Health Policy Open最新文献_第10页

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

An audit of surgical site infections among Omani travelers to India for spinal surgery 阿曼旅行者到印度做脊柱手术时手术部位感染的审计

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100049

K. Venugopal Menon , Mansur Abdelmottaleb , Khalifa Al Ghafri , Renjit Kumar

{"title":"An audit of surgical site infections among Omani travelers to India for spinal surgery","authors":"K. Venugopal Menon , Mansur Abdelmottaleb , Khalifa Al Ghafri , Renjit Kumar","doi":"10.1016/j.hpopen.2021.100049","DOIUrl":"10.1016/j.hpopen.2021.100049","url":null,"abstract":"<div><h3>Introduction</h3><p>Many Omani nationals travel to India for Spine surgery. Surgical site infection (SSI) rates in these patients is considered more than normal. The indications for surgery are also deemed liberal. Objective: To determine whether SSI rates are more in medical tourists.</p></div><div><h3>Materials & Methods</h3><p>Design: The submission is a retrospective observational study done at a tertiary care referral hospital in Oman. The participants were a cohort of 125 patients who had travelled to India for spine surgery between January 2013 and December 2015. Their data was retrieved from the hospital information system. They were evaluated for satisfaction, residual complaints, surgical site infection and putative indications for surgery. The primary outcome measure was surgical site infection. The SSI rates were compared to a group of patients treated in-house during the same period.</p></div><div><h3>Results</h3><p>All the surgeries done were in the private sector. Fifty-four of the 80 cases were advised surgery locally as well, while 26 were advised against intervention. There were 15 cases of SSI, 10 of them needing re-operation. Four patients had neurological deterioration with 2 wrong level surgeries.</p></div><div><h3>Discussion & Conclusions:</h3><p>The rate of SSI in medical tourism patients was 12% compared to the 2.7% native cases. There was a 78% chance of improvement when the surgery was locally approved and 74% chance of worsening when not approved.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727494","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

The effect of in utero exposure to household air pollution on child health: Evidence from Ghana 子宫内暴露于家庭空气污染对儿童健康的影响:来自加纳的证据

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2020.100029

Kwame Adjei-Mantey, Kenji Takeuchi

{"title":"The effect of in utero exposure to household air pollution on child health: Evidence from Ghana","authors":"Kwame Adjei-Mantey, Kenji Takeuchi","doi":"10.1016/j.hpopen.2020.100029","DOIUrl":"10.1016/j.hpopen.2020.100029","url":null,"abstract":"<div><p>This study examines the impact of <em>in utero</em> exposure to household air pollution on child health. By using a pseudo panel data compiled from three rounds of two separate household datasets in Ghana, we investigate the impacts of dirty fuel use which leads to household air pollution on child stunting at the district level. The results after analysis using the two stage residual inclusion approach indicate that exposure to household air pollution <em>in utero</em> causes stunting in children after birth. We found that children born in the districts using firewood or charcoal as a main cooking fuel are shorter on average after birth. The estimated impacts are sizable: for example, by switching cooking fuel from dirty fuels to LPG, the average height for age Z score in the sample would increase from –1.269 to –0.43. The gender dimensions of the household air pollution effects were further explored. Boys were found to take a worse hit from <em>in utero</em> exposures compared to girls. The findings imply that policy to enhance clean cooking fuel use will help reduce child stunting in developing countries. An increase in clean cooking fuel usage and a reduction in child stunting are both necessary to support the success of the SDGs.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100029"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2020.100029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727495","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: 8

Oral health guidelines in the primary care policies of five selected countries: An integrative review 五个选定国家初级保健政策中的口腔健康指南:一项综合审查

Health Policy Open Pub Date : 2021-12-01 DOI: 10.1016/j.hpopen.2021.100042

João Victor Inglês de Lara , Paulo Frazão

{"title":"Oral health guidelines in the primary care policies of five selected countries: An integrative review","authors":"João Victor Inglês de Lara , Paulo Frazão","doi":"10.1016/j.hpopen.2021.100042","DOIUrl":"10.1016/j.hpopen.2021.100042","url":null,"abstract":"<div><h3>Background</h3><p>Oral conditions remain a major health problem worldwide. Primary Health Care (PHC) has been recognized as a strategy to construct integrated health systems in order to produce the best health outcomes and reduce inequities through its attributes. Nevertheless, oral health integration in PHC remains unclear due to a lack of systematic knowledge.</p></div><div><h3>Aim</h3><p>To summarize oral health guidelines focused on the comprehensiveness component of PHC in the health system and on the intersectoral component of health promotion and disease prevention actions in five selected countries.</p></div><div><h3>Methods</h3><p>An integrative review of scientific and grey literature was led. Australia, Canada, New Zealand, United Kingdom and Brazil were selected. Content analysis was performed based on the comprehensiveness of care and health promotion and disease prevention categories.</p></div><div><h3>Results</h3><p>Forty-one studies were selected to compose the review. Regarding the comprehensiveness of care, the horizontal dimension was more prominent, suggesting that oral care should be provided in cooperation with other health areas. Health promotion and disease prevention actions in intersectoral contexts are complex but seem to be effective. Programs for spreading access to fluorides and actions with the education sector are the most established ones.</p></div><div><h3>Conclusion</h3><p>The integration of oral health in PHC policies is recommended in the guidelines of all countries, however, it stills represents a major challenge for the health care systems. These guidelines represent an important source to support decision-makers, policy-makers and stakeholders.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727497","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: 3