Σκοπός της εργασίας είναι η οικονομική αξιολόγηση της αγοράς φαρμάκου στην Ελλάδα. Η έννοια της αγοράς συνίσταται από την πλευρά της προσφοράς (εγχώριας παραγωγής και εισαγωγής), την πλευρά της ζήτησης (κατανάλωση) και του ρυθμιστικούς-ελεγκτικούς μηχανισμούς της όπως αυτοί υιοθετούνται από τους θεσμικούς εταίρους της αγοράς (κράτος, ασφαλιστικά ταμεία, ενώσεις, χρηματοπιστωτικά ιδρύματα, κ.λπ). Το αντικείμενο της έρευνας είναι η διερεύνηση των παραγόντων που διαμορφώνουν την αγορά του φαρμάκου στην Ελλάδα. / -

This thesis sheds light on differences in health insurance enrolment determinants and uptake barriers between urban and rural areas in the Jirapa district of Ghana. The National Health Insurance Scheme in Ghana has made significant progress in terms of enrolment, which has had a commensurate increase in utilization of health care services. However, there are challenges that pose a threat to the scheme’s transition to universal coverage; enrolment in the scheme has not progressed according to plan, and there are many barriers known to impede uptake of health care. Interestingly, these barriers vary in relation to locality, and rural residents appear to carry a disproportionate portion of the burden. A mixed method approach was employed to collect and analyse the data. On the basis of the primary qualitative and quantitative results, the thesis argues that the costs of enrolling and accessing health care is disproportionately higher for rural residents than it is their urban counterparts. It also highlights that the distribution of service benefits both in terms of the NHIS and health care in the Jirapa district favours urban residents. Lastly, the thesis found that whereas rural residents prefer health care provision to be social in nature, urban residents were more interested in the technical quality aspects of care. These findings suggest that rural residents are not benefitting from, or may not be accessing health services to the extent as their urban counterparts. Affordability, long distance to health facilities, availability and acceptability barriers were found to influence the resultant pro-urban distribution of the overall health care benefit.

This essay is about how the government formulates its policy regarding the health insurance and how these ambitions are then translated in the steering of the Swedish Swedish Social Insurance Fund. We have formulated the following questions: ● How is government policy and governance formulated in terms of health insurance? ● How does government policy and governance differ in terms of health insurance policy during the period studied? ● How does government's policy orientation affect the overall governance they provide to the Social Insurance Fund? We also analyze whether there are differences in policy and governance and between governments that took place in 2006, 2010 and 2014. We have read political material such as election manifesto and the Prime ministers´statement of government policy and compared this with the governments appropriation directions to the Swedish Social Insurance Fund and directions in the state budget. For the analysis, we use text analysis and we have, under the results and conclusions, identified two themes that all three governments commute between: the labor theme and the security theme. Our theoretical approach is the theory formulated by Frank Baumgartner och Bryan Jones Punctuated Equilibrium. We find that although there are differences in policy depending on the government's political color, governance is relatively stable. The overall objectives of the Swedish Social Insurance Fund have only been changed once during the period we have studied. In our analysis we have a reasoning for our outcome based on our theoretical perspective.

