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Public Health Care Expenditures: Canada and the United States

Public Health Care Expenditures: Canada and the United States

Canada and the USA. Vaillancourt & Vochin (2007) have used data on the populations for Canada and the USA and shown through forecasts (1975-2030) that both of those populations will be characterized by an increasingly high proportion of residents aged 65 and over. This result has great implications for the interpretation of our analysis because our paper puts the emphasis on the effect of aging on public health care spending. Also, as seen in Figure I, Canada has been spending most of its financial resources dedicated to health care for its newborn and elderly populations. With regards to childbirth spending, the following figure does not tell the whole story, in that allocation for the newborns is distributed between the child and the mother in a specific manner. That is, when the child is born, the delivery, nursing, physician, and other costs will mostly be allocated to the mother 10 while a small proportion of childbirth costs (related to direct care) will be allocated to the child. However a small portion of childbirth costs that is related to baby direct care (such as a nurse teaching the mother about feeding) will be allocated to the child. After which, all other costs (procedure for the newborn) will be attributed to the child.
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Artificial intelligence in health care: value for whom?

Artificial intelligence in health care: value for whom?

Comment www.thelancet.com/digital-health Vol 2 July 2020 e338 Artificial intelligence in health care: value for whom? Waymo, formerly Google’s self-driving technology company, has raised US$2·25 billion from outside investors, to expand its commercial efforts. Waymo might deploy its autonomous vehicle service in several geographical areas. After using public space for years— for the hundreds of cars driving more than 20 million miles—and human resources from Chandler, USA, to collect an enormous amount of data to its advantage, Waymo is going to commercialise its service according to a classic fee-for-ride model. Is the relationship balanced, between a company on one side that excels in technology yet lacks the necessary data; and society on the other side, which conversely has a lot of data yet little expertise in artificial intelligence technology? Most health-care systems will soon need to find an answer to a very similar question.
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View of The challenges facing Ontario’s health care system moving forward: a health policy perspective

View of The challenges facing Ontario’s health care system moving forward: a health policy perspective

RANKING and RECOMMENDATIONS Based on the aforementioned analysis and the recom- mendations of top health policy experts, managing the rising health care costs should be Ontario’s top health policy priority over the next five years [1,5,11]. Health care costs are increas- ing at a faster rate than the revenue of the government and the scramble by the provincial government to fund health care means that other critical priorities are being underfunded (i.e. education, social programs and the environment) [2]. Fund- ing cuts unaccompanied by thoughtful infrastructure redesign was seen in Ontario in the 1990s and only led to a decrease in quality of healthcare and short-term, not long-term savings. For long-term cost savings, investments must be made in preven- tion, costeffective treatments, and quality/accessibility. The final conclusion is that our provincial health system, like other health systems around the world, needs to continue to invest and mod- ernize its delivery systems to improve the health of our citizens, which in turn will make our future health care sustainable.
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Frailty transitions and health care use in Europe

Frailty transitions and health care use in Europe

demand model. 18 A growing body of the empirical literature has explored the specific impact of frailty on health care utilization. 19–21 Using cross-sectional data in Belgium, it has been shown that frail and prefrail individuals were more likely than robust elders to contact a GP, a specialist, or an emergency department. 19 Using panel data in 10 European countries, two studies showed that frailty was significantly associated with hospital and ambulatory care use, after controlling for both socioeconomic and health status. 20,21 However, less is known about the correlation between frailty and dental care. Previous research underlined the importance of considering dental care access issues among the frail elderly population, 22–25 but the evidence on the impact of (pre-) frailty on dental care use is scarce. The subject is important because by failing to consult for dental problems, pre-frail individuals may increase their chances to loose weight and become frail because of lower nutritional intake. 24,26
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Integration of oral health into primary health care
organization in cree communities: a workshop summary

Integration of oral health into primary health care organization in cree communities: a workshop summary

J Can Dent Assoc 2016;82:g30 ISSN: 1488-2159 2 of 3 Integration of Oral Health into Primary Health Care Organization in Cree Communities: A Workshop Summary J Can Dent Assoc 2016;82:g30 The presentation and discussions revealed that incorpora- tion of Cree culture, values and practices into health care decision-making are fundamental for strengthening the continuity of care, as is effective and empathic communi- cation within the health care team. In the long term, these strategies will lead to better performance of community health care organizations. During the workshop, strengths, challenges and ways to improve the performance of oral health care in Cree communities, as well as various evaluation models, were discussed. Strategies for the collection of community-based data were proposed by workshop participants and included community mapping, observations, document review, focus group discussions and individual interviews.
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The National Codes 1985 and health care facilities

