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[PMID]:29241620
[Au] Autor:Rahman MS; Rahman MM; Gilmour S; Swe KT; Krull Abe S; Shibuya K
[Ad] Endereço:Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; Global Public Health Research Foundation, Dhaka, Bangladesh. Electronic address: sohelruhrd@gmail.com.
[Ti] Título:Trends in, and projections of, indicators of universal health coverage in Bangladesh, 1995-2030: a Bayesian analysis of population-based household data.
[So] Source:Lancet Glob Health;6(1):e84-e94, 2018 Jan.
[Is] ISSN:2214-109X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many countries are implementing health system reforms to achieve universal health coverage (UHC) by 2030. To understand the progress towards UHC in Bangladesh, we estimated trends in indicators of the health service and of financial risk protection. We also estimated the probability of Bangladesh's achieving of UHC targets of 80% essential health-service coverage and 100% financial risk protection by 2030. METHODS: We estimated the coverage of UHC indicators-13 prevention indicators and four treatment indicators-from 19 nationally representative population-based household surveys done in Bangladesh from Jan 1, 1991, to Dec 31, 2014. We used a Bayesian regression model to estimate the trend and to predict the coverage of UHC indicators along with the probabilities of achieving UHC targets of 80% coverage of health services and 100% coverage of financial risk protection from catastrophic and impoverishing health payments by 2030. We used the concentration index and relative index of inequality to assess wealth-based inequality in UHC indicators. FINDINGS: If the current trends remain unchanged, we estimated that coverage of childhood vaccinations, improved water, oral rehydration treatment, satisfaction with family planning, and non-use of tobacco will achieve the 80% target by 2030. However, coverage of four antenatal care visits, facility-based delivery, skilled birth attendance, postnatal checkups, care seeking for pneumonia, exclusive breastfeeding, non-overweight, and adequate sanitation were not projected to achieve the target. Quintile-specific projections showed wide wealth-based inequality in access to antenatal care, postnatal care, delivery care, adequate sanitation, and care seeking for pneumonia, and this inequality was projected to continue for all indicators. The incidence of catastrophic health expenditure and impoverishment were projected to increase from 17% and 4%, respectively, in 2015, to 20% and 9%, respectively, by 2030. Inequality analysis suggested that wealthiest households would disproportionately face more financial catastrophe than the most disadvantaged households. INTERPRETATION: Despite progress, Bangladesh will not achieve the 2030 UHC targets unless the country scales up interventions related to maternal and child health services, and reforms health financing systems to avoid high dependency on out-of-pocket payments. The introduction of a national health insurance system, increased public funding for health care, and expansion of community-based clinics in rural areas could help to move the country towards UHC. FUNDING: Japan Ministry of Health, Labour, and Welfare.
[Mh] Termos MeSH primário: Cobertura Universal/organização & administração
Cobertura Universal/tendências
[Mh] Termos MeSH secundário: Bangladesh
Teorema de Bayes
Estudos Transversais
Características da Família
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


  2 / 2709 MEDLINE  
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[PMID]:29360301
[Au] Autor:Berry MD; Thomson Reuters Accelus.
[Ti] Título:Healthcare Reform: State Specific Responses.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-32, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Reforma dos Serviços de Saúde/organização & administração
Governo Estadual
[Mh] Termos MeSH secundário: Capitação
Custo Compartilhado de Seguro
Revelação
Custos de Cuidados de Saúde
Trocas de Seguro de Saúde/organização & administração
Seres Humanos
Cobertura do Seguro
Fundos de Seguro
Seguro Saúde/organização & administração
Medicaid/organização & administração
Patient Protection and Affordable Care Act
Atenção Primária à Saúde
Estados Unidos
Cobertura Universal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


