Health Policy Open最新文献

{"title":"The role of national hospital associations in health system governance before and during the COVID-19 pandemic: Findings from an exploratory online survey","authors":"Bruno Meessen ,&nbsp;Sara Perazzi","doi":"10.1016/j.hpopen.2022.100077","DOIUrl":"10.1016/j.hpopen.2022.100077","url":null,"abstract":"<div><h3>Objective</h3><p>Building on the premise that health authorities should govern their health systems in partnership with the full community of stakeholders, we document the contribution of national hospital associations to health policy processes, before and during the COVID-19 crisis.</p></div><div><h3>Methods</h3><p>This research followed a rapid cross-sectional comparative design. Data were collected through an online survey targeting hospital associations. Eighteen of them shared information on their institutional profile, their areas of activity, their position and participation as policy actors before and during the COVID-19 crisis, the barriers and enablers affecting their participation and the impact of the crisis on their own financial situation.</p></div><div><h3>Findings</h3><p>We have documented a spectrum of situations both for national policy platforms and hospital associations. In some countries, there is the ideal match of well-established associations and national participatory health policy platforms. In others, hospital associations have modest staffing and may struggle to get access to policy platforms of importance. Being a well-established and respected contributor seems to have been an enabling factor for the contribution of the hospital associations to the COVID-19 response. For most associations, the crisis has led to an increased effort to be present in the policy arena; an issue they follow closely is the negative impact of the lockdown on the hospitals’ revenue.</p></div><div><h3>Conclusion</h3><p>The growing pluralism characterizing our societies calls for the establishment of health policy platforms allowing for broader participation. Encouraging hospitals to set up their association for the latter to represent them in decision processes could be one of the components of the rebuilding of national health systems post pandemic.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"3 ","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9458550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9703825","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":"Breathing fresh air into the debate: Ventilators and the United States' intellectual property problem","authors":"Theora W. Tiffney ,&nbsp;Robert Cook-Deegan ,&nbsp;Heather M. Ross","doi":"10.1016/j.hpopen.2022.100069","DOIUrl":"10.1016/j.hpopen.2022.100069","url":null,"abstract":"<div><p>In 2006, the U.S. federal government launched a project to create a cheap, easily produced, and easy to use ventilator that could be stored for long periods of time for pandemic response. Despite successful funding and contracts with two separate medical device companies, not a single ventilator had been added to the stockpile by 2020. The company currently under federal contract for these ventilators is selling its product to private parties, rather than supplying it to the federal government. In the current crisis, government has instead turned to the Defense Production Act to supply ventilators.</p><p>Inaccessibility of medical equipment is a detriment to Americans’ health, particularly during a public health emergency like COVID-19. This persists despite the central role of the federal government in the funding of healthcare innovation. We place the shortage of ventilators in context of the ongoing debate about the federal government’s intellectual property powers, as well as the legal recourses available, then discuss why this situation is a strong argument for expanding compulsory licensing powers as a component of federal policy.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"3 ","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/4d/main.PMC10297820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739893","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":"Erratum regarding previously published articles","authors":"","doi":"10.1016/j.hpopen.2022.100079","DOIUrl":"10.1016/j.hpopen.2022.100079","url":null,"abstract":"","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"3 ","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10297768/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739898","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":"Erratum regarding previously published articles","authors":"","doi":"10.1016/j.hpopen.2022.100080","DOIUrl":"10.1016/j.hpopen.2022.100080","url":null,"abstract":"","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"3 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40466029","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":"A time-varying vulnerability index for COVID-19 in New Mexico, USA using generalized propensity scores","authors":"Morgan E. Gorris ,&nbsp;Courtney D. Shelley ,&nbsp;Sara Y. Del Valle ,&nbsp;Carrie A. Manore","doi":"10.1016/j.hpopen.2021.100052","DOIUrl":"10.1016/j.hpopen.2021.100052","url":null,"abstract":"<div><p>The coronavirus disease (COVID-19) pandemic has highlighted systemic inequities in the United States and resulted in a larger burden of negative social outcomes for marginalized communities. New Mexico, a state in the southwestern US, has a unique population with a large racial minority population and a high rate of poverty that may make communities more vulnerable to negative social outcomes from COVID-19. To identify which communities may be at the highest relative risk, we created a county-level vulnerability index. After the first COVID-19 case was reported in New Mexico on March 11, 2020, we fit a generalized propensity score model that incorporates sociodemographic factors to predict county-level viral exposure and thus, the generic risk to negative social outcomes such as unemployment or mental health impacts. We used four static sociodemographic covariates important for the state of New Mexico—population, poverty, household size, and minority population—and weekly cumulative case counts to iteratively run our model each week and normalize the exposure score to create a time-varying vulnerability index. We found the relative vulnerability between counties varied in the first eight weeks from the initial COVID-19 case before stabilizing. This framework for creating a location-specific vulnerability index in response to an ongoing disaster may be used as a quick, deployable metric to inform health policy decisions such as allocating state resources to the county level.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100052"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9700935","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 importance of combining open-ended and closed-ended questions when conducting patient satisfaction surveys in hospitals","authors":"Keren Semyonov-Tal ,&nbsp;Noah Lewin-Epstein","doi":"10.1016/j.hpopen.2021.100033","DOIUrl":"10.1016/j.hpopen.2021.100033","url":null,"abstract":"<div><h3>Background</h3><p>Using data obtained from the National Satisfaction Survey in General Hospitals, 2014, the present study examines patients’ satisfaction with medical care and hospitalization conditions in the public hospitals in Israel. Using the framework of ‘voice’ expression the study examines the added-value of analyzing verbal responses to gage patient satisfaction.</p></div><div><h3>Methods</h3><p>The analysis utilizes a series of closed-ended questions to construct indexes of patients’ satisfaction with medical doctors, nursing staff, and hospitalization conditions for a sample of 11,098 patients who were hospitalized in the 25 public hospitals. In addition, a content analysis was applied to the verbal responses (open ended question) to create categories of complaints. Using logistic regression models, we analyzed the social and demographic correlates of high satisfaction, and estimated the relationship between verbal complaints and satisfaction scores.</p></div><div><h3>Results</h3><p>Analysis of the satisfaction measures shows very high levels of patient satisfaction coupled with low variance. Yet, detailed analysis of responses to an open-ended question reveals considerably more critical assessments of the hospitalization experience.</p></div><div><h3>Conclusion</h3><p>The findings illustrate the limitations of closed-ended satisfaction items as the sole instrument for assessing the quality of medical care and underscore the value of the use of mixed methods as a more nuanced approach.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9735889","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":"Utilization and cost sharing for preventive cancer screenings","authors":"Nicholas Jennings,&nbsp;David O. Garcia,&nbsp;Howard Eng,&nbsp;Elizabeth Calhoun","doi":"10.1016/j.hpopen.2021.100044","DOIUrl":"10.1016/j.hpopen.2021.100044","url":null,"abstract":"<div><h3>Objective</h3><p>The Patient Protection and Affordable Care Act (ACA) eliminated cost sharing for certain preventive cancer screenings beginning in September 2010. This paper examines the policy change’s impact on three preventive screenings, mammography, colonoscopy, and cervical screening, among commercially insured individuals.</p></div><div><h3>Methods</h3><p>A retrospective longitudinal quasi-experimental design was utilized. Individuals in grandfathered plans were used as a comparison group because grandfathered plans are not subject to the preventive cost sharing benefit changes of the ACA. A multivariate logistic regression model matched individuals in treatment and comparison groups via propensity scoring. Monthly prevalence rates over the study period (2007–2014) were calculated as well as prevalence rates for the proportion of procedures with greater than 0 cost sharing. An interrupted time series regression analysis was conducted with the primary outcome variable the rate of preventive service utilization per person per month.</p></div><div><h3>Results</h3><p>The overall trend in utilization of preventive mammography and cervical cancer screening slightly decreased as a result of the ACA cost sharing benefit policy change. There was a non-significant decrease for colonoscopy utilization as a result of the ACA policy change.</p></div><div><h3>Conclusion</h3><p>The ACA’s cost benefit policy change is not having the desired impact of increasing preventive screening utilization. Further research is needed to determine whether providing educational materials covering the cost sharing benefit at policy enrollment might increase procedure uptake.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9735891","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":"Health-care guidelines and policies during the COVID-19 pandemic in Mexico: A case of health-inequalities","authors":"Elysse Bautista-González ,&nbsp;Jimena Werner-Sunderland ,&nbsp;Paulina Pérez-Duarte Mendiola ,&nbsp;Cesar Jeronimo Esquinca-Enríquez-de-la-Fuente ,&nbsp;Daniela Bautista-Reyes ,&nbsp;Maria Fernanda Maciel-Gutiérrez ,&nbsp;Inkel Murguía-Arechiga ,&nbsp;Cecilia Vindrola-Padros ,&nbsp;Manuel Urbina-Fuentes","doi":"10.1016/j.hpopen.2020.100025","DOIUrl":"10.1016/j.hpopen.2020.100025","url":null,"abstract":"<div><h3>Background</h3><p>Heterogeneous government responses have been reported in reaction to COVID-19. The aim of this study is to generate an exploratory review of healthcare policies published during COVID-19 by health-care institutions in Mexico. Analyzing policies within different health sub-systems becomes imperative in the Mexican case due to the longstanding fragmentation of the health-care system and health inequalities.