Health Economics Policy and Law最新文献_第6页

Preparing for uncertainty and health system responses: a new year for Health Economics, Policy and Law. 为不确定性和卫生系统应对做准备：卫生经济学、政策和法律的新一年。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-01-12 DOI: 10.1017/S1744133125100340

Iris Wallenburg, Rocco Friebel

引用次数: 0

A typology of private investor-ownership in health service provision and related regulatory frameworks in five countries. 5个国家卫生服务提供中的私人投资者所有权类型和相关监管框架。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-01-12 DOI: 10.1017/S1744133125100297

Chiara Berardi, Mark Hellowell, Marco Varkevisser

{"title":"A typology of private investor-ownership in health service provision and related regulatory frameworks in five countries.","authors":"Chiara Berardi, Mark Hellowell, Marco Varkevisser","doi":"10.1017/S1744133125100297","DOIUrl":"https://doi.org/10.1017/S1744133125100297","url":null,"abstract":"Private sector entities can invest in and own the means of healthcare provision, creating opportunities and risks for health systems. While private investment can enhance access to capital, promote competition, and foster innovation, it can also exacerbate incentives for providers to engage in supplier-induced demand, undue price increases, quality compromises, and 'cherry-picking' of the most profitable patients and services. Despite the growing presence of private investors in the healthcare sector, heterogeneity in investor types remains poorly understood. This limits the ability of policymakers to consider whether, and to what extent, regulatory intervention is called for in relation to different forms of investor-ownership. By drawing on principal-agent theory, this article begins to address this gap by presenting a typology of investor-ownership in health services provision. Examining the policy relevance of such a typology, we present a case study analysis of current regulations directed at ownership across five countries, representing different health system models. We find that regulatory frameworks that differentiate between types of for-profit investor-ownership are largely absent in Europe, but more developed in the US. We argue that growing private investments require a combination of entry regulation and behavioural oversight to better align the incentives of investor-owners with public health objectives.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-20"},"PeriodicalIF":3.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953252","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

Resource allocation in social care and the consequences for equitable access: findings from a secondary analysis of a systematic review. 社会关怀中的资源分配及其对公平获取的影响：系统评价的二次分析结果。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2026-01-07 DOI: 10.1017/S1744133125100327

Philipa Mos, Vivian Reckers-Droog

{"title":"Resource allocation in social care and the consequences for equitable access: findings from a secondary analysis of a systematic review.","authors":"Philipa Mos, Vivian Reckers-Droog","doi":"10.1017/S1744133125100327","DOIUrl":"https://doi.org/10.1017/S1744133125100327","url":null,"abstract":"Growing demand for social care and resource constraints compel decision-makers to decide how to allocate public resources to social care. Such decisions may result in differences in access to social care between groups in society. In this study we conducted a secondary analysis of articles included in a systematic review on the underpinnings of resource allocation decisions in social care, extending that work to examine the potential consequences of such decisions. We conducted the review in accordance with the PRISMA framework. Through a thematic framework analysis of 37 of the 42 articles included in the parent review, we identified five groups in society that may be disproportionately affected by the consequences of resource allocation decisions on social care: (1) individuals with long-term social care needs (2) informal caregivers, (3) lower socio-economic groups, (4) individuals with limited health literacy skills, and (5) individuals living across different regions. Our findings highlight that allocation decisions in social care particularly affect women and individuals facing language barriers and may create local variation in provision of social care. These findings suggest potential for inequitable access to social care in society and underscore the need for decision-makers to consider the consequences of their allocation decisions.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-15"},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913419","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 relationship between healthcare provider ownership and performance in high-income countries: An umbrella review. 高收入国家医疗保健提供者所有权与绩效之间的关系：总括性回顾。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2025-12-26 DOI: 10.1017/S1744133125100315

Michael Anderson, Sabrina Wimmer, Bradley Pittam, Cornelia Henschke, Matt Sutton, Thomas Rapp, Nils Gutacker, Rocco Friebel

