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Journal of Health Services Research & Policy

Rikke Søgaard, Ulrika Enemark
OBJECTIVE: To determine the relationship between cost and quality in European hospitals. METHODS: Juran's cost-quality curve served as a theoretical framework, linked to basic efficiency concepts. Based on systematic database searches, citation searches and cross-referencing, we identify 1093 empirical studies. After exclusion of studies from outside Europe (699), non-hospital settings (10 studies), lack of a cost parameter (194) or a quality parameter (27 studies), 22 studies (28 analyses) were assessed for direction of association and methodological heterogeneity...
December 6, 2016: Journal of Health Services Research & Policy
John Busby, Sarah Purdy, William Hollingworth
OBJECTIVES: To use geographic variation in unplanned ambulatory care sensitive condition admission rates to identify the clinical areas and patient subgroups where there is greatest potential to prevent admissions and improve the quality and efficiency of care. METHODS: We used English Hospital Episode Statistics data from 2011/2012 to describe the characteristics of patients admitted for ambulatory care sensitive condition care and estimated geographic variation in unplanned admission rates...
November 8, 2016: Journal of Health Services Research & Policy
Kyle Fluegge
The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insurer selection, coverage therein and especially the subsequent use of health services is a necessary step forward, especially given the increasing prevalence of multimorbidity. Such a novel advancement in health services research may eventually propel public and private insurers to redesign their infrastructure to more accurately reflect the behavioural inclinations of their beneficiary populations...
November 2, 2016: Journal of Health Services Research & Policy
Michael F Bath, Gregory Sj Duncan, V J Gokani
No abstract text is available yet for this article.
October 13, 2016: Journal of Health Services Research & Policy
Roland Bal
The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively...
October 13, 2016: Journal of Health Services Research & Policy
Leonie Segal, Claire Marsh, Rob Heyes
OBJECTIVES: We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. METHODS: The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out...
October 6, 2016: Journal of Health Services Research & Policy
Alan Boyd, Rachael Addicott, Ruth Robertson, Shilpa Ross, Kieran Walshe
The credibility of a regulator could be threatened if stakeholders perceive that assessments of performance made by its inspectors are unreliable. Yet there is little published research on the reliability of inspectors' assessments of health care organizations' services. OBJECTIVES: We investigated the inter-rater reliability of assessments made by inspectors inspecting acute hospitals in England during the piloting of a new regulatory model implemented by the Care Quality Commission (CQC) during 2013 and 2014...
October 5, 2016: Journal of Health Services Research & Policy
Shou-Hsia Cheng, Chi-Chen Chen, Hung-Chih Kuo, Chi-Chuan Wang
OBJECTIVES: To examine the long-term effects of drug reimbursement adjustments on drug-switching decisions and to investigate whether patients with complicated or severe conditions are more affected. METHODS: A population-based, longitudinal study with a before-and-after design. Analysis of 141,703 patients with type 2 diabetes covered by the universal health insurance program in Taiwan. Observation of five 6-month phases before and after a drug reimbursement adjustment implemented in October 2009...
October 3, 2016: Journal of Health Services Research & Policy
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Journal of Health Services Research & Policy
Rosalind Raine, Ray Fitzpatrick, John de Pury
No abstract text is available yet for this article.
October 2016: Journal of Health Services Research & Policy
Jonathan Stokes, Kath Checkland, Søren Rud Kristensen
'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. We look at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally...
October 2016: Journal of Health Services Research & Policy
Dani Filc, Nadav Davidovitch
OBJECTIVES: To analyse the process of health care privatization using the case of Israeli health care reforms during the last three decades. METHODS: We used mixed methods including quantitative analysis of trends in health expenditures in Israel and qualitative critical analysis of documents describing the main health reforms. RESULTS: Israel epitomizes how boundaries between the private and public sector become blurred when health care services are subject to privatization, both of finance and supply...
