Lessons from London: the British are reforming their national health service.

Abstract:

:In an effort to keep abreast of the changing needs of a more affluent society and to ensure better value for money, the British are reforming their National Health Service. They are promoting competition and entrepreneurship, and directing funding to follow a patient rather than flowing directly to institutions. British physicians are resisting these changes. The United States, in the middle of a health care crisis of its own, can learn a great deal from Britain, especially in the area of controlling expenditures. The low cost of the National Health Service can be attributed to four major factors: (1) It is general practitioner driven and no patient accesses a specialist or hospital directly. (2) Hospitals, which employ all the specialists and supply most of the technology, operate on very tight, cash-limited budgets. (3) Administrative costs are very low. (4) The expense of malpractice is not (yet) a major concern. Changes occurring in both countries foretell a future wherein our health care systems may look very much alike.

journal_name

Am J Public Health

authors

Vall-Spinosa A

doi

10.2105/ajph.81.12.1566

subject

Has Abstract

pub_date

1991-12-01 00:00:00

pages

1566-70

issue

12

eissn

0090-0036

issn

1541-0048

journal_volume

81

pub_type

杂志文章
  • Characteristics of physically active smokers and implications for harm reduction.

    abstract:OBJECTIVES:We sought to establish the prevalence of physical activity among smokers, whether or not physically active smokers were more likely to attempt cessation, and who these physically active smokers were. METHODS:We used logistic regression to contrast physically active and inactive smokers in a secondary data a...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2007.120469

    authors: Deruiter WK,Faulkner G,Cairney J,Veldhuizen S

    更新日期:2008-05-01 00:00:00

  • Impact of Two Adolescent Pregnancy Prevention Interventions on Risky Sexual Behavior: A Three-Arm Cluster Randomized Control Trial.

    abstract:OBJECTIVES: To test the efficacy of Reducing the Risk (RTR) and Love Notes (LN) on reducing risky sexual behavior among youths yet to experience or cause a pregnancy. METHODS: The four dependent variables were ever had sex, condom use, birth control use, and number of sexual partners at 3- and 6-month follow-up in a 3...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2016.303429

    authors: Barbee AP,Cunningham MR,van Zyl MA,Antle BF,Langley CN

    更新日期:2016-09-01 00:00:00

  • Factors affecting place of death of hospice and non-hospice cancer patients.

    abstract::We identified factors associated with death at home for 28,828 hospice and non-hospice cancer patients in 13 counties of western Washington State. Hospice participation was found to be the variable most strongly associated with death at home. Admission to hospice appears to override the tendency for certain subgroups ...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.79.11.1549

    authors: Moinpour CM,Polissar L

    更新日期:1989-11-01 00:00:00

  • Can medicaid reimbursement help give female condoms a second chance in the United States?

    abstract::The female condom is the only other barrier contraception method besides the male condom, and it is the only "woman-initiated" device for prevention of sexually transmitted infections. Although studies demonstrate high acceptability and effectiveness for this device, overall use in the United States remains low. The f...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2009.179598

    authors: Witte SS,Stefano K,Hawkins C

    更新日期:2010-10-01 00:00:00

  • The use of vitamin supplements and the risk of cataract among US male physicians.

    abstract:OBJECTIVES:The purpose of this study was to examine prospectively the association between reported use of vitamin supplements and risk of cataract and cataract extraction. METHODS:The study population consisted of 17,744 participants in the Physicians' Health Study, a randomized trial of aspirin therapy and beta-carot...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.84.5.788

    authors: Seddon JM,Christen WG,Manson JE,LaMotte FS,Glynn RJ,Buring JE,Hennekens CH

    更新日期:1994-05-01 00:00:00

  • Changes in prescribing of antiviral medications for influenza associated with new treatment guidelines.

    abstract::In 2006, the Centers for Disease Control and Prevention recommended discontinuing the use of adamantanes (amantadine and rimantadine) to treat influenza because of high levels of resistance to this class of antivirals. We examined changes in prescribing practices resulting from this recommendation and found that presc...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2009.171462

    authors: Hersh AL,Maselli JH,Cabana MD

    更新日期:2009-10-01 00:00:00

  • Association between community socioeconomic position and HIV diagnosis rate among adults and adolescents in the United States, 2005 to 2009.