The National Codes 1985 and health care facilities

With the intent of improving fire safety, increasing operational efficien- cy and combatting increased capital and operating costs for fire safety in health care [r]

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European survey on undocumented migrant's access to health care

European survey on undocumented migrant's access to health care

To do so the European Union has adopted several strong principles, including abolition of capital punishment and the right of all to the best health care. But those statements of intention must become reality. Today, the continent’s poorest and most vulnerable populations live in conditions that threaten their health and often exclude them from basic care. The various EU countries’ health care systems are still very different from each other. Not all of them can offer the same level of care, but the EU must strive towards that goal. Organising member states’ health care systems is not a European priority, although the fight against major epidemics (HIV, tuberculosis) and threats (bird flu) is.The fact cannot be overlooked that people in the most precarious situations are the most vulnerable to epidemics and the furthest outside the health care system. Neglecting to include the poorest populations in the health care improvement process would be fundamentally wrong in human, public health and financial terms.
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Impact of health care system on socioeconomic inequalities in doctor use

Impact of health care system on socioeconomic inequalities in doctor use

Impact of health care system on socioeconomic inequalities in doctor use 1. Introduction Access to health care constitutes a basic right according to the Charter of Fundamental Rights of the European Union. However, it is well demonstrated that there are significant social inequalities in use of health services in all European countries (van Doorsler et al., 2000; Hanratty et al 2007). The principal of horizontal equity requires that people in equal need of care are treated equally irrespective of their income, race or social position. In particular, the work by the Ecuity project draw attention to a “pro- rich” bias in the use of specialist care in Europe, whereas access to primary care was more equitably distributed across socioeconomic groups in most countries (Couffinhal et al., 2004; van Doorslaer and Koolman, 2004; van Doorslaer et al., 2006). At the same time, these studies show that the magnitude and direction of these inequalities vary significantly from one country to other. For example, in Ireland and Great Britain, there seem to be a “pro-poor” bias in the use of GP services while the opposite is observed in Portugal and in Finland. Again, the observed inequalities in specialist use vary significantly across European countries, being particularly marked in some countries despite universal health coverage (Hanratty, Zhang, Whitehead 2007).
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An analytics approach to problems in health care

An analytics approach to problems in health care

1.3 Ranking Liver Patients by Disease Severity to Decrease Adverse Events on the Waitlist 1.3.1 Problem of Interest When a deceased-donor liver is procured, health care practitioners must make a de- termination as to which patients deserve the greatest priority for transplantation. Unlike kidney transplant candidates for whom the option for dialysis significantly reduces the risk of demise while waiting for the “next” offer, liver transplant candi- dates face a more immediate “life-or-death” situation whereby disease severity cannot be reliably controlled in the absence of a liver transplant. Current practice relies on ranking patients by their model for end-stage liver disease (MELD) score, which has been haphazardly tweaked and adjusted to compensate for deficiencies in overall waitlist mortality rate and fairness for particular patient subpopulations that have been observed ex-post. We aspire to introduce a unified model that accounts for all patient characteristics to decrease adverse events on the waitlist and enable a more equitable organ allocation policy.
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Intergenerational transmission of health care habits in France

Intergenerational transmission of health care habits in France

There are several possible reasons for expecting this positive intergenerational correlation between health-care habits across generations. A first explanation is the existence of a transmission of preferences or a social construction of preferences (Manski 2000, Bisin and Verdier 2001). It may reflect both intentional or unintentional parental influence (Waldkirch 2004). Parents may intend to invest in the child human capital through health investments (Jacobson, 2000). Individuals observe the choice of their parents during childhood and are influenced by their consumptions or habits. It may also reflect the learning from parental habits of information concerning the health care system such as knowledge of pathways to care. But it may reflect more unintended reasons such as the share of other preferences such as time or risk preferences.
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The ecology of health care in a Belgian area

The ecology of health care in a Belgian area

and, above all, the characteristics of each health care system. The first version of the Square of White presented a figure of 250 people out of 1000 making contact with a doctor over the course of one month; 2 Green et al. reported a rise in this figure in 2001 to 327 inhabitants. 4 In our Belgian sample, almost one in two people had seen a doctor over the course of a month. This may raise the question of the possible over-qualification of these service providers: do all these health problems justify medical contact? This is an important question at a time when the possible transfer of skills within our health care system is a matter of debate, in particular the transfer of skills from doctors towards specialist nurses in terms of monitoring chronic conditions. 12 The issue of task shifting from GP to practice assistant or advanced nurse practitioner is the subject of current debate in many countries. 13–15
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Culturally adapted musical intervention for patient-centred health care

