Health policy
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In 2011, Member States and the European Parliament brought into force a Directive on the application of patients' rights in cross-border healthcare within the EU. Austria voted against this directive even though its national legislation was already in line with the rulings of the European Court of Justice which had triggered the negotiations on the directive. Why then, in the absence of any legal constraints on adapting to it, did Austria vote against the directive? The article argues that it was the federal structure of financing hospital infrastructure and the subnational level's influence on national position building which led to the rejection of the directive. The article retraces the process of position building by analyzing the interaction between the national and the subnational levels and concludes that Austria's position mirrors the national struggle between both levels of government over control of the hospital sector.
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I analyze the relationship between health care institutions and the utilization of outpatient services by individuals aged 50 and above. I use cross-sectional micro data from thirteen European countries. ⋯ I estimate the utilization of private specialist care to be higher in countries where copayments are required for public specialist care, and where the general practitioners have gatekeeper role. These estimated associations with private specialist care utilization are relatively large in magnitude, and are driven by individuals in the top income quartile.
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The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. ⋯ Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types.
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A scoping review was conducted to synthesise the findings of evaluations of voluntary agreements between business and government. It aimed to summarise the types of agreements that exist, how they work in practice, the conditions for their success and how they had been evaluated. ⋯ If properly implemented and monitored, voluntary agreements can be an effective policy approach, though there is little evidence on whether they are more effective than compulsory approaches. Some of the most effective voluntary agreements include substantial disincentives for non-participation and sanctions for non-compliance. Many countries are moving towards these more formal approaches to voluntary agreements.
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To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs). ⋯ Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities.