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Author : Gerard Martin La Forgia,Bernard Couttolenc Publisher : World Bank Publications Page : 462 pages File Size : 54,7 Mb Release : 2008-01-01 Category : Medical ISBN : 9780821373590
Hospital Performance in Brazil by Gerard Martin La Forgia,Bernard Couttolenc Pdf
Drawing on an eclectic array of research and evaluative studies culled from a mix of sources, this volume analyzes Brazilian hospital performance along several policy dimensions including resource allocation and use within hospitals, hospital payment mechanisms, organizational and governance arrangements, management practices, and regulation and quality. An agenda for hospital reform is proposed which synthesizes priorities that are integral to improving hospital performance-and which should be considered for implementation in the near and medium term.
Hospital Performance in Brazil by Gerard M. La Forgia,Bernard F. Couttolenc Pdf
Hospitals are at the center of the health care universe in Brazil. When ill, many Brazilians go straight to the hospital for want of a family doctor or primary care network. Hospitals are a critical part of the government's budget, absorbing nearly 70 percent of public spending on health. Hospitals influence the ebb and flow of politician's careers when hospital mishaps hit the headlines or the limelight falls on high-performing hospitals. Hospitals are at the forefront of policy discussions in Brazil. The discussions reflect their promise as centers of technological innovation and medical advances as well as widespread concern about their cost and quality. Brazilian hospitals are important to many people for many different reasons. What makes hospitals important is easy to understand. What makes hospitals deliver quality care efficiently or not is much harder to grasp. Can Brazil improve the performance of its hospitals? The evidence presented in this volume suggests that the answer is yes. However, it will take strong leadership, coordinated efforts of federal, state, and municipal governments, direct engagement with the private health sector, and systematic but continuous vision, policies, and actions. Such enabling factors have been generally weak or absent in the Brazilian health system. Promising initiatives have often been gutted or scrapped after changes of government.
Twenty Years of Health System Reform in Brazil by Michele Gragnolati,Magnus Lindelow,Bernard Couttolenc Pdf
It has been over twenty years since the Brazilian Sistema Único de Saúde (Unified Health System or SUS) was formally established by the 1988 Constitution. The impetus for the SUS came in part from rising costs and a crisis in the social security system that preceded the reforms, but also from a broad-based political movement calling for democratization and improved social rights. Building on reforms that started in the 1980s, the SUS was based on three overarching principles: (i) universal access to health services, with health defined as a citizen’s right and an obligation of the state; (ii) equality of access to health care; and (iii) integrality (comprehensiveness) and continuity of care; along with several other guiding ideas, including decentralization, increased participation, and evidence-based prioritization. The SUS reform established health a fundamental right and duty of the state, and started a process of fundamentally transforming Brazil’s health system to achieve this goal. So, what has been achieved since the SUS was established? And what challenges remain in achieving the goals that were established in 1988? These questions are the focus of this report. Specifically, it seeks to assess whether the SUS reforms have managed to transform the health system as envisaged more than 20 years ago, and whether the reforms have led to improved outcomes in terms of access to services, financial protection, and health status. Any effort to assess the performance of a health system runs into a host of challenges concerning the definition of boundaries of the “health system”, the outcomes that the assessment should focus on, data sources and quality, and the role of policies and reforms in understanding how the performance of the health system has changed over time. Building on an extensive literature on health system assessment, this report is based on a simple framework that specifies a set of health system “building blocks”, which affect a number of intermediate outcomes such as access, quality and efficiency, which, in turn, contribute to final outcomes, including health status, financial protection, and satisfaction. Based on this framework, the report starts by looking at how key building blocks of Brazil’s health system have changed over time and then moves on to review performance in terms of intermediate and final outcomes.
