The relationship between medicine and public health has a long and complex co-evolution. In developing countries where the health needs are greatest and resources are few, this relationship is of critical importance.This paper provides a case study of the development of the relationship between medical and public health at the Aga Khan University (AKU), a leading educational institution in Pakistan, which was founded with a vision of reuniting medicine and public health. Rapid growth and development have led to successful medicine and public health programs, but have fallen short in creating the synergies needed to address the population health problems of the country.In a twenty-five year history of strong growth and development, the AKU has recreated the schism that marked US institutional development in the 20th century, despite strategic consideration to address population health in the design of the University. We recommend the creation of public health schools that focus on leadership to renew an emphasis on unifying health concepts and actions following successful examples to bring medicine and public health together.
DOI: http://dx.doi.org/10.5915/18-1-11731 Prospective Paymem System DRGs are designed to limit the amount of payment to a hospital for any particular diagnosis, and the Peer Review Organizations are to police hospital activities. In every state, there is a PRO having a contract with the Health Care Financing Administration to perform the following junctions:(1) Review of reasonableness, necessity, and appropriateness of hospital admissions. (2) Validation of diagnosis for determination of Medicare reimbursement. (3) Review of completeness and quality of care provided. (4) Review of completeness and appropriateness of outlier cases.Getting a patient admitted to the hospital isn't as easy as it used to be, and it is going to become increasingly difficult. For a physician, it all adds up to another level of interference with which we haven't had to deal before.The overall PRO program, including preadmission certification and the retrospective review process, is discussed in this article. The focus is on recommendations for physicians of "How to survive under the Prospective Payment System and the PRO program."
This dialogue, which occurred in Atlanta in 2001 among respected international authorities in health care and corrections, addresses care for terminally ill offenders within the broader context of public health, correctional, and cultural issues. Grappling with how to provide appropriate and adequate services for the terminally ill in custody, it compares and contrasts the public health and correctional strategies of two nations–the United States and Canada–in their approaches to end-of-life care for individuals in North American correctional institutions. Dr. O’Neill moderated.
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