Passage of the Patient Protection and Affordable Care Act of 2010 marks an important step toward making health care available to all Americans. However, implementation of the legislation over the next decade faces organizational, political, and economic challenges (1). One of the surest ways to maximize the chances for health care reform to achieve its aims is to reduce the burden of chronic di...

Subsidized health care benefits would be guaranteed for early retirees ages fifty-five to sixty-four under President Bill Clinton's health care reform proposal. This is an important policy issue because persons in this age group are the least likely age cohort of the nonelderly population to be working. They are also the most likely to face high and uncertain health care costs. Previous researc...

The most significant investment a nursing executive can make in an organization and to the delivery of quality patient care is the development of current and future front-line nurse managers. We are on the brink of massive changes in access and the delivery of health care. The front-line manager is in a critical position to make it all work and deliver what the public wants: better access, impr...

Contractualization consists in the development and implementation of a documented agreement whereby one party (payer) provides compensation to the other party (provider) in exchange for a set of health services to a targeted population. We describe, through a case study, the history and the process of implementation of primary health care contractualization (since 1992) in Portugal, emphasizing...

Healthcare reforms aim to change certain parts of the health system to improve quality of care, access, or financial sustainability. Traditionally, healthcare reform is understood as an action undertaken by a government at a national or local level. However, bottom-up changes can also lead to improvements in the health system. This paper describes the efforts of a coordinated multi-stakeholder ...

~| y electing Democrat Harris Wofford B to the Senate over former Attorney General Richard T h o r n b u r g h in November 1991, the voters of Pennsylvania proved that healthcare reform is a politically salient issue. Policy analysts, amazed that Wofford's healthcare reform message was a key factor in his election, have debated during the past few months whether this was a fluke or the precurso...

BACKGROUND In the prenatal period, women can have sustained contact with nurses and other clinicians, forming relationships that are likely to be health enhancing for both the woman and her unborn child. Yet, first trimester care use in Oregon dropped noticeably over the past decade. In comparison with Washington state, Oregon has not shown substantial recovery. OBJECTIVE The aim of this stud...

OBJECTIVE To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. METHODS An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nur...