    abstract:OBJECTIVES:We examined the association between socioeconomic position (SEP) and HIV diagnosis rates in the United States and whether racial/ethnic disparities in diagnosis rates persist after control for SEP. METHODS:We used cases of HIV infection among persons aged 13 years and older, diagnosed 2005 through 2009 in 3...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2012.300853

    authors: An Q,Prejean J,McDavid Harrison K,Fang X

    更新日期:2013-01-01 00:00:00

  • Screening for colorectal neoplasia: physicians' adherence to complete diagnostic evaluation.

    abstract::This prospective study was done in a health maintenance organization colorectal cancer screening program to determine whether 166 persons found to have abnormal fecal occult blood test results typically underwent complete diagnostic evaluation (i.e., either colonoscopy or barium enema x-ray plus flexible sigmoidoscopy...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.83.11.1620

    authors: Myers RE,Balshem AM,Wolf TA,Ross EA,Millner L

    更新日期:1993-11-01 00:00:00

  • Outreach developmental services to children of patients in treatment for substance abuse.

    abstract:OBJECTIVES:This report describes a model for delivering developmental services to children of patients in treatment for substance abuse. METHODS:A multidisciplinary team provides developmental evaluations of children at a substance abuse treatment clinic. RESULTS:In 3 years of operation, 85% of 117 children completed...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.90.12.1930

    authors: Shulman LH,Shapira SR,Hirshfield S

    更新日期:2000-12-01 00:00:00

  • The evolution of changes in primary care delivery underlying the Veterans Health Administration's quality transformation.

    abstract:OBJECTIVES:Suffering from waning demand, poor quality, and reform efforts enabling veterans to "vote with their feet" and leave, the Veterans Health Administration (VA) health care system transformed itself through a series of substantive changes. We examined the evolution of primary care changes underlying VA's transf...

    journal_title:American journal of public health

    pub_type: 杂志文章,多中心研究

    doi:10.2105/AJPH.2007.115709

    authors: Yano EM,Simon BF,Lanto AB,Rubenstein LV

    更新日期:2007-12-01 00:00:00

  • Directive counseling on long-acting contraception.

    abstract::National rates of unintended births are a major public health concern. The availability of highly effective long-acting contraceptives has prompted some public officials to promote the coercive use of these methods to reduce such problems as intergenerational poverty and child abuse. Broad-brush public policies that r...

    journal_title:American journal of public health

    pub_type: 杂志文章,评审

    doi:10.2105/ajph.86.6.787

    authors: Moskowitz E,Jennings B

    更新日期:1996-06-01 00:00:00

  • The efficacy of female condom skills training in HIV risk reduction among women: a randomized controlled trial.

    abstract:OBJECTIVES:We evaluated the efficacy of skills training designed to increase female condom use among women. METHODS:We conducted a randomized controlled trial of 409 women, recruited from family planning clinics in northern California, who were randomly assigned to the experimental 4-session female condom skills train...

    journal_title:American journal of public health

    pub_type: 杂志文章,随机对照试验

    doi:10.2105/AJPH.2007.113050

    authors: Choi KH,Hoff C,Gregorich SE,Grinstead O,Gomez C,Hussey W

    更新日期:2008-10-01 00:00:00

  • The Rates and Medical Necessity of Cesarean Delivery in the Era of the Two-Child Policy in Hubei and Gansu Provinces, China.

    abstract:OBJECTIVES:To describe the cesarean rates in different child policy periods and assess the medical necessity of cesareans during the 2-child policy period. METHODS:We collected hospital-level aggregate data on 93 745 deliveries and individual-level data on 27 977 deliveries from 6 hospitals in the Hubei and Gansu prov...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2018.304868

    authors: Liao Z,Zhou Y,Li H,Wang C,Chen D,Liu J

    更新日期:2019-03-01 00:00:00

  • Ke 'Ano Ola: Moloka'i's community-based healthy lifestyle modification program.

