It is widely recognized that developed countries have been spending more than developing countries on health care. Objective of the study is to examine determinants of health expenditure and what factors influence it....It is widely recognized that developed countries have been spending more than developing countries on health care. Objective of the study is to examine determinants of health expenditure and what factors influence it. Fifteen Asian countries and 30 OECD countries were chosen to explore the difference of their health expenditure structures. Model of health expenditure per person was estimated to be dependent on market demand, market supply, and other exogenous factors. A model with country specific and time effects of health expenditure was used and estimated. The study found a negative but insignificant relationship between price and health expenditure and a positive and significant relationship between GDP and health expenditure. Urban population density as proxy of urbanization was found to induce the health expenditure in the OECD. Out-of-pocket payment was also found to induce health expenditure for both the Asian and the OECD countries. A net effect of improvement in the health status or a lower mortality rate and a higher life expectancy caused an increase in the health expenditure among the Asian countries studied but decreased health expenditure in the OECD countries. In terms of income elasticity, it was found to be smaller than one in both groups of the countries. Since the income has changed faster than the other factors, the net effect of changes of all factors over period of time will cause rising in health care expenditure. Finally, the model indicated that both the Asian and OECD countries will continue to have a rising health expenditure per person over a period of time.展开更多
The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, su...The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, suboptimal pulmonary function, poor quality of life and mortality. Children with bronchial asthma in River State University Teaching Hospital were just receiving acute care in the emergency room with no concrete plan for a follow up care for their chronic asthma;as a result most of the patients had uncontrolled asthma. In the hospital, the situation led to increased emergency hospitalization, resulting in decreased bed availability, increased burden on manpower and health resource utilization thereby putting more pressure on the limited health resources. Using the Kotter’s model for change management, transformational and situational leadership style, the change in the desired quality and scope of health service rendered to asthmatic patients was successfully implemented;as a result there was a decrease in emergency room visit for acute asthma by 57.5% and an increase in the uptake of scheduled clinic visits for asthma control services. The effect of these changes was an improvement in the control of asthma and quality of life of our patient cohort. Implementation of change in health service delivery is a delicate process that needs a stepwise approach in order to successfully implement and sustain the desired change.展开更多
文摘It is widely recognized that developed countries have been spending more than developing countries on health care. Objective of the study is to examine determinants of health expenditure and what factors influence it. Fifteen Asian countries and 30 OECD countries were chosen to explore the difference of their health expenditure structures. Model of health expenditure per person was estimated to be dependent on market demand, market supply, and other exogenous factors. A model with country specific and time effects of health expenditure was used and estimated. The study found a negative but insignificant relationship between price and health expenditure and a positive and significant relationship between GDP and health expenditure. Urban population density as proxy of urbanization was found to induce the health expenditure in the OECD. Out-of-pocket payment was also found to induce health expenditure for both the Asian and the OECD countries. A net effect of improvement in the health status or a lower mortality rate and a higher life expectancy caused an increase in the health expenditure among the Asian countries studied but decreased health expenditure in the OECD countries. In terms of income elasticity, it was found to be smaller than one in both groups of the countries. Since the income has changed faster than the other factors, the net effect of changes of all factors over period of time will cause rising in health care expenditure. Finally, the model indicated that both the Asian and OECD countries will continue to have a rising health expenditure per person over a period of time.
文摘The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, suboptimal pulmonary function, poor quality of life and mortality. Children with bronchial asthma in River State University Teaching Hospital were just receiving acute care in the emergency room with no concrete plan for a follow up care for their chronic asthma;as a result most of the patients had uncontrolled asthma. In the hospital, the situation led to increased emergency hospitalization, resulting in decreased bed availability, increased burden on manpower and health resource utilization thereby putting more pressure on the limited health resources. Using the Kotter’s model for change management, transformational and situational leadership style, the change in the desired quality and scope of health service rendered to asthmatic patients was successfully implemented;as a result there was a decrease in emergency room visit for acute asthma by 57.5% and an increase in the uptake of scheduled clinic visits for asthma control services. The effect of these changes was an improvement in the control of asthma and quality of life of our patient cohort. Implementation of change in health service delivery is a delicate process that needs a stepwise approach in order to successfully implement and sustain the desired change.