1st Edition

Healthcare Systems
Future Predictions for Global Care

ISBN 9781138052604
Published May 15, 2018 by CRC Press
600 Pages 107 B/W Illustrations

USD $180.00

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Book Description

In this book, we invited 146 authors with expertise in health policy, systems design, management, research, or practice, from each of the countries included, to consider health reforms or systems improvements in their country or region. The resulting case studies, of 52 individual countries and five regional groupings, cover 152 countries or territories, or three-quarters of the world’s nations. Each chapter author was asked to think 5–15 years into the future and make a prediction on how their health system could be strengthened as a result of the successful unfolding of their case study.

The types of projects our authors have chosen to explicate into the future are wide-ranging. They vary from e-consultation services in Estonia, achieving universal health coverage in Argentina and Mexico, reforming long-term care in the Netherlands, reassessing care for the aging population and the frail elderly in Australia, streamlining the health system through Lean Thinking in Nigeria, using regulation to improve care in South Africa, developing a new accreditation model in Turkey, through to a critique of physician specialization in Russia and applying IT initiatives to improve care in China, Lebanon, Taiwan, Papua New Guinea, the United Arab Emirates, Venezuela and Wales.

Chapter writers recognized that the improvement work they were doing was part of a moving target. There was general agreement that the effective use of limited resources and overcoming hurdles and constraints were crucial to enhancing health systems in order to deliver better care over the medium term. While some initiatives required considerable funding, many were relatively inexpensive. These case studies demonstrate ways in which fruitful application of partnerships and creativity can make considerable gains in strengthening healthcare delivery systems.


  • The third book in a series on international health reform
  • Involves 146 contributing authors, five regional editors, a series editor and a highly skilled support team to explore sustainable improvement in health systems in the future
  • Encompasses a time horizon of the next 5–15 years
  • Covers 152 countries or territories, with 52 individual countries and an analysis of five regional groupings comprising 100 countries

