Health Economics Policy and Law最新文献_第5页

Policy shift toward mandatory premarital screening in a Middle Eastern country: agenda- setting through the lens of Kingdon's multiple streams framework. 中东国家向强制性婚前检查的政策转变：通过金登的多流框架的镜头设定议程。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-03-31 DOI: 10.1017/S1744133126100450

Zainab Al Kindi, Joshua Muliira

{"title":"Policy shift toward mandatory premarital screening in a Middle Eastern country: agenda- setting through the lens of Kingdon's multiple streams framework.","authors":"Zainab Al Kindi, Joshua Muliira","doi":"10.1017/S1744133126100450","DOIUrl":"https://doi.org/10.1017/S1744133126100450","url":null,"abstract":"Premarital screening policies are increasingly adopted to prevent hereditary disorders in populations with high consanguinity. In Oman, a Middle Eastern country with significant sickle cell disease prevalence, the shift toward mandatory premarital screening emerged through a strategic policy process influenced by cultural, tribal, and religious values. In this context, premarital screening offers a critical opportunity for early detection and informed reproductive decision-making. This paper provides an explanatory analysis of the agenda-setting process that enabled the formal adoption of compulsory premarital screening for genetic disorders, using Kingdon's Multiple Streams Framework (MSF) as an analytical lens. The analysis demonstrates how hereditary blood disorders, in particular Sickle cell disease (SCD), transitioned from a socially normalised condition to a recognised public health and socioeconomic problem, and how a technically feasible and ethically sensitive policy solution was advanced. Oman's case illustrates how preventive health policies targeting socially sensitive issues can gain traction through stream convergence, and incremental reframing.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-7"},"PeriodicalIF":3.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582451","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

Why do health crises matter for populism? 为什么健康危机对民粹主义很重要？

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-03-26 DOI: 10.1017/S1744133126100425

Gregori Galofré Vilà

引用次数: 0

Depoliticising resilience? Uncovering the political theories of health system resilience. 非政治化的弹性呢?揭示卫生系统弹性的政治理论。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-03-09 DOI: 10.1017/S1744133126100437

Benjamin Ewert

{"title":"Depoliticising resilience? Uncovering the political theories of health system resilience.","authors":"Benjamin Ewert","doi":"10.1017/S1744133126100437","DOIUrl":"https://doi.org/10.1017/S1744133126100437","url":null,"abstract":"This paper examines Health System Resilience (HSR) through a political science lens, arguing that the capacity of health systems to become resilient is shaped not only by technical capabilities and available resources but also by the political theories underpinning health systems and health policy. While HSR has gained prominence in health research as a concept, its integration with political theories remains limited - particularly within political science literature. Drawing on a scoping review, the paper finds that political dimensions - such as governance and leadership, institutional path dependency, and power dynamics - are rarely and unevenly addressed in the literature. Most sources adopt a fragmented view of policy and politics, infrequently identifying the Political Determinants of Health (PDoH) systematically or analysing them through robust political theory. As a result, resilience is often depoliticised and treated as a managerial issue rather than a contested political process. In light of these findings, the paper proposes new opportunities to scrutinise how HSR is shaped by the interplay of actors, ideas, and institutions. In doing so, it contributes to developing a political science of health that fosters stronger interdisciplinary engagement. The paper calls on political scientists to engage more proactively with public health scholarship to support politically informed and more effective resilience strategies.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-16"},"PeriodicalIF":3.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379058","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

Acting reactively: private investment, controversies and regulatory and policy responses in residential long-term care in Ontario (Canada), Lombardy (Italy), the Netherlands and England (United Kingdom). 积极行动：安大略（加拿大）、伦巴第（意大利）、荷兰和英格兰（联合王国）在长期住宿护理方面的私人投资、争议以及监管和政策反应。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-03-03 DOI: 10.1017/S1744133126100401

Jitse Schuurmans, Laura De Brabandere, Michele Castelli, Sarbina Wimmer, Jean-Louis Denis

{"title":"Acting reactively: private investment, controversies and regulatory and policy responses in residential long-term care in Ontario (Canada), Lombardy (Italy), the Netherlands and England (United Kingdom).","authors":"Jitse Schuurmans, Laura De Brabandere, Michele Castelli, Sarbina Wimmer, Jean-Louis Denis","doi":"10.1017/S1744133126100401","DOIUrl":"https://doi.org/10.1017/S1744133126100401","url":null,"abstract":"Private investment in residential long-term care has surged around the world. Growing evidence shows that this is changing the institutional logic and the inner workings of the sector, prioritising the financial interests of asset holders above those of other stakeholders (eg. clients, care professionals and regulators). We know little about how policy makers and regulators are responding to private investment and profit-making in the long-term care sector. This paper addresses that gap by analysing policies prompting the growth of private investment and profit-making in residential long-term care, the emerging power struggles in some cases between asset holders and other stakeholders in long-term care, the controversies that have arisen and the concomitant responses of regulators and policy makers in Ontario (Canada), Lombardy (Italy), the Netherlands and England (United Kingdom). We show that the institutional context (eg. legal frameworks, policies and regulations) shapes controversies concerning quality, accessibility and affordability of care, and argue that regulators and policymakers in the constituencies we studied are responding reactively to such controversies rather than proactively anticipating and preventing unwanted effects. Our analysis provides policymakers with valuable insights regarding the regulation and governance of private investment and profit-making in the residential long-term care sector.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-15"},"PeriodicalIF":3.3,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345233","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

