Health Policy Open最新文献

{"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}

{"title":"Planning with a gender lens: A gender analysis of pandemic preparedness plans from eight countries in Africa","authors":"Beverley M. Essue ,&nbsp;Lydia Kapiriri ,&nbsp;Hodan Mohamud ,&nbsp;Marcela Claudia Veléz ,&nbsp;Suzanne Kiwanuka","doi":"10.1016/j.hpopen.2023.100113","DOIUrl":"10.1016/j.hpopen.2023.100113","url":null,"abstract":"<div><h3>Background</h3><p>Health planning and priority setting with a gender lens can help to anticipate and mitigate vulnerabilities that women and girls may experience in health systems, which is especially relevant during health emergencies. This study examined how gender considerations were accounted for in COVID-19 pandemic response planning in a subset of countries in Africa.</p></div><div><h3>Methods</h3><p>Multi-country document review of national pandemic response plans (published before July 2020 and as of March 2022) from Ethiopia, Ghana, Kenya, Nigeria, Rwanda, South Africa, Uganda, and Zambia, supplemented with secondary data on gender representation on planning committees. A gender analysis framework informed the study design and the Morgan et al. matrix guided data extraction and analysis.</p></div><div><h3>Results</h3><p>All plans reflected implicit and explicit considerations of the impacts of the pandemic responses on women and girls. Through a gender lens, the implicit considerations focused on ensuring safety and protections (e.g., training, access to personal protective equipment) for community and facility-based health care workers and broad engagement of the community in risk communication. The explicit gender considerations, reflected in a minority of plans, focused on addressing gender-based violence and providing access to essential services (e.g., sexual and reproductive health care, psychosocial supports), products (e.g., menstrual hygiene products) and social protection measures. Women were underrepresented on the COVID-19 planning committees in all countries.</p></div><div><h3>Conclusions</h3><p>The plans reflected varying national efforts to develop pandemic responses that anticipated and reflected unique vulnerabilities faced by women, though subsequent plans reflected further consideration of gender-relevant impacts compared to initial plans. Embedding a gender lens in emergency preparedness planning furthers equity and could support anticipation and timely mitigation of negative outcomes for women and girls who are often further marginalized during health emergencies.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229623000254/pdfft?md5=732c048b7cd2429751d93bd59653186c&pid=1-s2.0-S2590229623000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139016252","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":"Australian and Canadian financial wellbeing policy landscape during COVID-19: An equity-informed policy scan","authors":"Ana Paula Belon ,&nbsp;Aryati Yashadhana ,&nbsp;Krystyna Kongats ,&nbsp;Kayla Atkey ,&nbsp;Nicole M. Glenn ,&nbsp;Karla Jaques ,&nbsp;Laura Nieuwendyk ,&nbsp;Patrick Harris ,&nbsp;Evelyne de Leeuw ,&nbsp;Candace I.J. Nykiforuk","doi":"10.1016/j.hpopen.2023.100114","DOIUrl":"10.1016/j.hpopen.2023.100114","url":null,"abstract":"<div><h3>Background</h3><p>This targeted and comprehensive policy scan examined how different levels of governments in Australia and Canada responded to the financial crisis brought on by the COVID-19 pandemic. We mapped the types of early policy responses addressing financial strain and promoting financial wellbeing. We also examined their equity considerations.</p></div><div><h3>Methods</h3><p>Through a systematic search, snowballing, and manual search, we identified Canadian and Australian policies at all government levels related to financial strain or financial wellbeing enacted or amended in 2019–2020. Using a deductive-inductive approach, policies were categorized by jurisdiction level, focal areas, and target population groups.</p></div><div><h3>Results</h3><p>In total, 213 and 97 policies in Canada and Australia, respectively, were included. Comparisons between Canadian and Australian policies indicated a more diversified and equity-targeted policy landscape in Canada. In both countries, most policies focused on individual and family finances, followed by housing and employment areas.</p></div><div><h3>Conclusions</h3><p>The policy scan identified gaps and missed opportunities in the early policies related to financial strain and financial wellbeing. While fast, temporary actions addressed individuals’ immediate needs, we recommend governments develop a longer-term action plan to tackle the root causes of financial strain and poor financial wellbeing for better health and non-health crisis preparedness.</p></div><div><h3>Statement on Ethics and Informed Consent</h3><p>This research reported in this paper did not require ethical clearance or patient informed consent as the data sources were published policy documents. This study did not involve data collection with humans (or animals), nor any secondary datasets involving data provided by humans (or from animal studies).</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"6 ","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229623000266/pdfft?md5=36020b4b822906451b317441f6844e2a&pid=1-s2.0-S2590229623000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615666","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":"Governing health service purchasing agencies: Comparative study of national purchasing agencies in 10 countries in eastern Europe and central Asia","authors":"Loraine Hawkins ,&nbsp;Kaija Kasekamp ,&nbsp;Ewout van Ginneken ,&nbsp;Triin Habicht","doi":"10.1016/j.hpopen.2023.100111","DOIUrl":"https://doi.org/10.1016/j.hpopen.2023.100111","url":null,"abstract":"<div><p>This study discusses findings from comparative case studies of the governance of health services purchasing agencies in 10 eastern European and central Asian countries established over the past 30 years, and the relationship between governance attributes, institutional development, and the progress made in strategic purchasing. The feasibility and effectiveness of implementing international recommendations from the health sector and wider public sector governance literature and