International Journal of Health Planning and Management最新文献

{"title":"Collaborative governance in a primary health care partnership in Papua New Guinea","authors":"Georgina Dove,&nbsp;Adam Craig,&nbsp;Jethro Usurup,&nbsp;Annmaree O’Keeffe,&nbsp;Geoff Scahill,&nbsp;Ben Harris-Roxas,&nbsp;Angela Kelly-Hanku","doi":"10.1002/hpm.3808","DOIUrl":"10.1002/hpm.3808","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Collaboration in primary health care is recommended to achieve global health goals. Public-private partnerships (PPP) are one means of collaboration. Our study examined collaboration in a case study PPP for primary health care in Western Province, Papua New Guinea (PNG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Interviews with key informants involved in the PPP were conducted and key programme documents were reviewed. Data were coded and deductively analysed using the collaborative governance model developed by Emerson, Nabatchi and Balogh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The key features of the case study PPP that were highlighted by the collaborative governance model were: identification of partners, trust, procedural arrangements, and leadership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>We identified four lessons of significance in the practical establishment and implementation of a partnership in a complex and challenging setting such as PNG: the need to (i) prioritise in-person collaboration and communication, (ii) engage dynamic individuals to lead the partnership, (iii) encourage relationships across all sectors and actors, and (iv) remain flexible and adapt to local cultural and context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Collaborative governance offers a practical framework to understand, assess and strengthen collaboration in multi-stakeholder partnerships in the health sector.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1370-1382"},"PeriodicalIF":1.9,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How hospital autonomy affects provider payment reform effectiveness","authors":"Sian Hsiang-Te Tsuei,&nbsp;Winnie (Chi-Man) Yip","doi":"10.1002/hpm.3806","DOIUrl":"10.1002/hpm.3806","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Provider payment reforms (PPRs) have demonstrated mixed results for improving health system efficiency. Since PPRs require health care organisations to interpret and implement policies, the organizational characteristics of hospitals may affect the effectiveness of PPRs. Hospitals with more autonomy have the flexibility to respond to PPRs more efficiently, but they may not if the autonomy previously facilitated behaviours that counter the PPR's objective. This study examines whether hospitals with higher autonomy responds to PPRs more effectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from a matched-pair, cluster randomized controlled PPR intervention in a resource-limited Chinese province between 2014 and 2018. The intervention reformed the reimbursement method from the publicly administered New Cooperative Medical Scheme (NCMS) from fee-for-service to global budget. We interacted measures of hospital autonomy over surplus, hiring, and procurement (drugs, consumables, equipment, and overall index) with the difference-in-difference estimator to examine how autonomy moderated the intervention's effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Autonomy over surplus (<i>p</i> &lt; 0.01) and procurement of equipment (<i>p</i> &lt; 0.01) were associated with relatively faster NCMS expenditure growth, demonstrating worse PPR response. They were also associated with higher expenditure shifting to out-of-pocket expenditures (<i>p</i> &gt; 0.05). <i>Post hoc</i> analysis suggests that hospitals with surplus autonomy had higher OOP per admission (<i>p</i> &lt; 0.01), suggesting profiteering tendencies. Other dimensions of autonomy demonstrated imprecise association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Hospitals with more autonomy may not necessarily respond more effectively to PPRs that incentivise efficiency when they had previously been encouraged to maximise profit. Policymakers should assess the extent of perverse incentives before granting autonomy and adjust the incentives accordingly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1350-1369"},"PeriodicalIF":1.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brighter future: Tackling energy poverty through disability-informed policies in Europe","authors":"Christos Tsagkaris,&nbsp;Dimitrios V. Moysidis,&nbsp;Islam Kourampi,&nbsp;Fani Tsolaki,&nbsp;Georgios I. Tagarakis","doi":"10.1002/hpm.3804","DOIUrl":"10.1002/hpm.3804","url":null,"abstract":"","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1665-1668"},"PeriodicalIF":1.