Suchergebnisse

Introduction: Imbalanced distribution of healthcare providers between urban and rural areas is one of the difficulties facing health service provision in Indonesia. Several regulations have been made by the governmentto solve the problem. The objective of this paper is to describe the provision of human resources for healthcare services in Indonesia. Methodology: A review of medical related electronic databases, CINAHL and Ovid MEDLINE, was undertaken from their commencement date until the end of January 2017. The grey literature from the Indonesian government, the World Health Organisation and the World Bank websites was also searched. Results: There were 92 articles identified from the CINAHL and 222 articles from the Ovid MEDLINE databases. Five articles were included from the two databases and five documents from grey literature with ten articles to be reviewed. Discussion: Nurses and midwives account for the largest proportion of healthcare providers in Indonesia. The ratio of healthcare providers in Indonesia is lower than the average of South-East Asian and other lower middle income countries. More than half of the healthcare providers in Indonesia provide care in community health centres. Several regulations have been proclaimed to improve the imbalanced proportion of healthcare providers across the country. Conclusion: Indonesia continues to develop strategies towards successful distribution of healthcare providers across the country. A study investigating the impact of the programs reducing the imbalanced distribution of healthcare providers on health outcomes is essential for Indonesia.

Myanmar transitioned to a civilian government in March, 2011. Although the democratic process has accelerated since then, many problems in the field of healthcare still exist. Since there is a limited overview on the healthcare in Myanmar, this article briefly describes the current states surrounding health services in Myanmar. According to the Census 2014, the population in the Republic of the Union of Myanmar was 51,410,000. The crude birth rate in the previous one year was estimated to be 18.9 per 1,000, giving the annual population growth rate of 0.89% between 2003 and 2014. The Ministry of Health reorganized into six departments. National non-governmental organizations and community-based organizations support healthcare, as well as international non-governmental organizations. Since hospital statistics by the government cover only public facilities, the information on private facilities is limited. Although there were not enough medical doctors (61 per 100,000 population), the number of medical students was reduced from 2,400 to 1,200 in 2012 to ensure the quality of medical education. The information on causes of death in the general population could not be retrieved, but some data was available from hospital statistics. Although the improvement was marked, the figures did not reach the levels set by Millennium Development Goals 4 and 5. A trial prepaid health insurance system started in July 2015, to be followed by evaluation one year later. There are many international donors, including the Japan International Cooperation Agency, supporting health in Myanmar. With these efforts and support, a marked progress is expected in the field of healthcare.

This article sets out the moral failure of single-tier basic healthcare. Single-tier basic healthcare has been advocated on the grounds that the provision of healthcare should be divorced from ability to pay and unequal access to basic healthcare is morally intolerable. However, single-tier basic healthcare encounters a host of catastrophic moral failings. Given the fact of human pluralism it is impossible to objectively define 'basic' healthcare. Attempts to provide single-tier healthcare therefore become political processes in which interest groups compete for control of scarce resources with the most privileged possessing an inbuilt advantage. The focus on outputs in arguments for single-tier provision neglects the question of justice between individuals when some people provide resources for others without reciprocal benefits. The principle that only healthcare that can be provided to everyone should be provided at all leads to a levelling-down problem in which advocates of single-tier provision must prefer a situation where some individuals are made worse-off without any individual being made better-off compared to plausible multi-tier alternatives. Contemporary single-tier systems require the exclusion of non-citizens, meaning that their universalism is a myth. In the light of these pathologies it is judged that multi-tier healthcare is morally required.

[Italiano]: Una delle sfide che ha maggiormente segnato il dibattito pubblico degli ultimi anni ha riguardato lo sforzo di salvaguardare la sostenibilità dell'assistenza sanitaria in relazione al cambiamento demografico. Il progressivo invecchiamento della popolazione, nonché la tendenziale cronicizzazione delle malattie, richiede l'impiego di metodiche di cura con requisiti tecnologici-assistenziali sempre più avanzati e costosi, che in Italia gravano e mettono in difficoltà, sia da un punto di vista sanitario sia economico, il Sistema Sanitario Nazionale. Tale criticità è emersa anche durante la pandemia da COVID-19, comprovando la necessità di ripensare al modello di gestione della cronicità, ancora troppo centrato su una prospettiva specialistica e/o ospedaliera, per renderlo più idoneo a rispondere alle problematiche assistenziali dei pazienti nel rispetto delle risorse economiche disponibili. A questo proposito, può risultare di grande interesse l'Outcome Research, intesa come area di ricerca che si avvale della Real World Evidence (RWE), poiché dalle analisi delle evidenze prodotte nel mondo reale è possibile confermare o meno la validità delle decisioni politiche attuate al fine di migliorare la governance e la qualità dei servizi erogati. Questo lavoro intende proporre una fotografia dettagliata della prevalenza delle patologie croniche, e delle relative comorbidità, in Regione Campania ma, nel contempo, vuole anche essere un efficace strumento di conoscenze a disposizione di quei decisori impegnati nella programmazione delle politiche e delle strategie sanitarie. /[English]: One of the main challenges in the healthcare sector in recent years has concerned the effort to ensure the healthcare sustainability in view of demographic change. Due to the progressive increasing of aging and chronic conditions, it is necessary to employ treatment methods with increasingly advanced and costly technological and care requirements that the Italian Health System has to deal with both from a health and economic ...

1. Getting started -- 2. Introduction and overview -- 3. The first pillar : sort -- 4. The second pillar : set in order -- 5. The third pillar : shine -- 6. The fourth pillar : standardize -- 7. The fifth pillar : sustain -- 8. Reflections and conclusions.

Introduction: There have been two major transitions for healthcare in Indonesia: the implementation of government decentralisation and universal health insurance. A universal public health insurance called Badan Penyelenggara Jaminan Sosial (BPJS) was launched in January 2014 and aims to cover all Indonesian people. Objective: The objective of this paper is to discuss the funding of healthcare in Indonesia through a comparison with other South East Asian countries. Methodology: A search for relevant literature was undertaken using electronic databases, Ovid Medline, ProQuest Central, and Scopus from their commencement date until December 2015. The grey literature from the Indonesian government, the WHO's and World Bank's website, has been included. Results: There were nine articles from Ovid Medline, eight from ProQuest Central, and 12 from Scopus that met the criteria. Seventeen articles were duplicates leaving 12 articles to be reviewed. Nine documents have been identified from grey literature. Discussion: Most people in Indonesia sought health services from the private sector and were out-ofpocket financially or did not receive the required care. The private sector delivered 62.1% of health services compared to 37.9% by the government. Despite some inappropriate use of previous health insurance, the BPJS is expected to have improved management and will cover all citizens by the end of 2019. Conclusion: Indonesia has undergone a series of changes to health system funding and health insurance. There are lessons that can be learnt from other countries, such as Thailand, Cambodia, and Vietnam, so that Indonesia can improve its health funding. Abbreviations: BPJS – Badan Penyelenggara Jaminan Sosial.

Cover -- Half Title -- Title Page -- Copyright Page -- Table of Contents -- Foreword -- Preface -- Editors -- Contributors -- SECTION I: ESSAYS FROM THE FIELD: HEALTHCARE REI MAGINED FROM THE PATIENT AND CAREGIVER PERSPECTIVE -- 1: Introduction -- Participatory Medicine -- Online Tools -- Human Connection -- The Chapters and Authors -- Conclusion -- Notes -- 2: The New DIY Health Consumer -- Introduction -- DIY Comes to Healthcare -- Health Costs Drive Health Engagement -- Two High Healthcare Costs Getting More Transparent: Prescription Drugs and High Deductibles