Управление здравоохранением

[Наталья П.]

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Making Health Care Safer
"Сделать медицинскую помощь безопаснее"
Большое полнотекстовое руководство (англ)

[Наталья П.]

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Resources on Appropriate Healthcare Technologies for the Developing World

The Report on the 4th IET International Seminar on Appropriate Healthcare Technologies for Developing Countries which was held in London on 23-24 May 2006 can be found. Сlicking on Read a report on the 4th seminar.

You will need to be logged into the website before you can download the report.

[Наталья П.]

The State of Health Quality 2006

National committee for quality assurance
Washington

pdf файл
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[Наталья П.]

This database contains literature articles about the costs and/or benefits of health information technology, and is searchable by the user in a variety of ways.
It also contains information about how this database was created.

This database was developed by Southern California Evidence Based Practice Center - RAND under a contract from the Agency for Healthcare Research and Quality. It includes scientific data about the implementation of health IT, as documented in studies published through 2003.

All studies initially reviewed were screened for data on barriers to adoption and implementation. For this analysis, qualitative studies that were primarily focused on barriers and studies that collected quantitative data on barriers were included. Studies in which barriers were briefly discussed, but were not a primary focus, were excluded. A primary focus on barriers was identified through reviewer consensus.

The evidence-based practice report developed by RAND, summarizing the conclusions drawn from this database, can be accessed at

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[Наталья П.]

Welcome to Health and Quality of Life Outcomes
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[Наталья П.]

Журнал "Управление здравоохранением"
Health Technol Assess. 2007 Feb;11(5):1-178.

A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines.

Raynor DK, Blenkinsopp A, Knapp P, Grime J, Nicolson DJ, Pollock K, Dorer G, Gilbody S, Dickinson D, Maule AJ, Spoor P.

Pharmacy Practice and Medicines Management Group, School of Healthcare, University of Leeds, UK.

OBJECTIVES: To establish the role and value of written information available to patients about individual medicines from the perspective of patients, carers and professionals. To determine how effective this information is in improving patients' knowledge and understanding of treatment and health outcomes.
DATA SOURCES: Electronic databases searched to late 2004, experts in information design, and stakeholder workshops (including patients and patient organisations).
REVIEW METHODS: Data from selected studies were tabulated and the results were qualitatively synthesised along with findings from the information design and stakeholder workshop strands.
RESULTS: Most people do not value the written information they receive. They had concerns about the use of complex language and poor visual presentation and in most cases the research showed that the information did not increase knowledge. The research showed that patients valued written information that was tailored to their individual circumstances and illness, and that contained a balance of harm and benefit information. Most patients wanted to know about any adverse effects that could arise. Patients require information to help decision-making about whether to take a medicine or not and (once taking a medicine) with ongoing decisions about the management of the medicine and interpreting symptoms. Patients did not want written information to be a substitute for spoken information from their prescriber. While not everyone wanted written information, those who did wanted sufficient detail to meet their need. Some health professionals thought that written information for patients should be brief and simple, with concerns about providing side-effect information. They saw increasing compliance as a prime function, in contrast to patients who saw an informed decision not to take a medicine as an acceptable outcome.
CONCLUSIONS: The combination of a quantitative and qualitative review, an exploration of best practice in information design, plus the input of patients at stakeholder workshops, allowed this review to look at all perspectives. There is a gap between currently provided leaflets and information which patients would value and find more useful. The challenge is to develop methods of provision flexible enough to allow uptake of varying amounts and types of information, depending on needs at different times in an illness. This review has identified a number of areas where future research could be improved in terms of the robustness of its design and conduct, and the use of patient-focused outcomes. The scope for this research includes determining the content, delivery and layout of statutory leaflets that best meet patients' needs, and providing individualised information, which includes both benefit and harm information. In particular, studies of the effectiveness and role and value of Internet-based medicines information are needed.

[Наталья П.]

Бюллетень бесплатных информационных ресурсов, Февраль 2007 г.
Инфосеть «Здоровье Евразии» [Ссылки доступны только зарегистрированным пользователям ]


Измерение эффективности первичной медицинской помощи (Measuring the Performance of Primary Health Care) (на англ.яз.)

Автор: Университет Британской Колумбии. Центр исследований в области медицинских услуг и политики здравоохранения (University of British Columbia. Centre for Health Services and Policy Research).

