Examining health care spending trends over a decade: the Palestinian case

An analysis was made of recent health care spending patterns in the occupied Palestinian territory, in order to inform future health policy-making and planning. Data were obtained from the national health accounts for the period 2000-2011. The current level of resource allocation to the health care sector is higher than in many developed countries and is not sustainable. The private sector represents the largest source of health financing [61%] and the burden falls disproportionally on individual households, who account for 63% of private health care expenditure. Key recommendations include: building capacity in the government sector to reduce the outsourcing of health services; modifying inequitable financing mechanisms to reduce the burden on households; and allocating more resources for health promotion and disease prevention programmes. Reorientation of the health system is also needed in terms of reducing the share of spending on inpatient services in favour of more day surgery, outpatient and home-based services

Lecithin cholesterol acyltransferase activity is decreased in type 2 diabetes mellitus

Lecithin cholesterol acyltransferase [LCAT] plays a major role in the removal of free cholesterol from tissues via assisting HDL-C maturation, and its activity has been proposed as the main indicator of HDL-C function. The aim of the study was to measure LCAT activity in type 2 diabetic patients and to elucidate whether LCAT is associated with metabolic control, and insulin resistance. A case-control study was conducted, recruiting 45 type 2 diabetes mellitus patients and 45 healthy subjects. Cases and controls were matched regarding gender, age and body mass index [BMI]. FBS, lipid profile, LCAT activity, HbA[IC], insulin were measured and insulin resistance [HOMA-IR] was calculated for both patients and controls. The studied variables were then compared between the two groups, and the association of LCAT activity with any of the variables was examined. Twenty-five subjects were female and 20 male both among patients and controls. Mean age of diabetics was 49.9 yrs and of controls 51.1 yrs. FBS, HbA[IC], HOMA-IR and TG in patients were significantly higher than controls, and HDL-C in controls was significantly higher than patients. LCAT activity of patients [73 +/- 9.1 nmol/L/h] was significantly lower than that in controls [88 +/- 4.5 |imol/L/h] [P < 0.001]. LCAT activity had significant inverse correlations with HbA[IC] and duration of diabetes. After multilinear regression analysis in patients, LCAT activity was only correlated with HbA[IC] level [B= -0.9, P < 0.001]. LCAT activity had no significant association with HDL-C and HOMA-IR in any of the groups. LCAT activity is significantly decreased in patients with type 2 diabetes compared with healthy controls, and has an inverse correlation with the magnitude of hyperglycemia