The terms vertical and integrated are widely used in health service delivery, but
each describes a range of phenomena. In practice, the dichotomy between
them is not rigid, and the extent of verticality or integration varies between
programmes – including (1) a vertically funded, managed, delivered and...
Improved health care, lifestyle changes and changing demography mean that
more people are living longer and often with chronic diseases that cannot
currently be cured. Advances in health care that support longer life are to be
celebrated, but health care systems cannot cope with the increasing incidence
...
Skill-mix initiatives focus on changing professional roles - directly and indirectly.They change roles directly through extension of roles or skills, delegation, andthe introduction of a new type of worker; they change them indirectly throughmodifications of the interface between services - that is, wher...
The optimal balance between institutional, home-based and community care
for older adults requires an effective mix of organizational, funding and delivery
mechanisms for target populations. This spans health and social care, and the
coordination of care must respect older people’s care preferences and...
Health systems have developed at different speeds, and with differing degrees
of complexity throughout the twentieth century, reflecting the diverse political
and social conditions in each country.
Notwithstanding their diversity, all systems, however, share a common reason
for their existence, namely th...
The term “quality tools” is used in many different ways to refer to a method used by an individual, a team, an organization or a health system. It is most often used in a narrow sense in American texts to refer to a set of simple “continuous quality improvement” methods (CQI tools). More broadly,...
“Grey zone” treatments are those that rely upon the patient’s judgement of associated benefits versus harms. When clinicians judge patients are eligible for “grey zone” treatments, their acceptance should be consistent with informed patients’ values. The question is how can one obtain informe...
In most countries the pressure for health care reform is aimed at improving the efficiency, equity and effectiveness of the health sector. Emerging evidence shows that health care reforms can affect men and women differently, as a consequence of their different positions as users and producers of health ...
Homeless people have poorer physical and mental health than the general population, and often have problems obtaining suitable health care. This synthesis has critically reviewed the international literature pertaining to the health care needs of homeless people in countries with relatively well-develope...
For many people, the hospital has come to
symbolize the modern health care system.
Yet in many countries, the role of the acute
hospital is changing, with an emphasis on
outpatient diagnosis and treatment as well as
alternatives to long-term hospital care, leading to reductions in numbers of hospital
bed...
