Health Policy Open最新文献

{"title":"The doctor vote: Interactions between political ideological preferences and healthcare reform strategies among U.S. physicians","authors":"Maitri Patel ,&nbsp;Genevieve Lyons ,&nbsp;Kara Fitzgibbon ,&nbsp;B. Cameron Webb","doi":"10.1016/j.hpopen.2024.100123","DOIUrl":"10.1016/j.hpopen.2024.100123","url":null,"abstract":"<div><h3>Intro</h3><p>Improving the American healthcare system has consistently predominated the domestic policy agenda in the United States for decades. However, physicians have traditionally played a small role in the U.S. legislative process despite their direct observations of the obstacles that cost, access, and quality can have on their patients and their care. The goal of this study was to examine the relationship between physician political ideological preferences and health policy reform options.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional survey of 3,001 currently practicing U.S. physicians to predict how self-identification as liberal, moderate, or conservative impacted a physician’s policy preferences under the domains of cost, access, and quality.</p></div><div><h3>Results</h3><p>A total of 536 (18.8%) out of 3,001 physicians responded to the survey. Overall, 32% of physicians identified as liberal, 43% as moderate, and 22% as conservative.</p></div><div><h3>Conclusion</h3><p>Liberal-identifying physicians favored traditionally liberal reform ideas (a national health plan or public option), while conservative physicians preferred conservative policies (free market optimization). However, variation within political groups and domains of healthcare suggest that no single reform policy will be unanimously supported by every physician within a political group. Nonetheless, physicians are unanimously dissatisfied with the state of our current system, and physician-supported healthcare reform should be a national priority.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100123"},"PeriodicalIF":1.7,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259022962400008X/pdfft?md5=2448f279323a90a68152b2152924df5d&pid=1-s2.0-S259022962400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960353","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}

{"title":"Was priority setting considered in COVID-19 response planning? A global comparative analysis","authors":"Claudia-Marcela Vélez ,&nbsp;Lydia Kapiriri ,&nbsp;Susan Goold ,&nbsp;Marion Danis ,&nbsp;Iestyn Williams ,&nbsp;Bernardo Aguilera ,&nbsp;Beverley M. Essue ,&nbsp;Elysee Nouvet","doi":"10.1016/j.hpopen.2024.100125","DOIUrl":"10.1016/j.hpopen.2024.100125","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic forced governments across the world to consider how to prioritize resource allocation. Most countries produced pandemic preparedness plans that guide and coordinate healthcare, including how to allocate scarce resources such as ventilators, human resources, and therapeutics. The objective of this study was to compare and contrast the extent to which established parameters for effective priority setting (PS) were incorporated into COVID-19 pandemic response planning in several countries around the world.</p></div><div><h3>Methods</h3><p>We used the Kapriri and Martin framework for effective priority setting and performed a quantitative descriptive analysis to explore whether and how countries’ type of health system, political, and economic contexts impacted the inclusion of those parameters in their COVID-19 pandemic plans. We analyzed 86 country plans across six regions of the World Health Organization.</p></div><div><h3>Results</h3><p>The countries sampled represent 40% of nations in AFRO, 54.5% of EMRO, 45% of EURO, 46% of PAHO, 64% of SEARO, and 41% of WPRO. They also represent 39% of all HICs in the world, 39% of Upper-Middle, 54% of Lower-Middle, and 48% of LICs. No pattern in attention to parameters of PS emerged by WHO region or country income levels. The parameters: evidence of political will, stakeholder participation, and use of scientific evidence/ adoption of WHO recommendations were each found in over 80% of plans. We identified a description of a specific PS process in 7% of the plans; explicit criteria for PS in 36.5%; inclusion of publicity strategies in 65%; mention of mechanisms for appealing decisions or implementing procedures to improve internal accountability and reduce corruption in 20%; explicit reference to public values in 15%; and a description of means for enhancing compliance with the decisions in 5%.</p></div><div><h3>Conclusion</h3><p>The findings provide a basis for policymakers to reflect on their prioritization plans and identify areas that need to be strengthened. Overall, there is little consideration for explicit prioritization processes and tools and restricted attention to equity considerations; this may be a starting point for policymakers interested in improving future preparedness and response planning. Although the study focused on the COVID-19 pandemic, priority setting remains one of the policymakers’ most prominent challenges. Policymakers should consider integrating systematic priority setting in their routine decision-making processes.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100125"},"PeriodicalIF":1.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000108/pdfft?md5=37508f8fbc04b3bec6643a7f4534472b&pid=1-s2.0-S2590229624000108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845747","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}

