Acronym Definition
HPRN High Pass Resolution Network
HPRN High Peak Rate Network
HPRN High Performance Routing (APPN)
HPRN High Powered Rocketry Norm
HPRN High Priority Request Number
HPRN High Priority Requisition National
HPRN Highly Protected Risk Number
HPRN Hiring Process Report Notice
HPRN Holding Period Return Number
HPRN Home Page Reader Network
HPRN Hostes Populi Romani Network
HPRN Human Performance Reliability Network
HPRN Hydro-acoustic Position Reference Network
HPRN Home of Printer
HPRN Home of Pro Re Nata (Latin: for the existing occasion; as matters are; as
needed)
HPRN Home of Packet Radio Network
HPRN Home of Partido Resistencia Nicaragüense (Nicaraguan Resistance Party)
HPRN Home of Parts Return Notice
HPRN Home of Patient Reader Necessary (medication advice)
HPRN Home of Pearson Education Canada (publisher)
HPRN Home of Performance Racing Network
HPRN Home of Pesticide Registration Notice (EPA)
HPRN Home of Pinpoint Road Network
HPRN Home of Policy Renewal Notice (insurance)
HPRN Home of Polymer Recycling Network (UK)
HPRN Home of Practice Research Network
HPRN Home of Practicing Registered Nurse
HPRN Home of Premiere Radio Networks
HPRN Home of Premium Rate Number(s)
HPRN Home of Procurement Reallocation Notice
HPRN Home of Program Record/Reference Number
HPRN Home of Provide Roaming Number
HPRN Home of Pseudo Random Number
HPRN Home of Pseudo-Random Noise
HPRN High Plains Research Network
HPRN High Plains Radio Network
HPRN Humber Plus Refugee Network
HPRN Historic Printers’ Row Neighbors
HPRN Healthare Practice Research Network
HPRN Healthare Provider Research Network
HPRN Healthare Provider Research Network
Acronym Definition
HPRN High Pass Resolution Network
HPRN High Peak Rate Network
HPRN High Performance Routing (APPN)
HPRN High Powered Rocketry Norm
HPRN High Priority Request Number
HPRN High Priority Requisition National
HPRN Highly Protected Risk Number
HPRN Hiring Process Report Notice
HPRN Holding Period Return Number
HPRN Home Page Reader Network
HPRN Hostes Populi Romani Network
HPRN Human Performance Reliability Network
HPRN Hydro-acoustic Position Reference Network
HPRN Home of Printer
HPRN Home of Pro Re Nata (Latin: for the existing occasion; as matters are; as
needed)
HPRN Home of Packet Radio Network
HPRN Home of Partido Resistencia Nicaragüense (Nicaraguan Resistance Party)
HPRN Home of Parts Return Notice
HPRN Home of Patient Reader Necessary (medication advice)
HPRN Home of Pearson Education Canada (publisher)
HPRN Home of Performance Racing Network
HPRN Home of Pesticide Registration Notice (EPA)
HPRN Home of Pinpoint Road Network
HPRN Home of Policy Renewal Notice (insurance)
HPRN Home of Polymer Recycling Network (UK)
HPRN Home of Practice Research Network
HPRN Home of Practicing Registered Nurse
HPRN Home of Premiere Radio Networks
HPRN Home of Premium Rate Number(s)
HPRN Home of Procurement Reallocation Notice
HPRN Home of Program Record/Reference Number
HPRN Home of Provide Roaming Number
HPRN Home of Pseudo Random Number
HPRN Home of Pseudo-Random Noise
HPRN High Plains Research Network
HPRN High Plains Radio Network
HPRN Humber Plus Refugee Network
HPRN Historic Printers’ Row Neighbors
HPRN Healthare Practice Research Network
HPRN Healthare Provider Research Network
A health care provider or health professional is an organization or person who
delivers proper health care in a systematic way professionally to any individual
in need of health care services.
Institutions
Hospital
Hospital
A hospital is an institution for health care, often but not always providing for
longer-term patient stays. Today, hospitals are usually funded by the state,
health organizations (for profit or non-profit), by health insurances or by
charities and by donations. In history, however, they were often founded and
funded by religious orders or charitable individuals and leaders. Hospitals are
nowadays staffed by professional physicians, surgeons and nurses, whereas in
history, this work was usually done by the founding religious orders or by
volunteers.
Laboratories and research
Main articles: Medical laboratory and Biomedical research
A medical laboratory or clinical laboratory is a laboratory where tests are done
on biological specimens in order to get information about the health of a
patient. Such laboratories may be divided into categorical departments such as
microbiology, hematology, clinical biochemistry, immunology, serology,
histology, cytology, cytogenetics, or virology. In many countries, there are two
main types of labs that process the majority of medical specimens. Hospital
laboratories are attached to a hospital, and perform tests on these patients.
Private, or community laboratories receive samples from general practitioners,
insurance companies, and other health clinics for analysis.
Biomedical research, or experimental medicine, in general simply known as
medical research, is the basic research or applied research conducted to aid the
body of knowledge in the field of medicine. Medical research can be divided into
two general categories: the evaluation of new treatments for both safety and
efficacy in what are termed clinical trials, and all other research that
contributes to the development of new treatments. The latter is termed
preclinical research if its goal is specifically to elaborate knowledge for the
development of new therapeutic strategies.
Practitioners and professionals
Health care professionals include physicians, physician assistants, support
staff, nurses, pharmacists, therapists, psychologists, veterinarians, dentists,
optometrists, and a wide variety of other individuals regulated and/or licensed
to provide some type of health care.
This short section requires expansion.
Mental health professionals
Mental health professional
A mental health professional is a person who offers services for the purpose of
improving an individual's mental health or treating mental illness. These
professionals include psychiatrists, clinical psychologists, clinical social
workers, psychiatric nurses as well as other professionals. These professionals
often deal with the same illnesses, disorders, conditions, and issues; however
their scope of practice often differs. The most significant difference between
mental health professionals is education and training.
Health care systems
Health care systems
A health care system is the organization by which health care is provided. Such
systems could be endorsed and/or managed by governments or managed completely or
partially by private market-based institutions.
