Summary: The volumes in the European Observatory on Health Systems and Policies series focus on key issues for health policy-making in Europe. This book is a joint venture between the WHO/EO and the EuroDRG which addresses the challenges of using Diagnosis Related Group systems in Europe.
Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, accounting for 86% of total premature deaths, and research suggests that complex conditions such as diabetes and depression will impose an even greater health burden in the future - and not only for the rich and elderly in high-income countries, but increasingly for the poor as well as low- and middle-income countries. The epidemiologic and economic analyses in the first part of the book suggest that policy-makers should make chronic disease a priority. This book highlights the issues and focuses on the strategies and interventions that policy-makers have at their disposal to tackle this increasing challenge. Strategic discussed in the second part of this volume include (1) prevention and early detection, (2) new provider qualifications (e.g. nurse practitioners) and settings, (3) disease management programmes and (4) integrated care models. But choosing the right strategies will be difficult, particularly given the limited evidence on effectiveness and cost-effectiveness. In the third part, the book therefore outlines and discusses institutional and organizational challenges for policy-makers and managers: (1) stimulating the development of new effective pharmaceuticals and medical devices, (2) designing appropriate financial incentives, (3) improving coordination, (4) using information and communication technology, and (5) ensuring evaluation. To tackle these challenges successfully, key policy recommendations are made.
·What are the characteristics that define a Social Health Insurance system? ·How is success measured in SHI systems? ·How are SHI systems developing in response to external pressures? Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations. Covering a wide range of policy issues, the book: ·Explores the pressures these health systems confront to be more efficient, more effective, and more responsive ·Reviews their success in addressing these pressures ·Examines the implications of change on the structure of SHI’s as they are currently defined ·Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhere Social Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers. Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar.
How the medieval church drove state formation in Europe Sacred Foundations argues that the medieval church was a fundamental force in European state formation. Existing accounts focus on early modern warfare or contracts between the rulers and the ruled. In contrast, this major study shows that the Catholic Church both competed with medieval monarchs and provided critical templates for governing institutions, the rule of law, and parliaments. The Catholic Church was the most powerful, wealthiest, and best-organized political actor in the Middle Ages. Starting in the eleventh century, the papacy fought for the autonomy of the church, challenging European rulers and then claiming authority over people, territory, and monarchs alike. Anna Grzymała-Busse demonstrates how the church shaped distinct aspects of the European state. Conflicts with the papacy fragmented territorial authority in Europe for centuries to come, propagating urban autonomy and ideas of sovereignty. Thanks to its organizational advantages and human capital, the church also developed the institutional precedents adopted by rulers across Europe—from chanceries and taxation to courts and councils. Church innovations made possible both the rule of law and parliamentary representation. Bringing to light a wealth of historical evidence about papal conflict, excommunications, and ecclesiastical institutions, Sacred Foundations reveals how the challenge and example of powerful religious authorities gave rise to secular state institutions and galvanized state capacity.
Winner of the ASCAP Deems Taylor Award and Society of Music Theory's Wallace Berry Award This bold challenge to conventional notions about medieval music disputes the assumption of pure literacy and replaces it with a more complex picture of a world in which literacy and orality interacted. Asking such fundamental questions as how singers managed to memorize such an enormous amount of music and how music composed in the mind rather than in writing affected musical style, Anna Maria Busse Berger explores the impact of the art of memory on the composition and transmission of medieval music. Her fresh, innovative study shows that although writing allowed composers to work out pieces in the mind, it did not make memorization redundant but allowed for new ways to commit material to memory. Since some of the polyphonic music from the twelfth century and later was written down, scholars have long assumed that it was all composed and transmitted in written form. Our understanding of medieval music has been profoundly shaped by German philologists from the beginning of the last century who approached medieval music as if it were no different from music of the nineteenth century. But Medieval Music and the Art of Memory deftly demonstrates that the fact that a piece was written down does not necessarily mean that it was conceived and transmitted in writing. Busse Berger's new model, one that emphasizes the interplay of literate and oral composition and transmission, deepens and enriches current understandings of medieval music and opens the field for fresh interpretations.
