to an actual meeting and standing up and leaving the assembly when hearing a health care provider saying that it’s just sufficient to declare you succeeded the objectives to receive the financial incentive. I know the great majority of my colleagues are not that greedy. But here we touch the critical point: the moral hazard like insurers say.

Walmart

22 Nov
A typical Wal-Mart discount department store i...

Image via Wikipedia

According to a Kaiser Health News  report Wal-Mart is questioning the possibility to enter in primary health care by the mean of opening retail clinics in its stores.

A document written by the company contains the following statement: “Walmart intends to build a national, integrated, low-cost primary care healthcare platform that will provide preventative and chronic care services that are currently out of reach for millions of Americans.”

Retail clinics provide primary cares and preventive cares within a retail store. Are they an opportunity to reach the poorest patients or a risk of bad quality cares? A study published in the anal of internal medicine try to respond to the question. If Walmart enter in the primary care health market they will bring in their efficacy in reaching each American with 138 millions of them visiting their store every week. Some thinks it is a unique opportunity to enhance the productivity of the primary cares and to lower health care costs. More studies are needed to evaluate the quality of cares provided in retail clinics.

Two studies address the location of and the prices practiced by retail clinics and compare their efficacy with other primary cares providers.

Medical homes

9 Nov
Chalmette, LA, December 16, 2005 - A patient r...

Image via Wikipedia

An international telephone administered poll on primary care for patients suffering from chronic condition finds a highest satisfaction rate and efficacy for Medical homes as compared with traditional regular primary care practitioner.

These findings are not surprising (a Porsche goes faster than a Traban!). But the issue, not addressed by the study, is the cost of such medical homes for social security systems.

In France only 52 % of sicker adults suffering from a severe chronic condition had a medical home as defined by the study versus 74 % in the UK. France ranks near US (56 %) and Australia (51 %).

Access to the study here: Health Aff-2011-Schoen-hlthaff.2011.0923

The poll and the study were funded by a private foundation named The commonwealth fund.

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