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Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as the empowerment of an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit)(More)
In an attempt to limit its health care expenditures, Ontario is, as one option, exploring the possibilities of a capitated system for service delivery payments as opposed to the present mixture of global budgets and fee-for-service. After reviewing the literatures on capitation (primarily American) and on resource allocation (primarily British), the paper(More)
In this paper we consider whether methods currently used to measure utility of health outcomes are consistent with the equity criteria adopted by researchers. We show that unless the chosen equity criterion is incorporated in the design of the measurement instrument, the derived health state utilities are inconsistent with the equity criterion (except under(More)
The main objective of this paper is to determine whether the distribution of hospital service utilization corresponds to the distribution of needs within Canada. This is accomplished by identifying the factors affecting the relationship between the incidence and quantity of hospital services and self-assessed need for such care in Canada. The data were(More)
OBJECTIVES The scaling up of antiretroviral treatment (ART) for HIV-infected adults requires a sizeable investment of resources in the South African public health care system. It is important that these resources are used productively and in ways that reach those in need, irrespective of social status or personal characteristics. In this study we evaluate(More)
INTRODUCTION South Africa has the world's largest antiretroviral treatment (ART) programme. While services in the public sector are free at the point of use, little is known about overall access barriers. This paper explores these barriers from the perspective of ART users enrolled in services in two rural and two urban settings. METHODS Using a(More)
BACKGROUND Many jurisdictions have used public funding of health care to reduce or remove price at the point of delivery of services. Whilst this reduces an important barrier to accessing care, it does nothing to discriminate between groups considered to have greater or fewer needs. In this paper, we consider whether active targeted recruitment, in addition(More)
OBJECTIVE To evaluate preferences among ethnically diverse women for the management of a low-grade abnormal Pap smear result: early colposcopy or observation with repeat Pap smears. STUDY DESIGN Structured interviews were conducted with 170 women of diverse ethnic backgrounds to assess their preferences. Trained personnel conducted standardized(More)
OBJECTIVE To evaluate trials of acupuncture for osteoarthritis (OA) of the knee, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects, to identify patient or treatment characteristics associated with positive response, and to identify areas of future(More)