International Journal of Health Policy and Management最新文献

{"title":"What Defines an Age-Friendly Health System? Comment on \"Developing a Conceptual Framework for an Age-Friendly Health System: A Scoping Review\".","authors":"Margaret Wallhagen","doi":"10.34172/ijhpm.9374","DOIUrl":"10.34172/ijhpm.9374","url":null,"abstract":"<p><p>To address some of the changing needs of the increasing number of older adults, theories and conceptual frameworks designed to make environments and healthcare settings more welcoming to, and supportive of, older adults, have been proposed. Most recently, significant attention has been given to the concept of an \"age-friendly health system.\" While the concept of age-friendly environments is not new, how such environments are operationalized varies, few data are available on outcomes, and there remains debate about the essential nature of key components of an age-friendly environment. This commentary discusses the conceptual framework proposed by Karami and colleagues published in the 2023 edition of the <i>International Journal of Health Policy and Management</i>. Questions are raised about the meaning of age-friendly and how it can be integrated into a life-span perspective of health.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9374"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662734","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":"Comprehensive Evaluation of Quality Indicators: Analyzing the Dutch Breast Cancer Audit.","authors":"Elfi M Verheul, Margrietha van der Linde, Hester F Lingsma, Elvira Vos, Sabine Siesling, Linetta B Koppert, Nbca Consortium","doi":"10.34172/ijhpm.8943","DOIUrl":"10.34172/ijhpm.8943","url":null,"abstract":"<p><strong>Background: </strong>Quality indicators (QIs) are widely used to benchmark hospital performance and improve quality of care but are often based on expert opinion rather than data-driven assessment. This study aims to evaluate QIs, using a framework that assesses four criteria: Feasibility, discriminative ability, validity, and reliability.</p><p><strong>Methods: </strong>We used data from the Dutch breast cancer registry (NABON Breast Cancer Audit, NBCA) and included all surgically treated breast cancer patients in the Netherlands between 2021-2023. Eighteen QIs were evaluated. Feasibility was determined by QI numerator completeness, with >90% data availability considered feasible. Discriminative ability was assessed by between-hospital variation in QI scores, where an interquartile range (IQR) >10% indicated good discrimination. Validity was evaluated by the impact of case-mix adjustment and considered low when (pseudo-) R² <0.10. The (pseudo-)R² reflects the proportion of variance in QI scores explained by all case-mix variables in a regression model. Reliability was assessed by rankability, the proportion of between-hospital variation not due to chance and, therefore, explainable by quality of care. Rankability >75% was considered high.</p><p><strong>Results: </strong>After exclusion of one QI with feasibility <1%, feasibility ranged from 80.2%-100%, and 15 QIs were feasible. Overall, the IQR ranged from 1 to 36, with 8 QIs having an IQR higher than 10, indicating good discriminative ability. The (pseudo-)R² ranged from 0.01-0.53, with 11 QIs showing low case-mix impact. Rankability ranged from 0-69%, with none of the QIs having a high rankability. None of the QIs met all preset criteria, but six QIs met at least three out of four criteria.</p><p><strong>Conclusion: </strong>The QIs employed by the Dutch breast cancer registry fulfilled most criteria, but rankability is a concern and requires specific attention, especially for public reporting. Our results show the importance of considering feasibility, discriminative ability, validity, and reliability when evaluating QIs, and these should also be taken into account when developing new QIs.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8943"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662414","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":"Exploring Grassroots Indicators for Pandemic Prevention, Preparedness, and Response: A Systematic Narrative Review.","authors":"Million Tesfaye Eshete, Pami Shrestha, Charmaine Ang, José María Valderas, David L Heymann, Anders Nordström, Kelley Lee, Alex Cook, Clare Wenham, Pablo Perel, J Jaime Miranda, Alberto L Garcia-Basteiro, Helen Clark, Helena Legido-Quigley, Eivind Engebretsen","doi":"10.34172/ijhpm.8886","DOIUrl":"10.34172/ijhpm.8886","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has revealed how conventional top-down, expert-driven indicators often fail to align with local community realities, marginalising their perspectives, concerns, knowledge, and narratives. However, the limitations of pandemic-related and global health security indicators are not unique but reflect recurring patterns across major social metrics. In response, an alternative paradigm advocates for grassroots-inclusive approaches to developing indicators. Our objective is to assess how and why grassroots-inclusive approaches complement top-down approaches to developing indicators, and to synthesise their theoretical and practical contributions to public health.