Resource allocation problems and health services for the elderly.

The provision of appropriate health support services for the elderly has increased in importance because of the trend towards aging populations in Europe and other developed regions. Health service resource allocation models and their roles in health service systems, which are also changing to reflect changing needs for the elderly, are discussed in this article. Different types of economic and health care delivery systems are examined, particularly those leading towards decentralization, consumer participation and "deinstitutionalization". A promising resource allocation approach--the "balance-of-care" approach--is described in some detail. This and other potential approaches make it possible to identify areas which hold promise for crossnational research.

[Monitoring progress towards health for all in the European region of WHO IV. Changes in health systems]. / Vers la santé pour tous dans la région européenne de l'OMS surveillance des progrès accomplis IV. Réponses des systèmes de santé.

This review deals with recent changes in health services development and support among the Member States of the European Region in response to changes in health indicators in the framework of the Regional targets for Health for all. Developments in research, in health legislation and in training which take into account the targets of Health for all represent long-term actions; several countries mention efforts to increase community participation in the development and evaluation of health programmes, efforts which must be actively pursued. Changes are perforce slow, and economic pressure represents both a challenge and a constraint.

[Monitoring progress towards health for all in the European region of WHO. III. Life style and physical environment]. / Vers la Santé pour tous dans la région européenne de l'OMS surveillance des progrès accomplis. III. Modes de vie et milieu physique.

A review of recent progress towards the Regional targets set for Health for all in the European Region of WHO, as regards lifestyle and environmental factors. Tobacco consumption (in most countries), and alcohol drinking (mainly in countries with previous high consumption) show some improvement. Illicit drug use is emerging in new countries, although it appears to stabilise in previously affected areas. Despite considerable efforts on environmental factors, there remains a serious problem of communication with the public, and action is poorly coordinated; indicators for environmental health show little progress.

Equity and access: exploring the effects of hospital location on the population served--a case study in strategic planning.

This paper describes a case study in which a simulation model, specifically an attraction-constrained spatial interaction model, is used to provide information to assist in the exploration of different options for the future provision of in-patient hospital facilities in an English Regional Health Authority. The model is used to evaluate options on the basis of their effect on two different criteria: first the level of utilization of hospital in-patient facilities relative to need of populations resident in different parts of the region, and secondly the relative ease of geographical access of the facilities to the populations served.