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Health Policy

Emmanuel Kumah, Giulia Sciolli, Maria Laura Toraldo, Anna Maria Murante
The increasing prevalence of type 2 diabetes has highlighted the importance of evidence-based guidelines for effective prevention, management and treatment. Diabetes self-management education (SME) produces positive effects on patient behaviours and health status. We analyzed the literature to identify (i) the level of integration between usual care and SME programs and (ii) any possible differences across them in terms of outcomes. Searches were made on three databases - PubMed, Scopus and Web of Science - to identify relevant publications on diabetes SME to 2015, which also describe the provider of usual care...
July 11, 2018: Health Policy
Bernadeta Goštautaitė, Ilona Bučiūnienė, Žemyna Milašauskienė, Karolis Bareikis, Eglė Bertašiūtė, Gabija Mikelionienė
Due to a flow of healthcare professionals and students from emerging to industrialized economies, healthcare systems in source countries are facing increasing threats to a people-centered quality of care. This study investigates the prevalence and underlying reasons for emigration intentions among physicians, nurses, residents, and medical students in Lithuania (total N = 1080). In our sample, 39% of students, 21% of residents, 12% of nurses, and 6% of physicians had decided to emigrate within the next two years...
July 6, 2018: Health Policy
Mohammad Hajizadeh, Min Hu, Amy Bombay, Yukiko Asada
Using three nationally representative Aboriginal Peoples Surveys (2001, 2006 and 2012, n = 68,040), we examined income-related inequalities in self-perceived poor/fair general health status among Indigenous adults (18+) living off-reserve in Canada. We used the relative and absolute concentration indices (RC and AC, respectively) to quantify income-related inequalities in health for men and women, within the three Indigenous populations (First Nations, Métis, and Inuit), and in different geographic regions...
July 3, 2018: Health Policy
Irina Cleemput, Stephan Devriese, Laurence Kohn, René Westhovens
Early temporary reimbursement (ETR) schemes for new interventions targeting high unmet needs are increasingly applied in pharmaceutical policy. Crucial for these schemes is the assessment of unmet healthcare needs of patients and society. This study develops and tests a multi-criteria decision approach (MCDA) for assessing therapeutic and societal needs. The Belgian unmet needs commission, responsible for creating a list of unmet needs for the ETR programme, has tested this methodology to assess the needs in eight health conditions...
June 30, 2018: Health Policy
Brett Scholz, Julia Bocking, Chris Platania-Phung, Michelle Banfield, Brenda Happell
Contemporary health policies require consumers be involved at all stages of health service planning, implementation, delivery, and evaluation. The extent to which this policy is met, however, varies widely across the sector. One barrier to meeting policy requirements is power imbalances within systemic partnerships between consumers and other health professionals. Between September 2016 and February 2017, interviews were conducted with health care managers, clinicians, and consumers working on partnerships across various health service departments in one hospital...
June 28, 2018: Health Policy
Marshall H Chin, Paula T King, Rhys G Jones, Bryn Jones, Shanthi N Ameratunga, Naoko Muramatsu, Sarah Derrett
Aotearoa/New Zealand (Aotearoa/NZ) and the United States (U.S.) suffer inequities in health outcomes by race/ethnicity and socioeconomic status. This paper compares both countries' approaches to health equity to inform policy efforts. We developed a conceptual model that highlights how government and private policies influence health equity by impacting the healthcare system (access to care, structure and quality of care, payment of care), and integration of healthcare system with social services. These policies are shaped by each country's culture, history, and values...