</p><p><strong>Methods: </strong>We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. We systematically searched six databases (MEDLINE, Embase, CINAHL, Web of Science, Scopus, and PsycINFO), as well as Google Scholar, to identify relevant articles published from their inception to September 1, 2024. We included peer-reviewed articles, opinion pieces, and book chapters, narratively synthesising their findings.</p><p><strong>Results: </strong>This review included 43 studies from various disciplines. Across these studies, communities co-produced indicators through participatory workshops, interviews, and consensus exercises in areas such as environmental sustainability, disaster resilience, public health, well-being, and local development. The reported strengths included greater local relevance, community ownership, and accountability, alongside challenges in sustaining participation, integrating into top-down systems, and addressing data gaps. Notably, no study applied grassroots-inclusive indicators to health security or pandemic preparedness.</p><p><strong>Conclusion: </strong>Despite retrieving and analysing articles from various disciplines, no study has specifically applied grassroots-inclusive indicators to health security or pandemic preparedness. However, the evidence clearly shows that it is both feasible and practical to integrate expert and non-expert perspectives when developing indicators.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8886"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662585","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":"Rethinking Reallocations: Conceptual Limits of the Market Activity Index as a Measure of Competition and Purchasing Comment on \"Measuring Active Purchasing in Healthcare: Analyzing Reallocations of Funds Between Providers to Evaluate Purchasing Systems Performance in the Netherlands\".","authors":"Misja C Mikkers","doi":"10.34172/ijhpm.9322","DOIUrl":"10.34172/ijhpm.9322","url":null,"abstract":"<p><p>Stadhouders et al1 introduce the Market Activity Index (MAI) to assess the performance of healthcare systems, concluding that low budget reallocations in the hospital sector cast doubt on the effectiveness of managed competition and purchasing. We argue that while the MAI is a valuable descriptive tool, its interpretation as a proxy for competition is conceptually problematic. The index captures realized revenue flows, which may result from patient mobility, exogenous shocks, or administrative changes, rather than insurer behavior. Furthermore, selective contracting may be used for objectives such as risk selection rather than provider efficiency, particularly in segments of the market with low utilization. Without a normative benchmark or ability to disentangle strategic from structural effects, the MAI risks conflating system dynamics with market failure. We conclude that the MAI is best viewed as a measure of budgetary volatility, not a standalone indicator of competitive intensity or purchaser effectiveness.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9322"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662809","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-creating Inclusive and Non-ableist Public Health Policies With Persons With Disabilities 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":"Janet Njelesani","doi":"10.34172/ijhpm.8694","DOIUrl":"10.34172/ijhpm.8694","url":null,"abstract":"<p><p>In their study, Shikako et al analyzed how national policies during the COVID-19 pandemic either supported or neglected the rights of persons with disabilities, aiming to inform the development of inclusive policies that align with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). They concluded that the differences in policies across countries during the COVID-19 pandemic indicate a need for greater alignment and standardization of policy responses for individuals with disabilities. While the study revealed disparities across countries and underscored the importance of disability-inclusive policy, this commentary provides actionable insights to guide governments in creating equitable policies that uphold the rights of persons with disabilities during crises and beyond. Specific recommendations in accordance with the UNCRPD include the establishment of permanent consultative committees, adopting a shared understanding of disability, addressing intersectionality and structural barriers, and utilizing non-ableist participation methods so that a diverse range of perspectives are incorporated and lived experiences shape the policies that impact them.