scholarly journals Strategies and indicators to address health equity in health service and delivery systems

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sara Brushett ◽  
Hilary A.T. Caldwell ◽  
Emma Stirling Cameron ◽  
Cecilia Carrea ◽  
Mark Embrett ◽  
...  
Keyword(s):  
Health Service ◽  
Health Equity ◽  
Delivery Systems ◽  
Equity In Health

scholarly journals Profit distribution and managers’ behavior in vertical integrated medical delivery systems - An experimental economics study

2019 ◽  
Author(s):  
Yunque Bo ◽  
Miaojie Qi ◽  
Siyu Liu ◽  
Jiyu Cui ◽  
Youli Han
Keyword(s):  
Health Service ◽  
Community Health ◽  
Health Management ◽  
Delivery Systems ◽  
Community Health Service ◽  
Experimental Program ◽  
Improvement Rate ◽  
Effort Level ◽  
Profit Distribution ◽  
Medical Delivery

Abstract Background：Fragmentation of medical care has become one of the main reasons for the inefficiency of medical delivery systems. Vertical integration of medical delivery systems (VIMDS) is a reform direction in the world. Managers’ behavior toward profit distribution is an important factor that influences them to pursue the goal of VIMDS. We conducted a controlled economics experiment to explore decision-making by managers of medical institutions in respect of profits and what influences the distribution mechanism in VIMDS. Methods：Undergraduate and postgraduate Students majoring in health management, and administrative staffs from hospitals were recruited to make choices in the role of directors of institutions. Z-Tree software was used to design the experimental program. 96 subjects participated in the experiment. We gathered 479 valid contracts. Results: 66.39% of the subjects choose flexible contracts. The median of the bidding distribution rate to community health service centers of all auctions was 18.50%. The final distribution rate is about 3 percentage points higher than the bidding distribution rate. The median of the effort level was 9.00. There was a significant correlation between the improvement rate and the choice of effort level (p＜0.05) in flexible contracts. Conclusions: The hospital managers have a preference for flexible contracts because of uncertainty in the medical system. Community health service center director may be perfunctory as shading in the integration. Flexible contract and sharing rate beyond participants’ expectation motivate managers to make more cooperative behaviors.

scholarly journals Reducing Health Inequities Through Intersectoral Action: Balancing Equity in Health With Equity for Other Social Goods

2018 ◽  
Vol 8 (1) ◽  
pp. 1-3
Author(s):  
Maxwell J. Smith ◽  
Daniel Weinstock
Keyword(s):  
Social Justice ◽  
Health Equity ◽  
Health Inequities ◽  
Education Equity ◽  
Intersectoral Action ◽  
Equity In Health ◽  
General Account ◽  
Equity Research ◽  
Social Goods ◽  
Significant Attention

Significant attention has been devoted to developing intersectoral strategies to reduce health inequities; however, these strategies have largely neglected to consider how equity in health ought to be weighted and balanced with the pursuit of equity for other social goods (eg, education equity). Research in this domain is crucial, as the health sector’s pursuit of health equity may be at odds with policies in other sectors, which may consider the reduction of health inequities to be peripheral to, if not incompatible with, their own equity-related aims. It is therefore critical that intersectoral strategies to reduce health inequities be guided by a more general account of social justice that is capable of carefully balancing equity in health against the pursuit of equity in other sectors.

scholarly journals Profit distribution and managers’ behaviour in vertical integrated medical delivery systems – An experimental economics study

2020 ◽  
Author(s):  
Yunque Bo ◽  
Miaojie Qi ◽  
Siyu Liu ◽  
Jiyu Cui ◽  
Youli Han
Keyword(s):  
Health Service ◽  
Community Health ◽  
Hospital Staff ◽  
Delivery Systems ◽  
Community Health Service ◽  
Experimental Program ◽  
Improvement Rate ◽  
Effort Level ◽  
Medical Institutions ◽  
Medical Delivery

Abstract Background: The vertical integration of medical delivery systems (VIMDSs) is a reform direction both in China and worldwide. We conducted a controlled economic experiment to explore decision-making by managers of medical institutions with respect to profits and what influences the distribution mechanism in VIMDSs.Methods: Students and hospital staff were recruited to make choices regarding the role of directors of institutions. z-Tree software was used to design the experimental program. Ninety-six subjects participated in the experiment. We gathered 479 valid contracts.Results: Of the subjects, 66.39% chose flexible contracts. The median of the bidding distribution rate to community health service centres of all auctions was 18.50%. The final distribution rate was approximately 3 percentage points higher than the bidding distribution rate. The median effort level was 9.00. There was a significant correlation between the improvement rate and the choice of effort level (P＜0.05) in flexible contracts.Conclusions: Hospital managers have a preference for flexible contracts because of uncertainty in the medical system. A community health service centre director may behave perfunctorily by engaging in shading in the integration. Flexible contracts and sharing rates beyond the participants’ expectations motivate managers to engage in more cooperative behaviours.

Achieving equity in health service commissioning

2017 ◽  
pp. 233-254 ◽  
Author(s):  
Martin Wenzl ◽  
Elias Mossialos
Keyword(s):  
Health Service ◽  
Equity In Health
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