International Journal of Health Policy and Management最新文献

{"title":"Impact of China's National Volume-Based Drug Procurement: A Multilevel Interrupted Time Series Analysis on Medical Expenditures in Hypertensive Patients.","authors":"Yunxiang Huang, Yan Ren, Yuanjin Zhang, Yulong Jia, Qianrui Li, Minghong Yao, Yuning Wang, Fan Mei, Kang Zou, Huangang Hu, Jing Tan, Xin Sun","doi":"10.34172/ijhpm.8540","DOIUrl":"10.34172/ijhpm.8540","url":null,"abstract":"<p><strong>Background: </strong>The National Volume-Based Procurement (NVBP), implemented in China in 2019, aims to reduce patients' economic burden by lowering drug prices and promoting the use of NVBP drugs in public hospitals. We evaluated the impact of NVBP on medical expenditures among hypertensive patients, analyzing both the overall impact and variations in policy effects across individual hospitals.</p><p><strong>Methods: </strong>Using medical records from 1.17 million hypertensive patients across 82 hospitals in Tianjin (2017-2021), we conducted an interrupted time series analysis to assess expenditure changes among hypertensive patients for the treatment of hypertension, dyslipidaemia, type 2 diabetes, and chronic ischemic heart disease (IHD). Multilevel model was employed to estimate the overall impact and hospital-specific variations in policy effects.</p><p><strong>Results: </strong>NVBP implementation significantly reduced per-visit outpatient expenditures among hypertensive patients for the treatment of hypertension (-15.61%), dyslipidaemia (-25.77%), and diabetes (-17.59%) by lowering drug expenditures. Although drug expenditures for chronic IHD decreased, non-drug expenditures increased, leading to no significant change in total expenditures for chronic IHD (-8.97%). For inpatient expenditures, no significant changes in total per-admission expenditures were observed for chronic IHD or diabetes hospitalizations. Drug expenditures for diabetes decreased significantly, but diagnostic expenditures increased, while no significant change was found in chronic IHD drug expenditures. At the individual hospital level, significant variations in policy effects were observed. Despite the overall decrease in outpatient expenditures for the treatment of hypertension, dyslipidaemia, and diabetes, only 45.6%, 67.2%, and 46.3% of hospitals, respectively, showed significant decreases, while the remainder exhibited either non-significant changes or increases.</p><p><strong>Conclusion: </strong>NVBP effectively reduced outpatient expenditures among hypertensive patients for the treatment of hypertension, dyslipidaemia, and diabetes, suggesting its potential to alleviate patients' economic burdens. However, the increases in non-drug expenditures and substantial variations in policy effects across hospitals highlight a room for further improvement in policy implementation and overall effectiveness.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8540"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palestine Is Freeing Us All Before Palestine Is Free Comment on \"The Rhetoric of Decolonizing Global Health Fails to Address the Reality of Settler Colonialism: Gaza as a Case in Point\".","authors":"Yipeng Ge","doi":"10.34172/ijhpm.8677","DOIUrl":"10.34172/ijhpm.8677","url":null,"abstract":"<p><p>This commentary piece on the editorial piece by Eivind Engebretsen and Mona Baker entitled \"The Rhetoric of Decolonizing Global Health Fails to Address the Reality of Settler Colonialism: Gaza as a Case in Point\" explores the interconnected contexts of settler colonialism affecting health in occupied Turtle Island (also known as Canada) to Palestine. Addressing true and authentic health equity work means sharpening our politics and rhetoric beyond decolonizing \"global health\" as epistemically colonial and towards meaningful solidarity work and framings of liberatory or revolutionary health. There is a moral obligation to contextualize and historicize, rather than depoliticize. This ultimately means supporting through unwavering solidarity for collective liberation through the Indigenous resistance and resurgence movements in Turtle Island to Palestine if we are serious about decolonizing global health. Moving towards rhetoric and actions for collective liberation must be the focused goal of all who care deeply about true and authentic health equity work towards just and life-affirming systems for health for all.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8677"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing the Journey and the Destination Comment on \"Achieving Diagnostic Excellence: Roadmaps to Develop and Use PatientReported Measures With an Equity Lens\".","authors":"Theresa Schmidt, Jacqlyn Riposo","doi":"10.34172/ijhpm.8907","DOIUrl":"10.34172/ijhpm.8907","url":null,"abstract":"<p><p>McDonald and colleagues' paper on \"Achieving Diagnostic Excellence: Roadmaps to Develop and Use Patient-Reported Measures With an Equity Lens\" describes seven goals for using patient-reported measures (PRMs) to promote diagnostic excellence and describes roadmaps to plan the development and implementation of PRMs. Incorporating more patient voices into diagnostic measurement and measure development can improve the patient-centricity of processes and outcomes. Additionally, organizations beginning their measure development journeys may find road-mapping tools helpful, especially the focus on setting goals and engaging stakeholders. However, the authors do not offer suggestions for prioritizing measure concepts for development, and the long timeframes of the examples may dissuade some organizations from engaging in measurement to begin with. Real-world examples of measure development processes and potential applications of emerging technologies are important complements to aspirational roadmap goals and processes.