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Rising health care costs are essentially rooted in a health care system based upon adverse economic incentives, which encourage both providers and patients to act with little regard to costs. To effectively control demand and utilization of health services, and thus costs, a health care system should be structured to provide incentives which motivate all participants to seek cost-effective care. This study examines the theory and reviews the influence of financial incentives upon patient demand behavior. Utilization data from the CHAMPUS Reform Initiative (CRI) are analyzed in terms of the CRI program incentive structures in order to draw conclusions regarding the influence of incentives upon beneficiary demand behavior. Based upon the CRI analysis and descriptions of financial incentive-based models of demand behavior as described in the literature, suggestions for DOD health care reform are offered.

Understanding the effects of changes in health insurance policies on the demand for health care services is an important and timely topic. As the Military Health System (MHS) has evolved over time, it has begun to adopt cost-containment strategies that have been tested in private health plans. These strategies have led to changes in many aspects of the health care services offered to Department of Defense (DoD) beneficiaries. Each change potentially can affect the number of people accessing services, the intensity of use, and the cost to the DoD. The goal of this report is to summarize the research relevant for considering the effects of policy changes on the demand for DoD health care services and associated costs.

Understanding the effects of changes in health insurance policies on the demand for health care services is an important and timely topic. As the Military Health System (MHS) has evolved over time, it has begun to adopt cost-containment strategies that have been tested in private health plans. These strategies have led to changes in many aspects of the health care services offered to Department of Defense (DoD) beneficiaries. Each change potentially can affect the number of people accessing services, the intensity of use, and the cost to the DoD. The goal of this report is to summarize the research relevant for considering the effects of policy changes on the demand for DoD health care services and associated costs.

'Twenty-Sixth report on Action Taken by the Government on the Observations/Recommendations contained in the Twenty First Report of the Standing Committee on Defence(16th Lok Sabha) on ''Demands for Grants (2016-17) of the Ministry on Defence on Ordnance Factory Board, Defence Research and Development Organisation, Ex-Servicemen Contributory Health Scheme, Directorate General Quality Assurance and National Cadet Corps (Demand No. 20)''. (9-Mar-2017)' from the Parliament Digital Library

Artykuł w: Annales Universitatis Mariae Curie-Skłodowska, Sectio D, Medicina. Vol. 61, N2, nr 146 (2006), strony 819-824

Madness and the Demand for Recognition: A Philosophical Inquiry Into Identity and Mental Health Activism Mohammed Abouelleil Rashed

Despite the spike in mental health disorders since the disruptions caused by the COVID-19 pandemic, most OECD countries are still lacking a comprehensive public coverage of mental health care. This situation is puzzling considering that a public insurance is not particularly fiscally costly. Indeed, cost-benefit analyses have shown that a public insurance would increase access to treatments, which would, in turn, generate economic gains by improving the productivity of the population. In this article, we study if a lack of public demand represents one of the reasons why we are not seeing a proliferation of public mental health insurance programs. Mental health researchers have spent very little time thinking about political economy, while political economists do not study mental health policies. Most mental health researchers assume that stigma (culture) is the cause of weak mental health provision. The few studies on the issue have shown that stigma against mental health disorders is associated with weaker support for public spending on mental health care. Yet mental health problem occurrence and stigma don’t vary so much and can’t explain cross country variation. Hence, mental health specialist cannot explain why supply varies between countries. Contributions: • We are applying a political science framework to study mental health policy preferences. • Most previous studies do not analyze the interplay of self-interest and ideology to explain individuals’ willingness to pay for the expansion of public coverage for mental health care. We highlight the role of ideological factors in explaining preference for public mental health care and by mapping the coalitions for and against the extension of public insurance. • There is also a lack of research assessing the influence of individuals' personal experience with mental health, whether they use treatments themselves, or whether they themselves are covered by private insurance and support for greater public insurance coverage. Moreover, there is a paucity of public opinion studies on the issue in Canada. • The Canadian context is pertinent because the public coverage health care is traditionally limited to care provided by doctors and hospitals and doesn’t include several non-medical health services, such as psychotherapy. In this article, we rely on an original survey conducted by the firm Léger with a representative sample of the Quebec population (N=1000), a province in which one major party proposed a public insurance for psychological services at the last provincial election in 2022.

