This paper is aimed at examining the European medicine agency decisions in the field of human medicines. Different classes of human medicines approved in the last five years have been classified.... Show More

This paper is aimed at examining the European medicine agency decisions in the field of human medicines. Different classes of human medicines approved in the last five years have been classified. They have been analyzed considering: i) the relation between non generic drugs and generic drugs, ii) time of approval, iii) objectives of the clinical trials, iv) criteria of efficiency, efficacy, safety. By using the Summary of the European Public Assessment Report for every human medicine in the period 2010-2015, a dataset has been arranged. A Structural Equation Model analysis was carried out. The degree of efficiency, the degree of safety, the tradeoff between efficiency and safety that lead to the EMA approval decisions are conditioned by the nature of the medicines and the characteristics of their class. Different degrees of benefits and risks underpinning the decisions have been identified together with the consequent guiding principles that lead to the EMA decision process. A latent general “safety” factor at the basis of EMA decision process was assessed.

This study explored outpatient healthcare seeking behavior in India and estimated predisposing and enabling factors that influenced the satisfaction derived from the health care activity. The study... Show More

This study explored outpatient healthcare seeking behavior in India and estimated predisposing and enabling factors that influenced the satisfaction derived from the health care activity. The study assumed that if these gaps are fulfilled in the local facilities, this might invigorate lesser popular public providers within the neighborhood. The study was conducted in the state of West Bengal India. A multilevel framework was developed to incorporate factors affecting the satisfaction of the healthcare activity. Analysis revealed dependency on regional facilities and extensive traveling. Excessive traveling affected satisfaction negatively whereas in cases where respondent availed services from local primary health centers had positive impact on satisfaction. On the route to daily activity, ability to visit referred facility and visit to facility with modern amenities often triggered satisfaction. Segmented policy designed to fulfill these preferences might be indispensable to enhance local sufficiency.

Health and social services are increasingly produced in cooperation among several specialized organizations. This has increased the importance of service integration in the sector. While the... Show More

Health and social services are increasingly produced in cooperation among several specialized organizations. This has increased the importance of service integration in the sector. While the literature acknowledges the need for performance measurement addressing outcomes and effectiveness of service integration, not enough is known about applying such measurement practices. This paper examines the design of a performance measurement system to support the effectiveness management of an integrated service delivery. The research identifies three aspects of effectiveness – community, client and network level. Empirical examination reveals that success factors for design of measures for integrated service delivery include consensus on the targets, coordination and fluent cooperation among actors in the network. The paper contributes to performance measurement literature by illustrating how the design of system level measurement is carried out in practice and analyzing the lessons learned.

China has had some initial success in its current health care reform efforts. Five areas of reform have been targeted and include providing universal coverage, equitable access to basic health... Show More

China has had some initial success in its current health care reform efforts. Five areas of reform have been targeted and include providing universal coverage, equitable access to basic health insurance, establishing an essential medicine system, and improving primary health care facilities. The last area, the reform of the public hospitals, remains the most difficult to reform. General guidelines have been established by the national government and movement is being taken to delegate authority to local units for implementation. The aim of this paper is to compare China's formal government sponsored health care reform plan for public hospitals to the acknowledgement and acceptance by a sample of health care leaders in Guangzhou. Challenges are strong and include cost accountability, doctor training, employee empowerment, improprieties, and the influence of private hospitals. Based on this qualitative research, conclusions and recommendations are made by the authors as to what is necessary to have effective pubic hospital reform in China.