</p></div><div><h3>Data and Methods</h3><p>Policies purposely included in the analysis were published by four public health institutions (IMSS, ISSSTE, SSA and PEMEX) during the COVID-19 epidemic in Mexico (from February 29th to June 15th, 2020) on official institutional websites. Researchers reviewed each document and classified them into seven policy categories set by the Rapid Research Evaluation and Appraisal Lab (RREAL): public health response, health-care delivery, human resources, health-system infrastructure and supplies, clinical response, health-care management, and epidemiological surveillance.</p></div><div><h3>Results</h3><p>Policy types varied by health institution. The largest number of policies were aimed at public health responses followed by health-care delivery and human resources. Policies were mainly published during the community transmission phase.</p></div><div><h3>Conclusions</h3><p>The pandemic exposed underlying health-care system inequalities and a reactive rather than prepared response to the outbreak. Additionally, this study outlines potential policy gaps and delays in the response that could be avoided in the future.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100025"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2020.100025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10057167","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":"Study of the ex-post moral hazard of laboratory services in Iran","authors":"Seyed Alireza Otobideh,&nbsp;Hasan Yusefzadeh,&nbsp;Siamak Aghlmand,&nbsp;Cyrus Alinia","doi":"10.1016/j.hpopen.2021.100031","DOIUrl":"10.1016/j.hpopen.2021.100031","url":null,"abstract":"<div><p>The basic health insurances cover more than 90% of the Iranian population but have failed to organize the referral system and created favorable conditions for the ex-post moral hazard. Five hundred fifty people older than 15 years were randomly selected in five districts of Urmia city and completed the questionnaire to study the existence of Ex-post moral hazard in utilizing the high-consumption laboratory services (blood and urine tests). In this population-based cross-sectional study, utilization of the services in two groups of insured and uninsured people was analyzed using odds ratio statistics and logistic regression. The findings showed that being female (OR: 2.38) and having health insurance (OR: 2.03) played a very determinative role in obtaining selected laboratory services, and about 9% of the laboratory services provided were caused by ex-post moral hazard. The predicted size of ex-post moral hazard is significant, so its control requires modifying health insurance policies in determining the premium and cost-sharing schemes and controlling physicians' behavior as the principal applicants for these services.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hpopen.2021.100031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112953","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":"Tobacco control policies in India were unable to address inequities in Tobacco-related harm","authors":"Rohini Ruhil","doi":"10.1016/j.hpopen.2021.100053","DOIUrl":"10.1016/j.hpopen.2021.100053","url":null,"abstract":"<div><h3>Introduction</h3><p>The Global Adult Tobacco Survey (GATS) India 2016–17 has shown that increased regulations over time impacted tobacco use culture, which opened the doors for further regulation, making it an iterative process. But do the ‘tobacco control policies’ reach till most deprived sections of society? This paper tries to answer this question.</p></div><div><h3>Methods</h3><p>In this paper, the relative reduction in tobacco use prevalence is seen (from 2009 to 10 to 2016–17) across different levels of material deprivation and educational attainment. The relative reduction in prevalence/ use of various forms of smoking and smokeless tobacco products was also studied.</p><p>Material Deprivation as a new index was computed, where the weightage was given to various variables related to household ownership of various material things as available in data sets of GATS Survey. The recoded variables were then added and further categorised into six levels of material deprivation where Level 1 corresponds to least deprived and Level 6 corresponds to most deprived.</p><p>The relative reduction in the prevalence of tobacco use was calculated with the formula [(P1-P2)/P1]*100, where P1 is the prevalence of tobacco use (smoking or smokeless) during GATS1 (2009–10), and P2 is the prevalence of tobacco use (smoking or smokeless) during GATS2 (2016–17).</p></div><div><h3>Results</h3><p>It has been shown that the higher the level of material deprivation, the lesser the relative reduction in the prevalence of tobacco use. The relative reduction in tobacco use was more for higher levels of educational attainment. It has been found that relative reduction is more for smoking products as compared to smokeless tobacco (SLT) products. Khaini and Bidis are emerging as popular products, which are least regulated by existing tobacco control policies.</p></div><div><h3>Conclusion</h3><p>The reduction in the prevalence of tobacco use from GATS1 to GATS2 is inequitous across levels of material deprivation and levels of educational attainment by individuals. Also, there is a tendency for product substitution among tobacco users.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"2 ","pages":"Article 100053"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/3f/main.PMC10297741.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734400","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}