Health Economics Policy and Law最新文献

{"title":"Successfully changing the mode of regulation in clinical priority setting: how organisational factors contributed to establishing the Norwegian priority guidelines for specialist health care services.","authors":"Irene Aase-Kvåle","doi":"10.1017/S1744133123000014","DOIUrl":"10.1017/S1744133123000014","url":null,"abstract":"<p><p>This article investigates factors that contributed to the successful introduction of 33 priority guidelines for Norwegian specialist health care from 2008 to 2012. The guidelines constituted an important step in changing the regulation of clinical priority setting from largely self-regulation by medical professionals to a more centralised and hierarchical form, and therefore, resistance from the medical profession was expected. My focus is on organisational factors within the project that developed the guidelines, using policy documents and project documents as the main source of data. I find that the project was characterised by a high level of autonomy in terms of how it was organised and the actors included, with significant capacity for action in terms of both structure and personnel, and a broad inclusion of affected actors. The priority guideline project was dominated by medical professionals, and its organisation did not represent a radical break with established traditions of medical professional self-regulation. Although organisational autonomy, action capacity and broad inclusion were clearly of importance, the project's compliance with historical traditions and norms of medical governance stands out as the key factor in understanding the successful establishment of the priority guidelines.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 3","pages":"234-247"},"PeriodicalIF":3.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595631","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}

{"title":"Spillover effects of financial incentives for providers onto non-targeted patients: daycase surgery in English hospitals.","authors":"Philip Britteon, Søren Rud Kristensen, Yiu-Shing Lau, Ruth McDonald, Matt Sutton","doi":"10.1017/S1744133123000063","DOIUrl":"10.1017/S1744133123000063","url":null,"abstract":"<p><strong>Background: </strong>Incentives for healthcare providers may also affect non-targeted patients. These spillover effects have important implications for the full impact and evaluation of incentive schemes. However, there are few studies on the extent of such spillovers in health care. We investigated whether incentives to perform surgical procedures as daycases affected whether other elective procedures in the same specialties were also treated as daycases.</p><p><strong>Data: </strong>8,505,754 patients treated for 92 non-targeted procedures in 127 hospital trusts in England between April and March 2016.</p><p><strong>Methods: </strong>Interrupted time series analysis of the probability of being treated as a daycase for non-targeted patients treated in six specialties where targeted patients were also treated and three specialties where they were not.</p><p><strong>Results: </strong>The daycase rate initially increased (1.04 percentage points, SE: 0.30) for patients undergoing a non-targeted procedure in incentivised specialties but then reduced over time. Conversely, the daycase rate gradually decreased over time for patients treated in a non-incentivised specialty.</p><p><strong>Discussion: </strong>Spillovers from financial incentives have variable effects over different activities and over time. Policymakers and researchers should consider the possibility of spillovers in the design and evaluation of incentive schemes.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 3","pages":"289-304"},"PeriodicalIF":3.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9598281","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}

{"title":"Public health by organizational fix?","authors":"Albert Weale, David J Hunter, Peter Littlejohns, Toslima Khatun, Jacqueline Johnson","doi":"10.1017/S1744133123000051","DOIUrl":"10.1017/S1744133123000051","url":null,"abstract":"<p><p>In August 2020 the UK government announced without warning the abolition of Public Health England (PHE), the principal UK agency for the promotion and protection of public health. We undertook a research programme seeking to understand the factors surrounding this decision. While the underlying issues are complex two competing interpretations have emerged: an 'official' explanation, which highlights the failure of PHE to scale up its testing capacity in the early weeks of the COVID-19 pandemic as the fundamental reason for closing it down and a 'sceptical' interpretation, which ascribes the decision to blame-avoidance behaviour on the part of leading government figures. This paper reviews crucial claims in these two competing explanations exploring the arguments for and against each proposition. It concludes that neither is adequate and that the inability adequately to address the problem of testing (which triggered the decision to close PHE) lies deeper in the absence of the norms of responsible government in UK politics and the state. However our findings do provide some guidance to the two new organizations established to replace PHE to maximize their impact on public health. We hope that this information will contribute to the independent national COVID inquiry.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 3","pages":"274-288"},"PeriodicalIF":3.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960333","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}

