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1.
BMJ Open ; 11(4): e049069, 2021 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-33849861

RESUMO

OBJECTIVE: To investigate the association between participation in government subsidies for domestic travel (subsidise up to 50% of all travel expenses) introduced nationally in Japan on 22 July 2020 and the incidence of symptoms indicative of COVID-19 infections. DESIGN: Cross-sectional analysis of nationally representative survey data. SETTING: Internet survey conducted between 25 August and 30 September 2020 in Japan. Sampling weights were used to calculate national estimates. PARTICIPANTS: 25 482 survey respondents (50.3% (12 809) women; mean (SD) age, 48.8 (17.4) years). MAIN OUTCOME MEASURES: Incidence rate of five symptoms indicative of the COVID-19 infection (high fever, sore throat, cough, headache, and smell and taste disorder) within the past month of the survey, after adjustment for characteristics of individuals and prefecture fixed effects (effectively comparing individuals living in the same prefecture). RESULTS: At the time of the survey, 3289 (12.9%) participated in the subsidy programme. After adjusting for potential confounders, we found that participants in the subsidy programme exhibited higher incidence of high fever (adjusted rate, 4.7% for participants vs 3.7% for non-participants; adjusted OR (aOR) 1.83; 95% CI 1.34 to 2.48; p<0.001), sore throat (19.8% vs 11.3%; aOR 2.09; 95% CI 1.37 to 3.19; p=0.002), cough (19.0% vs 11.3%; aOR 1.96; 95% CI 1.26 to 3.01; p=0.008), headache (29.2% vs 25.5%; aOR 1.24; 95% CI 1.08 to 1.44; p=0.006) and smell and taste disorder (2.6% vs 1.8%; aOR 1.98; 95% CI 1.15 to 3.40; p=0.01) compared with non-participants. These findings remained qualitatively unaffected by additional adjustment for the use of 17 preventative measures (eg, social distancing, wearing masks and handwashing) and fear against the COVID-19 infection. CONCLUSIONS: The participation of the government subsidy programme for domestic travel was associated with a higher probability of exhibiting symptoms indicative of the COVID-19 infection.


Assuntos
/epidemiologia , Financiamento Governamental , Viagem/economia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade
3.
Cad Saude Publica ; 37(3): e00244719, 2021.
Artigo em Português, Espanhol | MEDLINE | ID: mdl-33852665

RESUMO

Since the Declaration of Alma-Ata in 1978, primary healthcare (PHC) is considered an essential component of health systems. In the Chilean case, management of primary care was municipalized during the dictatorship and maintained by the subsequent governments, with some reforms. The aim of this article was to estimate and analyze spending in PHC in Chile, during the governments of Sebastián Piñera and Michelle Bachelet. Collection of financial data was oriented by the model of National Health Accounts (CNS), and later the amounts were deflated according to the Consumer Price Index. The principal source of information was the National System of Municipal Information (SINIM). The results show that during the period there was a permanent increase in spending in PHC; however, the average percent change was slightly higher in the first government compared to the second. The percentage of spending in PHC in relation to public spending in health was 21.4% for the eight years, with few variations. Indicators show that inequalities between administrative and health regions are increasing steadily. Therefore, although transfers to fund primary care services are increasing, they may be poorly distributed. This and other problems like the commodification of services and dismantlement of the network compromise the consolidation of PHC, especially in a health system based on contributive insurance like the Chilean system.


Assuntos
Financiamento Governamental , Atenção Primária à Saúde , Brasil , Chile , Governo , Humanos
8.
Kennedy Inst Ethics J ; 31(1): 77-99, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33716228

RESUMO

What just societies owe to non-citizen immigrants is a controversial question. This paper considers three accounts of the requirements of distributive justice for non-citizens to determine what they might suggest about the provision of publicly funded health care to pregnant undocumented immigrants. These accounts are compared to locate an overlapping consensus on the duty of the state to provide care to pregnant undocumented immigrants. The aim of this paper is not to take a substantive position on the "right" prenatal policy, but rather to explore the moral space that this issue occupies and suggest that real moral progress can be achieved through the consistent application of shared values.


Assuntos
Financiamento Governamental/ética , Acesso aos Serviços de Saúde/economia , Serviços de Saúde Materna/economia , Imigrantes Indocumentados , Consenso , Feminino , Política de Saúde , Humanos , Obrigações Morais , Princípios Morais , Gravidez , Justiça Social , Problemas Sociais , Estados Unidos
9.
Health Aff (Millwood) ; 40(4): 664-671, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33764801

RESUMO

The COVID-19 pandemic has prompted concern about the integrity of the US public health infrastructure. Federal, state, and local governments spend $93 billion annually on public health in the US, but most of this spending is at the state level. Thus, shoring up gaps in public health preparedness and response requires an understanding of state spending. We present state spending trends in eight categories of public health activity from 2008 through 2018. We obtained data from the Census Bureau for all states except California and coded the data by public health category. Although overall national health expenditures grew by 4.3 percent in this period, state governmental public health spending saw no statistically significant growth between 2008 and 2018 except in injury prevention. Moreover, state spending levels on public health were not restored after cuts experienced during the Great Recession, leaving states ill equipped to respond to COVID-19 and other emerging health needs.


