The hong kong polytechnic university msc in management health services
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THE HONG KONG POLYTECHNIC UNIVERSITY MSc. In Management (Health Services). Health Systems Reform in Tax based Systems in Sweden Problem3: How effective are these measures and policies?. Current Issues in Health Services Management MGT 557. Group Members.

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The hong kong polytechnic university msc in management health services

THE HONG KONG POLYTECHNIC UNIVERSITY MSc. In Management (Health Services)

Health Systems Reform in Tax based Systems in Sweden

Problem3: How effective are these measures and policies?

Current Issues in Health Services Management MGT 557


Group members

Group Members

  • Cho Lai Shan, Doris 04703507G

  • Kwong Pui Man, Monica 02715793G

  • Lam Ka Yin, Katherine 05412738G

  • Lo Chi Yung, Owen 03700833G

  • Siu Chun Bong 03705299G

  • Tam Fung Kit, Sandy 04717905G


Health care system sweden

Health Care System Sweden

From each according to ability

To each according to needs


Health care system sweden1

Health Care System Sweden

Offers UNIVERSAL ACCESS to health care for the entire population

Desire to provide equal access regardless of residence

The system provides quality health care by international standards


Health care system sweden2

Health Care System Sweden

The physician, as the Fiscal gatekeeper

may not have the incentive for social

insurance cost containment


Social democracy

Economic development & efficiency

Economic well-being for ALL

Solidarity

Universality & Equality

Democracy & cooperation

Education & Access to information

Pragmatism

Social Democracy


Social democracy1

Social Democracy

  • Egalitarian approach

    Successful when

    the mean of level of health

    reduced inequality exists


Average unemployment rates for sweden the u s and other developed countries 1960 1994

Average Unemployment Rates for Sweden,the U.S. and Other Developed Countries, 1960-1994

Country or Group                     Average Rate ofof Countries                             Unemployment

Sweden                                      2.4%  

All OECD countries                     5.2%

15 European Union Members            5.6%United States                             6.0%

Canada                                     7.3%

Source: Olsen 1999.


Health care system sweden3

Health Care System Sweden

Single-payer system

Vs

Multiple sources of finance


Health care system sweden4

Health Care System Sweden

Identify DEMAND for Health Care

Evaluate the MEANS to fulfill


Health care system sweden5

Health Care System Sweden

Health resources between

Acute in-patient care

Ambulatory services

Pharmaceuticals


Health care system sweden6

Health Care System Sweden

Collective bargaining structure with separate negotiations amongst

Central Government

Municipals

County Councils


Health care system sweden7

Health Care System Sweden

Primary Care Services

Integration of Medical and Social Services for the elderly


Health care system sweden8

Health Care System Sweden

Regulated market

Separation of purchaser & provider roles within the County Councils


Health care system sweden9

Health Care System Sweden

Budgetary incentives

Introduction of performance-related reimbursement for hospitals


Health care system sweden10

Health Care System Sweden

Patient Choice

Rationing


Major problems and challenges

Major problems and challenges


Promoting community care

Promoting community care

  • Output of Elderly (Adel) reform (Sundstrom & Johansson, 2005)

    • Shift care from public hospital to community care

    • ↓no. of hospital bed & length of stay

    • Service contracted out to private provider

    • Income support payment ->informal caregiver

    • Swedish care leave


Promoting community care1

Promoting community care

  • Elderly reform, achievement:

    • ↓societal cost

    • ↑efficiency & effectiveness in acute care setting


Promoting community care2

Promoting community care

  • ↓no. of hospital bed & length of stay

    • ↓no. of Bed blocker

    • The rapid reduction of institutional beds for elderly care increases the pressure on other parts of the care system


Promoting community care3

Promoting community care

Source: Health at a glance: OECD indicators 2005


Promoting community care4

Promoting community care

  • ↑expenditure on community care

Current expenditure by medical services, medical goods & collective care, 2003

Source: Health at a glance: OECD indicators 2005


Promoting community care5

Promoting community care

  • ↓length of stay

Average length of stay for acute care, 1990 & 2002

Source:Health at a glance: OECD indicators 2005

Source:Health at a glance: OECD indicators 2005


The hong kong polytechnic university msc in management health services

Summary

  • The cost of elerly patient with long term care need could be significantly reduced by:

  • Decrease in length of stay in acute care hospital

  • Decrease in number of acute bed in hospital

  • Increase in expenditure for ambulatory care and home care


Major problems and challenges1

Major problems and challenges


Maximum waiting time guarantee mwg

Maximum waiting time guarantee (MWG)

  • Offered for 12 selected procedures

  • <3/12<

  • If not, patient be treated in other hospital at the expense of home hospital


Maximum waiting time guarantee mwg1

Maximum waiting time guarantee (MWG)

  • Output

    • ↓No. of patient waiting >3/12

    • ↓backlog

    • ↑provider awareness the need to ↓waiting time

    • Improved resource use within hospitals

    • Not crowding out other procedures that were not subject to the maximum waiting time (Hanning, 1996)


Maximum waiting time guarantee mwg2

Maximum waiting time guarantee (MWG)

Source:Hanning, M. (2005). Maximum waiting-time guarantee- a remedy to long waiting lists? Assessment of the Swedish waiting-time guarantee policy 1992-1996


The hong kong polytechnic university msc in management health services

Summary

  • Hanning study in 2005 shows that most departments can offer care to patients within the stipulated time limit. It was the result of better resource use because of better efficiency and improved medical technology.


Health care system sweden11

Health Care System Sweden

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