Market-based
Health insurance
Health insurance is a type of insurance whereby the insurer pays the medical
costs of the insured if the insured becomes sick due to covered causes, or due
to accidents. The insurer may be a private organization or a government agency.
Market-based health care systems such as that in the United States rely
primarily on private health insurance.
Health care, or healthcare, is the prevention, treatment, and management of
illness and the preservation of mental and physical well being through the
services offered by the medical, nursing, and allied health professions.
According to the World Health Organization, health care embraces all the goods
and services designed to promote health, including “preventive, curative and
palliative interventions, whether directed to individuals or to populations”.
The organised provision of such services may constitute a health care system.
This can include a specific governmental organisation such as, in the UK, the
National Health Service or a cooperation across the National Health Service and
Social Services as in Shared Care. Before the term "health care" became popular,
English-speakers referred to medicine or to the health sector and spoke of the
treatment and prevention of illness and disease.
In most developed countries and many developing countries health care is
provided to everyone regardless of their ability to pay. The National Health
Service in the United Kingdom was the world's first universal health care system
provided by government. It was established in 1948 by Clement Atlee's Labour
government. Alternatively, compulsory government funded health insurance with
nominal fees can be provided, as with Italy, which, according to the World
Health Organisation, has the second-best health system in the world. Other
examples are Medicare in Australia, established in the 1970s by the Labor
government, and by the same name Medicare in Canada, established between 1966
and 1984. Universal health care contrasts to the systems like health care in the
United States or South Africa, though South Africa is one of the many countries
attempting health care reform.
Industry
Health care industry
The health care industry is considered an industry or profession which includes
peoples exercise of skill or judgment or the providing of a service related to
the preservation or improvement of the health of individuals or the treatment or
care of individuals who are injured, sick, disabled, or infirm. The delivery of
modern health care depends on an expanding group of trained professionals coming
together as an interdisciplinary team.
The health care industry is one of the world's largest and fastest-growing
industries. Consuming over 10 percent of gross domestic product of most
developed nations, health care can form an enormous part of a country's economy.
In 2003, health care costs paid to hospitals, physicians, nursing homes,
diagnostic laboratories, pharmacies, medical device manufacturers and other
components of the health care system, consumed 15.3 percent of the GDP of the
United States, the largest of any country in the world. For the United States,
the health share of gross domestic product (GDP) is expected to hold steady in
2006 before resuming its historical upward trend, reaching 19.6 percent of GDP
by 2016. In 2001, for the OECD countries the average was 8.4 percent with the
United States (13.9%), Switzerland (10.9%), and Germany (10.7%) being the top
three.
Systems
Health care systems
See also: Medical model, Preventive medicine, and Social medicine
Purely private enterprise health care systems are comparatively rare. Where they
exist, it is usually for a comparatively well-off subpopulation in a poorer
country with a poorer standard of health care–for instance, private clinics for
a small, wealthy expatriate population in an otherwise poor country. But there
are countries with a majority-private health care system with residual public
service (see Medicare, Medicaid). The other major models are public insurance
systems. A Social security health care model is where workers and their families
are insured by the State. A Publicly funded health care model is where the
residents of the country are insured by the State. Within this branch is
Single-payer health care, which describes a type of financing system in which a
single entity, typically a government run organisation, acts as the
administrator (or "payer") to collect all health care fees, and pay out all
health care costs. Some advocates of universal health care assert that
single-payer systems save money that could be used directly towards health care
by reducing administrative waste. In practice this means that the government
collects taxes from the public, businesses, etc., creates an entity to
administer the supply of health care and then pays health care professionals.
Harry Wachtel estimate a single payer universal healthcare system will actually
save money through reduced bureaucratic administration costs. Social health
insurance is where the whole population or most of the population is a member of
a sickness insurance company. Most health services are provided by private
enterprises which act as contractors, billing the government for patient care.
In almost every country with a government health care system a parallel private
system is allowed to operate. This is sometimes referred to as two-tier health
care. The scale, extent, and funding of these private systems is very variable.
A traditional view is that improvements in health result from advancements in
medical science. The medical model of health focuses on the eradication of
illness through diagnosis and effective treatment. In contrast, the social model
of health places emphasis on changes that can be made in society and in people's
own lifestyles to make the population healthier. It defines illness from the
point of view of the individual's functioning within their society rather than
by monitoring for changes in biological or physiological signs.
World Health Organization
World Health Organization
See also: Global health
The Flag of the World Health OrganizationThe World Health Organization (WHO) is
a specialised United Nations agency which acts as a coordinator and researcher
for public health around the world. Established on 7 April 1948, and
headquartered in Geneva, Switzerland, the agency inherited the mandate and
resources of its predecessor, the Health Organization, which had been an agency
of the League of Nations. The WHO's constitution states that its mission "is the
attainment by all peoples of the highest possible level of health." Its major
task is to combat disease, especially key infectious diseases, and to promote
the general health of the peoples of the world. Examples of its work include
years of fighting smallpox. In 1979 the WHO declared that the disease had been
eradicated - the first disease in history to be completely eliminated by
deliberate human design. The WHO is nearing success in developing vaccines
against malaria and schistosomiasis and aims to eradicate polio within the next
few years. The organization has already endorsed the world's first official
HIV/AIDS Toolkit for Zimbabwe from October 3, 2006, making it an international
standard.
The WHO is financed by contributions from member states and from donors. In
recent years the WHO's work has involved more collaboration, currently around 80
such partnerships, with NGOs and the pharmaceutical industry, as well as with
foundations such as the Bill and Melinda Gates Foundation and the Rockefeller
Foundation. Voluntary contributions to the WHO from national and local
governments, foundations and NGOs, other UN organizations, and the private
sector (including pharmaceutical companies), now exceed that of assessed
contributions (dues) from its 193 member nations.
Regions
Map of countries with universal health care
Medicare brandHealth care systems
See also: Category:Healthcare by country
Oceania
Australia and New Zealand both have publicly funded health care systems, though
under the Conservative government in Australia, there has been new funding and
incentives for people who pay for private health insurance.