Legal implications of joint clinical assessments under the EU HTA regulation. 欧盟HTA法规下联合临床评估的法律含义。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-03-02 DOI: 10.1017/S1744133126100413

Nicolas S H Xander, Maureen P M H Rutten-van Mölken, Louis Bertin, Nenad Miljković, Carin A Uyl-de Groot

{"title":"Legal implications of joint clinical assessments under the EU HTA regulation.","authors":"Nicolas S H Xander, Maureen P M H Rutten-van Mölken, Louis Bertin, Nenad Miljković, Carin A Uyl-de Groot","doi":"10.1017/S1744133126100413","DOIUrl":"https://doi.org/10.1017/S1744133126100413","url":null,"abstract":"Joint clinical assessments (JCAs) under the European Union (EU) Regulation 2021/2282 on health technology assessment (HTA-R) and its implementing regulations have been linked to various implementation challenges. However, legal implications of practically relevant issues have mostly remained unexplored. This study investigated potential legal implications of disparities regarding patient population, intervention, comparator, and outcomes (PICOs) in JCAs from respective member states (MSs), and of managing conflicts of interest (CoIs) of experts involved in a JCA. Moreover, we discussed potential consequences for patient access. JCA reports are not legally binding for MS; PICO disparities can underpin the required justification for their non-consideration at national level. Legal action against negative reimbursement decisions due to unjustified non-consideration falls under national jurisdiction. Furthermore, too strict CoI management might leave perspectives of MSs with fewer experts and thus a higher chance of CoI occurrence unheard, requiring corresponding expert elicitation at national level. These implications might lead to an increased workload for health technology developers and national HTA bodies, potentially fostering marketing strategies and access delays. Thorough scoping processes and prioritising the need for a JCA's scientific excellence could facilitate more streamlined national HTA procedures and accelerated patient access.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-13"},"PeriodicalIF":3.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327592","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 equity involvement in long-term care: what can we learn from the United States, Ireland, and Poland? 私募股权参与长期护理：我们能从美国、爱尔兰和波兰学到什么？

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-02-20 DOI: 10.1017/S1744133126100383

Michael K Gusmano, Małgorzata Kalbarczyk, Julien Mercille, Anna Nicińska, Nicholas O'Neill

引用次数: 0

Cost-effectiveness thresholds in policy and practice: do HTA guidelines align with estimates of health opportunity cost? 政策和实践中的成本效益阈值：卫生保健协会指南是否与卫生机会成本估计值一致？

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-02-19 DOI: 10.1017/S1744133126100395

Peter Murphy, Susan Griffin, Simon Walker, Laura Vallejo-Torres, Oscar Espinosa, Mac Ardy J Gloria, Jessica Ochalek

{"title":"Cost-effectiveness thresholds in policy and practice: do HTA guidelines align with estimates of health opportunity cost?","authors":"Peter Murphy, Susan Griffin, Simon Walker, Laura Vallejo-Torres, Oscar Espinosa, Mac Ardy J Gloria, Jessica Ochalek","doi":"10.1017/S1744133126100395","DOIUrl":"https://doi.org/10.1017/S1744133126100395","url":null,"abstract":"Health technology assessment (HTA) processes provide evidence to inform the supply of healthcare, often comparing results from economic evaluation to a policy threshold to judge cost-effectiveness. However, recommended policy thresholds may not always align with empirical estimates of the opportunity costs of health care expenditure, captured by marginal productivity of healthcare expenditure ('k'). Such estimates are needed to inform the net health impact of funding decisions. We map policy thresholds in HTA guidelines against published estimates of k. We extract information from HTA guidelines identified in a previous literature review, including recommended perspective, relevant costs and outcomes, and justification for the threshold. Studies estimating k were obtained from a separate review. Of the 47 included HTA guidelines, 20 state an explicit policy threshold and 12 justify their choice. Estimates of k were available for 13 countries. Among the eight countries with explicit policy thresholds and k estimates, three matched. The recommended perspective influences whether k alone is sufficient or appropriate to inform cost-effectiveness judgements. It is important that guideline setters are aware of empirical estimates of k; and that economic evaluations consider k to reflect health opportunity costs even where the policy threshold is justified on other grounds.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-29"},"PeriodicalIF":3.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221232","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 equity investments in health care in OECD countries: an exploratory analysis. 经合组织国家医疗保健领域的私人股本投资：探索性分析。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-01-28 DOI: 10.1017/S1744133125100352