    abstract::We evaluated a community-based 12-week healthy lifestyle program in Moloka'i, HI, called Ke 'Ano Ola, which was developed to decrease chronic disease risk through health education emphasizing weight loss, exercise, and risk factor reduction. Program leaders' strong commitment and positive role modeling, along with soc...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2009.176222

    authors: Gellert KS,Aubert RE,Mikami JS

    更新日期:2010-05-01 00:00:00

  • The impact of depressive symptomatology on physical disability: MacArthur Studies of Successful Aging.

    abstract:OBJECTIVES:The purpose of these analyses was to test the hypothesis that depressive symptomatology affects the risk of onset of physical disability in high-functioning elderly adults. METHODS:The data come from the MacArthur Study of Successful Aging, a community-based cohort of high-functioning adults aged 70 through...

    journal_title:American journal of public health

    pub_type: 杂志文章,多中心研究

    doi:10.2105/ajph.84.11.1796

    authors: Bruce ML,Seeman TE,Merrill SS,Blazer DG

    更新日期:1994-11-01 00:00:00

  • Policies of containment: immigration in the era of AIDS.

    abstract::The US Public Health Service began the medical examination of immigrants at US ports in 1891. By 1924, national origin had become a means to justify broad-based exclusion of immigrants after Congress passed legislation restricting immigration from southern and eastern European countries. This legislation was passed ba...

    journal_title:American journal of public health

    pub_type: 历史文章,杂志文章

    doi:10.2105/ajph.84.12.2011

    authors: Fairchild AL,Tynan EA

    更新日期:1994-12-01 00:00:00

  • The epidemic of endometrial cancer: a commentary.

    abstract::Vital statistics show that a rise in incidence of endometrial cancer began in the mid-1960s on the West Coast of the United States. This rise was continuous and reached a peak in 1975. Elsewhere, incidence rates for endometrial cancer rose during the 1970s. It now seems evident that much of the rise in all areas of th...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.70.3.264

    authors: Jick H,Walker AM,Rothman KJ

    更新日期:1980-03-01 00:00:00

  • Senile dementia: public policy and adequate institutional care.

    abstract::Increasing costs of institutional care for the aged have occasioned a variety of government cost containment measures. People with senile dementia of the Alzheimer's type (SDAT) will be the principal group to suffer from cutbacks. SDAT patients are usually eligible for Intermediate Care Facilities (ICFs), rather than ...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.74.12.1381

    authors: Brody EM,Lawton MP,Liebowitz B

    更新日期:1984-12-01 00:00:00

  • A prospective study of syphilis and HIV infection among injection drug users receiving methadone in the Bronx, NY.

    abstract:OBJECTIVES:The purpose of this study was to assess the relationship between syphilis and human immunodeficiency virus (HIV) infection in injection drug users. METHODS:A 6-year prospective study of 790 injection drug users receiving methadone maintenance treatment in the Bronx, NY, was conducted. RESULTS:Sixteen perce...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.86.8_pt_1.1112

    authors: Gourevitch MN,Hartel D,Schoenbaum EE,Selwyn PA,Davenny K,Friedland GH,Klein RS

    更新日期:1996-08-01 00:00:00

  • Public health's response to a changed world: September 11, biological terrorism, and the development of an environmental health tracking network.

    abstract::Historically, the importance of public health has often been recognized during or as a result of major tragedy. The attacks that occurred in the United States in 2001 are no exception. These events have raised awareness of our vulnerability and the need for emergency preparedness, the need for a flexible and sustainab...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.93.8.1226

    authors: Marmagas SW,King LR,Chuk MG

    更新日期:2003-08-01 00:00:00

  • Drug prescribing in hospitals: an international comparison.

    abstract::This paper presents a comparison of prescribing habits for patients hospitalized in medical wards of university hospitals in America and Scotland. American patients received almost twice as many drugs both during and prior to hospitalization than did comparable Scots. The differences between the countries were consist...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.66.7.644

    authors: Lawson DH,Jick H

    更新日期:1976-07-01 00:00:00

  • Family physicians' views of chiropractors: hostile or hospitable?

    abstract::Family physicians in the State of Washington were surveyed about their knowledge and views about chiropractors; 79 per cent (476) responded. Sixty-six per cent indicated discomfort with what they believed chiropractors do while acknowledging their effectiveness for some patients; 25 per cent viewed chiropractors as an...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.79.5.636

    authors: Cherkin D,MacCornack FA,Berg AO

    更新日期:1989-05-01 00:00:00

  • Prevention through pre-review in occupational health and safety.

