RESUMEN
From June 27th to July 1st 2016, the International Hospital Federation (IHF) and Health Investment & Financing hosted a Hospital Executive Study Tour in New York City, NY, USA. The objective of the Hospital Executive Study Tour was to enable participant to learn how the US hospital sector addresses some of the key challenges and solutions in transforming the way hospital care is delivered in the 21st Century. The New York Study Tour was part of a series of premier events offered by the IHF. This Study Tour was a collaborative effort among regional members and partner organizations in hosting various events to allow an exchange of ideas, knowledge, experiences and best practices in the delivery of healthcare services, and in the leadership and management of their organizations.
Asunto(s)
Administradores de Hospital/educación , Aprendizaje , Patient Protection and Affordable Care Act , Administración Hospitalaria , Administradores de Hospital/psicología , Humanos , Ciudad de Nueva York , Estados UnidosAsunto(s)
Salud Ambiental/normas , Contaminación Ambiental/efectos adversos , Salud Global/normas , Adolescente , Adulto , Distribución por Edad , Anciano , Contaminantes Atmosféricos/efectos adversos , Niño , Preescolar , Enfermedad Crónica/epidemiología , Enfermedad Crónica/prevención & control , Conservación de los Recursos Naturales , Costo de Enfermedad , Salud Ambiental/economía , Salud Ambiental/legislación & jurisprudencia , Contaminación Ambiental/prevención & control , Femenino , Salud Global/estadística & datos numéricos , Política de Salud , Disparidades en el Estado de Salud , Humanos , Lactante , Recién Nacido , Cooperación Internacional , Masculino , Persona de Mediana Edad , Mortalidad Prematura , Enfermedades no Transmisibles/epidemiología , Salud Laboral/normas , Pobreza , Características de la Residencia , Contaminantes del Suelo/efectos adversos , Contaminantes del Agua/efectos adversos , Organización Mundial de la Salud , Adulto JovenRESUMEN
BACKGROUND: In this paper, we review lessons learned about Universal Health Coverage (UHC) in middle-income countries, with specific reference to achievements and challenges observed during recent years in four middle-income to upper-middle-income countries - Mexico, Turkey, The Republic of Korea and Ukraine. Three of these countries - Mexico, the Republic of Korea, Turkey are members of the Organization for Economic Cooperation and Development (OECD). Ukraine has aspired to join Western institutions like the OECD since its independence in 1991. METHODS: The research included a combination of cross-sectional and longitudinal reviews of both statistical and contextual data, available from both published sources and available "grey literature" reports. RESULTS: Based on the research, we conclude the following. First, reaching UHC is achievable in middle-income and upper-middle-income countries. It is not an unattainable goal reserved for upper income countries. Second, successes and failures are evident both in the case of countries that pursue a contributory health insurance path to UHC and those that pursue a core government funding path. Third, the devil is often in the detail. De jure constitutional guarantees and national health legislation are often a necessary but do not constitute a guaranteed path to success without accompanying institutional measure to secure sustainability (political and economic) and supply and demand constraints in service provision and consumer/patient behavior. De facto, in most countries expansion in health insurance coverage does not happen "with the stroke of a pen" but require years of commitment and efforts to change the supply and demand after critical legislation has been enacted. Fourth, two major approaches dominate: incremental and "big bang" health system reforms. CONCLUSIONS: We caution against the pitfalls of over-attribution from drawing too strong conclusion from individual longitudinal country experiences ("over-determinism") and over-generalization from broad sweeping cross-sectional statistical analysis ("reductionism"). Every country is different and needs to find its own path towards UHC considering their contextual specificities, learning from the achievements and failures of others, but not try to copy their experiences.
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Países en Desarrollo , Atención de Salud Universal , Estudios Transversales , Humanos , Renta , Cobertura Universal del Seguro de SaludRESUMEN
Health worker finance and provision are discussed in this article in the context of the global shortage of human resources. Key issues related to public and private finance or provision of tertiary health education institutions are highlighted, and costs, benefits, and feasibility of potential financing or provision solutions are identified. Engagement of the private sector can expand the resources available for education and align incentives to address an important inefficiency: the unfunded mandate of post-graduate in-service training at hospitals that jointly provide education and health services.