Описание: “… Ввиду своей ключевой роли, первичная медицинская помощь (ПМП) в течение длительного времени была в центре мероприятий по ее обновлению, и не так давно она улучшилась в результате серьезных правительственных инвестиций. Тем не менее... в Канаде отсутствует самая элементарная возможность измерения и мониторирования нашей системы ПМП. Нам мало известно о том, как структурированы системы ПМП в различных провинциях Канады, как реализуются услуги по оказанию ПМП и о том, насколько эффективны эти услуги.”

Как получить: Через Интернет в формате PDF [37 с.]
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Регулирование частного медицинского страхования в Европейском Союзе: влияния законодательства общего рынка и соревновательной политики. (Regulating private health insurance in the European Union: the implications of single market legislation and competition policy) (2006) (на англ.яз.)

Автор: Сара Томсон, Элиас Моссиалос (Sarah Thomson, Elias Mossialos). Лондонская школа экономики и политических наук.

Описание: Рабочий документ No. 4/2006. “….Данный документ рассматривает влияния единого рынка страховых услуг на регулирование частного медицинского страхования в Европейском Союзе. Он рассматривает области неопределенности в интерпретации третьей директивы по страхованию, не связанному с страхованием жизни, особенно применительно к тому, когда и как правительства могут регулировать частное медицинское страхование, и ставит вопросы о способности Директивы обеспечить защиту потребителей и социальную защиту на рынках медицинского страхования.”

Как получить: Через Интернет в формате PDF [30 с.]
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Австралия: обзор системы здравоохранения. Системы здравоохранения переходного периода (Australia: Health system review. Health Systems in Transition) (2006) (на англ.яз.)

Автор: Джудит Хили, Эвелин Шарман, Буддима Локуге (Judith Healy, Evelyn Sharman, Buddhima Lokuge). Всемирная Организация Здравоохранения – Европейская обсерватория по системам и политике здравоохранения.

Описание: “… Профили переходных систем здравоохранения (ПСЗ) – это отчеты, основанные на отдельных странах, в которых приводится детальное описание системы здравоохранения и инициатив в области политики здравоохранения, находящихся в становлении или в стадии формирования. ПСЗ изучают различные подходы к организации, финансированию и предоставлению медицинской помощи и роли ведущих действующих лиц в системах здравоохранения; описывают сеть институтов, процесс, содержание и внедрение политики здравоохранения и оказания медицинской помощи, а также выявляет те трудности и сферы, которые требуют дополнительного углубленного анализа.”

Как получить: Через Интернет в формате PDF [178 с.]
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[Наталья П.]

There is a nice list in the report *2003-Review of Hospital Quality Reports for Health Care Consumers*, *Purchasers and* *Providers*. /IPRO Rep./, IPRO, Lake Success. at:
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USA Today has an article in today's paper with a focus of state reported transparency:

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bibliography:

#1 Consumer Checkbook
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Consumer Checkbook is a consumer publisher and Web site supported by the
Center for the Study of Services, a Washington, D.C., nonprofit
organization. Its guide includes "desirability" ratings for hospitals
based on surveys of physicians, risk-adjusted mortality figures, and
adverse outcome rates for several surgical procedures. The desirability
scores are just a matter of physician

Hospital Compare
Hospital Compare - Hospital Compare was created by the Centers for
Medicare & Medicaid Services (CMS), an agency of the U.S. Department of
Health and Human Services (DHHS) along with the Hospital Quality
Alliance (HQA). The HQA was founded to the reporting of hospital quality
of care. The HQA counts among its member's organizations that represent
consumers, doctors, employers, hospitals, accrediting organizations and
Federal agencies.
Hospital Compare uses quality measures to determine how often hospitals
provide recommended care to obtain the best results for most patients.
Measures include treatment for a heart attack, heart failure, pneumonia,
or having surgery. Visit the Hospital Compare website at
[Ссылки доступны только зарегистрированным пользователям ].
opinion. The mortality and outcome information is based on 1996-99 Medicare data, so it's out of date. The Web version of the guide can be hard to follow. The guide costs $19.95, either in print or through the Web site.

#2 National Voluntary Hospital Reporting Initiative
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This is Medicare's foray into hospital quality rating. So far, three conditions are covered: heart attack, heart failure, and pneumonia.
Hospitals have been asked to provide information on certain aspects of care for those conditions - for example, the percentage of heart attack patients that receive an aspirin upon arrival. Each hospital's performance is compared with results for the top 10% and 50% of hospitals. For example, if 99% of heart attack patients at the top 10% of hospitals get an aspirin upon arrival, but only 70% of the patients at your hospital do, maybe heart attack care at your hospital isn't what it should be. This is just a pilot project, so many hospitals aren't listed. It would be helpful to have some explanation for why these particular aspects of care are important.