    abstract::Occupational health problems have needlessly been produced at many worksites as a consequence of their not having been anticipated during design and construction. Pre-review may be an effective and efficient mechanism for preventive intervention in occupational health and safety. Legal and administrative precedents ar...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.70.2.157

    authors: Richter ED,Kretzmer D

    更新日期:1980-02-01 00:00:00

  • Perspectives on the past and future of psychiatric epidemiology. The 1981 Rema Lapouse Lecture.

    abstract::Two generations of epidemiological studies of the true prevalence of mental disorders have been conducted since the turn of the century. The first and smaller in number took place prior to World War II and was characterized by the use of records and key informants to define "cases." The second, utilizing the greatly e...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.72.11.1271

    authors: Dohrenwend BP,Dohrenwend BS

    更新日期:1982-11-01 00:00:00

  • Smoking in 6 diverse Chicago communities--a population study.

    abstract:OBJECTIVES:We analyzed smoking survey data across communities in Chicago, Ill, to explore community-level variations in smoking behavior. METHODS:We conducted a health survey of 6 racially and ethnically diverse Chicago communities during 2002-2003. The survey included questions about current smoking, smoking history,...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2004.051169

    authors: Dell JL,Whitman S,Shah AM,Silva A,Ansell D

    更新日期:2005-06-01 00:00:00

  • Barriers to universal prenatal HIV testing in 4 US locations in 1997.

    abstract:OBJECTIVES:We determined rates of prenatal HIV testing and investigated barriers to testing. METHODS:We surveyed 1362 representative parturient women from 7 hospitals in 4 locations of the United States. RESULTS:Overall, 89.9% of women reported being offered HIV testing and 69.6% reported being tested. Proportions of...

    journal_title:American journal of public health

    pub_type: 杂志文章,多中心研究

    doi:10.2105/ajph.91.5.727

    authors: Royce RA,Walter EB,Fernandez MI,Wilson TE,Ickovics JR,Simonds RJ,Perinatal Guidelines Evaluation Project.

    更新日期:2001-05-01 00:00:00

  • Effects of alcohol tax and price policies on morbidity and mortality: a systematic review.

    abstract:OBJECTIVES:We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact. METHODS:We searched 12 databases, along with articles' reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and...

    journal_title:American journal of public health

    pub_type: 杂志文章,评审

    doi:10.2105/AJPH.2009.186007

    authors: Wagenaar AC,Tobler AL,Komro KA

    更新日期:2010-11-01 00:00:00

  • Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work.

    abstract:OBJECTIVES:We determined racial/ethnic differences in social support and exposure to violence and transphobia, and explored correlates of depression among male-to-female transgender women with a history of sex work (THSW). METHODS:A total of 573 THSW who worked or resided in San Francisco or Oakland, California, were ...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2010.197285

    authors: Nemoto T,Bödeker B,Iwamoto M

    更新日期:2011-10-01 00:00:00

  • The gender gap in heart disease: lessons from Eastern Europe.

    abstract::Why are men more susceptible to heart disease than women? Traditional risk factors cannot explain the gender gap in coronary heart disease (CHD) or the rapid increase in CHD mortality among middle-aged men in many of the newly independent states of Eastern Europe. However, Eastern European men score higher on stress-r...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/ajph.93.5.768

    authors: Weidner G,Cain VS

    更新日期:2003-05-01 00:00:00

  • Decreasing Hepatitis C Incidence Among a Population With Repeated Tests: British Columbia, Canada, 1993-2011.

    abstract:OBJECTIVES:We estimated HCV incidence among individuals who repeatedly underwent anti-HCV testing. METHODS:We studied HCV-negative individuals who had at least 2 tests between April 1992 and September 2012 in British Columbia, Canada. We calculated incidence as the number of new infections per 100 person-years at risk...

    journal_title:American journal of public health

    pub_type: 杂志文章

    doi:10.2105/AJPH.2015.302591

    authors: Kuo M,Janjua NZ,Burchell AN,Buxton JA,Krajden M,Gilbert M

    更新日期:2015-08-01 00:00:00