Health Policy Open最新文献_第10页

Long-term care (LTC) policy in Thailand on the homebound and bedridden elderly happiness 泰国长期照护(LTC)政策对居家与卧床老人幸福感的影响

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2020.100026

Savinee Suriyanrattakorn , Chia-Lin Chang

引用次数: 10

The role of document analysis in health policy analysis studies in low and middle-income countries: Lessons for HPA researchers from a qualitative systematic review 文件分析在低收入和中等收入国家卫生政策分析研究中的作用:定性系统评价给卫生政策研究人员的教训

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2020.100024

Naomi Karen Kayesa, Maylene Shung-King

{"title":"The role of document analysis in health policy analysis studies in low and middle-income countries: Lessons for HPA researchers from a qualitative systematic review","authors":"Naomi Karen Kayesa, Maylene Shung-King","doi":"10.1016/j.hpopen.2020.100024","DOIUrl":"10.1016/j.hpopen.2020.100024","url":null,"abstract":"<div><h3>Introduction</h3><p>Document analysis is commonly used in health policy analysis (HPA) studies, but the purpose and rigour of application is unclear. This review explored the application and utility of document analysis in HPA studies conducted in low-and-middle income countries (LMICs), intending to derive lessons for strengthening this methodology.</p></div><div><h3>Methods</h3><p>Employing a qualitative systematic review approach, nine electronic databases were searched for LMIC HPA articles that employed document analysis. Articles were subjected to systematic retrieval, storage and quality-assessment. Thematic analysis was used in coding, extraction and analysis of data.</p></div><div><h3>Results</h3><p>Only 28 studies had sufficiently detailed document analyses and met the inclusion criteria. Document analyses were mainly complimentary to primary data collection forms. The majority, barring four studies, lacked clear purpose and utility in answering the research questions, and rigour in methodology and the reporting thereof. The approach to document analyses bore no relationship to the policy phase investigated. Challenges in accessing documents contributed to methodological difficulties.</p></div><div><h3>Conclusion</h3><p>Well-executed document analysis has potential to strengthen HPA studies. Health Policy researcher skill in applying this methodology needs strengthening and could be improved by: purposive alignment of the method to research questions; rigorously applying and reporting on search strategy with rigour; source, organize and store documents systematically; apply robust data coding and analysis; and clearly linking document contribution to study findings and conclusions.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100024"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2020.100024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

Risk-based contracting for high-need Medicaid beneficiaries: The Arkansas PASSE program 高需求医疗补助受益人的基于风险的合同:阿肯色州PASSE计划

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2020.100023

Adrienne Nevola , Michael E. Morris , Carrie Colla , J.Mick Tilford

{"title":"Risk-based contracting for high-need Medicaid beneficiaries: The Arkansas PASSE program","authors":"Adrienne Nevola , Michael E. Morris , Carrie Colla , J.Mick Tilford","doi":"10.1016/j.hpopen.2020.100023","DOIUrl":"10.1016/j.hpopen.2020.100023","url":null,"abstract":"<div><p>The high cost of health care for people with behavioral health (BH) conditions or intellectual and developmental disabilities (IDD) in the United States led one state to implement the Provider-led Arkansas Shared Savings Entity (PASSE) program. PASSE is a managed care model that puts provider-led organizations at risk for the highest need people with BH conditions or IDD in Medicaid, a public health insurance program for low-income residents. Drawing on key informant interviews and payment models across the United States, we describe the PASSE program, how it compares with state Medicaid programs for similar populations, and prospects for the program. Key informants cited several PASSE features as promising mechanisms to improve beneficiary outcomes: expanded care coordination, service flexibility, incentives for community investments, accountability for cost and quality across physical health, behavioral health, and long-term care, quality target accountability, fostered competition, and provider ownership. Informants worry that PASSE features will be insufficient to catalyze changes in provider behavior. Efforts may be targeted to control costs primarily through service reductions with uncertain effects on quality of care. PASSE hinges on improved care coordination and increased efforts to address social determinants of health. Success or failure in these areas will likely determine whether PASSE leads to improved outcomes for two of the most costly and vulnerable populations.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100023"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2020.100023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physician descriptions of the influence of pay for performance on medical decision-making 医生描述绩效薪酬对医疗决策的影响

