Comparison Of Healthcare Systems Research Articles

Comparison of health care systems in Poland and Great Britain by Poles staying temporarily in Great Britain prior to the COVID pandemic.

Poland's accession to the European Union intensified migration for work purposes. One of the most popular destinations for emigration was Great Britain, which allocates more money to health protection than Poland, where there is a widespread belief that the quality of public health care is poor. However, more negative opinions were expressed by migrants about health care in Great Britain. The aim of the study was to compare and assess the quality of health services in Poland and Great Britain prior to the SARS COVID-19 pandemic. The study was conducted in the form of a questionnaire addressed to Poles who stay or stayed in the territory of Great Britain and used services provided by both Polish and British medical entities. 1,625 people took part in the study: 1,402 women (86.28%) and 223 men (13.72%). The survey contained 30 questions, of which statistically significant results were obtained in 5 of them. There was a statistically significant difference in the average assessments of health services in Poland and Great Britain. The availability of primary health care services and specialist services, other than gynaecology, in Poland was rated higher. In addition, the quality and costs of treatment received a much higher average score in the evaluation of Polish health care compared to the British system. Although the amount of financial outlays and statistical data should suggest the advantage of the British health care system, the respondents assessed the services provided in Poland being better.

OP057: Implementation of universal Lynch syndrome tumor screening programs – A comparison of health care systems with and without programs

Screening all colorectal cancer (CRC) tumors for Lynch syndrome (LS) was first recommended in 2009. Universal tumor screening (UTS) for LS among all newly diagnosed cases of colorectal (CRC) and endometrial (EC) cancers continues to be a cost-effective genomic medicine intervention with top-tier evidence for reducing cancer morbidity and mortality that is recommended by multiple professional organizations. After over a decade of this recommendation, most individuals with LS remain undiagnosed. One reason is the variable implementation of UTS programs in healthcare systems.

The EU Member States’ national healthcare systems compared using the single synthetic index

Implementation of health protection requires effective quantitative methods of its evaluation. Assessment could be based on usage of synthetic indices which aggregate couple input variables into a single measure. In this paper, the exploitation of a new synthetic index (by the author called HAI—the Healthcare Aggregated Index) was proposed with the aim of the assessment and long-term interstate comparisons of healthcare systems of the EU countries. Using taxonomic methodology, HAI involves three variables: the number of hospital beds, the number of physicians and the public expenditures on healthcare. HAI utilisation includes dynamic interstate comparisons of national healthcare systems of the different exploitations of human, physical and financial resources. The HAI application to assessment of twenty European Union Member States’ healthcare systems revealed an effect of substitution between healthcare resources within the slight international differentiation of the health protection level and the minor dynamic of changes in time series.

Comparison of Health Care System of China and Yemen

Health is one of the basic requirements of the nation and the developing nations required introduced reforms into the health care system to ensure better health care facilities. The presence status of health care centers in the prime parameter to judge the human health index and indirectly define the country's prosperity. China is the leading developing nation with the highest growth rate of the human index, and the health care reforms are significant to boost up the health care facilities of its citizens. Although Yemen’s government respectively has been providing a free healthcare services to its people, still it lacks basic public health care infrastructure which is far behind the average of the world health quality standers. we consolidated the comparison of public health between China and Yemen, recommended some health care reforms for Yemen by keeping the Chinese health system as a model, especially after Covid19 pandemic occurrence the world recognized the power and the potential of the china healthcare system in managing the outbreak. The quantitative and qualitative data analysis revealed that Chinese health care system is semi saturated with the presence of modern medical treatment, equipment and workers professionalism in its major cities. The Yemenis public health care system is much disturbed due to country political situation, lack of funding, and the basic medical facilities are even poor at major cities. Thus, people expressed high sort of dissatisfaction from the current health care system. Combined with the effectiveness of the strategies china’s adopt, this study would shed light on the needs and encourage Yemeni to model china’s health care strategy to create better public health reforms. Keywords: healthcare facilities, patient security, economic influence, China, Yemen DOI: 10.7176/JHMN/73-03 Publication date: April 30 th 2020

