Article history: Received 5 August 2009 Accepted 7 August 2009 China has recently unveiled an ambitious new health-care reform plan, entailing a doubling of government health spending as well as a number of concrete reforms. While the details of the plan have not yet been completely announced, we offer a preliminary assessment of how well the reform is likely to achieve its stated goal of assur...

Latin American national health systems were drastically overhauled by the health sector reforms the 1990s. Governments were urged by donors and by the international financial institutions to make major institutional changes, including the separation of purchaser and provider functions and privatization. This article first analyses a striking paradox of the far-reaching reform measures: contrary...

Issue Expanded Medicaid enrollment under the Affordable Care Act has heightened the importance of states’ roles as principal purchasers of health care for low-income and medically vulnerable populations. Concurrently, the federal government has augmented states’ purchasing tools. Goal To examine the evolution of payment and delivery system reform in 10 ACA Medicaid expansion states. Methods...

Sweden and Spain experiment with different provider models to reform healthcare provision. Both models have in common that they extend the role of the for-profit sector in healthcare. As the analysis of Saltman and Duran demonstrates, privatisation is an ambiguous and contested strategy that is used for quite different purposes. In our comment, we emphasize that their analysis leaves questions ...

or over 20 years, the composition, delivery and importance of primary care have been the subject F of quickening international reform. In 1993, the United Kingdom government announced a “primary care-led” National Health Service, underpinned by primary care commissioning and general practitioner fundholding, both vehicles to allow local primary care clinicians to influence government purchasing...

A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other publi...

INTRODUCTION In April 2008, Japan launched a radical reform in regional health planning that emphasized the development of disease-oriented clinical care pathways. These 'inter-provider critical paths' have sought to ensure effective integration of various providers ranging among primary care practitioners, acute care hospitals, rehabilitation hospitals, long-term care facilities and home care....

Background Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. Methods A facilit...

As discussion around national health reform continues, state experiences can provide important lessons to help inform national reform efforts. Since 1998, North Carolina has been implementing an enhanced medical home model of care in its Medicaid program called Community Care of North Carolina (CCNC). CCNC puts many of the ideals that have been articulated for broad health reform into practice....