The Experts below are selected from a list of 28515 Experts worldwide ranked by ideXlab platform
Ann M Holmes - One of the best experts on this subject based on the ideXlab platform.
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a qaly based societal Health Statistic for canada 1985
Social Science & Medicine, 1995Co-Authors: Ann M HolmesAbstract:This paper assesses the appropriateness of QALYs (quality adjusted life years) as a foundation for an index of societal Health, and the feasibility of using such an index to guide Health care policy. Results of this paper suggest that the standard aggregate QALY index imposes an ethical position on policy makers which may promote inequality in well-being associated with Health. It is possible to rectify this problem in theory, but current data are insufficient to estimate such corrected indices. A QALY-based index, constructed using the best available data, indicates morbidity has a significant effect on Canadian Health status (e.g. life expectancy figures alone overstate community Health by about 10%), that the impact of morbidity is unequal across regions and gender, and that role (the ability to fulfil social functions) and mobility dysfunction are important determinants of ill-Health in this population.
David Newlands - One of the best experts on this subject based on the ideXlab platform.
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internal contracting of Health services in cambodia drivers for change and lessons learned after a decade of external contracting
BMC Health Services Research, 2018Co-Authors: Sreytouch Vong, Joanna Raven, David NewlandsAbstract:Since the late 1990s, contracting has been employed in Cambodia in an attempt to accelerate rural Health system recovery and improve Health service delivery. Special Operating Agencies (SOA), a form of ‘internal contracting’, was introduced into selected districts by the Cambodia Ministry of Health in 2009. This study investigates how the SOA model was implemented and identifies effects on service delivery, challenges in operation and lessons learned. The study was carried out in four districts, using mixed methods. Key informant interviews were conducted with representatives of donors and the Ministry of Health. In-depth interviews were carried out with managers of SOA and Health facilities and Health workers from referral hospitals and Health centres. Data from the Annual Health Statistic Report 2009–2012 on utilisation of antenatal care, delivery and immunisation were analysed. There are several challenges with implementation: limited capacity and funding for monitoring the SOA, questionable reliability of the monitoring data, and some facilities face challenges in achieving the targets set in their contracts. There are some positive effects on staff behaviour which include improved punctuality, being on call for 24 h service, and perceived better quality of care, promoted through adherence to work regulations stipulated in the contracts and provision of incentives. However, flexibility in enforcing these regulations in SOA has led to more dual practice, compared to previous contracting schemes. There are reported increases in utilization of services by the general population and the poor although the quantitative findings question the extent to which these increases are attributable to the contracting model. Capacity in planning and monitoring contracts at different levels in the Health system is required. Service delivery will be undermined if effective performance management is not established nor continuously applied. Improvements in the implementation of SOA include: better monitoring by the central and provincial levels; developing incentive schemes that tackle the issues of dual practice; and securing trustworthy baseline data for performance indicators.
Newlands David - One of the best experts on this subject based on the ideXlab platform.
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Internal contracting of Health services in Cambodia: drivers for change and lessons learned after a decade of external contracting
BioMed Central, 2018Co-Authors: Vong Sreytouch, Raven Joanna, Newlands DavidAbstract:** From PubMed via Jisc Publications Router. ** History: received 05-05-2017; accepted 30-04-2018.Since the late 1990s, contracting has been employed in Cambodia in an attempt to accelerate rural Health system recovery and improve Health service delivery. Special Operating Agencies (SOA), a form of 'internal contracting', was introduced into selected districts by the Cambodia Ministry of Health in 2009. This study investigates how the SOA model was implemented and identifies effects on service delivery, challenges in operation and lessons learned. The study was carried out in four districts, using mixed__methods. Key informant interviews were conducted with representatives of donors and the Ministry of Health. In-depth interviews were carried out with managers of SOA and Health facilities and Health workers from referral hospitals and Health centres. Data from the Annual Health Statistic Report 2009-2012 on utilisation of antenatal care, delivery and immunisation were analysed. There are several challenges with implementation: limited capacity and funding for monitoring the SOA, questionable reliability of the monitoring data, and some facilities face challenges in achieving the targets set in their contracts. There are some positive effects on staff behaviour which include improved punctuality, being on call for 24__h service, and perceived better quality of care, promoted through adherence to work regulations stipulated in the contracts and provision of incentives. However, flexibility in enforcing these regulations__in SOA has led to more dual practice, compared to previous contracting schemes. There are reported increases in utilization of services by the general population and the poor although the quantitative findings question the extent to which these increases are attributable to the contracting model. Capacity in planning and monitoring contracts at different levels in the Health system is required. Service delivery will be undermined if effective performance management is not established nor continuously applied. Improvements in the implementation of SOA include: better monitoring by the central and provincial levels; developing incentive schemes that tackle the issues of dual practice; and securing trustworthy baseline data for performance indicators.sch_iih18pub5389pub37
Xu Ruifang - One of the best experts on this subject based on the ideXlab platform.
