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Many individuals are concurrently eligible for multiple sources of government-reimbursed health care services (e.g. Department of Veterans Affairs (VA) and Medicare). Unclear is whether combined eligibility translates into increased access to care and/or improved outcomes of care. Alternatively continuity of care may suffer, promoting health inequalities when patients receive health services from multiple unrelated sources of care. The current study examines the impact of dual eligibility for government-reimbursed care on long-term outcomes of care for a population of veterans diagnosed with colorectal cancer and initially treated surgically at Department of Veterans Affairs Medical Centers.

Misinterpretation of a negative test results in health screening may initiate less preventive effort and more future lifestyle-related disease. We predict that misinterpretation occurs more frequently among individuals with a low level of education compared with individuals with a high level of education.

The empirical analyses are based on unique data from a randomized controlled screening experiment in Norway, NORCCAP (NORwegian Colorectal Cancer Prevention). The dataset consists of approximately 50,000 individuals, of whom 21,000 were invited to participate in a once only screening with sigmoidoscopy. For all individuals, we also have information on outpatient consultations and inpatient stays and education. The result of health behaviour is mainly measured by lifestyle-related diseases, such as COPD, hypertension and diabetes type 2, identified by ICD-10 codes.

The results according to intention-to-treat indicate that screening does not increase the occurrence of lifestyle related diseases among individuals with a high level of education, while there is an increase for individuals with low levels of education. These results are supported by the further analyses among individuals with a negative screening test.

This chapter presents a framework for an action research based intervention to develop and transform sustainable healthcare in a regional context. The framework is illustrated by the case of the Regional Cancer Centre (RCC) West in western Sweden.

The framework draws upon and develops Pettigrew’s context–content–process model of strategic change and applies it to the unfolding narrative of the change effort. The empirical focus is the activities of a learning platform consisting of the RCC leadership, senior cancer physicians designated as process owners and an action research team. Data were collected from documents, observations of the learning platform, notes from meetings and interviews. Outcome data were obtained via the self-reporting of the physicians.

The learning platform established the capability for wide ranging development and quality improvement on the 23 cancer pathways as well as some support activities around principles of patient-centred care. A clear result is greater inter-organisational collaboration between care professionals as well as the introduction of new medicines, clinical methods, joint learning activities and new forms of measurement and monitoring of care practices. All of the improved measures are sustained.

Whilst there is no shortage of rhetoric on patient-centred care, the reality is that in complex healthcare systems solutions such as process-oriented approaches often fail. This case presents a model and an approach that eschews clear visions for change and instead places an emphasis on dialogue, participation, professional autonomy and collaborative communities as means for achieving the patient-centred ideal. The case also shows the value of seeing sustainable health systems as being grounded on practitioner–scholar collaboration that combines practical knowing with scientific knowledge.

Purpose – Women are more susceptible to specific health risks such as breast cancer, cervical cancer, and risk during pregnancy and childbirth. These can affect women’s well-being and also need to be managed to avoid financial loss. Takaful operators in Malaysia have been offering special takaful products for women. Women can mitigate exposure to these risks through insurance. This study examines the risks faced by Malaysian women and the coverage they are offered by Islamic insurance.

Methodology/approach – The study used a qualitative methodology involving documentary evidence and interviews with four Islamic insurance agents and four product development officers from four Islamic insurance providers in Malaysia.

Findings – Among the risks faced by women are female-specific illnesses, the cost of expensive treatments, crime-related accidents or loss, social or career risks and privatisation policy. Due to these risks, women are in need of female-specific takaful products to reduce risk and protect themselves.

Originality/value – Specific takaful products for women are crucial to protect them from risks, improving their well-being and increasing their participation in the nation’s economic and social development.

While Americans have often believed that the United States has the best health care system in the world and that, as one of the wealthiest nations, we therefore must have the best health care available to our citizens, researchers in medical sociology, public health and health services research have emphasized for decades that America tolerates extremes of wealth and poverty much greater than in many European countries. This toleration of extremes extends to the approach to the delivery of social and health services, as well as to consumer goods. Over 40 million Americans do not have health insurance and thus have limited access to expensive health care services (Morone & Jacobs, 2005b). Even more may have very poor health coverage, so that if a serious illness were to occur, the person would have a very hard time finding care and paying for that care. Even if people have coverage for major health care problems, many people do not have insurance that covers areas of health care such as vision care, dental care and audiology services. While these are not life threatening health care concerns, they are health care concerns that impact quality of life and even ability to achieve. A child who cannot see well has trouble succeeding in school. A person in pain from tooth problems has trouble concentrating on tasks, and poor oral health is one contributor to nutrition concerns among the elderly. Lack of access to hearing aids increases the social isolation of the elderly, but these services are not covered by Medicare, the federal program that does provide access to health care services for most of the elderly in the United States.

