Toward a utility theory foundation for health status index models.
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The axioms of utility theory are restated in terms of health outcomes, and some additional assumptions, consistent with the assumptions implicit in health status index models, are adduced to develop a consistent theory of the utility of health states. On the basis of the axioms and specific assumptions, techniques for measuring the health utility functions of individuals are described, and it is shown how these axioms and assumptions may be used to determine the utility to the individual of health programs that will affect him in various ways. (+info)
State intervention in medical care: types, trends and variables.
(42/14889)
This article attempts to develop some of the basic elements for a theory of state intervention in medical care. First, a typology of state intervention is proposed based on two dimensions: the form of state control over the production of medical services and the basis for eligibility of the population. The resulting twelve types provide a means of describing national patterns of state intervention at a given point in time. Next, in order to analyse the changing patterns of state intervention in medical care over time, changes in state control and population coverage are used to construct three hypothetical 'paths' of state intervention, which may serve to depict broad historical trends in major groups of countries. In the final section, several variables are analysed according to their expected effect on the patterns of convergence and divergence in the form and degree of state intervention between countries. This cross-national comparative perspective is offered as a strategy for building a theory capable of explaining state intervention, a process that, to a large extent, informs the medical experience of today. (+info)
The National Health Service in the UK: from myths to markets.
(43/14889)
This paper traces the introduction of economic principles into the NHS over the past 40 years. During this period the service has changed from one which specifically sought to distance the delivery of health care from homo-economicus to one which is increasingly shaped by economic motivation and market-oriented strategies. Three phases in this development are discussed: the administered phase 1948-74, the planning phase 1974-84, and the present management phase. Each phase required different systems of information to support the organization of the service according to the underlying beliefs and philosophy about the relevance of economics to health care. It is suggested that the impact of market provision of health care will need to be vigilantly monitored to ensure that standards of the nation's health care are effective and equitably distributed. (+info)
Human resource development: the management, planning and training of health personnel.
(44/14889)
The morale of health personnel is fast becoming the major factor affecting both the sustainability and the quality of health care world-wide. Low morale mirrors problems ranging from declining balance of payments allocation to GNP, and a lack of support for the health system from the very top down to the rigid application of national pay, grading and career structures, and the stress of not being able to do the job properly. While many of these and other problems have been voiced again and again in the press and in the academic literature, much of the work on health manpower development has focused on the planning and production of personnel. This has been with the aim of producing specific categories of better-trained health workers with relevant qualifications, resulting in a heavy emphasis on a quantitative output. In this paper it is argued that the management of health personnel, the qualitative aspect of staff development, has been relatively neglected. Unless and until the management of human resource development receives the attention it needs, seeds of discontent, disillusion and dissatisfaction will ultimately lead to national health services losing their competitiveness as employers. The sustainability and quality of health programmes will then be in even greater jeopardy than they are at present. The planning, production and management components of health manpower development have developed haphazardly as verticle activities. A new term such as 'human resource development; the management of health personnel' might help ensure the concept of an integrated process contingent on economic, political, organizational and other important circumstances. (+info)
The mortality component of health status indexes.
(45/14889)
The mortality component of contemporary health indexes is discussed. Since these indexes reduce to mortality indexes when only life and death states enter the analysis, they share the conceptual weaknesses of mortality indexes. Also, they do not incorporate consumption variables explicity and therefore provide no structure for relating health status and living standard. Some attention is devoted to methodological problems of assessing survival probabilities, either from survey or experimental data or from beliefs of experts or individuals who are affected directly. The final section deals with individual preferences for survival lotteries. Conceptual weaknesses of common indexes are discussed, several canonical models for survival preferences are presented, the interdependence of individual utilities is discussed, and methods for eliciting individual survival preferences are considered, along with some illustrative empirical results. (+info)
Influence of archwire and bracket dimensions on sliding mechanics: derivations and determinations of the critical contact angles for binding.
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There is every indication that classical friction controls sliding mechanics below some critical contact angle, theta c. Once that angle is exceeded, however, binding and notching phenomena increasingly restrict sliding mechanics. Using geometric archwire and bracket parameters, the theta c is calculated as the boundary between classical frictional behaviour and binding-related phenomena. What these equations predict is independent of practitioner or technique. From these derivations two dimensionless numbers are also identified as the bracket and the engagement index. The first shows how the width of a bracket compares to its Slot; the second indicates how completely the wire fills the Slot. When nominal wire and bracket dimensions are calculated for both standard Slots, the maximum theta c theoretically equals 3.7 degrees. Thus, knowledge of the archwire or bracket alone is insufficient; knowledge of the archwire-bracket combination is necessary for theta c to be calculated. Once calculated, sliding mechanics should be initiated only after the contact angle, theta, approaches the characteristic value of theta c for the particular archwire-bracket combination of choice--that is, when theta approximately theta c. (+info)
Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions.
(47/14889)
The premise of this article is that, until recently, health promotion for people with disabilities has been a neglected area of interest on the part of the general health community. Today, researchers, funding agencies, and health care providers and consumers are leading an effort to establish higher-quality health care for the millions of Americans with disabilities. The aims of a health promotion program for people with disabilities are to reduce secondary conditions (eg, obesity, hypertension, pressure sores), to maintain functional independence, to provide an opportunity for leisure and enjoyment, and to enhance the overall quality of life by reducing environmental barriers to good health. A greater emphasis must be placed on community-based health promotion initiatives for people with disabilities in order to achieve these objectives. (+info)
Global and local implications of biotechnology and climate change for future food supplies.
(48/14889)
The development of improved technology for agricultural production and its diffusion to farmers is a process requiring investment and time. A large number of studies of this process have been undertaken. The findings of these studies have been incorporated into a quantitative policy model projecting supplies of commodities (in terms of area and crop yields), equilibrium prices, and international trade volumes to the year 2020. These projections show that a "global food crisis," as would be manifested in high commodity prices, is unlikely to occur. The same projections show, however, that in many countries, "local food crisis," as manifested in low agricultural incomes and associated low food consumption in the presence of low food prices, will occur. Simulations show that delays in the diffusion of modern biotechnology research capabilities to developing countries will exacerbate local food crises. Similarly, global climate change will also exacerbate these crises, accentuating the importance of bringing strengthened research capabilities to developing countries. (+info)