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Slovakia ranks among the European countries with the lowest efficiency of the health system. If Slovakia will use of its potential to increase efficiency in the health care system, it can according to the OECD findings manage to save up to 2.7% of GDP per year, it is a third of public expenditure in health care. Measuring the health systems effectiveness is becoming a fundamental problem because of its methodological complexity and problems associated with variations in health care systems, infrastructure, market dynamics, epidemiology and demographics. The aim of this article is to assess the technical efficiency of Slovak hospitals at the regional level for the period from 2010 to 2012. Data were used for analyses from the National Health Information Center of the Slovak Republic. Technical efficiency of Slovak hospitals was measured on the basis of data on the number of doctors, nurses and beds, representing the inputs and the number of completed hospitalization procedures and average length of stay in days, representing outputs of hospitals for all regions of Slovakia during 2010-2012. For the analysis we used two different CCR input-oriented DEA models. Based on the results obtained from the analysis was implemented a ranking of regions according to their effectiveness. The conclusion of the article points to the possible solutions of effectiveness in Slovak hospitals, which would help our health sector to move towards performance-better-functioning health care systems in the OECD countries and the EU. [ABSTRACT FROM AUTHOR]

Medicare has seen increased provision of benefits through managed care or private health plans of which the most common is receipt of services through a Health Maintenance Organization. This paper compares racial/ethnic disparities in reported health status between managed care and fee-service Medicare beneficiaries using 2004-2006 data from the National Health Interview Survey (NHIS). The black/white disparity was greater in every analysis among managed care/HMO enrollees than fee-for-service with the largest discrepancy among those who were poor and have diabetes or hypertension. For the Hispanic/white disparity the only analysis the managed care/HMO disparity was greater was among those who were poor and have diabetes or hypertension. Changes made to Medicare in 2003 could entice or force Medicare beneficiaries, especially racial/ethnic minorities to enroll in managed care plans, resulting in negative health consequences and possible increases in racial/ethnic disparities. [ABSTRACT FROM AUTHOR]

This paper examines the impact and perception of the HIPAA Privacy Rule, from the perspective of patients. While a patient-centric focus is rare in the existing literature on HIPAA, such an orientation is important for several reasons: First, patients are ostensibly the primary intended beneficiaries of the HIPAA regulations, and yet we currently know little about how patients have actually been affected. Second, while patients are not full-time participants in most healthcare organizations, patients nonetheless are both influenced by and exert influence upon healthcare organizations and related legal environments. Finally, our evidence suggests that the HIPAA Privacy Rule may act, among other things, as a "symbolic law" with significant unintended consequences stemming from interactions between health care organizations and patients. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Our reliance on an employment based health insurance system in the United States means that those individuals who are disadvantaged in the labor market are also disadvantaged in terms of health insurance coverage. Hispanics in the United States, and especially those of Mexican origin, have historically been disadvantaged in both domains. Throughout the life course, Americans of Mexican origin have lower rates of health insurance coverage than other groups, including African Americans and other Hispanics. Although employment in jobs that do not offer benefits is the major barrier to health care coverage for this population, other factors, including immigration history, citizenship status, and language proficiency play a role. In this paper we examine health insurance coverage among Mexican American pre-retirement age adults and the elderly and compare it to that of blacks and other Hispanic groups. We use data from the 2001 Current Population Survey (CPS) to identify the major sources of health care coverage for young and older adults from the three major Hispanic groups, Mexican Americans, Cuban Americans, and Puerto Ricans and to compare their coverage to that of non-Hispanic blacks and whites. The results clearly reveal that health coverage disadvantages among Hispanic elders represent the continuation of life-long disadvantages that begin in the earliest years of the life course. A very important motivation for such a comparison arises from the fact that given a finite economic pie different age groups necessarily compete for resources. The fact that Mexican Americans, in particular, are at elevated risk of inadequate health care coverage at all ages adds an ethnic dimension to age differences in health care financing. We end with a discussion of policy options for overcoming some of the major barriers to adequate health care coverage for this group and other poor Americans. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Abstract:Patient care is shaped by multiple economic, political, social, and cultural contexts. One such context is the public policies within which medical care takes place, including the Medicaid program, the principle financing mechanism for care of poor patients. Generous eligibility criterion generating high Medicaid enrollment can exacerbate physician reluctance to serve publicly insured patients due to financial and administrative constraints. Using the state of Maine as a case study, this research explores physician attitudes about patient eligibility for Medicaid. In-depth interviews with 28 doctors explored attitudes about the U.S. health care system, with a particular focus on public policies shaping patient care. Qualitative analyses reveal physician frustration with increasing caseloads of Medicaid beneficiaries in Maine, particularly relative to other states. Physicians lament patient behaviors seen as abusing the system, such as securing eligibility through becoming pregnant or relocating to Maine. Moreover, physicians reveal a structuralist orientation in perceiving patient behaviors as originating in state policies rewarding patient transgression. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]