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Health Policy

Ricarda Milstein, Jonas Schreyoegg
Across the member countries of the Organisation for Economic Co-operation and Development (OECD), pay-for-performance (P4P) programs have been implemented in the inpatient sector to improve the quality of care provided by hospitals. This paper provides an overview of 34 existing P4P programs in the inpatient sector in 14 OECD countries based on a structured literature search in five databases to identify relevant sources in Danish, English, French, German, Hebrew, Italian, Japanese, Korean, Norwegian, Spanish, Swedish and Turkish...
September 20, 2016: Health Policy
Sabine Vogler, Nina Zimmermann, Kees de Joncheere
BACKGROUND: Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015. METHODS: We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included...
September 20, 2016: Health Policy
Victoria Porthé, Ingrid Vargas, Belén Sanz-Barbero, Isabel Plaza-Espuña, Lola Bosch, Maria Luisa Vázquez
Policy measures introduced in Spain during the economic crisis included a reduction in public health expenditure and in healthcare entitlements (RDL16/2012), which affected the general population as a whole, but especially immigrants. This paper analyzes changes in immigrants' access to health care during the economic crisis from the perspective of health professionals (medical and administrative) and immigrants. A qualitative descriptive-interpretative study was conducted in Catalonia through individual interviews with a theoretical sample of health professionals (n=34) and immigrant users (n=20)...
September 19, 2016: Health Policy
Sabine Fuchs, Britta Olberg, Dimitra Panteli, Matthias Perleth, Reinhard Busse
OBJECTIVES: Health Technology Assessment (HTA) of Medical devices (MDs) and MD-based procedures can be challenging due to the unique features and particularities of this group of technologies, such as device-operator interaction. The aim of this study was to (1) clarify, and supplement earlier findings on European HTA institutions' structural, procedural and methodological characteristics with regard to the assessment of MDs and to (2) capture the institutions' perceptions regarding challenges and future trends...
September 14, 2016: Health Policy
Annika Herr, Thu-Van Nguyen, Hendrik Schmitz
OBJECTIVES: Since 2009, German nursing homes have been evaluated regularly by an external institution with quality report cards published online. We follow recent debates and argue that most of the information in the report cards does not reliably measure quality of care. However, a subset of up to seven measures does. Do these measures that reflect "risk factors" improve over time? METHOD: Using a sample of more than 3000 German nursing homes with information on two waves, we assume that the introduction of public reporting is an exogenous institutional change and apply before-after-estimations to obtain estimates for the relation between public reporting and quality...
September 13, 2016: Health Policy
Anthony Mwinkaara Sumah, Leonard Baatiema, Seye Abimbola
BACKGROUND: Decentralised governance of health care has been widely adopted globally over the past three decades. But despite being implemented as a management strategy across many health systems, its impact on health equity is yet unclear. OBJECTIVE: To conduct a systematic literature review of the implications of decentralised governance of health care on equity in health, health care and health financing. METHODS: A systematic search of CINAHL, EconLit, Embase, MEDLINE, PsycINFO, PubMed, Scopus, and Cochrane database of systematic reviews was conducted...
September 13, 2016: Health Policy
Luz María Peña-Longobardo, Juan Oliva-Moreno, Sandra García-Armesto, Cristina Hernández-Quevedo
At the end of 2006, a new System for Promotion of Personal Autonomy and Assistance for Persons in a Situation of Dependency (SAAD) was established in Spain through the approval of the Act 39/2006 of 14th December (the Dependency Act, DA). The DA acknowledged the universal entitlement of Spanish citizens to social services. The recent economic crisis added degrees of uncertainty to several dimensions of the SAAD implementation process. Firstly, the political consensus on which its foundation rested upon has weakened...