This chapter seeks to investigate the journey of breast and bowel cancer patients at the HMC Antoniushove. It zooms in on specific touch points and the possibilities for improvements. Furthermore, it elucidates the learning process and more particular the dissemination between the hospital (staff and medical students) and hospitality students and professionals and emphasizes that looking from different perspectives and various disciplines is beneficial for all the stakeholders involved in hospitals.

Diseases are increasingly chronic; patients are more demanding and competition between different hospitals is increasing. That is why, in addition to excellent medical treatment, excellent service (referred to here as hospitality) is becoming increasingly important in the healthcare sector, including in hospitals. What does it have to meet? What do patients appreciate, what needs to be improved and how can these improvements be designed and implemented with the involvement of both patients and hospital staff?

Medical and hospitality students collaborated in this project analysing and describing the journey of patients with breast and bowel cancer. They examined the patient journey and elucidated the touch points, which patients indicated as critical during their ‘journey’.

Most important finding resulted from the learning process of this collaboration and the insight gained, a greater awareness and understanding of the non-medical needs and wishes, i.e. hospitality, of patients. Furthermore, the mutual understanding between the evidence-based stance of thinking of medical students and hospital staff at the one side and the more on soft skills–focused attitude of hospitality students on the other hand increased.

This chapter develops a productivity analysis of the New Jersey PPO Health Insurance Industry for 2018. The chapter concerns five New Jersey PPO insurance companies. The two output variables are claims paid and loss ratio. The two input variables include premiums collected and assets.

This chapter summarises the role of EU actions in supporting healthcare policies in the EU Member States, both looking at implemented actions and describing current priorities for the future. It argues that these coordinated actions can be beneficial for EU Member States by helping them to avoid duplication of effort and to attain economies of scale. Moreover, data sharing with proper safeguards can unleash vast amount of ‘learning what works’ both for medical treatments and for healthcare sustainability measures. The need for this common learning appears ever more urgent while facing the health and economic consequences of the present pandemic.

