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During the COVID-19 pandemic, nucleic acid amplification tests (NAATs) and rapid antigen tests (RATs) have been widely used to direct patient care and control transmission (1). NAATs, such as reverse [...]

Human resources for health have been recognized as essential to the development of responsive and effective health systems. Low- and middle-income countries seeking to achieve universal health coverage face human resource constraints--whether in the form of health worker shortages, maldistribution of workers or poor worker performance--that seriously undermine their ability to achieve well-functioning health systems. Although much has been written about the human resource crisis in the health sector, labour economic frameworks have seldom been applied to analyse the situation and little is known or understood about the operation of labour markets in low- and middle-income countries. Traditional approaches to addressing human resource constraints have focused on workforce planning: estimating health workforce requirements based on a country's epidemiological and demographic profile and scaling up education and training capacities to narrow the gap between the 'needed' number of health workers and the existing number. However, this approach neglects other important factors that influence human resource capacity, including labour market dynamics and the behavioural responses and preferences of the health workers themselves. This paper describes how labour market analysis can contribute to a better understanding of the factors behind human resource constraints in the health sector and to a more effective design of policies and interventions to address them. The premise is that a better understanding of the impact of health policies on health labour markets, and subsequently on the employment conditions of health workers, would be helpful in identifying an effective strategy towards the progressive attainment of universal health coverage. [TEXT NOT REPRODUCIBLE IN ASCII] [TEXT NOT REPRODUCIBLE IN ASCII] Les ressources humaines du secteur de la sante sont essentielles au developpement de systemes medicaux efficaces et reactifs. Les pays a revenu faible et moyen qui cherchent a obtenir une couverture maladie universelle souffrent de restrictions en matiere de ressources humaines--que ce soit sous forme de penurie d'agents de sante, de mauvaise repartition ou de faibles performances des travailleurs--qui compromettent serieusement leur capacite a creer un systeme de sante optimal. Meme si on a beaucoup ecrit au sujet de la crise des ressources humaines dans le secteur de la sante, des cadres economiques de travail ont rarement ete appliques pour analyser la situation, et on con nait ou on comprend peu de choses sur le fonctionnement des marches du travail dans les pays a revenu faible et moyen. Les approches traditionnelles dans le but de repondre aux restrictions en matiere de ressources humaines accordent de l'importance a la planification des effectifs : estimer les besoins en matiere de travailleurs de la sante par rapport au profil demographique et epidemiologique d'un pays, et intensifier les capacites de formation et d'enseignement pour reduire recart entre le nombre de travailleurs 'necessaire' et le nombre reel. Toutefois, cette approche neglige d'autres facteurs importants qui influent sur la capacite des ressources humaines, notamment les dynamiques du marche du travail et les reponses et preferences comportementales des travailleurs de la sante. Ce document explique comment l'analyse du marche du travail peut aider a mieux comprendre les facteurs qui sont a l'origine des restrictions en matiere de ressources humaines dans le secteur de la sante, mais aussi a mettre en oeuvre des politiques et des interventions plus efficaces pour y remedier, lihypothese initiale est qu'une meilleure comprehension de l'impact des politiques de sante sur les marches du travail de la sante et, par ailleurs, sur les conditions d'emploi des travailleurs de la sante, serait utile pour pouvoir identifier une strategie efficace et progressivement mettre en place une couverture maladie universelle. [TEXT NOT REPRODUCIBLE IN ASCII] El papel de los recursos humanos en el sector sanitario se considera esencial para el desarrollo de sistemas sanitarios eficaces y con capacidad de respuesta. Los paises de ingresos bajos y medianos que aspiran a alcanzar la cobertura sanitaria universal se enfrentan a las limitaciones en materia de recursos humanos, sea por escasez de personal sanitario, la distribucion ineficaz del personal o el desempeno ineficiente del mismo, factores que socavan gravemente la capacidad para lograr sistemas sanitarios con un funcionamiento adecuado. Aunque se ha vertido mucha tinta acerca de la crisis de recursos humanos en el sector sanitario, rara vez se han aplicado los marcos economicos laborales para analizar la situacion y poco se sabe o entiende sobre el funcionamiento de los mercados laborales en los paises de ingresos bajos y medianos. Los enfoques tradicionales para hacer frente a las limitaciones en materia de recursos humanos se han centrado en la planificacion del personal, mediante el calculo de las necesidades de personal sanitario basada en el perfil epidemiologico y demografico del pais y la ampliacion de los recursos educativos y formativos para reducir la brecha entre el numero <> de personal sanitario y el numero real. Sin embargo, este enfoque deja de lado otros factores importantes que influyen en la capacidad de los recursos humanos, como la dinamica del mercado de trabajo, las respuestas de comportamiento y las preferencias del personal sanitario. Este informe describe como el analisis del mercado laboral pretende mejorar la comprension de los factores que explican la escasez en materia de recursos humanos en el sector sanitario y ofrecer un diseno mas eficaz de las politicas e intervenciones para abordarlos. La premisa para ello es que una mejor comprension del impacto de las politicas sanitarias en el mercado laboral sanitario, y por consiguiente, en las condiciones laborales del personal sanitario, seria de gran ayuda en la identificacion de una estrategia eficaz para alcanzar la cobertura sanitaria universal de forma progresiva., Health workforce challenges Human resources for health are central to any health system insofar as health workers perform or mediate most health system functions. They make treatment decisions at the [...]