{"title":"Puerto Rican physician’s recommendations to mitigate medical migration from Puerto Rico to the mainland United States","authors":"Adrián J. Santiago-Santiago ,&nbsp;Joshua Rivera-Custodio ,&nbsp;Claudia A. Mercado-Ríos ,&nbsp;Yoymar González-Font ,&nbsp;Sheilla R. Madera ,&nbsp;Nelson Varas-Díaz ,&nbsp;Mark Padilla ,&nbsp;Alíxida Ramos-Pibernus ,&nbsp;Kariela Rivera-Bustelo ,&nbsp;John Vertovec ,&nbsp;Armando Matiz-Reyes ,&nbsp;Kevin Grove","doi":"10.1016/j.hpopen.2024.100124","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100124","url":null,"abstract":"<div><p>Puerto Rico (PR) is a United States (US) territory with a history of colonial violence, poverty, and government corruption. Due to these sociopolitical factors and natural disasters (e.g., hurricanes and earthquakes), there has been a sharp increase in PR residents migrating to the mainland US. Local media and professional health organizations focus on the impact of medical migration on the PR health system (e.g., health personnel shortages and long waiting periods for critical care). According to the PR College of Physicians and Surgeons, 365–500 physicians have left annually since 2014, which represents a crisis of access to health services. However, few studies have focused on ways to mitigate medical migration from PR to the US mainland. This article describes the recommendations provided by migrating and non-migrating Puerto Rican Physicians (PRPs) to mitigate medical migration from PR to the US mainland. We focus on qualitative data from a mixed-methods NIH-funded study (1R01MD014188) to explore factors that motivate or mitigate migration among migrating (n = 26) and non-migrating (n = 24) PRPs. Interviews were analyzed following thematic analysis guidelines. Results show the following themes: 1) strategies to retain early-career medical residents living in PR; 2) recommendations for local government on future health policy; and 3) work environment initiatives for health institutions to mitigate physician migration. Findings suggest multilevel efforts are required to mitigate medical migration in PR.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100124"},"PeriodicalIF":1.7,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000091/pdfft?md5=8879cc103e2da7d8d30b9284b91d22dc&pid=1-s2.0-S2590229624000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582353","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}

{"title":"Do social protection programmes affect the burden of breast and cervical cancer? A systematic review","authors":"Ligia Gabrielli ,&nbsp;Sheila M. Alvim Matos ,&nbsp;Ana Luísa Patrão ,&nbsp;Emanuelle F. Góes ,&nbsp;Maria da Conceição C. Almeida ,&nbsp;Greice M.S. Menezes ,&nbsp;Isabel dos-Santos-Silva ,&nbsp;Gulnar Azevedo e Silva ,&nbsp;Maria Teresa Bustamante-Teixeira ,&nbsp;Mauricio L. Barreto ,&nbsp;Srinivasa Vittal Katikireddi ,&nbsp;Alastair H. Leyland ,&nbsp;Luana Ferreira Campos ,&nbsp;Ester Maria Dias Fernandes de Novaes ,&nbsp;Daniela de Almeida Pereira ,&nbsp;Elvira Rodrigues Santana ,&nbsp;Fernanda Rodrigues Gonçalves Zeferino ,&nbsp;Ana Cleide da Silva Dias ,&nbsp;Fábio G. Fernandes ,&nbsp;Ana Cristina de Oliveira Costa ,&nbsp;Estela M.L. Aquino","doi":"10.1016/j.hpopen.2024.100122","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100122","url":null,"abstract":"<div><h3>Background</h3><p>Socioeconomic conditions are strongly associated with breast and cervical cancer incidence and mortality patterns; therefore, social protection programmes (SPPs) might impact these cancers. This study aimed to evaluate the effect of SPPs on breast and cervical cancer outcomes and their risk/protective factors.</p></div><div><h3>Methods</h3><p>Five databases were searched for articles that assessed participation in PPS and the incidence, survival, mortality (primary outcomes), screening, staging at diagnosis and risk/protective factors (secondary outcomes) for these cancers. Only peer-reviewed quantitative studies of women receiving SPPs compared to eligible women not receiving benefits were included. Independent reviewers selected articles, assessed eligibility, extracted data, and assessed the risk of bias. A harvest plot represents the included studies and shows the direction of effect, sample size and risk of bias.</p></div><div><h3>Findings</h3><p>Of 17,080 documents retrieved, 43 studies were included in the review. No studies evaluated the primary outcomes. They all examined the relationship between SPPs and screening, as well as risk and protective factors. The harvest plot showed that in lower risk of bias studies, participants of SPPs had lower weight and fertility, were older at sexual debut, and breastfed their infants for longer.</p></div><div><h3>Interpretation</h3><p>No studies have yet assessed the effect of SPPs on breast and cervical cancer incidence, survival, or mortality; nevertheless, the existing evidence suggests positive impacts on risk and protective factors.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100122"},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000078/pdfft?md5=6c2f8be0bcd84bf92f179eab98d77eef&pid=1-s2.0-S2590229624000078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948113","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}

