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archives@tulane.edu / Public health finance is still a relatively young field and, as such, many questions have yet to be asked—and answered. To date, few have examine how specific revenue streams—alone or in combination—shape local health departments’ (LHD) resources and capacity to accomplish their public health missions. Given ongoing policy conversations about financing for public health, it’s important for researchers to rigorously examine the and the potential costs and benefits associated with different revenue sources. Introduction Chapter: The central thesis for the body of work encapsulated by this dissertation is simple: where money comes from matters. This chapter critically examines published evidence and theory linking public health financing mechanisms and their interactions to LHD operations, outputs, and even outcomes. The chapter also introduces situates the specific research questions addressed in this dissertation within a broader conceptual framework. Paper 1: The first paper examines the relationship between revenue diversification and revenue volatility among Washington State LHDs. Using fixed effects linear regression models and revenue data reported during 1998-2014 by all LHDs operating in Washington State, the paper finds little evidence to suggest revenue diversification is significantly associated with revenue volatility. Paper 2: The second paper evaluates whether available revenue sources differentially effected the scope of programs provided by Washington State LHDs between 2000 and 2011. Using two measures of program scope and both linear and non-linear fixed effects panel regression models, the paper finds that only funding received from federal Medicaid was consistently and significantly associated with both measures of program scope. Paper 3: The third paper examines changes in total LHD expenditures in Washington State between 2006 and 2013 following introduction of a new state funding program to support core public health services and infrastructure. Using a pre-post design regression model to evaluate changes in LHD expenditures, the paper finds overall spending among LHDs significantly increased with receipt of the new state funds in the first years of the program. However, those increases were not sustained over the longer term Conclusion Chapter: The final chapter reviews findings from the three papers and discusses their implications for public health policy, practice, finance, and research. / 1 / Abigail Hope Viall

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-07-18T11:46:31Z No. of bitstreams: 1 Ricardo De Angelis Colli.pdf: 1173300 bytes, checksum: 51bbcc3090a9156ce11fc31de9c2bd5e (MD5) / Made available in DSpace on 2018-07-18T11:46:31Z (GMT). No. of bitstreams: 1 Ricardo De Angelis Colli.pdf: 1173300 bytes, checksum: 51bbcc3090a9156ce11fc31de9c2bd5e (MD5) Previous issue date: 2018-03-30 / The Brazil has faced since the deployment of the Unified Health System (SUS), in 1988, deep financial resources dispute to ensure the universal and integral health right. Among the biggest problems that involve the financing of SUS are: the lack of greater participation of the federal Government in determining sources of public revenues and the wacky tax structure, charge on the poorest individuals and families; and, the release of resources for public health, thickening the payment of public debt. In this context will be analyzed the different views regarding the taxation of large fortunes, to identify the main barriers to your institution. The objective of this research is to investigate the role that tax on large fortunes could have as a source of funding for the SUS / O Brasil tem enfrentado desde a implantação do Sistema Único de Saúde (SUS), em 1988, profundas disputas por recursos financeiros para garantir o direito universal e integral à saúde. Dentre os maiores problemas que envolvem o financiamento do SUS estão: de um lado, a falta de maior participação do governo federal na determinação de fontes de receitas públicas e a estrutura tributária regressiva, onerando os indivíduos e famílias mais pobres; de outro, a desvinculação de recursos destinados à saúde pública, que podem engrossar o pagamento da dívida pública. Neste contexto serão analisados os diferentes pontos de vista a respeito da tributação das grandes fortunas, bem como identificar os principais entraves à sua instituição. O objetivo desta pesquisa é investigar o papel que a tributação sobre as grandes fortunas poderia ter como fonte de financiamento para o SUS