Australia
Medicare (Australia)
Medicare was introduced by the Whitlam Labor Government on 1 July 1975 through
the Health Insurance Act 1973. The Australian Senate rejected the changes
multiple times and they were passed only after a joint sitting after the 1974
double dissolution election. Yet Medicare has been supported by subsequent
governments and became a key feature of Australia’s public policy landscape. The
exact structure of Medicare, in terms of the size of the rebate to doctors and
hospitals and the way it has administered, has varied over the years. The
original Medicare program proposed a 1.35% levy (with low income exemptions) but
these bills were rejected by the Senate, and so Medicare was originally funded
from general taxation. In October 1976, the Fraser Government introduced a 2.5%
levy. The program is now nominally funded by an income tax surcharge known as
the Medicare levy, which is currently set at 1.5% with exemptions for low income
earners. In practice the levy raises only a fraction of the money required to
pay for the scheme. If the levy was to fully pay for the services provided under
the medicare banner then it would need to be set at about 8%. There is an
additional levy of 1.0%, known as the Medicare Levy Surcharge, for those on high
annual incomes ($50,000) who do not have adequate levels of private hospital
coverage. This is part of an effort by the current Coalition Federal Government
to encourage people towards private health insurance.
Europe
See also: Directorate-General for Health and Consumer Protection (European
Commission)
All of Europe has publicly sponsored and regulated health care. Countries
include Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary,
Ireland, Italy, Slovenia, the Netherlands, Norway, Poland, Portugal, Romania,
Russia, Spain, Sweden and the United Kingdom.
Ireland
Health care in the Republic of Ireland
Health care in the Republic of Ireland is governed by the Health Act 2004, which
established a new body to govern the national health service in the Republic of
Ireland, the Health Service Executive. The new health service came into being
officially on 1 January 2005; however the new structures are in the process of
being established. Currently the HSE is continuing to manage the health service
under the Health Act 1970 structures. The Health Boards no longer exist as
corporate entities, however the structures which existed remain as divisions of
the HSE until a plan of reorganisation is complete. Each former health board
area operates as a division of the HSE and the former chief executive officer of
each health board is now known as a chief officer for the HSE region.
Slovenia
Health care in Slovenia
Slovene Health Insurance Card.The Health Insurance Institute of Slovenia (the
Institute) was founded on March 1, 1992, according to the Law on health care and
health insurance, after declaring independence from Yugoslavia. The Institute
conducts its business as a public institute, bound by statute to provide
compulsory health insurance. In the field of compulsory health insurance, the
Institute's principal task is to provide effective collection (mobilisation) and
distribution (allocation) of public funds, in order to ensure the insured
persons quality rights arising from the said funds. The rights arising from
compulsory health insurance, furnished by the funds collected by means of
compulsory insurance contributions, comprise the rights to health care services
and rights to several financial benefits (sick leave pay, reimbursement of
travel costs and funeral costs, and insurance money paid in case of death). The
Institute comprises 10 regional units and 45 branch offices distributed around
the territory of Slovenia. The functional unit the Information Centre and the
Directorate complete the Institute structure. At the end of 2005, the Institute
staff numbered regular 929 employees. The Institute is governed by an Assembly,
whose members are the (elected) representatives of employers (including the
representatives of the Government of the Republic of Slovenia) and employees.
The executive body of the Assembly is the Institute Board of Directors. The
Slovene health insurance card system was introduced, at the national scale, in
the year 1999. The system provided the insured persons with a smart card and set
up data links between the health care service providers and health insurance
providers (the Health Insurance Institute and the two voluntary health insurance
providers).
Switzerland
Healthcare in Switzerland
Healthcare in Switzerland is regulated by the Federal Health Insurance Act.
Health insurance is compulsory for all persons resident in Switzerland (within
three months of taking up residence or being born in the country). International
civil servants, members of permanent missions and their familiy members are
exempted from compulsory health insurance. They can, however, apply to join the
Swiss health insurance system, within six months of taking up residence in the
country. Health insurance covers the costs of medical treatment and
hospitalisation of the insured. However, the insured person pays part of the
cost of treatment. This is done (a) by means of an annual excess (or deductible,
called the franchise), which ranges from CHF 300 to a maximum of CHF 2,500 as
chosen by the insured person (premiums are adjusted accordingly) and (b) by a
charge of 10% of the costs over and above the excess.
United Kingdom
National Health Service
The logo of the NHS in England. The colour, "NHS Blue" (Pantone 300), is used on
signs and leaflets throughout the English NHS.The NHS is the world's largest,
centralised health service, and the world's third largest employer after the
Chinese army and the Indian railways. It was created in the aftermath of World
War II, by Clement Attlee's Labour government, based on the proposals of the
Beveridge Report, prepared in 1942. The structure of the NHS in England and
Wales was established by the National Health Service Act 1946 (1946 Act). The
current Labour government has invested billions of new money in the NHS.
However, Tony Blair's policy, whilst leaving services free at point of use, was
to encourage outsourcing of medical services and support to the private sector.
Under the Private Finance Initiative, an increasing number of hospitals have
been built (or rebuilt) by private sector consortia; hospitals may have both
medical services (such as "surgicentres"), and non-medical services (such as
catering) provided under long-term contracts by the private sector. These are
more expensive than if the new build was simply funded from the public purse. A
study by a consultancy company which works for the Department of Health shows
that every ￡200 million spent on privately financed hospitals will result in the
loss of 1000 doctors and nurses. The first PFI hospitals contain some 28 per
cent fewer beds than the ones they replaced. Even so there is for the first time
complete political consensus on the importance of free public health care.
Latin America
Most countries in Latin America have public health care provided. Mexico is
planning to launch its own universal health care network though at the moment
the standards of health care in Mexico are seriously lacking with large divides
between rich and poor. Puerto Rico is planning its own health reform for the
poorest of the population. Health care in Venezuela is probably the most
extensive and given the country's fortunes in oil wealth, expenditure has
recently increased greatly, starting with mass vaccinations under the Plan
Bolivar 2000.