Assuntos
/epidemiologia , Gastos em Saúde , Saúde Pública/economia , /economia , Financiamento Governamental , Humanos , Pandemias , Estados Unidos/epidemiologia
11.
Healthc Policy ; 16(3): 16-25, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33720820

RESUMO

Canada's provinces are without a publicly funded psychotherapy program for common mental disorders despite evidence that psychological services help reduce the length and number of depressive episodes, symptoms of post-traumatic stress and associated negative outcomes (hospitalizations and suicide attempts). Studies also show that including psychological services as part of the service package offered under the public health plan for those without access pays for itself. We posit that a publicly funded psychotherapy program in Canada, including digitized self-guided psychotherapy platforms for common mental disorders, will lead to improved population health useful in the COVID-19 context and beyond.


Assuntos
Prática Clínica Baseada em Evidências/economia , Financiamento Governamental , Transtornos Mentais/terapia , Psicoterapia/economia , /epidemiologia , Canadá/epidemiologia , Humanos
13.
Artigo em Inglês | MEDLINE | ID: mdl-33525469

RESUMO

With the year-on-year growth of e-commerce transactions and the increasing popularity of the concept of ecological civilization, the waste and recycling of express packages have aroused widespread discussion and attention. On the issue of express package recycling, how consumers, e-commerce enterprises, and e-commerce platforms choose their own strategies, how to better promote the recycling of express packages, and what is the effect mechanism of government subsidies on different players. These are the questions that this article wants to answer. Since this article involves many stakeholders, in order to better identify the strategic choice and evolution of different entities and to better study the influence of government subsidies on the strategic choice of game players, this article uses two triparty evolutionary game models. The results show that without subsidies, changes in the rate of return and the initial probability will affect the evolution of the equilibrium strategy, while the synergistic benefits will have a corrective effect in some cases; when government subsidies are included and the probability of the three parties choosing "green strategies" is relatively low, subsidies should be paid to e-commerce companies mainly; lower subsidies can only provide incentives for e-commerce platforms. This article can provide certain references and value for government policymakers.


Assuntos
Embalagem de Produtos , Reciclagem , Comércio , Financiamento Governamental , Governo
18.
J Med Internet Res ; 23(2): e23957, 2021 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-33544690

RESUMO

BACKGROUND: During the COVID-19 pandemic in Canada, Prime Minister Justin Trudeau provided updates on the novel coronavirus and the government's responses to the pandemic in his daily briefings from March 13 to May 22, 2020, delivered on the official Canadian Broadcasting Corporation (CBC) YouTube channel. OBJECTIVE: The aim of this study was to examine comments on Canadian Prime Minister Trudeau's COVID-19 daily briefings by YouTube users and track these comments to extract the changing dynamics of the opinions and concerns of the public over time. METHODS: We used machine learning techniques to longitudinally analyze a total of 46,732 English YouTube comments that were retrieved from 57 videos of Prime Minister Trudeau's COVID-19 daily briefings from March 13 to May 22, 2020. A natural language processing model, latent Dirichlet allocation, was used to choose salient topics among the sampled comments for each of the 57 videos. Thematic analysis was used to classify and summarize these salient topics into different prominent themes. RESULTS: We found 11 prominent themes, including strict border measures, public responses to Prime Minister Trudeau's policies, essential work and frontline workers, individuals' financial challenges, rental and mortgage subsidies, quarantine, government financial aid for enterprises and individuals, personal protective equipment, Canada and China's relationship, vaccines, and reopening. CONCLUSIONS: This study is the first to longitudinally investigate public discourse and concerns related to Prime Minister Trudeau's daily COVID-19 briefings in Canada. This study contributes to establishing a real-time feedback loop between the public and public health officials on social media. Hearing and reacting to real concerns from the public can enhance trust between the government and the public to prepare for future health emergencies.


Assuntos
Governo Federal , Processamento de Linguagem Natural , Saúde Pública , Opinião Pública , Mídias Sociais , Canadá , Emigração e Imigração , Financiamento Governamental , Governo , Humanos , Estudos Longitudinais , Pandemias , Equipamento de Proteção Individual , Política Pública , Quarentena , Aprendizado de Máquina não Supervisionado
20.
PLoS One ; 16(2): e0246249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33606725

RESUMO

Societal responses to crises require coordination at multiple levels of organization. Exploring early efforts to contain COVID-19 in the U.S., we argue that local governments can act to ensure systemic resilience and recovery when higher-level governments fail to do so. Event history analyses show that large, more urban areas experience COVID-19 more intensely due to high population density and denser socioeconomic networks. But metropolitan counties were also among the first to adopt shelter-in-place orders. Analyzing the statistical predictors of when counties moved before their states, we find that the hierarchy of counties by size and economic integration matters for the timing of orders, where both factors predict earlier shelter-in-place orders. In line with sociological theories of urban governance, we also find evidence of an important governance dimension to the timing of orders. Liberal counties in conservative states were more than twice as likely to adopt a policy and implement one earlier in the pandemic, suggesting that tensions about how to resolve collective governance problems are important in the socio-temporal dynamic of responses to COVID-19. We explain this behavior as a substitution effect in which more urban local governments, driven by risk and necessity, step up into the action vacuum left by higher levels of government and become national policy leaders and innovators.


Assuntos
Financiamento Governamental , Pandemias/economia , População Rural , População Urbana , /economia , Humanos , Estados Unidos/epidemiologia
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