{"title":"The relationship between healthcare provider ownership and performance in high-income countries: An umbrella review.","authors":"Michael Anderson, Sabrina Wimmer, Bradley Pittam, Cornelia Henschke, Matt Sutton, Thomas Rapp, Nils Gutacker, Rocco Friebel","doi":"10.1017/S1744133125100315","DOIUrl":"https://doi.org/10.1017/S1744133125100315","url":null,"abstract":"The role of healthcare provider ownership in shaping health system performance remains contested. An umbrella review was conducted to synthesise evidence on the relationship between healthcare provider ownership and performance in high-income countries. Systematic reviews were included that examined performance of healthcare providers based on ownership status. Searches yielded 1,862 results, with 31 systematic reviews meeting the inclusion criteria, and one further systematic review identified through grey literature searches. Following the exclusion of 10 reviews classified as low-quality and two previous umbrella reviews both published in 2014, 20 reviews were eligible for data extraction and synthesis. Inconsistent evidence was found across reviews between healthcare provider ownership and several performance indicators including health outcomes, technical efficiency, and patient satisfaction. Private hospitals tend to serve wealthier patients, select less complex or costly patients, and charge higher payments for care than public comparators. Private for-profit (FP) providers of hospital and long-term care generally had poorer workforce outcomes than private not-for-profit or public providers, including reduced staffing levels, higher workloads, and lower job satisfaction. Private PF hospitals and nursing homes had improved financial performance based on revenues or profit margins. Our findings underscore the need for nuanced regulatory responses to the expansion of private FP provision within publicly funded systems.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-23"},"PeriodicalIF":3.3,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835018","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

An opportunity to remove harmful intellectual property provisions from the Comprehensive and Progressive Agreement for Trans-Pacific Partnership. 从《全面与进步跨太平洋伙伴关系协定》（Comprehensive and Progressive Agreement for Trans-Pacific Partnership）中删除有害知识产权条款的机会。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2025-11-26 DOI: 10.1017/S1744133125100261

Deborah Gleeson, Joel Lexchin, Brigitte Tenni, Ronald Labonté

{"title":"An opportunity to remove harmful intellectual property provisions from the Comprehensive and Progressive Agreement for Trans-Pacific Partnership.","authors":"Deborah Gleeson, Joel Lexchin, Brigitte Tenni, Ronald Labonté","doi":"10.1017/S1744133125100261","DOIUrl":"https://doi.org/10.1017/S1744133125100261","url":null,"abstract":"Legal provisions in trade agreements, including those related to intellectual property (IP), can impede access to medicines. The 12-party Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) is currently undergoing a review. This provides an opportunity to update the CPTPP's Intellectual Property Chapter to remove certain provisions that were negotiated in the context of its precursor, the Trans Pacific Partnership (TPP), many of which have been suspended. These include several 'TRIPS-Plus' provisions - IP provisions exceeding the requirements of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). This paper reviews the CPTPP's TRIPS-Plus provisions, including those suspended and those still in place, and argues for their removal based on evidence of their likely effects on medicines access and recent changes in the political environment. Since the CPTPP was signed in 2018, accumulated evidence has demonstrated that TRIPS-Plus provisions negatively impact access to medicines. Lack of access to COVID-19 medical products in low- and middle-income countries has highlighted major problems with TRIPS. Furthermore, the US has diverged from a TRIPS-Plus agenda, rendering the suspended provisions obsolete. Removing the CPTPP's TRIPS-Plus provisions, while challenging, would preserve Parties' policy flexibility to design their laws in ways that protect access to medicines.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-8"},"PeriodicalIF":3.3,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606821","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

Incremental choices, system-wide impact on health system performance. 增量选择，对卫生系统绩效的全系统影响。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2025-10-23 DOI: 10.1017/S174413312510025X

Rocco Friebel, Iris Wallenburg

引用次数: 0

The contaminated blood scandal in England: exploring the social harms experienced by infected and affected individuals. 英国受污染的血液丑闻：探索受感染和受影响的个人所经历的社会危害。

IF 3.3 3区医学

Health Economics Policy and Law Pub Date : 2025-08-19 DOI: 10.1017/S1744133125100200