Subsidies, taxes, premiums, and eligibility for health insurance can potentially cause "marriage lock," in which couples stay married for the sake of health insurance coverage, and marriage lock may change under the Affordable Care Act. In the first two chapters, marriage lock is examined in the context of two key health insurance decisions: divorce decisions upon qualification for Medicare at age 65, and marriage and divorce decisions associated with the introduction of the Massachusetts insurance mandate and health insurance exchange market reforms in 2006. In the first chapter, using the Health and Retirement Study data, I find evidence of a 7 percentage point increase in the number of divorces upon achieving Medicare eligibility at age 65 for people with spousal insurance coverage relative to those without it. In the second chapter, using the American Community Survey data, I find that the 2006 Massachusetts healthcare reform increased incentives for marriage in the health insurance exchange market relative to control states. Specifically, the Massachusetts reform appears to have reduced the divorce rate by 0.5 percentage point and increased marriage rate by 1.4 percentage points. In the third chapter, I use data from the China Household Finance Survey (CHFS) to explore three decisions potentially affected by the implementation of Medical Savings Accounts (MSAs). First, I find that individuals with MSAs incur 17 RMB more medical expenses per 1000 RMB increase in their MSAs balance, while I find no significant effect of after-tax income on medical expenses. Second, I study preference heterogeneity as revealed by three types of risky behaviors. I find undertaking risky investments is associated with 23% more medical expenditures, while always using a seatbelt and obeying traffic signals are associated with 16% and 22% higher medical expenditures, respectively. Finally, I find evidence suggesting that individuals become more risk adverse with MSAs than without, specifically by increasing their use of seatbelts and obeying traffic signals. These findings, using recent Chinese data, suggest that MSAs play an important role when consumers make health expenditure decisions, and that preferences involving risk and prevention also appear to be influenced by the MSA scheme.

PROBLEM: As part of Indonesia’s strategy to achieve the goal of Universal Health Coverage (UHC), large investments have been made to increase health access for the poor. These have resulted in the implementation of various public health insurance (PHI) schemes, including Jamkesmas, the largest health insurance program in Indonesia in 2012, targeted towards the poor and near-poor. In the backdrop of Indonesia’s aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. With the implementation of various pro-poor PHI programs in Indonesia, there is limited understanding of how these programs impact maternal health services among poor women. METHODS: This study used a mixed-methods design. The quantitative component entailed secondary analysis of the Indonesian Demographic and Health Survey (IDHS) from 2007 and 2012 on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). Qualitative interviews (n=55) were conducted from May-Aug 2015 in the province of Jakarta and Banten among community representatives and key stakeholders to describe the successes and challenges of health insurance membership and maternal health services among the poor. RESULTS: Controlling for all independent variables, poor women with Jamkesmas were 21% (OR=1.21 [1.05–1.39]) more likely to have HFD and 20% (OR=1.20 [1.03–1.39]) more likely to have SBD compared to poor women without health insurance. Qualitative interviews provide some explanation to the modest effect of Jamkesmas health insurance on HFD and SBD seen in the quantitative analysis, including: the preference for pregnant women to deliver in their parents’ village; the use of traditional birth attendants; lack of proper documentation for health insurance registration, distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. CONCLUSION: Poor women with Jamkesmas membership had a modest increase in HFD and SBD. These findings indicate that pro-poor PHI schemes may be able to reduce financial barriers to care. However, factors such as socio-cultural beliefs, accessibility, and quality of care are important elements that need to be addressed as part of the national UHC agenda to improve maternal health services in Indonesia.

Philosophiae Doctor - PhD / This study addresses the issue of the low participation in or enrolment of the poor in Ghana’s National Health Insurance Scheme (NHIS). The low enrolment of the poor in the NHIS is attributed to the difficulty in identifying who qualifies for exemptions from paying health insurance premiums. In an attempt to address this problem, the purpose of this study was, therefore, to develop a model for identifying very poor households for health insurance premium exemptions in the Kassena-Nankana District of Northern Ghana in an effort to increase their access to equitable health care

O objetivo deste trabalho é o estudo dos amortecedores automáticos para contornar crises em sistemas de asseguramento privado em saúde, com vistas a proteger os consumidores de planos e seguros saúde das incertezas. A pesquisa escolheu dois sistemas de seguros-saúde eminentemente privados, o holandês e o norte- americano; averiguou as metodologias empregadas nesses países para o amortecimento de crises potenciais de insolvência para, comparativamente ao subsistema de seguros privados brasileiro a denominada saúde suplementar , pensar que medidas podem ser adotadas no Brasil para encarar as incertezas e instabilidades que se apresentam no cenário do asseguramento privado em saúde. Os amortecedores mais adequados ao caso brasileiro são os seguros garantidores, que em caso de insolvência de seguradoras e operadoras de saúde, entram em ação para oferecer continuidade assistencial, de caráter transitório, até que uma empresa saudável possa absorver a carteira da insolvente. O trabalho também analisa a dualidade presente no sistema de saúde brasileiro, com um mix público- privado representado pelo SUS e pela saúde suplementar. A presença dessa dualidade, em que pese a desarticulação entre os dois campos, sugere que o SUS, universal, será o acolhedor de última instância, ao oferecer proteção aos potenciais excluídos do subsistema privado brasileiro razão pela qual o SUS deve ser fortalecido

