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Health Policy

Niek Stadhouders, Florien Kruse, Marit Tanke, Xander Koolman, Patrick Jeurissen
Unsustainable growth in healthcare expenditure demands effective cost-containment policies. We review policy effectiveness using total payer expenditure as primary outcome measure. We included all OECD member states from 1970 onward. After a rigorous quality appraisal, we included 43 original studies and 18 systematic reviews that cover 341 studies. Policies most often evaluated were payment reforms (10 studies), managed care (8 studies) and cost sharing (6 studies). Despite the importance of this topic, for many widely-used policies very limited evidence is available on their effectiveness in containing healthcare costs...
November 2, 2018: Health Policy
Casper G Schoemaker, Jeanne van Loon, Peter W Achterberg, Matthijs van den Berg, Maartje M Harbers, Frank R J den Hertog, Henk Hilderink, Geertjan Kommer, Johan Melse, Hans van Oers, Marjanne H D Plasmans, Robert A A Vonk, Nancy Hoeymans
Policy-oriented foresight reports aim to inform and advise decision-makers. In value-laden areas such as public health and healthcare, deliberative scenario methods are clearly needed. For the sixth Dutch Public Health Status and Forecasts-report (PHSF-2014), a new approach of co-creation was developed aiming to incorporate different societal norms and values in the description of possible future developments. The major future trends in the Netherlands were used as a starting point for a deliberative dialogue with stakeholders to identify the most important societal challenges for public health and healthcare...
October 26, 2018: Health Policy
Elina Miteniece, Milena Pavlova, Bernd Rechel, Dace Rezeberga, Liubovė Murauskienė, Wim Groot
INTRODUCTION: Latvia has a high maternal mortality ratio compared to other European countries, as well as major inequities in accessing adequate maternal care. Adequacy refers to the extent to which services are safe, effective, timely, efficient, equitable and people-centred. This study aims to explore stakeholder views on access to adequate maternal care in Latvia and the extent to which there was consensus. METHODS: This mixed-method study is based on an online survey among women who recently gave birth, as well as interviews with healthcare providers and decision-makers...
October 25, 2018: Health Policy
Mary Bartram, Jennifer M Stewart
This paper compares income-based inequities in access to psychotherapy and other mental health services in Canada and Australia, two federal parliamentary systems with sharply contrasting responses to high rates of unmet need. Income-based inequity is measured by need-standardized concentration indices, using comparable data from the Canadian Community Health Survey 2011-2012 and the Australian National Survey of Mental Health and Well-Being 2007. The results indicate that utilization of psychologist services is more concentrated at higher income levels (i...
October 16, 2018: Health Policy
Peter Alders, Frederik T Schut
In 2015 the system of long-term care (LTC) financing and provision in the Netherlands was profoundly reformed. The benefits covered by the former comprehensive public LTC insurance scheme were split up and allocated to three different financing regimes. The objectives of the reform were to improve the coordination between LTC, medical care and social care, and to reinforce incentives for an efficient provision of care by making risk-bearing health insurers and municipalities responsible for procurement. Unintentionally, the reform also created a number of major incentive problems, however, resulting from the way: (i) LTC benefits were split up across the three financing regimes; (ii) the various third party purchasers were compensated; and (iii) co-payments for the beneficiaries were designed...
October 16, 2018: Health Policy
Petronille Bogaert, Hans van Oers, Herman Van Oyen
BACKGROUND: Health information in the EU is characterised by diversity and fragmentation of health information infrastructures. A well-defined and sustainable EU health information system infrastructure is lacking. The potential of a European Research Infrastructure Consortium on Health Information for Research and Evidence-based Policy (HIREP-ERIC) to take up this role is investigated. METHODS: Two working groups, a BRIDGE Health Steering Committee and the European Commission's Drafting Group of the Expert Group on Health Information, discussed the technical and scientific description of the HIREP-ERIC through a consensus-driven modified Delphi technique...