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8907"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Transformation Plan for Universal Health Coverage in Iran: Reflections From the Past.","authors":"Sameen Siddiqi","doi":"10.34172/ijhpm.8817","DOIUrl":"10.34172/ijhpm.8817","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8817"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"<i>Pundits Are Saying This Is 'Anti-poor'</i>\": Competing Framing Strategies for Child Road Safety Policy in the Philippines.","authors":"Sarah N Champagne, Adam D Koon, Allan R Ulitin, Haidee A Valverde, Lamisa Ashraf, Ma-Ann M Zarsuelo, Connie Hoe, Hilton Y Lam, Abdulgafoor M Bachani","doi":"10.34172/ijhpm.8585","DOIUrl":"10.34172/ijhpm.8585","url":null,"abstract":"<p><strong>Background: </strong>Child restraint systems (CRS) can lead to a 60% reduction in child deaths, yet few low- and middle-income countries (LMICs) have comprehensive policies to enforce best practice standards. In 2019, the Philippines established such a policy: the Child Safety in Motor Vehicles (CSMV) Act.</p><p><strong>Methods: </strong>Drawing on framing theory, this study aims to understand the social dimensions of policy change to identify the Act's origins, design, and implementation. Three sources of data - 25 articles, 27 key-informant interviews, and field notes - were collected and thematically analysed.</p><p><strong>Results: </strong>We present the findings according to two features of the framing process: storytelling and naming. The policy process can be sharply distinguished into two sections: the Act's passage into law (which was swift and successful) and its implementation (which to date has not been). The Act's implementation was stymied by three overarching frames - that it is \"anti-poor,\" \"unnecessary,\" and a \"strategic political distraction.\" A media backlash at the time of implementation solidified these frames, leading President Duterte to indefinitely defer enforcement of the Act.</p><p><strong>Conclusion: </strong>The CSMV Act emphasises that passing a law is insufficient. The trajectory of the act highlights the combined importance of (a) the framing of policy, (b) framing processes operate throughout a policy's lifecycle, and (c) the media in creating a narrative. Our findings offer valuable insights for other LMICs implementing evidence-based road safety measures, suggesting that successful implementation requires not only strong legislation but also strategic communication and frame management throughout the policy process. Understanding framing dynamics can help policy-makers anticipate and address potential resistance to life-saving public health interventions.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8585"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's Feeding the Beast\": Lessons for Governance of Public Health Surveillance and Response From an Australian Case Study Analysis.","authors":"Stephanie M Topp, Alexandra Edelman, Thu Nguyen, Emma S McBryde, Sue Devine, Tammy Allen, Jeffrey Warner, Julie Mudd, Paul F Horwood","doi":"10.34172/ijhpm.8605","DOIUrl":"10.34172/ijhpm.8605","url":null,"abstract":"<p><strong>Background: </strong>Public health is a core governmental responsibility, with ministries or departments of health responsible for setting and ensuring adherence to standards, managing performance and instituting reforms as required. Although North Queensland (NQ), Australia has a well-developed health infrastructure, the COVID-19 pandemic exposed significant vulnerabilities in its public health surveillance and response system. Globally, research has highlighted how human and cultural elements (\"system software\") influence the effectiveness of infrastructure, governance, and data systems (\"system hardware\"). This study examines the interaction between these elements to examine specific governance challenges and opportunities for strengthening communicable disease surveillance and response in NQ.</p><p><strong>Methods: </strong>Using an embedded case study design, we analysed four disease units-COVID-19, tuberculosis (TB), arboviruses, and sexually transmitted infections (STIs)-through interviews (n=47), document review, and observations across NQ health services (October 2020-December 2021). Data were mapped against Sheikh and colleagues' hardware-software framework to examine the nature of governance bottlenecks in this region of northern Australia.</p><p><strong>Results: </strong>Two key governance challenges emerged: (1) Accountability deficits-Hospital and Health Services (HHSs) lacked clear reporting or performance monitoring systems within Queensland's devolved health service governance model, contributing to inconsistent prioritisation of resourcing for communicable disease functions by health service leadership. Within HHSs, public health units (PHUs) faced systemic underfunding, with prevention services accounting for as little as 0.1% of some health service budgets. (2) Data governance failures-Fragmented, siloed data systems, restrictive data-sharing norms, and risk-averse culture hindered coordinated surveillance and response efforts. Weak interoperability and mistrust in data-sharing partnerships further compromised system effectiveness.</p><p><strong>Conclusion: </strong>This study highlights how political, normative, and structural factors shape public health performance alongside the more commonly assessed functional and technical dimensions. Findings suggest the need to improve performance monitoring systems, leadership, and data governance to build an effective, accountable, and data-driven surveillance and response system in NQ.