{"title":"What's the ideal World Health Organization (WHO)?","authors":"Clare Wenham, Sara E Davies","doi":"10.1017/S174413312300004X","DOIUrl":"10.1017/S174413312300004X","url":null,"abstract":"<p><p>The World Health Organization (WHO) is tasked with the 'attainment by all peoples of the highest possible level of health', yet, it is widely struggling to meet this mandate, and COVID-19 has revealed significant limitations of the organisation. Despite clear guidance provided by the institution as to how best to respond to the pathogen, many governments departed from WHO's guidance in their response efforts. Is this a new crisis for WHO? Does WHO need to restore its legitimacy in the eyes of the global community? As renewed calls for changes to WHO emerge, in this perspective we lay out the obstacles WHO face to become the WHO 'we' need. The assumption is that UN member states need an empowered and well-funded organisation. Yet, many years of discussion of reform of WHO have failed to lead to meaningful change, and glaring challenges remain in its financing, governance and politics, which are considered in turn. The reality may be that we have the WHO that UN member states need - one that can provide guidance and advice, but also take criticism for health governance failures when states want to avoid blame or responsibility. We discuss this, by analysing three key areas of WHO'S challenges: mandate and scope; structure, governance and money and domestic vs international.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 3","pages":"329-340"},"PeriodicalIF":3.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960335","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}

{"title":"The forgotten dimension of integrated care: barriers to implementing integrated clinical care in English NHS hospitals.","authors":"Michele Castelli,&nbsp;Jonathan Erskine,&nbsp;David Hunter,&nbsp;Amritpal Hungin","doi":"10.1017/S1744133122000214","DOIUrl":"https://doi.org/10.1017/S1744133122000214","url":null,"abstract":"<p><p>Multimorbid patients who enter English NHS hospitals are frequently subject to care pathways designed to assess, diagnose and treat single medical conditions. Opportunities are thereby lost to offer patients more holistic, person-centred care. Hospital organisations elsewhere are known to use in-hospital, multi-specialty, integrated clinical care (ICC) to overcome this problem. This perspective piece aims to critically discuss barriers to implementing this form of ICC in the English NHS focusing on six key areas: information technologies, the primary-secondary care interface, internal hospital processes, finance, workload, professional roles and behaviours. Integrated care programmes currently underway are largely focused on macro (system) and meso (organisational) levels. A micro (clinical) level ICC, offering highly coordinated multispecialty expertise to multimorbid hospital patients could fill an important gap in the current care pathways.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 3","pages":"321-328"},"PeriodicalIF":1.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9606731","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}

{"title":"Emergency care reconfiguration in the Netherlands: conflicting interests and trade-offs from a multidisciplinary perspective.","authors":"Nanne van Velzen,&nbsp;Richard Janssen,&nbsp;Marco Varkevisser","doi":"10.1017/S1744133123000099","DOIUrl":"https://doi.org/10.1017/S1744133123000099","url":null,"abstract":"<p><p>Many countries are reconfiguring their emergency care systems to improve quality and efficiency of care, and this often includes the concentration of emergency departments (EDs). This trend is evident in the Netherlands, but the best approach is the subject of debate among stakeholders. We (i) examined the views of stakeholders on the concentration of EDs in the Netherlands and (ii) identified the main conflicting interests and trade-offs that are relevant for health policy. To do this, we organised focus groups and semi-structured interviews with emergency care professionals, hospital executives and selected external stakeholders. First, the participants saw both advantages and disadvantages to concentration, but these were also contested and debated. Second, we found that - sometimes conflicting - public health care goals (i.e. quality, accessibility and affordability) and narrower interests (e.g. the interests of specific hospitals, insurers, medical specialists and local administrators) were both pointed out. Third, there was no clear preferred approach to the future organisation of EDs, although most stakeholders mentioned some form of centralised decision-making at the national level, combined with regional customisation. Our findings will facilitate health policy decision-making around the reconfiguration of emergency care with the long-term goal of achieving efficient and high-quality emergency care.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685346","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}

{"title":"Research on the Mechanism and Path of Rural Industry Revitalization Enabled by Digital Economy in Southwest China","authors":"Zhai Haomiao, Gao Fuxia","doi":"10.22158/elp.v6n1p57","DOIUrl":"https://doi.org/10.22158/elp.v6n1p57","url":null,"abstract":"Establishing a long-term mechanism for empowering rural industry revitalization through the digital economy is the key to comprehensively promoting rural revitalization during the 14th Five Year Plan period. This article analyzes the influencing factors and characteristics of different models of rural industry development in the southwest region, and identifies specific models that can match the digital economy’s empowerment of different industries in the southwest region. And from the perspective of supply side structural reform, the research on the development mechanism and implementation path of rural industry revitalization in Southwest China is placed under the national strategy of digital economy, aiming to provide scientific decision-making basis for the matching mode, mechanism design, and implementation path in the process of rural industry revitalization in Southwest China from the perspective of supply side structural reform.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"239 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72675973","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}

