International Journal of Health Policy and Management最新文献

{"title":"Construct Clarity in Physician-Hospital Alignment: The Need for Precision in Definition, Measurement, and Management Comment on \"Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands\".","authors":"Chad T Brinsfield","doi":"10.34172/ijhpm.8644","DOIUrl":"https://doi.org/10.34172/ijhpm.8644","url":null,"abstract":"<p><p>The study by Ubels and van Raaij highlights the importance of alignment in hospital-physician relationships and the challenges in understanding, measuring, and managing it. Despite extensive research on alignment, drawing precise conclusions about its nature, drivers, and outcomes is difficult due to construct clarity and construct validity issues. This commentary focuses on clarifying these issues and the problems they create for hospitals attempting to manage alignment, as well as for scientific inquiry in this area. These issues involve the need to specify more clearly the essential nature of alignment and how it is distinct from other constructs such as engagement. It also involves demarcating alignment from the structures, arrangements, or processes intended to foster it, as well as from its outcomes. Improved precision in these areas will enable the development of more reliable and valid measures, thereby supporting hypothesis testing, theory building, and the identification of best practices.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8644"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768803","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":"Decentralisation of the Health System Derailed by Organisational Inertia in Machinga, Malawi.","authors":"Sandram Erixy Naluso, MacDonald Isaac Kanyangale","doi":"10.34172/ijhpm.7956","DOIUrl":"10.34172/ijhpm.7956","url":null,"abstract":"<p><strong>Background: </strong>Managing the transition of a health system (HS) from a centralised to a decentralised model has been touted as a panacea to the complex challenges in developing countries like Malawi. However, recent studies have demonstrated that decentralisation of the HS has had mixed effects in service provision with more dominant negative outcomes than positive results. The aim of this study was to develop a substantive grounded theory (GT) that elaborates on how activities of central decision-makers and local healthcare mangers shape the process of shifting the HS to a decentralised model in Machinga, Malawi.</p><p><strong>Methods: </strong>The study was qualitative in nature and employed the Straussian version of GT. Some participants were interviewed twice, and a total of 36 semi-structured interviews were conducted with 25 purposively selected participants using an interview guide. The interviews were conducted at the headquarters of the Ministry of Health (MoH) and other ministries and agencies, and in Machinga District. Data were analysed using open, axial, and selective coding processes of the GT methodology; and the conditional matrix and paradigm model were used as data analysis tools.</p><p><strong>Results: </strong>The findings of this study revealed seven different activities, forming two opposing and interactional sub-processes of enabling and impeding patterns that derailed the decentralisation drive. The study generated a GT labelled \"decentralisation of the HS derailed by organisational inertia,\" which elaborates that decentralisation of the HS produced mixed results with more predominant negative outcomes than positive effects due to resistance at the upper organisational echelons and members of the District Health Management Team (DHMT).</p><p><strong>Conclusion: </strong>This article concludes that organisational inertia at the personal and strategic levels of leadership entrusted with decentralising the HS in Malawi, contributed immensely to the derailment of shifting the HS from the centralised to the decentralised model of health service provision.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"7956"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889136","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":"Effect of Cost-Exemption Policy on Treatment Interruption in Patients With Newly Diagnosed Pulmonary Tuberculosis in South Korea.","authors":"Sang Chul Lee, Jae Kwang Lee, Hyun Woo Ji, Jung Mo Lee, Seon Cheol Park, Chang Hoon Han","doi":"10.34172/ijhpm.8262","DOIUrl":"10.34172/ijhpm.8262","url":null,"abstract":"<p><strong>Background: </strong>In 2021, South Korea had the highest incidence rate (49 per 100 000 population) and the third highest mortality rate (3.8 per 100 000 population) due to pulmonary tuberculosis (TB) among Organization for Economic Co-operation and Development countries. Notably, premature interruption of TB treatment interferes with TB control efforts. Therefore, we examined the effect of the co-payment waiver on treatment interruption and mortality among patients with pulmonary TB in South Korea.</p><p><strong>Methods: </strong>Patients who had newly treated TB in South Korea from 2013 to 2019 were selected from the nationwide data of the entire Korean National Health Insurance Service (NHIS) population. The effects of policy implementation on treatment adherence and mortality rates depending on treatment interruption history were evaluated.