October 16, 2018: Health Policy
Julieta Casanova-Juanes, Jorge Mestre-Ferrandiz, Jaime Espín-Balbino
Spain has a reference price system (RPS) for off-patent medicines since 1997. In addition, from 2012, Andalusia is running a series of tenders for procuring off-patent medicines dispensed by community pharmacies, for those medicines included in the system of homogenous clusters within the national reference price system. Such tenders offer additional savings to the regional payer - in the form of rebates ("economic improvements") from companies winning the tender. This paper estimates that the regional savings were between €43 M to €54 M over the period of study (April - September 2015)...
October 12, 2018: Health Policy
Laia Palència, Maica Rodríguez-Sanz, M José López, Nuria Calzada, Raquel Gallego, Ernesto Morales, Nicolás Barbieri, Xavier Blancafort, Montse Bartroli, M Isabel Pasarín
BACKGROUND: The aim of this study was to analyse trends in several health-related indicators in socioeconomically deprived neighbourhoods in Barcelona with strong community action for health (CA), and compare them to neighbourhoods without such community action. A secondary goal was to analyse trends in socioeconomic inequalities in health in both types of neighbourhood. METHODS: We performed a quasi-experimental pre-post study using data from the Barcelona Health Surveys of 2001 and 2011...
October 12, 2018: Health Policy
Maggie MacNeil, Melissa Koch, Ayse Kuspinar, Don Juzwishin, Pascale Lehoux, Paul Stolee
OBJECTIVES: Health care innovation and technologies can improve patient outcomes, but policies and regulations established to protect the public interest may become barriers to improvement of health care delivery. We conducted a scoping review to identify policy and regulatory barriers to, and facilitators of, successful innovation and adoption of health technologies (excluding pharmaceutical and information technologies) in Canada. METHODS: The review followed Arksey and O'Malley's methodology to assess the breadth and depth of literature on this topic and drew upon published and grey literature from 2000-2016...
October 12, 2018: Health Policy
Yael Ashkenazi, Michal Gordon, Bruce Rosen
BACKGROUND: In 2011, Israel instituted financial incentives as part of a larger program to attract doctors to residency programs in peripheral hospitals. OBJECTIVE: To explore the impact of these incentives and related changes on the choices of locations for residency training in Israel. METHODS: We performed (A) an analysis of administrative data on the location of all new medical residencies in 2005-2014 (B) an internet/phone survey of residents who began specialty training in 2013-2014, with a response rate of 71%...
October 12, 2018: Health Policy
Marisa Silbernagl, Rudolf Slamanig, Gabriele Fischer, Laura Brandt
Prisoners constitute a considerable gap in the hepatitis C virus (HCV) tested population. The present study examined HCV prevalence in imprisoned opioid-maintained patients (OMT-P) and adolescents and young adults (AYA, 14-26 years). In addition, HCV testing and treatment provision, knowledge of HCV status and psychiatric comorbidity were assessed. Data collection took place in six Austrian prisons. Participants were N = 133 for OMT-P (78% male, mean age 35.7 years) and N = 71 for AYA (100% male, mean age 19...
October 11, 2018: Health Policy
Marco E Mazevet, V Garyga, Nigel B Pitts, Mark W Pennington
France possesses a mixed public-private oral health system with no out of pocket payments for most routine dental treatments. The "Convention" regulates tariffs between the elected dental trade unions, the National Health Insurance and Complimentary Health Insurers. It is periodically revised and negotiated by the three parties in order to introduce new procedures, improve the access to dental care of the population and to adjust procedure costs for inflation. At the beginning of the last negotiations in September 2016 health minister Marisol Touraine introduced a new legal procedure, the Arbitrary Judgment, which came into force if the Dentists failed to agree to the NHI's propositions...
October 11, 2018: Health Policy
Margaret Kelaher, Khic-Houy Prang, Hana Sabanovic, David Dunt
The dissemination of public performance reporting (PPR) cards aims to increase utilisation of information on quality of care by consumers when making health plan choices. However, evaluations of PPR cards show that they have little impact on consumer choices. The aim of this study is to undertake a systematic review and meta-analysis of the impact of PPR cards in promoting health plan selection and switching between health plans by consumers. We searched five online databases and eight previous reviews for studies reporting findings on PPR and health plans...
