Suchergebnisse

We study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of general practitioners (GPs). In the secondary care market there are two hospitals choosing quality and specialisation. Patients, who are ex ante uninformed, can consult a GP to receive an (imperfect) diagnosis and obtain information about the secondary care market. We show that hospital competition is amplified by higher GP attendance but dampened by improved diagnosing accuracy. Therefore, compulsory gatekeeping may result in excessive quality competition and too much specialisation, unless the mismatch costs and the diagnosing accuracy are sufficiently high. Second-best price regulation makes direct regulation of GP consultation redundant, but will generally not implement first-best.

Cover -- Title -- Copyright -- CONTENTS -- INTRODUCTION -- CHAPTER 1: THE MOUNTING COSTS OF HEALTH CARE -- WHERE HAS THE COMMUNITY DOCTOR GONE? -- THE GROWING ROLE-AND GROWING COST-OF TECHNOLOGY -- WHILE COSTS SOARED, AMERICANS LOST CARE -- A STEP TOWARD HEALTH CARE FOR EVERYONE -- CHAPTER 2: THE WHAT, WHY, AND HOW OF HEALTH INSURANCE -- WHAT IS INSURANCE? -- HOW DOES HEALTH INSURANCE WORK? -- HEALTH INSURANCE COMES OF AGE -- A DETERMINED PRESIDENT FACES THE CHALLENGE -- CHAPTER 3: GOVERNMENT, INSURANCE, AND THE HEALTH CARE INDUSTRY: WHY CAN'T THEY ALL AGREE? -- A CENTURY OF CONTENTIOUS PROPOSALS -- COST AND CONTROL: THE GREAT DIVIDE -- INSURING THE UNINSURED -- IS THE FREE MARKET THE ANSWER? -- CHAPTER 4: ETHICAL DILEMMAS IN HEALTH CARE DECISIONS -- ALLOCATION OF LIMITED RESOURCES -- AN OUNCE OF PREVENTION OR A POUND OF CURE? -- THE PRICE OF MEDICAL MISTAKES -- CHAPTER 5: THE FUTURE OF HEALTH CARE -- CONSTITUTIONAL CHALLENGES -- The Claim: The Plan Is Unconstitutional -- The Claim: The Plan Is Constitutional -- THE FUTURE OF HEALTH CARE IN AMERICA -- THE MEASURES OF SUCCESS -- GLOSSARY -- FOR MORE INFORMATION -- WEB SITES -- FOR FURTHER READING -- BIBLIOGRAPHY -- INDEX -- ABOUT THE AUTHOR -- PHOTO CREDITS

volume 1. A-L -- volume 2. M-Z ; Glossary ; Organizations ; State health insurance exchanges ; State health agencies ; Top health insurance companies ; Federal health information centers and clearinghouses ; Toll-free numbers for health information ; General index.

In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.

Background: Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal.Methods: A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal. A structured questionnaire and observation checklist were used for data collection.Results: The waste generation rate is found significantly correlated with bed capacity, patient flow rate and annual budget spent in the hospital. It is found significantly higher in Teaching hospital than other Health Care Institutions of Nepal. An average of 3.3 kg/day/patient of medical waste (2.0 kg/day/patient non-hazardous and 1.0 kg/day/patient hazardous waste) was generated during the study period. Further, it was found that most of the Health care wastes were not disinfected before transportation to waste disposal sites. Very limited number of Health Care Institutions had conducted Environmental Assessment. Similarly, some of the Health Care Institutions had not followed Health care waste management guideline 2009 of Nepal Government.Conclusions: We found poor compliance of medical waste management practice as per existing legislation of Government of Nepal. Hence, additional effort is needed for improvement of Health care waste management practice at Health Care Institutions of Nepal.