{"title":"Atlas 2022 of African health Statistics: Key results towards achieving the health-related SDGs targets","authors":"Bataliack Serge ,&nbsp;Mbondji Ebongue ,&nbsp;Saha Tahoum Ursull Alexandra ,&nbsp;Karamagi Humphrey","doi":"10.1016/j.hpopen.2024.100121","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100121","url":null,"abstract":"<div><h3>Introduction</h3><p>The Atlas 2022 of African Health Statistics is a comprehensive tool that gives an overview of the health ecosystem in the African region. As such, it tracks progress towards globally agreed objectives, such as Sustainable Development Goals (SDGs), assesses the capacity of African countries to achieve them, and helps policymakers identify gaps and areas requiring substantial reinforcement.</p></div><div><h3>Methods</h3><p>We analyzed health-related SDGs’ key indicators in the Atlas 2022 of African Health Statistics. This platform is a nexus for consistent and comparable data sources across countries. A review of studies addressing the evolution of health-related SDG indicators in Africa was also considered for discussion and recommendations.</p></div><div><h3>Results</h3><p>Hunger and different forms of malnutrition remain prevalent in the Region. Maternal and neonatal mortality is still high compared to other regions, with increasing incidences of non-communicable diseases and poor mechanisms to address mental health issues. Many inequalities are noted in violence against women, access to health services, or access to water and basic sanitation, which is exacerbated in rural areas. Regarding achieving the SDGs, the trend of most indicators shows they will be challenging to perform at the Regional level. However, a few countries are on track to achieve some goals. These results clearly show that countries have different experiences and, therefore, different progress in achieving sustainable development goals. The delays experienced by many countries in terms of development in other sectors, such as climate and the environment, poverty reduction and economic growth, equity and justice, etc., will make it even more difficult to achieve the health-related SDGs. Achieving these goals should, therefore, be seen as a transdisciplinary and inclusive process.</p></div><div><h3>Conclusion</h3><p>Beyond the COVID-19 pandemic that has recently challenged health systems worldwide, the African Region is also dealing with several threats, jeopardizing its progress toward achieving the SDGs by 2030. Given the Region’s particular context, a readjustment of the regional targets and/or deadlines would be advisable to ensure they are achievable.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000066/pdfft?md5=0208b294f39e5ebf7ef7679223b25a32&pid=1-s2.0-S2590229624000066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910198","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}

{"title":"Price transparency in Iranian healthcare market","authors":"Ameneh Rahban ,&nbsp;Abolfazl Ghahramani ,&nbsp;Hasan Yusefzadeh ,&nbsp;Iraj Harirchi ,&nbsp;Cyrus Alinia","doi":"10.1016/j.hpopen.2024.100120","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100120","url":null,"abstract":"<div><p>Insufficient price transparency has emerged as a pivotal contributor to patient dissatisfaction, escalating costs, and diminished productivity within Iran's health system. This study aims to delineate and elucidate a definition of price transparency, identify suitable strategies, and present the outcomes associated with establishing a health system that embraces transparent pricing while also addressing the challenges ahead. Employing a quantitative–qualitative research design, data were extracted from a semi-structured interviews with stakeholders. A purposive sampling method, encompassing sequential and snowball techniques, was employed to capture the perspectives of all stakeholders involved in the issue of price transparency in Iran. The interview data were analyzed using the grounded theory approach was classified into three categories: price transparency before, during, and after the receipt of healthcare services. Our findings reveal the causes of low price transparency, strategies to address the issue, and the consequences associated with increased levels of transparency. Ultimately, we contend that health systems can significantly enhance efficiency, patient satisfaction, and the performance of health insurance by adopting transparent pricing for health services, thus obviating the need for resource-intensive restructuring efforts.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100120"},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000054/pdfft?md5=2c07cab57db34a579c0b9b35541eacb1&pid=1-s2.0-S2590229624000054-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140818579","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}

