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9.
Tunis Med ; 96(10-11): 847-857, 2018.
Article in English | MEDLINE | ID: mdl-30746678

ABSTRACT

In the 21st century, public health is not only about fighting infectious diseases, but also contributing to a "multidimensional" well-being of people (health promotion, non-communicable diseases, the role of citizens and people in the health system etc.). Six themes of public health, issues of the 21st century will be addressed. Climate change is already aggravating already existing health risks, heat waves, natural disasters, recrudescence of infectious diseases. Big data is the collection and management of databases characterized by a large volume, a wide variety of data types from various sources and a high speed of generation. Big data permits a better prevention and management of disease in patients, the development of diagnostic support systems and the personalization of treatments. Big data raises important ethical questions. Health literacy includes the abilities of people to assess and critique and appropriate health information. Implementing actions to achieve higher levels of health literacy in populations remains a crucial issue. Since the 2000s, migration flows of health professionals have increased mainly in the "south-north" direction. India is the country with the most doctors outside its borders. The USA and the UK receive 80% of foreign doctors worldwide. Ways have been identified to try to regulate the migratory phenomena of health professionals around the world. The mobilization of citizen, health system users and patient associations is a strong societal characteristic over the last 30 years. In a near future, phenomena will combine to increase the need for accompaniment of patient or citizen to protect health, such increase of the prevalence of chronic diseases, reinforcement of care trajectories, medico-social care pathways, and importance of health determinants. Interventional research in public health is very recent. It is based on experimentation and on the capitalization of field innovations and uses a wide range of scientific disciplines, methods and tools. It is an interesting tool in the arsenal of public health research. It is essential today to be able to identify the multiple challenges that health systems will face in the coming years, to anticipate changes, and to explore possible futures.


Subject(s)
Public Health , Quality of Health Care , Africa, Northern/epidemiology , Climate Change/statistics & numerical data , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/etiology , Electronic Health Records , Health Literacy/history , Health Literacy/trends , Health Personnel/organization & administration , Health Personnel/trends , History, 21st Century , Humans , Patient Advocacy/standards , Patient Advocacy/trends , Public Health/history , Public Health/standards , Public Health/trends , Public Health Administration/standards , Public Health Administration/trends , Public Health Systems Research , Quality of Health Care/history , Quality of Health Care/standards , Quality of Health Care/trends , Social Change/history
10.
Public Health Res Pract ; 27(4)2017 Oct 11.
Article in English | MEDLINE | ID: mdl-29114711

ABSTRACT

In 2017, Australia celebrates 50 years since the 1967 referendum, when more than 90% of Australians voted to amend the constitution to allow the national government to create laws for Indigenous people and include them in the census. We spoke with the Honourable Ken Wyatt, the Minister for Indigenous Health and the Minister for Aged Care, about what has occurred over the past 50 years in Indigenous health from a political perspective, and what we have learnt to improve health outcomes in the future.


Subject(s)
Health Policy , Health Services, Indigenous/history , Health Services, Indigenous/legislation & jurisprudence , Politics , Quality of Health Care/history , Quality of Health Care/legislation & jurisprudence , Australia , Health Services, Indigenous/organization & administration , History, 20th Century , History, 21st Century , Humans , Native Hawaiian or Other Pacific Islander , Quality of Health Care/organization & administration
17.
Rural Policy Brief ; (2016 3): 1-4, 2016 Jul 01.
Article in English | MEDLINE | ID: mdl-27991746

ABSTRACT

Purpose. In this policy brief, we assess variation in Medicare's star quality ratings of Medicare Advantage (MA) plans that are available to rural beneficiaries. Evidence from the recent Centers for Medicare & Medicaid Services (CMS) quality demonstration suggests that market dynamics, i.e., firms entering and exiting the MA marketplace, play a role in quality improvement. Therefore, we also discuss how market dynamics may impact the smaller and less wealthy populations that are characteristic of rural places. Key Data Findings. (1) Highly rated MA plans serving rural Medicare beneficiaries are more likely to be health maintenance organizations (HMOs) and local preferred provider organizations (PPOs), as opposed to regional PPOs. HMOs and local PPOs may be better able to improve their quality scores strategically in response to the bonus payment incentive due to existing internal monitoring mechanisms. (2) On average, the rural enrollment rate is lower in plans with higher quality scores (59 percent) than the corresponding urban rate (71 percent). This differential is likely due, in part, to lack of availability of highly rated plans in rural areas: 17.8 percent of rural counties lacked access to a plan with four or more (out of five) stars, while just 3.7 percent of urban counties lacked such access. (3) MA plans with high quality scores have been operating longer, on average, and have a lower percentage of rural counties within their contract service areas than plans with lower quality scores.


Subject(s)
Medicare Part C/organization & administration , Quality of Health Care/statistics & numerical data , Forecasting , Health Care Sector , Health Maintenance Organizations , History, 21st Century , Humans , Medicare Part C/history , Preferred Provider Organizations , Quality of Health Care/history , Quality of Health Care/trends , Rural Health , Rural Population , United States
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