</p><p><strong>Results: </strong>In total, 73 116 and 1673 patients with drug-susceptible (DS) and multidrug-resistant (MDR) pulmonary TB, respectively, were included in the final study population. After implementing the cost-exemption policy, the treatment interruption rate tended to decrease in the continuation phase in the DS-TB group (slope change: -0.097, <i>P</i>=.011). However, it increased in the intensive phase in the MDR-TB group (slope change: 0.733, <i>P</i>=.001). MDR-TB patients were likely to experience an interruption of TB treatment (adjusted odds ratio [aOR], 6.04; 95% CI, 5.43-6.71), and treatment interruption history was a significant risk factor for 1-year and overall mortality rates (adjusted hazard ratios [aHRs]: 2.01, 95% CI, 1.86-2.18 and 1.77, 95% CI, 1.70-1.84, respectively) in the DS-TB group.</p><p><strong>Conclusion: </strong>Implementing the cost-exemption policy effectively reduced the treatment interruption rate among patients with DS pulmonary TB.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8262"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889137","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":"Entry of Migrant Workers to Malaysia: Consideration to Implement Mass Drug Administration Against Intestinal Parasitic Infections.","authors":"Norhidayu Sahimin, Nabila Abu Bakar, Yvonne Ai Lian Lim, Jerzy Marian Behnke, John Lewis, Nurliana Kamaruddin, Siti Nursheena Mohd Zain","doi":"10.34172/ijhpm.2024.7842","DOIUrl":"10.34172/ijhpm.2024.7842","url":null,"abstract":"<p><p>Over the last five decades, widespread industrialisation and urbanisation have resulted in the influx of low-skilled workers, particularly from Southeast and West Asia to Malaysia. The current practice for migrant workers entry for employment requires mandatory medical screening for infectious diseases. However, screening for parasitic infections in Malaysia is woefully inadequate. Many migrants come from low-income countries where parasitic infections are common, which may have public health implications for their overall well-being as parasitic infections, although not critical, may impact their overall productivity. The high prevalence of intestinal parasitic infections (IPIs) recorded among migrant workers in Malaysia necessitates improvement in the national health policy to include mandatory mass administration of a single dose of anthelmintic drugs to all low-skilled migrant labourers, particularly upon entry into the country, admission, and encourage continuous surveillance. A constant stream of migrant labourers is anticipated, potentially resulting in an ongoing occurrence of parasitic infections within the population. The implementation of economic measures like health awareness initiatives, routine deworming campaigns, and improved sanitation facilities holds the potential to reduce the spread of these infections notably. More often than not, taking preventive actions proves to be more financially efficient over time compared to addressing severe infections at a later stage.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"7842"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889138","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":"Negative Emotions Are Associated With Older Self-perceived Age: A Cross-section Study From the UK Biobank.","authors":"Tianyi Wang, Shixing Feng, Junqi Wang, Hangyu Li, Yang Song, Dongran Han, Yixing Liu","doi":"10.34172/ijhpm.8060","DOIUrl":"10.34172/ijhpm.8060","url":null,"abstract":"<p><strong>Background: </strong>Prior research has indicated a potential connection between psychological stress and how individuals perceive their own age. Building on this foundation, the current study explores the relationship between negative emotions and self-perceived age.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from the UK Biobank, a comprehensive cohort study representing the UK population. The analysis included 347 892 participants, aged between 39 and 73 years, of which 184 765 were women, accounting for 53.1% of the sample. Participants were categorized into three groups based on their self-perceived age: feeling younger than their chronological age (group Younger), feeling older than their chronological age (group Older), and feeling as old as their actual age (group Same). To investigate the relationship between negative emotions and self-perceived age, we utilized a multinomial logistic regression model with the Younger group serving as the reference category.</p><p><strong>Results: </strong>Of 347 892 participants, after adjusted for covariates, the results showed that participants with irritability, nervous feelings, worrier/anxious feelings or fed-up feelings, worry too long and loneliness/isolation are more likely to be rated as \"about your age\" or \"older than you are,\" with \"younger than you are\" as the reference group, indicating that negative emotions may influence one's self-perceived age. Among those negative emotions, irritability has the most significant impact self-perceived age, with the odds ratios (ORs) being 1.44 (95% CI: 1.35-1.54) and 1.11 (95% CI: 1.09-1.14).</p><p><strong>Conclusion: </strong>Negative emotions are associated with older self-perceived age, and irritability has the greatest impact. Further studies analyzing self-perceived age are needed to take psychological factors into consideration.