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8694"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788997","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":"Determinants of Socioeconomic Inequalities in Well-Being in Canada: Evidence From the Nova Scotia Quality of Life Survey.","authors":"Daniel Keays, Mohammad Hajizadeh","doi":"10.34172/ijhpm.8643","DOIUrl":"10.34172/ijhpm.8643","url":null,"abstract":"<p><p>There are relatively few studies that have measured and explained socioeconomic inequalities in the well-being of populations. Using unique information available in the 2019 Nova Scotia Quality of Life Survey (NSQLS, n=9388), this study provides analysis of the determinants of socioeconomic inequalities in well-being of adults aged 18 and above in Nova Scotia, Canada. The population's well-being was measured using the Canadian Index of Wellbeing (CIW), which encompasses quality of life across eight domains. The Concentration index (C) approach was utilized to quantify and identify factors explaining socioeconomic inequality in well-being. A positive value of the C (0.0294; 95% confidence interval: 0.0267 to 0.0321) indicated pro-rich inequality in well-being among Nova Scotian residents. Results of the decomposition analysis indicated that the concentration of favorable mental health, education levels, and income among high socioeconomic status (SES) groups accounted for over 86% of the observed socioeconomic inequality in the population's well-being. Our findings demonstrated that inequalities in mental health, education, and income are significant obstacles to reducing inequality in well-being in Nova Scotia, Canada. Thus, policies aimed at alleviating inequalities in these factors may help to reduce socioeconomic inequality in well-being in Nova Scotia, Canada.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8643"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789004","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":"Governance of Public-Private Partnerships for Primary Healthcare in Low- and Lower-Middle-Income Countries, 2000-2023: A Systematic Review.","authors":"Georgina Dove, Adam Craig, Ben Harris-Roxas, Angela Kelly-Hanku","doi":"10.34172/ijhpm.8442","DOIUrl":"10.34172/ijhpm.8442","url":null,"abstract":"<p><strong>Background: </strong>Public-private partnerships (PPPs) in the health sector are established to achieve health outcomes by maximising the combined resources of both public and private sectors. Good governance is core to PPP function and success. This paper explores the factors that enable and constrain governance in the delivery of PPPs for primary healthcare (PHC) in low- and lower-middle-income countries (LLMICs).</p><p><strong>Methods: </strong>A systematic search of four literature databases was conducted to identify peer reviewed articles published between 2000 and 2023 related to the governance of PPPs for PHC in LLMICs. A deductive analysis of data extracted from selected articles against the domains of Greer's TAPIC (transparency, accountability, participation, integrity, and policy capacity) governance framework was conducted to identify commonly reported enabling and constraining factors.</p><p><strong>Results: </strong>Of the 4290 records screened, 14 were included. Common enabling factors for governance within each domain of the framework were found: Transparency: unequal and top-down resource allocation, and opaque and resource allocation was a barrier to PPP governance; Accountability and policy capacity: monitoring and evaluation; Participation: partner engagement, covering topics of developing and managing relationships, collaborative activities, and communication; and Integrity: the design of the PPP, covering formal agreements between partners, level of policy direction, and integration within the broader health system.</p><p><strong>Conclusion: </strong>The five domains of the TAPIC governance framework provide guidance for considering governance in PPPs. The enabling factors identified in the review help facilitate the successful implementation of a PPP and thus influence the PPP's impact on health outcomes, through establishing and maintaining healthy working relationships between partners, and defining and documenting systems and processes.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8442"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789022","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 Impact Mechanism of Government Regulation on the Operation of Smart Health Senior Care Service Platform: A Perspective From Evolutionary Game Theory.","authors":"Meng Xiao, Huan Liu","doi":"10.34172/ijhpm.8646","DOIUrl":"10.34172/ijhpm.8646","url":null,"abstract":"<p><strong>Background: </strong>Smart health and senior care services have developed rapidly to cater to the aging society, but the corresponding regulations are not perfect. The platform and senior care service enterprises have chosen different strategies due to various factors, resulting in disorderly platform development and inefficient resource allocation. This research attempts to establish a regulatory mechanism to promote the active development of the platform.</p><p><strong>Methods: </strong>In order to mitigate opportunistic behaviors in the smart health senior care service platform, drawing from evolutionary game theory, this study establishes a decision-making model involving the government, the platform, and senior care service enterprises, and scrutinizes the evolutionary behaviors and equilibrium strategies of these three parties.