Cuba
Health care in Cuba
Che Guevara, here at Havana airport, made the case for publicly funded health
care across Latin AmericaThe Cuban government operates a national health system
and assumes fiscal and administrative responsibility for the health care of its
citizens. Following the Revolution, the new Cuban government asserted that
universal healthcare was to become a priority of state planning. In 1960
revolutionary and physician Che Guevara outlined his aims for the future of
Cuban healthcare in an essay entitled "On Revolutionary Medicine", stating: "The
work that today is entrusted to the Ministry of Health and similar organizations
is to provide public health services for the greatest possible number of
persons, institute a program of preventive medicine, and orient the public to
the performance of hygienic practices." These aims were hampered almost
immediately by an exodus of almost half of Cuba’s physicians to the United
States, leaving the country with only 3,000 doctors and 16 professors in
University of Havana’s medical college. Beginning in 1960, the Ministry of
Public Health began a program of nationalization and regionalization of medical
services. In 1976, Cuba's healthcare program was enshrined in Article 50 of the
revised Cuban constitution which states
"Everyone has the right to health protection and care. The state guarantees this
right by providing free medical and hospital care by means of the installations
of the rural medical service network, polyclinics, hospitals, preventative and
specialized treatment centers; by providing free dental care; by promoting the
health publicity campaigns, health education, regular medical examinations,
general vaccinations and other measures to prevent the outbreak of disease. All
the population cooperates in these activities and plans through the social and
mass organizations."
Like the rest of the Cuban economy, Cuban medical care has suffered from severe
material shortages following the end of Soviet subsidies and the ongoing United
States embargo against Cuba that began after the Cuban Missile Crisis. Data for
2004 show that Cuba has one of the highest life expectancy rates in Latin
America. Costa Rica, Chile, Virgin Islands, Guadeloupe, and Martinique now have
a higher life expectancy for combined sexes from birth.
North America
Canada
Main articles: Health care in Canada and Medicare (Canada)
The federal government of Lester B. Pearson, pressured by the New Democratic
Party (NDP) who held the balance of power, introduced the Medical Care Act in
1966 that extended the HIDS Act cost-sharing to allow each province to establish
a universal health care plan. It also set up the Medicare system. In 1984, the
Canada Health Act was passed, which prohibited user fees and extra billing by
doctors. In 1999, the prime minister and most premiers reaffirmed in the Social
Union Framework Agreement that they are committed to health care that has
"comprehensiveness, universality, portability, public administration and
accessibility." The Canadian system is for the most part publicly funded, yet
most of the services are provided by private enterprises, private corporations.
Most all doctors do not receive an annual salary, but receive a fee per visit or
service. About 30% of Canadians' health care is paid for through the private
sector. This mostly goes towards services not covered or only partially covered
by Medicare such as prescription drugs, dentistry and optometry. Many Canadians
have private health insurance, often through their employers, that cover these
expenses. In Canada, some services are permitted and some are not. The Supreme
Court of Quebec ruled, in Chaoulli v. Quebec, that private services must be
allowed to compete with the public program , thus opening the door to a dual
system of private and public healthcare. Quebec has been the fastest to adopt
this system and has the most private healthcare available of all the Canadian
provinces.
United States
Main articles: Health care in the United States and Medicare (United States)
President Johnson signing the Medicare amendment. Harry Truman and his wife,
Bess, are on the far rightIn the United States, certain publicly funded health
care programs help to provide for the elderly, disabled, military service
families and veterans, children, and the poor, and federal law ensures public
access to emergency services regardless of ability to pay; however, a system of
universal health care has not been implemented. The Commonwealth of
Massachusetts is attempting to implement a near-universal health care system by
mandating that residents purchase health insurance by July 1, 2007. California,
Maine, Pennsylvania, and Vermont also are attempting universal systems at the
state level, with some smaller locations such as San Francisco also attempting
this at the citywide level . Some government health care systems allow private
practitioners to provide services, and some do not.
Asia
Israel, South Korea, Seychelles and Taiwan have universal health care. Thailand
plans to. Health care in India is guaranteed to "improve" for all under the
constitution, although the reality does not live up to the vague wording of the
article. In Sri Lanka, drugs are provided by a government owned drug
manufacturer called the State Pharmaceuticals Corporation of Sri Lanka. In the
Philippines, the Department of Health (Philippines) organises public health for
the country, and was established at the initiative of the American governors,
before independence. Saudi Arabia has a publicly funded health system, although
its levels are lower than the regional average.
Japan
Health care in Japan
In Japan, payment for personal medical services is offered through a universal
insurance system that provides relative equality of access, with fees set by a
government committee. People without insurance through employers can participate
in a national health insurance program administered by local governments. Since
1973, all elderly persons have been covered by government-sponsored insurance.
Patients are free to select physicians or facilities of their choice. In the
early 1990s, there were more than 1,000 mental hospitals, 8,700 general
hospitals, and 1,000 comprehensive hospitals with a total capacity of 1.5
million beds. Hospitals provided both out-patient and in-patient care. In
addition, 79,000 clinics offered primarily out-patient services, and there were
48,000 dental clinics. Most hospitals sell medicine directly to patients, but
there are 36,000 pharmacies where patients could purchase synthetic or herbal
medication.
National health expenditures rose from about 1 trillion Yen in 1965 to nearly 20
trillion Yen in 1989, or from slightly more than 5% to more than 6% of Japan's
national income. In addition to cost-control problems, the system was troubled
with excessive paperwork, long waits to see physicians, assembly-line care for
out-patients (because few facilities made appointments), over medication, and
abuse of the system because of low out-of-pocket costs to patients. Another
problem is an uneven distribution of health personnel, with cities favored over
rural areas.
Africa
Health care in Africa is usually non existent or highly limited and under
resourced. The outbreak and spread of HIV/AIDS in Africa has crippled many
populations and sent life expectancies plummeting. However some countries have
been able to tackle the challenges, for instance health care in Uganda as well
as education has reduced HIV/AIDS infections from 13% to 4.1% from 1990 to 2003.
