Health Budgeting

Health budgeting must address the existing health factors and the required controls and need for sampling or screening. This may require that an industrial hygienist be hired full-time, part-time, or 

OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT A PRACTICAL APPROACH 

The best use of doUar resources will determine the best approach to the effective use of the money available. Programs that may require sampling are hazardous chemicals, radiation, and noise. If new chemicals are to be put to use, this may require more sampling than previously. If OSHA citations have been issued then more sampling may be necessary to maintain compliance. The presence of hazardous waste may require training in spill containment and remediation as well as contracts for disposal and spill cleanup or remediation. The health issues involved in the company s operation may result in special types of personal protective equipment being needed and purchases. Training will be needed on the use of the equipment, which is a cost factor in loss of production and time and must be accounted for. 

---

Third, the developing countries differ sharply in the speed of their development. The least developed developing countries have health budgets that do not surpass two or three dollars per inhabitant per year. In such situations access to modern... 

Among elderly women as much as 80% suffer from involuntary voiding of the bladder, urinary incontinence (UI). In the United States approximately 12.5 million people are affected by incontinence and a European study showed a prevalence of between 12% and 22% in all ages and an increase to 30-40% in ages over 75 years (Hampel et al. 1997). Women experience UI twice as often as men. Incontinence becomes more common in old age, with existing co-morbidity of all kinds and life styles (Box 5.5). There are different forms of urinary incontinence and they differ in cause and treatment. This problem causes not only personal distress but also a considerable cost for society as a whole (Jackson 1997). Lower quality of life is often reported in people with UI and the risk increases by the withdrawal from social interaction and participation in sports and other activities. An estimated cost for the care of patients with UI in the United States was approximately 26 billion dollars in year 1995 (Wagner and Hu 1998). Other studies have come up with a calculated cost that represents two percent of the total national health budget. 

Section 1 of the guidelines establishes the context of the submission. It asks for a description of the drug, its use on the PBS and the therapies that wiU be co-administered or substituted. Section 2 asks for the best available evidence on the clinical performance of the drug, including the scientific and statistical rigour of randomised trials, and a preliminary economic evaluation based on evidence from the randomised trials. Section 3 describes when extrapolation beyond the preliminary economic evaluation maybe made and how adjustments can be made in a modelled economic evaluation. Section 4 requests a financial analysis from the perspective of the PBS and government health budgets. 

And finally, in the Western world total drug costs range between 6 and 10% of the health budget and in developing countries this percentage can even be much higher. 

The successful use of DDT led to enormous optimism that malaria could be eradicated from the entire globe. The reasons for this optimism were clearly apparent DDT was, and is, highly effective in killing the malaria vector and interrupting the transfer of the malaria parasite, and it is also cheap and easy to use, putting it within reach of even the poorest countries health budgets. 

In addition, provincial hospitals have taken the lion s share of funding from the national health budget and it is projected to decline from 68 per cent to 61 per cent between 1999/2000 and 2005/6 (Blecher and Thomas 2003). But, provincial health spending on medicines (other current expenses) is expected to grow above personnel expenditure (see Table 23.2). 

PHC Project (Primary Health Care) was introduced in 1981. This provides basic medical care to rural areas through hospitals and health centers. District Hospitals and Provincial Hospitals act as referral hospitals. The Philippines Department of Health has allocated 60% of its budget to the running of government hospitals. The government spends 40 million on pharmaceuticals, amounting to 16% of the Department of Health budget, but... 

In 1950, funding for the NIMH was less than 1 million ten years later, it was 87 million in 1992, it reached 1 bilhon. In 1965, when Medicare and Medicaid were enacted, their cost was 65 biUion in 1993, it was nearly 939 billion. Between 1969 and 1994, the national mental health budget increased from about 3 billion to 80 billion. Between 1968 and 1983, the number of clinical psychologists tripled, from 12,000 to more than 40,000 the number of clinical social workers grew from 25,000 in 1970, to 80,000 in 1990 and membership in the American Psychological Association grew from fewer than 3,000 in 1970 to more than 120,000 in 1993. ... 

Resources are finite and competing demands are made upon them. This is true whether we talk about a national health budget or the research and development budget of a pharmaceutical company. In both cases it turns out that short-term costs are much easier to quantify than long-term benefits and the former are in any case usually more certain, whereas the latter are more speculative. In order to make rational decisions about a medicine, whether it be the price which should be paid for it or whether it is a decision whether it should be developed, complex calculations involving costs, probabilities and utilities are necessary. In the first edition, I wrote There is a growing realization that this is so and hence the science of pharmaco-economics is currently enjoying a terrific boom. By far the most remarkable fact associated with this development, however, is that it did not occur earlier. In the ten years since. 

Costs of direct hospital care, essentially additional time in hospital, have recently been estimated from the Dutch adverse events study finding that about 3 % of all bed days and 1 % of the total health budget could be attributed to preventable adverse events. The real overall costs are probably a good deal higher, as this estimate does not include additional treatments and investigations or any of the associated societal costs discussed above. Remember also that these estimates are confined to the hospital sector we have no idea of the additional costs of adverse events in primary care or mental health. 

Thus, developers of an occupational safety and health budget must hitch their proverbial wagon to as many real to life safety and health issues as possible. This means that the best approach is to tie as much of the expenditures to compliance with regulatory requirements as humanly possible. Another approach is to show how the use of dollars for intervention and prevention of potential cost (a cost-avoidance strategy) can demonstrate savings. 

All tools necessary to implement a good safety and health program are more than adeqnate and effectively used. The management safety and health representative has expertise appropriate to facility size and process, and has access to professional advice when needed. Safety and health budgets and funding procedures are reviewed periodically for adequacy. 

Many programs are running lean. More safety and health budgets will be cut in 2012 (20%) than increased (17%), according to ISHN s White Paper research. The same goes for staffing 12% of programs will cut heads 11% will add to headcount. 

In turn, the Ministry of Health budget grew from R 59 billion in 2006 to R 100.5 billion in 2013, also in real terms. By 2013, the amoimt... 

---