Table of Contents




About the Editors

About the Contributors



Jeffrey Braithwaite, Russell Mannion, Yukihiro Matsuyama, Paul

G. Shekelle, Stuart Whittaker, Samir Al-Adawi, Kristiana Ludlow, and

Wendy James

Part I The Americas

Paul G. Shekelle

1 Argentina: Achieving Universal Coverage

Hugo Arce, Ezequiel García-Elorrio, and Viviana Rodríguez

2 Brazil: Patient Safety: Distance-Learning Contribution

Walter Mendes, Ana Luiza Pavão, Victor Grabois, and Margareth

Crisóstomo Portela

3 Canada: The Future of Health Systems: Personalization

Anne W. Snowdon, Charles Alessi, John Van Aerde, and Karin Schnarr

4 Chile: The Struggle for an Integrated Health Insurance System

Oscar Arteaga

5 Guyana: Paradigm Shift: From Institutional Care to

Community-Based Mental Health Services

William Adu-Krow, Vasha Elizabeth Bachan, Jorge J. Rodríguez Sánchez,

Ganesh Tatkan, and Paul Edwards

6 Mexico: Leveraging Conditional Cash Transfers and Universal

Health Coverage to Tackle Non-Communicable Diseases

Jafet Arrieta, Enrique Valdespino, and Mercedes Aguerrebere

7 Trinidad and Tobago: Nurse Training: A Competency-Based


Claudine Richardson-Sheppard

vi Contents

8 The United States of America: The U.S. Healthcare System: A

Vision for the Future

Robert H. Brook and Mary E. Vaiana

9 Venezuela: Learning from Failure and Leveraging Technology:

Innovations for Better Care

Pedro Delgado, Luis Azpurua, and Tomás J. Sanabria

Part II Africa

Stuart Whittaker

10 Namibia: Lessons from Patient Involvement in HIV Care: A

Paradigm for Patient Activation and Involvement across Health


Bruce Agins, Joshua Bardfield, Margaret K. Brown, Daniel Tietz, Apollo

Basenero, Christine S. Gordon, Ndapewa Hamunime, and Julie Taleni Neidel

11 Nigeria: Doing More with Less: Lean Thinking in the Health


Emmanuel Aiyenigba

12 South Africa: Regulated Standards: Implementation and


Stuart Whittaker, Lizo Mazwai, Grace Labadarios, and Bafana Msibi

13 Rwanda: Embracing One Health as a Strategy to Emerging

Infectious Diseases Prevention and Control

Roger Bayingana and Edward Chappy

14 Africa: Equity for All: A Global Health Perspective for the


Jacqui Stewart and Shivani Ranchod

Part III Europe

Russell Mannion

15 Austria: Primary Healthcare Centers: A Silver Bullet?

Maria M. Hofmarcher, Susanne Mayer, Nataša Perić, and Thomas E. Dorner

16 Denmark: Patient-Reported Outcomes: Putting the Patient First

Liv Dørflinger, Jesper Eriksen, Janne Lehmann Knudsen, and Carsten Engel

Contents vii

17 England: Getting Personal? Personal Health Budgets

Martin Powell and Russell Mannion

18 Estonia: e-Consultation Services: Cooperation between Family

Doctors and Hospital Specialists

Ruth Kalda, Kaja Põlluste, and Margus Lember

19 Finland: A Real-Life Experiment in Precision Medicine

Persephone Doupi

20 France: Horizon 2030: Adopting a Global-Local Approach to

Patient Safety

Catherine Grenier, René Amalberti, Laetitia May-Michelangeli, and

Anne-Marie Armanteras-de-Saxcé

21 Germany: Health Services Research and Future Planning in

Pediatric Care

Wolfgang Hoffmann, Angelika Beyer, Holger Pfaff, and Neeltje van den Berg

22 Greenland: Everyday Life with Chronic Illness: Developing a

Democratic and Culture-Sensitive Healthcare Practice

Tine Aagaard and Lise Hounsgaard

23 Italy: The Introduction of New Medical Devices in an Era of

Economic Constraints

Americo Cicchetti, Valentina Iacopino, Silvia Coretti, and Marcella Marletta

24 Malta: The National Cancer Plan: Strengthening the System

Sandra C. Buttigieg, Kenneth Grech, and Natasha Azzopardi-Muscat

25 The Netherlands: Reform of Long-Term Care

Madelon Kroneman, Cordula Wagner, and Roland Bal

26 Northern Ireland: Developing a Framework to Support

Building Improvement Capacity across a System

Gavin Lavery, Cathy McCusker, and Charlotte McArdle

27 Norway: Bridging the Gap: Opportunities for Hospital Clinical

Ethics Committees in National Priority Setting

Ånen Ringard and Ellen Tveter Deilkås

28 Portugal: Prevention of Antimicrobial Resistance through

Antimicrobial Stewardship: A Nationwide Approach

José-Artur Paiva, Paulo André Fernandes, and Paulo Sousa

viii Contents

29 Russia: The Future of Physicians’ Specialization

Vasiliy V. Vlassov and Mark Swaim

30 Scotland: Deliberative Engagement: Giving Citizen

Involvement Meaning and Impact

Richard Norris, Andrew Thompson, and David R. Steel

31 Spain: How Can Patient Involvement and a Person-Centered

Approach Improve Quality in Healthcare? The Patients’