September 9, 2016: Health Policy
Udo Schneider, Roland Linder, Frank Verheyen
The implementation of a graded return-to-work (RTW) program to reintegrate those in long-term sickness started in Germany in 1971. Based on a return plan by the physician and insured, participants increase their working hours slowly over a specified period of time. Using data on sick leaves from claims data of the Techniker Krankenkasse, we consider sick-leave spells starting from October 2010 to January 2011 with a successful return to work within 517 days. We applied a propensity score matching between participants and non-participants to further analyze differences in sickness spells, medical demand and treatment costs in a follow-up period of 540 days and hence estimate the average treatment effect on the treated (ATT) for the RTW participation with respect to sickness time, sickness benefits and medical expenditures...
September 8, 2016: Health Policy
Katja Behrendt, Oliver Groene
BACKGROUND: Public reporting of surgeon outcomes has become a key strategy in the English NHS to ensure accountability and improve the quality of care. Much of the evidence that supported the design of the strategy originates from the USA. This report aims to assess how the evidence on public reporting could be harnessed for cross-country translation of this health system strategy; in particular, to gauge the expected results of the UK surgeon outcome initiative and to propose criteria that elucidate that prerequisites and factors that are needed to public reporting effective...
September 7, 2016: Health Policy
Yewande Kofoworola Ogundeji, John Martin Bland, Trevor Andrew Sheldon
BACKGROUND: Pay for performance (P4P) incentive schemes are increasingly used world-wide to improve health system performance but results of evaluations vary considerably. A systematic analysis of this variation in the effects of P4P schemes is needed. METHODS: Evaluations of P4P schemes from any country were identified by searching for and updating systematic reviews of P4P schemes in health care in four bibliographic databases. Outcomes using different measures of effect were converted into standardized effect sizes and each study was categorized as to whether or not it found a positive effect...
September 5, 2016: Health Policy
Sonica Singhal, Muhammad Mamdani, Andrew Mitchell, Howard Tenenbaum, Gerald Lebovic, Carlos Quiñonez
BACKGROUND: Policy advocates continue to argue for the expansion of dental care services for people on social assistance in order to meet their health needs and to promote the move from welfare-to-work. However, there is little to no evidence to support the idea that receiving dental care ultimately improves employment outcomes. METHODS: A retrospective cohort study was designed using administrative data from five Ontario regions and from the province's social assistance ministry...
September 4, 2016: Health Policy
Shuli Brammli-Greenberg, Ruth Waitzberg, Vadim Perman, Ronni Gamzu
Historically, Israel paid its non-profit hospitals on a perdiem (PD) basis. Recently, like other OECD countries, Israel has moved to activity-based payments. While most countries have adopted a diagnostic related group (DRG) payment system, Israel has chosen a Procedure-Related Group (PRG) system. This differs from the DRG system because it classifies patients by procedure rather than diagnosis. In Israel, the PRG system was found to be more feasible given the lack of data and information needed in the DRG classification system...
September 1, 2016: Health Policy
Sebastian Salas-Vega, Annika Bertling, Elias Mossialos
Drug listing recommendations from health technology assessment (HTA) agencies often fail to coincide with one another. We conducted a comparative analysis of listing recommendations in Australia (PBAC), the Netherlands (CVZ), Sweden (TLV) and the UK (NICE) over time, examined interagency agreement, and explored how process-related factors-including time delay between HTA evaluations, therapeutic indication and orphan drug status, measure of health economic value, and comparator-impacted decision-making in drug coverage...
August 31, 2016: Health Policy
Katharina Elisabeth Fischer, Thomas Heisser, Tom Stargardt
BACKGROUND: Little is known on the performance of the newly introduced health benefit assessment process, AMNOG, in Germany compared to other health technology assessment agencies. OBJECTIVE: We analysed whether decisions of the German Federal Joint Committee (FJC) deviate from decisions of the UK National Institute for Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC) and the Australian Pharmaceutical Benefits Advisory Committee (PBAC)...