Emily Warren, Eva Cyhlarova, Jessica Carlisle, Martin Knapp, Ellen Nolte

{"title":"The contaminated blood scandal in England: exploring the social harms experienced by infected and affected individuals.","authors":"Emily Warren, Eva Cyhlarova, Jessica Carlisle, Martin Knapp, Ellen Nolte","doi":"10.1017/S1744133125100200","DOIUrl":"10.1017/S1744133125100200","url":null,"abstract":"During the 1970s and 1980s, over 30,000 people in the UK were infected with HIV and/or hepatitis C because of treatment with blood and blood products for conditions such as haemophilia or through blood transfusion. We used the social harms perspective to understand the experiences of those affected. We conducted in-depth interviews with 41 infected people and 11 family members and analysed the data according to five dimensions of social harm: physical harms, psychological harms, cultural harms, economic harms, and harms of misrecognition. We found that people were harmed by the medical system, the social context that perpetuated stigma and shame against them, and successive governments being largely unwilling to address the many health, social, and economic impacts of infection on families. What stood out were the many reports of harms of misrecognition, which were often experienced as more irreconcilable than the circumstances of infection itself. They were also harms that have been largely ignored.While patient safety encompasses a broad field of work, much of the research focuses on physical harm and medical error. The social harms lens can provide important insights into patient safety incidents as it can help explain the complexity of the different dimensions of harm that individuals and their families experience.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-16"},"PeriodicalIF":3.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875939","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 roadmaps to managed competition: theory and practice. 管理竞争的路线图：理论与实践。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2025-07-23 DOI: 10.1017/S1744133125100170

Josefa Henriquez, Shuli Brammli-Greenberg, Maria Trottmann, Francesco Paolucci

引用次数: 0

Making care primary: a renewed investment into primary care. 初级保健：重新对初级保健进行投资。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2025-07-15 DOI: 10.1017/S174413312510011X

Cameron J Sabet, Bhav Jain, Sandeep Palakodeti

{"title":"Making care primary: a renewed investment into primary care.","authors":"Cameron J Sabet, Bhav Jain, Sandeep Palakodeti","doi":"10.1017/S174413312510011X","DOIUrl":"https://doi.org/10.1017/S174413312510011X","url":null,"abstract":"The Making Care Primary (MCP) model represents a sharp shift in Medicare's approach to primary care, yet its current design risks duplicating failures from prior alternative payment models. Our editorial suggests refinements to address these gaps. To prevent early provider dropout from MCP's rigid track-based system, we propose a sliding-scale infrastructure payment model that adjusts based on practice needs rather than abrupt phase-outs. Given MCP's reliance on community-based organisations (CBOs) for social determinants of health interventions, we also advocate for direct, outcomes-based contracts between providers and CBOs, ensuring accountability for patient outcomes rather than passive referrals. We recommend that MCP enforce data-sharing mandates for commercial insurers and Medicaid agencies, drawing from Washington State's successful Multi-Payer Collaborative, to avoid payer disengagement that plagued previous multi-payer models. To expand beyond conventional quality measures, we propose integrating patient-centred outcomes from the International Consortium for Health Outcomes Measurement, making sure MCP captures meaningful clinical impact. Finally, we propose programme adjustments frequently at two- to three-year intervals to refine risk adjustment methodologies. These approaches could enhance MCP's sustainability, preventing the financial instability and misaligned incentives that undermined past value-based care initiatives.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638328","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

Lead-attributable productivity losses in low- and middle-income countries. 铅在低收入和中等收入国家造成的生产力损失。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2025-07-03 DOI: 10.1017/S1744133125100121

Bret Ericson, Mary Jean Brown

{"title":"Lead-attributable productivity losses in low- and middle-income countries.","authors":"Bret Ericson, Mary Jean Brown","doi":"10.1017/S1744133125100121","DOIUrl":"https://doi.org/10.1017/S1744133125100121","url":null,"abstract":"This study estimates productivity losses resulting from intellectual decrement due to paediatric lead exposure in low- and middle-income countries (LMICs). The published literature on blood lead levels in LMICs was reviewed and summarised. Intelligence Quotient decrement and consequent productivity losses were calculated for a one-year cohort of 5-year-old children in each country. We calculated the present value of lifetime earnings as the discounted average earning potential for workers in a specific economy. Blood lead level (BLL) data for children were available for 39 countries and could be interpolated for additional 82 countries, resulting in 121 countries in the final analysis. Total lead-attributable productivity losses in LMICs ranged from USD 305 billion in our high discount scenario to USD 499 billion in our low discount scenario for each one-year cohort of 5-year-old children (2019 USD). As a share of GDP, these costs ranged from 0.7 to 4.2% by region, depending on discount scenario used. Total economic impacts were generally consistent with previous estimates and further validate those efforts with a substantially expanded dataset. Differences in the findings resulted primarily from the use of a more conservative dose-response model in the present study. Improved reporting of BLLs is essential and could be facilitated through a centralised registry of study results.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555237","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