Objetivo: Determinar la rentabilidad de una muestra establecida de 10 centros odontológicos privados en la ciudad de Lima metropolitana. Materiales y métodos: Se evaluó 10 centros odontológicos ubicados en Lima Metropolitana. La rentabilidad anual fue evaluada mediante el producto de la utilidad neta sobre la inversión multiplicándolo por cien. La utilidad neta y la inversión fueron obtenidas mediante los registros oficiales contables que cada participante voluntario brindó. De la misma manera brindaron los datos de pacientes atendidos diariamente y unidades de atención Resultados: Se encontró que la rentabilidad presentó una media de 106.29% con una mediana de 83.35% y desviación estándar de 94.93%, siendo el valor mínimo de 3.71% y el valor máximo 251.61%. La utilidad neta presentó un valor de S./ 94,161.94 en la medía, con una mediana de S./ 66,459.25 y desviación estándar de S./ 88,819.23, siendo su máximo valor S/. 281,086.50 y el mínimo S/. 14,412.98. Para la inversión los resultados hallados fueron de S./ 147,973.80 en la desviación estándar, S./ 147,783.90 en la mediana, S./ 180,689.80 de media, y con máximo resultado de S./ 388,358.60 y el mínimo fue de S./ 24,510.84. Con respecto a los números de pacientes atendidos diariamente se obtuvo en valor de 12 en la media y en la desviación estándar fue 7.38, el máximo fue 30 y mínimo de 4. En las unidades de atención los resultados obtenidos en la media fueron de 2.20 en la media, 0.79 en la desviación estándar, 4 en el máximo y 1 en el mínimo. Conclusiones: Los diez centros odontológicos que conformaron la muestra privados de Lima metropolitana presentaron rentabilidad, pero sus resultados se encontraron dependientes al modo como administraban sus financiamientos. Así mismo la utilidad y la inversión demostraron estar sujetos a prioridad de los administradores. / Objective: Determine the profitability of an established sample of 10 private dental centers in Lima Metropolitana city. Materials and methods: The 10 dental centers located in Metropolitan Lima were evaluated. The Profitability was assessed by the product of net income on investment multiplying it by one hundred. Net income and investment were obtained through the accounting records that each volunteer participant provided. In the same way they provided the data of patients treated daily and care units Results: It was found that the profitability presented a mean of 106.29% with a median of 83.35% and standard deviation of 94.93%, with the minimum value of 3.71% and the maximum value 251.61%. Net income presented a mean value of S. / 94,161.94, with a median of S. / 66,459.25 and standard deviation of S. / 88,819.23, with its maximum value being S /. 281,086.50 and the minimum S /. 14,412.98. For investment, the results found were S. / 147,973.80 in the standard deviation, S. / 147,783.90 in the median, S. / 180,689.80 on the mean, and with a maximum result of S. / 388,358.60 and the minimum was S. / 24,510.84. Regarding the number of patients seen daily, a value of 12 was obtained in the mean and the standard deviation was 7.38, the maximum was 30 and the minimum was 4. In the care units, the results obtained in the mean were 2.20 in the mean, 0.79 in the standard deviation, 4 in the maximum and 1 in the minimum. Conclusions: The ten dental centers that formed the private sample of metropolitan Lima presented profitability, but their results were dependent on the way they managed their financing. Likewise, profit and investment proved to be subject to managers' priority. / Tesis

This thesis examines the structure and flow of public funding between the public and private sectors in the South African health system and the consequences thereof for the achievement of equity. The conceptual framework used to undertake the analysis derives from Richard Titmuss’ core theoretical framework, the Social Division of Welfare. The application of the Social Division of Welfare applied to the South African health care context demonstrates how state resources end up benefitting the non-poor and, as a result, reproduce inequality. Those who access public institutions such as public health care are assumed to be ‘dependent’ on the state, whilst those who access private health facilities claim to be ‘independent’ of the state. However, this thesis shows that these assumptions are flawed. Access to the formal labour market, and subsequently the paying of taxes, authorises one to access state subsidies not available to those who do not. The application of the Social Division of Welfare shows that tax-paying private health care patients benefit considerably from state resources. This thesis argues that due to cost escalation in the private health sector, a consequence of the commodification of health care, these private health care ‘consumers’ as well as the private health industry in general are dependent upon state resources. This thesis analyses the role played by the profit motive present in the private health industry and the consequences for equity, quality, access and efficiency in health care provision