This contrasts to some governments' approach, especially that of the South
African Health Ministry who until recently denied the link between HIV/AIDS.
Nigeria
Health care in Nigeria
Health care provision in Nigeria is a concurrent responsibility of the three
tiers of government in the country. However, because Nigeria operates a mixed
economy, private providers of health care have a visible role to play in health
care delivery. The federal government's role is mostly limited to coordinating
the affairs of the university teaching hospitals, while the state government
manages the various general hospitals and the local government focus on
dispensaries. The total expenditure on health care as % of GDP is 4.6, while the
percentage of federal government expenditure on health care is about 1.5%. A
long run indicator of the ability of the country to provide food sustenance and
avoid malnutrition is the rate of growth of per capita food production; from
1970-1990, the rate for Nigeria was 0.25%. Though small, the positive rate of
per capita may be due to Nigeria's importation of food products.
Historically, health insurance in Nigeria can be applied to a few instances:
free health care provided and financed for all citizens, health care provided by
government through a special health insurance scheme for government employees
and private firms entering contracts with private health care providers.
However, there are few people who fall within the three instances. In May 1999,
the government created the National Health Insurance Scheme, the scheme
encompasses government employees, the organized private sector and the informal
sector. Legislative wise, the scheme also covers children under five,
permanently disabled persons and prison inmates. In 2004, the administration of
Obasanjo further gave more legislative powers to the scheme with positive
amendments to the original 1999 legislative act.
Countries
Click "show" on the right of the templates below to release the drop down menu
for health care by country. If your country has no article, please begin it with
a short description.
[show]v ? d ? eHealth care in Oceania
Australasia Australia · Norfolk Island · Christmas Island · Cocos (Keeling)
Islands · New Zealand
Melanesia East Timor1 · Fiji · Indonesia1 · New Caledonia · Papua New Guinea ·
Solomon Islands · Vanuatu
Micronesia Guam · Kiribati · Marshall Islands · Northern Mariana Islands ·
Federated States of Micronesia · Nauru · Palau
Polynesia American Samoa · Cook Islands · French Polynesia · Niue · Pitcairn ·
Samoa · Tokelau · Tonga · Tuvalu · Wallis and Futuna
1 countries spanning more than one continent
[show]v ? d ? eHealth care in Europe
Sovereign states Albania · Andorra · Armenia1 · Austria · Azerbaijan2 · Belarus
· Belgium · Bosnia and Herzegovina · Bulgaria · Croatia · Cyprus1 · Czech
Republic · Denmark · Estonia · Finland · France · Georgia2 · Germany · Greece ·
Hungary · Iceland · Ireland · Italy · Kazakhstan2 · Latvia · Liechtenstein ·
Lithuania · Luxembourg · Republic of Macedonia · Malta · Moldova · Monaco ·
Montenegro · Netherlands · Norway · Poland · Portugal · Romania · Russia3 · San
Marino · Serbia · Slovakia · Slovenia · Spain · Sweden · Switzerland · Turkey2 ·
Ukraine · United Kingdom (England · Scotland · Northern Ireland · Wales)
Dependencies,
autonomies, and
other territories Abkhazia2 · Adjara1 · Akrotiri and Dhekelia · ?land · Azores ·
Crimea · Faroe Islands · Gagauzia · Gibraltar · Guernsey · Jan Mayen · Jersey ·
Kosovo · Man, Isle of · Madeira4 · Nagorno-Karabakh1 · Nakhchivan1 · South
Ossetia2 · Svalbard · Transnistria · Turkish Republic of Northern Cyprus1, 5
1 Entirely in Southwest Asia; included here because of cultural, political and
historical association with Europe. 2 Partially or entirely in Asia, depending
on the definition of the border between Europe and Asia. 3 Mostly in Asia. 4
Entirely in the African Plate, included here because of cultural, political and
historical association with Europe. 5 Only recognised by Turkey.
[show]v ? d ? eHealth care in South America
Sovereign states Argentina · Bolivia · Brazil · Chile · Colombia · Ecuador ·
Guyana · Panama* · Paraguay · Peru · Suriname · Trinidad and Tobago* · Uruguay ·
Venezuela
Dependencies Aruba* (Netherlands) · Falkland Islands (UK) · French Guiana
(France) · Netherlands Antilles* (Netherlands) · South Georgia and the South
Sandwich Islands (UK)
* Territories also in or commonly reckoned elsewhere in the Americas (North
America).
[show]v ? d ? eHealth care in North America
Sovereign states Antigua and Barbuda · Bahamas · Barbados · Belize · Canada ·
Costa Rica · Cuba · Dominica · Dominican Republic · El Salvador · Grenada ·
Guatemala · Haiti · Honduras · Jamaica · Mexico · Nicaragua · Panama* · Saint
Kitts and Nevis · Saint Lucia · Saint Vincent and the Grenadines · Trinidad and
Tobago* · United States
Dependencies and
other territories Anguilla · Aruba* · Bermuda · British Virgin Islands · Cayman
Islands · Greenland · Guadeloupe · Martinique · Montserrat · Navassa Island ·
Netherlands Antilles* · Puerto Rico · Saint Barthélemy · Saint Martin · Saint
Pierre and Miquelon · Turks and Caicos Islands · U. S. Virgin Islands
* Territories also in or commonly reckoned elsewhere in the Americas (South
America).
