In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based o...

Steven Lewis and colleagues have produced a thoughtful article in the British Medical Journal w1x on the challenges facing the Canadian health care system. Lewis et al. point out that the Canadian health care system, an icon of Canadian values, is going through a period of turbulence and a crisis of confidence. They rightly point out that Canadians continue to favour a publicly funded, comprehe...

Increasing the racial and ethnic diversity of the health care workforce is essential for the adequate provision of culturally competent care to our nation's burgeoning minority communities. A diverse health care workforce will help to expand health care access for the underserved, foster research in neglected areas of societal need, and enrich the pool of managers and policymakers to meet the n...

Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The home health interim payment system in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which ...

BACKGROUND The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reform...

Strengthening the primary care system and promoting utilization of primary care are the major targets of China's ambitious health reforms to meet its people's escalating health care needs. However, the changing trend of primary care utilization 4 years before and after 2009, when the health reforms started, is against the government's stated goal. The percentage of outpatient visits in primary ...

Starting in 2002, the UK Labour Government of 1997-2010 introduced a series of changes to the National Health Service (NHS) in England designed to increase patients' choices of the place of elective hospital care and encourage competition among public and private providers of elective hospital services for NHS-funded patients. In 2006, the Department of Health initiated the Health Reform Evalua...

background: the iranian healthcare system is primarily an insurance based system. this structure has an important influence on the efficiency and equity of the provision of healthcare in iran. this paper reviews the history of the iranian healthcare system and the impact of the iranian health insurance system on healthcare performance based on the results of interviews with key opinion leaders ...

OBJECTIVES To examine whether the Health System Reforms delivered the promise of being a coherent and mutually supporting reform programme; to identify the underlying programme theory of the reform programme; to reflect on whether lessons have been learned. METHODS Documentary analysis mapping the implicit and explicit programme theories about how the reforms intended to achieve its goals and...