Health Economics Policy and Law最新文献_第2页

Policy actors as data integrators: mixing data in tobacco control evaluation and assessment. 作为数据整合者的政策行为者：烟草控制评价和评估中的混合数据。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-27 DOI: 10.1017/S1744133126100619

Claire L Ma, Holly Jarman, Praneetha Vissapragada, Jamie Hartmann-Boyce

{"title":"Policy actors as data integrators: mixing data in tobacco control evaluation and assessment.","authors":"Claire L Ma, Holly Jarman, Praneetha Vissapragada, Jamie Hartmann-Boyce","doi":"10.1017/S1744133126100619","DOIUrl":"10.1017/S1744133126100619","url":null,"abstract":"Tobacco control policies are complex with the potential for significant health effects. The public health actors and regulators who design, influence, and implement these policies place a high value on the evidence base that underpins them, engaging in scientific and applied debates about how to evaluate the success of existing policies and justify new actions. To investigate the construction of this evidence base, we conducted interviews with 40 individuals involved in formulating, advising, and implementing flavour restrictions for tobacco products. Our interviews inform case studies of six jurisdictions in three US states, Canada, the UK, and the Netherlands. We find that tobacco policy stakeholders, which include regulators and public health personnel, play a vital role as data integrators in the construction of this evidence base: they bring together disparate types and sources of information to create synthetic evaluations of tobacco control policies that incorporate the complexity of the policy environment and differential impacts on population subgroups. Significantly, data integration is not easy to replicate or automate; should these positions be lost due to funding cuts as political priorities shift in the US and globally, the capacity they add to our policymaking and research systems will be difficult to restore.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Redesigning national health service delivery: the case for community-based health service providers in Uganda. 重新设计国家保健服务提供：乌干达社区保健服务提供者的案例。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-21 DOI: 10.1017/S1744133126100644

Megha Rao, Sakshi Mohan, Chrispus Mayora, Elizabeth Ekirapa, Finn McGuire, Brenda Nakimuli, Beatrice Namirembe, Perez Ochanda, Richard Ssempala, Aloysius Ssennyonjo, Paul Revill, Simon Mark Walker, Freddie Ssengooba

{"title":"Redesigning national health service delivery: the case for community-based health service providers in Uganda.","authors":"Megha Rao, Sakshi Mohan, Chrispus Mayora, Elizabeth Ekirapa, Finn McGuire, Brenda Nakimuli, Beatrice Namirembe, Perez Ochanda, Richard Ssempala, Aloysius Ssennyonjo, Paul Revill, Simon Mark Walker, Freddie Ssengooba","doi":"10.1017/S1744133126100644","DOIUrl":"https://doi.org/10.1017/S1744133126100644","url":null,"abstract":"Generating evidence to guide investments in new service delivery platforms remains a major challenge. We applied a linear constrained optimisation model, ex ante, to estimate the potential health impact and trade-offs of integrating community-based providers (CBPs) into Uganda's essential healthcare package. Specifically, we compared a facility-only delivery strategy with an integrated strategy that included Village Health Teams (VHTs) and medicine retailers. Outcomes included potential expansion of the optimal service package, additional net disability-adjusted life years averted, average cost-effectiveness, and maximum cost-effective investment per provider. Integrating CBPs could avert an additional 4.7 million net disability-adjusted life years and expand Uganda's optimal health package by 25 interventions compared to the facility-only strategy. VHTs achieved health gains at $42 per net DALY averted and remained cost-effective at an investment of up to $3,423 per provider; medicine retailers remained cost-effective up to $19,792 per provider. Although current policies restrict CBP utilisation, results indicate substantial potential for health system strengthening. Constrained optimisation provides a systematic approach to quantify the value of new delivery platforms. Our findings provide an evidence-based roadmap for integrating CBPs in Uganda, while the adaptable model itself serves as a replicable tool to inform similar analyses in other settings.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Towards a new compact for health financing in Lao People's Democratic Republic. 制定老挝人民民主共和国卫生筹资新契约。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-16 DOI: 10.1017/S1744133126100620

Praveena Gunaratnam, Sengchanh Kounnavong, Elizabeth A Ashley, Manilung Nalongsack, Tom Drake, Bounserth Keopasith, Mayfong Mayxay

{"title":"Towards a new compact for health financing in Lao People's Democratic Republic.","authors":"Praveena Gunaratnam, Sengchanh Kounnavong, Elizabeth A Ashley, Manilung Nalongsack, Tom Drake, Bounserth Keopasith, Mayfong Mayxay","doi":"10.1017/S1744133126100620","DOIUrl":"https://doi.org/10.1017/S1744133126100620","url":null,"abstract":"Inadequate or ineffective health financing poses a significant challenge to the Government of Lao People's Democratic Republic's goal of achieving universal health coverage by 2030. Here we explore possible application in the Lao context of the Center for Global Development's New Compact approach, including locally-led evidence-informed prioritisation, domestic financing and consolidated supplementary aid. Using WHO's political economy analysis guide we identify opportunities and barriers and propose a road map towards implementation of the New Compact. This includes firstly, increasing local capacity and systems to generate and use evidence in policy and resource allocation decisions, starting with specific use cases related to the Essential Services Health Package and vaccines portfolio. Secondly, shifting available domestic resources to highest priority services, including at the primary health care level, based on deeper understanding of existing funding and where efficiency, cost-effectiveness and equity can be optimised. Thirdly, improving government and donor coordination aligned to national priorities and gradually increasing funds pooling as feasible.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Private health insurance in universal health systems: a comparative analysis of Discovery Group's operations in the United Kingdom and South Africa. 全民医疗系统中的私人医疗保险：探索集团在英国和南非业务的比较分析。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-08 DOI: 10.1017/S1744133126100590