Intended as a companion piece to volume 3 in the Method Series, Health Manpower Planning (CE 024 231), this third of six volumes in the International Health Planning Reference Series is a combined literature review and annotated bibliography dealing with health manpower planning for developing countries. The review identifies literature relevant to three areas of interest. Assessment of supply behavior includes topics of supply analysis: physicians, nurses, midwives, health teams, technicians, dentists, health center staff, medical education, health training, and productivity analysis. Assessment of demand behavior includes such topics of demand analysis as projection and economic constraints as factors. Assessment of balance behavior covers topics of administration, organization, distribution, access, utilization, and planning/evaluation. The 223 references included in the review are contained in the bibliography. (References are also listed by categories discussed in the review. Within the review the reader is directed to the corresponding list.) The format for each entry is author, title, source or publisher, date of publication, and annotation. (YLB)

Today we are in Philadelphia to demand that Hahnemann Hospital does not shut down to further enrich the wealthy. We are demanding an end to the profiteering and the greed in our health care system. We are demanding Medicare for All. @ninaturner https://t.co/yJSi7Woekd Source: https://twitter.com/BernieSanders/status/1150787024716214276 Uploader: Bernie Sanders

Project Overview: This research evaluates the system-level response of Alberta's mental health services to the COVID-19 pandemic using a health economics and policy framework. The study models the simultaneous rise in demand and expansion of supply within Alberta's publicly funded mental health system during 2023–2024. Purpose: The goal of this project is to explore how Alberta managed a sudden surge in mental health service demand through a series of integrated interventions. These included virtual care expansion (e.g., the Virtual Opioid Dependency Program), community-based recovery communities, and school-based mental health classrooms (e.g., CASA Mental Health). The study also examines Alberta's approach to addressing economic frictions in mental healthcare, such as moral hazard, adverse selection, and information asymmetry. Methodology: We used a mixed-methods approach, combining health policy evaluation with supply-demand economic modeling. Primary data were extracted from Alberta's 2023–2024 Mental Health and Addiction Annual Report, while supplementary data and theoretical inputs were drawn from peer-reviewed literature and benchmark economic models. Simulations were conducted to evaluate market equilibrium shifts, service utilization trends, and the impact of zero-dollar copayment policies on access and efficiency. Key Findings: Demand for mental health services increased sharply, particularly among youth, rural, and Indigenous populations. Alberta's system capacity grew by over 50% due to digital infrastructure, workforce expansion, and the creation of new recovery programs. Despite rising demand, prices remained stable, indicating successful policy-driven equilibrium balancing. Programs such as CASA Mental Health and the Virtual Opioid Dependency Program exceeded their projected service delivery targets. Expected Outcomes: This study contributes to the literature on public mental health economics by demonstrating how targeted interventions can address both supply and demand challenges during crises. Alberta's model serves as a potentially transferable framework for other jurisdictions seeking to expand equitable access to mental health services without introducing out-of-pocket costs. Relevance: The registration ensures transparency in data use and modeling logic, and it provides stakeholders, such as policymakers, public health professionals, and academics, with insights into how integrated health system design can respond effectively to external shocks like pandemics.

Project Overview: This research evaluates the system-level response of Alberta's mental health services to the COVID-19 pandemic using a health economics and policy framework. The study models the simultaneous rise in demand and expansion of supply within Alberta's publicly funded mental health system during 2023–2024. Purpose: The goal of this project is to explore how Alberta managed a sudden surge in mental health service demand through a series of integrated interventions. These included virtual care expansion (e.g., the Virtual Opioid Dependency Program), community-based recovery communities, and school-based mental health classrooms (e.g., CASA Mental Health). The study also examines Alberta's approach to addressing economic frictions in mental healthcare, such as moral hazard, adverse selection, and information asymmetry. Methodology: We used a mixed-methods approach, combining health policy evaluation with supply-demand economic modeling. Primary data were extracted from Alberta's 2023–2024 Mental Health and Addiction Annual Report, while supplementary data and theoretical inputs were drawn from peer-reviewed literature and benchmark economic models. Simulations were conducted to evaluate market equilibrium shifts, service utilization trends, and the impact of zero-dollar copayment policies on access and efficiency. Key Findings: Demand for mental health services increased sharply, particularly among youth, rural, and Indigenous populations. Alberta's system capacity grew by over 50% due to digital infrastructure, workforce expansion, and the creation of new recovery programs. Despite rising demand, prices remained stable, indicating successful policy-driven equilibrium balancing. Programs such as CASA Mental Health and the Virtual Opioid Dependency Program exceeded their projected service delivery targets. Expected Outcomes: This study contributes to the literature on public mental health economics by demonstrating how targeted interventions can address both supply and demand challenges during crises. Alberta's model serves as a potentially transferable framework for other jurisdictions seeking to expand equitable access to mental health services without introducing out-of-pocket costs. Relevance: The registration ensures transparency in data use and modeling logic, and it provides stakeholders, such as policymakers, public health professionals, and academics, with insights into how integrated health system design can respond effectively to external shocks like pandemics.

