Health systems have transitioned, over the past few decades, from an era of expansion to an era of costcontainment and, more recently, an era of outcomes. Scarce resources and an ever-increasing number of healthcare innovations have resulted in the introduction of evaluation methods and mechanisms to prioritise the adoption of more effective interventions for achieving the desired outcomes. For...

BACKGROUND Primary care teams are facing an increased need to develop quality programmes at local level. GPs must lead this process and promote a positive organizational culture if they want to achieve and maintain a continuous improvement of the service. OBJECTIVE The aim of the present study was to test the applicability and reliability of the European Foundation for Quality Management (EFQ...

The 1991 reforms to the UK NHS created a group of buyers of hospital care from amongst primary care physicians. The implementation of the reforms was such that these buyers had incentives to increase their use of hospital services prior to entering the scheme in order to inflate their budgets. It has been argued that non-financial motives would limit such behaviour. The paper shows that these h...

INTRODUCTION The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS ...

BACKGROUND The introduction of efficacious physical activity interventions in primary health care is a complex process. Understanding factors influencing the process can enhance the development of effective introduction strategies. This Delphi study aimed to identify factors most relevant for the adoption, implementation, and continuation of physical activity interventions in primary health car...

Just as China has struggled with bringing an expanding economy to a country with large areas of economic underdevelopment, the Chinese health care system is experiencing tension between tradition and modernization. Because of this tension, health care in the Peoples' Republic of China has been undergoing significant reform since the beginning of the 1980s. Experiments in market-based health sys...

BACKGROUND The work of a family physician is quite different in each country, and if we consider different continents, differences are even more remarkable. Social and cultural contexts justify a particular organization, not only of the health-care system but also its providers as well. OBJECTIVES By analyzing different health-care systems, new ideas may come about which may trigger positive ...

BACKGROUND In recent years there has been increasing interest in transferring new knowledge into health care practices, a process often referred to as implementation. The various subcultures that exist among health care workers may be an obstacle in this process. The aim of this study was to explore how professional groups and managers experienced the implementation of a new tool for lifestyle ...

In this article the legal limitations in the practice of the primary health care nurse in the Republic of South Africa, having direct implications for the achievement of the goal: "Health for all by the year 2000", are explored and described. The questions which had to be answered by means of the research are in relation to the nature and scope of the limitations obstructing the practice of the...

Perspectives 387 Response to Bellini's (2007) Commentary on Lichten and Simon's (2007) " Defining Mental Retardation: A Matter of Life or Death " .