</p><p><strong>Results: </strong>There are five equilibrium points among the three parties in the game, and the strategy selection shows periodic changes. The cost and level of positive government regulation, the conversion rate of smart aging construction services provided by the platform, penalties for opportunistic behavior by the platform, as well as the benefits of positive cooperation and penalties for passive cooperation by senior care service enterprises, will significantly affect the strategies of all parties involved.</p><p><strong>Conclusion: </strong>The research results indicate that establishing a regulatory mechanism for the smart health senior care service platform can promote effective cooperation between platform and senior care service enterprises. Active government regulation is the key to the smooth operation of the platform. Through quantitative analysis, the main strategic choices of participants in the smart health senior care service platform can be explained. This model can provide a reference for formulating policies related to smart senior care.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8646"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789060","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 Missing Link: Why Value-Based Healthcare Needs Healthcare and Management Science to Unite Efforts Comment on \"Reflections on Managing the Performance of Value-Based Healthcare: A Scoping Review\".","authors":"Dorine van Staalduinen, Paul van der Nat","doi":"10.34172/ijhpm.9121","DOIUrl":"10.34172/ijhpm.9121","url":null,"abstract":"<p><p>Value-based healthcare (VBHC) has emerged as a widely embraced strategy to address pressing healthcare challenges, including workforce shortages, rising healthcare costs, and inconsistent care quality. A scoping review by van Elten et al shows that despite their expected importance of integrating VBHC with performance management systems, very few articles provide concrete examples of this integration. Drawing on existing performance management literature, the authors explore possible reasons for why VBHC practitioners and researchers have largely overlooked this topic. This commentary critically engages with their review by examining their conceptual definitions, offering alternative explanations for the apparent lack of performance management in VBHC, and suggesting directions for future interdisciplinary research.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9121"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789062","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":"Who Is Most Likely to Experience Corruption When Seeking Healthcare in Nigerian Healthcare Facilities?","authors":"Ifunanya Clara Agu, Chukwudi Nwokolo, Obinna Onwujekwe, Martin McKee, Eleanor Hutchinson, Blake Angell, Dina Balabanova","doi":"10.34172/ijhpm.8687","DOIUrl":"10.34172/ijhpm.8687","url":null,"abstract":"<p><strong>Background: </strong>Experiencing corruption when seeking health services remains a significant problem in Nigeria. An effective response requires knowledge of the individual characteristics of those impacted by corruption when seeking healthcare. This study examined the prevalence of corruption among those seeking health services in Nigeria's public healthcare facilities and how it varies among different user groups.</p><p><strong>Methods: </strong>We used a pre-tested interviewer-administered questionnaire to collect data from 1659 individuals randomly selected from households in two Nigerian states. We collected data on respondents' socio-demographic characteristics and experiences of corrupt practices. We undertook descriptive and binomial logistic regression analyses.</p><p><strong>Results: </strong>Approximately 50% (823) of respondents experienced corrupt practices, such as using connections for faster treatment and bribery when seeking health services. 446 (27%) respondents bribed or made so-called unapproved payments to health providers to obtain health services. Gender was a strong predictor, with male healthcare service users being more likely to experience corrupt practices (%point risk difference=24; 95% CI=20, 29) and bribe or make an unapproved payment to obtain healthcare (%point risk difference=20; 95% CI=15, 25). Residents in the northern state were (%point risk difference=30; 95% CI=26, 35) more likely to experience corrupt practices than residents in the eastern state. People seeking healthcare in urban (%point risk difference=09; 95% CI=-05, 08) and semi-urban (%point risk difference=12; 95% CI=05, 19) locations were more likely to have bribed or made 'unapproved' payments to healthcare providers compared to rural residents.</p><p><strong>Conclusion: </strong>Health sector corruption, in its various forms, is frequently reported in both northern and southern Nigeria. However, user experience of corruption varies according to socio-demographic characteristics, and this is often insufficiently acknowledged. To combat corrupt practices in both health sectors, anti-corruption initiatives must be tailored to particular groups and settings, addressing specific disadvantages at individual and community levels.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8687"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789068","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}