[show]v ? d ? eHealth care in Asia
Sovereign states
and other territories Afghanistan · Armenia · Azerbaijan1 · Bahrain · Bangladesh
· Bhutan · Brunei · Burma · Cambodia
China (People's Republic of China [Hong Kong · Macau] · Taiwan) · Cyprus ·
Egypt1 · Georgia1 · India · Indonesia1 · Iran · Iraq
Israel · Japan · Jordan · Kazakhstan1 · Korea (North Korea · South Korea) ·
Kuwait · Kyrgyzstan · Laos · Lebanon · Malaysia
Maldives · Mongolia · Nepal · Oman · Pakistan · Philippines · Qatar · Russia1 ·
Saudi Arabia · Singapore · Sri Lanka · Syria
Tajikistan · Thailand · Timor-Leste (East Timor)1 · Turkey1 · Turkmenistan ·
United Arab Emirates · Uzbekistan · Vietnam · Yemen1
1countries spanning more than one continent
[show]v ? d ? eHealth care in Africa
Sovereign states Algeria · Angola · Benin · Botswana · Burkina Faso · Burundi ·
Cameroon · Cape Verde · Central African Republic · Chad · Comoros · Democratic
Republic of the Congo · Republic of the Congo · C?te d'Ivoire (Ivory Coast) ·
Djibouti · Egypt · Equatorial Guinea · Eritrea · Ethiopia · Gabon · The Gambia ·
Ghana · Guinea · Guinea-Bissau · Kenya · Lesotho · Liberia · Libya · Madagascar
· Malawi · Mali · Mauritania · Mauritius · Morocco · Mozambique · Namibia ·
Niger · Nigeria · Rwanda · S?o Tomé and Príncipe · Senegal · Seychelles · Sierra
Leone · Somalia · South Africa · Sudan · Swaziland · Tanzania · Togo · Tunisia ·
Uganda · Zambia · Zimbabwe
Dependencies,
autonomies and
other territories Canary Islands (Spain) · Ceuta (Spain) · Madeira (Portugal) ·
Mayotte (France) · Melilla (Spain) · Puntland · Réunion (France) · St. Helena
(UK) · Socotra (Yemen) · Somaliland · Southern Sudan · Western Sahara · Zanzibar
(Tanzania)
Economics
Health care economics
Medical (health) insurance is subject to the well-known economic problem of
adverse selection which may also be referred to as a market failure. Adverse
selection in insurance markets occurs because those providing insurance have
limited information with which to estimate the risks their clients wish to
insure against. In simple terms, those with poor health will apply for
insurance, raising the cost of providing insurance; those with good health will
find the cost of insurance too expensive, raising costs further. In practical
terms, adverse selection means that private insurers are economically
incentivized to spend substantial sums on 'weeding out' bad risks in advance by
providing medical insurance only to the most healthy. Among the potential
solutions posited by economists are forms of universal health insurance, such as
requiring all citizens to purchase insurance, limiting the ability of insurance
companies to deny insurance to individuals or vary price between individuals.
Compulsory universal health insurance is a common thread, although there is no
requirement that the insurance or medical services be provided by government.
Country Life expectancy Infant mortality rate Physicians per 1000 people Nurses
per 1000 people Per capita expenditure on health (USD) Healthcare costs as a
percent of GDP % of government revenue spent on health % of health costs paid by
government
Australia 80.5 5.0 2.47 9.71 2,519 9.5 17.7 67.5
Canada 80.5 5.0 2.14 9.95 2,669 9.9 16.7 69.9
France 79.5 4.0 3.37 7.24 2,981 10.1 14.2 76.3
Germany 80.0 4.0 3.37 9.72 3,204 11.1 17.6 78.2
Japan 82.5 3.0 1.98 7.79 2,662 7.9 16.8 81.0
Sweden 80.5 3.0 3.28 10.24 3,149 9.4 13.6 85.2
UK 79.5 5.0 2.30 12.12 2,428 8.0 15.8 85.7
USA 77.5 6.0 2.56 9.37 5,711 15.2 18.5 44.6
Most European systems are financed through a mix of public and private
contributions. The majority of universal health care systems are funded
primarily by tax revenue (e.g. Portugal ). Some nations, such as Germany, France
and Japan employ a multi-payer system in which health care is funded by private
and public contributions. In 2001 Canadians paid $2,163 per capita versus $4,887
U.S., according to the Los Angeles Times (also, see table above). According to
Dr. Stephen Bezruchka, a senior lecturer in the School of Public Health at the
University of Washington in Seattle, Canadians do better by every health care
measure. According to a World Health Organization report published in 2003, life
expectancy at birth in Canada is 79.8 years, versus 77.3 in the U.S .
A distinction is also made between municipal and national healthcare funding.
For example, one model is that the bulk of the healthcare is funded by the
municipality, speciality healthcare is provided and possibly funded by a larger
entity, such as a municipal co-operation board or the state, and the medications
are paid by a state agency. No entirely private health care system exists,
although the reform bill in Massachusetts attempts to make private health care
more affordable.
Conservative Republican US Senator Bill Frist argued in the New England Journal
of Medicine that the free market will keep costs down, because individuals who
have to pay for their own health care will make wiser decisions and not spend
money on unneeded or inefficient care. A deregulated free market, Frist argues,
will also encourage efficiency and innovation. The US currently (2007) has the
most expensive health care of any OECD country and also has the highest
percentage of costs paid privately.
Politics
Health care politics
The politics of health care depends largely on which country one is in. Current
concerns in Britain, for instance, revolve around the use of private finance
initiatives to build hospitals or the excessive use of targets in cutting
waiting lists. In Germany and France, concerns are more based on the rising cost
of drugs to the governments. In Brazil, an important political issue is the
breach of intellectual property rights, or patents, for the domestic manufacture
of Antiretroviral drugs used in the treatment of HIV/AIDS. The South African
government, whose population sets the record for HIV infections, came under
pressure for its refusal to admit there is any connection with AIDS because of
the cost it would have involved. In the United States, which has some of the
most sophisticated, technologically advanced health care in the world, 12% to
16% of the citizens are still unable to afford complete health insurance.
Opponents of universal health care in the United States often argue that it will
require higher taxes and a great likelihood of poorly performing health care
facilities and physicians. The absence of a market mechanism may slow innovation
in treatment and research leading to rationing of care through waiting lists. A
statistical comparison shows that it is not universal health care that leads to
a doctor shortage, but the payment system to doctors that causes a doctors
shortage. In Italy, doctors are paid a fee per patient per year, a per capita
salary, and Italy does not have a doctor shortage but has one of the highest
doctor per patient ration, 5.8 doctors per 1,000 patients. In Italy though, it
should be noted that most physicians subsequently have very limited hours; many
only maintaining patient hours 2 days per week. Canada, whose universal health
care system pays its doctors a "fee per visit", creates a real market condition,
where doctors' salaries are protected, and even increased, by decreasing the
supply of doctors. Canada has a low doctor per patient ration of 2.1 doctors per
1,000 patients. A comparative analysis shows that a salaried doctor system,
while not perfect, results in more doctors; however, they work substantially
fewer hours, while the fee per visit system creates economic pressures to reduce
the number of doctors, who subsequently work more hours.
