Suchergebnisse

Cover -- CONTENTS -- PREFACE -- INTRODUCTION -- PART I -- 1 HISTORICAL BACKGROUND -- Towards an international economy -- Colonialism -- Emigration and the export of capital -- Why did not all countries develop? -- Economic development between the wars -- A world order comes into being -- The institutional framework -- Economic recovery in Europe and Japan -- The world order begins to function -- The developing countries in the world economy -- Decolonisation -- The economic development of the developing countries -- Critique of the existing order -- Poor and less poor developing countries -- The threat from the developing countries -- A world order in crisis -- 2 THE DEVELOPING COUNTRIES' DEMANDS FOR A NEW INTERNATIONAL ECONOMIC ORDER -- The developing countries' demands evolve -- The economico-political prelude to a New International Economic Order -- UN decision on a New International Economic Order -- From decision to practical action -- PART II -- 3 MOVING TOWARDS A NEW INTERNATIONAL ECONOMIC ORDER -- What actually is an international economic order? -- Is there a proposal for a new world order? -- How does a new world order come into being? -- A critical look at some central demands of the developing countries -- Indexation and deteriorating terms of trade -- The integrated commocity programme - stabilisation of prices and export revenues -- UNCTAD'S code of conduct for liner conferences -- Debt cancellation -- The forgotten aid -- 4 AN EQUITABLE WORLD ORDER -- International and national problems -- New or equitable international economic order -- Unity and negotiating strength -- BIBLIOGRAPHY -- Appendix I: The Declaration and Programme of Action for the Establishment of a New International Economic Order of the Sixth Special Session of the General Assembly of the UN. -- INDEX -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M.

Mass unemployment has returned to Europe, and we know precious little about its causes and effective remedies. There is, however, a clear connection with the breakdown of the postwar boom. In the 1970s a long period of rapid stable growth abruptly gave way to sluggish, unstable growth and financial insecurity. The general consensus among economists is that classical unemployment increased rapidly during the 1970s. There are, however, manifest problems on the demand side. The international economic system is intrinsically geared toward contraction. The classical remedy—that is, lower real wages—could work in theory. In practice, it is too painful and wasteful to be politically feasible. The obvious measures are lower payroll taxes and social service charges in order to reduce labor costs without reducing wages; internationally coordinated demand management; and more employment-focused priorities.

The 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.

Background: A number of reforms have been implemented in Swedish health care to support integrated care for frail older people and to reduce utilization of hospital care by this group. Outcomes and process indicators have been used in pay-for-performance (P4P) schemes by both national and local governments to support developments.Objective: To analyse limitations in the use of outcome and process indicators to incentivize integrated care for elderly patients with significant health care needs in the context of primary care.Method: Data were collected from the Region Skåne county council. Eight primary care providers and associated community services were compared in a ranking exercise based on information from interviews and registered data. Registered data from 150 primary care providers were analysed in regression models.Results and conclusion: Both the ranking exercise and regression models revealed important problems related to risk-adjustment, attribution, randomness and measurement fixation when using indicators in P4P schemes and for external accountability purposes. Instead of using indicators in incentive schemes targeting individual providers, indicators may be used for diagnostic purposes and to support development of new knowledge, targeting local systems that move beyond organizational boundaries.

OBJECTIVE: The objective was to examine the association between primary care consultations and a Care Need Index (CNI) used to compensate Swedish primary care practices for the extra workload associated with patients with low socioeconomic status. DESIGN: Observational study combining graphical analysis with linear regressions of cross-sectional administrative practice-level data. SETTING: Three Swedish regions, Västra Götaland, Skåne and Östergötland (3.5 million residents). Outcomes were measured in February 2018 and the CNI was computed based on data for 31 December 2017. SUBJECTS: The unit of analysis was the primary care practice (n = 390). MAIN OUTCOME MEASURES: i) Number of GP visits per registered patient; ii) Number of nurse visits per registered patient; iii) Number of morbidity-weighted GP visits per registered patient; iv) Number of morbidity-weighted nurse visits per registered patient. RESULTS: The linear associations between the CNI and GP visits per patient were positive and statistically significant (p<0.01) for both the unweighted and weighted measure in two regions, but the associations were mainly due to 10 practices with very high CNI values. The results for nurse visits varied across regions. CONCLUSIONS: For most levels of the CNI, there was no association with the number of consultations provided. This result may indicate insufficient compensation, weak incentives to spend the money, decisions to spend the money on other things than consultations, or stronger competition for patients among low-CNI practices. The result of this observational study should not be taken as evidence against the possibility that the CNI adjustment of capitation may have affected the socioeconomic equity in GP and nurse visits. Key Points Swedish primary care practices receive extra compensation for socioeconomically deprived patients but it is unknown how this affects service provision. Practice-level data from three regions years 2017-2018 indicate weak or no relation between the socioeconomic burden and the number of physical consultations per patient. Results are similar when adjusting for patients' morbidity levels, suggesting that the weak gradient was not explained by longer consultations. The exception is that a small number of practices with very high burdens provide more consultations per patient. The results may reflect insufficient compensation, lack of incentives, or funds being spent on other things than consultations.