Using Twitter to identify healthcare consumer sentiment

Twitter is a social networking service, founded in 2006, and now with over 400 million monthly active users. This study was designed to assess the utility of Twitter as a tool for the assessment and comparison of healthcare systems. Java and R programs were used to capture, analyze, and compare Tweets posted about one academic university hospital system and two community hospital systems in a large metro area in the Southeastern United States throughout 2016. Natural language processing with sentimental analysis was used in conjunction with an object clustering algorithm to categorize and quantify positive versus negative posts regarding care received at these facilities. An analysis of the positive and negative tweets for the academic facility was completed. Among the 12,579 Tweets captured for 2016, 89.4% were associated with the academic medical center, 9.7% with community hospital #1, and 0.9% with community hospital #2. Relative to annual patient visits, the use of Twitter was 0.31% for the academic hospital, 0.34% for community hospital #1, and 0.03% for community hospital #2. A majority of Tweets were positive for all three hospital systems. Hospital system #2 received the highest percentage of positive and the lowest percentage of negative tweets ( Table 1 ). The subject of positive comments concerning the academic facility were hospital staff, hospital facilities, and hospital services, while the negative comments focused on appointments, wait time, and emergency room visits. This study demonstrates the utility of Twitter to determine the overall sentiment of a segment of users of competing healthcare systems. In our initial analysis, we were able to compare the largest competitors of our academic system and to assess the topics of the positive and negative comments made by our healthcare system users. Further study and development of computing techniques are needed to fully maximize the potential this tool offers.

Challenges in International Comparison of Health Care Systems

International comparisons of health system performance exert major influence on the public and on policy makers. These comparisons allow for reflection on and evaluation of national performance, provide empirical bases to drive reform, and serve as a way to promote accountability. Most international comparisons seek to identify high performers, often conceptualized as health systems with the best outcomes or most value for money. Even though these notions seem relatively straightforward, operationalizing them is difficult. There are at least 3 key challenges of conducting international comparisons: drawing the boundaries of the health system, managing limitations of data, and accounting for different values inherent in national systems. Without understanding and addressing these challenges, cross-national comparisons will fail to improve health policy and may lead to misinterpretations and poor policy making.

Comparisons of Health Care Systems in the United States, Germany and Canada

The purpose of this research paper is to compare health care systems in three highly advanced industrialized countries: The United States of America, Canada and Germany. The first part of the research paper will focus on the description of health care systems in the above-mentioned countries while the second part will analyze, evaluate and compare the three systems regarding equity and efficiency. Finally, an overview of recent changes and proposed future reforms in these countries will be provided as well. We start by providing a general description and comparison of the structure of health care systems in Canada, Germany and the United States.

The Health Care Dilemma: A Comparison of Health Care Systems in Three European Countries and the US

The Health Care Dilemma: A Comparison of Health Care Systems in Three European Countries and the US

PHP167 Tell Me Who Your Friends are: “Peers” in Comparing Health Care Systems

Total health spending and its share in the social product have been staple indicators in assessing and comparing health care systems. Comparison of health care systems based on Euros and cents is limiting, however, since the health care system is not an artifact of the economy. Institutions shape societal values on health care leading to peculiarities even among health care systems that share traditions in terms of health care financing and delivery. This paper presents a framework to compare health care systems in a meaningful way that accounts for systemic differences and similarities using the empirical technique cluster analysis. The analysis will follow a three-step procedure. A review of the literature will be conducted to identify major institutional indicators of any given health care system. Cluster analysis will then be employed using these indicators based on data of OECD member countries. Based on the isolated clusters using the “minimum description length” approach, “peer” health care systems will be identified and described highlighting so-called leaders of the pack. At the heart of the performance of every health care system is the extent to which it is able to respond to the desire for a healthy life by members of society. This implies accounting for both efficiency, which investigates the link between the link between health care resources and health outcomes, and effectiveness, which assesses the achievement of goals rather than choosing one over the other. Assessing health care systems against peers and over time would not only set systems apart given their shared intent of ensuring health by providing health care but may well engender learning and lead to a race to the top.

Comparative analysis of international healthcare systems

International comparisons of healthcare systems are usually performed using subjective methods available in the literature. As a result, it is difficult to obtain standard rankings for countries. A mathematical evaluation method based on the concept of Pareto-optimal organisation is proposed for this paper. The method is simple and uses a linear programming model. The weights for various measurements are chosen by an objective method and are standard. The method is illustrated with real data from a sample of OECD member countries.

Health expenditures [2010:2

A basic measure in the international comparison of health care systems is health care expenditures.It provides a glimpse of the health care resources available to, and used by, the varioushealth care agencies.

