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10.
PLoS One ; 15(7): e0234642, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614845

RESUMO

The role of external actors in national health policy in aid-independent countries has received relatively little attention in the literature, despite the fact that influence continues to be exerted once financial support is curtailed as countries graduate from lower income status. Focusing on a specific health policy in an aid-independent country, this qualitative study explores the role of external actors in shaping Thailand's migrant health insurance. Primary data were collected through in-depth interviews with eighteen key informants from September 2018 to January 2019. The data were analysed using thematic analysis, focusing on three channels of influence, financial resources, technical expertise and inter-sectoral leverage, and their effect on the different stages of the policy process. Given Thailand's export orientation and the importance of reputational effects, inter-sectoral leverage, mainly through the US TIP Reports and the EU carding decision, emerged as a very powerful channel of influence on priority setting, as it indirectly affected the migrant health insurance through efforts aimed at dealing with problems of human trafficking in the context of labour migration, especially after the 2014 coup d'état. This study helps understand the changed role external actors can play in filling health system gaps in aid-independent countries.


Assuntos
Política de Saúde , Pessoas sem Cobertura de Seguro de Saúde , Determinantes Sociais da Saúde , Migrantes , Cobertura Universal do Seguro de Saúde , Financiamento de Capital , Instituições de Caridade/economia , Países em Desenvolvimento , Órgãos Governamentais , Gastos em Saúde , Tráfico de Pessoas , Humanos , Agências Internacionais , Colaboração Intersetorial , Entrevistas como Assunto , Pessoas sem Cobertura de Seguro de Saúde/legislação & jurisprudência , Organizações/economia , Política , Mudança Social , Tailândia , Migrantes/legislação & jurisprudência , Imigrantes Indocumentados/legislação & jurisprudência , Cobertura Universal do Seguro de Saúde/economia , Cobertura Universal do Seguro de Saúde/legislação & jurisprudência , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos
13.
Hist Cienc Saude Manguinhos ; 26(suppl 1): 79-108, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31994682

RESUMO

This article investigates how the santas casas de misericórdia charitable associations in the state of São Paulo were subsidized by the municipal, provincial, and state governments at the turn of the twentieth century. Budget appropriations from 1838 to 1915 were examined to evaluate these charitable grants as well as the growth in funding during this period. While a care network created with strong state backing, it was put into action by philanthropic assistance. This network of hospital care retained the same format until at least the first third of the twentieth century, and included misericórdia establishments created within the interior of the state of São Paulo.


O artigo analisa como as santas casas de misericórdia do estado de São Paulo foram subvencionadas pelos governos municipais, provincial e estadual na passagem do século XIX para o XX. Para tanto, são discutidas as dotações orçamentárias realizadas de 1838 a 1915, com o fim de avaliar o repasse e a ampliação de verbas nesse ínterim. É possível notar que foi criada uma rede de assistência fortemente apoiada pelo Estado, mas efetivada pela assistência filantrópica. Essa rede de atendimento hospitalar permanece com o mesmo formato até pelo menos o primeiro terço do século XX, contexto em que se incluíam as misericórdias criadas pelo interior do estado paulista.


Assuntos
Instituições de Caridade/história , Política de Saúde/história , Hospitais/história , Brasil , Orçamentos/história , Instituições de Caridade/economia , Instituições de Caridade/legislação & jurisprudência , Economia Hospitalar/história , Financiamento Governamental/história , Governo/história , História do Século XVIII , História do Século XIX , História do Século XX , Humanos
14.
J Exp Psychol Appl ; 26(3): 538-550, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31916807

RESUMO

Public recognition is usually thought to motivate charitable giving. However, the current research identifies an important context in which the opposite occurs. We examine commonplace donation decisions involving modest amounts of money, which either take place in private, or are observed by others. We find robust evidence that public recognition can decrease donation likelihood. Furthermore, we demonstrate that this effect operates through a self-signaling mechanism: Public recognition creates ambiguity about whether the choice to donate is motivated by genuine altruism or the desire for recognition. As a result, public recognition can crowd out, or undermine, the self-signal of altruism, which in turn decreases donation rates. Finally, we test an important theoretical boundary, and show that when the social benefits associated with public recognition for donating are sufficiently valuable, the negative effects of public recognition attenuate. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Altruísmo , Instituições de Caridade/economia , Comportamento de Ajuda , Motivação , Psicologia Social , Adulto , Feminino , Humanos , Masculino
15.
Addiction ; 115(4): 690-699, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31506995

