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Health Policy

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https://www.readbyqxmd.com/read/28314467/association-between-copayment-medication-adherence-and-outcomes-in-the-management-of-patients-with-diabetes-and-heart-failure
#1
REVIEW
George Gourzoulidis, Georgia Kourlaba, Panagiotis Stafylas, Gregory Giamouzis, John Parissis, Nikolaos Maniadakis
OBJECTIVE: To determine the association between copayment, medication adherence and outcomes in patients with Heart failure (HF) and Diabetes Mellitus (DM). METHODS: PubMed, Scopus and Cochrane databases were searched using combinations of four sets of key words for: drug cost sharing; resource use, health and economic outcomes; medication adherence; and chronic disease. RESULTS: Thirty eight studies were included in the review. Concerning the direct effect of copayment changes on outcomes, the scarcity and diversity of data, does not allow us to reach a clear conclusion, although there is some evidence indicating that higher copayments may result in poorer health and economic outcomes...
February 28, 2017: Health Policy
https://www.readbyqxmd.com/read/28318606/on-the-role-of-environmental-corruption-in-healthcare-infrastructures-an-empirical-assessment-for-italy-using-dea-with-truncated-regression-approach
#2
Marina Cavalieri, Calogero Guccio, Ilde Rizzo
OBJECTIVES: This paper investigates empirically whether the institutional features of the contracting authority as well as the level of 'environmental' corruption in the area where the work is localised affect the efficient execution of public contracts for healthcare infrastructures. METHODS: A two-stage Data Envelopment Analysis (DEA) is carried out based on a sample of Italian public contracts for healthcare infrastructures during the period 2000-2005. First, a smoothed bootstrapped DEA estimator is used to assess the relative efficiency in the implementation of each single infrastructure contract...
February 27, 2017: Health Policy
https://www.readbyqxmd.com/read/28237388/using-administrative-data-to-look-at-changes-in-the-level-and-distribution-of-out-of-pocket-medical-expenditure-an-example-using-medicare-data-from-australia
#3
Xinyang Hua, Guido Erreygers, John Chalmers, Tracey-Lea Laba, Philip Clarke
OBJECTIVES: Australia's universal health insurance system Medicare generates very large amounts of data on out-of-pocket expenditure (OOPE), but only highly aggregated statistics are routinely published. Our primary purpose is to develop indices from the Medicare administrative data to quantify changes in the level and distribution of OOPE on out-of-hospital medical services over time. METHODS: Data were obtained from the Australian Hypertension and Absolute Risk Study, which involved patients aged 55 years and over (n=2653)...
February 22, 2017: Health Policy
https://www.readbyqxmd.com/read/28259501/the-role-costs-and-value-for-money-of-external-consultancies-in-the-health-sector-a-study-of-new-zealand-s-district-health-boards
#4
Erin Penno, Robin Gauld
Public spending on external consultancies, particularly within the health sector, is highly controversial in many countries. Yet, despite the apparently large sums of money involved, there is little international analysis surrounding the scope of activities of consultants, meaning there is little understanding of how much is spent, for what purpose and with what result. This paper examines spending on external consultancies in each of New Zealand's 20 District Health Boards (DHB). Using evidence obtained from DHBs, it provides an insight into the cost and activities of consultants within the New Zealand health sector, the policies behind their engagement and the processes in place to ensure value for money...
February 21, 2017: Health Policy
https://www.readbyqxmd.com/read/28238451/public-reaction-to-the-uk-government-strategy-on-childhood-obesity-in-england-a-qualitative-and-quantitative-summary-of-online-reaction-to-media-reports
#5
Rebecca Gregg, Ajay Patel, Sumaiya Patel, Laura O'Connor
This work aimed to summarise public real-time reaction to the publication of the UK government childhood obesity strategy by applying a novel research design method. We used a netnographic technique to carry out thematic analysis of user-generated comments to online newspaper articles related to the strategy. We examined likes/dislikes associated with comments as a proxy of agreement of the wider community with identified themes. To examine media influence on the comments we carried out thematic analysis of online media headlines published about the strategy, and compared these themes with themes identified from comments...
February 20, 2017: Health Policy
https://www.readbyqxmd.com/read/28233600/leveraging-consumer-s-behaviour-to-promote-generic-drugs-in-italy
#6
Cristina Zerbini, Beatrice Luceri, Donata Tania Vergura
OBJECTIVE: The aim of this study was to fill the lack of knowledge regarding a more grounded exploration of the consumer's decision-making process in the context of generic drugs. In this perspective, a model, within the theoretical framework of the Theory of Planned Behaviour (TPB), for studying the consumers' purchase intention of generic drugs was developed. METHODS: An online survey on 2,222 Italian people who bought drugs in the past was conducted. The proposed model was tested through structural equation modelling (SEM)...