Assessment of financial flow in the health system of Serbia in a period 2003-2006

The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessability of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and allows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD "A System of Health Accounts (SHA)" Version 1.0. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9% of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions "out of pocket" with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Hertzegovina. This allocating of financial resources in total, however, was low as the consequence of relatively low level of GDP in Serbia. Establishing NHA provided a pattern of national healthcare spending and allowed a comparison of healthcare system in Serbia with the systems of other countries. Analysing a period 2003-2006 revealed a similarity between Serbia and the countries of the European Unity in regard to the level of average financial resources allocation for healthcare expressed as a percentage of GDP, as well as in regard to financiers in the system of healthcare. A high purchasing power disparity, however, in healthcare services was observed between the population of Serbia and other European countries.

Low Mortality and Key Aspects of Delivery of Care for End-Stage Renal Disease in Italy

End-stage renal disease (ESRD) is a global health problem. There are differences in mortality among patients with ESRD amid industrialized countries that may be related to their respective systems of delivery of care. A nationwide survey was completed in Italy, a country with low mortality rate for ESRD patients, in order to help understand key aspects of ESRD delivery of care that contribute to mortality. Survey responses were obtained and analyzed from 131 of 575 dialysis centers (23%), covering data from 13,170 dialysis patients in 2006. The mortality rate was 11.2% and the prevalence of diabetes-associated kidney disease was 21%. Of the patients, 88% were on hemodialysis and 12% were on peritoneal dialysis. Most patients were in the age range of 65–75 years (66.7%), were seen by a nephrologist at CKD stage 3, and began dialysis at mean estimated GFR of 9.6 ml/min/1.73 m2. AV fistulae were the prevailing form of vascular access (83%) and were most frequently placed by a nephrologist (61.2%). In 98% of the dialysis centers, a nephrologist was present during dialysis sessions. The following may explain the low mortality for ESRD patients in Italy: low prevalence of diabetes, high use of AV fistulae, delivery of care by nephrologists beginning in pre-ESRD stages, their involvement in placement of dialysis vascular access, and their physical presence requirement during dialysis sessions. These findings portray key aspects of the contemporary delivery of care for Italian dialysis patients and provide a platform for international comparison of healthcare systems for ESRD.

Where are the patients in the quality of health care?

While the achievements of the Organisation for Economic Co-Operation and Development (OECD) Health Care Quality Indicators (HCQI) Project [1] are laudable and enable international comparisons of health care systems in terms of a particular type of quality, it is important to remember that quality is not value neutral. As Donabedian pointed out, 1981, explicit measures of quality carry with them the values of those who have defined the measures, and such measures are amenable to being used as instruments of control [2]. Who defines quality and who measures it are pivotal questions for those who engage in its pursuit. However, it would seem there is little consensus about the meaning or measurement of quality from the stakeholders involved in health. Of greater concern is that, despite the apparent plethora of attempts to gauge patient satisfaction with their health care experiences, there is a worrying downgrading of patients' perspective views of what they feel comprises quality health care. In most instances quality health care is assumed to occur with quality medical care [3, 4], including in Donabedian's seminal Structure/Process/Outcomes model [5], yet even physicians have a difficult time agreeing …

Teaching Medical Students about Different Health Care Systems: An International Exchange Program

Understanding how different health care systems are organized and financed is rarely taught in medical school. In 1997, several U.S. and European medical schools formed an ongoing, innovative, and collaborative exchange program to enable their medical students to gain an insight into the dynamics of another country's health care system. One student from each participating institution completes a month-long rotation at a host medical school under the supervision of a faculty mentor. Selected target diagnoses serve as the basis for comparative case studies. To enable the student to effectively study the host country's health care system, each is assigned a patient with the preselected specific diagnosis. The students view the patient's care within the context of the host country's delivery system rather than being limited to the clinical diagnosis and treatment of the disease. Matching the student with a patient permits the student to see how medical care is delivered and financed in the host country. Each student is required to prepare a written report focusing on costs; organization and delivery of care; quality and outcomes of care; politics, culture, and ethics; and learning. The case studies permit comparisons of health care systems among the participating U.S. and European Union countries, as well as opportunities for institutional and individual learning.

Collecting unit cost data in multicentre studies

International comparisons of health care systems and services have created increased interest in the comparability of cost results. This study compared top-down and bottom-up approaches to collecting unit cost data across centres in the context of examining the cost-effectiveness of dialysis therapy across Europe. The study tested whether health care technologies in different countries can be costed using consistent and transparent methods to increase the comparability of results. There was more agreement across the approaches for peritoneal dialysis than for than haemodialysis, with differences, respectively of Euro 91-1,687 vs. 333-7,314 per patient per year. Haemodialysis results showed greatest differences where dialysis units were integrated as part of larger hospitals. Deciding which approach to adopt depends largely on the technology. However, bottom-up costing should be considered for technologies with a large component of staff input or overheads, significant sharing of staff or facilities between technologies or patient groups and health care costing systems which do not routinely allocate costs to the intervention level. In these circumstances this costing approach could increase consistency and transparency and hence comparability of cost results.