RESUMO

BACKGROUND AND AIMS: The burden on family members of those who are dependent on illicit drugs is largely unidentified, despite the presence of significant negative financial, health and social impacts. This makes it difficult to provide appropriate services and support. This study aimed to assess the preferences for treatment attributes for heroin dependence among family members affected by the drug use of a relative and to obtain a measure of the intangible economic benefit. DESIGN: Discrete choice experiment. Data were analysed using mixed logit which accounted for repeated responses. SETTING: Australia. PARTICIPANTS: Eligible participants were Australian residents aged 18+ years with a relative with problematic drug use. Complete data on 237 respondents were analysed; 21 invalid responses were deleted. MEASUREMENTS: Participant preference for likelihood of staying in treatment, family conflict, own health status, contact with police and monetary contribution to a charitable organization providing treatment. FINDINGS: All attributes were significant, and the results suggest that there was a preference for longer time in treatment, less family discord, better own health status, less likelihood of their relative encountering police and, while they were willing to contribute to a charity for treatment to be available, they prefer to pay less, not more. In order of relative importance, participants were willing to pay an additional A$4.46 [95% confidence interval (CI) = 3.33-5.60] for treatment which resulted in an additional 1% of heroin users staying in treatment for longer than 3 months, A$42.00 (95% CI = 28.30-55.69) to avoid 5 days per week of family discord, A$87.94 (95% CI = 64.41-111.48) for treatment options that led to an improvement in their own health status and A$129.66 (95% CI = 53.50-205.87) for each 1% decline in the chance of police contact. CONCLUSIONS: Drug treatment in Australia appears to have intangible benefits for affected family members. Families are willing to pay for treatment which reduces family discord, improves their own health, increases time in treatment and reduces contact with police.


Assuntos
Comportamento de Escolha , Comportamento do Consumidor/economia , Família/psicologia , Dependência de Heroína/terapia , Adulto , Instituições de Caridade/economia , Conflito Familiar/economia , Feminino , Nível de Saúde , Humanos , Aplicação da Lei , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Hist. ciênc. saúde-Manguinhos ; 26(supl.1): 79-108, out.-dez. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1056285

RESUMO

Resumo O artigo analisa como as santas casas de misericórdia do estado de São Paulo foram subvencionadas pelos governos municipais, provincial e estadual na passagem do século XIX para o XX. Para tanto, são discutidas as dotações orçamentárias realizadas de 1838 a 1915, com o fim de avaliar o repasse e a ampliação de verbas nesse ínterim. É possível notar que foi criada uma rede de assistência fortemente apoiada pelo Estado, mas efetivada pela assistência filantrópica. Essa rede de atendimento hospitalar permanece com o mesmo formato até pelo menos o primeiro terço do século XX, contexto em que se incluíam as misericórdias criadas pelo interior do estado paulista.


Abstract This article investigates how the santas casas de misericórdia charitable associations in the state of São Paulo were subsidized by the municipal, provincial, and state governments at the turn of the twentieth century. Budget appropriations from 1838 to 1915 were examined to evaluate these charitable grants as well as the growth in funding during this period. While a care network created with strong state backing, it was put into action by philanthropic assistance. This network of hospital care retained the same format until at least the first third of the twentieth century, and included misericórdia establishments created within the interior of the state of São Paulo.


Assuntos
Humanos , História do Século XVIII , História do Século XIX , História do Século XX , Instituições de Caridade/história , Política de Saúde/história , Hospitais/história , Brasil , Orçamentos/história , Instituições de Caridade/economia , Instituições de Caridade/legislação & jurisprudência , Economia Hospitalar/história , Financiamento Governamental/história , Governo/história
17.
Nat Commun ; 10(1): 3968, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481650

RESUMO

The current study uses big data to study prosocial behavior by analyzing donations made on the GoFundMe platform. In a dataset of more than $44 million in online donations, we find that 21% were made while opting to be anonymous to the public, with survey results indicating that 11% of these anonymous donations (2.3% of all donations) are not attributable to any egoistic goal. Additionally, we find that donors gave significantly more to recipients who had the same last name as them. We find evidence that men and women donated more when more donors of the opposite sex were visible on the screen at the time of donating. Our results suggest that men and women were both significantly affected by the average donation amounts visible at the time of their decisions, and men were influenced more. We find that women expressed significantly more empathy than men in messages accompanying their donations.


Assuntos
Instituições de Caridade/estatística & dados numéricos , Motivação , Mídias Sociais/estatística & dados numéricos , Adulto , Altruísmo , Instituições de Caridade/economia , Tomada de Decisões , Feminino , Humanos , Masculino , Nomes , Sistemas On-Line , Comportamento Social , Mídias Sociais/economia , Inquéritos e Questionários
18.
JAMA ; 322(5): 422-429, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31386135

