The promises and perils of hospital autonomy: Reform by decree in Viet Nam

This article investigates impacts of hospital autonomization in Viet Nam employing a “decision-space” framework that examines how hospitals have used their increased discretion and to what effect. Analysis suggests autonomization is associated with increased revenue, increasing staff pay, and greater investment in infrastructure and equipment. But autonomization is also associated with more costly and intensive treatment methods of uncertain contribution to the Vietnamese government's stated goal of quality healthcare for all. Impacts of autonomization in district hospitals are less striking. Despite certain limitations, the analysis generates key insights into early stages of hospital autonomization in Viet Nam.     

Environmental risk factors in outpatient recovery from malnutrition

Studies evaluating Nutrition Rehabilitation Centres indicate that they hold several advantages over alternative methods of care for malnourished children. Nonetheless, an important minority of outpatient cases attending such centres does not make adequate progress, and this has been attributed to shortcomings in their home environment.

A survey in Uganda showed that different features of the home environment affected progress for urban and rural outpatients. The findings also suggest that for both groups the child's home situation can indeed be used to explain his progress, with eight variables explaining around 70 percent of the variance in recovery scores. These variables describe the size of the child's family, the level of food resources available, and the amount of help his mother can martial in caring for him.

Information on these predictors of recovery could be recorded in the case notes on the child's first attendance at the clinic, thereby providing an initial estimate of the risk that he will not respond adequately to the outpatient treatment, requiring, instead, more intensive care.     

Measuring socioeconomic health inequalities in presence of multiple categorical information

While many of the measurement approaches in health inequality measurement assume the existence of a ratio-scale variable, most of the health information available in population surveys is given in the form of categorical variables. Therefore, the well-known inequality indices may not always be readily applicable to measure health inequality as it may result in the arbitrariness of the health concentration index's value. In this paper, we address this problem by changing the dimension in which the categorical information is used. We therefore exploit the multi-dimensionality of this information, define a new ratio-scale health status variable and develop positional stochastic dominance conditions that can be implemented in a context of categorical variables. We also propose a parametric class of population health and socioeconomic health inequality indices. Finally we provide a twofold empirical illustration using the Joint Canada/United States Surveys of Health 2004 and the National Health Interview Survey 2010.     

Non-governmental health planning: Is the Rochester approach an alternative to regulatory certificate of need?

ObjectiveHealth planning is the process of identifying community needs for health care, facilities and technology and allocating resources to meet those needs to the exclusion of redundant capacity. Health planning in the United States was pioneered in Rochester, New York through private sector efforts but today, health planning is generally understood in the US as referring to a governmental function: “certificate of need” regulation. Yet health planning need not be, and indeed is not today, an exclusively governmental function. The original conception of a health planning agency as a civil society-based, non-governmental organization survives in Rochester. This study assesses the, viability of this private option as an alternative to regulation.MethodOutcomes of applications to a, non-governmental health planning entity in the Rochester region (CTAAB) were compared to, outcomes from the state agency (DOH) for two adjacent regions.ResultsThe non-governmental, approach to health planning appeared to be more restrictive, with the Rochester region spending less. There are numerous extraneous commas in the text as it appears on my screen. Are they part of the document? Iif so, they need to be removed. If they were not added to the document, the document does not look right in the Online Proofing application. Overall and in particular, utilizing less advanced imaging.ConclusionsThe Rochester NY region, appears to demonstrate that cooperative efforts by stakeholders can lower health care costs. For such, voluntary efforts to succeed, policymakers need not regulate—they can engage with community, leaders by convening them to analyze local utilization patterns, review options for chartering or, subsidizing non-governmental organizations to implement planning, and delineate safe harbors from, antitrust or other potential liability arising from collective action     

儿童保健教育效果分析

目的 通过保健教育使儿童加深对健康知识的了解,自觉培养良好的卫生行为习惯.方法 对我医院2011年6~12月收治确诊的70例儿童进行保健教育,出院后再进行为期1年的随访,随访期间继续进行保健教育,随访结束后发放调查表,了解保健教育前后患者行为变化及保健基本知识知晓率的变化.结果 多数儿童对保健基本知识有了更详细全面的了解,自觉养成了健康的行为习惯.结论 行之有效的儿童保健教育可以保持儿童健康,减少儿科相关疾病,增进儿童身体健康的成长.     

Ebola in West Africa: an international medical emergency

West Africa is facing the worst Ebola outbreak with 3 685 cases and 1 841 deaths reported from Liberia, Guinea, Senegal, Sierra Leona and Nigeria. There is no vaccine or direct treatment available to treat the patients with Ebola. World Health Organization (WHO) has approved the use of experimental drugs for Ebola patients. Health workers are at high risk. The governments and WHO are responsible to provide necessary protective equipment to health workers dealing with Ebola. There is a strong need to identify the invisible chains of virus transmission. World Bank pledges $200 million to fight against Ebola, while WHO said $430 million are needed to control the Ebola outbreak. Ebola can be contained by early detection and isolation of case, contact tracing, monitoring of contacts and adaptation of rigorous procedures for virus control.     

健康指导在稳定期COPD治疗中的作用观察

目的探究健康指导在稳定期COPD治疗中的作用。方法随机选取2010年10月至2013年10月我科收治的126例COPD患者,所取病例分为对照组(63例)、指导组(63例)。对照组予以常规治疗,指导组予以健康指导加常规治疗,对照分析两组患者的治疗效果。结果对照组急性加重频次和并发症的发生率明显高于指导组。结论在稳定期COPD的治疗中予以积极健康指导,可减轻患者症状,减少患者的住院率及并发症发生,延缓肺功能的下降,提高了生活质量,