Organization and Financing of Public Health Services in Europe


Book Description

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).




Medical Law in France


Book Description

Derived from the renowned multi-volume International Encyclopaedia of Laws, this convenient volume provides comprehensive analysis of the law affecting the physician-patient relationship in France. Cutting across the traditional compartments with which lawyers are familiar, medical law is concerned with issues arising from this relationship, and not with the many wider juridical relations involved in the broader field of health care law. After a general introduction, the book systematically describes law related to the medical profession, proceeding from training, licensing, and other aspects of access to the profession, through disciplinary and professional liability and medical ethics considerations and quality assurance, to such aspects of the physician-patient relationship as rights and duties of physicians and patients, consent, privacy, and access to medical records. Also covered are specific issues such as organ transplants, human medical research, abortion, and euthanasia, as well as matters dealing with the physician in relation to other health care providers, health care insurance, and the health care system. Succinct and practical, this book will prove to be of great value to professional organizations of physicians, nurses, hospitals, and relevant government agencies. Lawyers representing parties with interests in France will welcome this very useful guide, and academics and researchers will appreciate its comparative value as a contribution to the study of medical law in the international context.




Voluntary Health Insurance in Europe: Country Experience


Book Description

No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.




Building Primary Care in a Changing Europe


Book Description

For many citizens primary health care is the first point of contact with their health care system, where most of their health needs are satisfied but also acting as the gate to the rest of the system. In that respect primary care plays a crucial role in how patients value health systems as responsive to their needs and expectations. This volume analyses the way how primary are is organized and delivered across European countries, looking at governance, financing and workforce aspects and the breadth of the service profiles. It describes wide national variations in terms of accessibility, continuity and coordination. Relating these differences to health system outcomes the authors suggest some priority areas for reducing the gap between the ideal and current realities.




Assessing Chronic Disease Management in European Health Systems


Book Description

This publication explores some of the key issues, ranging from interpreting the evidence base to assessing the policy context for, and approaches to, chronic disease management across Europe. Drawing on 12 detailed country reports (available in a second, online volume), the study provides insights into the range of care models and the people involved in delivering these; payment mechanisms and service user access; and challenges faced by countries in the implementation and evaluation of these novel approaches.




Medical Law in France


Book Description

Derived from the renowned multi-volume International Encyclopaedia of Laws, this convenient volume provides comprehensive analysis of the law affecting the physician-patient relationship in France. Cutting across the traditional compartments with which lawyers are familiar, medical law is concerned with issues arising from this relationship, and not with the many wider juridical relations involved in the broader field of health care law. After a general introduction, the book systematically describes law related to the medical profession, proceeding from training, licensing, and other aspects of access to the profession, through disciplinary and professional liability and medical ethics considerations and quality assurance, to such aspects of the physician-patient relationship as rights and duties of physicians and patients, consent, privacy, and access to medical records. Also covered are specific issues such as organ transplants, human medical research, abortion, and euthanasia, as well as matters dealing with the physician in relation to other health care providers, health care insurance, and the health care system. Succinct and practical, this book will prove to be of great value to professional organizations of physicians, nurses, hospitals, and relevant government agencies. Lawyers representing parties with interests in France will welcome this very useful guide, and academics and researchers will appreciate its comparative value as a contribution to the study of medical law in the international context.




Protecting Data Privacy in Health Services Research


Book Description

The need for quality improvement and for cost saving are driving both individual choices and health system dynamics. The health services research that we need to support informed choices depends on access to data, but at the same time, individual privacy and patient-health care provider confidentiality must be protected.




Patients with Passports


Book Description

Can your employer require you to travel to India for a hip replacement as a condition of insurance coverage? If injury results, can you sue the doctor, hospital or insurer for medical malpractice in the country where you live? Can a country prohibit its citizens from helping a relative travel to Switzerland for assisted suicide? What about travel for abortion? In Patients with Passports, I. Glenn Cohen tackles these important questions, and provides the first comprehensive legal and ethical analysis of medical tourism. Medical tourism is a growing multi-billion dollar industry involving millions of patients who travel abroad each year to get health care. Some seek legitimate services like hip replacements and travel to avoid queues, save money, or because their insurer has given them an incentive to do so. Others seek to circumvent prohibitions on accessing services at home and go abroad to receive abortions, assisted suicide, commercial surrogacy, or experimental stem cell treatments. In this book, author I. Glenn Cohen focuses on patients traveling for cardiac bypass and other legal services to places like India, Thailand, and Mexico, and analyzes issues of quality of care, disease transmission, liability, private and public health insurance, and the effects of this trade on foreign health care systems. He goes on to examine medical tourism for services illegal in the patient's home country, such as organ purchase, abortion, assisted suicide, fertility services, and experimental stem cell treatments. Here, Cohen examines issues such as extraterritorial criminalization, exploitation, immigration, and the protection of children. Through compelling narratives, expert data, and industry explanations Patients with Passports enables the reader to connect with the most prevalent legal and ethical issues facing medical tourism today.




The Pasteurization of France


Book Description

What can one man accomplish, even a great man and brilliant scientist? Although every town in France has a street named for Louis Pasteur, was he alone able to stop people from spitting, persuade them to dig drains, influence them to undergo vaccination? Pasteur’s success depended upon a whole network of forces, including the public hygiene movement, the medical profession (both military physicians and private practitioners), and colonial interests. It is the operation of these forces, in combination with the talent of Pasteur, that Bruno Latour sets before us as a prime example of science in action. Latour argues that the triumph of the biologist and his methodology must be understood within the particular historical convergence of competing social forces and conflicting interests. Yet Pasteur was not the only scientist working on the relationships of microbes and disease. How was he able to galvanize the other forces to support his own research? Latour shows Pasteur’s efforts to win over the French public—the farmers, industrialists, politicians, and much of the scientific establishment. Instead of reducing science to a given social environment, Latour tries to show the simultaneous building of a society and its scientific facts. The first section of the book, which retells the story of Pasteur, is a vivid description of an approach to science whose theoretical implications go far beyond a particular case study. In the second part of the book, “Irreductions,” Latour sets out his notion of the dynamics of conflict and interaction, of the “relation of forces.” Latour’s method of analysis cuts across and through the boundaries of the established disciplines of sociology, history, and the philosophy of science, to reveal how it is possible not to make the distinction between reason and force. Instead of leading to sociological reductionism, this method leads to an unexpected irreductionism.




Global Health Law


Book Description

The international community has made great progress in improving global health. But staggering health inequalities between rich and poor still remain, raising fundamental questions of social justice. In a book that systematically defines the burgeoning field of global health law, Lawrence Gostin drives home the need for effective global governance for health and offers a blueprint for reform, based on the principle that the opportunity to live a healthy life is a basic human right. Gostin shows how critical it is for institutions and international agreements to focus not only on illness but also on the essential conditions that enable people to stay healthy throughout their lifespan: nutrition, clean water, mosquito control, and tobacco reduction. Policies that shape agriculture, trade, and the environment have long-term impacts on health, and Gostin proposes major reforms of global health institutions and governments to ensure better coordination, more transparency, and accountability. He illustrates the power of global health law with case studies on AIDS, influenza, tobacco, and health worker migration. Today's pressing health needs worldwide are a problem not only for the medical profession but also for all concerned citizens. Designed with the beginning student, advanced researcher, and informed public in mind, Global Health Law will be a foundational resource for teaching, advocacy, and public discourse in global health.