International Journal of Health Policy and Management最新文献

{"title":"From Transaction to Transformation: Building Trust in Health Systems; A Response to Recent Commentaries.","authors":"Martin McKee, May Ci van Schalkwyk, Rachel Greenley, Govin Permanand","doi":"10.34172/ijhpm.9188","DOIUrl":"10.34172/ijhpm.9188","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9188"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789020","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":"How Can We Prevent a Resurgence of Vaccine Nationalism?","authors":"Qi Shao","doi":"10.34172/ijhpm.9038","DOIUrl":"10.34172/ijhpm.9038","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9038"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789025","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":"Barriers and Enablers of Value-Based Procurement in Dutch Healthcare Providers.","authors":"Barbara Tip, Niels Uenk, Fredo Schotanus","doi":"10.34172/ijhpm.8514","DOIUrl":"10.34172/ijhpm.8514","url":null,"abstract":"<p><strong>Background: </strong>Value-based procurement (VBP) is gaining traction in healthcare. This approach to procurement prioritizes obtaining the best health outcomes for patients while considering overall healthcare costs. Despite its recognized potential, VBP remains underutilized in hospitals. Little is known about the barriers and enablers of VBP in hospitals. This study aims to identify barriers and enablers specific to VBP in hospital procurement, utilizing the Theoretical Domains Framework (TDF).</p><p><strong>Methods: </strong>This qualitative study comprises semi-structured interviews with 20 Dutch purchasers working at hospitals. The interviews aim to capture diverse perspectives on VBP, with the data undergoing an extensive coding and analysis process. Using redefined domains of the TDF, themes for barriers and enablers are identified.</p><p><strong>Results: </strong>We explored the significance of broader barriers and enablers while also pinpointing new and distinctive ones specific to VBP in a hospital context. The newly identified barriers encompass challenges in procurement skills, low strategic priority, environmental context and resources, stakeholder influences, and outcome expectations. Noteworthy barriers include a cost saving focus, resistance to change, influence of the health insurer, and supplier preferences by end-users. Enablers involve stakeholder commitment, positive buyer-supplier relationships, effective storytelling, and demonstrated effectiveness of VBP. Stakeholder influence emerges as an important enabler, emphasizing the importance of the early involvement of medical specialists and other key stakeholders, overcoming resistance and fostering collaboration during VBP adoption in hospitals.</p><p><strong>Conclusion: </strong>VBP in healthcare prioritizes optimal patient outcomes and value over costs. Although this is a promising concept, we identified several barriers and enablers for implementing VBP. While facing barriers related to procurement skills and environmental context, successful implementation relies on, among other things, training and stakeholder involvement, including early involvement of key stakeholders such as medical specialists and healthcare insurers, ambassadorship, trust-building, and effective storytelling.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8514"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788980","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":"Barriers and Facilitators to International Universal Health Coverage Reforms: A Realist Review.","authors":"Liz Farsaci, Padraic Fleming, Louise Caffrey, Sara Van Belle, Catherine O'Donoghue, Arianna Almirall-Sanchez, David Mockler, Steve Thomas","doi":"10.34172/ijhpm.8709","DOIUrl":"10.34172/ijhpm.8709","url":null,"abstract":"<p><strong>Background: </strong>The journey towards universal health coverage (UHC) began decades ago but has recently moved to centre stage in global health discourses with its inclusion in the Sustainable Development Goals (SDGs). As part of this renewed interest, 193 countries have committed to introducing UHC by 2030. However, its implementation often necessitates far-reaching health system reforms. This, coupled with the struggles countries face in relation to health financing, as well as distinct political, social and cultural contexts, means there are significant challenges to UHC implementation. This article contributes new knowledge to these discourses by identifying key contexts and mechanisms that facilitate the successful implementation of UHC reforms, as well as barriers that can impede progress.</p><p><strong>Methods: </strong>This realist review identifies key contexts and mechanisms that can facilitate the successful implementation of UHC reforms. EMBASE, MEDLINE and Web of Science were searched (1995-2022), resulting in 957 articles with the protocol published through Prospero (PROSPERO 2023: CRD42023394427). Further theory-driven searches resulted in an additional 988 studies. Descriptive, inductive, deductive, and retroductive realist analysis aided the development of Context-Mechanism-Outcome Configurations (CMOCs), along with stakeholder engagement to confirm or refute results. Causal pathways, and the interplay between contexts and mechanisms that triggered outcomes, were revealed.</p><p><strong>Results: </strong>How each country goes about implementing UHC reforms depends on its context. Cohesion across all systems, as well as the functions of financing, governance and service delivery, facilitates these reforms. Implementation can also be facilitated through political commitment, communication between stakeholders in the public health system and the development of a strong primary care sector. Conversely, fragmentation across these functions pose significant barriers to UHC reforms.