University and Other Lessons from Spain

Laura Fernández-Maldonado, Sergi Blancafort Alias, Marta Ballester

Santiago, Lilisbeth Perestelo-Pérez, and Antoni Salvà Casanovas

32 Sweden: The Learning Health System

John Øvretveit and Camilla Björk

33 Switzerland: Teamwork and Simulation

Anthony Staines and Adriana Degiorgi

34 Turkey: Moving Quality in Healthcare Beyond Hospitals: The

Turkish Accreditation Model

Mustafa Berktaş and İbrahim H. Kayral

35 Wales: Realizing a Data-Driven Healthcare Improvement

Agenda: A Manifesto for World-Class Patient Safety

Andrew Carson-Stevens, Jamie Hayes, Andrew Evans, and Sir Liam Donaldson

36 Central and Eastern Europe: Strengthening Community-Based

Family Care and Improving Health Equities

Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Russell Mannion

37 Central Asia: From Russia with Love: Health Reform in the

Stans of Central Asia

Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Yukihiro Matsuyama

Part IV Eastern Mediterranean

Samir Al-Adawi

38 Iran: Hospital Accreditation: Future Directions

Ali Mohammad Mosadeghrad

39 Jordan: Improving Quality of Care by Developing a National

Human Resources for Health Strategy

Reem Al-Ajlouni and Edward Chappy

Contents ix

40 Lebanon: m-Health for Healthcare Delivery Reform: Prospects

for Lebanese and Refugee Communities

Nasser Yassin, Rawya Khodor, and Maysa Baroud

41 Oman: Paradigm Change: Healthy Villages to Meet Tomorrow’s

Health Needs

Ahmed Al-Mandhari, Huda Alsiyabi, Samia Al Rabhi, Sara S. H.

Al-Adawi, and Samir Al-Adawi

42 Pakistan: The Way Forward

Syed Shahabuddin and Usman Iqbal

43 Qatar: Hospice Palliative Care

Yousuf Al Maslamani, Noora Alkaabi, and Nagah Abdelaziz Selim

44 The United Arab Emirates: Improving Healthcare through a

National Unified Medical Record

Subashnie Devkaran

45 Yemen: Integrating Public Health and Primary Care: A Strategy

for the Health System of the Future

Khaled Al-Surimi

46 Middle East and North Africa (MENA): Health Systems in


Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Subashnie Devkaran

Part V South-East Asia and the Western Pacific

Jeffrey Braithwaite and Yukihiro Matsuyama

47 Australia: The Silver Tsunami: The Impact of the Aging

Population on Healthcare

Ken Hillman, Fakhri Athari, Steven Frost, and Jeffrey Braithwaite

48 China: Integrated Stratified Healthcare System

Hao Zheng

49 Hong Kong: Integrated Health Services: A Person-Centered


Eliza Lai-Yi Wong, Hong Fung, Patsy Yuen-Kwan Chau, and Eng-Kiong Yeoh

50 India: How to Build a First-World Health System on a Third-

World Budget

Girdhar Gyani

x Contents

51 Japan: Toward a Community-Friendly Dementia Strategy

Yukihiro Matsuyama

52 Malaysia: The Future Malaysian Antenatal Care System:

Building upon the Old

Ravindran Jegasothy and Ravichandran Jeganathan

53 Mongolia: Health System Financing

Tumurbat Byamba and Tsolmongerel Tsilaajav

54 New Zealand: Strengthening Primary Healthcare

Jacqueline Cumming

55 Papua New Guinea: Strengthening the Collection, Analysis,

and Use of Health Data through eHealth Solutions

Paulinus Lingani Ncube Sikosana

56 Taiwan: "My Data, My Decision": Taiwan’s Health

Improvement Journey from Big Data to Open Data

Yu-Chuan (Jack) Li, Wui-Chiang Lee, Min-Huei (Marc) Hsu, and

Usman Iqbal

57 South-East Asia: Taming Communicable Diseases

Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Yukihiro Matsuyama

Discussion and Conclusion

Jeffrey Braithwaite, Russell Mannion, Yukihiro Matsuyama, Paul

G. Shekelle, Stuart Whittaker, Samir Al-Adawi, Kristiana Ludlow,

Wendy James, and Elise McPherson



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Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FAIM, FCHSM, FFPHRCP (UK), FAcSS (UK), Hon FRACMA, FAHMS is foundation director, Australian Institute of Health Innovation, director, Centre for Healthcare Resilience and Implementation Science, and professor of health systems research, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. He has appointments at six other universities internationally, is a board member and is President Elect of the International Society for Quality in Health Care (ISQua) and a member of the World Health Organization Global Patient Safety Network. His research examines the changing nature of health systems, attracting funding of more than AU$108 million (US$80.6 million). He is interested in healthcare as a resilient system, and applying complexity science to healthcare problems. In addition to this, he is interested in the Anthropocene and the impact of human activity on human and species’ health, population, and climate. Professor Braithwaite has contributed over 870 publications, presented at or chaired international and national conferences, workshops, symposia, and meetings on more than 900 occasions, including over 80 keynote addresses. His research appears in outlets such as The BMJ, The Lancet, Social Science & Medicine, BMJ Quality & Safety, and the International Journal of Quality in Health Care. He has received 39 different national and international awards for his teaching and research. Further details are available at his Wikipedia entry: http://en.wikipedia.org/wiki/Jeffrey_Braithwaite