{"title":"Violence, Its Roots, and How to Stop It","authors":"Amos Avny","doi":"10.22158/elp.v6n1p35","DOIUrl":"https://doi.org/10.22158/elp.v6n1p35","url":null,"abstract":"The Essay opens with the claim that personal Aggression, Violence and Hostility became permanent visitors in our place. This sad situation was the main reason for writing this paper. Along a short historical review, the Author explains the difference between the former well-organized 20th Century and the current Chaotic world perception of the 21st Century. The Author further reminds that the 20th Century contained two World Wars, that killed tens million people and the Cold War, that had divided the world into two large blocs. Further, the essay explains that in this regard the current century is different. No-more big world-wide armed conflicts, but many end-less small disturbing disorders, violent and terror cases. The difference referred also to the personal prominence of the leaders of the wars. The eminence Winston Churchill—the great outstanding leader of the West, Joseph Stalin—the sadist Communist Dictator who killed tenths millions, and Adolf Hitler—the mentally-ill Tyrant of the Nazi regime who was a horrendous, barbaric and murderer of millions. Comparing to these leaders the nowadays villains and terrorists are sick, confused and weak persons who seek recognition. Abstract cut. The Author assumes that criminal Violence and Terror expand at present as result of three reasons: (1) The termination of political debates due to the political parties’ deterioration, (2) A wrong understanding of today’s developments, and (3) an erroneous feeling, about equality that causes much frustrations and lead to wrong expectations. The Author supports countries’ current initiative for fighting against present terrorists by establishing special Polce and Military units, which know the job, professionally and effectively.  However, for (a cut) improving the treatment of this sick phenomenon at the future, the Author emphasizes the need to collect reliable information about the relevant population and its personal weaknesses. At the end a six steps therapeutic program is proposed: (a cut), 1) Revealing and Building the Individual’s Inner-self, 2) Pursuing the “Meaning for life” as Life’s Goal, 3) Endorsing Collaboration and Togetherness, 4) Developing and Empowering the Self-esteem, 5) Recognizing and Accepting Social Heterogeneity, and 6) Sharing actively Social Rights and Commitments. Violence and Terrorism are like Malaria mosquitos, small, unseen but very dangerous. Decisiveness, Consistency and Determination are required for successfully eradicate them.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"93 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86253493","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}

{"title":"The Current Situation, Problems and Countermeasures of High-Quality Economic and Social Development of Securities Companies Serving Districts and Counties","authors":"Yinzhong Chen, Shi-Wei Huang, Jing Lu, Jieyue Luo","doi":"10.22158/elp.v6n1p18","DOIUrl":"https://doi.org/10.22158/elp.v6n1p18","url":null,"abstract":"Districts and counties are the most basic units of administrative divisions in China. Therefore, the key to promoting high-quality economic and social development in China lies in promoting high-quality economic and social development in districts and counties. With the deepening of the “One Division One County” twinning assistance initiative, the role of securities companies in serving the high-quality economic and social development of districts and counties has become increasingly apparent. In order to better promote the high-quality economic and social development of securities companies serving districts and counties, this paper summarizes the main problems based on the analysis of the current situation of the high-quality economic and social development of securities companies serving districts and counties, and puts forward corresponding policy suggestions from the aspects of giving full play to the role of associations, building bridges serving districts and counties, giving full play to the professional advantages of securities companies, and creating characteristic comprehensive financial services.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"68 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89076251","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}

{"title":"Health misinformation and freedom of expression: considerations for policymakers.","authors":"João Marecos,&nbsp;Ethan Shattock,&nbsp;Oliver Bartlett,&nbsp;Francisco Goiana-da-Silva,&nbsp;Hendramoorthy Maheswaran,&nbsp;Hutan Ashrafian,&nbsp;Ara Darzi","doi":"10.1017/S1744133122000263","DOIUrl":"https://doi.org/10.1017/S1744133122000263","url":null,"abstract":"<p><p>Health misinformation, most visibly following the COVID-19 infodemic, is an urgent threat that hinders the success of public health policies. It likely contributed, and will continue to contribute, to avoidable deaths. Policymakers around the world are being pushed to tackle this problem. Legislative acts have been rolled out or announced in many countries and at the European Union level. The goal of this paper is not to review particular legislative initiatives, or to assess the impact and efficacy of measures implemented by digital intermediaries, but to reflect on the high constitutional and ethical stakes involved in tackling health misinformation through speech regulation. Our findings suggest that solutions focused on regulating speech are likely to encounter significant constraints, as policymakers grasp with the limitations imposed by freedom of expression and ethical considerations. Solutions focused on empowering individuals - such as media literacy initiatives, fact-checking or credibility labels - are one way to avoid such hurdles.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"204-217"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9904458","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}