</p><p><strong>Conclusion: </strong>Examining international experiences of UHC reforms supports learning around the mechanisms that support or hinder implementation processes. These learnings can empower policy-makers and health system leaders by providing roadmaps for reform implementation.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8709"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788981","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":"Broadening the Boundaries of Integrated Care in Response to Necessity: Where Are the Limits for Each Sector, and Who Should Pay for What? Comment on \"The Effect of Integrated Care After Discharge From Hospitals on Outcomes Among Korean Older Adults\".","authors":"Jonathan Stokes","doi":"10.34172/ijhpm.9084","DOIUrl":"10.34172/ijhpm.9084","url":null,"abstract":"<p><p>Impacts of integrated care interventions, particularly on utilisation and financial outcomes, can be mixed, sometimes quite disappointing when compared to expectations. Positive deviants come along occasionally, but it is extremely difficult to unpick exactly why one intervention might \"work\" where others have not. Choi and Yoo evaluated a programme in Korea, which appears to have increased time older patients discharged from hospital spend at home, reduced their odds of a subsequent emergency admission, and decreased total expenditure, although re-admissions increased. The programme stands out particularly in its breadth of non-traditional care activity, home-based primary care and long-term (social) care services, but also broader activities such as nutrition support (eg, meal delivery), movement assistance, lifestyle education, housekeeping, and even home repair. In this commentary, I discuss this broadening of interventions to capture more social determinants of health, ask where boundaries of each sector/service should lie, and who should pay for what.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9084"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788994","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":"Confronting \"Socio-Political Inertia\" on the Long and Winding Road to \"Healthy Societies\" Comment on \"How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks\".","authors":"Harvy Joy Liwanag, Natasha Howard","doi":"10.34172/ijhpm.9150","DOIUrl":"10.34172/ijhpm.9150","url":null,"abstract":"<p><p>The vision to create \"Healthy Societies\" is a reiteration of \"Health for All\" first made in the Declaration of Alma-Ata almost half a century ago. We contend that this long journey is due to \"Socio-Political Inertia\" that has prevented societies from transforming even in the presence of enabling policies. The analysis of policy documents by Nambiar et al could help set the stage for understanding how best to advance healthy societies, but the aspirations expressed in documents require active engagement and implementation to enable societal change. We first draw inspiration from the convergence of multiple streams in Kingdon's model in exploring how to chart the journey toward healthy societies. We then argue that the vision of healthy societies should be articulated in ways that speak to the different societies that will own it and build coalitions to turn this vision into reality.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9150"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788999","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":"Co-production of Diagnostic Excellence - Patients, Clinicians, and Artificial Intelligence Comment on \"Achieving Diagnostic Excellence: Roadmaps to Develop and Use Patient-Reported Measures With an Equity Lens\".","authors":"Sumant R Ranji, Benjamin I Rosner","doi":"10.34172/ijhpm.8973","DOIUrl":"10.34172/ijhpm.8973","url":null,"abstract":"<p><p>Patients often experience long journeys within the healthcare system before obtaining a diagnosis. Though progress has been made in measuring the quality of diagnosis, existing measures largely fail to capture the diagnostic process from the patient's perspective. McDonald and colleagues' paper presents 7 overarching goals for the use of patient-reported measures (PRMs) in diagnostic excellence and presents visual roadmaps to guide the development, implementation, and evaluation of these measures. To accelerate the real-world use of PRMs, organizations should initially prioritize the use of patient-reported metrics that are already in development, such as patient-reported experience measures. Pairing PRMs with artificial intelligence (AI) techniques, such as \"diagnostic wayfinding\" (a dynamic diagnostic refinement process that also includes analysis of electronic health record data and metadata to characterize the diagnostic journey), should also improve diagnostic performance. Ultimately, combining PRMs with technological advancements holds the potential to achieve true co-production of diagnostic excellence.