Providers
Health care provider
A health care provider or health professional is an organization or person who
delivers proper health care in a systematic way professionally to any individual
in need of health care services. A health care provider could be a government,
Health care industry, health care equipment, institution such as a hospital or
medical laboratory, physicians, support staff, nurses, therapists,
psychologists, veterinarians, dentists, optometrists, pharmacists, or even a
health insurance company.
Public health is concerned with threats to the overall health of a community
based on population health analysis. Health is defined and promoted differently
by many organizations. The World Health Organization, the United Nations body
that sets standards and provides global surveillance of disease, defines health
as: "A state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity." Public health experts agree that
nutritional, spiritual, and intellectual aspects also affect an individual's
health.
The population in question can be as small as a handful of people or as large as
all the inhabitants of several continents (for instance, in the case of a
pandemic). Public health has many sub-fields, but is typically divided into the
categories of epidemiology, biostatistics and health services. Environmental,
social and behavioral health, and occupational health, are also important fields
in public health.
An alternative definition by Winslow from Modern Medicine in 1920 is: "the
science and art of preventing disease, prolonging life and promoting health
through the organised efforts and informed choices of society, organisations,
public and private, communities and individuals."
Objectives
The focus of a public health intervention is to prevent rather than treat a
disease through surveillance of cases and the promotion of healthy behaviors. In
addition to these activities, in many cases treating a disease can be vital to
preventing it in others, such as during an outbreak of an infectious disease.
Vaccination programs and distribution of condoms are examples of public health
measures.
Most countries have their own government public health agencies, sometimes known
as ministries of health, to respond to domestic health issues. In the United
States, the frontline of public health initiatives are state and local health
departments. The United States Public Health Service (PHS), led by the Surgeon
General of the United States, and the Centers for Disease Control and
Prevention, headquartered in Atlanta and a part of the PHS, are involved with
several international health activities, in addition to their national duties.
There is a vast discrepancy in access to healthcare and public health intiatives
between developed nations and developing nations. In the developing world,
public health infrastructures are still forming. There may not be enough trained
health workers or monetary resources to provide even a basic level of medical
care and disease prevention. As a result, a large majority of disease and
mortality in the developing world results from and contributes to extreme
poverty. For example, many African governments spend less than USD$10 per person
per year on healthcare, while, in the United States, the federal government
spent approximately USD$4,500 per capita in 2000.
Many diseases are preventable through simple, non-medical methods. Public health
plays a very important role in prevention efforts in both the developing world
and in developed countries, either through local health systems or through
international non-governmental organizations.
The two major postgraduate professional degrees related to this field are the
Master of Public Health (MPH) or the (much rarer) Doctor of Public Health
(DrPH). Many public health researchers hold PhDs in their fields of speciality,
while some public health programs confer the equivalent Doctor of Science degree
instead. The United States medical residency specialty is General Preventive
Medicine and Public Health.
History of public health
In some ways, public health is a modern concept, although it has roots in
antiquity. From the beginnings of human civilization, it was recognized that
polluted water and lack of proper waste disposal spread vector-borne diseases.
Early religions attempted to regulate behavior that specifically related to
health, from types of food eaten, to regulating certain indulgent behaviors,
such as drinking alcohol or sexual relations. The establishment of governments
placed responsibility on leaders to develop public health policies and programs
in order to gain some understanding of the causes of disease and thus ensure
social stability prosperity, and maintain order.
Early public health interventions
By Roman times, it was well understood that proper diversion of human waste was
a necessary tenet of public health in urban areas. The Chinese developed the
practice of variolation following a smallpox epidemic around 1000 BC. An
individual without the disease could gain some measure of immunity against it by
inhaling the dried crusts that formed around lesions of infected individuals.
Also, children were protected by inoculating a scratch on their forearms with
the pus from a lesion. This practice was not documented in the West until the
early-1700s, and was used on a very limited basis. The practice of vaccination
did not become prevalent until the 1820s, following the work of Edward Jenner to
treat smallpox.
During the 14th century Black Death in Europe, it was believed that removing
bodies of the dead would further prevent the spread of the bacterial infection.
This did little to stem the plague, however, which was most likely spread by
rodent-borne fleas. Burning parts of cities resulted in much greater benefit,
since it destroyed the rodent infestations. The development of quarantine in the
medieval period helped mitigate the effects of other infectious diseases.
However, according to Michel Foucault, the plague model of governmentality was
later controverted by the cholera model. A Cholera pandemic devastated Europe
between 1829 and 1851, and was first fought by the use of what Foucault called
"social medicine", which focused on flux, circulation of air, location of
cemeteries, etc. All those concerns, born of the miasma theory of disease, were
mixed with urbanistic concerns for the management of populations, which Foucault
designated as the concept of "biopower". The German conceptualized this in the
Polizeiwissenschaft ("Science of police").
The science of epidemiology was founded by John Snow's identification of a
polluted public water well as the source of an 1854 cholera outbreak in London.
Dr. Snow believed in the germ theory of disease as opposed to the prevailing
miasma theory. Although miasma theory correctly teaches that disease is a result
of poor sanitation, it was based upon the prevailing theory of spontaneous
generation. Germ theory developed slowly: despite Anton van Leeuwenhoek's
observations of Microorganisms, (which are now known to cause many of the most
common infectious diseases) in the year 1680 , the modern era of public health
did not begin until the 1880s, with Robert Koch's germ theory and Louis
Pasteur's production of artificial vaccines.
Modern public health
As the prevalence of infectious diseases in the developed world decreased
through the 20th century, public health began to put more focus on chronic
diseases such as cancer and heart disease.