practice are also discussed. The study finds that only those countries that have transitioned from middle to high-income status during the study period have been successful in comprehensively and consistently implementing internationally recommended practices. Moreover, these countries have made varying progress in developing capable purchasers with technical and operational independence, as well as advancing strategic purchasing. However, the current middle-income countries (MICs) in the study have implemented only certain elements of recommended governance practices, often superficially. Notably, the study reveals that some international recommendations, particularly those related to higher degrees of purchaser autonomy and the associated governance structures observed in western European social health insurance funds, have proven challenging to implement effectively or sustain in the MICs. None of the MICs succeeded in strategic purchasing beyond a limited agenda or scale, and even then, only implementing and sustaining them during favorable conditions. Difficulties in maintaining these achievements can be attributed, in part, to governance deficiencies. However, setbacks are commonly linked to periods of political and economic instability, which in turn lead to fluctuations in policy priorities, institutional instability, and inadequacies in health budgets. The study findings point to some actions related to civil society and stakeholder engagement, accountability frameworks, and digitalization in MICs that can facilitate continuity in health reforms and the functioning of purchasing institutions despite these challenges. The findings of the study provide important lessons for countries designing or newly implementing health purchasing agencies and for countries reviewing the performance and governance of their health purchasing agencies with a view to developing or strengthening strategic purchasing.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"5 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229623000230/pdfft?md5=fec464c1979d8378edb27d0c36efdd73&pid=1-s2.0-S2590229623000230-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483822","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":"Primary care reforms in Central Asia – On the path to universal health coverage?","authors":"Bernd Rechel,&nbsp;Aigul Sydykova,&nbsp;Saltanat Moldoisaeva,&nbsp;Dilorom Sodiqova,&nbsp;Yerbol Spatayev,&nbsp;Mohir Ahmedov,&nbsp;Susannah Robinson,&nbsp;Anna Sagan","doi":"10.1016/j.hpopen.2023.100110","DOIUrl":"https://doi.org/10.1016/j.hpopen.2023.100110","url":null,"abstract":"<div><p>This article reviews progress in primary care reforms in the four Central Asian countries Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. It draws on the country monitoring work of the European Observatory on Health Systems and Policies, a review of the peer-reviewed literature and an analysis of data available in international databases. The retrieved information was organized according to key health system functions (governance, provision, financing and resource generation), as well as key aims of universal health coverage (access to and quality of primary care and financial protection). The article finds that the four countries have made substantial reforms in all of these areas, but that there is still some way to go towards universal health coverage. Key challenges are the overall lack of public funding for primary care, poor financial protection due to prescribed outpatient medications being generally outside of publicly funded benefits packages, the low status and salary of primary care workers, problems of access to primary care in rural areas, and underdeveloped quality monitoring and improvement systems.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"5 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229623000229/pdfft?md5=992725682c6b45a3f87eaf0f1094b8f0&pid=1-s2.0-S2590229623000229-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138474802","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":"Implicit factors influencing the HTA deliberative processes in 5 European countries: results from a mixed-methods research","authors":"Clara Monleón ,&nbsp;Hans Martin-Späth ,&nbsp;Carlos Crespo ,&nbsp;Claude Dussart ,&nbsp;Mondher Toumi","doi":"10.1016/j.hpopen.2023.100109","DOIUrl":"https://doi.org/10.1016/j.hpopen.2023.100109","url":null,"abstract":"<div><h3>Background</h3><p>Health technology assessment (HTA) bodies across Europe rely on explicit factors for decision making. However, additional undefined factors play a role. This mixed-methods research aimed to identify the implicit factors involved in HTA deliberative processes in five European countries, and to analyze their impact on decision making.</p></div><div><h3>Methods</h3><p>Between February and May 2021, semi-structured interviews (n = 20) were conducted with HTA experts of three different profiles (chair, advisor, and committee member) from France, Germany, Italy, Spain, and the United Kingdom. The degree of influence of a set of implicit factors and attributes that play a role in the HTA deliberative process, as previously identified in a systematic literature review, was scored by the experts. Experts were also asked to make recommendations on ways of improving the deliberative process. A qualitative analysis and descriptive statistics of quantitative variables are reported.</p></div><div><h3>Results</h3><p>Most (18/20) experts concurred that implicit factors play a role in the HTA deliberative process. Recommendations for improving the process fell into three categories: transparency, methodology improvement, and stakeholder involvement. The results suggest a need for 1) increased external involvement HTA and 2) development of a methodology to mitigate the influence of implicit factors in the deliberative process. This could be achieved by updating the current frameworks to acknowledge these implicit factors and by developing methods to address them.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"5 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229623000217/pdfft?md5=a0ed6fed397a38fca8df16fef25de9ed&pid=1-s2.0-S2590229623000217-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138430865","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}