Abstract:
BACKGROUND:In 2012 the Norwegian Coordination Reform was implemented. The main motivation was to encourage municipalities to expand local, primary health care services. From 2012 to 2014, under the Municipal Co-Financing regime, municipalities were obliged to cover 20 % of the costs of health services provided at the specialist (hospital) level. Importantly, use of rehabilitation services in private institutions was not part of the cost-sharing mechanism of Municipal Co-Financing. Rehabilitation services may be seen as quite similar in nature whether they be provided by municipalities, hospitals or private institutions. Thus, with rehabilitation patients readily "transferrable" between levels, the question is whether the reform brought with it a sought after shift towards more municipal rehabilitation and less specialist rehabilitation. METHODS:Data from the Norwegian Patient Register and from Statistics Norway/KOSTRA were utilized to gauge annual expenditures and inputs in specialist, municipal and private institution rehabilitation services respectively. Fixed effects and first difference regression analyses for the period 2010-2013 were carried out to account for certain time-invariant traits of municipalities and/or hospital regions, and results were adjusted for contemporaneous trends in local needs. RESULTS:Expenditures in specialist rehabilitation services declined sharply (typically by 8-10 %) from 2011 (pre-reform) to 2012 (post-reform), while expenditures in private rehabilitation services rose markedly in the same period (typically by 42-44 %). The results do not suggest any general expansion of municipal rehabilitation services. CONCLUSIONS:The results of the analyses suggest that municipalities shift away from the use of specialist rehabilitation services and towards the use of rehabilitation services in private institutions since the latter becomes relatively cheaper (free-of charge) than both municipal and specialist services in post-reform periods (as specialist services come at a cost to municipalities post-reform). While the main goal of the reform has not materialized the results nevertheless suggest that incentives (of cost-shifting) do play a significant role in rehabilitation service use.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Monkerud LC,Tjerbo Tdoi
10.1186/s12913-016-1564-6subject
Has Abstractpub_date
2016-08-05 00:00:00pages
353issue
aissn
1472-6963pii
10.1186/s12913-016-1564-6journal_volume
16pub_type
杂志文章abstract:BACKGROUND:The most recent strategic call to action of the World Health Organization sets the elimination of pediatric HIV as a goal. While recent efforts have focused on building infrastructure and ensuring access to high-quality treatment, we must now turn our focus to the behavior change needed to eliminate vertical...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-406
更新日期:2013-10-10 00:00:00
abstract:BACKGROUND:Management, culture and systems for better quality and patient safety in hospitals have been widely studied in Norway. Nursing homes and home care, however have received much less attention. An increasing number of people need health services in nursing homes and at home, and the services are struggling with...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05149-x
更新日期:2020-04-03 00:00:00
abstract:BACKGROUND:Recently, there has been growing interest in providing more tailored, patient-centered care for the treatment of type 2 diabetes mellitus (T2DM). Yet it remains unclear which patient characteristics should be determined to guide such an approach. Therefore, the opinions of healthcare providers (HCP) and peop...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4371-z
更新日期:2019-08-16 00:00:00
abstract:BACKGROUND:Health systems evidence can enhance policymaking and strengthen national health systems. In the Middle East, limited research exists on the use of evidence in the policymaking process. This multi-country study explored policymakers' views and practices regarding the use of health systems evidence in health p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-200
更新日期:2012-07-16 00:00:00
abstract:BACKGROUND:Despite global efforts, HIV-related stigma continues to negatively impact the health and well-being of people living with HIV/AIDS. Even in healthcare settings, people with HIV/AIDS experience discrimination. Anecdotal evidence suggests that healthcare professionals in the Lao People's Democratic Republic, a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2068-8
更新日期:2017-02-10 00:00:00
abstract:BACKGROUND:In international comparisons, rates of amputations of the lower limb are relatively high in Germany. This study aims to analyze trends in lower limb amputations over time, as well as outcomes of care concerning in-hospital mortality and reamputation rates during the same hospital stay which might indicate th...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3759-5
更新日期:2019-01-06 00:00:00
abstract:BACKGROUND:The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP). The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collabora...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-68
更新日期:2012-03-20 00:00:00
abstract:BACKGROUND:Systems for monitoring effectiveness and quality of rehabilitation services across health care levels are needed. The purpose of this study was to develop and pilot test a quality indicator set for rehabilitation of rheumatic and musculoskeletal diseases. METHODS:The set was developed according to the Rand/...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4091-4
更新日期:2019-04-29 00:00:00
abstract:BACKGROUND:Like much of the developed world, healthcare costs in Canada are rising. A small proportion of patients account for a large proportion of healthcare spending and much of this spending occurs in acute care settings. The purpose of our study was to determine potentially modifiable factors related to care proce...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2746-6
更新日期:2017-11-25 00:00:00
abstract:BACKGROUND:Preoperative and hospital-acquired anaemia is common among surgical patients. It is associated with an increased risk of morbidity and mortality and a strong risk factor for allogeneic blood transfusions with their own inherent risks. Patient Blood Management (PBM) concepts aim to increase and preserve autol...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-014-0576-3
更新日期:2014-11-19 00:00:00
abstract:BACKGROUND:For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9). The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-235
更新日期:2010-08-12 00:00:00
abstract:BACKGROUND:Given the documented benefits of Patient Own Drugs (PODs) in most developed countries and scanty data on PODs management in developing countries the aim of the study was to evaluate the assessment, quality and extent of PODs use among hospitalised patients. Furthermore the perceived benefits and challenges i...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3860-9