Paying for Performance in Healthcare: Implications for Health System Performance and Accountability by Cheryl Cashin,Y-Ling Chi,Michael Borowitz,Sarah Thompson Pdf
Health spending continues to grow faster than the economy in most OECD countries. In 2010, the OECD published a study of strategies to increase value for money in health care, in which pay for performance (P4P) was identified as an innovative tool to improve health system efficiency in several OECD countries. However, evidence that P4P increases value for money, boosts quality of processes in health care, or improves health outcomes is limited.This book explores the many questions surrounding P4P such as whether the potential power of P4P has been over-sold, or whether the disappointing results to date are more likely rooted in problems of design and implementation or inadequate monitoring and evaluation. The book also examines the supporting systems and process, in addition to incentives, that are necessary for P4P to improve provider performance and to drive and sustain improvement. The book utilises a substantial set of case studies from 12 OECD countries to shed light on P4P programs in practice.Featuring both high and middle income countries, cases from primary and acute care settings, and a range of both national and pilot programmes, each case study features: Analysis of the design and implementationdecisions, including the role of stakeholders Critical assessment of objectives versus results Examination of the of 'net' impacts, includingpositive spillover effects and unintended consequences The detailed analysis of these 12 case studies together with the rest of this critical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. As a result, this book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability. This title is in the European Observatory on Health Systems and Policies Series.
OECD Reviews of Health Systems: Brazil 2021 by OECD Pdf
In the 30 years since the inception of the Unified Health System (Sistema Único de Saúde, or SUS), Brazil has reduced health inequalities, and improved coverage and access to health care. However, mobilising sufficient financing for the universal health coverage mandate of SUS has been a constant challenge, not helped by persistent inefficiencies in the use of resources in the Brazilian health system.
Paying for Performance in Health Care Implications for Health System Performance and Accountability by OECD,World Health Organization Pdf
This report examines recent activation policies in the United Kingdom aimed at moving people back into work. It offers insight into how countries can improve the effectiveness of their employment services and also control spending on benefits.
Author : The World Bank Publisher : World Bank Publications Page : 296 pages File Size : 52,9 Mb Release : 2014-11-04 Category : Business & Economics ISBN : 9781464802171
Brazil Country Program Evaluation, FY2004-11 by The World Bank Pdf
Over 2004-11, the World Bank Group program in Brazil aimed to support to government in achieving greater equity, sustainability, and competitiveness. IEG judges the outcome of the Bank Group program as moderately satisfactory, with some important variability across themes.
OECD Reviews of Health Systems Primary Health Care in Brazil by OECD Pdf
Primary health care in Brazil is well-organised, the result of sustained commitment to providing high quality primary health care for the whole population. Brazil has implemented a set of reforms over the past decades to improve the distribution of doctors, develop new forms of service organisation, introduce new financing models, and implement a range of quality improvement initiatives.
Health Networks in Action by Pinto, Diana M.,Regalia, Ferdinando,Perez-Cuevas, Ricardo,Marín, Tania,Astorga, Ignacio,Máñez, Miguel Angel,Gutiérrez Alba, Gaudencio,Jaramillo Castell, Fabiola,Minué, Sergio,Muños Hernández, José Alberto,Reyes Morales, Hortensia,Ricaurte Cepeda, Melissa,Santilli, Irene,Yépez Chamorro, María Clara,Cejas, Cintia,Juárez Ramírez, Clara Pdf
Integrated Health Service Delivery Networks (IHSDN) based on primary health care (PHC) are the most promising solution for health systems to satisfy the health needs of the population and to address access, efficiency, quality and equity challenges faced by health systems of the world. PHCs essential attributes (people and family centered care, comprehensiveness, continuity, longitudinality) position this approach as one of the key strategies for countries to meet the aspiration of achieving universal health coverage. Creating care networks has been a common thread running through Latin America and the Caribbeans health policy agendas. In terms of actually putting the IHSDN model in action, there is a wide range of interpretations and experiences, with designs, scales, organizational methods, and maturity levels that vary within and between countries. This book shares evidence of the progress made in forming and launching IHSDN in Latin America based on four case studies conducted in Argentina, Brazil, Colombia, and Mexico. The results were found by systematically applying an instrument that collects regional information on the context and features of the IHSDNs governance, funding, care models, and IHSDN management models. The books chapters describe the characteristics of IHSDN in the four studied countries, lessons are drawn from how these IHSDN have been designed and implemented, challenges for the future are identified and recommendations are provided on what will it take to consolidate the IHSDN model in Latin America. The hypothetical story of Dioselina, illustrates throughout the book the obstacles and difficulties that arise for a diabetic patient when using health services that are not people-centered. The results shed light on how prepared IHSDN in this region are to provide patient-centered care and where to focus efforts for improvement. The evidence found in this study will help develop and advance PHC in Latin America.