If you're a behavioral healthcare provider that, in the midst of yet another difficult quarter, is asking, 'Why can't I work in a hot growth business?' you need to take [...]

Abstract. In the immediate postwar era the primary object of health reform among the advanced industrial democracies was to expand, if not universalize, access to a broad spectrum of health [...]

Information about a two-day oral care workshop organized by representatives from dentistry, medicine, the academic community, and the insurance industry, is presented. It was reported that participants achieved general consensus regarding the need for greater cooperation among health care professions.

As health care costs continue to escalate, cost control measures will likely become unavoidable and painful. One approach is to engage external forces to allocate resources--for example, through managed care or outright rationing. Another approach is to engage consumers to make their own allocation decisions, through 'self-rationing,' wherein they are given greater awareness, control, and hence responsibility for their health care spending. Steadily gaining popularity in this context is the concept of 'consumer directed health care' (CDHC), which is envisioned to both control cost and enhance choice, by combining financial incentives with information to help consumers make more informed health care decisions and to appreciate the economic trade-offs of those decisions. While CDHC is gaining attention in the popular press, business publications, and academic journals, it is not without controversy about its relative merits and demerits. CDHC raises questions regarding the ethical limits of consumer responsibility for their choices. While the emphasis on consumer choice implies that autonomy is the ruling ethical principle in CDHC, it must be tempered by justice and beneficence. Justice must temper autonomy to protect disadvantaged populations from further widening disparities in health care access and outcomes that could arise from health care reform efforts. Beneficence must temper autonomy to protect consumers from unintended consequences of uninformed decisions. Thoughtful paternalism suggests that CDHC plans offer choices that are comprehensible to lay consumers, limited in their range of options, and carefully structured with default rules that minimize potential error costs. Keywords: choice, consumerism, ethics, managed care, responsibility

Prior to the era of managed care in the US, health care delivery was managed by the professional activities of physicians. Managed care replaces management by profession with bureaucratic management structures and oversight, such as utilization review and gatekeeping (required referrals to specialty care). Practically, this means that physicians cannot use the professional relationships that typified practice under fee-for-service medicine, potentially changing not only what physicians do (e.g., order test or not, refer or not), but also how they do what they do. In this paper I look at just one of the changes brought about by managed care: contractual arrangements that require primary care providers to refer patients to a closed panel of specialist physicians. Through an in-depth case study of 45 primary care providers' in the USA who face restricted specialist panels for their managed care patients, but not for their fee-for-service patients, I investigate how the practice of referring is changed by this requirement. First, I use interview data to describe primary care providers general preferences for referral consultants, as well as their views of the referral process and potential barriers in it. Next I present data from all referrals over a four-week period to analyze the extent of referral relationships in actual referrals. Finally, I conclude by discussing some ways that managed care entities can facilitate rather than diminish referral relationships among physicians. Keywords: Managed care; Physicians; Physician referrals; Health care; USA

The public finance and foreign exchange crisis of the 1980s aggravated the unfavourable economic trends in many developing countries and resulted in budget cuts in the health sector. Policymakers, following the suggestions of World Bank experts, introduced user fees. Economic analysis of the demand for health care in these countries focused on the impact of price and income on health service utilisation. But the lesson to date from experiences in cost recovery is that without visible and fairly immediate improvements in the quality of care, the implementation of user fees will cause service utilisation to drop. For this reason, the role of quality of health care has been recently a subject of investigation in a number of health care demand studies. In spite of using the data from both households and facilities, recent studies are quite limited because they measure quality only by structural attributes (availability of drugs, equipment, number and qualifications of staff, and so on). Structural attributes of quality are necessary but not sufficient conditions for demand. A unique feature of this study is that it also considers the processes followed by practitioners and the outcome of care, to determine simultaneously the respective influence of price and quality on decision making. A nested multinomial logit was used to examine the choice between six alternatives (self-treatment, modern treatment at home, public hospital, public dispensary, for-profit facility and non-profit facility). The estimations are based on data from a statistically representative sample of 1104 patients from 1191 households and the data from a stratified random sample of 42 out of 84 facilities identified. The results indicate that omitting the process quality variables from the demand model produces a bias not only in the estimated coefficient of the 'price' variable but also in coefficients of some structural attributes of the quality. The simulations suggest that price has a minor effect on utilisation of health services, and that health authorities can simultaneously double user fees and increase utilisation by emphasising improvement of both the structural and process quality of care in public health facilities. Keywords: Quality of care; Demand for care; Price; Mali

This article examines the role of telemedicine, or health services delivered to remote patients though telecommunication, in twenty-first century health care. Telemedicine's ability to contain costs, remove geographical limitations, and reach specialized populations indicate that it will be a lasting tool in the politically and economically changeable health care industry.

Literacy is essential to career success, encompassing the ability to think critically, write coherently, and ultimately develop increasing levels of mastery of an area of knowledge. The business world is [...]