  3 / 2709 MEDLINE  
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[PMID]:27770797
[Au] Autor:Dawson A; Bateson D; Estoesta J; Sullivan E
[Ad] Endereço:Faculty of Health, University of Technology, Sydney (UTS), P.O. Box 123, Ultimo, NSW 2007, Sydney, NSW, Australia. angela.dawson@uts.edu.au.
[Ti] Título:Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia.
[So] Source:BMC Health Serv Res;16(1):612, 2016 10 22.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. METHODS: We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. RESULTS: This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. CONCLUSIONS: Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical abortion. However, to implement such directives leadership is required from Australian medical, nursing, midwifery and pharmacy practitioners, academic faculties and their associated professional associations. In addition, political will is needed to nationally decriminalise abortion and ensure dedicated public provision that is based on comprehensive models tailored for all populations.
[Mh] Termos MeSH primário: Aborto Induzido/normas
Acesso aos Serviços de Saúde/normas
[Mh] Termos MeSH secundário: Instituições de Assistência Ambulatorial/normas
Austrália
Canadá
Assistência à Saúde
Países Desenvolvidos
Feminino
Seres Humanos
Renda
Liderança
Tocologia
Nova Zelândia
Satisfação do Paciente
Gravidez
Federação Russa
Telemedicina/normas
Reino Unido
Estados Unidos
Cobertura Universal
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180117
[Lr] Data última revisão:
180117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  4 / 2709 MEDLINE  
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[PMID]:29255893
[Au] Autor:Naylor CD
[Ad] Endereço:Department of Medicine, Dalla Lana School of Public Health, and Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Canada as Single-Payer Exemplar for Universal Health Care in the United States: A Borderline Option.
[So] Source:JAMA;319(1):17-18, 2018 Jan 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Programas Nacionais de Saúde
Sistema de Fonte Pagadora Única
Cobertura Universal
[Mh] Termos MeSH secundário: Canadá
Comparação Transcultural
Reforma dos Serviços de Saúde
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19668


  5 / 2709 MEDLINE  
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[PMID]:29255843
[Au] Autor:Fuchs VR
[Ad] Endereço:Stanford University, Stanford, California.
[Ti] Título:Is Single Payer the Answer for the US Health Care System?
[So] Source:JAMA;319(1):15-16, 2018 Jan 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: National Health Insurance, United States/economia
Sistema de Fonte Pagadora Única
[Mh] Termos MeSH secundário: Redução de Custos
Sistema de Fonte Pagadora Única/economia
Sistema de Fonte Pagadora Única/organização & administração
Governo Estadual
Estados Unidos
Cobertura Universal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.18739


  6 / 2709 MEDLINE  
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[PMID]:29234795
[Au] Autor:Gostin LO
[Ad] Endereço:Lawrence O. Gostin, JD, is University Professor and Faculty Director, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, and Director of the World Health Organization Collaborating Center on Public Health Law and Human Rights.
[Ti] Título:Five Ethical Values to Guide Health System Reform.
[So] Source:JAMA;318(22):2171-2172, 2017 Dec 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Temas Bioéticos
Reforma dos Serviços de Saúde/ética
Acesso aos Serviços de Saúde/economia
Qualidade da Assistência à Saúde/ética
Cobertura Universal/ética
[Mh] Termos MeSH secundário: Acesso aos Serviços de Saúde/ética
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.18804


