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...

OBJECTIVE The objective of the paper is to describe the impact of Spanish psychiatric reform on the organization and functioning of mental health services. METHOD This paper is based on official administrative reports and on relevant related publications. RESULTS The most significant achievements of Spanish psychiatric reform have been: (i) the development of a new organization of mental he...

The upcoming public health law must serve as the basis for public health reform. The text of the law should allow public health structures to be modernized and adapted to the country's new needs. A broader concept of public health and a redefinition of its functions and basic services are required. Some of the main suggestions for the upcoming law are the establishment of a Spanish Agency for P...

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...

BACKGROUND In 2006, Massachusetts passed sweeping health care reform legislation aimed at improving access to health care for residents. This study investigates how this landmark legislation affected contraceptive access for low-income women. STUDY DESIGN This study included (a) 16 in-depth interviews with family planning providers, (b) 9 focus group discussions with 52 low-income English- an...

The consolidation of a universal health system coupled with a process of regional devolution characterise the institutional reforms of the National Health System (NHS) in Spain in the last two decades. However, scarce empirical evidence has been reported on the effects of changes in health inputs, outputs and outcomes, both at the country and at the regional level. This paper examines health ca...

The purpose of this paper is to provide an overview of the evolution of health care expenditure in Spain during the period 1980-1997, and henceforth to comment on the cost containment measures put forward to control its growth. The paper is divided into three separate sections. The first offers a brief description of the Spanish Health Care System, with emphasis placed on the issue of expenditu...

The Spanish National Health System (SNHS) has sustainability problems resulting from weaknesses in institutional design and governance compounded by the economic crisis it faces. The global economic crisis has had a particularly virulent impact in Spain, characterized by high levels of unemployment and public and private debt. Fiscal adjustment policies implemented may significantly compromise ...

health reform is the outcome of dispersed policy initiatives in different sectors, at different levels and across time. policy work which can drive coherent health reform needs to operate across the governance structures as well as the institutions that comprise healthcare systems. building policy capacity to support health reform calls for clarity regarding the nature of such policy work and t...