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Health Policy

Mathias Kifmann
Since the 1990s, Germany has introduced a number of competitive elements into its public health care system. Sickness funds were given some freedom to sign selective contracts with providers. Competition between ambulatory care providers and hospitals was introduced for certain diseases and services. As competition has become more intense, the importance of competition law has increased. This paper reviews these areas of competition policy. The problems of introducing competition into a corporatist system are discussed...
November 24, 2016: Health Policy
Sunjay Sharma, Des Bohn, Iphigenia Mikroyiannakis, Joslyn Trowbridge, Donna Thompson, Robert Bell, James Rutka
Neurosurgical emergencies require expedient access to definitive care at neurosurgical centers. Neurosurgical resources in province of Ontario are highly centralized, and subsequently, most patients with neurosurgical emergencies will present to non-neurosurgical centers. From 2000-2010, metrics demonstrated the organization of neurosurgical resources might not be optimal. In response to this a program entitled Provincial Neurosurgery Ontario (PNO)- was formed to address these issues in cooperation with neurosurgeons, hospitals and the provincial government...
November 22, 2016: Health Policy
T Hedenrud, H Håkonsen
Considering the general lack of knowledge on how over-the-counter paracetamol is used combined with the reported increase in paracetamol poisonings after the reregulation of the Swedish pharmacy market in 2009, we aimed to analyze purchase habits and use of paracetamol in Sweden. A further aim was to investigate sources of information about paracetamol. Data were collected in October 2015 through the Citizen Panel, a Web-based panel encompassing over 50,000 Swedes. A stratified sample of 6000 (aged 18 years and older) was emailed a survey invitation...
November 19, 2016: Health Policy
Lena Gunvor Larsson, Siv Bäck-Pettersson, Sven Kylén, Bertil Marklund, Eric Carlström
OBJECTIVES: The aim of this study was to investigate primary care managers' perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient's care needs and plan care interventions together. METHODS: Semi-structured interviews with 18 primary care managers in western Sweden were conducted using Westrin's theoretical cooperation model...
November 19, 2016: Health Policy
Ab Klink, H Christiaan Schakel, Sander Visser, Patrick Jeurissen
We analyze the assessments of recent health reforms by the Congressional Budget Office (CBO) in the United States and the Bureau for Economic Policy Analysis (CPB) in the Netherlands. Both reforms aim to capitalize on productivity gains, which is appealing for policymakers because of the potential for cost savings while maintaining - or enhancing - quality and access. These measures however generally translate into more health care, rather than care that is affordable and appropriate. Scoring agencies therefore have rightfully been reluctant to assign significant savings to these measures...
November 15, 2016: Health Policy
Kristin Farrants, Clare Bambra, Lotta Nylen, Adetayo Kasim, Bo Burström, David Hunter
BACKGROUND: User charges in Swedish healthcare have increased during recent decades. This can be seen in terms of the recommodification of healthcare: making healthcare access more dependent on market position. This study investigates whether the increase in user charges had an impact on educational inequalities in access to healthcare in Sweden between 1980 and 2005. METHODS: Data from the Swedish Living Conditions Survey were used to calculate the odds ratios of access to healthcare for the low and higher educated in Sweden, and the results were stratified by health status (Good and Not good health) for each year 1980-2005...
November 14, 2016: Health Policy
Inger Plaisier, Debbie Verbeek-Oudijk, Mirjam de Klerk
Reforms have recently been introduced in the Dutch care system in order to constrain the rising expenditure on long-term care. In this study we examined changes in community-based care use between 2004 and 2011 and changes in the explanatory effects of its determinants (health, personal and facilitating factors) that may result from these reforms. The study drew on care use registration data linked to data from national health surveys and income data from the tax authorities. Changes in community-based care use determined by health, personal and facilitating factors between 2004 and 2011 were studied...
November 14, 2016: Health Policy
Martin Emmert, Fatemeh Taheri-Zadeh, Benjamin Kolb, Uwe Sander
BACKGROUND: Evidence from the US has demonstrated that hospital report cards might generate confusion for consumers who are searching for a hospital. So far, little is known regarding hospital ranking agreement on German report cards as well as underlying factors creating disagreement. OBJECTIVE: This study examined the consistency of hospital recommendations on German hospital report cards and discussed underlying reasons for differences. METHODS: We compared hospital recommendations for three procedures on four German hospital report cards...
November 14, 2016: Health Policy
Manja Bomhoff, Roland Friele
In health care policies, the right to complain is presented as a key patient right. Complaints are also seen as a potential vehicle for quality improvement. However, in long-term care facilities for older persons in the Netherlands, relatively few complaints are registered. An explorative qualitative study was performed at three long-term care facilities to examine the ways in which different relevant actors define and relate to complaints. We conducted observations and semi-structured interviews with 76 persons: residents, their family members, nurses, volunteers, middle (facility) and upper (institutional) managers and complaint handling personnel...
