Healthcare reform

OBJECTIVES: Major reforms to the organisation of the National Health Service (NHS) in England established 42 integrated care systems (ICSs) to plan and coordinate local services. The changes are based on the idea that cross-sector collaboration is needed to improve health and reduce health inequalities-and similar policy changes are happening elsewhere in the UK and internationally. We explored local interpretations of national policy objectives on reducing health inequalities among senior leaders working in three ICSs...

BACKGROUND: In 2016, an innovative medical pricing reform called zero-markup drug policy (ZMDP) was implemented in selected pilot cities in China, which focuses on curbing the unreasonable growth of medical expenses. This study aimed to evaluate the impacts of ZMDP on medical expenditure of stroke in western China. METHODS: The quantitative data of inpatients diagnosed with stroke was extracted from the medical insurance system in 7 tertiary public hospitals. An interrupted time series (ITS) was used to analyze the instantaneous level and long-term trend changes of hospitalization expenses per visit from January 2015 to November 2018...

This paper contrasts the Irish experience of the 2008 economic crisis and the Covid-19 pandemic, and the health system responses to these shocks, from the perspective of health system leaders working across both time periods. Based on semi-structured interviews with seven senior national and international officials, the research presented here forms the qualitative component of RESTORE, a five-year research project examining health system resilience and reform, funded through the Health Research Board's Research Leader Award in Ireland...

The US healthcare system is at a crossroads. With an aging population requiring more care and a strained system facing workforce shortages, capacity issues, and fragmentation, innovative solutions and policy reforms are needed. This paper aims to spark dialogue and collaboration among healthcare stakeholders and inspire action to meet the needs of the aging population. Through a comprehensive analysis of the impact of an aging society, this work highlights the urgency of addressing this issue and the importance of restructuring the healthcare system to be more efficient, equitable, and responsive...

RESEARCH QUESTION: What are the views and experiences of patient and expert stakeholders on the positive and negative impacts of commercial influences on the provision of assisted reproductive technology (ART) services, and what are their suggestions for governance reforms? DESIGN: Semi-structured interviews were conducted with 31 ART industry experts from across Australia and New Zealand and 25 patients undergoing ART from metropolitan and regional Australia, between September 2020 and September 2021...

The South African government is moving toward universal health coverage (UHC) with the passing of the National Health Insurance (NHI) Bill. Access to quality primary healthcare (PHC) is the cornerstone of UHC principles. The South African governmental health department have begun focusing efforts on improving the efficiency and functionality of this system; that includes the involvement of private healthcare professionals and medical insurance companies. This study sought to explore perceptions of medical insurance company personnel on PHC re-engineering as part of NHI restructuring...

Consumer and community involvement (CCI) in preventive research and health initiatives is not only encouraged but is expected within a rapidly evolving landscape across health policy, practice and research. Here, we summarise the fundamental principles of CCI, as well as outline the barriers and current developments in working towards best practices at organisational and systems levels. CCI stands at a critical juncture. Best practice emphasises meaningful partnerships with consumers and communities to deliver impactful research and prevention activities, yet complex challenges and systematic barriers remain...

Global economic and health shocks, such as the 2008 global financial crisis and the COVID-19 pandemic typically impact healthcare financing and delivery. Cutler found that profound societal changes in the 20th century induced three waves of healthcare reform across seven major OECD countries. Our study investigates whether major crises in the 21st century induced similar reform waves. Through thematic analysis, we systematically compared health system changes in response to these shocks, using data from the Observatory on Health Systems and Policies and the OECD...

CONTEXT: The connection between law and political determinants of health is not well-understood, but nevertheless it is suggested that the two are inseparable, and that this represents an "upstream" level with scope for influencing other determinants of health (particularly social). Solidarity underpins European healthcare systems and given its clear link with redistribution, can be seen as a means to address health inequities. As such, solidarity may be seen as a political determinant of health in the specific context of EU competition policy...

The objective of this paper is to explain the political factors determining the relatively weak performance of the Polish health care (HC) sector. This can be treated as a critical case due to several reasons: first, the Poles as patients belong to the most unsatisfied ones in the European Union (EU), second, Poland spends on its HC-related expenditures one of the lowest shares of the GDP among the OECD countries, third, the number of doctors per 1000 inhabitants remains at the lowest European level, and the life expectancy in Poland is one of the lowest in the EU and is decreasing...