February 20, 2017: Health Policy
https://www.readbyqxmd.com/read/28222905/implementation-of-the-2013-amended-patients-rights-act-in-norway-clinical-priority-guidelines-and-access-to-specialised-health-care
#7
Kjell Arne Johansson, Elizabeth Nygaard, Berit Herlofsen, Frode Lindemark
In 2013, the Norwegian Patient Rights' Act was amended in order to simplify the priority setting process for specialized elective health care and to improve access to care. As a result of the amendment, priority for treatment is now determined by only two criteria: 1) clinical effectiveness; and 2) cost-effectiveness of the intervention. There are 33 clinical priority-setting guidelines organised by medical specialty, which help hospitals evaluate whether individual patients have a right to access care. Following the amendment of the Patient Rights' Act, these guidelines had to be revised in order to assure coherence with the new legislation...
February 20, 2017: Health Policy
https://www.readbyqxmd.com/read/28228243/private-health-insurance-in-sweden-fast-track-lanes-and-the-alleged-attempts-to-stop-them
#8
John Lapidus
According to the Health and Medical Services Act (1982:763), those who have the greatest need for healthcare shall be given priority. This is being challenged by the rapid emergence of private health insurance which increases the share of private funding and creates fast-track lanes where some people get faster access to healthcare than others. The Stop Law, implemented by a Social Democratic government in 2006, was generally regarded as a way to put an end to the fast-track lanes in Swedish healthcare. Based on a thorough examination of the law and its legislative history - official reports, propositions, comments on official reports - this article argues that the Stop Law was so full of exceptions and loopholes that it did not threaten the existence of fast-track lanes...
February 19, 2017: Health Policy
https://www.readbyqxmd.com/read/28222904/the-2016-proposal-for-the-reorganisation-of-urgent-care-provision-in-belgium-a-political-struggle-to-co-locate-primary-care-providers-and-emergency-departments
#9
Koen Van den Heede, Wilm Quentin, Cécile Dubois, Stephan Devriese, Carine Van de Voorde
Internationally the number of emergency department (ED) visits is on the rise while evidence suggests that a substantial proportion of these patients do not require emergency care but primary care. This paper presents the Belgian 2016 proposal for the reorganisation of urgent care provision and places it into its political context. The proposal focused on re-designing patient flow aiming to reduce inappropriate ED visits by improving guidance of patients through the system. Initially policymakers envisaged, as cornerstone of the reform, to roll-out as standard model the co-location of primary care centres and EDs...
February 17, 2017: Health Policy
https://www.readbyqxmd.com/read/28238340/payers-experiences-with-confidential-pharmaceutical-price-discounts-a-survey-of-public-and-statutory-health-systems-in-north-america-europe-and-australasia
#10
Steven G Morgan, Sabine Vogler, Anita K Wagner
Institutional payers for pharmaceuticals worldwide appear to be increasingly negotiating confidential discounts off of the official list price of pharmaceuticals purchased in the community setting. We conducted an anonymous survey about experiences with and attitudes toward confidential discounts on patented pharmaceuticals in a sample of high-income countries. Confidential price discounts are now common among the ten health systems that participated in our study, though some had only recently begun to use these pricing arrangements on a routine basis...
February 16, 2017: Health Policy
https://www.readbyqxmd.com/read/28233599/unmet-healthcare-needs-in-ireland-analysis-using-the-eu-silc-survey
#11
Sheelah Connolly, Maev-Ann Wren
The analysis used the 2013 Survey of Income and Living Conditions to examine the extent and causes of unmet need for healthcare services in Ireland. The analysis found that almost four per cent of participants reported an unmet need for medical care. Overall, lower income groups, those with poorer health status and those without free primary care and/or private insurance were more likely to report an unmet healthcare need. The impact of income on the likelihood of reporting an unmet need was particularly strong for those without free primary care and/or private insurance, suggesting a role for the health system in eradicating income based inequalities in unmet need...
February 16, 2017: Health Policy
https://www.readbyqxmd.com/read/28233598/does-enrollment-in-multidisciplinary-team-based-primary-care-practice-improve-adherence-to-guideline-recommended-processes-of-care-quebec-s-family-medicine-groups-2002-2010
#12
Mamadou Diop, Julie Fiset-Laniel, Sylvie Provost, Pierre Tousignant, Roxane Borgès Da Silva, Marie-Jo Ouimet, Eric Latimer, Erin Strumpf
BACKGROUND: We investigated whether multidisciplinary team-based primary care practice improves adherence to process of care guidelines, in the absence of financial incentives related to pay-for-performance. METHODS: We conducted a natural experiment including 135,119 patients, enrolled with a general practitioner (GP) in a multidisciplinary team Family Medicine Group (FMG) or non-FMG practice, using longitudinal data from Quebec's universal insurer over the relevant time period (2000-2010)...