Reference to or quotation from someone's speech, thoughts, or writing is a key component of narrative. These reports further a narrative, make it more interesting, natural, and vivid, ask the reader to engage with it, and reflect historical cultural understandings of modes of discourse presentation. To a large extent, the way we perceive a story depends on the ways it presents discourse, and along with it, speech, writing, and thought. In this book, Beatrix Busse investigates speech, writing, and thought presentation in a corpus of 19th-century narrative fiction including Frankenstein, Jane Eyre, Wuthering Heights, Oliver Twist, and many others. At the intersection between corpus linguistics and stylistics, this book develops a new corpus-stylistic approach for systematically analyzing the different narrative strategies of discourse presentation in key pieces of 19th-century narrative fiction. Speech, Writing, and Thought Presentation in 19th-Century Narrative Fiction identifies diachronic patterns as well as unique authorial styles, and places them within their cultural-historical context. It also suggests ways for automatically identifying forms of discourse presentation, and shows that the presentation of characters' minds reflects an ideological as well as an epistemological concern about what cannot be reported, portrayed, or narrated. Through insightful interdisciplinary analysis, Busse demonstrates that discourse presentation fulfills the function of prospection and encapsulation, marks narrative progression, and shapes readers' expectations.
This innovative book reassesses the history of musicology, unearthing the field’s twentieth-century German and global roots. In the process, Anna Maria Busse Berger exposes previously unseen historical relationships such as those between the modern rediscovery of medieval music, the rise of communal singing, and the ways in which African music intersected with missionary work in the German colonial period. Ultimately, Busse Berger offers a monumental new account of the early twentieth-century music culture in Germany and East Africa. ?The book unfolds in three parts. Busse Berger starts with the origins of comparative musicology circa 1900, when early proponents used ideas from comparative linguistics to test whether parallels could be drawn between nonwestern and medieval European music. She then turns to youth movements of the era—the Wandervogel, Jugendmusikbewegung, and Singbewegung—whose focus on joint music making influenced many musicologists. Finally, she considers case studies of Protestant and Catholic mission societies in what is now Tanzania, where missionaries—many of them musicologists and former youth-group members—extended the discipline via ethnographic research and a focus on local music and communities. In highlighting these long-overlooked transnational connections and the role of global music in early musicology, Busse Berger shapes a fresh conception of music scholarship during a pivotal part of the twentieth century.
·What are the characteristics that define a Social Health Insurance system? ·How is success measured in SHI systems? ·How are SHI systems developing in response to external pressures? Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations. Covering a wide range of policy issues, the book: ·Explores the pressures these health systems confront to be more efficient, more effective, and more responsive ·Reviews their success in addressing these pressures ·Examines the implications of change on the structure of SHI’s as they are currently defined ·Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhere Social Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers. Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar.
Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector
Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, accounting for 86% of total premature deaths, and research suggests that complex conditions such as diabetes and depression will impose an even greater health burden in the future - and not only for the rich and elderly in high-income countries, but increasingly for the poor as well as low- and middle-income countries. The epidemiologic and economic analyses in the first part of the book suggest that policy-makers should make chronic disease a priority. This book highlights the issues and focuses on the strategies and interventions that policy-makers have at their disposal to tackle this increasing challenge. Strategic discussed in the second part of this volume include (1) prevention and early detection, (2) new provider qualifications (e.g. nurse practitioners) and settings, (3) disease management programmes and (4) integrated care models. But choosing the right strategies will be difficult, particularly given the limited evidence on effectiveness and cost-effectiveness. In the third part, the book therefore outlines and discusses institutional and organizational challenges for policy-makers and managers: (1) stimulating the development of new effective pharmaceuticals and medical devices, (2) designing appropriate financial incentives, (3) improving coordination, (4) using information and communication technology, and (5) ensuring evaluation. To tackle these challenges successfully, key policy recommendations are made.
This report provides a policy review of the regulatory system of pharmaceutical policy in Finland. The aim was to assess the current policy context and prepare options that could be considered as part of the pharmaceutical review currently under way.
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