#3 Select Quality Care
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Select Quality Care is a Web site developed by HealthShare Technology, an Acton, Mass., company. Unlike the other sites on this list , it's not accessible to the public - only to people enrolled in health plans that HealthShare has contracts with. At least one other company is selling a similar, members-only report card Web site to health plans. One nice feature of the site is that the hospital rankings depend on how you
personally rate the importance of patient volume, mortality rates, and several other factors. If you revise your preferences you can see how it affects the rankings. The site also has graphics that make the averages for your area clear, so you can easily tell whether a hospital falls above or below the mean.

#4 NCQA
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National Committee for Quality Assurance (NCQA),
It is a private, independent nonprofit health care quality oversight organization that measures and reports on health care quality and unites diverse groups around a common goal: improving health care quality.
NCQA, has demonstrated several successful provider-level measurement initiatives connected to P4P programs, notable among them Bridges to Excellence programs in several markets, physician recognition programs, the Integrated Healthcare Association's P4P initiative in California, the National Forum on Performance Benchmarking of Physician Offices and Organizations, and health plan accreditation

#5 National Quality Healthcare Award, presented by the National Quality Forum.
The award is conducted in partnership with Modern Healthcare and underwritten by the Cardinal Health Foundation. Prior awards were presented by the National Сommittee for Quality Health Care, which merged with the NQF last year. The criteria were revamped, and this year's award puts more emphasis on use of standardized quality measures and public reporting of performance data.


#6 Solucient
Top 100 Hosptials
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4-bafc-4d77c5a323f4%40sessionmgr2


#7 HealthGrades - Information on Hospitals, Doctors and Nursing Homes
Information on: Hospital Quality Report. Quality Ratings; 32 Common Procedures and Diagnoses; Award Recipients ... and much more! ...
Stock quote for HGRD
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#8 J.D. Power Consumer Center
Check out the hospital's quality ratings provided by a number of different organizations, including HealthGrades ([Ссылки доступны только зарегистрированным пользователям ]),
The Leapfrog Group ...
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#9 Quality Check
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[Наталья П.]

performance and reporting this performance on their Web site, Hospital
Compare. It is unknown whether these process performance measures are
related to hospital-level outcomes.


#12
The Surgical Care Improvement Project (SCIP) is a national partnership
of organizations committed to improving the safety of surgical care
through the reduction of post-operative complications. Partners in the
SCIP believe that a meaningful reduction in complications requires that
surgeons, anesthesiologists, perioperative nurses, pharmacists,
infection control professionals and hospital executives work together to
intensify their commitment to making surgical care improvement a
priority.
In addition to continuing to reduce surgical site infections (SSIs), the
SCIP Partnership is broadening the scope of the new national project by
targeting additional adverse events to include cardiac, respiratory and
venous thromboembolic complications.

Quality Measures
Acute Myocardial Infarction (AMI):
Aspirin at arrival
Aspirin prescribed at discharge
Beta Blocker at arrival
Beta Blocker prescribed at discharge
ACE inhibitor or ARB for left ventricular systolic dysfunction
Optional Measures:
Smoking cessation advice/counseling
Thrombolytic agent received within 30 minutes of hospital arrival
PCI received within 120 minutes of hospital arrival
Heart Failure (HF):
Left ventricular function assessment
ACE inhibitor/ARB for left ventricular systolic dysfunction
Optional Measures:
Discharge instructions
Smoking cessation advise/counseling
Pneumonia (PNE):
Initial antibiotic received within four hours of hospital arrival
Oxygenation assessment within 24 hours of hospital arrival
Pnuemococcal vaccination
Optional Measures:
Blood culture performed prior to the initial antibiotic received in the
hospital
Initial antibiotic selection for community acquired pneumonia in
immunocompetent patients
Adult smoking cessation advice/counseling
Influenza vaccination

#13
IHI 5 Million Lives Campaign

The Institute for Healthcare Improvement (IHI) has launched the 5
Million Lives Campaign, an initiative to protect patients from five
million incidents of medical harm over the next two years (December 2006
- December 2008)
Proven Interventions
The 5 Million Lives Campaign challenges American hospitals to adopt 12
changes in care that save lives and reduce patient injuries:
The six interventions from the 100,000 Lives Campaign
* Deploy Rapid Response Teams...at the first sign of patient
decline
* Deliver Reliable, Evidence-Based Care for Acute Myocardial
Infarction...to prevent deaths from heart attack
* Prevent Adverse Drug Events (ADEs)...by implementing medication
reconciliation
* Prevent Central Line Infections...by implementing a series of
interdependent, scientifically grounded steps
* Prevent Surgical Site Infections...by reliably delivering the
correct perioperative antibiotics at the proper time
* Prevent Ventilator-Associated Pneumonia...by implementing a
series of interdependent, scientifically grounded steps