Pauline Pearcy, Kay-Leigh Sussman, Rocco Friebel

{"title":"Private health insurance in universal health systems: a comparative analysis of Discovery Group's operations in the United Kingdom and South Africa.","authors":"Pauline Pearcy, Kay-Leigh Sussman, Rocco Friebel","doi":"10.1017/S1744133126100590","DOIUrl":"https://doi.org/10.1017/S1744133126100590","url":null,"abstract":"The growing involvement of private health insurers within universal health systems has intensified debate over their effects on access, equity, and long-term system sustainability. This paper examines the role of private insurers in the United Kingdom (UK) and South Africa through a case study of the Discovery Group, operating across both settings. We explore how private sector engagement shapes health financing, workforce dynamics, service delivery, digital infrastructure, and governance. Our analysis reveals that the impact of private health insurance on universal health systems is fundamentally context-dependent, mediated by institutional frameworks, regulatory environments, and the stage of universal coverage development. We find that private insurers can contribute meaningfully to digital health innovation and behavioural health interventions. However, expansion also introduces significant risks concerning workforce distribution, financing sustainability, and equity of access. These dynamics manifest differently across contexts. In the UK's mature universal system, private insurance plays a supplementary role offering expedited access to care for members. In South Africa's transitional dual system, private insurers more fundamentally shape whether quality care is accessible at all. As health systems evolve, the central challenge lies in developing governance frameworks that enable beneficial private sector contributions while safeguarding equitable access and national health system priorities.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From infodemics to collective resistance: populist mobilisation and health consequences. 从信息流行病到集体抵抗：民粹主义动员和健康后果。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-08 DOI: 10.1017/S1744133126100589

Yuxi Wang

{"title":"From infodemics to collective resistance: populist mobilisation and health consequences.","authors":"Yuxi Wang","doi":"10.1017/S1744133126100589","DOIUrl":"https://doi.org/10.1017/S1744133126100589","url":null,"abstract":"The COVID-19 pandemic unfolded alongside an unprecedented 'infodemic' that reshaped public engagement with science, health, and authority. This study examines how online infodemics translated into collective resistance and influenced population health through political mobilisation. Using structural equation models across six European countries, I conceptualise resistance as a latent construct - captured by residential mobility and protests opposing vaccines, lockdowns, and public health measures linked to populist radical right (PRR) movements - acting as a behavioural bridge between digital information environments and epidemic outcomes. The findings reveal a robust infodemic-resistance-epidemic pathway: greater exposure to infodemic content consistently predicts stronger opposition to non-pharmaceutical interventions (NPIs) and vaccination. This effect is strongest in Germany and Italy, where PRR networks amplified narratives of 'elite overreach' and 'freedom under threat', transforming online discontent into organised mobilisation. In other countries, resistance appears weaker and more pandemic-specific. By integrating informational, political, and epidemiological processes, the analysis shows how epidemics can evolve into politicised collective behaviour that undermines compliance and sustains transmission. The results highlight populist mobilisation as a key amplifier of epidemic risk and suggest that effective responses must rebuild trust, depoliticise health communication, and address structural sources of grievance.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent trends in private health insurance prices and cost-sharing for hospital-based professional services. 私人医疗保险价格和医院专业服务费用分摊的最新趋势。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-07 DOI: 10.1017/S1744133126100565

Erin Duffy, Christopher Garmon, Bich Ly

{"title":"Recent trends in private health insurance prices and cost-sharing for hospital-based professional services.","authors":"Erin Duffy, Christopher Garmon, Bich Ly","doi":"10.1017/S1744133126100565","DOIUrl":"https://doi.org/10.1017/S1744133126100565","url":null,"abstract":"Numerous consumer protection regulations (e.g., No Surprises Act, Transparency in Coverage) have been implemented recently in the United States that could impact private health insurance prices and patient cost-sharing for many health care services. We use a large multi-payer database of health insurance claims for employer-sponsored health plans in the U.S. to describe the trajectory of prices and patient cost-sharing for the services of clinicians that are likely most affected by these regulatory changes: emergency physicians, radiologists, pathologists, and neonatologists. We find that in-network prices and patient cost-sharing generally increased for all four specialties between 2012 and 2022. However, all four specialties experienced periods of decline in out-of-network prices and cost-sharing, with different starting points, and substantial reductions in prices and cost-sharing from 2021 to 2022, particularly for self-funded health plans. Although we cannot isolate the causal impact of any law or regulation, our results suggest that out-of-network prices and cost-sharing decreased when the NSA and TIC were implemented in 2022, especially for the previously less regulated self-funded health plans. Our results imply that patients who previously struggled with the financial burdens of surprise out-of-network medical bills may have benefited significantly from the recent regulatory changes.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-28"},"PeriodicalIF":2.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A closer look at provider market consolidation and the role of private capital. 仔细研究供应商市场整合和私人资本的作用。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-06 DOI: 10.1017/S1744133126100553