The extent to which healthcare reforms affect health remains understudied. Healthcare reforms result in policy outputs that determine provision of medical services, which have consequences for the health of the population. We scrutinize this relationship between health policy outputs and population health, using an original dataset of healthcare reforms passed in 36 European countries from 1989 to 2019. Focusing more specifically on legislative changes implying privatization of healthcare delivery and finance, we ask the following question: What is the relationship between reforms that privatize healthcare provision and population health in terms of health outcomes and inequalities? We answer this question by relying on fixed effects time-series cross-section models...

OBJECTIVES: The study assessed the performance of Mental Health Centres compared to previous non-integrated mental health facilities. METHODS: The study used National Health Fund (NHF) data of individuals over 18 years treated in 27 centres (January 2017 - February 2020). Performance indicators from 19 months before (N = 124,497) and after the introduction of Mental Health Centres (N = 182,789) were compared for outpatient care, community treatment teams, inpatient wards and day wards...

PURPOSE: In recent years, dental education has witnessed significant advancements and curriculum shifts in response to evolving healthcare needs, technological advances, and changing societal demands. As a result, dental universities worldwide have undergone substantial curriculum changes to ensure the adequate education and training of future dental professionals. The purpose of this study was to delineate the curriculum innovations over the past 20 years, with a focus on content within the current dental curriculum at universities worldwide...

IMPORTANCE: Innovative nuclear medicine services offer substantial clinical value to patients. However, these advancements often come with high costs. Traditional payment strategies do not incentivize medical institutes to provide new services nor determine the fair price for payers. A shift towards a value-based pricing strategy is imperative to address these challenges. Such a strategy would reconcile the cost of innovation with incentives, foster transparent allocation of healthcare resources, and expedite the accessibility of essential medical services...

Since 2006, the Australian Aboriginal and Torres Strait Islander Health Performance Framework (HPF) reports have provided information about Indigenous Australians' health outcomes. The HPF was designed, in consultation with Indigenous stakeholder groups, to promote accountability and inform policy and research. This paper explores bridging the HPF as a theoretical construct and the publicly available data provided against its measures. A whole-of-framework, whole-of-system monitoring perspective was taken to summarise 289 eligible indicators at the state/territory level, organised by the HPF's tier and group hierarchy...

Globally and historically, Indigenous healthcare is efficacious, being rooted in Traditional Healing (TH) practices derived from cosmology and place-based knowledge and practiced on the land. Across Turtle Island, processes of environmental dispossession and colonial oppression have replaced TH practices with a colonial, hospital-based system found to cause added harm to Indigenous Peoples. Growing Indigenous health inequities are compounded by a mental health crisis, which begs reform of healthcare institutions...

Value-based payment aims to shift the focus from traditional volume-driven arrangements to a system that rewards providers for the quality and value of care delivered. Previous research has shown that it is difficult for providers to change their medical and organizational practices to adopt value-based payment, but the role of actors in these reforms has remained underexposed. This paper unravels the motives of non-clinical and clinical professionals to maintain institutionalized payment practices when faced with value-based payment...

Rapid recent advances in information technology have opened the door for artificial intelligence (AI)-related technologies to be applied extensively across many industries. The Ministry of Education has emphasized the importance of cultivating advanced-level professionals in diverse fields, particularly in smart machinery, the Asia-Silicon Valley sector, green energy technology, biotechnology, national defense, new agricultural, and circular economy industries, to enhance innovation and promote industrial competitiveness (Kuo, 2019)...

OBJECTIVES: The present study expands on previous research by examining whether the spouse's retirement affects individual depression both directly, by the changes in individual health investment, and indirectly, through the social interaction effect of the couples' depression. METHODS: Using the panel data from the 2010-2018 China Family Panel Studies, we investigate the direct and indirect spillover effects of the spouse's retirement on depression among Chinese urban-worker couples (men aged 50-70, women aged 40-60; n = 10,466)...

The COVID-19 pandemic generated tremendous interest in using real world data (RWD). Many consortia across the public and private sectors formed in 2020 with the goal of rapidly producing high-quality evidence from RWD to guide medical decision-making, public health priorities, and more. Experiences were gathered from five large consortia on rapid multi-institutional evidence generation during the COVID-19 pandemic. Insights have been compiled across five dimensions: consortium composition, governance structure and alignment of priorities, data sharing, data analysis, and evidence dissemination...