Author : Asian Development Bank Publisher : Asian Development Bank Page : 213 pages File Size : 55,9 Mb Release : 2013-11-01 Category : Medical ISBN : 9789292543013
Guidebook on Public–Private Partnership in Hospital Management by Asian Development Bank Pdf
The Universal Declaration of Human Rights proclaims that "everyone has the right to a standard of living adequate for the health and well-being of himself and of his family." The guarantee of good health for its people is therefore every government's aspiration. Public–private partnerships (PPP) in health offer effective and sustainable solutions where the private sector and government can work together to bring long-term benefits to the people. This guidebook offers readers a guide for the development of a PPP in hospital management through six simple, customizable steps. It looks at hospital management as an important component of well-rounded health care systems. Through PPPs in hospital management, people will have increased access to effective, affordable, and compassionate health care services.
This 2015 OECD Economic Survey of Brazil examines recent economic developments, policies and prospects. The special chapters cover: Strengthening the industrial sector and Improving health policies.
An Opportunity for a Different Peru by Marcelo Giugale,Vicente Fretes Cibils Pdf
For the first time in the republican history of Peru, the presidential transition takes place in democracy, social peace, fast economic growth and favorable world markets. In other words, there has never been a better chance to build a different Peru - a richer country, more equal and governable. There are multiple ways to achieve that goal. New reforms must stem from a widespread and participatory debate, one of a common vision conceived for and by Peruvians. This book aims at making a technical and independent contribution to such debate; it summarizes the knowledge available about the challenges to be faced by the new administration. The study does not recommend silver bullets, but suggests policy options. It is based on the analysis of the current reality and in six decades of relationships with Peru, in which the Bank has implemented more than 100 projects and prepared more than 500 technical reports covering the wide range of development topics. When necessary, the study provides lessons that the Bank has learned elsewhere. The study provides a conceptual framework to the analysis of the country's 34 economic sectors and the two historical perspectives behind them. In doing so, it offers a comprehensive reform agenda that sheds light on possible priorities and courses of action.
Brazil by International Monetary Fund. Western Hemisphere Dept. Pdf
This paper assesses the importance of financial market developments for the business cycle in Brazil. The results underscore the importance of macro-financial linkages and highlight risks to the recovery going forward. Although some of the rise in credit growth in Brazil can be attributed to financial deepening and rising income levels, it may have implications for economic activity going forward. Cross-country evidence suggests that periods of easy financial conditions can amplify economic fluctuations and possibly lead to adverse economic outcomes. To explore the nexus between the financial cycle and business cycle, cycles are estimated using a variety of commonly-used statistical methods and with a small, semi-structural model of the Brazilian economy. An advantage of using the model-based approach is that financial and business cycles can be jointly estimated, allowing information from all key economic relationships to be used in a consistent way. Financial sector developments are found to be an important source of macroeconomic fluctuations. Financial accelerator models highlight the role of credit and asset prices in shaping the business cycle.
Government-Sponsored Health Insurance in India by Gerard La Forgia,Somil Nagpal Pdf
This book presents the first comprehensive review of all major government-supported health insurance schemes in India and their potential for contributing to the achievement of universal coverage in India are discussed.
Fiscal Challenges of Population Aging in Brazil by Mr.Alfredo Cuevas,Ms.Izabela Karpowicz,Mr.Carlos Mulas-Granados,Mauricio Soto Pdf
In recent decades, population has been aging fast in Brazil while old age pensions and healthrelated spending have increased. As the population ages, the spending trend threaten to reach unsustainable levels absent reforms. Increasing the retirement age is key, but by itself will not provide sufficient savings to close the pension system financing gap, and reforms reducing replacement rates are necessary. In the area of health, there is scope for improving expenditure efficiency by strengthening outpatient care and regional networks, and developing clinical guidelines for cost-effective treatments and drugs. Reforms are urgent, so that they can be gradual.