Made available in DSpace on 2014-06-11T19:27:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-08-08Bitstream added on 2014-06-13T20:56:52Z : No. of bitstreams: 1 gois_bc_me_araca.pdf: 135050 bytes, checksum: b8ca6744d1191ad44fcb4ecd830be9bf (MD5) / O setor de saúde suplementar atualmente representa a porta de entrada de cerca de 42 milhões de brasileiros a serviços de saúde. Passaram-se anos até que finalmente surge a regulamentação do setor. O objetivo deste trabalho foi realizar uma análise da representação da classe odontológica frente a Agência Nacional de Saúde Suplementar - ANS, responsável pela regulamentação e fiscalização do setor. Por meio de uma investigação do conteúdo das Atas de reuniões da ANS no período de 1998 a 2006 realizou-se a identificação e classificação das citações relativas à odontologia, tentando traçar um perfil da representação da classe junto ao setor. A odontologia foi referenciada 135 vezes nos documentos examinados, os representantes da classe odontológica foram responsáveis por 77 citações (57%), destas 19 trataram sobre a cobertura e rol de procedimentos sendo 7 de caráter reivindicatório; outras 35 colocações trataram do gerenciamento e padronização dos serviços e contratos oferecidos pelos planos odontológicos, sendo que 5 foram de caráter reivindicatório; outras 3 reivindicações foram pleiteadas pelos representantes em relação à política de reajustes e taxas e totalizaram 10 citações a respeito dos prestadores de serviços. Concluímos que a classe odontológica parece estar bem representada, sendo imprescindível a continuidade dos trabalhos executados por nossos representantes junto a ANS. / The sector of health insurance is the entrance of 42 millions Brazilian people for health services. Passed a lot of years until regulations appears. The objective of this article was made an analysis of dental institutions participation at the national agenc y of health insurance - ANS, response for regulation and investigation in Brazil. Through an documental analysis of texts described in meeting registration of ANS, from 1998 to 2006, was made an identification of dental citations, try to describe a standard of dental representation in the meetings. The dentistry was present in 135 citations, the dentistry representatives institutional made 77 citations (57%), 19 was about dentistry proceeds and 7 of those was to ask resolutions; others 35 citations was about manager and standard of services offer by insurance companies, 5 was ask resolutions; others 3 asks was about taxes and fees, and 10 others was about relationship between companies and employs. The results show that dentistry has a good presence by their institutional representatives in ANS meetings.