In America, public health worker Dr. Sara Josephine Baker lowered the infant
mortality rate using preventative methods. She established many programs to help
the poor in New York City keep their infants healthy. Dr. Baker led teams of
nurses into the crowded neighborhoods of Hell's Kitchen and taught mothers how
to dress, feed, and bathe their babies. After WWI many states and countries
followed her example in order to lower infant mortality rates.
During the 20th century, the dramatic increase in average life span is widely
credited to public health achievements, such as vaccination programs and control
of infectious diseases, effective safety policies such as motor-vehicle and
occupational safety, improved family planning, fluoridation of drinking water,
anti-smoking measures, and programs designed to decrease chronic disease.
Meanwhile, the developing world remained plagued by largely preventable
infectious diseases, exacerbated by malnutrition and poverty. Front-page
headlines continue to present society with public health issues on a daily
basis: emerging infectious diseases such as SARS, making its way from China to
Canada and the United States; prescription drug benefits under public programs
such as Medicare; the increase of HIV-AIDS among young heterosexual women and
its spread in South Africa; the increase of childhood obesity and the
concomitant increase in type II diabetes among children; the impact of
adolescent pregnancy; and the ongoing social, economic and health disasters
related to the 2005 Tsunami and Hurricane Katrina in 2006. These are all ongoing
public health challenges.
Since the 1980s, the growing field of population health has broadened the focus
of public health from individual behaviors and risk factors to population-level
issues such as inequality, poverty, and education. Modern public health is often
concerned with addressing determinants of health across a population, rather
than advocating for individual behaviour change. There is a recognition that our
health is affected by many factors including where we live, genetics, our
income, our educational status and our social relationships - these are known as
"social determinants of health." A social gradient in health runs through
society, with those that are poorest generally suffering the worst health.
However even those in the middle classes will generally have worse health
outcomes than those of a higher social stratum (WHO, 2003). The new public
health seeks to address these health inequalities by advocating for
population-based policies that improve the health of the whole population in an
equitable fashion.
The burden of treating conditions caused by unemployment, poverty, unfit housing
and environmental pollution have been calculated to account for between 16-22%
of the clinical budget of the British National Health Service.
UK Public health functions include: ? Health surveillance, monitoring and
analysis ? Investigation of disease outbreaks, epidemics and risk to health ?
Establishing, designing and managing health promotion and disease prevention
programmes ? Enabling and empowering communities to promote health and reduce
inequalities ? Creating and sustaining cross-Government and intersectoral
partnerships to improve health and reduce inequalities ?Ensuring compliance with
regulations and laws to protect and promote health ? Developing and maintaining
a well-educated and trained, multi-disciplinary public health workforce ?
Ensuring the effective performance of NHS services to meet goals in improving
health, preventing disease and reducing inequalities ? Research, development,
evaluation and innovation ? Quality assuring the public health function
Public health programs
This 1963 poster featured CDC’s national symbol of public health, the "Wellbee",
encouraging the public to receive an oral polio vaccine.Today, most governments
recognize the importance of public health programs in reducing the incidence of
disease, disability, and the effects of aging, although public health generally
receives significantly less government funding compared with medicine. In recent
years, public health programs providing vaccinations have made incredible
strides in promoting health, including the eradication of smallpox, a disease
that plagued humanity for thousands of years.
One of the most important public health issues facing the world currently is
HIV/AIDS. Tuberculosis, which claimed the lives of authors Franz Kafka and
Charlotte Bront?, and composer Franz Schubert, among others, is also reemerging
as a major concern due to the rise of HIV/AIDS-related infections and the
development of tuberculin strains that are resistant to standard antibiotics.
Another major public health concern is diabetes. In 2006, according to the World
Health Organization, at least 171 million people worldwide suffered from
diabetes. Its incidence is increasing rapidly, and it is estimated that by the
year 2030, this number will double.
A controversial aspect of public health is the control of smoking. Many nations
have implemented major initiatives to cut smoking, such as increased taxation
and bans on smoking in some or all public places. Proponents argue by presenting
evidence that smoking is one of the major killers in all developed countries,
and that therefore governments have a duty to reduce the death rate, both
through limiting passive (second-hand) smoking and by providing fewer
opportunities for smokers to smoke. Opponents say that this undermines
individual freedom and personal responsibility (often using the phrase nanny
state in the UK), and worry that the state may be emboldened to remove more and
more choice in the name of better population health overall. However, proponents
counter that inflicting disease on other people via passive smoking is not a
human right, and in fact smokers are still free to smoke in their own homes.
Public Hygiene
Public hygiene includes public behaviors individuals can take to improve their
personal health and wellness. Topics include public transportation, food
preparation and public washroom use. These are steps individuals can take
themselves. Examples would include avoiding crowded subways during the flu
season, using gloves when touching the handrails and opening doors in public
malls as well as going to clean restaurants.
Economics of public health
The application of economics to the realm of public health has been rising in
importance since the 1980s. Economic studies can show, for example, where
limited public resources might best be spent to save lives or cause the greatest
increase in quality of life.
Research
Public health investigates sources of disease and descriptors of health through
scientific methodology. This can lead to a public health solution to an
epidemic, or a community based intervention for chronic diseases. Either way,
research can provide the link between cause and effect for public health issues.
Community based participatory research
Community-based participatory research
In contrast to clinical, patient oriented, or literature review research,
community based participatory research (CBPR) investigates community-based
eitology, involves community leaders, and overall respects the forces under
which the community and its participants preside toward promoting and sustaining
public health matters. As described by the WK Kellogg Foundation Community
Health Scholars Program, CBPR is a
"collaborative approach to research that equitably involves all partners in the
research process and recognizes the unique strengths that each brings. CBPR
begins with a research topic of importance to the community, has the aim of
combining knowledge with action and achieving social change to improve health
outcomes and eliminate health disparities."
CBPR methods have been necessary for implementation of certain public health
actions. This have been difficult to accomplish because communities in poorer,
less well developed areas often distrust researchers and scientists from
"outside."
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