  7 / 2709 MEDLINE  
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[PMID]:29040336
[Au] Autor:Iyer V; Sidney K; Mehta R; Mavalankar D; De Costa A
[Ad] Endereço:Indian Institute of Public Health, Gandhinagar, Gujarat, India.
[Ti] Título:Characteristics of private partners in Chiranjeevi Yojana, a public-private-partnership to promote institutional births in Gujarat, India - Lessons for universal health coverage.
[So] Source:PLoS One;12(10):e0185739, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Chiranjeevi Yojana (CY) is a Public-Private-Partnership between the state and private obstetricians in Gujarat, India, since 2007. The state pays for institutional births of the most vulnerable households (below-poverty-line and tribal) in private hospitals. An innovative remuneration package has been designed to disincentivise unnecessary cesareans. This study examines characteristics of private facilities which participated in the program. METHODS: We conducted a cross-sectional survey of all facilities which had conducted any births between June 2012 and April 2013 in three districts. We identified 111 private and 47 public facilities. Ninety of the 111 private facilities did caesarean sections in the last three months and were eligible to participate in the CY program. Of these, 40 (44%) participated in the CY program. We conducted descriptive and bivariate analyses followed by a Poisson regression model to estimate prevalence ratios of facility characteristics that predicted participation. RESULTS: We found that facilities participating in the CY program had a significantly higher likelihood of being general facilities (PR 1.9, 95% CI 1.3-2.9), or conducting lower proportion of cesarean births (PR 2.1, 95% CI 1.2-3.5) or having obstetricians new in private practice (PR 1.9, 95% CI 1.2-3.1) or being less expensive (PR 1.8, 95% CI 1.1-3.0). But none of these factors retained significance in a multi variable model. CONCLUSION: Private obstetricians who participate in the CY program tend to be new to private practice, provide general services, conduct fewer caesareans and are also less expensive. This is advantageous to the PPP and widens the target beneficiary groups that can be serviced by the PPP. The state should design remuneration packages with the aim of attracting relatively new obstetricians to set up practices in more remote areas. It is possible that the CY remuneration package design is effective in keeping caesarean rates in check, and needs to be studied further.
[Mh] Termos MeSH primário: Cesárea/utilização
Parto Obstétrico/tendências
Serviços de Saúde Materna/estatística & dados numéricos
Parcerias Público-Privadas/estatística & dados numéricos
Cobertura Universal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Análise de Variância
Cesárea/economia
Cesárea/estatística & dados numéricos
Estudos Transversais
Parto Obstétrico/economia
Feminino
Instalações de Saúde/estatística & dados numéricos
Acesso aos Serviços de Saúde
Seres Humanos
Índia
Serviços de Saúde Materna/economia
Pobreza
Gravidez
Parcerias Público-Privadas/economia
Cobertura Universal/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185739


  8 / 2709 MEDLINE  
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[PMID]:28968399
[Au] Autor:Bilinski A; Neumann P; Cohen J; Thorat T; McDaniel K; Salomon JA
[Ad] Endereço:Interfaculty Initiative in Health Policy, Harvard University, Cambridge, Massachusetts, United States of America.
[Ti] Título:When cost-effective interventions are unaffordable: Integrating cost-effectiveness and budget impact in priority setting for global health programs.
[So] Source:PLoS Med;14(10):e1002397, 2017 Oct.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Potential cost-effective barriers in cost-effectiveness studies mean that budgetary impact analyses should also be included in post-2015 Sustainable Development Goal projects says Joshua Salomon and colleagues.
[Mh] Termos MeSH primário: Análise Custo-Benefício
Saúde Global/economia
Política de Saúde/economia
Cobertura Universal/economia
[Mh] Termos MeSH secundário: Orçamentos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002397


  9 / 2709 MEDLINE  
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[PMID]:28957914
[Au] Autor:Potera C
[Ad] Endereço:Carol Potera.
[Ti] Título:United States Flunks an International Health Care Analysis.
[So] Source:Am J Nurs;117(10):16, 2017 Oct.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Findings reveal worst overall U.S. ranking, including for access, equity, and outcomes.
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Acesso aos Serviços de Saúde/estatística & dados numéricos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos
Pesquisa sobre Serviços de Saúde
Cobertura Universal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Canadá
Comparação Transcultural
Eficiência Organizacional
Europa (Continente)
Financiamento Governamental
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000525860.98310.15


  10 / 2709 MEDLINE  
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[PMID]:28895493
[Au] Autor:Alshamsan R; Lee JT; Rana S; Areabi H; Millett C
[Ad] Endereço:1 College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11632, Saudi Arabia.
[Ti] Título:Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health.
[So] Source:J R Soc Med;110(9):365-375, 2017 Sep.
[Is] ISSN:1758-1095
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage.
[Mh] Termos MeSH primário: Assistência à Saúde/normas
Países em Desenvolvimento
Indicadores de Qualidade em Assistência à Saúde
[Mh] Termos MeSH secundário: Idoso
China
Doença Crônica/terapia
Comparação Transcultural
Estudos Transversais
Feminino
Gana
Acesso aos Serviços de Saúde
Disparidades em Assistência à Saúde
Seres Humanos
Renda
Índia
Masculino
México
Meia-Idade
Assistência Centrada no Paciente
Federação Russa
África do Sul
Cobertura Universal
Organização Mundial da Saúde
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1177/0141076817724599



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