Russell Mannion, BA (Hons), PG Dip Health Econ, PhD, FRSA, FAcSS, has over 30 years experience in health care research. He is Chair in Health Systems, University of Birmingham, Visiting Professor at the Australian Institute of Health Innovation, Macquarie University, and Visiting Professor in the Faculty of Medicine, University of Oslo. He was previously Director of the Centre for Health and Public Services Management, University of York, and Board Director of the York Health Economics Consortium. He provides expert advice to various health agencies including WHO, OECD, European Health Management Association and UK Department of Health. He has authored or edited 10 books and around 200 peer-reviewed publications, many in leading scientific journals including The BMJ, The Lancet and The Milbank Quarterly. He is associate editor on the editorial board of four international health policy journals and has garnered several international prizes for his research including the Baxter European Book Award.

Yukihiro Matsuyama, PhD, is Research Director, the Canon Institute for Global Studies, Affiliate Professor, Chiba University of Commerce and Honorary Professor, the Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences at Macquarie University. His research examines the sustainability of safety-net systems in Japan including healthcare, pension, pandemic crisis and employment through international comparative analyses. He has served on government committees including as a member of the Welfare Committee. He has published many books including Healthcare Economics in the United States (1990), which introduced the theoretical concept of DRG/PPS and Managed Care into Japan for the first time, AIDS War: Warning to Japan (1992), Health Reform in the United States (1994), Break Through of Japan痴 Economy under Half-Population (2002), Healthcare Reform and Integrated Healthcare Network, as a co-author of: Keiko Kono (2005), Health Reform and Economic Growth (2010) and Depth of Healthcare Reform (2015).

Paul  G. Shekelle is a staff physician at the West Los Angeles Veterans Affairs Medical Center, and is a professor of medicine at the University of California, Los Angeles (UCLA) School of Medicine. He is widely recognized in the field of guidelines, quality measurement, and evidence-based medicine. In 1996-1997, he spent a year in England as Atlantic Fellow in Public Policy. He is a past chair of the Clinical Guidelines Committee of the American College of Physicians (ACP).

Stuart Whittaker, BSc, MBChB, FFCH (CM), MMed, MD, founder and former Chief Executive Officer of the Council for Health Service Accreditation of Southern Africa. He pioneered the concepts of a facilitated accreditation programme and graded recognition to assist disadvantaged hospitals in Southern Africa and other developing countries to comply with professional standards. He has presented at numerous international and national conferences. As a temporary consultant to the World Health Organisation (WHO) he participated in projects to assess the impact of accreditation on national health systems and choosing Quality Approaches in Health Systems. He was appointed by the Minister of Health of South Africa in 2013, and re-appointed in 2017, to serve on the Board of Directors for the Office of Health Standards Compliance (OHSC) in South Africa. He is a Visiting Professor at the School of Public Health and Medicine at the Faculty of Health Sciences, University of Cape Town. 

Samir Al-Adawi is a Professor of Behavioral Medicine at the College of Medicine, Sultan Qaboos University, Oman. Previously, he was a Fulbright Senior Scholar at the Department of Physical Medicine and Rehabilitation, Harvard Medical School, US, and a research scientist sponsored by Matsumae International Foundation at the Department of Psychosomatic Medicine, Graduate School of Medicine, University of Tokyo, Japan. His doctorate training was at the Institute of Psychiatry, King’s College, UK. Dr. Al-Adawi has research interests that focus on non-communicable diseases. His research and publications have specifically focused on psychosocial determinants of health and ill health. Dr. Al-Adawi is a member of the World Health Organization (WHO) Expert Consultation Group on Feeding and Eating Disorders, reporting to the International Advisory Group for the Revision of International Classification of Diseases (ICD-10) for Mental and Behavioural Disorders.