June 28, 2018: Health Policy
Eric Andrew Finkelstein, Semra Ozdemir, Chetna Malhotra, Tazeen H Jafar, Lina Choong Hui Lin, Sheryl Gan Shien Wen
BACKGROUND: Despite literature suggesting conservative management (CM) is a viable option for elderly comorbid ESRD patients, the vast majority in Singapore receive dialysis. We hypothesized that the high demand for dialysis is driven by 1) lack of knowledge of CM and relative benefits of dialysis to CM, 2) adherence to physician recommendations which favour dialysis, and 3) high subsidies for haemodialysis (HD). METHODS: We tested these hypotheses via a survey, including a discrete choice experiment (DCE), administered to 151 elderly pre-dialysis kidney patients and their family caregivers...
June 27, 2018: Health Policy
Cornelis van Mosseveld, Vincent van Polanen Petel, Patricia Hernández-Peña, Piet Verbiest
Compatibility of statistical frameworks and comparability of data are aspects of statistical quality. This paper explores comparability of data from National Accounts (NA) and Care Accounts/health accounts (CA&HA) of the Netherlands. Although based on the same sources, differences result from specificities of each framework, making data adjustments necessary. Data comparison of major aggregates and household spending is a means for verification and for triangulation of sources. Monitoring household spending on health is one of the Sustainable Development Goals...
June 19, 2018: Health Policy
Eline M Bunnik, Nikkie Aarts, Suzanne van de Vathorst
BACKGROUND: Today, public and private bodies around the world are trying to facilitate and increase expanded access to unapproved, investigational drugs for patients with unmet medical needs. METHODS: This paper discusses three major shifts in the field of expanded access and presents an argumentative account of ethical issues connected with those shifts, based on a literature study and unstructured interviews with 35 stakeholders in the Netherlands. RESULTS AND DISCUSSION: Traditionally, expanded access has been based on three key principles: 1) it is exceptional, 2) it is done 'out of compassion', and 3) it has a therapeutic aim...
June 18, 2018: Health Policy
M Obucina, N Harris, J A Fitzgerald, A Chai, K Radford, A Ross, L Carr, N Vecchio
The Triple Aim framework is an increasingly popular tool for designing and assessing quality improvements in the health care sector. We systematically reviewed the empirical evidence on the application of the Triple Aim framework within primary healthcare settings since its inception almost a decade ago. Results show that primary healthcare providers varied in their interpretation of the Triple Aim framework and generally struggled with a lack of guidance and an absence of composite sets of measures for performance assessment...
June 18, 2018: Health Policy
Lisa Ann Baumann, Jannah Baker, Adam G Elshaug
BACKGROUND: Effective management of hospital staff time is crucial to quality patient care. Recent years have seen widespread implementation of electronic health record (EHR) systems but the effect of this on documentation time is unknown. This review compares time spent on documentation tasks by hospital staff (physicians, nurses and interns) before and after EHR implementation. METHODS: A systematic search identified 8153 potentially relevant citations. Studies examining proportion of total workload spent on documentation with ≥40 h of staff observation time were included...
June 5, 2018: Health Policy
Jayson O Swanson, Verena Vogt, Leonie Sundmacher, Terje P Hagen, Tron Anders Moger
BACKGROUND: This study compares continuity of care between Germany - a social health insurance country, and Norway - a national health service country with gatekeeping and patient lists for COPD patients before and after initial hospitalization. We also investigate how subsequent readmissions are affected. METHODS: Continuity of Care Index (COCI), Usual Provider Index (UPC) and Sequential Continuity Index (SECON) were calculated using insurance claims and national register data (2009-14)...
May 26, 2018: Health Policy
David C Grabowski, Jesse Fishman, Imane Wild, Bruce Lavin
Epilepsy has a relatively high prevalence, and diagnosis and treatment are often challenging. Seizure freedom without significant side effects is the ultimate goal for both physicians and patients, but not always achievable. In those cases, the treatment goals of patients and providers may differ. In the United States, many clinicians continue to prescribe older AEDs, even though newer AEDs have a more desirable safety and tolerability profile, fewer drug-drug interactions, and are associated with lower epilepsy-related hospital visits...
