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Journal ArticleDOI

International comparison of health care systems using resource profiles

01 Jan 2000-Bulletin of The World Health Organization (World Health Organization)-Vol. 78, Iss: 6, pp 770-778

TL;DR: A simple framework for comparing data underlying health care systems is presented, which distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures.

AbstractThe most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despite important criticisms of this method, relatively few alternatives have been used in practice. A simple framework for comparing data underlying health care systems is presented in this article. It distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures. Measures of real resources are further subdivided according to whether their factor prices are determined primarily in national or global markets. The approach is illustrated using a simple analysis of health care resource profiles for Denmark, France, Germany, Sweden, the United Kingdom, and the USA. Comparisons based on measures of both real resources and expenditures can be more useful than conventional comparisons of expenditures alone and can lead to important insights for the future management of health care systems.

Topics: Health care (64%), International health (59%), Gross domestic product (54%), Public health (53%), Human resources (52%)

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Citations
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Journal Article
TL;DR: The findings emphasize the need to implement effective and low cost management regimens based on absolute levels of cardiovascular risk appropriate for the economic context and reduce the average blood pressure in the population.
Abstract: Objective To evaluate the prevalence, awareness, treatment and control of hypertension among elderly individuals in Bangladesh and India. Method A community-based sample of 1203 elderly individuals (670 women; mean age, 70 years) was selected using a multistage cluster sampling technique from two sites in Bangladesh and three sites in India. Findings The overall prevalence of hypertension (WHO–International Society for Hypertension criteria) was 65% (95% confidence interval = 62–67%). The prevalence was higher in urban than rural areas, but did not differ significantly between the sexes. Multiple logistic regression analyses identified a higher body mass index, higher education status and prevalent diabetes mellitus as important correlates of the prevalence of hypertension. Physical activity, rural residence, and current smoking were inversely related to the prevalence of hypertension. Among study subjects who had hypertension, 45% were aware of their condition, 40% were taking anti-hypertensive medications, but only 10% achieved the level established by the US Sixth Joint National Committee on Detection, Evaluation and Treatment of Hypertension (JNC VI)/WHO criteria. A visit to a physician in the previous year, higher educational attainment and being female emerged as important correlates of hypertension awareness. Conclusions Our findings emphasize the need to implement effective and low cost management regimens based on absolute levels of cardiovascular risk appropriate for the economic context. From a public health perspective, the only sustainable approach to the high prevalence of hypertension in the Indian subcontinent is through a strategy to reduce the average blood pressure in the population.

203 citations


Journal ArticleDOI
TL;DR: Spending on health care in the United States has been rising at a faster pace than spending in the rest of the economy since the 1960s and is expected to reach $4.0 trillion and amount to 20% of the GDP by 2015.
Abstract: This position paper concerns improving health care in the United States. Unlike previous highly focused policy papers by the American College of Physicians, this article takes a comprehensive approach to improving access, quality, and efficiency of care. The first part describes health care in the United States. The second compares it with health care in other countries. The concluding section proposes lessons that the United States can learn from these countries and recommendations for achieving a high-performance health care system in the United States. The articles are based on a position paper developed by the American College of Physicians' Health and Public Policy Committee. This policy paper (not included in this article) also provides a detailed analysis of health care systems in 12 other industrialized countries. Although we can learn much from other health systems, the College recognizes that our political and social culture, demographics, and form of government will shape any solution for the United States. This caution notwithstanding, we have identified several approaches that have worked well for countries like ours and could probably be adapted to the unique circumstances in the United States.

156 citations


Cites background from "International comparison of health ..."

  • ...The differences in total and per capita expenditures appear to be due primarily to higher prices in the United States and greater intensity of services, including greater use and earlier dispersion of technology (60)....