August 9, 2016: Health Policy
Euna Han, Sun-Young Park, Eui-Kyung Lee
The Price-Volume Agreement Program (PVAP) was promulgated in 2007 in South Korea as the first attempt to adjust drug pricing according to total consumption in order to contain drug expenditure. This study was designed to assess the impact of the PVAP on diabetes drug expenditure for a period of a 10-year period (2003-2012) using claims data from the National Health Insurance Service. We estimated a multilevel mixed-effects linear regression model by comparing the level of total monthly diabetes drug expenditure for drugs subject to PVAP and existing drugs after adjusting the average differences in drug expenditure before and after the PVAP...
August 2, 2016: Health Policy
Iwona Kowalska-Bobko, Anna Mokrzycka, Anna Sagan, Cezary Włodarczyk, Michał Zabdyr-Jamróz
In October 2014, after over 12 months of delay, Poland finally implemented directive 2011/24/EU on the application of patients' rights in cross-border healthcare. The implementing legislation in the area of cost reimbursement and prior authorization is very restrictive. The goal is to either defer the public payer's expenses into the future or to discourage patients from seeking care abroad or from seeking care altogether. The Polish government and the Ministry of Health, the key stakeholders in the implementation process, seemed to overlook the potential monetary benefits that the implementation of the directive could bring, for example, by promoting Poland as a destination for health tourism...
July 28, 2016: Health Policy
Anna Mokrzycka, Iwona Kowalska-Bobko, Anna Sagan, Włodzimierz Cezary Włodarczyk
At the end of 2013, the Minister of Health started legislative changes directly and indirectly affecting primary health care (PHC). The reforms were widely criticised among certain groups of medical professionals, including family medicine physicians. The latter mainly criticised the formal inclusion of specialists in internal diseases and paediatrics into PHC within the statutory health care system, which in practice meant that these two groups of specialists were no longer required to specialize in family medicine from 2017 in order to enter into contracts with the public payer and would be able to set up solo PHC practices-something over which family medicine physicians used to have a monopoly...
July 25, 2016: Health Policy
Manuela S Macinati, Stefano Bozzi, Marco Giovanni Rizzo
Professional hybrids in healthcare have attracted a great deal of policy, managerial, and research interest. However, the current literature offers little guidance on (i) how hybrid roles can be supported by the hospital organization they work for as well as (ii) the cognitive and behavioral driving forces underpinning medical managers' managerial work that determine how they inhabit their roles and consequently meet the standards of performance that contribute to organizational effectiveness. Building on engagement theory and social cognitive theory and using data collected from clinical managers working in a large Italian public hospital, the current study focuses on the mediating role of psychological variables associated with the managerial role of medical managers, namely managerial job engagement and managerial self-efficacy, in the budgetary participation-job performance link...
September 2016: Health Policy
Rocco Palumbo, Carmela Annarumma, Paola Adinolfi, Marco Musella, Gabriella Piscopo
Inadequate health literacy, namely the problematic individual's ability to navigate the health care system, has been depicted as a silent epidemic affecting a large part of the world population. Inadequate health literacy has been variously found to be a predictor of patient disengagement, inappropriateness of care, increased health care costs, and higher mortality rates. However, to date the evidence on the prevalence of limited health literacy is heterogeneous; moreover, studies dealing with this topic show a pronounced geographical concentration...
September 2016: Health Policy
Kyu-Tae Han, Hyo Jung Lee, Eun-Cheol Park, Woorim Kim, Sung-In Jang, Tae Hyun Kim
In South Korea, lumbar intervertebral disc disorder (LIDD) patients are increasing in all age groups due to an aging population and changes in lifestyle, like sedentary, and there has been concern about reducing quality of care and increasing healthcare expenditure. Therefore, we aim to study the impact of hospital volume and hospital staffing, such as neurosurgeon or nurse, for length of stay or readmission in LIDD inpatients. We used health insurance claim data from 157 hospitals, consisting of 88,949 inpatient cases during 2010-2013...
September 2016: Health Policy
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