November 14, 2016: Health Policy
Daan Westra, Gloria Wilbers, Federica Angeli
No abstract text is available yet for this article.
November 8, 2016: Health Policy
Christopher Godfrey Fawsitt, Jane Bourke, Jennifer E Lutomski, Sarah Meaney, Brendan McElroy, Rosemary Murphy, Richard Anthony Greene
Depending on obstetric risk, maternity care may be provided in one of two locations at hospital level: a consultant-led unit (CLU) or a midwifery-led unit (MLU). Care in a MLU is sparsely provided in Ireland, comprising as few as two units out of a total 21 maternity units. Given its potential for greater efficiencies of care and cost-savings for the state, there has been an increased interest to expand MLUs in Ireland. Yet, very little is known about women's preferences for midwifery-led care, and whether they would utilise this service when presented with the choice of delivering in a CLU or MLU...
November 8, 2016: Health Policy
Ilaria Mosca
No abstract text is available yet for this article.
November 8, 2016: Health Policy
Carlo Signorelli, Gaetano Maria Fara, Anna Odone, Antonello Zangrandi
No abstract text is available yet for this article.
October 26, 2016: Health Policy
Krzysztof Piotr Malinowski, Paweł Kawalec, Wojciech Trąbka
The aim of this study was to assess the influence of different factors on the final reimbursement recommendations for drugs in Poland and to identify the correlation between these factors and the probability of a positive reimbursement recommendation for an applicant drug issued by the President of the Agency for Health Technology Assessment and Tariff System (AOTMiT). We analysed all recommendations for the period of 2012-2014 in Poland, three years following the launch of the new Reimbursement Act of Medicines, Foodstuffs Intended for Particular Nutritional Uses and Medical Devices...
October 26, 2016: Health Policy
Julia Abelson, Sara Allin, Michel Grignon, Dianna Pasic, Marjan Walli-Attaei
BACKGROUND: Although a wide range of health system performance indicators are commonly reported on, there has been little effort to establish their relevance to the objectives that health systems actually pursue. OBJECTIVE: The aim of this study was to identify, explore and better understand health policy makers' views regarding the objectives and outcomes for their health systems, how they are prioritized, and the underlying processes that yield them to inform the development of health system efficiency measures...
October 25, 2016: Health Policy
Blake Angell, Jennie Pares, Gavin Mooney
In spite of a substantial literature developing frameworks for policymakers to use in resource allocation decisions in healthcare, there remains limited published work reporting on the implementation or evaluation of such frameworks in practice. This paper presents findings of a targeted survey of 18 leading researchers around the implementation and evaluation of priority-setting exercises. Approximately one third of respondents knew of situations where recommendations of priority-setting exercises had been implemented, one third knew that recommendations had not been implemented and the final third responded that they did not know whether recommendations had been adopted...
October 18, 2016: Health Policy
Karin Dyrstad, Thomas Halvorsen, Karl-Gerhard Hem, Tarald Rohde
Sickness absence represents a substantial cost in most of Western Europe, whether the insurance scheme is public or private. The objective of this study was to analyse whether waiting time for elective treatment in specialist health care is associated with the length of individual sickness absence in Norway. To estimate the association between waiting time and the duration of sick leave, we used data from the working population aged 18-67 years in 2010-2012. The files combined register data from The Norwegian Patient Registry with individual characteristics and sickness absence data from Statistics Norway, and was analysed using zero-truncated negative binomial regression...
October 18, 2016: Health Policy
Jens Wilkens, Hans Thulesius, Ingrid Schmidt, Christina Carlsson
Starting in 2015, the Swedish government has initiated a national reform to standardize cancer patient pathways and thereby eventually speed up treatment of cancer. Cancer care in Sweden is characterized by high survival rates and a generally high quality albeit long waiting times. The objective with the new national program to standardize cancer care pathways is to reduce these waiting times, increase patient satisfaction with cancer care and reduce regional inequalities. A new time-point for measuring the start of a care process is introduced called well-founded suspicion, which is individually designed for each cancer diagnosis...
October 18, 2016: Health Policy
Alain Braillon
No abstract text is available yet for this article.
October 13, 2016: Health Policy
Koen Van den Heede, Carine Van de Voorde
OBJECTIVE: To describe policy interventions that have the objective to reduce ED use and to estimate their effectiveness. METHODS: Narrative review by searching three electronic databases for scientific literature review papers published between 2010 and October 2015. The quality of the included studies was assessed with AMSTAR, and a narrative synthesis of the retrieved papers was applied. RESULTS: Twenty-three included publications described six types of interventions: (1) cost sharing; (2) strengthening primary care; (3) pre-hospital diversion (including telephone triage); (4) coordination; (5) education and self-management support; (6) barriers to access emergency departments...
October 13, 2016: Health Policy
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