October 10, 2018: Health Policy
Karen Stenner, Jude Edwards, Freda Mold, Simon Otter, Molly Courtenay, Ann Moore, Nicola Carey
OBJECTIVE: Making best use of existing skills to increase service capacity is a global challenge. The aim was to systematically review physiotherapy and podiatrist prescribing and medicines management activity, including evidence of impact on patient care, levels of knowledge and attitudes towards extended medicines role. METHODS: A search of MEDLINE, CINAHL, and Cochrane databases, using terms to identify prescribing and medicines management across a range of roles, was conducted from January 1985 to May 2016 for physiotherapy, and January 1968 to May 2016 for podiatry...
October 10, 2018: Health Policy
Kaja Põlluste, Elise Kosunen, Tuomas Koskela, Kari J Mattila, Willemijn L A Schäfer, Wienke G W Boerma, Margus Lember
INTRODUCTION: Since the early 1990s, the Estonian and Finnish health systems have undergone various changes which are expected to have impacted the type and range of services provided by general practitioners (GPs). OBJECTIVE: To compare GP services between Estonia and Finland in 1993 and 2012 and draw a parallel with transformations occurred in the health systems of both countries during these two decades. METHODS: Data were collected through surveys among 129 and 288 GPs from Estonia and Finland in 2012 and 139 Estonian and 239 Finnish GPs in 1993...
October 9, 2018: Health Policy
Kai Ruggeri, Nevena Ivanović, Josip Razum, Ondřej Kácha, Igor G Menezes, Zafar Zafari, Eduardo Garcia-Garzon
Global medical travel has had an increasing trend without a comprehensive, evidence-driven policy to ensure safe and effective practice. To identify key factors that influence medical travel, we conducted a series of studies culminating with a preference and decision-making component of over 500 prospective medical travelers from a number of countries. Results indicated that quality of care was the most critical factor in the decision, followed by lower costs of procedure and shorter waiting times. Lower costs were less of a factor if the procedure was more invasive, which also increased the importance of waiting time in the decision...
October 3, 2018: Health Policy
Genovaitė Liobikienė, Jurga Bernatonienė
The aim of this study is to analyze the determinants of access to health-related information on the Internet and their influence on perceived knowledge of health-related topics in European countries. Referring to the European citizens' digital health literacy survey and applying structural equation modelling hypotheses, the obtained results showed that assumption of acceptance of information and capacity level are the main determinants which have the biggest influence on the perception of access to health-related information on the Internet...
October 3, 2018: Health Policy
A Makady, A van Veelen, A de Boer, H Hillege, O H Klungel, W Goettsch
BACKGROUND: Conditional financing (CF) of expensive hospital drugs was applied in the Netherlands between 2006 and 2012; a 4-year coverage with evidence development (CED) framework for expensive hospital drugs. This study aims to evaluate the CF framework, focusing on Health Technology Assessment (HTA) procedures. METHODS: Using a standardised data extraction form, researchers independently extracted information on procedural, methodological and decision-making aspects from HTA reports of drugs selected for CF...
September 28, 2018: Health Policy
Julia Abelson, Laura Tripp, Jonathan Sussman
Despite Canada's long history with mammography screening, little is known about citizens' perspectives about mammography and how best to support women to make informed choices about screening. To address this gap, a series of four citizen deliberation events were held in 2015-16 in Ontario, a Canadian province with an organized population-based breast screening program in place since 1990. Forty-nine individuals participated in four citizen panels, each comprising an information session highlighting the evidence about mammography, and large- and small-group deliberations about approaches to support informed decision making for screening...
September 28, 2018: Health Policy
Yusuke Nakamura, Hiroshige Matsumoto, Noriko Yamamoto-Mitani, Miho Suzuki, Ayumi Igarashi
In the continuously aging society, private sectors are expected to play a role in older adult care. Implementing an agreement between municipalities and private sectors is one of the key mechanisms for encouraging private sectors to participate in supporting older adults. The study's aim was to evaluate whether the support agreement has promoted support activities by convenience store staff for older adults. A retrospective observational study was conducted between 2013 and 2016 using data from a nationwide survey of convenience stores...
September 28, 2018: Health Policy
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