Health Care Spending Growth: How Different Is the United States from the Rest of the OECD
Congressional Budget Office, Washington, DC, USA.Health Affairs (Impact Factor: 4.97). 01/2007; 26(1):154-61. DOI: 10.1377/hlthaff.26.1.154
This paper compares the long-term (1970-2002) rates of real growth in health spending per capita in the United States and a group of high-income countries in the Organization for Economic Cooperation and Development (OECD). Real health spending growth is decomposed into population aging, overall economic growth, and excess growth. Although rates of aging and overall economic growth were similar, annual excess growth was much higher in the United States (2.0 percent) versus the OECD countries studied (1.1 percent). That difference, which is of an economically important magnitude, suggests that country-specific institutional factors might contribute to long-term health spending trends.
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- "Health spending has dramatically increased in recent decades due to several factors such as demographic trends or the widespread diffusion of expensive technological advances in medical practice (White, 2007). At global level, data from World Health Organization show that total expenditure on public and private health reached a much larger proportion of gross domestic product – 10.4% in 2010 compared to 8.2% in 2000 and has almost doubled on a per capita basis from US$485 spent in 2000 to US$947 in 2010. 1 At European level, overall health spending grew by an average of more than 4% per year, ranging from 1.9% in Italy to 10.3% in Slovak Republic (OECD Health Data 2012). "
ABSTRACT: Emergency medical services (EMS) are public safety systems responsible for the pre-hospital stabilization and transport of seriously injured patients. The goal of such systems is to respond adequately to population calls by providing first aid services and transferring patients, when needed, to the emergency department of the appropriate hospital. In order to achieve this goal, a variety of tools (e.g. simulation, mathematical programming and queuing theory models) have been used to improve the performance of EMS. This paper focuses specifically on computer simulation models used for the analysis and improvement of EMS. In particular, we give a critical overview of the existing international literature on simulation models for EMS by pinpointing the issues considered, the associated modeling assumptions as well as the results obtained. Such a contribution is lacking in the current literature.Computers & Industrial Engineering 12/2013; 66(4):734–750. DOI:10.1016/j.cie.2013.09.017 · 1.78 Impact Factor
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- "Rising levels of demand due to ageing populations and increases in long-term conditions (White, 2007), increased levels of expectation amongst patients and inflationary pressure caused by the rising cost of new technologies are amongst the explanations for the funding shortfalls in government funded health systems across the world. The challenge facing these health systems has also been intensified by the worldwide economic downturn. "
ABSTRACT: The aims of this paper are to explore the experiences of budget holders within the English National Health Service (NHS), in their attempts to implement programmes of disinvestment, and to consider factors which influence the success (or otherwise) of this activity. Between 24 January and 15 March 2011 semi-structured, telephone interviews were conducted with representatives of 12 Primary Care Trusts in England. Interviews focussed on: understanding of the term "disinvestment"; current activities, and perceived determinants of successful disinvestment decision making and implementation. Data were organised into themes according to standard qualitative data coding practices. Findings indicate that experiences of disinvestment are varied and that organisations are currently adopting a range of approaches. There are a number of apparently influential determinants of disinvestment which relate to both health system features and organisational characteristics. According to the experiences of the interviewees, many of the easier disinvestment options have now been taken and more ambitious plans, which require wider engagement and more thorough project management, will be required in the future. Findings from the research suggest that issues around understanding and usage of disinvestment terminology should be addressed and that a more in-depth and ethnographic research agenda will be of most value in moving forward both the theory and practice of disinvestment. This research suggests that, in the English NHS at least, there is a disjuncture between common usage of the term "disinvestment" and the way that it has previously been understood by the wider research community. In addition to this, the research also highlights a broader range of potential determinants of disinvestment than are considered in the extant literature.Journal of Health Organisation and Management 01/2013; 27(6):762-80. DOI:10.1108/JHOM-11-2012-0225 · 0.36 Impact Factor
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- "hospitals, hotel rooms, apartments, houses, classrooms). Such kind of smart environments will be increasingly more frequent in the industrialized countries (like in North America, Europe and Japan) as their proportion of aged populations is increasing . In addition to helping dependant people in increasing their autonomy and quality of life, the smart environments allow to reduce the needed interventions from professional healthcare caregivers, reducing by the way the induced costs. "
ABSTRACT: Ambient and pervasive technologies provide several ways to assist people with special needs in smart environments. However, the system's complexity and the size of the contextual information of these environments lead to several difficulties in deploying and providing the assistance services. A service provision mechanism which is aware of the environment context can simplify the deployment of assistance services on environment devices, by taking care of the decision processes. Moreover, the integration of the interaction modalities in the decision processes of such mechanisms allows deliveries of services to users based on their capabilities and preferences. In this paper, we present a context-aware service provision system for smart environment, which takes into account a whole set of contextual information: user profiles, device profiles, software profiles and environment topology. In regards to our previous work, this paper focuses on the modeling of the user interaction capabilities, built around the notion of interaction modalities. We also detail the integration of the model to the service provision reasoning process, as well as its implementation. Finally, we demonstrate the functionalities of this system through technical validations and scenarios carried out in a real smart apartment.Journal of Ambient Intelligence and Smart Environments 01/2013; 5(1):47-64. DOI:10.3233/AIS-120190 · 1.06 Impact Factor
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