Health Equity: 06/22/09

Monday, June 22, 2009

[EQ] Theory versus Practice: Discussing the Governance of Health Technology Assessment Systems

Theory versus Practice:
Discussing the Governance of Health Technology Assessment Systems

Paul Healy, policy analyst, Stockholm Network, and Dr Meir P. Pugatch, director of research, Stockholm Network

Stockholm 5 Network 2009

Available online as PDF [63p.] at:
http://www.stockholm-network.org/downloads/publications/Theory_versus_Practice.pdf

“….This paper examines the issue of governance of Health Technology Assessment (HTA) systems. It finds that, while there seems to be a convergence among different countries towards the HTA appraisal and review process, there are still considerable differences in the manner in which national HTA systems operate as a whole. Such differences, it is argued, ultimately lead to different outcomes and outputs of national HTA systems, not least in the context of patients’ ability to access new and innovative healthcare technologies.

Focusing on four key countries – Australia, Canada, Germany and the United Kingdom – this paper analyses some of the key elements embedded in HTA systems, which by and large affect the issue of governance of such systems.

Accordingly, the paper does the following:

- Describes and analyses the different HTA agencies in the above countries;

- Outlines and determines their relationship with healthcare decision makers;

- Assesses the competence of HTA bodies to provide recommendations and decisions about the endorsement or rejection of healthcare technologies;

- Considers the degree of openness and level of inclusion of inputs from different stakeholders;

- Gauges outputs and performance in terms of the number of reviews and decisions provided by the relevant HTA bodies; and,

- Discusses the overall public perception of these bodies…..”

Contents

Executive Summary

Introduction

HTA Process

HTA Systems

Australia

Canada

Germany

United Kingdom

Conclusions and policy considerations

Bibliography

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[EQ] A Quantitative Tool for Workforce Planning in Healthcare: Example Simulations

A Quantitative Tool for Workforce Planning in Healthcare:
Example Simulations

Jasmina Behan, Nora Condon, Ivica Milic´evic´, Caroline Shally

Skills and Labour Market Research Unit (SLMRU) - Planning & Research Department, FÁS

Dublin Ireland – June 2009

Available online as PDF [136p.] at: http://www.skillsireland.ie/media/egfsn090617_healthcare_report.pdf

"….The research, conducted by the Skills and Labour Market Research Unit at FÁS, developed a quantitative tool that facilitates the assessment of how different policy scenarios and changes in the size and composition of the population – the main determinant of demand for health services – will affect the balance between the supply and demand of a range of healthcare occupations.

The research has taken an economy-wide approach and also includes the private healthcare sector. It shows that there are shortfalls facing some occupations, while others are in oversupply. The analysis is based on domestic supply only so as to test the adequacy of the Irish supply system to the replacement needs of the occupations reviewed…."

Table of Contents

Foreword

Executive Summary

Section 1 Introduction

Section 2 Methodology

Section 3 Demand and supply by occupation

3.1 Consultants

3.2 General practitioners (GPs)

3.3 Specialists in public health medicine (PHM)

3.4 Speech and language therapists (SLTs)

3.5 Physiotherapists

3.6 Nurses and midwives

3.7 Health care assistants (HCAs)

3.8 Home helps

3.9 Social care workers

3.10 Clinical psychologists

3.11 Medical physicists

3.12 Radiation therapists

Section 4 Summary of findings

Section 5 Recommendations

Appendix 1A Expert Group on Future Skills Needs (EGFSN) Members

Appendix 1B Skills and Labour Market Research Unit

Appendix 1C Study Liaison/Steering Group

Appendix 2 Private Hospital and Clinics Surveyed

Appendix 3 Survey Questionnaire − Private Hospitals and Clinics

Appendix 4 Independent Voluntary Agencies (Non-Statutory FEDVOL Members) Surveyed

Appendix 5 Survey Questionnaire − Independent Voluntary Agencies

Appendix 6 Catholic Voluntary Nursing Homes Surveyed

Appendix 7 Survey Questionnaire − Catholic Voluntary Nursing Homes Surveyed

Appendix 8 Medical Practitioners − Modelling Supply

Appendix 9 Principal bodies that provided data/comments during consultation process

Appendix 10 Nursing and midwifery education and Budget 2009 implications

References

Publications by the Expert Group on Future Skills Needs

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"Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members".
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[EQ] Health Systems in Transition- Israel Health system review

Health Systems in Transition- Israel Health system review

Bruce Rosen, Director, Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Israel

Hadar Samuel, Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Israel

Edited by Sherry Merkur, European Observatory on Health Systems and Policies

World Health Organization 2009 on behalf of the European Observatory on Health Systems and Policies

Available online as PDF file [253p.] at: http://www.euro.who.int/Document/E92608.pdf

“……….The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.

Israel has a national health insurance (NHI) system that provides a broad benefits package to the population. There is free choice among four competing, non-profit-making health plans that receive NHI funds from the Government according to a capitation formula. The system is financed primarily from public sources via payroll and general tax revenues. Health care accounts for approximately 8% of gross domestic product (GDP). Hospitals and public clinics each account for approximately 40% of national health expenditure, and dental care accounts for a further 10%. In recent years the share of public financing has declined to 64% of total health system financing, while the share of private financing, especially voluntary health insurance and co-payments, has increased to 36%.

In recent years the Ministry of Health has developed strong capabilities in the areas of technology assessment, the prioritization of new technologies, health plan regulation, quality monitoring for community-based care, as well as strategic planning, to set goals for population health and strategies for achieving them. Critical components of the Israeli health system include: a sophisticated public health effort, run by the Ministry of Health; high-level primary care services provided by the health plans; highly sophisticated hospital care; and a strong system of emergency care delivery……….”

Contents

Preface

Abstract

Executive summary

1. Introduction

1.1 Geography and socio-demography

1.2 Economic context

1.3 Political context

1.4 Health status

2. Organizational structure

3. Health care financing and expenditure

3.1 Overview

3.2 Health expenditure

3.3 Population coverage and basis for entitlement

3.4 Revenue collection/sources of funds

3.5 Pooling of funds

3.6 Purchasing and purchaser–provider relations

3.7 Payment mechanisms

4. Regulation and planning

5. Physical and human resources

6. Provision of services

6.1 Public health

6.2 Primary care

6.3 Secondary and tertiary care

6.4 Emergency care

6.5 Pharmaceutical care

6.6 Rehabilitation

6.7 Social care

6.8 Services for informal caregivers

6.9 Palliative care

6.10 Mental health care

6.11 Dental care

6.12 Complementary and alternative health care

6.13 Health care for specific populations

7. Health care reforms

7.1 The Netanyahu Commission

7.2 Introduction of national health insurance

7.3 Prioritization of new technologies

7.4 Mental health reform

7.5 The effort to transfer mother and child preventive health care services to the health plans

7.6 The hospital trusts initiative and other reforms of the hospital system

7.7 Reforming Israel’s emergency response system during and after the Second Lebanon War

7.8 The Patients’ Rights Law

7.9 Reforming the status and pay levels of physicians

7.10 Summary and timeline of health care reforms

8. Assessment of the health care system

9. Appendices

9.1 References

9.2 Further reading

9.3 Useful web sites

9.4 HiT methodology and production process

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