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Journal ArticleDOI
TL;DR: The prevalence of penicillin-nonsusceptible pneumococci is sharply divided between France and Germany, and the overarching importance of a sociocultural approach to preventing antibiotic resistance in the community is emphasized.
Abstract: The prevalence of penicillin-nonsusceptible pneumococci is sharply divided between France (43%) and Germany (7%). These differences may be explained on different levels: antibiotic- prescribing practices for respiratory tract infections; patient-demand factors and health-belief differences; social determinants, including differing child-care practices; and differences in regulatory practices. Understanding these determinants is crucial for the success of possible interventions. Finally, we emphasize the overarching importance of a sociocultural approach to preventing antibiotic resistance in the community.

152 citations


Cites background from "International comparison of health ..."

  • ...Moreover, living standards, expenditures on health, and key survival statistics (infant deaths, life expectancy) are roughly equivalent, which allowed us to assume that at least in terms of general health indicators both countries could be judged to be comparable (4)....

    [...]


MonographDOI
TL;DR: The authors conclude by proposing concrete public policy measures that governments can introduce to strengthen and improve the effectiveness of community involvement in health care financing.
Abstract: Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable populations absent, and government oversight of the informal health sector lacking. In this context of extreme public sector failure, community involvement in the financing of health care provides a critical albeit insufficient first step in the long march towards improved access to health care by the poor and social protection against the cost of illness. Health Financing for Poor People stresses that community financing schemes are no panacea for the problems that low-income countries face in resource mobilization. They should be regarded as a complement to - not as a substitute for - strong government involvement in health care financing and risk management related to the cost of illness. Based on an extensive survey of the literature, the main strengths of community financing schemes are the extent of outreach penetration achieved through community participation, their contribution to financial protection against illness, and increase in access to health care by low-income rural and informal sector workers. Their main weaknesses are the low volume of revenues that can be mobilized from poor communities, the frequent exclusion of the very poorest from participation in such schemes without some form of subsidy, the small size of the risk pool, the limited management capacity that exists in rural and low-income contexts, and their isolation from the more comprehensive benefits that are often available through more formal health financing mechanisms and provider networks. The authors conclude by proposing concrete public policy measures that governments can introduce to strengthen and improve the effectiveness of community involvement in health care financing.

151 citations


Journal ArticleDOI
TL;DR: An integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making is presented, drawing on a framework for health systems performance assessment.
Abstract: Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. Conceptual and methodological issues for selecting indicators for HRH monitoring and evaluation are discussed, and a range of primary and secondary data sources that might be used to generate indicators are reviewed. Descriptive analyses are conducted drawing primarily on one type of source, namely routinely reported data on the numbers of health personnel and medical schools as covered by national reporting systems and compiled by the World Health Organization. Regression techniques are used to triangulate a given HRH indicator calculated from different data sources across multiple countries. Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources' representation. Evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues. In order to enhance cross-national comparability, data collection efforts should be processed through the use of internationally standardized classifications (in particular, for occupation, industry and education) at the greatest level of detail possible.

120 citations


References
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Book
15 May 2009
Abstract: "Human Capital" is Becker's study of how investment in an individual's education and training is similar to business investments in equipment. Becker looks at the effects of investment in education on earnings and employment, and shows how his theory measures the incentive for such investment, as well as the costs and returns from college and high school education. Another part of the study explores the relation between age and earnings. This edition includes four new chapters, covering recent ideas about human capital, fertility and economic growth, the division of labour, economic considerations within the family, and inequality in earnings.