February 13, 2017: Health Policy
https://www.readbyqxmd.com/read/28214047/assessing-decentralisation-is-a-challenging-but-necessary-task-if-it-should-continue-as-a-reform-strategy-reflections-from-the-systematic-review-by-sumah-baatiema-and-abimbola
#13
LETTER
https://www.readbyqxmd.com/read/28215356/the-financial-burden-of-prescription-drugs-for-neurological-conditions-in-canada-results-from-the-national-population-health-study-of-neurological-conditions
#14
Sara Guilcher, Sarah Munce, James Conklin, Tanya Packer, Molly Verrier, Connie Marras, Tarik Bereket, Joan Versnel, Richard Riopelle, Susan Jaglal
This paper describes the current situation in Canada concerning the availability and use of prescription drugs for neurological conditions. We conducted semi-structured qualitative interviews with health care providers, administrators, community organization representatives, opinion leaders and policy makers. The analysis revealed three primary themes related to the availability of and access to prescription drugs to treat neurological conditions. First, we learned that across Canada there is significant vulnerability and a need for advocacy on behalf of people living with these conditions...
February 4, 2017: Health Policy
https://www.readbyqxmd.com/read/28189271/implementing-hospital-pay-for-performance-lessons-learned-from-the-french-pilot-program
#15
Anne Girault, Martine Bellanger, Benoît Lalloué, Philippe Loirat, Jean-Claude Moisdon, Etienne Minvielle
Despite a wide implementation of pay-for-performance (P4P) programs, evidence on their impact in hospitals is still limited. Our objective was to assess the implementation of the French P4P pilot program (IFAQ1) across 222 hospitals. The study consisted of a questionnaire among four leaders in each enrolled hospital, combined with a qualitative analysis based on 33 semi-structured interviews conducted with staff in four participating hospitals. For the questionnaire results, descriptive statistics were performed and responses were analyzed by job title...
February 1, 2017: Health Policy
https://www.readbyqxmd.com/read/28214046/productivity-growth-case-mix-and-optimal-size-of-hospitals-a-16-year-study-of-the-norwegian-hospital-sector
#16
Kjartan Sarheim Anthun, Sverre Andreas Campbell Kittelsen, Jon Magnussen
BACKGROUND AND OBJECTIVES: This paper analyses productivity growth in the Norwegian hospital sector over a period of 16 years, 1999-2014. This period was characterized by a large ownership reform with subsequent hospital reorganizations and mergers. We describe how technological change, technical productivity, scale efficiency and the estimated optimal size of hospitals have evolved during this period. MATERIAL AND METHODS: Hospital admissions were grouped into diagnosis-related groups using a fixed-grouper logic...
January 30, 2017: Health Policy
https://www.readbyqxmd.com/read/28162814/eu-accession-a-policy-window-opportunity-for-nursing
#17
REVIEW
Paul De Raeve, Anne-Marie Rafferty, Louise Bariball, Ruth Young, Olga Boiko
European enlargement has been studied in a wide range of policy areas within and beyond health. Yet the impact of EU enlargement upon one of the largest health professions, nursing, has been largely neglected. This paper aims to explore nurse leadership using a comparative case study method in two former Communist countries, Romania and Croatia. Specifically, it considers the extent to which engagement in the EU accession policy-making process provided a policy window for the leaders to formulate and implement a professional agenda while negotiating EU accession...
January 25, 2017: Health Policy
https://www.readbyqxmd.com/read/28162813/the-determinants-of-medical-technology-adoption-in-different-decisional-systems-a-systematic-literature-review
#18
REVIEW
Yauheniya Varabyova, Carl Rudolf Blankart, Ann Lennarson Greer, Jonas Schreyögg
Studies of determinants of adoption of new medical technology have failed to coalesce into coherent knowledge. A flaw obscuring strong patterns may be a common habit of treating a wide range of health care innovations as a generic technology. We postulate three decisional systems that apply to different medical technologies with distinctive expertise, interest, and authority: medical-individualistic, fiscal-managerial, and strategic-institutional decisional systems. This review aims to examine the determinants of the adoption of medical technologies based on the corresponding decision-making system...
January 24, 2017: Health Policy
https://www.readbyqxmd.com/read/28139253/determinants-of-evidence-use-in-public-health-policy-making-results-from-a-study-across-six-eu-countries
#19
Ien van de Goor, Riitta-Maija Hämäläinen, Ahmed Syed, Cathrine Juel Lau, Petru Sandu, Hilde Spitters, Leena Eklund Karlsson, Diana Dulf, Adriana Valente, Tommaso Castellani, Arja R Aro
The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities, lacking the most effective approaches, thus limiting the impact of health promotion strategies. This article focuses on facilitators and barriers in the use of evidence in developing health enhancing physical activity policies...
January 20, 2017: Health Policy
https://www.readbyqxmd.com/read/28117075/eliciting-preferences-for-medical-devices-in-south-korea-a-discrete-choice-experiment
#20
Hye-Jae Lee, Eun-Young Bae
This study aims to identify the attributes that contribute to the value of medical devices and quantify the relative importance of them using a discrete choice experiment. Based on a literature review and expert consultation, seven attributes and their levels were identified-severity of disease (2), availability of substitutes (2), improvement in procedure (3), improvement in clinical outcomes (2), increase in survival (2), improvement in quality of life (3), and cost (4). Among 576 hypothetical profiles, optimal choice sets with 20 choices were developed and experts experienced in health technology assessment and reimbursement decision making in South Korea were surveyed...
January 10, 2017: Health Policy
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