Culturally adapted musical intervention for patient-centred health care

Improved anxiety regulation and pain control is critical for maintaining health and well-being, empowerment of positive health care behaviours, and optimal care management. 13,14 Music has been used in several clinical settings to engage patients in self-regulation of anxiety and pain control. 15 Growing clinical evidence attests that music exerts anxiolytic effects on patients undergoing invasive medical procedures or cancer experience. It may be used as an adjunctive intervention in many conditions such as musculoskeletal disease, cardiovascular disease, and dementia, by influencing the activity of brain/emotion networks, initiating corresponding physiological responses, and contributing to psychological well-being and engagement in self-care activities. 15–22
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Designing a Health Treatment Network: Optimizing Performance in the Modern Health Care Delivery System

Designing a Health Treatment Network: Optimizing Performance in the Modern Health Care Delivery System

Analysis Research) Figure 2: Treatment Network Complexity Beyond Health Care Although the focus of this research is on health care many industries are consolidating and dealing with similar network issues such as the alignment of enterprise processes and

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Three essays on the impact of financial incentives, waiting times and home care on patients' health and utilization of health care services in Quebec

Three essays on the impact of financial incentives, waiting times and home care on patients' health and utilization of health care services in Quebec

3.1. Introduction The proportion of elderly people has increased significantly in recent years in Quebec. The proportion of people over 65 is now larger than the proportion of youth under 15. From 7.6% in 1976, the proportion of people over 65 increased to 18% in 2016 (Annex A.3.1 ). During the same period, life expectancy at 65 increased from 15.4 to 21.6 years. The aging of the popu- lation leads to increased demand for many services. The health sector is highly impacted, since older people are intensive users of medical services. The share of health expenditures in the total budget of Quebec increased from 24% in 1980 to 42% in 2010 (Annex A.3.1 ). This share was around 50% in 2018. The increase of health expenditures is due principally to two factors, the growth of the population, but also, and most of all, to the aging of the population. Between 1998 and 2008, the contribution of population growth to health expenditures was 11% while that of population aging was 22% (Canadian Institute for Health Information). Elderly medical services can be grouped into two kinds of services : health care and home care. Since these two types of services are generally organized and funded separately ( Brod- sky et al. , 2003 ; Kodner & Spreeuwenberg , 2002 ), the analysis of the interrelationship bet- ween them appears to be very important. In addition, health care and home care do not have the same purposes, the same utilization and the same costs. Health care is used to ei- ther restore or maintain health, while home care is provided to increase overall well-being by facilitating activities of daily living ( Scanlon , 1992 ). Home care services also support people in dealing with the consequences of physical or cognitive impairments other than the health consequences ( Brodsky et al. , 2003 ; Norton , 2000 ). The nature of health and home care ser- vices suggests that the utilization of home care will have an impact on the demand for health care ( Johri et al. , 2003 ). There are many potential ways for reducing health system costs with home care, for example, treat chronic diseases outside the hospital setting, take care of se- niors at home to prevent them from being in the hospital or in an emergency. The impact of home care on health outcome depends on the type of home care.
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Toward a Smart Health-care Architecture Using WebRTC and WoT

Toward a Smart Health-care Architecture Using WebRTC and WoT

Toward a Smart Health-care Architecture Using WebRTC and WoT 7 5.3 Emergency intervention in case of an accident The last use case is the one of an accident, as shown in Figure 5. Once a paramedic arrives to the place of the accident, to help the injured person. First she/he will attach all the available wearable medical devices to the body of the person. We suppose that the paramedic had already an equipment that speaks WebRTC with a doctor or with an ERC that implements our architecture (ca- pable of accessing smart objects in this case we consider the case of medical wearable smart objects). Then, the paramedic starts a communication with the remote ERC/ doctor, and at the same time the wearable objects will start send- ing vital information in real-time to the ERC, using WebRTC Datachannel.The paramedic will at the same time apply first aides to the person in the simple case, and in case of serious injuries the ERC/doctor can give real-time instruc- tions, while transporting the patient. Moreover, the ERC can also contact the different hospitals to see availability for receiving the injured person and to start preparing a room for surgery, if the person needs emergency intervention.
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Understanding informal payments in health care: motivation of health workers in Tanzania.