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an analysis of occupational Health status after performing basic occupational Health service in qingpu district shanghai
Journal of environmental and occupational medicine, 2009Co-Authors: Yang Huifen, Cai Jinbao, Xu Huifang, Gu Chun, Zhou Ying, He Liyun, Xu RuifangAbstract:[Objective] To understand the status of occupational Health(OH) after performing Basic Occupational Health Service(BOHS) in Qingpu,Shanghai further to explore the practical BOHS system.[Methods] Based on the data from field investigation and local annual occupational Health Statistic reports,compared the OH status of post-BOHS and pre-BOHS.[Results] After performing BOHS since 2007,91.90% of the local enterprises established occupational Health records,90.86% sent their report of occupational hazards in factory to local Health Authority,and 52.99% received official heath inspection.Meanwhile,69.25% enterprises provided occupational Health examination to their employees with a cover rate of 94.11% of total employees,the rate of environmental hazard monitoring in workplace was 34.83%.The OH status was obviously improved than that prior to performing BOHS.What's more,almost all the enterprises performed pre-assessment for occupational hazards in construction project,and the number of enterprises performed the effective-assessment for occupational hazard control in construction project increased year by year,and the OH awareness apparently improved both in employees and management.According to the investigation,occupational hazards in 1 717 enterprises were analyzed and OH Guidance Manual based on their own conditions were prepared and allocated to each enterprise.[Conclusion] Performing on BOHS for enterprises,giving professional advice in OH,intensifying official inspection,supplying OH training to both employees and management can improve OH status in enterprises.It is necessary to push the trial of BOHS in our district forward to a regular systematically management on OH in order to protect employees from occupational hazards.
Sreytouch Vong - One of the best experts on this subject based on the ideXlab platform.
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internal contracting of Health services in cambodia drivers for change and lessons learned after a decade of external contracting
BMC Health Services Research, 2018Co-Authors: Sreytouch Vong, Joanna Raven, David NewlandsAbstract:Since the late 1990s, contracting has been employed in Cambodia in an attempt to accelerate rural Health system recovery and improve Health service delivery. Special Operating Agencies (SOA), a form of ‘internal contracting’, was introduced into selected districts by the Cambodia Ministry of Health in 2009. This study investigates how the SOA model was implemented and identifies effects on service delivery, challenges in operation and lessons learned. The study was carried out in four districts, using mixed methods. Key informant interviews were conducted with representatives of donors and the Ministry of Health. In-depth interviews were carried out with managers of SOA and Health facilities and Health workers from referral hospitals and Health centres. Data from the Annual Health Statistic Report 2009–2012 on utilisation of antenatal care, delivery and immunisation were analysed. There are several challenges with implementation: limited capacity and funding for monitoring the SOA, questionable reliability of the monitoring data, and some facilities face challenges in achieving the targets set in their contracts. There are some positive effects on staff behaviour which include improved punctuality, being on call for 24 h service, and perceived better quality of care, promoted through adherence to work regulations stipulated in the contracts and provision of incentives. However, flexibility in enforcing these regulations in SOA has led to more dual practice, compared to previous contracting schemes. There are reported increases in utilization of services by the general population and the poor although the quantitative findings question the extent to which these increases are attributable to the contracting model. Capacity in planning and monitoring contracts at different levels in the Health system is required. Service delivery will be undermined if effective performance management is not established nor continuously applied. Improvements in the implementation of SOA include: better monitoring by the central and provincial levels; developing incentive schemes that tackle the issues of dual practice; and securing trustworthy baseline data for performance indicators.
