Integrating Behavioral Health Care and Primary Care: Application of a Clinical and Economic Model in Culturally Diverse Communities

Although mental illness treatment protocols exist, the organization and financing of screening and treatment services inhibit access. These challenges are compounded for refugees, immigrants, and other groups vulnerable due to their ethnicity, race, or culture. By creating a system-wide, collaborative, integrated model that recognizes and addresses critical clinical and economic aspects in the delivery of services, high quality, evidence-based care can be made available to groups susceptible to the burdens of mental illness. Clinically and financially aligning primary and specialty care offers a viable alternative for improving access and quality of mental health services to vulnerable populations.     

The New Public Management Theory and the Reform of European Health Care Systems: An International Comparative Perspective

The New Public Management (NPM) Theory is a rhetorical construction with diverse intellectual roots. That diversity means that it is open to reinterpretation and shifts in implementation across countries (Sahlin-Andersson, 2001 Sahlin-Andersson, K. 2001. “National, international and transnational constructions of New Public Management”. In New Public Management—The transformation of ideas and practice, Edited by: Christensen, T. and ægreid, P. L. 43–72. Aldershot, , UK: Ashgate.  [Google Scholar]; Smullen, 2007 Smullen, A. 2007. Translating agency reform: Rhetoric and culture in comparative perspective, Rotterdam, , The Netherlands: PhD Dissertation, Erasmus University.  [Google Scholar]). This overview article critically investigates NPM application in various EU health care systems. NPM led to a greater focus on market forces and competition and improved information sharing and cooperation among health care networks, and changed the way care is delivered. This article also identifies significant misfits between policy announcements and NPM implementation. NPM has taken root much more substantially in the United Kingdom (UK) than in France and Germany. The variety of capitalism and institutional systems provides an explanation for divergences in NPM implementation.     

How Government and Community Nonprofit Collaboration and Non-Collaboration Affects Public Sector Outcomes

This four state foster care study seeks to understand what practices state public managers perform with regards to community nonprofits that contributes to effectiveness in producing better public sector outcomes. The study produced key player field research data on the conditions under which community nonprofits produce better public sector outcomes.

This article offers reasons as to why some effective community nonprofits were able to achieve collaboration with the public sector, while others were not, despite their effectiveness. Effective public managers in the area of foster care administration permit, and at times recruit, community nonprofits to have an impact on their foster care domain, while ineffective public managers never reach out to community nonprofits as partners or further yet, block nonprofits from access.     

政府购买居家养老服务:模式分析与战略设计——基于比较研究的视角

政府购买居家养老服务不仅是我国应对"银色化浪潮"的重要战略选择,也是完善养老制度的重要组成部分。我国老龄化日益严重,具有"未富先老"的特点。在比较分析相关研究的基础上,总结我国政府购买居家养老服务的迫切性,概括国外政府购买居家养老服务的实践,并从我国现有的法律和文件、购买模式及面临的问题归纳现阶段政府购买居家养老服务的现状。为政府购买居家养老服务提出对策建议,以期新养老方式不断得以完善与推广,更好地满足老龄化社会的需求。     

Restrained Voices

Abstract

This research presents the voices of women inmates on health care services in prisons. Foucault's discourse analysis as a means of bringing to the surface restrained voices provides the theoretical basis for this study. The research is based on face-to-face interviews of fifty-six women inmates to understand better the role gender plays in prison health care delivery. The results show that women are willing to discuss only physical ailments and are reluctant to speak about mental health care or HIV. While women benefit from health care services in prison, they still feel that a female-oriented approach to health care in general will improve the services tremendously. This approach is not dictated by the “difference” in the ailments between men and women, but by the “difference” in the way men and women encounter health care providers and illnesses.     

