Consolidating the social health insurance schemes in China: towards an equitable and efficient health system

Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health ...

Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008–2013

Good governance for health (part of Strategy 3 of the Framework on Integrated People-Centred Health Services) involves broad, continuous and consultative policy dialogue on crucial health sector issues amongst and between all relevant social, technical and political stakeholders. Ideally, policy dialogue should also be based on the best available evidence. This paper demonstrates how building and maintaining data and evidence on relevant health sector issues, in this case the essential health services package in DRC, can contribute to rational policy dialogue over a sustained period of time. 

Background

10 Best resources on… intersectionality with an emphasis on low- and middle-income countries

Intersectionality has emerged as an important framework for understanding and responding to health inequities by making visible the fluid and interconnected structures of power that create them. It promotes an understanding of the dynamic nature of the privileges and disadvantages that permeate health systems and affect health. It considers the interaction of different social stratifiers (e.g. 'race'/ ethnicity, indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion) and the power structures that underpin them at multiple levels. In doing so, it is a departure from previous health inequalities research that looked at these forms of social stratification ...

Community participation for transformative action on women's, children's and adolescents' health

The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action ...

Person-centered care - ready for prime time

Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that ...

Health-care improvements in a financially constrained environment

Although the European Council agreed on common values such as good quality, universally accessible care in 1996, those values are now under threat. Health expenditure in all European Union (EU) countries between 1996 and 2013 increased from 7·9% to 9·5% of gross domestic product. There is a need to adapt to a financially constrained environment.

WE CARE is an EU Seventh Framework Programme consortium tasked to propose a research and development roadmap for innovative, cost-contained, quality care. The roadmap should not only consider efficacy from clinical trials but also community effectiveness, including the appropriateness of services provided.

Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial

Highlights

• Person-centred care in the recovery after an acute coronary syndrome event,
• Details of a co-created health plan to produce a partnership between patients and health care professionals,
• The transition of care continuing the partnership from in-hospital care to primary care,
• Improved self-efficacy by including a partnership compared to standard care alone.

Aim

To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome.

Method

199 patients with acute coronary syndrome < 75 years were randomly assigned to person-centred care intervention or treatment as usual and ...

Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial

Objective

To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA).

Interventions

The 12-week intervention, with 6-month follow-up, focused on partnership between participant and physical therapist and tailored health-enhancing physical activity and balancing life activities. The reference group continued with regular activities; both groups received usual health care.

Main Outcome Measures

Primary outcome was general fatigue (visual analog scale). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire) and fatigue-related variables (ie, disease, health, function).

Results

At posttest, general fatigue improved more in the intervention group than the reference group ...

Diversity Conceptual Model for aged care: Person-centred and difference-oriented and connective with a focus on benefit, disadvantage and equity

AIM:

This project aimed to develop a Diversity Conceptual Model to support the aged care sector to identify diversity characteristics and associated benefits and disadvantages in order to consider greater equity in policy and practice.

METHODS:

A multi-method approach was used to develop the Diversity Conceptual Model using a literature review, organisation-wide consultation using a questionnaire, focus groups and interviews with key stakeholders.

RESULTS:

A Diversity Conceptual Model was developed as a visual 'tool', made up of numerous components, with a focus on diversity characteristics that may be creating benefits and disadvantages for a consumer to participate in their health ...

Circles of Support and personalization: Exploring the economic case

Circles of Support aim to enable people with learning disabilities (and others) to live full lives as part of their communities. As part of a wider study of the economic case for community capacity building conducted from 2012 to 2014, we conducted a mixed methods study of five Circles in North West England. Members of these Circles were supporting adults with moderate to profound learning disabilities and provided accounts of success in enabling the core member to live more independent lives with improved social care outcomes within cost envelopes that appeared to be less than more traditional types of support ...