Lauren C Makhoul, Owen Ayers, Shareef Ghanem

{"title":"A closer look at provider market consolidation and the role of private capital.","authors":"Lauren C Makhoul, Owen Ayers, Shareef Ghanem","doi":"10.1017/S1744133126100553","DOIUrl":"https://doi.org/10.1017/S1744133126100553","url":null,"abstract":"This paper examines the relationship between provider market consolidation, setting-of-care (SOC) dynamics, and healthcare costs in the United States. The authors argue that consolidation is not solely a driver of rising unit prices, but also a response to structural pressures, including rising practice costs, stagnant physician reimbursement, and increasing administrative complexity. Drawing on recent empirical analyses, the authors demonstrate that prices vary substantially by SOC, with hospital outpatient departments representing the highest-cost settings. They further show that physician affiliation models are associated with distinct patterns of SOC utilisation. These findings suggest that the relationship between consolidation and cost is not uniform and depends on underlying organisational incentives. The authors contend that current policy discourse around private capital lacks sufficient nuance and risks obscuring more fundamental drivers of cost growth, particularly reimbursement design. They call for a more balanced dialogue and additional research to better understand how consolidation, payment policy, and SOC decision-making interact, concluding that policymakers should prioritise incentives that support clinically appropriate care in lower-cost settings.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The changing landscape of PrEP deserts in the United States. 美国PrEP沙漠不断变化的景观。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-01 Epub Date: 2026-05-29 DOI: 10.1017/S1744133126100528

Kellen A Kane

引用次数: 0

Tobacco end-game policies and the intrinsic connection of health and EU market law. 烟草终局政策与健康与欧盟市场法的内在联系。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1017/S1744133126100541

Vincent Delhomme, Anniek De Ruijter, Tamara Hervey, Martin McKee, Jacquelyn Veraldi

{"title":"Tobacco end-game policies and the intrinsic connection of health and EU market law.","authors":"Vincent Delhomme, Anniek De Ruijter, Tamara Hervey, Martin McKee, Jacquelyn Veraldi","doi":"10.1017/S1744133126100541","DOIUrl":"10.1017/S1744133126100541","url":null,"abstract":"This article explores the relationship between EU internal market law and ambitious tobacco end-game policies, using the United Kingdom's proposed smoke-free generation measure and its application to Northern Ireland under the Windsor Framework as a focal case. Responding to objections raised by EU Member States through the Technical Regulations Information System (TRIS), the article develops an interpretative framework that situates free movement rules within the EU's broader constitutional commitment to public health protection. Drawing on a doctrinal analysis of EU primary law, the Tobacco Products Directive, EU Court of Justice case law, and the TRIS submissions themselves, the article challenges claims that generational sales bans are inherently incompatible with EU law. It argues that such claims rely on narrow and selective readings of internal market doctrine that overlook the extent to which health protection is embedded in EU market regulation. The analysis demonstrates that EU law leaves significant regulatory space for national authorities to pursue proportionate, evidence-based tobacco control measures, including end-game strategies. Beyond the immediate UK-Northern Ireland context, the findings have broader implications for innovative public health regulation within the EU, contributing to ongoing debates at the intersection of health policy, regulatory governance, and economic integration.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"269-284"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reforming the funding of long-term care for older people: costs and distributional impacts of planned changes in England. 改革老年人长期护理的资金：英格兰计划变化的成本和分配影响。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-01 Epub Date: 2025-05-14 DOI: 10.1017/S1744133125000088

Bo Hu, Ruth Hancock, Raphael Wittenberg, Derek King, Marcello Morciano

{"title":"Reforming the funding of long-term care for older people: costs and distributional impacts of planned changes in England.","authors":"Bo Hu, Ruth Hancock, Raphael Wittenberg, Derek King, Marcello Morciano","doi":"10.1017/S1744133125000088","DOIUrl":"10.1017/S1744133125000088","url":null,"abstract":"Reforms to the means tests in England for state-financed long-term care were planned for implementation in 2025. They included a lifetime limit (cap) on how much an individual must contribute to their care, with the state meeting subsequent care costs. We present projections of the costs and distributional impacts of these reforms for older people, using two linked simulation models which draw on a wide range of data. We project that by 2038 public spending on long-term care for older people in England would be about 14% higher than without the reforms. While the main direct beneficiaries of the lifetime cap would have been the better off who currently receive no state help with their care costs, the reforms also treated capital assets more generously than the current system, helping people with more modest incomes and wealth. When analysing the impacts of the reforms it is therefore important to consider the whole reform package. Our results depend on a range of assumptions, and the impacts of the reforms would be sensitive to the levels of the cap and other reformed parameters of the means test on implementation.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"285-305"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0