RESUMO

Importance: Although independent charity patient assistance programs improve patient access to costly prescription drugs, recent federal investigations have raised questions about their potential to increase pharmaceutical spending and to violate the federal Anti-Kickback Statute. Little is known about the design of the programs, patient eligibility, or drug coverage. Objective: To examine the eligibility criteria of the independent charity patient assistance programs and the drugs covered by them. Design, Setting, and Participants: Descriptive cross-sectional study of the 6 largest independent charities offering patient assistance programs for patients including, but not limited to, Medicare beneficiaries in 2018. These charities offered 274 different disease-specific patient assistance programs. Drugs were identified for subgroup analysis that had any use reported on the Medicare Part D spending dashboard and any off-patent brand-name drugs that incurred more than $10 000 in Medicare spending per beneficiary in 2016. Exposures: Support by independent charity patient assistance programs. Main Outcomes and Measures: The primary outcomes were the characteristics of patient assistance programs, including assistance type, insurance coverage (vs uninsured), and income eligibility. The secondary outcomes were the cost of the drugs covered by the patient assistance programs and the coverage of expensive off-patent brand-name drugs vs substitutable generic drugs. Results: Among the 6 independent charity foundations included in the analysis, their total revenue in 2017 ranged from $24 million to $532 million, and expenditures on patient assistance programs ranged from $24 million to $353 million, representing on average, 86% of their revenue. Of the 274 patient assistance programs offered by these organizations, 168 (61%) provided only co-payment assistance, and the most common therapeutic area covered was cancer or cancer treatment-related symptoms (113 patient assistance programs; 41%). A total of 267 programs (97%) required insurance coverage as an eligibility criterion (ie, excluded uninsured patients). The most common income eligibility limit was 500% of the federal poverty level. The median annual cost of the drugs per beneficiary covered by the programs was $1157 (interquartile range, $247-$5609) compared with $367 (interquartile range, $100-$1500) for the noncovered drugs. Off-patent brand-name drugs (cost: >$10 000) were covered by a mean of 3.1 (SD, 2.0) patient assistance programs, whereas their generic equivalents were covered by a mean of 1.2 (SD, 1.0) patient assistance programs. Conclusions and Relevance: In 2018, among 274 patient assistance programs operated by the 6 independent charity foundations, the majority did not provide coverage for uninsured patients. Medications that were covered by the patient assistance programs were generally more expensive than those that were not covered.


Assuntos
Instituições de Caridade/economia , Definição da Elegibilidade , Renda , Pessoas sem Cobertura de Seguro de Saúde , Medicamentos sob Prescrição/economia , Instituições de Caridade/legislação & jurisprudência , Estudos Transversais , Custos de Medicamentos , Indústria Farmacêutica/economia , Gastos em Saúde , Humanos , Cobertura do Seguro , Assistência Médica/economia , Medicare Part D , Estados Unidos
19.
Int J Health Plann Manage ; 34(4): e1810-e1819, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31436892

RESUMO

BACKGROUND: Charitable donations play a major role in the provision of hospice and palliative care (HPC) services, most of which are not reimbursed by health insurance programs. A good understanding of the constitution and use of donations is thus conducive to maintaining a high-quality HPC unit. METHODS: The data sources were the publicly available balance sheet, work report, and donor lists of a foundation exclusively supporting one of the best HPC units in Taiwan in the fiscal year of 2017. The analysis included the donation amounts and frequencies by donor type (individual, corporate, and group) and the categories of expenses. RESULTS: The foundation received 3033 donations worth a total of 7.8 million New Taiwan dollars (NTD) (approximately 258 thousand US dollars) in 2017. Two-thirds of the donations were allocated to the provision of direct care services. Of the 3033 donations, only 11 (0.4%) were worth 100 000 NTD or more, while 108 (3.6%) were valued between 10 000 and 99 999 NTD, 1268 (41.8%) were valued between 1000 and 9999 NTD, and 1646 (54.2%) were worth less than 1000 NTD. Of 1051 donors, 974 (92.7%) were individuals, 378 (36.0%) donated more than once, and 106 (10.1%) donated 12 or more times in one year. CONCLUSION: HPC services in Taiwan are sponsored by lots of individuals and small donations. For sustainability of standards-based and quality HPC services, the benevolence of the public should be thus cherished and adequately responded to.


Assuntos
Instituições de Caridade/estatística & dados numéricos , Hospitais para Doentes Terminais , Cuidados Paliativos , Instituições de Caridade/economia , Fundações/economia , Fundações/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Hospitais para Doentes Terminais/economia , Humanos , Cuidados Paliativos/economia , Taiwan
20.
Healthc Manage Forum ; 32(6): 323-325, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31266346

RESUMO

Clinical research is funded by industry, governments, charities, and hospitals. It is important to know the economic commitment of the various funding bodies, but until now there has been no national source available which provides these data. We surveyed the major funders to provide such a measure. There is evidence that government and charity funding of medical research is a trigger for private sector research investment; therefore, tracking all sources of funding for clinical research will provide policy-makers with an overall picture of health research funding. These data support policy decision-making related to clinical research in Canada.


Assuntos
Pesquisa Biomédica/economia , Apoio à Pesquisa como Assunto , Pesquisa Biomédica/organização & administração , Canadá , Instituições de Caridade/economia , Instituições de Caridade/organização & administração , Financiamento Governamental/economia , Financiamento Governamental/organização & administração , Humanos , Formulação de Políticas , Apoio à Pesquisa como Assunto/métodos , Apoio à Pesquisa como Assunto/organização & administração
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