Erica S. Breslau, Ph.D., M.P.H. is a scientific program director in the Applied Cancer Screening Research Branch, in the Behavioral Research Program within the Division of Cancer Control and Population Sciences at the National Cancer Institute. Dr. Breslau’s research interests focus on women’s oncology issues in general, and specifically as they pertain to the social, behavioral, and psychological influences associated with breast, gynecological and colorectal cancer screening. Recent efforts include ensuring that research is able to inform and improve the quality of health services among women disproportionately affected with breast and cervical cancer through the dissemination of evidence-based intervention approaches. She has conducted population-based research in the area of infectious diseases, including HIV/AIDS and sexually transmitted diseases in military populations, and has implemented large-scale health promotion approaches to improve the adoption of prevention practices. Dr. Breslau received her Ph.D. in Public Health from The Johns Hopkins Bloomberg School of Public Health, and her Master’s in Public Health from Tulane University, School of Public Health and Tropical Medicine.Vasilikie Demos is a Professor of Sociology at the University of Minnesota-Morris. She has studied ethnicity and gender in the United States and is currently completing a monograph on her study of Kytherian Greek women based on interviews in Greece and among immigrants in the United States and Australia. With Marcia Texler Segal, she is co-editor of the Advances in Gender Research series and Ethnic Women: A Multiple Status Reality (General Hall, 1994). She is a past president of Sociologists for Women in Society and of the North Central Sociological Association, and has been an Honorary Visiting Professor at the University of New South Wales in Australia.Heather Hartley is an Assistant Professor of Sociology at Portland State University. Dr. Hartley’s research interests include the sociology of health and medicine, the sociology of gender, the sociology of sexualities, and political sociology. Within these general specialty areas, her work focuses on the politics of women’s health, the pharmaceutical industry and the changing distribution of power within the health care system.Beth E. Jackson is a Doctoral Student in Sociology at York University in Toronto, Canada. Drawing on the traditions of feminist epistemologies and critical social studies of science, her dissertation research puts questions of epistemic authority and the nature of evidence into the specific context of public health and epidemiology. Specifically, she explores the conditions, contexts, tools and processes through which public health knowledge claims are made, by focusing on a particular technology of “population health” i.e. the National Population Health Survey (NPHS) (a longitudinal, biennial survey of the mental and physical health of Canadians and their use of health care services). Her research also speaks to policy implications of “situated” data and evidence – in this case, the implications of how “women’s health” is defined, and the extent to which a gendered analysis of health is considered in the construction and analysis of the NPHS.Jennie Jacobs Kronenfeld is a Professor in the Department of Sociology, Arizona State University. She conducts research in the areas of health policy, health across the life course, health behavior including preventive health behavior, and research into AIDS in geographically mobile populations. She has recently authored Health Care Policy: Issues and Trends (Praeger, 2002). She has conducted research in a variety of topics related to child health, including recruitment into CHIP (child health insurance program) and has published a book on the impact of school based health clinics, Schools and the Health of Children (Sage, 2000). She is a past president of Sociologists for Women in Society and past chair of the Medical Sociology Section of the American Sociological Association.Nancy Luke is an Assistant Professor of Research in the Population Studies and Training Center at Brown University and a Research Fellow in the Center for Population and Development Studies at Harvard University. Her primary research interest is the impact of social organization on health and well-being, particularly among women and adolescents. She is presently co-Principal Investigator of two research projects, both of which include collection of household survey and ethnographic data. A project in Kenya studies the influence of marriage and economic transactions on sexual behavior in an area of high HIV/AIDS prevalence, and a project in India examines women’s empowerment in a context where norms sanction intimate partner violence. She has also collaborated with numerous non-governmental organizations on research projects pertaining to reproductive health and gender equity in developing countries. Dr. Luke has a Ph.D. in Demography and Sociology from the University of Pennsylvania and an M.A. from Johns Hopkins School of Advanced International Studies.Deborah Parra-Medina, Ph.D., M.P.H., is Assistant Professor at the University of South Carolina with joint appointments in the Department of Health Promotion, Education and Behavior (HPEB) and Women’s Studies. She received her Ph.D. in Epidemiology at the UC San Diego, an M.P.H. in Health Promotion at San Diego State University and a B.A. in Social Science at UC Berkeley. She has extensive experience working with under-served communities, having worked in several chronic disease prevention and control efforts including cancer screening, tobacco control, weight loss and nutrition. Her research based on a participatory action model emphasizes the intersections of race, class and gender and the influence of socio-cultural environment on adaptive and maladaptive health behaviors. This perspective is exemplified in her current research. She is Principle Investigator of the SC American Legacy Empowerment (SCALE) Evaluation Project that is examining how to effectively engage youth as agents for social change within the context of tobacco prevention and control. Dr. Parra-Medina was recently awarded a pilot study grant from NCI, the broad goal of this project is to foster individual and organizational empowerment among the emerging Hispanic population in South Carolina in relation to cancer prevention and health promotion through the development of the South Carolina Hispanic Health Coalition: Partnership for Cancer Prevention (PCP).Colleen Reid recently completed her Ph.D. in Interdisciplinary Studies in health promotion research at the University of British Columbia in Vancouver, Canada. Her doctoral dissertation was a feminist action research project with a group of women on low income. Together they examined the relationship between exclusion and health, the women’s varied discourses of poverty and health, and the promises and challenges of engaging in feminist action research. Dr. Reid has also been involved in community health research projects with organizations including the Vancouver YWCA, AIDS Vancouver, Literacy B.C., and the B.C. Centre of Excellence for Women’s Health.Elianne Riska is von Willebrand-Fahlbeck Professor of Sociology at Åbo Akademi University, Finland since 1985. She has been Chairperson of the Department of Sociology 1985–1997 and Director of the Institute of Women’s Studies at Åbo Akademi University 1986–1993. Elianne Riska received her Ph.D. in Sociology at the State University of New York at Stony Brook in 1974. She was an Assistant Professor and an Associate Professor of Sociology in the Department of Sociology and College of Human Medicine at Michigan State University from 1974 to 1981. She was Academy Professor of the Academy of Finland 1997–2002. She is currently the President of the Research Committee of the Sociology of Health (RC15) of the International Sociological Association (2002–2006). Her most recent books are Gender, Work and Medicine (Sage, 1993), Gendered Moods (Routledge, 1995) and Medical Careers and Feminist Agendas: American, Scandinavian, and Russian Women Physicians (Aldine de Gruyter, 2001).Marcia Texler Segal is Associate Vice-Chancellor for Academic Affairs, Dean for Research and a Professor of Sociology at Indiana University Southeast. Her research and consulting focus on education and on women in Sub-Saharan Africa and on ethnic women in the United States. With Vasilikie Demos, she is co-editor of the Advances in Gender Research series and Ethnic Women: A Multiple Status Reality (General Hall, 1994). She is a past president of the North Central Sociological Association and past chair of the American Sociological Association Sections on Sex and Gender and Race, Gender and Class.Lynn Weber is a Director of the Women’s Studies Program and Professor of Sociology at the University of South Carolina. For the 2002–2003 year, she is Visiting Professor in the Consortium for Research on Race, Gender, and Ethnicity and the Department of Women’s Studies at the University of Maryland. Her research and teaching explore the intersections of race, class, gender, and sexuality particularly as they are manifest in women’s health, in the process of upward social mobility and work, and in the creation of an inclusive classroom environment. In 2001 and 2002, she published two books, Understanding Race, Class, Gender, and Sexuality: A Conceptual Framework and Understanding Race, Class, Gender, and Sexuality: Case Studies (NY: McGraw-Hill) which are intended to move the field of intersectional scholarship ahead by serving as a guide to facilitate intersectional analyses and to foster more integrative thinking in the classroom. Dr. Weber is also co-author of The American Perception of Class.