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Our glossary helps you understand the terms (issues, process stages, actors, ratings and keywords) used in our surveys. Please choose a term from the drop down menu.

Funding / Pooling

Sustainable Financing of Health Care Systems: This cluster has been divided into 1. ?funding and pooling of funds? and 2. ?remuneration and paying providers?, i.e. the relationship between population/patients and payers on one side and between payers/purchasers and providers on the other. The first sub-section includes generation and collection of funds for health care (i.e. taxes, social insurance contributions or co-payments) as well as their pooling and (re-)distribution to the payers (sickness funds or health authorities, incl. risk structure compensation). Important considerations relate to efficiency and equity. The second sub-section includes budgeting, diagnostic related group (DRG) systems, as well as remuneration issues closely related to the organization of the health system, the definition of the benefit basket, and access to health care / scope of coverage of health insurance plans.

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Remuneration / Payment

This cluster is about remuneration and paying providers. It includes budgeting, diagnostic related group (DRG) systems, as well as remuneration issues closely related to the organization of the health system, the definition of the benefit basket, and access to health care / scope of coverage of health insurance plans. For funding / pooling aspects, please see separate definition.

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HR Training/Capacities

Education & training, numbers & planning, projected shortages of qualified medical and non-medical personnel etc.

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Quality Improvement

This should include tools such as guidelines, evidence-based-medicine, peer reviews, re-certification of physicians, outcome measurements as well as measures to make them work (i.e. purchaser-provider contracts, financial/non-financial incentives), patient safety and medical errors/malpractice, public disclosure of provider performance data, benchmarks, best-practice.

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Benefit Basket

This cluster includes both the decision-making process on (new) technologies and services, i.e. whether health technology assessment becomes mandatory, as well as actual changes in the benefits covered, i.e. the exclusion of dental care.

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Access

In contrast to the previous cluster which deals with technologies and services, this cluster is about de facto access by individuals to health care, including problems such as rationing, waiting lists (equity concerns!) etc., strategies for solving these restrictions, and for reducing disparities in care.

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Responsiveness

Responsiveness of the Health Care system and of health policy to patients, payers [link to PopUp Def of Payers]? expectations, patients rights and patient chartas.

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Political Context

Political context and public administration includes description and analysis of levels of competency (incl. EU), policy making styles, stewardship role etc. Under this heading, changes affecting health policy competencies (mix/split) at Government level (Ministry of Health, Ministry of Labour/Social Security, Ministry of Consumer Protection, Ministry of Environment) are reported, as are shifting competencies. Key words: Decentralization (devolution, delegation, deconcentration), centralization, etatism; role of corporatism and interest group lobbying in health policy making; subsidiarity, vertical vs. horizontal levels of responsibility for service delivery (in-patient vs out-patient services); (changing) role of local government vs. central government in health planning, facility management etc.; mechanisms of civil society participation in health care issues.

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System Organisation/ Integration

Health System Organization / Integration of Care across Sectors: This cluster incorporates developments which aim at the reconfiguration of health care providers, especially to overcome institutional and sectoral boundaries in order to provide disease management and other forms of integrated care. It is also about steering functions and responsibilities in the organization of the health care system (funding, remuneration, and service delivery).

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Long term care

LTC is about care for the elderly, i.e. nursing and social care, home or institutionalized care, and specific treatment measures (management of multimorbid patients, geriatrics, mental health, gerontopsychiatry) for the age group 60+. Quality management, human resources and competence plans to address a fast growing need in ageing societies should also be addressed here.

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Role Private Sector

This cluster deals with developments which specifically aim at changing (regulating, deregulating) the role of the private sector in funding and/or delivery of health care. Depending on your country, it may be useful to make a distinction between private for-profit and private non-profit health facilities. You may also want to report a development that occurred within the private sector (mergers, concentrations of payers and/or providers, i.e. HMOs/PPOs, health insurances, hospital chains, group practices etc). However, the invention of a break-through technology - should be categorized in the next cluster and not here.

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Pharmaceutical Policy

Drug pricing policy, generic drugs, pharmaceutical research and drug innovations ? Some overlap between this category and others may well exist: more specifically with 10 Private Sector, 3 Quality assurance, and 4 benefit basket / priority setting, 5 access / coverage of insurance plans. However, since pharmaceutical policy often is highly visible, controversial (industry vs. health policy) and heavily interest-loaded at the same time, it is worthwhile having an extra category.

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New Technology

While we are not interested in all new technologies, this cluster has been included to report and assess technological innovations expected to have major impact on effectiveness, quality, costs, or the organization of the system (e.g. genetic testing, chip card, electronic patient records; teleconsulations, etc.).

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Prevention

Prevention comprises all initiatives or policy approaches geared towards primary and secondary prevention, and rehabilitation (immunization, screening, health promotion and education, individual health behaviour, lifestyle, environmental health, health and workplace. In contrast to the public health category, the focus here lies on more though not exclusively on the individual?s responsibility for her/his health status.

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Public Health

Health policy makers are more and more advised by public health experts, replacing the classical advisers from medicine, economics, law or business. The effect of this shift from a single specialists? view to more complex perspective on the health care system is increasinly reflected in public health plans, policy papers with a clear commitment to ?New? Public Health, health as a public good, and the close relationsship of primary care and public health.

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Others

If a health policy development was described that does not fit in any of the clusters, it was added to "others".

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