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100036

Beth Jeanette Graefe , JoAnn Foley Markette

{"title":"Physician descriptions of the influence of pay for performance on medical decision-making","authors":"Beth Jeanette Graefe , JoAnn Foley Markette","doi":"10.1016/j.hpopen.2021.100036","DOIUrl":"10.1016/j.hpopen.2021.100036","url":null,"abstract":"<div><h3>Objectives</h3><p>To explore physician descriptions of the influence of pay for performance (P4P) programs on their medical decision-making for the delivery of health care through three antecedents of behavior intention—attitude toward program compliance, perceived behavioral control, and subjective norms.</p></div><div><h3>Study design/setting</h3><p>This study utilized a qualitative descriptive research methodology to capture physician descriptions through semi-structured interviews and a focus group. Primary data was collected from actively practicing physicians in the United States with P4P experience.</p></div><div><h3>Principal findings</h3><p>The findings imply that multiple factors influence physicians’ attitudes toward program compliance summarized by four primary themes: (a) program compliance and beliefs of physicians in delivering patient care, (b) design, control, and performance motivation, (c) physician performance measurements and the opinions of others, and (d) patient care and compensation program considerations.</p></div><div><h3>Conclusions</h3><p>The findings suggest that physician involvement in the design, implementation, communication, and on-going evaluation of P4P models influence physician behavior. The findings also suggest that physicians are motivated by the delivery of what they believe is good patient care more than by P4P financial incentives. Finally, the most influential voices for physician P4P compliance includes their physician peers and administrators. Outside of the larger societal benefit of P4P compliance, individual family, friends, policymakers, payors, and others have little to no influence on physician decision-making.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9735890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Women’s satisfaction with maternal care services in Georgia 格鲁吉亚妇女对产妇护理服务的满意度

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2020.100028

Lela Sehngelia , Milena Pavlova , Wim Groot

{"title":"Women’s satisfaction with maternal care services in Georgia","authors":"Lela Sehngelia , Milena Pavlova , Wim Groot","doi":"10.1016/j.hpopen.2020.100028","DOIUrl":"10.1016/j.hpopen.2020.100028","url":null,"abstract":"<div><h3>Introduction</h3><p>Patient satisfaction is a key indicator of health care quality. We investigated women’s satisfaction with antenatal, natal and immediate postnatal care, as well as the association between women’s satisfaction with the care they received and background characteristics.</p></div><div><h3>Methods</h3><p>We conducted a survey in the capital and two regions of Georgia. 400 women, who gave birth to healthy babies during the preceding twelve months before the date of data collection, were the target population. Women’s opinion about the organization of maternal care (tangibility, availability, accessibility) and process characteristics (responsiveness, reliability, empathy, communication and courtesy) were measured. Women satisfaction with antenatal, natal and postnatal services was also measured.</p></div><div><h3>Results</h3><p>Women’s satisfaction with antenatal, natal, and immediate postnatal services was high. The respondents’ perception about the tangibility of maternity houses was quite positive, more than three quarters of the respondents agreed or strongly agreed with the statements that maternity houses/units were attractive and medical equipment was up to date. Regression analysis on satisfaction with antenatal, natal, and immediate postnatal showed that those who paid for services were less satisfied than those who did not pay. Women in urban areas were more satisfied with antenatal and natal services than in rural areas. High educated women were less satisfied than women with the lowest education level.</p></div><div><h3>Conclusions</h3><p>In general, women are satisfied with maternal care in Georgia. The high level of satisfaction can be due to the improvement in structural factors of maternal health care such as tangibility, availability, and accessibility.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2020.100028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Cost and budget impact analysis of a school-based vision screening programme in Cambodia and Ghana: Implications for policy and programme scale-up 柬埔寨和加纳基于学校的视力筛查方案的成本和预算影响分析:对政策和方案扩大的影响

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100043

Thomas Engels , Guillaume Trotignon , David Agyemang , Imran Khan , Kann Puthy , Liesbeth Roolvink , Elena Schmidt

{"title":"Cost and budget impact analysis of a school-based vision screening programme in Cambodia and Ghana: Implications for policy and programme scale-up","authors":"Thomas Engels , Guillaume Trotignon , David Agyemang , Imran Khan , Kann Puthy , Liesbeth Roolvink , Elena Schmidt","doi":"10.1016/j.hpopen.2021.100043","DOIUrl":"10.1016/j.hpopen.2021.100043","url":null,"abstract":"<div><p>Poor vision due to unaddressed refractive error in children is considered to be a public health problem in many low- and middle-income countries. Research shows that correcting refractive error with spectacles could have a positive impact on school attendance and academic performance for children. The aim of this study was to estimate the cost of integrating vision screening and provision of spectacles in existing school health programmes in Cambodia and Ghana. Budget impact analysis of the intervention scale up is also reported, including univariate and multivariate sensitivity analyses. This study suggests that the scale up of school-based vision screening programmes is affordable in resource limited settings, such as Cambodia and Ghana, considering the current education budgets, and providing there is sufficient in-country capacity to deliver such interventions at scale. The study highlights several policy and programme implications and provides suggestions for minimising costs and maximising efficiencies of vision screening in a school setting. Findings from this analysis can help education planners and international partners to improve their planning and budgeting processes for school-based interventions to improve health and learning outcomes for children in low- and middle-income countries.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Messenger effects in COVID-19 communication: Does the level of government matter? COVID-19传播中的信使效应:政府级别重要吗?