July 2018: Health Policy
Thomas G Kuijpers, Marc C Willemsen, Anton E Kunst
INTRODUCTION: In many countries, health advocates aim to increase public support for tobacco control policies by framing these policies in terms of child protection. We examined whether support for the protection of children is indeed associated with support for tobacco control policies, even among smokers, opponents of state intervention and opponents of a governmental role in tobacco control. METHODS: We used a survey on a representative sample of Dutch adults of 18 years and older (n = 1631)...
May 26, 2018: Health Policy
Sara Burke, Sarah Barry, Rikke Siersbaek, Bridget Johnston, Maebh Ní Fhallúin, Steve Thomas
In May 2017, an Irish cross-party parliamentary committee published the 'Houses of the Oireachtas Committee on the Future of Healthcare "Sláintecare" report'. The report, known as 'Sláintecare', is unique and historic as it is the first time there has been a cross-party political consensus on major health reform in Ireland. Sláintecare sets out a high level policy roadmap to deliver whole system reform and universal healthcare, phased over a ten year period and costed. Sláintecare details reform proposals which, if delivered, will establish; a universal, single-tier health service where patients are treated solely on the basis of health need; the reorientation of the health system 'towards integrated primary and community care, consistent with the highest quality of patient safety in as short a time-frame as possible'...
May 22, 2018: Health Policy
Thomas Rice, Lynn Y Unruh, Ewout van Ginneken, Pauline Rosenau, Andrew J Barnes
Since the election of Donald Trump as President, momentum towards universal health care coverage in the United States has stalled, although efforts to repeal the Affordable Care Act (ACA) in its entirety failed. The ACA resulted in almost a halving of the percentage of the population under age 65 who are uninsured. In lieu of total repeal, the Republican-led Congress repealed the individual mandate to purchase health insurance, beginning in 2019. Moreover, the Trump administration is using its administrative authority to undo many of the requirements in the health insurance exchanges...
May 22, 2018: Health Policy
Zeynep Or, Anne Penneau
BACKGROUND: Rising numbers of visits to emergency departments (EDs), especially amongst the elderly, is a source of pressure on hospitals and on the healthcare system. This study aims to establish the determinants of ED visits in France at a territorial level with a focus on the impact of ambulatory care organisation on ED visits by older adults aged 65 years and over. METHODS: We use multilevel regressions to analyse how the organisation of healthcare provision at municipal and wider 'department' levels impacts ED utilisation by the elderly while controlling for the local demographic, socioeconomic and health context of the area in which patients live...
May 18, 2018: Health Policy
Yakov Flaumenhaft, Ofir Ben-Assuli
Personal health records (PHR) have been endorsed as a promising tool for the self-management of an individual's medical information, affording benefits to both the individual patient and the healthcare system as a whole. Nevertheless, adoption rates have been relatively slow and widespread acceptance has yet to be achieved. A significant obstacle often cited as delaying the implementation of these systems has been concern regarding the ability to properly ensure the security and privacy of this sensitive information...
May 14, 2018: Health Policy
Peter Leslie Annear, Soonman Kwon, Luca Lorenzoni, Stephen Duckett, Dale Huntington, John C Langenbrunner, Yuki Murakami, Changwoo Shon, Ke Xu
Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs". We focus first on technical issues and follow with a discussion of implementation challenges and policy questions. We reviewed the literature and worked as an expert team to investigate existing documentation from Japan, Republic of Korea, and Thailand...
May 7, 2018: Health Policy
Jason Dean-Chen Yin, Alex Jingwei He
Singapore and Hong Kong, two high-income "Tiger economies" in Asia, were ranked as the top two most efficient health systems in the world. Despite remarkable similarities in history and socioeconomic development, both economies embraced rather different paths in health care reforms in the past decades, which reflect their respective sociopolitical dynamics. Rapidly ageing populations and the anxiety about future funding of health care have prompted them to embark on major health financing reforms in the recent three years...
April 30, 2018: Health Policy
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