Understanding informal payments in health care: motivation of health workers in Tanzania.

When asked to describe how the phenomenon could affect the health system, all participants agreed that access to health care was seriously compromised by this practice. It appears that poor people are unable to afford even pri- mary care, while the majority of the population cannot access specialized services at all in urban public hospitals. "Those who can't manage to bribe; they will all die since they will never be able to access the treatments. Just imagine the women who are about to deliver, or children and those who are really sick, or the poor: do you think they will survive? They will all die just for [inability to make] informal payments" (Midwife, Tumbi Hospital).
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Taxing Sin Goods and Subsidizing Health Care

Taxing Sin Goods and Subsidizing Health Care

Proposition 1. In the first-best, if α i = α > 0, then θ S  θ D ⇐⇒ h xe  0. Proposition 1 says that the sin tax is higher (lower) in the case of dual self than in the case of persistent error if the marginal productivity of health expenditures decreases (increases) with the consumption of the sin good. Consequently, the comparison depends on the sign of the cross-derivative. A positive sign means that the marginal effectiveness (productivity) of health-care expenditures increases with the consumption of the sin good; with a negative sign, health-care expenditures are less effective for higher sin-good consumption levels. The sign of this cross-derivative depends upon the type of sin good under consideration. For instance, it seems reasonable to assume that it is positive if the sin good is sugar: the more you eat, the more medications designed to treat diabetes may be helpful to you. With this assumption, the sin tax is smaller when the individual acknowledges his mistake in the second period of his life. Given the increased produc- tivity of health care, in the dual case the individual easily corrects for his earlier excess while the individual in the persistent-errors case is unable or unwilling to do so. The opposite assumption can be made for smok- ing: heavy smokers increase their probability of developing lung cancer, for which there is up to now no efficient cure in the majority of cases. Put bluntly, there is not much utility that you can obtain from consuming health care if you end up with lung cancer following heavy smoking.
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Adapting the Lean Enterprise Self Assessment Tool for health care

Adapting the Lean Enterprise Self Assessment Tool for health care

Ideally, all three types of continuity and the stakeholders in the extended enterprise will be considered in the design of health care services and delivery processes.. The final pra[r]

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Indicators of Sustainable Development for Health Care Waste Treatment Industry

Indicators of Sustainable Development for Health Care Waste Treatment Industry

Sustainable development is more and more considered as a key parameter and a driving strategy for sustaina- ble performance. Today, numerous organizations develop their own performance indicators as no standard set of performance indicators could be generalized as meaningful in terms of sustainability performance. Particu- larly, the context of developing countries, where the concept of sustainability is not well diffused yet and where economic difficulties and constraints result most of the times in underestimation of environmental and social considerations, requires specifically adapted indicators. Specially, the sector of health care waste management lacks of sustainability indicators. This sector ensures the treatment, before disposal, of hazardous health care waste generated by health care centers (hospitals, clinics, and others). The evaluation system is designed for monitoring the pace of gaining sustainability within this sector. The objective of this article is to propose a su- stainability evaluation system adapted to the needs and situation of developing countries, based on meaningful, practical, easily measurable and applicable indicators for the Infectious Health Care Waste (IHCW) Treatment sector. Keywords: Infectious Health Care Waste Treatment Industry, sustainability, indicators, sustainable performance. Introduction
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Can Health Care Information Technology Save Babies?

Can Health Care Information Technology Save Babies?

group. All controls from Column 4, Table 2 included but not reported to improve readability. Robust standard errors clustered at the county level. * p < 0.10, ** p < 0.05,*** p < 0.01. improved survival rates for low-birthweight white infants but not for black infants. If such treatment were standardized across races, there might be further improvements in death rates. There are also concerns that physicians and other practitioners may provider better medial care to richer white and non-Hispanic patients. This contention is supported in a randomized experiment conducted by Schulman et al. (1999) that finds racial differences in health care treatment. 8 This suggests that clinical uncertainty combined with physician discretion may lead to variation in treatment decisions that harms certain populations. To the extent the healthcare IT systems reduce this variation, they may improve outcomes for black and Hispanic mothers more than for whites. Previous studies of other technological innovations (such as the spread of NICUs) on infant mortality have found an important role for medical advances in reducing deaths overall, but a general failure to reduce socioeconomic disparities (Gortmaker and Wise, 1997).
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