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8973"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789000","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":"Engaging Councillors to Address Structural and Social Drivers of HIV Infections in Blantyre City: A Formative Study.","authors":"Edna N Bosire, Victor Mwapasa, Emily Mendenhall, Sara Allinder, Deborah Hoege, Pilira Chirambo, Emmanuel Kanjunjunju, Gift Kawalazira, Yohane Kamwigira, Tione Chilambe, Charles B Holmes","doi":"10.34172/ijhpm.8550","DOIUrl":"10.34172/ijhpm.8550","url":null,"abstract":"<p><strong>Background: </strong>Blantyre city is among the jurisdictions in Malawi with the highest rates of people living with HIV and new HIV infections, driven by numerous structural factors. The Malawi National AIDS Commission hypothesized that local elected officials may be uniquely positioned to understand and address structural drivers of HIV infection in their communities. However, these leaders have been disengaged in HIV prevention efforts over time. This formative study aimed to explore city councillors' understanding of the HIV landscape in Blantyre, including structural drivers of HIV, and to identify opportunities for engaging elected city councillors to address these drivers.</p><p><strong>Methods: </strong>Between November-December 2021, we conducted a descriptive qualitative study in Blantyre city, involving 59 purposively sampled participants: 23 city councillors, 14 technical experts, 7 implementing partners, and 15 community leaders. Data were collected through in-depth interviews and analysed thematically using MAXQDA software.</p><p><strong>Results: </strong>HIV technical experts and implementing partners were generally knowledgeable about the current HIV epidemic in Blantyre while most councillors and community leaders were not. Nearly all participants referenced structural drivers of HIV transmission in the city, including migration between districts, poverty, substance abuse, and transactional sex. Councillors noted their successes in mobilizing people and identifying resources for projects. However, they reported limited knowledge and training in HIV, no involvement in related programmes in their wards, and had minimal access to HIV data. They suggested access to trainings and data would equip them to better engage with HIV programs.</p><p><strong>Conclusion: </strong>Elected leaders in Blantyre have limited access to HIV data and training. However, they demonstrate well-established relationships with ward residents and possess motivation and interest in enhancing their knowledge and capacity to address structural and other drivers of HIV infection-key factors for designing interventions for local leaders.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8550"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789015","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":"Features of Remote Patient Monitoring Systems That Implement Integrated Care: A Perspective Aligned With Current Challenges for Digital Health Technologies Comment on \"Towards A Framework for Implementing Remote Patient Monitoring From an Integrated Care Perspective: A Scoping Review\".","authors":"Ana Londral","doi":"10.34172/ijhpm.8724","DOIUrl":"10.34172/ijhpm.8724","url":null,"abstract":"<p><p>This commentary elaborates on the model proposed by Miranda et al for implementing remote patient monitoring (RPM) from an integrated care perspective. It stresses the complexity of RPM deployment as a digital health technology (DHT) and discusses essential features that developers and procurement managers should take into consideration in RPM systems to facilitate the implementation of integrated care practices. Furthermore, three major challenges for DHT implementation that align with the proposed RPM-based integrated care model are discussed: (1) the success of DHT in implementing a healthcare strategy requires elements of service innovation that align to the context of care delivery; (2) evidence generation methods influence the adoption of DHT and need an evolutive and multi-stakeholder perspective; (3) governance and policy strategies are crucial since they profoundly influence digital health priorities, investments, and resource allocation within organizations and healthcare systems.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8724"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789017","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 Benefit Package Revision Is an Art as Much as a Science - Lessons Learned on the Organization of the Appraisal Phase.","authors":"Rob Baltussen, Mojtaba Nouhi, Andrew Mirelman, Sameen Siddiqi, Cassandra Nemzoff, Gavin Surgey, Stella Umuhoza, Saltanat Zhetibaeva, Baktygul Isaeva, Anna Vassal","doi":"10.34172/ijhpm.8819","DOIUrl":"10.34172/ijhpm.8819","url":null,"abstract":"<p><p>Many low- and middle-income countries are designing or revising their health benefit packages (HBPs), with appraisal-prioritizing services for reimbursement-being a critical phase. This occurs in a complex landscape of multiple criteria, multiple stakeholders, limited evidence, budget constraints, and tight timelines, varying across countries. Existing guidance documents do not fully address these complexities, requiring analysts to balance methodological rigor with practical constraints. This editorial highlights four key themes in organizing appraisal: decision-making structures, trade-offs between criteria, final recommendations, and the use of cost-effectiveness evidence, thresholds, and budgets. These emerged as central challenges in HBP revisions in Iran, Kyrgyzstan, Liberia, Pakistan, and Rwanda. We emphasize cross-country learning to address these challenges pragmatically, recognizing that high-quality, legitimate appraisal is as much an art as a science. More detailed documentation of appraisal processes is needed to refine HBP revision guidelines and strengthen priority-setting in health systems.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8819"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789023","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}