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2020.100027

Nathen Favero , Sebastian Jilke , Julia A. Wolfson , Chengxin Xu , Matthew M. Young

引用次数: 8

Intersection of class, caste, gender and unmet healthcare needs in India: Implications for health policy 印度阶级、种姓、性别和未满足的医疗保健需求的交集:对卫生政策的影响

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100040

Sandhya R. Mahapatro , K.S. James , Udaya S. Mishra

{"title":"Intersection of class, caste, gender and unmet healthcare needs in India: Implications for health policy","authors":"Sandhya R. Mahapatro , K.S. James , Udaya S. Mishra","doi":"10.1016/j.hpopen.2021.100040","DOIUrl":"10.1016/j.hpopen.2021.100040","url":null,"abstract":"<div><p>Despite renewed policy priorities to universalise health coverage, unmet need for healthcare is long-standing concern in India. The recent data suggests the unmet healthcare need amounts to a notable share of twelve per cent. While studies have examined inequalities in healthcare utilisation in single axes of social power, there was no consensus on the role of the intersectionality between class, caste and gender in shaping the unmet health need. Utilising data from National Sample survey 75th round (2017–18), this paper identifies the factors contributing to such unmet need and investigate the intersectionality of class with caste and gender in determining unmet need. The contribution of socioeconomic factors was assessed by the decomposition method & multivariate logistic regression was used to measure inter and intra-class differentials in unmet need.</p><p>The analysis informs that class inequality is fundamental to having unmet need with limited role of gender and caste. Economic class however, interacting with caste and gender unfolds wider gaps in access to healthcare. While inter-class differences in unmet need are observed across caste as well as gender, intra-class differences intensify more by caste inequalities. The findings indicate the significance of the intersectional approach in identifying the sources of health inequity and special recognition to the income-poor and socially marginalised in policy agenda. Eliminating the barriers to health care access therefore needs a multidimensional construct of identifying combination of attributes to be focused towards realization of universal health coverage. These observations should aid in formulation and restructuring of the existing healthcare interventions to achieve equity in healthcare provision.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

From science to sustainable systems: Evidence based-decision making for adolescent fertility in Zambia 从科学到可持续系统:赞比亚青少年生育的循证决策

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100046

Margarate N. Munakampe , Marte E.S.H. Haaland , Joseph M. Zulu , Charles Michelo

{"title":"From science to sustainable systems: Evidence based-decision making for adolescent fertility in Zambia","authors":"Margarate N. Munakampe , Marte E.S.H. Haaland , Joseph M. Zulu , Charles Michelo","doi":"10.1016/j.hpopen.2021.100046","DOIUrl":"10.1016/j.hpopen.2021.100046","url":null,"abstract":"<div><h3>Background</h3><p>Adolescent fertility is a global health and sustainable development indicator, and requires robust information systems for priority setting and decision-making to control. Evidence-based decision making for health stresses the use of scientific objective data and methodologies, which typically sieve out the more contextually understood social and economic factors that impact health.</p><p><em>Main Text</em>: The rising adolescent fertility rates in Zambia warrant the use of robust information systems for planning and resource allocation. In addition to the shortage of information on adolescent health in general, the existing information systems are limited. Sustainable information systems require an investment in data collection that transcends the existing and heavily relied on quantitative evidence base on adolescent sexual and reproductive health, arguing for the need to include data generated through qualitative and participatory methodologies, generating a more holistic understanding of health phenomena.</p><p><em>Conclusion:</em> There is a need to collect data on adolescent fertility using alternative methods to make decisions that work for adolescents.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Designing a critical care solution using in-person and telemedicine approaches in the US-Mexico border area during COVID-19 在2019冠状病毒病期间，在美墨边境地区使用面对面和远程医疗方法设计重症监护解决方案

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100051

Venktesh R. Ramnath , Linda Hill , Jim Schultz , Jess Mandel , Andres Smith , Stacy Holberg , Lucy E. Horton , Atul Malhotra , Lawrence S. Friedman

{"title":"Designing a critical care solution using in-person and telemedicine approaches in the US-Mexico border area during COVID-19","authors":"Venktesh R. Ramnath , Linda Hill , Jim Schultz , Jess Mandel , Andres Smith , Stacy Holberg , Lucy E. Horton , Atul Malhotra , Lawrence S. Friedman","doi":"10.1016/j.hpopen.2021.100051","DOIUrl":"10.1016/j.hpopen.2021.100051","url":null,"abstract":"<div><h3>Background</h3><p>UC San Diego Health System (UCSDHS) is the largest academic medical center and integrated care network in US-Mexico border area of California contiguous to the Northern Baja region of Mexico. The COVID-19 pandemic compelled several UCSDHS and local communities to create awareness around best methods to promote regional health in this economically, socially, and politically important border area.</p></div><div><h3>Purpose</h3><p>To improve understanding of optimal strategies to execute critical care collaborative programs between academic and community health centers facing public health emergencies during the COVID-19 pandemic, based on the experience of UCSDHS and several community hospitals (one US, two Mexican) in the US-Mexico border region.</p></div><div><h3>Methods</h3><p>After taking several preparatory steps, we developed a two-phase program that included 1) in-person activities to perform needs assessments, hands-on training and education, and morale building and 2) creation of a telemedicine-based (Tele-ICU) service for direct patient management and/or educational coaching experiences.</p><p>Findings.</p><p>A clinical and educational program between academic and community border hospitals was feasible, effective, and well received.</p></div><div><h3>Conclusion</h3><p>We offer several policy-oriented recommendations steps for academic and community healthcare programs to build educational, collaborative partnerships to address COVID-19 and other cross-cultural, international public health emergencies.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2