12,071 citations


Posted Content
Abstract: A diverse array of factors may influence both earnings and consumption; however, this work primarily focuses on the impact of investments in human capital upon an individual's potential earnings and psychic income. For this study, investments in human capital include such factors as educational level, on-the-job skills training, health care, migration, and consideration of issues regarding regional prices and income. Taking into account varying cultures and political regimes, the research indicates that economic earnings tend to be positively correlated to education and skill level. Additionally, studies indicate an inverse correlation between education and unemployment. Presents a theoretical overview of the types of human capital and the impact of investment in human capital on earnings and rates of return. Then utilizes empirical data and research to analyze the theoretical issues related to investment in human capital, specifically formal education. Considered are such issues as costs and returns of investments, and social and private gains of individuals. The research compares and contrasts these factors based upon both education and skill level. Areas of future research are identified, including further analysis of issues regarding social gains and differing levels of success across different regions and countries. (AKP)

7,856 citations


Journal ArticleDOI
TL;DR: The United States has the lowest percentage of the population with government-assured health insurance, and it also has the fewest hospital days per capita, the highest hospital expenditures per day, and substantially higher physician incomes than the other OECD countries.
Abstract: In 1997 the United States spent $3,925 per capita on health or 13.5 percent of gross domestic product (GDP), while the median Organization for Economic Cooperation and Development (OECD) country spent $1,728 or 7.5 percent. From 1990 to 1997 U.S. health spending per capita increased 4.3 percent per year, compared with the OECD median of 3.8 percent. The United States has the lowest percentage of the population with government-assured health insurance. It also has the fewest hospital days per capita, the highest hospital expenditures per day, and substantially higher physician incomes than the other OECD countries. On the available outcome measures, the United States is generally in the bottom half, and its relative ranking has been declining since 1960.

180 citations


BookDOI
01 Jan 1999
TL;DR: Part 1: health care and cost containment in the EU - an overview - health care systems, health care spending, cost containment measures,cost containment measures in practice, Eli Mossialos and Julian Le Grand and Panos Kanovos.
Abstract: Part 1: health care and cost containment in the EU - an overview - health care systems, health care spending, cost containment measures, cost containment measures in practice, Eli Mossialos and Julian Le Grand cost containment and health expenditure in the EU - a macroeconomic perspective, Panos Kanovos is there convergence in health expenditures of the EU member states?, Adelina Comas-Herrera. Part 2: cost containment and health care reform in Belgium, David Crainich and Marie-Christine Closon health care and cost containment in Denmark, Terkel Christiansen et al cost containment in Germany - 20 years experience, Reinhard Busse and Chris Howorth cost containment and health care in Greece, Aris Sissouras et al cost containment in health care - the case of Spain, Guillem Lopez i Casanovas 20 years of cures for the French health care system, Pierre-Jean Lancry and Simone Sandier health expenditure and cost containment in Ireland, Jenny Hughes cost containment and structural reforms in the Italian national health service, Giovanni Fattore cost containment in health care - the case of Luxembourg, Elias Mossialos developments in health care cost containment in the Netherlands, Mirjam van het Loo et al health expenditure and cost control in Austria, Engerbert Theurl health care reform and cost containment in Portugal, Joao Pereira et al cost containment in Finnish health care, Unto Hakkinen health care forms and cost containment - the Swedish experience, Anders Anell and Patrick Svarvar cost containment and health care reforms in the British NHS, Giovanni Fattore.

162 citations


Journal ArticleDOI
TL;DR: Two of the most seasoned observers of comparative health system research and a colleague provide the latest data and some commentary upon them for the health care enterprises of the twenty-four countries that are members of the Organization for Economic Cooperation and Development (OECD).
Abstract: Prologue: Changes in the way health care systems finance services are often driven by some combination of data, public pressure, payer receptivity, and the expressed views of the medical profession and allied disciplines. In this paper, two of the most seasoned observers of comparative health system research and a colleague provide the latest data and some commentary upon them for the health care enterprises of the twenty-four countries that are members of the Organization for Economic Cooperation and Development (OECD). George Schieber is director of the Office of Research at the U.S. Health Care Financing Administration (HCFA). Jean-Pierre Poullier is principal administrator, Directorate for Social Affairs, Manpower, and Education for the OECD in Paris. Leslie Greenwald is a health policy analyst in the HCFA Office of Research and also a doctoral candidate in public policy at the University of Virginia. The OECD's health database provides the most current road map available to compare the status of the ...

117 citations