更新日期:2019-01-11 00:00:00
abstract:BACKGROUND:Psychosocial job characteristics require nursing staff with high self-consistency and good mental health. However, the attention and effort of such study remained very limited in China. METHODS:A self-administered questionnaire was distributed to the bedside nurses in an affiliated hospital of Hebei Medical...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1463-x
更新日期:2016-06-28 00:00:00
abstract:BACKGROUND:Postal questionnaires are widely used to collect data in healthcare research but a poor response rate may reduce the validity and reliability of results. There was a lack of evidence available relating to use of a monetary incentive to improve the response rate in the healthcare setting. METHODS:The MRC ORA...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-5-55
更新日期:2005-08-18 00:00:00
abstract:BACKGROUND:Disrespectful and abusive care of women during their pregnancies has been shown to be a barrier for women accessing health care services for antenatal care and delivery. As part of an implementation research study to improve women's access to health care services in Rorya District, Mara, Tanzania, we conduct...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3463-5
更新日期:2018-08-22 00:00:00
abstract:BACKGROUND:Proton pump inhibitors (PPIs) remain one of the world's most frequently prescribed medications and there is a growing number of publications on correct versus incorrect use of PPIs worldwide. The objective of this observational retrospective study was to assess changes in PPI prescribing trends over the past...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3358-5
更新日期:2018-07-11 00:00:00
abstract:BACKGROUND:Effective clinician-patient communication about health behavior change is one of the most important and most overlooked strategies to promote health and prevent disease. Existing guidelines for specific health behavior counseling have been created and promulgated, but not successfully adopted in primary care...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-12-109
更新日期:2012-05-03 00:00:00
abstract:BACKGROUND:We studied the prevalence of common mental disorders among Dutch hospital physicians and investigated whether the presence of a mental disorder was associated with insufficient self-reported work ability. METHODS:A questionnaire was sent to all (n = 958) hospital physicians of one academic medical center, u...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-292
更新日期:2012-08-31 00:00:00
abstract:BACKGROUND:The Eastern Cape Province reports among the poorest health service indicators in South Africa with some of its districts standing out as worst performing as regards maternal health indicators. To understand key drivers and outcomes of this underperformance and to explore whether a participatory analysis coul...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3726-1
更新日期:2018-11-29 00:00:00
abstract:OBJECTIVE:This online cross-sectional survey assesses the signs/symptoms, the protective measures taken and the awareness and risk perception regarding COVID-19 among Italian dental hygienists. All Italian dental hygienists were invited to participate. The ad hoc online questionnaire was divided into four domains: pers...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05842-x
更新日期:2020-10-31 00:00:00
abstract:BACKGROUND:Objective was to describe variations in how social insurance officers conceive the cooperation with the health care in their daily work with sick leave. METHODS:Fifteen social insurance officers (SIOs) working with administration of sickness benefits were interviewed. They were purposefully recruited to rep...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-231
更新日期:2008-11-07 00:00:00
abstract:BACKGROUND:Recognizing the importance of increased patient participation in healthcare decisions leads decision makers to consider effective ways to incorporate patient perspectives in Health Technology Assessment (HTA) processes. The implementation of local health HTA units in university hospitals in Quebec provides a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-54
更新日期:2009-03-27 00:00:00
abstract:BACKGROUND:Swiss ambulatory care is characterized by independent, and primarily practice-based, physicians, receiving fee for service reimbursement. This study analyses supply sensitive services using ambulatory care claims data from mandatory health insurance. A first research question was aimed at the hypothesis that...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-315
更新日期:2010-11-23 00:00:00
abstract:BACKGROUND:The republic of Trinidad and Tobago (T&T) is a middle income country with a comparatively high prevalence of diabetes mellitus (DM) compared to others in the Caribbean. To date, there have been no studies on health care professionals' (HCP) perspectives regarding the barriers to achieving optimal care of pat...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1066-y
更新日期:2015-09-19 00:00:00
abstract:BACKGROUND:HIV testing and counseling (HTC) remains critical in the global efforts to reach a goal of universal access to prevention and timely human immunodeficiency virus (HIV) treatment and health care. Routine HIV testing has been shown to be cost-effective and life-saving by prolonging the life expectancy of HIV p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-267
更新日期:2014-06-19 00:00:00
abstract:BACKGROUND:Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the heal...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-92
更新日期:2013-03-11 00:00:00
abstract:BACKGROUND:The Whole Systems Demonstrator was a large, pragmatic, cluster randomised trial that compared telehealth with usual care among 3,230 patients with long-term conditions in three areas of England. Telehealth involved the regular transmission of physiological information such as blood glucose to health professi...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-14-334
更新日期:2014-08-06 00:00:00
abstract:BACKGROUND:Early identification of patients who need post-acute care (PAC) may improve discharge planning. The purposes of the study were to develop and validate a score predicting discharge to a post-acute care (PAC) facility and to determine its best assessment time. METHODS:We conducted a prospective study includin...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-154
更新日期:2008-07-22 00:00:00
abstract:BACKGROUND:In dementia care, it is crucial that the chain of care is adapted to the needs of people with dementia and their informal caregivers throughout the course of the disease. Assessing the existing dementia care system with regard to facilities, availability and utilization may provide useful information for ens...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3592-x
更新日期:2018-10-16 00:00:00
abstract:BACKGROUND:The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4750-5
更新日期:2019-11-29 00:00:00