{"title":"Does health insurance status influence healthcare-seeking behavior in rural communities? evidence from rural Ghana","authors":"Emmanuel Kumah ,&nbsp;Yussif Asana ,&nbsp;Samuel Kofi Agyei ,&nbsp;Collins Kokuro ,&nbsp;Samuel E. Ankomah ,&nbsp;Adam Fusheini","doi":"10.1016/j.hpopen.2024.100119","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100119","url":null,"abstract":"<div><h3>Introduction</h3><p>National health insurance programs are considered important mechanisms for ensuring equity in access to and utilization of healthcare services by removing financial barriers associated with seeking treatment in healthcare facilities. Although studies on health insurance schemes in many low-and-middle-income countries (LMICs) have demonstrated a significant relationship between health insurance status and healthcare-seeking behavior, data on the influence of this health financing policy on the decision to seek formal healthcare among rural inhabitants remains limited. Underpinned by the Andersen-Newman behavioral model of healthcare use, this study examined the influence of health insurance status on healthcare-seeking behavior among rural dwellers in Ghana.</p></div><div><h3>Methods</h3><p>A community-based cross-sectional study was conducted among 460 rural residents in Ghana from 8th September to 5th December 2022<strong>.</strong> Chi-square tests were used to study the significance level and association between healthcare-seeking behavior and selected independent variables. A multiple logistic regression model was fitted to test the association between health insurance status and healthcare-seeking behavior, introducing other selected explanatory variables as controls.</p></div><div><h3>Results</h3><p>The mean age of the respondents was 29.6 ± 6.8 years. A little above half (53.1 %) disclosed having insurance, whereas 46.1 % stated they were without coverage. Regarding healthcare-seeking behavior, the most commonly chosen treatment source was traditional healers (37.2 %), followed by the public healthcare system (28.3 %) and self-treatment (18.2 %). The private healthcare system was the least preferred, with only 16.3 % opting for it. While the bivariate analysis demonstrated a significant relationship between health insurance status and healthcare-seeking behavior (p-0.001), the logistic regression model results showed that health insurance status was not an independent predictor of healthcare-seeking behavior (p = 0.069).</p></div><div><h3>Conclusion</h3><p>It could, therefore, not be concluded that the respondents with health insurance coverage were more likely than the uninsured to use formal healthcare providers as their most frequent source of treatment during illness. This study provides vital information for policymakers aiming at increasing access to and utilization of facility-based formal care in rural and remote settings.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000042/pdfft?md5=a5261b71f4467af604f3223b03b4150c&pid=1-s2.0-S2590229624000042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618188","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}

{"title":"Aligned or misaligned: Are public funding models for speech-language pathology reflecting recommended evidence? An exploratory survey of Australian speech-language pathologists","authors":"T. Nickless ,&nbsp;B. Davidson ,&nbsp;S. Finch ,&nbsp;L. Gold ,&nbsp;R. Dowell","doi":"10.1016/j.hpopen.2024.100117","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100117","url":null,"abstract":"<div><p>Government subsidised funding arrangements serve as an essential medium for families to access private speech-language pathology (SLP) services in Australia. This study aimed to investigate whether, from a provider perspective, contemporary public funding models (PFMs) align with best-available scientific evidence for management of children and young persons with swallowing and communication disorders within Australian private-practice settings. This exploratory study was distributed to paediatric speech-language pathologists throughout Australia via an online survey. A total of 121 valid surveys were completed by Australian speech-language pathologists with divergent career experiences. In comparing three familiar PFMs using mixed effects logistic regression models to estimate odds ratios, results indicated that perceived congruence with recommended scientific evidence for SLP management varied across PFMs: the odds of failing to align with scientific evidence was 4.92 times higher for Medicare’s Chronic Disease Management Plan (MBS_CDMP) than for the National Disability Insurance Scheme; and 7.40 times higher in comparison to Medicare’s Helping Children with Autism initiative. This study is the first to report on (in)congruence between PFMs that provide access to independent Australian SLP services for children and young persons and best available scientific evidence to inform clinical practice. Participants identified that: (a) four out of seven contemporary PFMs were unfamiliar to speech-language pathologists; and (b) MBS_CDMP initiative failed to align with the evidence-base for best scientific SLP management.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000029/pdfft?md5=ce0b4b38712d9d518e54be766ea7b2be&pid=1-s2.0-S2590229624000029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113513","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}