The Impact Imprisonment has on Women's Health and Health Care from the Perspective of Female Inmates in Kansas

This multimethod study, conducted at the Topeka Correctional Facility during the summers of 2001, 2002, and 2003, investigated the impact of imprisonment on women's health and health care. The researcher hypothesized that 3 independent constructs—(a) extended strain, (b) level of health care received either before or during incarceration, and (c) detrimental social structural influences—could predict the health status of female inmates prior to and during incarceration. Multiple regression analyses conducted on 1 survey sample of 120 inmates revealed that only health care prior to incarceration and extended strain contributed significantly to explaining the inmates' self-perceived health status prior to and during incarceration. When life history interviews with 22 inmates were examined to determine inmates' perceptions of their health status and the health care they had received, prior to and during their imprisonment, qualitative results revealed inmates expressed dissatisfaction with the quality of health care received in prison, as well as the manner in which it was administered.     

The reliability and validity of self,peer and staff reports of bullying and victimisation in correctional and care institutions

Abstract

Connell and Farrington (1997) carried out the first study of the reliability and validity of reports of bullying and victimisation in correctional institutions, using individual interviews. The present research describes the second study on this topic using questionnaire measures of self, peer and staff reports of bullying and victimisation in one Children's Home (N=16 residents, 15 peers, 6 staff, making up to 1440 comparisons) and one Correctional Home (N=19 residents, 18 peers, 6 staff, making up to 2052 comparisons) in Croatia. The present study improved on the Connell and Farrington study by examining the test–retest stability of the questionnaire and using relative improvement over chance coefficients in assessing inter-rater reliability. Unlike in the Connell and Farrington study, self-reports of bullying and victimisation were collected in small groups rather than in individual interviews. Generally, there was significant agreement between residents, peers and staff in identifying bullies and victims, and the test–retest stability of the questionnaire was high. In line with the findings of Connell and Farrington, it is concluded that self-reports provide the most reliable and valid data about bullying amongst institutionalised youth.     

城市社区老年群体就医行为影响因素分析

日益增长的老年人健康需求是老龄化带来的诸多挑战中的一个重要方面。新一轮医药卫生体制改革突出强调基本医疗服务供给和基层卫生服务体系建设,在缓解老年人健康压力方面有一定的积极作用。老年人在身体条件、经济能力、思想观念等方面的特点,使得其就医行为受到机构服务能力、距离、费用、就医过程等多方面因素影响。在新医改背景下,需要结合这些影响因素继续完善基层医疗服务体系,以更好地满足老年群体健康需求。     

Special Issue on electronic media,markets and civil society in East and Southeast Asia: Introduction

Abstract

The government of Hong Kong has been trying to reform the territory's health care financing system since the early 1990s and is finally on the verge of succeeding. The objective of this paper is to assess the reform efforts and explain the causes of repeated failures and eventual success. It will argue that the government's fortunes changed only after it abandoned the core reform goal and decided to pursue peripheral objectives. It will explain the abandonment with reference to the peculiar political system in Hong Kong that makes it difficult for the government to adopt substantial policy reforms in the face of even moderate opposition. The reason for the government's policy incapacity is the existence of liberalism in a non-democratic setting, which allows the government to neither suppress opposition nor mobilize popular support. This has been illustratively evident in its health care reforms when its proposals to improve the system's fiscal sustainability invariably met an early death because they imposed costs on employers, the population or both. The current proposal has fared better not only because it addresses a simpler peripheral problem but also because it offends almost no one and pleases many among the powerful.     

A Targeted Approach to the Provision of Ubiquitous Healthcare Services for the Newly Retired

The purpose of this research is to discuss a targeted approach to health care provisions for the newly retired. This approach focuses on the application of specific services provided by the development of Web 2.0 technologies and an identification system that determines the needs of a community of newly retired. The paper examines the significance of this community and also discusses the steps required for the research. The first phase of the research which is covered here involves reviewing pervious literature to determine what information has been gathered about the subject. Once this has been accomplished that the researcher will investigate the defined community to determine what resources are in place and what additional resources need to be in put in place in order to help the community to continue to thrive. The final steps include implementing what services were found to be necessary for the continued growth of the community and a follow-up concerning the success of these services.