Thesis submitted in fulfillment of the requirements for the degree Master Technologiae: Biomedical Technology In the Faculty of Health and Wellness Sciences At the CAPE PENINSULA UNIVERSITY OF TECHNOLOGY 2014 / Over the past few decades, it has been shown that various critical diseases including heart disease, cancer, and diabetes associated with free radical generation and low endogenous antioxidant capacity, lead to oxidative stress and cell injury. In recent years, numerous studies have also reported that antioxidants, present in various beverages, vegetables and some foods have attracted a significant research interest due to their potential benefits to human health. However, epidemiological evidence shows a correlation between the intake of food rich in antioxidants and the reduced incidence of some mortality of chronic diseases, certain cancers and coronary heart disease. The aims of this study were to determine the effects of rooibos teas (fermented and unfermented) and green tea as a comparison on the biochemical parameters and the trace element absorption in a rat model. In this study 4 groups of experimental animals were used. All groups had ad libitum access to standard rat chow. Group A, the controls (11 animals), were fed with tap water; group B (11 animals) were fed with the liquid extract of fermented rooibos tea; group C (9 animals) were fed with the liquid extracts of unfermented rooibos and group D (9 animals) were fed with the liquid extract of green tea. All groups were fed for a period of 10 weeks. After the feeding period, the animals were sacrificed by euthanization with intraperitoneal injections of pentobarbital. Blood was sampled by cardiac puncture and centrifuged to obtain the serum. Some elemental analyses were performed with X-ray emission and backscattering. ICP-OES was used to determine the magnesium content. For X-ray emission, backscattering and ICP-OES analyses, 100 μL of each serum sample in a group were added to 2 mL freeze-drying tube. Of the combined specimen, 100 μL was used for the magnesium determination by ICP-OES. The remainder of the combined serum specimens for each group were freeze-dried at -80 ºC and then pressed into a pellet. The pellet was coated with carbon and analyzed using X-ray emission and backscattering. The elemental X-rays of P, S, Ca, Mn, Fe, Cu, Co, Zn, Mo, Ca and Se emitted were quantified to obtain the respective concentrations. Biochemical chemistry analyses were performed on each serum sample of each animal. The biochemical parameters tested for were total protein, albumin, globulin, total bilirubin, lactate dehydrogenase, blood urea nitrogen, uric acid, total cholesterol, aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase and creatinine. The P concentration increased (p=0.028) when fed with the fermented rooibos tea liquid extract and S content increased when fed with the - the unfermented tea liquid extract (p=0.041). The concentrations of Cl and Cr were not affected (p>0.05) by any of tea liquid extracts. The unfermented rooibos tea liquid extract and the green tea indicated a decrease in the concentrations of Fe (p=0.031 and p=0.032, respectively) and Mn (p=0.041 and p=0.034, respectively). The concentrations of Fe, Zn and Cu in the serum increased when feeding with fermented rooibos tea liquid extract (p=0.024; p=0.030 and p=0.015, respectively) while Se, Mo and Mg concentrations were decreased by the liquid extracts of the fermented, unfermented and green teas (p=0.014, p=0.017 and p=0.011; p=0.024, p=0.026 and p=0.019; p=0.031, p=0.034 and p=0.025, respectively). Concerning the biochemical parameters, the total protein, globulin and the uric acid contents in the serum sample were slightly affected with the green tea extract (p=0.041, p=0.039 and p=0.047 respectively). The albumin, lactate dehydrogenase, blood urea nitrogen, the total cholesterol, the alanine aminotransferase and the aspartate aminotransferase concentrations were not affected (p>0) by any of the tea liquid extracts. However, the total bilirubin content was decreased (p=0.012) when feeding with the fermented rooibos group while the creatine phosphokinase and the creatinine contents were decreased (p=0.042 and p=0.033, respectively) when feeding with the unfermented rooibos tea liquid extract.

O objetivo deste trabalho é o estudo dos amortecedores automáticos para contornar crises em sistemas de asseguramento privado em saúde, com vistas a proteger os consumidores de planos e seguros saúde das incertezas. A pesquisa escolheu dois sistemas de seguros-saúde eminentemente privados, o holandês e o norte- americano; averiguou as metodologias empregadas nesses países para o amortecimento de crises potenciais de insolvência para, comparativamente ao subsistema de seguros privados brasileiro a denominada saúde suplementar , pensar que medidas podem ser adotadas no Brasil para encarar as incertezas e instabilidades que se apresentam no cenário do asseguramento privado em saúde. Os amortecedores mais adequados ao caso brasileiro são os seguros garantidores, que em caso de insolvência de seguradoras e operadoras de saúde, entram em ação para oferecer continuidade assistencial, de caráter transitório, até que uma empresa saudável possa absorver a carteira da insolvente. O trabalho também analisa a dualidade presente no sistema de saúde brasileiro, com um mix público- privado representado pelo SUS e pela saúde suplementar. A presença dessa dualidade, em que pese a desarticulação entre os dois campos, sugere que o SUS, universal, será o acolhedor de última instância, ao oferecer proteção aos potenciais excluídos do subsistema privado brasileiro razão pela qual o SUS deve ser fortalecido