Suchergebnisse

In an attempt to determine the key challenges and opportunities of creating a dialogue about sustainability in regards to the Alberta oil sands, 13 professionals from four key stakeholder groups (industry, government, media and NGO) were asked the same set of seven questions about their conceptualization of sustainability. Key findings included the following: (1) Vague language pervaded many of the discussions including references to 'responsible development,' 'corporate social responsibility,' or 'triple bottom line.' (2) The sample illustrated a continuum of positions regarding both the notion of sustainability writ large and within the context of the oil sands specifically. (3) The largest concentration of discussion about sustainability surrounded practices and values, with goals and indicators figuring much less prominently. This paper provides useful insight to both the areas where stakeholders are still struggling to agree upon and those places where there is in fact some overlap. Areas for future research include exploration into one more key stakeholder: the indigenous voice.

AbstractWhile established measures gauge poverty across diverse aspects of life, a definitive metric for health poverty in Australia remains absent. This study examines health poverty trends, identifying priorities for interventions to improve overall population health. We define health poverty as the state of falling below a specified minimum threshold in any critical health aspect, encompassing physical function, role function, social function, pain, mental health and vitality. Additionally, mortality (i.e., dying within 1 year) is integrated into the health poverty measure. The percentage of the overall adult population grappling with health poverty was 42 percent in 2001, falling to 37 percent in 2009 before ascending to 43 percent in 2018. The level of health poverty was more prevalent among women, older age groups and Indigenous individuals than in men, younger age groups or non‐Indigenous people, respectively. By meticulously monitoring health poverty trends across various dimensions, this study unveils the sociodemographic group susceptible to health poverty and quantifies its impact on overall population well‐being. The investigation highlights poor role functioning and vitality deficiency as pivotal components contributing to health poverty.

AbstractThe UK has experienced substantial increases in both the number of claimants of work incapacity benefit and the proportion of claims for mental health reasons. However, identifying causality between experiencing mental health problems and claiming benefits is complex as claiming disability benefits may be the instigator or result of having a mental health problem. We use longitudinal data from the British Household Panel Survey (1991–2008) to disentangle the relationship between claiming benefits and mental health problems. We model the probability of claiming disability benefits using a dynamic random‐effects probit model, which reduces the endogeneity bias in modelling the effects of health on claiming disability benefits. Mental health has the largest effect of all health conditions modelled on the probability of disability benefit claiming. We find that the causal effect of mental health on claiming disability benefits is substantially over‐estimated by cross‐sectional associations. The effect decreases in magnitude from 12.5 to 0.5 percentage points for males and 8 to 0.7 percentage points for females. Policymakers should pay attention to other important influences on claiming disability benefits as well as interventions to improve the health of the working‐age population.

Abstract
Waiting times have been a central concern in the English NHS, where care is provided free at the point of delivery and is rationed by waiting time. Pro-market reforms introduced in the NHS in the 1990s were not accompanied by large drops in waiting times. As a result, the English government in 2000 adopted the use of an aggressive policy of targets coupled with the publication of waiting times data at the hospital level and strong sanctions for poor performing hospital managers. This regime has been dubbed 'targets and terror'. We estimate the effect of the English target regime for waiting times for hospital care after 2001 by a comparative analysis with Scotland, a neighbouring country with the same healthcare system that did not adopt the target regime. We estimate difference-in-differences models of the proportion of people on the waiting list who waited over 6, 9 and 12 months. Comparisons between England and Scotland are sensitive to whether published or unpublished data are used but, regardless of the data source, the 'targets and terror' regime in England lowered the proportion of people waiting for elective treatment relative to Scotland.

Background: General practice systems in the Nordic countries share certain common features. The sector is based on the Nordic model of a tax-financed supply of services with a political objective of equal access for all. The countries also share the challenges of increased political expectations to deliver primary prevention and increased workload as patients from hospital care are discharged earlier. However, within this common framework, primary care is organized differently. This is particularly in relation to the private-public mix, remuneration systems and the use of financial and non-financial incentives. Objective: The objective of this paper is to compare the differences and similarities in primary care among the Nordic countries, to create a mapping of the future plans and reforms linked to remuneration and incentives schemes, and to discuss the pros and cons for these plans with reference to the literature. An additional objective is to identify gaps in the literature and future research opportunities. Results/Conclusions: Despite the many similarities within the Nordic health care systems, the primary care sectors function under highly different arrangements. Most important are the differences in the gate-keeping function, private versus salaried practices, possibilities for corporate ownership, skill-mix and the organisational structure. Current reforms and political agendas appear to focus on the side effects of the individual countries' specific systems. For example, countries with salaried systems with geographical responsibility are introducing incentives for private practice and more choices for patients. Countries with systems largely based on private practice are introducing more monitoring and public regulation to control budgets. We also see that new governments tends to bring different views on the future organisation of primary care, which provide considerable political tension but few actual changes. Interestingly, Sweden appears to be the most innovative in relation to introducing new incentive schemes, perhaps because decisions are made at a more decentralised level.Published: April 2016.