RESUMEN
Hingeless shading systems inspired by nature are increasingly the focus of architectural research. In contrast to traditional systems, these compliant mechanisms can reduce the amount of maintenance-intensive parts and can easily be adapted to irregular, doubly curved, facade geometries. Previous mechanisms rely merely on the reversible material deformation of composite structures with almost homogeneous material properties. This leads to large actuation forces and an inherent conflict between the requirements of movement and the capacity to carry external loads. To enhance the performance of such systems, current research is directed at natural mechanisms with concentrated compliance and distinct hinge zones with high load-bearing capacity. Here, we provide insights into our biological findings and the development of a deployable structure inspired by the Flexagon model of hindwings of insects in general and the hierarchical structure of the wing cuticle of the shield bug (Graphosoma lineatum). By using technical fibre-reinforced plastics in combination with an elastomer foil, natural principles have been partially transferred into a multi-layered structure with locally adapted stiffness. Initial small prototypes have been produced in a vacuum-assisted hot press and sustain this functionality. Initial theoretical studies on test surfaces outline the advantages of these bio-inspired structures as deployable external shading systems for doubly curved facades.
Asunto(s)
Heterópteros/fisiología , Modelos Biológicos , Alas de Animales/fisiología , Animales , Fenómenos Biomecánicos , Materiales Biomiméticos/química , Microscopía Electrónica de Transmisión , Alas de Animales/anatomía & histología , Alas de Animales/ultraestructuraRESUMEN
Developing countries account for 84 percent of world population and 93 percent of the worldwide burden of disease; however, they account for only 18 percent of global income and 11 percent of global health spending. Limited resources and administrative capacity coupled with strong underlying needs for services pose serious challenges to governments in the developing world. This paper analyzes health spending, health outcomes, and health delivery system characteristics for the six developing regions of the world as well as for low-, medium-, and high-income country groupings.
Asunto(s)
Atención a la Salud/estadística & datos numéricos , Países en Desarrollo/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Costo de Enfermedad , Recolección de Datos , Atención a la Salud/economía , Reforma de la Atención de Salud , Indicadores de Salud , Humanos , Renta/estadística & datos numéricosRESUMEN
This paper discusses the basic conditions necessary for the successful implementation of health sector reforms. Lessons from health sector reforms in the 24 western industrialized member countries of the Organization for Economic Cooperation and Development (OECD) are discussed and applied in the context of reform efforts in developing countries. Reform areas addressed include: public and private institutional infrastructure development, financing arrangements, benefit design, eligibility determination, reimbursement and cost control methods, and service delivery system configurations.
Asunto(s)
Atención a la Salud/organización & administración , Países en Desarrollo/economía , Reforma de la Atención de Salud , Control de Costos , Atención a la Salud/economía , Estudios de Evaluación como Asunto , Financiación Gubernamental , Seguro de Salud , Objetivos Organizacionales , Sector Privado , Sector Público , Mecanismo de ReembolsoRESUMEN
U.S. health expenditure levels and rates of increase continue to exceed those of other Western industrialized nations. The pluralistic U.S. health care system has the highest excess health care inflation and opportunity costs of forgone nonhealth consumption and investment when compared with other major industrialized countries. While poor U.S. performance in terms of life expectancy at birth and infant mortality may partially result from social problems, there is little quantifiable evidence of value for money or equity in terms of health system performance.
Asunto(s)
Gastos en Salud/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Europa (Continente) , Unión Europea , Humanos , Evaluación de Resultado en la Atención de Salud , Calidad de la Atención de Salud/economía , Estados UnidosRESUMEN
Data comparing health expenditures in twenty-four industrialized nations show that the United States continues to lead the world in health spending as a percentage of gross domestic product. In 1991 the United States spent $2,868 per person on health care, compared with an average of $1,305 in Organization for Economic Cooperation and Development (OECD) countries. The U.S. figure exceeds spending in Canada, the next-highest spender, by 50 percent. Measures of health care use and health status do not provide convincing evidence that the United States has a superior health care system for its larger expenditure levels.
Asunto(s)
Comparación Transcultural , Gastos en Salud/tendencias , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Resultado del Tratamiento , Anciano , Anciano de 80 o más Años , Recolección de Datos , Europa (Continente) , Femenino , Gastos en Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/economía , Humanos , Lactante , Mortalidad Infantil/tendencias , Recién Nacido , Esperanza de Vida/tendencias , Masculino , Persona de Mediana Edad , Estados UnidosRESUMEN
In this article, the authors present the most recently available data on the health care financing and delivery systems of the 24 industrialized member countries of the Organization for Economic Cooperation and Development (OECD). U.S. health expenditure performance is compared with the performance of other OECD countries. Thirty-six tables of data from 1960-90 are presented on health expenditures, health care prices, availability and utilization of health care services, health outcomes, and basic economic and demographic factors.