October 2016: Journal of Health Services Research & Policy
Nadeem Qureshi, Stephen Weng, Nick Hex
In England, general practitioners are incentivized through a national pay-for-performance scheme to adopt evidence-based quality improvement initiatives using a portfolio of Quality and Outcomes Framework (QOF) indicators. We describe the development of the methods used to assess the cost-effectiveness of these pay-for-performance indicators and how they have contributed to the development of new indicators. Prior to analysis of new potential indicators, an economic subgroup of the National Institute for Health and Care Excellence (NICE) Indicator Advisory Committee is formed to assess evidence on the cost-effectiveness of potential indicators in terms of the health benefits gained, compared to the cost of the intervention and the cost of the incentive...
October 2016: Journal of Health Services Research & Policy
Joel Howell, John Ayanian
No abstract text is available yet for this article.
October 2016: Journal of Health Services Research & Policy
Sharon Desmond
Academic interest in strategies to reduce the impact of health services on climate change is quickening. Research has largely focused on local innovations with little consideration of the contextual and systemic elements that influence sustainable development across health systems. A realistic framework specifically to guide decision-making by health care providers is still needed. To address this deficit, the literature is explored in relation to health services and climate change mitigation strategies, and the contextual factors that influence efforts to mitigate climate effects in health service delivery environments are highlighted...
October 2016: Journal of Health Services Research & Policy
Ido Morag, Ann Heylighen, Liliane Pintelon
OBJECTIVES: Wayfinding in hospitals is a complex problem since patients, who are likely to be under stress, may have to navigate their way to multiple locations in the course of a single visit. While good wayfinding design can reduce stress, poor wayfinding can not only increase individuals' anxiety but also generate additional costs for the hospital due to: lost time among staff members who need to direct patients rather than concentrate on their designated task; missed appointments or delayed meetings; and additional security staff to ensure that patients do not enter restricted areas...
October 2016: Journal of Health Services Research & Policy
Vincent Lorant, Benoît Rihoux, Pablo Nicaise
OBJECTIVES: Health care policies are influenced by many groups which in turn influence each other. Our aim was to describe a network of nominated influential stakeholders and analyze how it affects attitudes to reforming primary care. METHODS: Face-to-face interviews were carried out in Belgium with 102 influential people. Each respondent was asked to score solutions for improving the role of general practice in the health care system and to nominate up to six other influential stakeholders...
October 2016: Journal of Health Services Research & Policy
Annette Boaz, Juan Baeza, Alec Fraser
OBJECTIVE: To test whether the model of 'diffusion of innovations' enriches understanding of the implementation of evidence-based thrombolysis services for stroke patients. METHODS: Four case studies of the implementation of evidence on thrombolysis in stroke services in England and Sweden. Semistructured interviews with 95 staff including doctors, nurses and managers working in stroke units, emergency medicine, radiology, the ambulance service, community rehabilitation services and commissioners...
October 2016: Journal of Health Services Research & Policy
Birgit Prodinger, Alan Tennant, Gerold Stucki, Alarcos Cieza, Tevfik Bedirhan Üstün
OBJECTIVE: Our aim was to specify the requirements of an architecture to serve as the foundation for standardized reporting of health information and to provide an exemplary application of this architecture. METHODS: The World Health Organization's International Classification of Functioning, Disability and Health (ICF) served as the conceptual framework. Methods to establish content comparability were the ICF Linking Rules. The Rasch measurement model, as a special case of additive conjoint measurement, which satisfies the required criteria for fundamental measurement, allowed for the development of a common metric foundation for measurement unit conversion...
October 2016: Journal of Health Services Research & Policy
Ida Lillehagen, Kristin Heggen, Eivind Engebretsen
OBJECTIVES: Funding bodies, policy makers, researchers and clinicians are seeking strategies to increase the translation of knowledge between research and practice. Participatory research encompasses a range of approaches for clinicians' involvement in research in the hope of increasing the relevance and usability of research. Our aim was to explore how knowledge is translated and integrated in participants' presentations and negotiations about knowledge. METHODS: Twelve collaboration meetings were observed, and discussions between researchers and clinicians were recorded...
October 2016: Journal of Health Services Research & Policy
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