New interventions targeted at harm
* Prevent Harm from High-Alert Medications... starting with a
focus on anticoagulants, sedatives, narcotics, and insulin
* Reduce Surgical Complications... by reliably implementing all of
the changes in care recommended by SCIP, the Surgical Care Improvement
Project ([Ссылки доступны только зарегистрированным пользователям ])
* Prevent Pressure Ulcers... by reliably using science-based
guidelines for their prevention
* Reduce Methicillin-Resistant Staphylococcus aureus (MRSA)
infection...by reliably implementing scientifically proven infection
control practices
* Deliver Reliable, Evidence-Based Care for Congestive Heart
Failure... to avoid readmissions
* Get Boards on Board ... by defining and spreading the best-known
leveraged processes for hospital Boards of Directors, so that they can
become far more effective in accelerating organizational progress toward
safe care


#14
The Appropriate Care Measure Identified Participant Group
The Appropriate Care Measure (ACM) Identified Participant Group (IPG) is
a hospital initiative designed to bring transformational change to the
health care arena and raise the bar for performance to provide the right
care for every patient, every time.
Project Goals
Provide information and assistance to assess and improve
hospital systems in managing three clinical conditions -- Acute
Myocardial Infarction, Heart Failure and Pneumonia -- and ten publicly
reportable quality-of-care measures
Expand public reporting of performance measures to include all
Hospital Quality Alliance (HQA) proposed indicators
ACM Scoring Methodology
The ACM is a composite measure based upon five AMI measures, two Heart
Failure measures, and three Pneumonia measures. All patients eligible
for at least one of the ten measures are counted in the denominator. To
be counted in the numerator, the patient must receive all of the care
specified by the measures that the patient is eligible for. There is no
weighting in this calculation.
For example:
Mr. S is admitted with an AMI, and by chart abstraction, is eligible for
aspirin and Beta Blockers but is not eligible for ACEI or ARB upon
discharge. Mr. S is eligible for
Aspirin upon arrival
Aspirin at discharge
Beta Blocker at arrival
Beta Blocker prescribed at discharge
Chart abstraction results:
Received aspirin upon arrival? Yes
Received aspirin at discharge? Yes
Received Beta Blocker at arrival? Yes
Received Beta Blocker at discharge? No
Analysis:
Mr. S fails the ACM because a single element of care for which he is
eligible was not provided, namely the Beta Blocker at discharge.
The move to a patient-centric measure rather than a process-centric
measure is in keeping with the CMS mantra of "The Right Care for Every
Person Every Time." Given this change, it is important to realize that
if you are doing well at every process but one, your score CANNOT exceed
your weakest score.

#15

Home Health Quality Initiative Quality Measures for Public Reporting
OASIS Outcome Measure Consumer Language
Improvement in upper body dressing Patients who get better at
getting dressed
Improvement in bathing Patients who get better at bathing
Stabilization in bathing Patients who stay the same (don't get
worse) at bathing
Improvement in toileting Patients who get better getting to and
from the toilet
Improvement in ambulation/locomotion Patients who get better at
walking or moving around
Improvement in transferring Patients who get better at getting in
and out of bed
Improvement in management of oral medications Patients who get better
at taking their medicines correctly (by mouth)
Improvement in confusion frequency Patients who are confused less
often
Improvement in pain interfering with activity Patients who have less
pain when moving around
Acute care hospitalization Patients who had to be admitted to the
hospital
Any emergent care provided Patients who need urgent, unplanned
medical care


#16

The Leapfrog Group
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1. What measures are included in Leapfrog Hospital Insights?
Leapfrog Hospital Insights measures quality, efficiency and overall
performance in five clinical areas. The quality measures are a
combination of Joint Commission Accreditation of Healthcare
Organizations (JCAHO) core measures - processes of care that should be
standard for every applicable admission - and the Leapfrog Hospital
Quality and Safety Survey, which focuses on patient safety practices
known to reduce preventable medical mistakes. The Leapfrog Hospital
Insights efficiency measure is the first nationally collectable and
comparable measure of hospital resource efficiency. The five areas of
inpatient care measured by Leapfrog Hospital Insights are the following:

* Acute myocardial infarction (AMI), commonly known as heart
attack;
* Coronary artery bypass graft (CABG), commonly known as bypass
surgery;
* Percutaneous coronary intervention (PCI), commonly known as
angioplasty;
* Community-acquired pneumonia (CAP); and
* Deliveries/newborn care.