Provider continuity in family medicine: does it make a difference for total health care costs?

International comparisons of health care systems have shown a relationship at the macro level between a well-structured primary health care plan and lower total health care costs. The objective of this study was to assess whether provider continuity with a family physician is related to lower health care costs using the individual patient as the unit of analysis. We undertook a study of a stratified sample of patients (age, sex, region, insurance company) for which 2 cohorts were constructed based on the patients' utilization pattern of family medicine (provider continuity or not). Patient utilization patterns were observed for 2 years. The setting was the Belgian health care system. The participants were 4,134 members of the 2 largest health insurance companies in 2 regions (Aalst and Liège). The main outcome measures were the total health care costs of patients with and without provider continuity with a family physician, controlling for variables known to influence health care utilization (need factors, predisposing factors, enabling factors). Bivariate analyses showed that patients who were visiting the same family physician had a lower total cost for medical care. A multivariate linear regression showed that provider continuity with a family physician was one of the most important explanatory variables related to the total health care cost. Provider continuity with a family physician is related to lower total health care costs. This finding brings evidence to the debate on the importance of structured primary health care (with high continuity for family practice) for a cost-effective health policy.

Commentary: Problematic issues in cultural comparisons.

This commentary offers a critique of cross-cultural comparisons of health care systems between the United States and less economically developed nations. Two main issues are discussed: the abuse of power in such comparisons and the reluctance of nurses from the United States to address conditions of suffering in their own country. Recommendations are given to increase sensitivity of nurses.

A standardised instrument for patient evaluations of general practice care in Europe

Objective: International comparisons of health care systems may provide important insights, but they require internationally standardised and validated instruments. This paper describes the validity and reliability of the EUROPEP instrument for patient evaluation of general practice care. Methods: Surveys were performed in 16 countries among patients who visited the general practice (n=23892), using the 23-item EUROPEP questionnaire. Data were analysed with respect to content validity, reliability, criterion validity, construct validity and sensitivity of the instrument. Results: The item response among responders was good or acceptable for most items. Two internally consistent dimensions were identified, 'clinical behaviour' (17 items) and 'organisation of care' (6 items). The answers to the 23 questions predicted the overall attitudes regarding the general practitioner. Higher age, more visits to the GP and better health status predicted more positive evaluations of care, as was expected beforehand. Differences between countries were significant but moderate for most of the questions. In specific countries problems with respect to validity and reliability were found. Conclusions: An internationally standardised and validated instrument for patients' evaluations of general practice care is now available for international comparisons. Future research should improve its validity to solve the problems that were found in some countries. Eur J Gen Pract 2000;6:82–7.

The comparison of health care systems through regional analysis: The case of hospital admissions in Belgium and The Netherlands

One of the problems in the international comparison of health care systems is the small number of units of analysis. Usually only a small number of systems is compared which makes cross-sectional statistical analysis impossible. The two obvious solutions to this problem—neither of which is generally feasible—are either to enlarge the number of systems being compared or to use time series on a small number of health care systems. Quite another solution is to study regional variations within and between a small number of systems. The number of regions has to be sufficiently large to make statistical analysis possible. This is the solution chosen in this article. The phenomenon which is central to our analysis is the number of hospital admissions per 1000 of the population. To explain variations in the hospital admission rate, it is hypothesized that there are a number of variables that have the same kind of influence on hospital admission rates in all western industrialized countries (such as the supply of hospital beds and the health status of the population). On the other hand there are determinants of regional variation in the number of admissions which either exert an influence dependent on the nature of the system, or are unique to a particular health care system. Concerning the first group of hypotheses (the general model), our analysis based on data for 1974 showed that the only variables to have a clear and equal influence on the regional variation in hospital admission rates in the Netherlands as well as in Belgium are the number of hospital beds per 1000 inhabitants and standardized mortality (an operationalization of the concept of health status). The influence of system-specific variables (the second group of hypotheses) has been analysed, taking the difference between the actual number of admissions and the number of admissions expected on the basis of the number of beds and mortality as the dependent variable. In the Netherlands, none of the variables appears to have a clear influence on the level of this ratio, whereas in Belgium there is a greater number of admissions than expected in regions with a higher birthrate and a higher number of both general practitioners and specialists in the common disciplines (internal medicine, pediatrics, gynaecology) in relation to the total number of specialists.