Project Overview: This research evaluates the system-level response of Alberta's mental health services to the COVID-19 pandemic using a health economics and policy framework. The study models the simultaneous rise in demand and expansion of supply within Alberta's publicly funded mental health system during 2023–2024. Purpose: The goal of this project is to explore how Alberta managed a sudden surge in mental health service demand through a series of integrated interventions. These included virtual care expansion (e.g., the Virtual Opioid Dependency Program), community-based recovery communities, and school-based mental health classrooms (e.g., CASA Mental Health). The study also examines Alberta's approach to addressing economic frictions in mental healthcare, such as moral hazard, adverse selection, and information asymmetry. Methodology: We used a mixed-methods approach, combining health policy evaluation with supply-demand economic modeling. Primary data were extracted from Alberta's 2023–2024 Mental Health and Addiction Annual Report, while supplementary data and theoretical inputs were drawn from peer-reviewed literature and benchmark economic models. Simulations were conducted to evaluate market equilibrium shifts, service utilization trends, and the impact of zero-dollar copayment policies on access and efficiency. Key Findings: Demand for mental health services increased sharply, particularly among youth, rural, and Indigenous populations. Alberta's system capacity grew by over 50% due to digital infrastructure, workforce expansion, and the creation of new recovery programs. Despite rising demand, prices remained stable, indicating successful policy-driven equilibrium balancing. Programs such as CASA Mental Health and the Virtual Opioid Dependency Program exceeded their projected service delivery targets. Expected Outcomes: This study contributes to the literature on public mental health economics by demonstrating how targeted interventions can address both supply and demand challenges during crises. Alberta's model serves as a potentially transferable framework for other jurisdictions seeking to expand equitable access to mental health services without introducing out-of-pocket costs. Relevance: The registration ensures transparency in data use and modeling logic, and it provides stakeholders, such as policymakers, public health professionals, and academics, with insights into how integrated health system design can respond effectively to external shocks like pandemics.

Project Overview: This research evaluates the system-level response of Alberta's mental health services to the COVID-19 pandemic using a health economics and policy framework. The study models the simultaneous rise in demand and expansion of supply within Alberta's publicly funded mental health system during 2023–2024. Purpose: The goal of this project is to explore how Alberta managed a sudden surge in mental health service demand through a series of integrated interventions. These included virtual care expansion (e.g., the Virtual Opioid Dependency Program), community-based recovery communities, and school-based mental health classrooms (e.g., CASA Mental Health). The study also examines Alberta's approach to addressing economic frictions in mental healthcare, such as moral hazard, adverse selection, and information asymmetry. Methodology: We used a mixed-methods approach, combining health policy evaluation with supply-demand economic modeling. Primary data were extracted from Alberta's 2023–2024 Mental Health and Addiction Annual Report, while supplementary data and theoretical inputs were drawn from peer-reviewed literature and benchmark economic models. Simulations were conducted to evaluate market equilibrium shifts, service utilization trends, and the impact of zero-dollar copayment policies on access and efficiency. Key Findings: Demand for mental health services increased sharply, particularly among youth, rural, and Indigenous populations. Alberta's system capacity grew by over 50% due to digital infrastructure, workforce expansion, and the creation of new recovery programs. Despite rising demand, prices remained stable, indicating successful policy-driven equilibrium balancing. Programs such as CASA Mental Health and the Virtual Opioid Dependency Program exceeded their projected service delivery targets. Expected Outcomes: This study contributes to the literature on public mental health economics by demonstrating how targeted interventions can address both supply and demand challenges during crises. Alberta's model serves as a potentially transferable framework for other jurisdictions seeking to expand equitable access to mental health services without introducing out-of-pocket costs. Relevance: The registration ensures transparency in data use and modeling logic, and it provides stakeholders, such as policymakers, public health professionals, and academics, with insights into how integrated health system design can respond effectively to external shocks like pandemics.

'Twenty-Eighth Report on ''Demands for Grants of the Ministry of Defence for the year 2017-18 on General Defence Budget, Border Roads Organisation, Indian Coast Guard, Military Engineer Services, Canteen Stores Department, Directorate General Defence Estates, Defence Public Sector Undertakings, Welfare of Ex-Servicemen, Defence Pensions and Ex-Servicemen Contributory Health Scheme (Demand No. 19 & 22)''. (9-Mar-2017)' from the Parliament Digital Library

'Twenty-Eighth Report on ''Demands for Grants of the Ministry of Defence for the year 2017-18 on General Defence Budget, Border Roads Organisation, Indian Coast Guard, Military Engineer Services, Canteen Stores Department, Directorate General Defence Estates, Defence Public Sector Undertakings, Welfare of Ex-Servicemen, Defence Pensions and Ex-Servicemen Contributory Health Scheme (Demand No. 19 & 22)''. (9-Mar-2017)' from the Parliament Digital Library

'Twenty-Eighth Report on ''Demands for Grants of the Ministry of Defence for the year 2017-18 on General Defence Budget, Border Roads Organisation, Indian Coast Guard, Military Engineer Services, Canteen Stores Department, Directorate General Defence Estates, Defence Public Sector Undertakings, Welfare of Ex-Servicemen, Defence Pensions and Ex-Servicemen Contributory Health Scheme (Demand No. 19 & 22)''. (9-Mar-2017)' from the Parliament Digital Library

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

In today's marketplace, conventional agricultural products are produced all around the world due to economic reasons. However, recent environmental challenges such as global warming and climate change has strongly been affected by the high volumes of chemical pesticides and fertilizers used to produce these products. Several published reports have indicated the negative effects of the chemicals used in conventional agriculture as well as the effect of climate change on human health. The aim of this study is to develop and analyze a multi-objective linear mathematical model for a sustainable supply chain with an agro-food deteriorating product. The product is produced by two different methods, both by organic and conventional means. In this way, we attempt to create a balance between the production and consumption of conventional and organic products in order to achieve three objectives: reducing costs, reducing environmental degradation, and increasing levels of consumer health. Partial backorder for each product, as well as conventional demand substitution by organic products, are taken into account. In order to assess the impact of supply chain operations on public health, we define a new function based on each product's production and consumption amounts as well as the amount of wastes. The developed model is solved by augmented ɛ-constraint method. Numerical results indicate the important role of supply chain's managers in the formation of sustainable health production and consumption patterns.

This article is from Tobacco Control , volume 23 . Abstract Background: Illicit tobacco (IT) undermines the effectiveness of tobacco control strategies. We assessed the implementation and impact of a new programme designed to reduce demand for, as well as supply of, IT, in the north of England, where IT was prevalent. Methods: ‘Mixed methods’ research was undertaken. Qualitative methods included stakeholder interviews (at outset and 1 year later) and ethnographic research. Indicators reflecting those supply and demand issues for which data were available were identified and monitored, including relevant items on two cross-sectional surveys carried out in 2009 and 2011 with over 4000 individuals from which a social marketing campaign was also developed. IT reports to two existing hotlines, promoted through the programme, were assessed. Results: Initially, concerns abounded about the different philosophies and ways of working of local and national enforcement and health agencies, but these were much reduced at follow-up. A protocol was developed which greatly facilitated the flow of intelligence about IT supply. A social marketing campaign was developed highlighting two messages: IT makes it easier for children to start smoking and brings crime into the community, thereby avoiding misleading messages about relative harms of illicit and licit tobacco. Public and stakeholder awareness of IT increased as did calls to both hotlines. Conclusions: A partnership of agencies, with competing values, was established to tackle IT, a complex public health issue and, inter alia, implemented a social marketing campaign using novel messages. This improved the flow of intelligence about the supply of IT and increased awareness of IT.

This article is from BMC Public Health , volume 12 . Abstract Background: High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSY)and Chiranjeevi Yojana (CY), were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. Methods/designs: The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. Discussion: The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making among policy makers and program managers who currently work with or are planning similar programs in different contexts.

This article is from BMC Public Health , volume 12 . Abstract Background: High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSY)and Chiranjeevi Yojana (CY), were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. Methods/designs: The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. Discussion: The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making among policy makers and program managers who currently work with or are planning similar programs in different contexts.

VHA s Family Caregiver Program is designed to provide support and services to family caregivers of post-9/11 veterans who have a serious injury incurred or aggravated in the line of duty. The program provides approved primary family caregivers with a monthly financial stipend as well as training and other support services, such as counseling and respite care.

Rising health care costs are essentially rooted in a health care system based upon adverse economic incentives, which encourage both providers and patients to act with little regard to costs. To effectively control demand and utilization of health services, and thus costs, a health care system should be structured to provide incentives which motivate all participants to seek cost-effective care. This study examines the theory and reviews the influence of financial incentives upon patient demand behavior. Utilization data from the CHAMPUS Reform Initiative (CRI) are analyzed in terms of the CRI program incentive structures in order to draw conclusions regarding the influence of incentives upon beneficiary demand behavior. Based upon the CRI analysis and descriptions of financial incentive-based models of demand behavior as described in the literature, suggestions for DOD health care reform are offered.

The Joint Military Medical Command - San Antonio is responsible for the delivery of all military medical care in the San Antonio catchment area. With this task comes the responsibility to effectively and efficiently allocate resources for providing services. A planning tool has been developed, in the form of a conceptual model, to serve as a decision support mechanism. This mechanism guides resource allocations by predicting demand for health care services. The model incorporates a four-step process for determining demand. In Step 1., service utilization is determined. Step 2. involves the identification of the population who use health services and the establishment of the population mix. Age, family income, and sex, were specifically evaluated here. With utilization and population data, incidence rates are computed. Then in Step 3., using the incidence rates computed in Step 2., future demand is forecast by regressing the average yearly change in population mix and associated incidence rates into future years. The final step is to periodically determine which demographic factors can be used as predictors of health care demand.

The Joint Military Medical Command - San Antonio is responsible for the delivery of all military medical care in the San Antonio catchment area. With this task comes the responsibility to effectively and efficiently allocate resources for providing services. A planning tool has been developed, in the form of a conceptual model, to serve as a decision support mechanism. This mechanism guides resource allocations by predicting demand for health care services. The model incorporates a four-step process for determining demand. In Step 1., service utilization is determined. Step 2. involves the identification of the population who use health services and the establishment of the population mix. Age, family income, and sex, were specifically evaluated here. With utilization and population data, incidence rates are computed. Then in Step 3., using the incidence rates computed in Step 2., future demand is forecast by regressing the average yearly change in population mix and associated incidence rates into future years. The final step is to periodically determine which demographic factors can be used as predictors of health care demand.

The Military Health Services System (MHSS) provides health care to active-duty service members, military retirees, and their dependents. Over the past several years, the system has faced the twin challenges of downsizing in consonance with the rest of the Department of Defense (DoD) and of controlling escalating health care costs. These challenges cannot, however, be dealt with independently. Closing military treatment facilities (MITs) could drive non- active-duty beneficiaries to seek more expensive medical care from the civilian sector, care that is reimbursed by DoD through the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). In 1991, in response to a congressional request, the Director of Program Analysis and Evaluation (PA&E) undertook an evaluation of health care utilization and costs within the current system and of various possible alternatives to that system. PA&E turned to RAND's National Defense Research Institute (NDRl) for analytic support in responding to Congress. Specifically, we were asked to compare current utilization by military beneficiaries with use by civilians, to develop analytic cases to study alternatives to the current medical structure, and to assess costs and changes in utilization associated with these cases (with the exception of MIF costs, which are being assessed by the Institute for Defense Analyses). pg10. JMD