Asunto(s)
Atención a la Salud/economía , Gastos en Salud/estadística & datos numéricos , Recursos en Salud/estadística & datos numéricos , Anciano , Canadá , Control de Costos , Recolección de Datos , Demografía , Europa (Continente) , Femenino , Política de Salud/economía , Indicadores de Salud , Humanos , Recién Nacido , Agencias Internacionales , Japón , Masculino , Persona de Mediana Edad , Estados UnidosAsunto(s)
Atención a la Salud/economía , Gastos en Salud/estadística & datos numéricos , Servicios de Salud/estadística & datos numéricos , Femenino , Salud Global , Accesibilidad a los Servicios de Salud , Estado de Salud , Hospitalización/estadística & datos numéricos , Humanos , Recién Nacido , Cooperación Internacional , Masculino , Embarazo , Estados UnidosRESUMEN
In this article, the authors provide an overview of the problem of health care cost containment. Both the growth of health care spending and its underlying causes are discussed. Further, the authors define cost containment, provide a framework for describing cost-containment strategies, and describe the major cost-containment strategies. Finally, the role of research in choosing such a strategy for the United States is examined.
Asunto(s)
Control de Costos/métodos , Costos de la Atención en Salud/tendencias , Política de Salud/economía , Seguro de Costos Compartidos , Deducibles y Coseguros , Eficiencia , Costos de la Atención en Salud/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Gastos en Salud/tendencias , Investigación sobre Servicios de Salud , Hospitales , Medicare/estadística & datos numéricos , National Health Insurance, United States , Médicos , Estados UnidosRESUMEN
In this article, levels and changes in health care expenditures for Canada, France, the Federal Republic of Germany, Italy, Japan, the United Kingdom, and the United States are analyzed. First, the levels and changes in the share of gross domestic product (GDP) devoted to health are reviewed in terms of the health-to-GDP ratio, nominal health expenditure and GDP growth, and changes in population and prices. Second, absolute levels of health spending denominated in U.S. dollars are compared over time. Finally, some concluding observations are made.
Asunto(s)
Economía Hospitalaria/tendencias , Economía Médica/tendencias , Gastos en Salud/estadística & datos numéricos , Servicios de Salud/economía , Canadá , Europa (Continente) , Japón , Estadística como Asunto , Estados UnidosRESUMEN
This paper provides a detailed description of the statistical systems of the U.S. Medicare program and discusses how these data bases can be used for health policy analyses and for international comparisons of health systems at the microeconomic level. First, the Medicare program in the context of the entire U.S. health care financing and delivery system is described. Second, the Medicare data collection process and the detailed data elements collected as part of the various Medicare administrative and research data bases are discussed in detail. Third, the use of these microdata for international comparisons of medical effectiveness, incentive effects of alternative reimbursement systems, technology assessment, service use by consumers, and industry impacts is suggested. International comparisons of health systems based on microdata are essential for understanding the underlying dynamics of health systems as well as for attributing performance to specific features or policies.
Asunto(s)
Centers for Medicare and Medicaid Services, U.S. , Recolección de Datos/métodos , Sistemas de Apoyo a Decisiones Administrativas , Sistemas de Información Administrativa , Medicare/estadística & datos numéricos , United States Dept. of Health and Human Services , Comparación Transcultural , Interpretación Estadística de Datos , Atención a la Salud/organización & administración , Investigación sobre Servicios de Salud/organización & administración , Análisis de Sistemas , Estados UnidosRESUMEN
Health care expenditure and utilization trends in the 24 Organization for Economic Cooperation and Development countries are provided and analyzed in terms of trends in price, population, and volume-intensity. The United States spends more on health than other countries, both in absolute dollar terms and relative to gross domestic product. Moreover, the gap appears to have grown in recent years. Although international comparisons are difficult for a number of reasons outlined in the article, they can be useful in focusing efforts to understand what the United States is getting for its one-half trillion dollar expenditure on health services.
Asunto(s)
Gastos en Salud/estadística & datos numéricos , Comparación Transcultural , Europa (Continente) , Estados UnidosRESUMEN
The United States has a greater per capita outlay for health care than any other nation. While expending a higher share of gross domestic product (GDP), it is not certain that health care outcomes are better than those of other industrialized countries. Further research is needed to elucidate this paradox.