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8060"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889168","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 Opportunities for WHO \"Best Buys\" Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review.","authors":"Giulia Loffreda, Stella Arakelyan, Ibrahim Bou-Orm, Hampus Holmer, Luke N Allen, Sophie Witter, Alastair Ager, Karin Diaconu","doi":"10.34172/ijhpm.2023.7989","DOIUrl":"10.34172/ijhpm.2023.7989","url":null,"abstract":"<p><strong>Background: </strong>Improving the adoption and implementation of policies to curb non-communicable diseases (NCDs) is a major challenge for better global health. The adoption and implementation of such policies remain deficient in various contexts, with limited insights into the facilitating and inhibiting factors. These policies have traditionally been treated as technical solutions, neglecting the critical influence of political economy dynamics. Moreover, the complex nature of these interventions is often not adequately incorporated into evidence for policy-makers. This study aims to systematically review and evaluate the factors affecting NCD policy adoption and implementation.</p><p><strong>Methods: </strong>We conducted a complex systematic review of articles discussing the adoption and implementation of World Health Organization's (WHO's) \"best buys\" NCD policies. We identified political economy factors and constructed a causal loop diagram (CLD) program theory to elucidate the interplay between factors influencing NCD policy adoption and implementation. A total of 157 papers met the inclusion criteria.</p><p><strong>Results: </strong>Our CLD highlights a central feedback loop encompassing three vital variables: (1) the ability to define, (re)shape, and pass appropriate policy into law; (2) the ability to implement the policy (linked to the enforceability of the policy and to addressing NCD local burden); and (3) ability to monitor progress, evaluate and correct the course. Insufficient context-specific data impedes the formulation and enactment of suitable policies, particularly in areas facing multiple disease burdens. Multisectoral collaboration plays a pivotal role in both policy adoption and implementation. Effective monitoring and accountability systems significantly impact policy implementation. The commercial determinants of health (CDoH) serve as a major barrier to defining, adopting, and implementing tobacco, alcohol, and diet-related policies.</p><p><strong>Conclusion: </strong>To advance global efforts, we recommend focusing on the development of robust accountability, monitoring, and evaluation systems, ensuring transparency in private sector engagement, supporting context-specific data collection, and effectively managing the CDoH. A system thinking approach can enhance the implementation of complex public health interventions.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"7989"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863856","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":"Fostering Experiential Learning and Evidence-Informed Impact in Health Systems: Reflections From a Canadian Health System Impact Fellow.","authors":"Jawad Chishtie, Peter Kellett, Mohammed Imran, Meaghan Sim, Shawna Cronin, Christopher Collins, Beverley Catharine Craven, Sara Guilcher, Susan Jaglal","doi":"10.34172/ijhpm.8074","DOIUrl":"https://doi.org/10.34172/ijhpm.8074","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8074"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768701","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":"A Need for Honoring Healthcare Retirees: Proposed Recommendations.","authors":"Fatemeh Shaygani, Behnam Honarvar, Farahnaz Izadi, Fatemeh Rafiee","doi":"10.34172/ijhpm.8455","DOIUrl":"https://doi.org/10.34172/ijhpm.8455","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8455"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768794","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":"A New Outcomes-Based Payment Plan From a Chinese Company to Improve Patient Affordability of CAR-T Product.","authors":"Si-Li Zheng, Xiao-Qing Zhang","doi":"10.34172/ijhpm.8543","DOIUrl":"https://doi.org/10.34172/ijhpm.8543","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8543"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768795","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":"Activating Mechanisms Through Employee-Driven Innovation Comment on \"Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review\".","authors":"Carolyn Steele Gray","doi":"10.34172/ijhpm.8612","DOIUrl":"https://doi.org/10.34172/ijhpm.8612","url":null,"abstract":"<p><p>Caddedu and colleagues' paper \"Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review,\" presents findings regarding the state of the literature around employee-driven innovation (EDI). In uncovering the who, what, and how of EDI in healthcare organizations the authors suggest that embracing EDI at an organizational level may be a key to supporting larger system transformation efforts. This commentary builds on this contention suggesting that to help realize that broader vision, attention should be paid to the overlapping implementation mechanisms around empowerment, adaptability, learning, and meaning and value that drive both processes. Finally, it is suggested that what may be most powerful about EDI is its ability to bring joy and vitality back to a healthcare workforce that is currently in crisis.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8612"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768796","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}