Financing Long-Term Services and Supports: Ideas From Singapore

Financing long-term services and supports (LTSS) for the elderly is a pressing issue in the Unites States with reforms of long-term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore. 

Integrated care in practice – the South Eastern Sydney experience

The purpose of this paper is to describe the recent efforts of a large publicly funded health care organisation in Sydney, Australia to implement integrated care (IC) "at scale and pace" in the messy, real-world context of a District Health Service. This paper highlights key factors relating to implementation and evaluation of a local IC Strategy in the real world. 

The new frontier of strategic alliances in health care: New partnerships under accountable care organizations

Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful cordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. This article findings suggests that the success of the ACO model will hinge in large part upon the success of new partnerships, with important implications for understanding ACO readiness and capabilities, the relatively small savings achieved to date by ACO programs, and the path to providers bearing more risk for population health management. 

Perceived mHealth barriers and benefits for home-based HIV testing and counseling and other care: Qualitative findings from health officials, community health workers, and persons living with HIV in South Africa

mHealth has been proposed to address inefficiencies in the current South African healthcare system, including home-based HIV testing and counseling (HTC) programs. Yet wide-scale adoption of mHealth has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by skateholders remains. 

The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: A systematic review

A non-dispensing pharmacist conducts clinical pharmacy services aimed at optimizing patients individual pharmacotherapy. Embedding a non-dispensing pharmacist in primary care practice enables collaboration, probably enhancing patient care. The degree of integration of non-dispending pharmacists into multidisciplinary health care teams varies strongly between settings. The degree of integration may be a determinant for its success. This study investigates how the degree of integration of a non-dispensing pharmacist impacts medication related health outcomes in primary care. 

Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability

Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduce to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. 

This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level sclae-up implications. The paper focuses on costs to provider (healht system andd donors) to inform planning and budgeting, and does not cover cost-effectiveness. 

Lessons from Brazil: on the difficulties of building a universal health care system

A number of developing countries that are often referred to as emerging economies have turned their attention to addressing their public health issues in more comprehensive and systematic ways. While the trajectory of this particular initiative and similar ones elsewhere is yet to be determined, the aim of this piece is to draw some lessons from an emerging economy that, for contingent historical and political reasons, started building a universal public health care system earlier: Brazil. The key argument offered from the Brazilian experience is that building a robust public health care system based on the principles of universality and ...

A new paradigm on health care accountability to improve the quality of the system: four parameters to achieve individual and collective accountability

Healthcare systems the world over are facing significant financial pressures and growing demands for services. Many nations have therefore set common goal of improving the population´s health, the quality of the outcomes, and the containment of costs. So, these changes in the health care systems´priorities have set the ground for an interdisciplinary approach necessary to assess the activities of health care professionals and, in general, of health care systems. 

Centers of excellence in healthcare institutions: what they are and how to assemble them

Centers of excellence-specialized programs within healthcare institutions which supply exceptionally high concentrations of expertise and related resources centered on particular medical areas and delivered in a comprehensive, interdisciplinary fashion-afford many advantages for healthcare providers and the populations they serve. To achieve full value from centers of excellence, proper assembly is an absolute necessity, but guidance is somewhat limited. This effectively forces healthcare providers to pursue establishment largely via trial-and-error, diminishing opportunities for success. 

Advancing team-based primary health care: a comparative analysis of policies in western Canada

The article analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada.