Health Care System

It took some time for the western system of medicine to make its influence on the people of India as a whole, even after the arrival of the Britishers in India. Because of the deliberate policy of the Britishers to keep the nation economically and socially backward, the health care system they introduced remained incomplete. As a consequence not only the Indian indigenous system of medicine was ignored, people in need of health care had to depend upon the limited capability of the practitioners of these systems. Fortunately this state of neglect did not continue for long time in spite of Britishers political policy of exploitation (Parsad, 1992).

This work supports an end user and online consultation. Here author propose a framework that enables clients to get moment direction on their medical problems through an astute social intelligent health care system online. The framework is bolstered with different symptoms and the disease or illness associated with those systems. Also the system allows user to share their symptoms and issues. Data Mining as a field of research has already well proven capabilities of identifying hidden patterns, analysis and knowledge applied on different research domains, now gaining popularity day by day among researchers and scientist towards generating novel and deep insights of these large biomedical datasets also. Uncovering new biomedical and healthcare related knowledge to support clinical decision making, is another dimension of data mining [3].

By closing best-price contracts sooner, Baylor will accelerate savings on medication. The contract negotiation process can be reduced by 1 to 5 months, but an average reduction of negotiation time is approximately 2 months. Each contract can save the Health Care System up to $36,000 annually, or $3,000 per month, once negotiated. Therefore, the savings for one contract is $3,000 x 2 months = $6,000 per year. The system negotiates about 20 contracts per year. So by implementing this on-line negotiation, BHCS estimates that it will save about $120,000 per year, for pharmacy contracts alone. Once this implementation is expanded to other types of contracts, more hard-dollar value will be realized.

The Roseburg campus consists of 200 acres and 32 buildings. VARHS offers primary care and hospital services in medicine, surgery and mental health for the veterans who reside in Cen- tral and southern Oregon, and northern California. Specialty services are provided within the health-care system or through referral consultations to the university-affiliated tertiary care centers located in Portland, Ore., and Seattle, or through refer- rals in the community. Specialty services offered include car- diology, neurology, infectious diseases, optometry, ophthalmol- ogy, otolaryngology, endocrinology, urology, renal, gerontology, pulmonary, gastroenterology, general surgery, dermatology and vocational rehabilitation. Additional specialty services are avail- able within the Northwest Network.

and treating the medical devices as the part of the cloud, where software modules are automatically deployed on demand when required with appropriate resources which can improve medical functionality. Local HIMS (Hospital Management Information system) is hosted into cloud. Also this system connects different medical devices in cloud to improve their processing capability. TCLOUD [5] proposes a home health care system using cloud computing. In TCLOUD system patients, medical personnel’s and doctors will be connected to get different services. The services provided are drug therapies management (for improving compliance with doctor recommendations), sleep and light management (sleep monitoring) and physical activity management of patients. To implement TCLOUD OPENSTACK is used as IAAS. SWIFT component of open Stack is used to provide database functionality via redundant storage and NOVA component empowers Virtual machines. Apache is used as web server and Mysql as database server. User communicates with the TCLOUD through a Web Portal and SOAP interface. STRIDE method is used for security threat modelling. LIDDUN method is used for privacy thread modelling and equipment elicitation.

Abstract: China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949. In the following sections, we describe the current Chinese health care delivery system and the current health insurance system. We then focus on the construction of the Chinese health information system as well as several existing registers and research projects on health data. Finally, we discuss the opportunities and challenges of the health care system in regard to clinical epidemiology research. China now has three main insurance schemes. The Urban Employee Basic Medical Insurance (UEBMI) covers urban employees and retired employees. The Urban Residence Basic Medical Insurance (URBMI) covers urban residents, including children, students, elderly people without previous employment, and unemployed people. The New Rural Cooperative Medical Scheme (NRCMS) covers rural residents. The Chinese Government has made efforts to build up health information data, including electronic medical records. The establishment of universal health care insurance with linkage to medical records will provide potentially huge research opportunities in the future. However, constructing a complete register system at a nationwide level is challenging. In the future, China will demand increased capacity of researchers and data managers, in particular within clinical epidemiology, to explore the rich resources.

We do not use the two part model that has become a standard in the death related costs studies (see Werblow, Felder and Zweifel, 2007 and others) as we do not face the problem of the sample selection bias. The Czech health care system where the enrolees do not pay any deductible and where 92.5 % of the population is registered to GPs paid by capitation schemes (source: Institute of Health Information and Statistics of the Czech Republic (Ú ZIS)) having thus minimum annual expenditure of 396 CZK does not face the problem of the lack of the data on health expenditure. In line with Werblow, Felder and Zweifel (2007) we use the OLS with robust standard errors and the GLM model with family gamma and logarithmic link. The problem of the linear models in the context of the health expenditures data that are highly skewed to the right and heteroscedastic has been largely discussed in the literature. The use of the log transformation of the HCE data that have approximately lognormal distribution is connected with the problem of retransformation, however OLS without transformation suffers from lack of robustness. The GLM models do not face the

Findings from this study suggest areas for research. The knowledge and experiences of clinicians regarding deaf pa- tients should be further explored, including the reasons for not arranging for interpreter services. Advanced education pro- grams in health care interpreting should be offered, and their impact on health outcomes studied. Deaf people sometimes reported not requesting interpreter services from their clini- cians. Self-advocacy educational programs should be tested to see how they impact frequency of use, satisfaction, and out- comes of care. Programs that teach health care students and professionals about deafness should also be studied. National surveys of health and health care experiences should include individuals who are deaf, 23,24 and information regarding the nature of the hearing loss and preferred language should be included in the data collection. This will facilitate accurate as- sessments of the impact of technical innovations such as see- through surgical masks, computer software that converts spo- ken language to written text, video relay service (VRS, see Table 4), and remote sign language interpreter services using videoconferencing equipment with high bandwidth connec- tions (VRI, see Table 4). Finally, programs that help interest- ed deaf people to enter careers in the health professions should be examined to see their effect on health care system access for deaf people and their families.

The concept behind the “Smart Village” is that technology plays an important role for development rendering to education, power, farming, local business opportunities, improving health care, entrepreneurship, internet connectivity and overall enhancement of rural village dwellers. It is a modern approach for off-grid communities. There are major obstacles for the rural people in accessing the health care services In India. With the wide use of advanced technologies, it can establish a better and smarter health care delivery system as Internet of Things (IoT) is revolutionizing the health care industry by adding up new and advanced technologies to make healthcare efficient, improve access to care, increase care quality and reduce care cost. It will take an important role in delivering health care to people in remote areas by monitoring the health care system through internet connectivity providing emergency notifications and accurate data in real time for better health decisions. It has the potential to bring better health care in reducing mortality rate of the rural areas. The introduction of smart health care will be one the essential strategic approaches to meet the health care services in the rural villages of India. This paper explores the role of the advances technologies in healthcare delivery taking a close look at the smart health care aspects in the perspective of Smart Village.

For example, officials from the Centers for Disease Control and Prevention and the Office of Population Affairs (OPA), which runs the Title X national family planning program, have been working to develop several contraception-related measures, with the goal of obtaining an endorse- ment, perhaps in 2015, from the National Quality Forum. Simultaneously, OPA staff are working through Integrating the Healthcare Enterprise, an international organization that establishes stan- dards used by EHR system vendors for encod- ing and transmitting data, on a set of important contraceptive and sexual health variables, such as pregnancy intention and current contraceptive method. 3 If these efforts succeed in getting key

2 As the authors of this study conclude: "The individual insurance market is clearly inadequate as a source of affordable health coverage for those Americans who[r]

Six in ten (61 percent) say changing the system of financial rewards some physicians receive for ordering tests and procedures would be an effective solution. Physicians who see fewer than 100 patients a week are more likely than others to say this would be effective (67 percent vs. 49 percent).

The centre of gravi﬑ in the combina﬒ on of indi- cators falls on the health results. Their selec﬒ on contains big responsibili﬑ due to the fact that a big part of the modifi ca﬒ ons in the health are determined by external, objec﬒ ve (from the point of view of the healthcare system) factors like heredi﬑ and biology, ethogenic changes (unsanitary conduct of the individuals), socio- economic environment, ecological factors. The objec﬒ ve in our case was to select such indica- tors that indicate the abili﬑ of the health sys- tem the produce qualita﬒ ve and eff ec﬒ ve result. One indisputable indicator for health like “life expectancy” is present in all methodologies for assessment of the health status, the health system, the human development and the com- pe﬒ ﬒ veness of the na﬒ onal economy. In spite

minimum care standards for the residential facilities which are provided either directly by the HSE or funded by it. The standards for residential care for drug and alcohol users in recovery from addiction cannot be less than those deemed acceptable by society for those for older people, children or people with disabilities. The working group were particularly impressed by the standards set out in the Scottish Executive document National Care Standards: care homes for people with drug and alcohol misuse problems. They also noted that in the UK, the Care Standards Act defines a home as a care home if it provides accommodation together with nursing or personal care. Included are homes for persons who are, or who have been, suffering from dependence on alcohol or drugs. Residential services for substance users are required to register under the Act. Inspections are carried out by the Care Standards Commission twice a year with at least one of those visits being unannounced. It is a requirement that all mangers and staff of residential homes be appropriately trained and working towards a recognised qualification.

One approach is to increase the buyer power of hospitals, nursing homes and other health care providing organizations as they form group purchasing organizations (GPOs). 2 Gener- ally, GPOs do not purchase drugs and resell them but aggregate their members’ demand and solicit bids from manufacturers. Supply contracts typically including rebates, are conducted with one or more firms and the members of the GPOs are able to purchase at the prices and other terms specified in the contracts. It is up to the GPOs whether they conclude rebate contracts with all possible manufacturers (multiple rebate contracts) or exclusively with one of them (exclusive rebate contracts). In order to increase total volume discounts and thereby lower prices for all members of the GPOs, it might pay to restrict consumers’ choice via exclusive rebate contracts. Though, if a pharmaceutical product is not covered by the rebate contract, and there are no possibilities to buy o ff -contract, consumers have to substitute the horizontally di ff erentiated pharmaceutical products.

Care for the individual patient with MCC is often frag- mented, split between providers leading to inefficient, in- complete and ineffective care. The individual with MCC is at risk for preventable adverse drug events [11], avoidable hospital admissions [12] and mortality [13]. Boyd et al. have estimated that a patient with five co-morbid condi- tions, treated according to clinical guidelines, would result in the prescription of 19 doses of 12 different medica- tions taken at five time points during the day and carry- ing the risk of ten attendant interactions or adverse events [14]. Treatments for one disease can be considered either synergic or contradictory for other conditions. While trying to improve a patient’ s health, one might actually be harming the patient in another aspect leading to in- creased hospitalization, increased burden on primary care physicians [5], increased consults and spiraling healthcare costs [15].

Despite these challenges, there is a meaningful chance that such partnerships can be used to successfully advocate for healthcare reform. First, the fact that patie[r]

Two weeks after the birth of your child, the District Nurse from the consultatiebureau will visit you at home. She will give you advice on care and feeding, make an appointment for your first visit to the clinic, and give you a "growth book" which outlines a baby's first year of development, supplies important phone numbers, holds your appointments at the clinic, records vaccinations and charts your baby's height and weight. You should always bring this book with you to your appointments.

The system controls the medical doses remotely and consists of six basic compo- nents, as shown in Fig. 2, such as: smartphone, Wi-Fi module (ESP8266), RTC (DS1307) the Arduino board, Ultrasonic, and the motor’s drivers. The control passes through three main stages: first, the smartphone connects to the Wi-Fi module; then, the Wi-Fi module passes the commands and the time of the smartphone to the Ar- duino via a serial communication port; in the third step, the Arduino reads the time of RTC module and control the device (lower the doses on-time) via motor’s drivers and sends an alarm through GSM module.

Since the creation of the Federal Republic two health care reform proposals failed in 1960 and in 1964. Both of them contained provisions for user charges which exceeded by far the extent of user charges introduced during the cost-containment period (Bandelow 1998). In 1960 a co-payment of DM 1.50 was planned for each item on the medical fee schedule delivered by physicians in the ambulatory sector. The co-payment would have been limited to 6 weeks for every disease episode. At the same time a differentiated co-payment for pharmaceuticals up to DM 3 per prescription was suggested. Highly relevant was the co-insurance for hospital-, preventive spa treatment and rehabilitation of 0.5% of the monthly income up to DM 3.30 per day (in 1960 the assessable income limit was DM 630). The second reform proposal in 1964 planned user charges of a total of 25% of all outpatient medical and dental services (Müller 1980). Both reforms failed in the political process. While the physician associations