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8605"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involving Service Users in Care Regulation: A Scoping Review of Empirical Literature.","authors":"Josje Kok, Flora Palimetaki, Nada Akrouh, Linda Schoonmade, Hester van de Bovenkamp, Anne Margriet Pot","doi":"10.34172/ijhpm.8509","DOIUrl":"10.34172/ijhpm.8509","url":null,"abstract":"<p><strong>Background: </strong>Ensuring the quality and safety of service delivery extends beyond the realm of health and care professionals, necessitating collaboration among various stakeholders, including external regulatory organizations. The policy agenda of care regulators increasingly features the topic of service user involvement. Despite the extensive research on participatory healthcare, scholarly attention to service user involvement in regulatory practices has been limited. This scoping review delves into the landscape of service user involvement in the regulation of care services of all types and for all different age groups, examining the characteristics and focus of peer reviewed original research. In particular, it addresses a notable knowledge gap by examining how these studies report on the practical utilization of service user input, as well as the regulator's perspective on service user involvement.</p><p><strong>Methods: </strong>We conducted a literature search in PubMed, Embase, CINAHL, APA PsycInfo, and Scopus from inception to July 14, 2023. Thirteen (n=13) empirical studies were included.</p><p><strong>Results: </strong>The underlying motives for service user involvement vary, ranging from legal imperatives and political pressure to enhancing institutional legitimacy and regulatory decision-making. Care regulators employ both reactive and proactive involvement methods. Empirical evidence delineates the challenges and benefits of service user involvement, highlighting concerns about bias, time investments, and the need for a distinct skillset for inspectors. Despite the valuable insights gained, there are instances where service user input is downplayed in practice.</p><p><strong>Conclusion: </strong>The findings underscore the importance of additional research on users' preferences for involvement, optimal communication conditions to honor the collected input, and the challenges inspectors encounter in fostering meaningful involvement with service users. Addressing these challenges is crucial for aligning regulatory efforts with the genuine needs and experiences of services users.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8509"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rights of People With Disabilities in Policy Development Comment on \"How Did Governments Address the Needs of People With Disabilities During the COVID-19 Pandemic? An Analysis of 14 Countries' Policies Based on the UN Convention on the Rights of Persons With Disabilities\".","authors":"Olaf Kraus de Camargo","doi":"10.34172/ijhpm.8736","DOIUrl":"10.34172/ijhpm.8736","url":null,"abstract":"<p><p>Shikako et al analysis highlights that needs of persons with disability (PwD) were often overlooked, with policies primarily focused on general population health measures rather than specific accommodations for PwD. This commentary suggests adopting universal design principles in policy development to ensure inclusivity and advocate for maintaining services essential for PwD even during crises. It emphasizes the importance of involving PwD in policy-making processes and enhancing data collection for better policy analysis and concludes with recommendations for creating more inclusive policies, stressing the need for international collaboration and the integration of PwD needs into all policy levels.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8736"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The United States Withdrawal From the World Health Organization: Implications and Challenges.","authors":"Vahid Yazdi-Feyzabadi, Ali-Akbar Haghdoost, Martin McKee, Amirhossein Takian, Elizabeth Bradley, Ruairí Brugha, Nir Eyal, Sana Eybpoosh, Lawrence Gostin, Naoki Ikegami, Ilona Kickbusch, Ronald Labonté, Russell Mannion, Ole F Norheim, Jeremy Shiffman, Mohammad Karamouzian","doi":"10.34172/ijhpm.9086","DOIUrl":"10.34172/ijhpm.9086","url":null,"abstract":"<p><p>President Trump's 2025 decision to remove the United States (US) from the World Health Organization (WHO), echoing his initial 2020 move, raises existential questions about the future of global health governance. This editorial explores the immediate and long-term potential impacts of the withdrawal, noting that it poses a significant threat to the WHO financing. This, in turn, will have adverse consequences for future pandemic preparedness, health inequities, and cross-border collaboration. We also explore the potential role of private philanthropies in bridging the funding gap, against the risk of shifting health priorities away from local needs. For the US, withdrawal means diminished influence on global health policies and weaker alignment with new international regulations. Moving forward, structural reforms within the WHO, equitable contributions from global powers, and renewed US involvement are essential to maintain strong health systems worldwide. Ultimately, a collaborative approach is necessary to uphold collective preparedness against emerging health crises.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9086"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Aspiration to Action: Aligning the Pandemic Agreement with Equity in Vaccine Access; A Response to Recent Commentaries.","authors":"Luciana Correia Borges, Henrique Zeferino de Menezes, Eric Crosbie","doi":"10.34172/ijhpm.9192","DOIUrl":"10.34172/ijhpm.9192","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9192"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}