The Military Health Services System (MHSS) provides health care to active-duty service members, military retirees, and their dependents. Over the past several years, the system has faced the twin challenges of downsizing in consonance with the rest of the Department of Defense (DoD) and of controlling escalating health care costs. These challenges cannot, however, be dealt with independently. Closing military treatment facilities (MITs) could drive non- active-duty beneficiaries to seek more expensive medical care from the civilian sector, care that is reimbursed by DoD through the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). In 1991, in response to a congressional request, the Director of Program Analysis and Evaluation (PA&E) undertook an evaluation of health care utilization and costs within the current system and of various possible alternatives to that system. PA&E turned to RAND's National Defense Research Institute (NDRl) for analytic support in responding to Congress. Specifically, we were asked to compare current utilization by military beneficiaries with use by civilians, to develop analytic cases to study alternatives to the current medical structure, and to assess costs and changes in utilization associated with these cases (with the exception of MIF costs, which are being assessed by the Institute for Defense Analyses). pg10. JMD

The purpose of this study is to determine the scope of medical services that should be provided to enrolled beneficiaries at the future Naval Health Clinic Charleston based on projected demand and demographics of the population. Twelve months of historical relative value unit (RVU) workload data were used to conduct forecasts to project the future demand for health care services in 10 specialty practices. Two independent predictive models were created using time-series analysis and utilization rates from the population of interest. Projections were evaluated against Navy Medicine annual benchmark standards for clinical practices to determine if sufficient demand existed to provide each service. Both independent methodologies indicated the need for 5 of the 10 specialty practices evaluated in the study. Results of this study suggest the demographic make-up of the targeted population likely limits the need for certain specialty services that typically serve an older population.

This study investigated Nigeria's private university lecturers' welfare and their legal rights. The study adopted a doctrinal approach which enabled a proper examination of the extant laws applicable to a lecturer as an employee and the reviewed laws included: the Constitution of the Federal Republic of Nigeria 1999 (as Amended), Labour Act Cap L1, LFN 2004, Industrial Training Fund Cap 19 LFN 2004 (as Amended), National Health Insurance Scheme Act, Cap N42, LFN 2004, National Housing Fund Act, Cap N45 LFN 2004, Pension Reform Act 2014, Personal Income Tax Act Cap P8 LFN 2004, Trade Dispute Act Cap T8 LFN 2004, Trade Unions Act Cap T14 LFN 2004. The study made a case for lecturers with the private universities in comparison to their counterparts with the public owned universities. The findings showed that there is wanton disregard for the extant provision of the Labour Act in Nigeria amongst the lecturers working with the private universities. Similarly, the study likewise discovered that there is paucity of reported cases regarding enforcement action involving private university lecturers and their employers. The study perceives that the inability of private university lecturers to demand for their rights is because the Nigerian law also allows freedom of contract in upholding and binding employers and employees to their agreements. Recommendations from the study asserted that the lecturers are entitled to same right as every other professional employee in Nigeria. This exposes the lecturers in the private universities to a weak state where despite the existence of the laws protecting their rights, they are unable to leverage on the existing laws to advance their rights. [For the complete Volume 21 proceedings, see ED629259.]

Mr. Chairman and distinguished members of the Committee, thank you for inviting me to testify today. It is an honor and pleasure to be here. I will discuss the findings from RAND's recent evaluation of the VA's Enrollee Healthcare Project Model as it relates to the topic of your hearing today. More specifically, my testimony will briefly review the findings from our evaluation, discuss the model's utility to support the proposed advance appropriation of the VA budget, and discuss recommendations for improving the model. In 1996, the mission of the Veterans Administration (VA) broadened dramatically. The Veterans' Health Care Eligibility Reform Act of 1996 transformed the VA from an episodic provider of inpatient care for veterans to a comprehensive health care provider responsible for all the medical needs of veterans who enroll. To support budgeting and planning for this broader mission, the VA relies on a complex model known as the Enrollee Health Care Projection Model (EHCPM). This model predicts future demand for veterans' health care needs. The VA asked RAND (in conjunction with an independent actuary) to evaluate the model, which was developed and is operated by an actuarial consulting firm. The RAND team reviewed how the model works and addressed three main questions in its evaluation: Does the modeling approach support long-term budget planning and policy analysis?; Does it accurately project VA service demand and costs?; Is the design and operation of the model transparent to users and outside parties? Overall, RAND's evaluation found that the EHCPM is useful for short-term budget planning, but it is less useful for longer range planning, especially in a dynamic policy environment. Fortunately, the model is structured in a way that would allow modifications to support longer term policy and planning applications without disrupting its usefulness for near-term budget planning.