Yashaswini Singh, Megha Reddy, Irene Papanicolas, Richard Scheffler

{"title":"Private equity investments in health care in OECD countries: an exploratory analysis.","authors":"Yashaswini Singh, Megha Reddy, Irene Papanicolas, Richard Scheffler","doi":"10.1017/S1744133125100352","DOIUrl":"https://doi.org/10.1017/S1744133125100352","url":null,"abstract":"Private equity (PE) firms are increasingly investing in healthcare, seeking short-term returns through market consolidation, price increases, asset sales, and financial engineering. Although PE is transforming the healthcare sector, many countries lack systematic data to determine whether a regulatory response is warranted. Using data from PitchBook, we document substantial and growing PE investment in health care across 25 of 38 Organization of Economic Cooperation and Development (OECD) countries, totalling over 8,400 reported deals and $1.4 trillion in capital between 2013 and 2023. Outpatient clinics represent the dominant target of investment, while hospital and elder care sectors have attracted investments in select countries. Exploratory regression analyses suggest that PE firms are less likely to invest in countries with a social health insurance system and that PE deal volume is positively associated with health expenditures. Country-specific deviations from model predictions underscore the importance of unmeasured country-specific factors such as regulation, payment policy, and market competition. Eight case studies illustrate the operational, financial, and social implications of PE investments, as well as diverse regulatory contexts. Given the lack of disclosure requirements, a key policy priority for governments is to enhance transparency to enable effective monitoring of the financialisation of health care delivery.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-28"},"PeriodicalIF":3.3,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067149","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

No sanctuary? Public attitudes about healthcare providers and their role in immigration enforcement and policy. 没有避难所?公众对医疗保健提供者的态度及其在移民执法和政策中的作用。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-01-26 DOI: 10.1017/S1744133125100364

Christine Crudo Blackburn, Simon F Haeder

{"title":"No sanctuary? Public attitudes about healthcare providers and their role in immigration enforcement and policy.","authors":"Christine Crudo Blackburn, Simon F Haeder","doi":"10.1017/S1744133125100364","DOIUrl":"https://doi.org/10.1017/S1744133125100364","url":null,"abstract":"This study aims to understand if the American public supports five policies related to the involvement of healthcare providers in immigration enforcement efforts such as documenting legal status in medical charts to actively assisting immigration enforcement. We also seek to establish whether public attitudes are stable on this issue using an experiment highlighting the implications of these policies for immigrants, communities, and the broader public. To assess public attitudes, we fielded a survey (N = 6049) from 7 March to 26 March 2025. We randomly assigned respondents to one of six treatments highlighting various implications of these policies for immigrants and communities. We found a divided public on the topic, with a substantial number of Americans willing to blur the lines between immigration policy and the provision of healthcare. Respondents were most receptive to tracking the number of undocumented patients served and least supportive of assisting in detaining patients. We found substantial differences based on party affiliation and presidential vote choice but not personal connections or residence inside or outside of border states. Our findings suggest that a majority of Americans support some level of immigration enforcement in healthcare settings while public opinion on this issue is hard to move.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-24"},"PeriodicalIF":3.3,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046641","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

Long-term care insurance and accessibility of home and community-based services for older adults: evidence from China. 长期护理保险与老年人家庭和社区服务的可及性：来自中国的证据。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-01-12 DOI: 10.1017/S1744133125100303

Chen Bai, Zhenyu Zhu, Tianyu Wang, Mengting Li

{"title":"Long-term care insurance and accessibility of home and community-based services for older adults: evidence from China.","authors":"Chen Bai, Zhenyu Zhu, Tianyu Wang, Mengting Li","doi":"10.1017/S1744133125100303","DOIUrl":"https://doi.org/10.1017/S1744133125100303","url":null,"abstract":"With population aging, the establishment of universal long-term care insurance (LTCI) has emerged as a critical policy issue. This paper examines the effects of China's LTCI pilots on the physical accessibility of home and community-based services (HCBS) and specific services for older adults. Using three-wave panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyze the rollout of LTCI pilots across different cities from 2014 to 2021, employing a time-varying difference-in-differences (DID) approach. Our findings indicate that LTCI significantly improves access to HCBS for older adults, particularly in personal daily care. Heterogeneity analysis indicates that LTCI has a stronger positive effect on the accessibility of HCBS for older adults with physical impairment, lower financial transfers from children, or living alone or with a spouse only, and the positive effect is more salient in regions with higher reimbursement for HCBS and more generous coverage. This study provides compelling evidence regarding the pivotal role of institutional design of LTCI in shaping older adults' care-seeking behavior and system-level resource allocation. It offers nuanced insights into the evaluation of differentiated pilot programs across cities, which can inform the development of a uniform national LTCI policy and carry implications for other developing countries.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-16"},"PeriodicalIF":3.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953272","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