National Health Service economics

It is extremely difficult to forecast what the Spanish health system of even the near future will be like, particularly if it continues to be anchored in the dynamics offered today by national health services services as if they were just another administrative service, national implying a strong tendency towards uniformity and health denoting an intention that is not always translated into the best integration (for instance, between ultimate objectives and the provision of services, or between health sector policies and all the other economic and social sector policies). 

Third, economic data are more important when there is substantial budgetary impact. In some jurisdictions, technologies are selected for appraisal only if they have a substantial impact on the (national) health service (e.g., in the United Kingdom), or if the manufacturer wants a premium price over other drugs to treat the given health condition (e.g., in the Netherlands). In addition, in several countries the authorities require an estimation of overall budgetary impact as well as the incremental cost-effectiveness ratio. 

In the United Kingdom, the Department of Health asks NICE to evaluate health technologies that have a major impact on the National Health Service. Although not formally based on efficiency considerations, this approach is more consistent with obtaining the best value for money from the use of resources on economic evaluation. More recently, methods involving the estimation of the expected value of perfect information have been used in a pilot study to inform research priorities in the United Kingdom (Claxton et al. 2004). 

Funded by the government, the National Institute for Clinical Excellence (NICE) was set up as a Special Health Authority in the United Kingdom in 1999 and, as such, it is a part of the National Health Service (NHS). It was set up to provide the NHS [patients, health professionals, and the public] with authoritative, robust and reliable guidance on current best practice. Its key functions are to appraise the clinical benefits and the costs of those [health care] interventions and to make recommendations. Guidance is issued from each appraisal based on the clinical benefits, cost-effectiveness, and total economic impact on the... 

Nowadays a drug company has not only to show its paymasters - governments, insurers and so on - that its new prodnct is safe and works, but also that it is cost-effective. In Anstralia, this has been spelled out in legislation. Since 1993, any drng submitted for approval must be accompanied not only by the resnlts of clinical trials bnt also by an economic impact analysis. In 1999, the United Kingdom set np a National Institnte for Clinical Excellence (NICE) to advise the National Health Service on the cost-effectiveness of health care technologies. Other countries ask formally or informally for pharmacoeconomic analysis. Economic impacts can be measured in a variety of ways, for example, cost-effectiveness, cost-utility or full cost-benefit stndies. 

These finding s demonstrate the immense economic dependence of psychiatrists on institutional employment. In other Western countries, where economic opportunities and social demands for private psychiatric services are much less than in the United States, the proportion of psychiatrists working in mental and other institutions is even greater. In Britain, for example, only 4.5 percent of the psychiatrists spend more than half their working time in private practice 69 percent are employed on a full-time basis in the National Health Service and 77 percent spend at least part of their time engaged in the treatment of hospital inpatients (as against 51 percent of American psychiatrists). In communist countries, all psychiatry is, of course. Institutional Psychiatry. 

Institutional Context Factors Economic and regulatory context National health service executive Links with external organizations... 

At an economic level the repercussions are also serious. Within the UK, 5% of the National Health Service s budget is spent on treating diabetes and its complications. This equates to 3.5 billion per year or 9.6 million per day. Following extensive and widespread trials, unequivocal evidence exists that monitoring and adjusting diabetic blood sugar levels to maintain them within tight boundaries dramatically reduces the health risks faced by diabetics. ... 

Over time, of course, such awareness has continued to grow, although so too has the realization that it should not be cost that drives macro or micro decision-making, but cost-effectiveness. That is, the health-care system needs to achieve a good balance between the resources it uses (the costs) and the outcomes it achieves (the effectiveness). More recent developments, such as the establishment of the National Institute for Clinical Excellence, make abundantly clear both the enduring relevance of economic considerations when deciding how to use health service resources and the pervasive need to balance economic with clinical (and related) objectives. 

However, these results are not applicable to compulsory pubhc insurance, nor to National Health Systems. The most notable differences between drag co-payment in an insurance market and in a National Health System or compulsory public insurance environment lie in their voluntariness or otherwise (users ability to choose their coverage) and the ultimate financing of the services (risk-adjusted premiums as opposed to taxes or social insurance contributions adjusted according to economic capacity). Hence, in compulsory public insurance systems, co-payment regulation is used not only as a health policy instrument but also as one of redistribution of income. 

Food Safety and Inspection Service (FSIS) sets standards for food safety and inspects meat, poultry, and egg products produced domestically and imported. The Service inspects animals and birds at slaughter and processed products at various stages of the production process, and analyzes products for microbiological and chemical adulterants. FSIS also informs the public about meat, poultry, and egg product food safety issues. FSIS works with the Research, Education and Economics mission area on food safety research issues and the Animal and Plant Health Inspection Service on instances where animal diseases impact food safety. FSIS also facilitates the management of US activities pertaining to the Codex Alimentarius Commission, an international organization created by the United Nations, to promote the health and economic interests of consumers while encouraging fair international trade in food. 

A national health care system reflects the social, political, economic, and cultural character of a nation. A nation s historical roots and dominant values shape policies and directions for the organization, quality, financing, and access to health care services. These factors determine who gets what kind of care—at which locations, for what price, and paid by whom. 

In accordance with the National Health Development of the National Economic and Social Development plans, the Thai FDA strives to offer good quality services, effective consumer health protection and human resources development for the sake of the public health and overall development of the country. 

Schizophrenia is the most devastating of the major mental illnesses. Its prevalence is stable across cultural and national boundaries, affecting between 0.5% and 1.5% of all populations. In the United Kingdom the economic cost of schizophrenia has been put at some 850 million per year, ranking it third behind strokes and learning disabilities as the most costly illness to the health service (Knapp, 1997). In human terms, the damage caused by schizophrenia is incalculable. It is known, for example, that as many as 12% of schizophrenics eventually commit suicide (Brown, 1997). 

---