{"title":"The evolving value assessment of cancer therapies: Results from a modified Delphi study","authors":"Myrto Lee ,&nbsp;Hugo Larose ,&nbsp;Martin Gräbeldinger ,&nbsp;Jon Williams ,&nbsp;Anne-Marie Baird ,&nbsp;Susan Brown ,&nbsp;Johannes Bruns ,&nbsp;Russell Clark ,&nbsp;Javier Cortes ,&nbsp;Giuseppe Curigliano ,&nbsp;Andrea Ferris ,&nbsp;Louis P. Garrison ,&nbsp;Y.K. Gupta ,&nbsp;Ravindran Kanesvaran ,&nbsp;Gary Lyman ,&nbsp;Luca Pani ,&nbsp;Zack Pemberton-Whiteley ,&nbsp;Tomas Salmonson ,&nbsp;Peter Sawicki ,&nbsp;Barry Stein ,&nbsp;Jens Grueger","doi":"10.1016/j.hpopen.2024.100116","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100116","url":null,"abstract":"<div><p>The move toward early detection and treatment of cancer presents challenges for value assessment using traditional endpoints. Current cancer management rarely considers the full economic and societal benefits of therapies. Our study used a modified Delphi process to develop principles for defining and assessing value of cancer therapies that aligns with the current trajectory of oncology research and reflects broader notions of value. 24 experts participated in consensus-building activities across 5 months (16 took part in structured interactions, including a survey, plenary sessions, interviews, and off-line discussions, while 8 participated in interviews). Discussion focused on: 1) which oncology-relevant endpoints should be used for assessing treatments for early-stage cancer and access decisions for early-stage treatments, and 2) the importance of additional value components and how these can be integrated in value assessments. The expert group reached consensus on 4 principles in relation to the first area (consider oncology-relevant endpoints other than overall survival; build evidence for endpoints that provide earlier indication of efficacy; develop evidence for the next generation of predictive measures; use managed entry agreements supported by ongoing evidence collection to address decision-maker evidence needs) and 3 principles in relation to the second (routinely use patient reported outcomes in value assessments; assess broad economic impact of new medicines; consider other value aspects of relevance to patients and society).</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000017/pdfft?md5=27ec497a500af69570e4b729153030db&pid=1-s2.0-S2590229624000017-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140024442","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}

{"title":"“Pick a Plan and Roll the Dice”: A qualitative study of consumer experiences selecting a health plan in the non-group market","authors":"Elena Faugno ,&nbsp;Melissa B. Gilkey ,&nbsp;Lauren A. Cripps ,&nbsp;Anna Sinaiko ,&nbsp;Alon Peltz ,&nbsp;Jon Kingsdale ,&nbsp;Alison A. Galbraith","doi":"10.1016/j.hpopen.2023.100112","DOIUrl":"10.1016/j.hpopen.2023.100112","url":null,"abstract":"<div><h3>Background</h3><p>For consumers without access to employer-sponsored or public insurance, health plan choices in the non-group (individual) insurance market that do not meet consumer needs have the potential for negative downstream implications for health and financial well-being.</p></div><div><h3>Objective</h3><p>This qualitative interview study sought to understand consumers’ experiences and challenges with choosing a non-group health plan, among those who later had negative experiences with the plan they chose.</p></div><div><h3>Methods</h3><p>We conducted semi-structured telephone interviews with a purposive sample of 36 participants from a large regional health insurance carrier in three states who enrolled in non-group plans in 2017 (21 in Affordable Care Act (ACA) Marketplace plans and 15 enrolled off-Marketplace). Participants were included if they reported negative experiences using their plan after enrollment, such as higher-than-expected medical costs. Interviews explored challenges choosing a plan; information needed for choosing; usefulness of available tools; and preferred format for interventions to improve plan choice experiences. We analyzed interview transcripts using thematic content analysis.</p></div><div><h3>Results</h3><p>Study participants reported experiencing substantial challenges to choosing an insurance plan. Key barriers included understanding insurance terms, finding relevant information, and making comparisons across plans. Participants valued the ability to make comparisons across carriers when using the Marketplace websites but were less satisfied with customer service. Suggestions for improvement included greater standardization of plans and language and availability of customized one-on-one assistance.</p></div><div><h3>Conclusion</h3><p>Findings from this study suggest that health plan selection in the non-group market presents challenges to consumers that may be addressed through enrollment assistance and improved presentation of information. Personalized assistance to find and choose coverage may lead to plan choices that better meet consumer needs and increase confidence choosing a plan in subsequent enrollment periods.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"5 ","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229623000242/pdfft?md5=ecf805ebaba2f51b65f49272058ede82&pid=1-s2.0-S2590229623000242-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617470","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}