#17
Quality Tools
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okup_id=528&mode=4

#18
Quality Indicator Project (QI Project)
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#19
National Quality Measures Clearinghouse:
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#20
National Quality Forum (NQF) [Ссылки доступны только зарегистрированным пользователям ]
Note: Norton Healthcare is a member of NQF.
* hospital care
* cardiac surgery - also see - The Society for Thoracic Surgeons
(STS)
* nursing-sensitive care
* ambulatory (physician office) care
* safe practices

#21
Norton HealthCare Quality Report
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Quality Indicators Included:

Patient satisfaction
Nursing care

Antibiotic susceptibility
Patient safety

Infection control
Other indicators

Surgery
Childbirth

Pneumonia
Childbirth - other

Heart failure
Children

Heart attack
Safe practices

Cardiovascular procedures
Cancer survival rates

Physician office care
Data validity

[Наталья П.]

#24
The Vermont Oxford Network
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* Neonatal mortality by birth weight
#25
National Database of Nursing Quality Indicators
#26
American Nurses Association's National Database of Nursing Quality
Indicators (NDNQI)National Database of Nursing Quality Indicators
(NDNQI) .
#27
Improving America's Hospitals: A Report on Quality and Safety" released
by the Joint Commission


#28
Institute of Medicine

#29
National Patient Safety Foundation
[Ссылки доступны только зарегистрированным пользователям ]


#29
National Healthcare Quality Report (NHQR), sponsored by the US Agency
for Healthcare Quality and Research


#8
OECD Health Care Quality Indicators Project - multiple panels within?

#29
President's Advisory Commission on Consumer Protection and Quality in
the Health Care Industry

#30
National Committee for Quality Assurance
#31
National Quality Forum (NQF)


#32
Ambulatory Care Quality Alliance,
[3] a national consortium of key stakeholders that includes physicians,
employers, government agencies, health insurance plans, and accrediting
organizations all working together, announced consensus on a uniform
starter set of 26 ambulatory performance measures

#33
NHRQ


#22
Joint Commission for Accreditation of Healthcare Organizations (JCAHO)
* National Patient Safety Goals
JCAHO and the Centers for Medicare and Medicaid Services (CMS)
* Indicators (these are included in the NQF Hospital Care
indicators)
The Agency for Healthcare Research and Quality (AHRQ)
* Patient Safety Indicators (PSIs) and Inpatient Quality
Indicators (IQIs)
Note: For consistency with other indicators in the Norton Healthcare
Quality Report, we show the AHRQ indicators as percentages rather than
as rates per 1,000.
Additional pediatric indicators come from
JCAHO's ORYX indicators, which we collect through:
#23
The BENCHmarking Effort for Networking Children's Hospitals (MMP)
* Asthma readmissions and returns to the Emergency Department#34
National Forum on Performance Benchmarking of Physician Offices and
Organizations
See handout on physician performance

#35
US National Healthcare Quality Report.


#36
IHI Global Trigger Tool for Measuring Adverse Events.
Griffin FA, Resar RK. IHI Innovation Series white paper. Cambridge, MA:
Institute for Healthcare Improvement; 2007.


Patient Safety Indicators
Hospital Quality Alliance
CMS/ Doctors Office Quality
Physician Consortium for Performance Improvement/AMA


This link will take you to a 2003 report of Review of Hospital Quality
Reports 36 total
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[Наталья П.]

[Ссылки доступны только зарегистрированным пользователям ]

The German Agency for Quality in Medicine

[Наталья П.]

