Colorectal cancer represents a major health problem and an important economic burden in Puerto Rico. In the 1990's, the Commonwealth of Puerto Rico implemented a health care reform through the privatization of the public health system. The goal was to ensure access to health services, eliminate disparities for medically indigent citizens and provide special coverage for high-risk conditions suc...

• SPDs are the primary source of health plan information: The summary plan description (SPD) is the primary source of information for workers who participate in an employment-based health care plan. This study investigates whether private-sector employers' SPDs are written so that an average plan participant can identify and read important information contained in the document, as required by f...

1990’s were marked by massive introduction of user fee health care plans as a mean of improving efficiency by moderating demand, containing cost, and mobilize more funds for health care than existing sources provided. Introduction of user fees raised a lot of controversy with common claims that their implementation reinforced the poverty trap in developing world, which has considerable health a...

Despite its theoretical appeal, integrated care remains a new frontier for health and social care systems in many countries. A key motivation for increasing the integration of a range of health care services with socialor community-based services is the imperative to improve the patient experience, particularly for individuals with ongoing multiple and complex health care and functional needs. ...

THE ABILITY OF LARGE HEALTH CARE SYSTEMS to respond to the rapidly changing landscape in which they operate is in many ways dependent upon the leadership knowledge and capabilities of those heading up the transformation. Although the central direction and core vision for health system transformation is typically concentrated in a relatively tight circle of a few individuals, it is the broader a...