Во имя безопасности: десять разборов случаев снижения вреда для пациентов (Committed to Safety: Ten Case Studies on Reducing Harm to Patients)(2006) (на англ.яз)

Автор: Д. Маккарти [D. McCarthy], Д. Блюменталь [D. Blumenthal]. Фонд содружества [The Commonwealth Fund]
Описание: “В этом докладе представлены 10 случаев изучения работы лечебно-профилактических учреждений, клинических бригад и обучающих сотрудничеств, создавших новаторские идеи в пяти областях, являющихся многообещающими для улучшения безопасности пациентов в национальном масштабе, а именно: пропаганда организационной культуры безопасности, улучшение работы в команде и общения, усиление быстрого реагирования для предотвращения инфаркта миокарда и других кризисных ситуаций в стационаре, профилактика инфекций, связанных с лечением в отделении интенсивной терапии и реанимации, и предотвращение проявления побочного действия медикаментов во всей больнице…. Вообще, эти случаи демонстрируют тот факт, что улучшения можно добиться в любом учреждении, где имеется руководство, целенаправленное применение методов и желание измениться во имя безопасности пациентов.”
Как получить: Имеется в режиме online в формате PDF [98 стр.]
URL: [Ссылки доступны только зарегистрированным пользователям ]

[Наталья П.]

Рациональный путь вперед для Национальной системы здравоохранения Англии. Дискуссионный доклад об альтернативном подходе к реформе здравоохранения – май 2007 г. (A rational way forward for the NHS in England. A discussion paper outlining an alternative approach to health reform - May 2007) (на англ.яз)

Автор: Британская медицинская ассоциация (BMA)
Описание: “Доктора на ежегодной конференции BMA в 2006 г. выразили свою тревогу, связанную с непоследовательностью политической линии правительственной системы Национального здравоохранения… 24 рекомендации призывают к альтернативному пути вперед, с помощью которого можно оказывать лучшие услуги пациентам при сохранении основных моральных ценностей NHS.”
Как получить: Имеется в режиме online в формате PDF [82 стр.]
URL: http://www.bma.org.uk/ap.nsf/AttachmentsByTitle/PDFrationalwayforward/$FILE/rationalwayforward.pdf


Финансирование здравоохранения: в 2008 г. и впоследствии (Funding Health Care: 2008 and Beyond) (на англ.яз)

Автор: Джон Эпплби [John Appleby] (редактор). King’s Fund
Описание: Из доклада на саммите в Leeds Castle. “С целью содействия информированию обсуждения финансирования здравоохранения в течение последующего периода длительностью от пяти до десяти лет Фонд организовал в Leeds Castle встречу старших менеджеров, экономистов здравоохранения и советников по нормативно-правовому регулированию. Они обсудили не только то, какой уровень общественного финансирования реален и желателен, но также и процесс, с помощью которого следует принимать подобные решения, а также концептуальную основу, что должна направлять и информировать тех, кто отвечает за нормативно-правовое регулирование здравоохранения. Данный документ включает презентации по ключевым аспектам проводящихся в настоящее время системных реформ и резюме обсуждений….”
Как получить: Имеется в режиме online в формате PDF [85 стр.]
URL: [Ссылки доступны только зарегистрированным пользователям ]

[Наталья П.]

[Ссылки доступны только зарегистрированным пользователям ]
the Cochrane Effective Practice and Organisation of Care Review Group

As a review group of the Cochrane Collaboration, the focus of EPOC is on
reviews of interventions designed to improve professional practice and the
delivery of effective health services. This includes various forms of
continuing education, quality assurance, informatics, financial,
organisational and regulatory interventions that can affect the ability of
health care professionals to deliver services more effectively and
efficiently. The site includes training guides and tools for EPOC review
authors, links to EPOC protocols and systematic reviews, background on the
scope of the group, an online form for anyone interested in joining EPOC,
and information about the development of the EPOC specialised register.

[Наталья П.]

Стратегии достижения универсального охвата: Почерпнуты ли уроки из стран со средним доходом? 2007
(Strategies to achieve universal coverage: are there lessons from middle income countries?)
(на англ.яз)

Автор:
Anne Mills, Программа экономики и финансов здравоохранения, Лондонская школа гигиены и тропической медицины

Описание
Обзор литературы, проведенный по заказу Инфосети систем здравоохранения Комиссии по социальным детерминантам здоровья Всемирной Организации Здравоохранения (Health Systems Knowledge Network World Health Organisation's Commission on Social Determinants of Health). "Страны, которым еще предстоит достичь универсального охвата, рассматривают множество вариантов стратегий, способных приблизить их к поставленной цели. С учетом того, что универсальный охват требует перекрестных субсидий различных типов, особенно, со стороны более богатых групп населения в пользу менее обеспеченных, политическая динамика и более широкие социальные влияния исключительно важны в своем воздействии и на выбор стратегий, и на темп прогресса."

Как получить
Имеется в виде файла PDF [42 стр.]

[Ссылки доступны только зарегистрированным пользователям ]