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and countermeasures for China's centralised volume-based procurement policy in healthcare","authors":"Qi Chang,&nbsp;Yihui Tian,&nbsp;Lingyun Gao,&nbsp;Nan Xia","doi":"10.1002/hpm.3803","DOIUrl":"10.1002/hpm.3803","url":null,"abstract":"<p>To reduce the cost of healthcare expenditures in China, the government has developed a centralised volume-based procurement (CVBP) policy for medicines and medical consumables. Based on tracking the development history of centralised procurement in China, this study explores China's CVBP model. By comparing the centralised procurement models and healthcare expenditure data among China, the United States (U.S), the United Kingdom (UK), and Singapore, we find that China still faces many challenges in implementing the CVBP policy. The main challenges are as follows. First, the policy cannot be guaranteed the effectiveness of implementation without a well-coordinated regulatory mechanism. Second, the CVBP rules and quality evaluation standards are imperfect. Third, the interests of healthcare companies cannot be guaranteed. Fourth, the policy affects the benefits of medical institutions, and the government has not built a compensation mechanism for medical institutions. Fifth, it poses a challenge to the operational capacity and innovation level of Chinese companies. Therefore, this paper posits a three-stage strategy and nine measures that could benefit China's progress in implementing the CVBP policy.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1330-1349"},"PeriodicalIF":1.9,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140746669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can pain be self-managed? Pain change in vulnerable participants to a health education programme","authors":"Charlotte Faurie,&nbsp;Alexandra Alvergne,&nbsp;Demi Cheng,&nbsp;Claire Duflos,&nbsp;Liset Elstgeest,&nbsp;Rosanna Ferreira,&nbsp;Hein Raat,&nbsp;Verushka Valsecchi,&nbsp;Alberto Pilotto,&nbsp;Graham Baker,&nbsp;Marta M. Pisano,&nbsp;Yves-Marie Pers","doi":"10.1002/hpm.3802","DOIUrl":"10.1002/hpm.3802","url":null,"abstract":"<p>Chronic pain exerts a significant impact on the quality of life, giving rise to both physical and psycho-social vulnerabilities. It not only leads to direct costs associated with treatments, but also results in indirect costs due to the reduced productivity of affected individuals. Chronic conditions can be improved by reducing modifiable risk factors. Various educational programs, including the Chronic Disease Self-Management Programme (CDSMP), have demonstrated the advantages of enhancing patient empowerment and health literacy. Nevertheless, their efficacy in addressing pain symptoms has received limited attention, especially concerning vulnerable populations. This research aims to assess the effectiveness of the CDSMP in alleviating pain among socio-economically vulnerable participants with chronic conditions. By accounting for a wide range of variables, and using data from the EFFICHRONIC project (EU health programme), we investigated the changes in pain levels after the intervention, among 1070 participants from five European countries. Our analyses revealed a significant reduction in pain following the intervention. This finding supports the notion that training programs can effectively ameliorate pain and alleviate its impact on the quality of life, particularly in vulnerable populations. Younger participants, as well as those with higher education levels and individuals experiencing higher levels of pain at baseline, were more likely to experience a reduction in their pain levels. These findings underscore the importance of recognising the social determinants of health.</p><p>The study was registered at ClinicalTrials.gov (ISRCTN70517103).</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1313-1329"},"PeriodicalIF":1.9,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3802","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘We're at war.’ Healthcare workers’ experience with organisational change, uncertainty and vaccine hesitancy in 2021 and 2022 during the COVID-19 vaccination programe in Poland","authors":"Michał Wróblewski,&nbsp;Joanna Stankowska,&nbsp;Ewa Kawiak-Jawor","doi":"10.1002/hpm.3801","DOIUrl":"10.1002/hpm.3801","url":null,"abstract":"<p>This article analyses the organisation of the mass COVID-19 vaccination programme in Poland and its consequences for various aspects of the social identity of healthcare workers (HCWs). Based on 31 in-depth interviews with HCWs, our study reveals the following: (1) Certain elements of the programme (inclusion of other healthcare professionals like pharmacists and laboratory diagnosticians as vaccinators) and the provision of additional infrastructure (pharmacies and shopping malls) may prompt scepticism and criticism in physicians and nurses who feel challenged about their professional autonomy and hierarchies; (2) Given the high levels of professional uncertainty, the implementation of the COVID-19 vaccination is forcing HCWs to revise their attitude to medical standards, resulting in specific responses and adaptation strategies (ranging from the active involvement in the programme due to the sense of mission, to more or less evident scepticism); and (3) Confronting vaccine hesitancy, both among patients and other HCWs, contributes to the feeling of helplessness, leading to criticism of policymakers.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1298-1312"},"PeriodicalIF":1.9,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the training, mentorship, and professional development priorities of early career embedded researchers","authors":"Otuto Amarauche Chukwu,&nbsp;Jessica Nadigel,&nbsp;Bahar Kasaai,&nbsp;Rhonda Boateng,&nbsp;Richard H. Glazier,&nbsp;Meghan McMahon","doi":"10.1002/hpm.3800","DOIUrl":"10.1002/hpm.3800","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Health systems are constantly evolving in response to existing and emerging health challenges and are increasingly adopting the Quintuple Aim to guide transformation and improvement efforts. Addressing health challenges and achieving the Quintuple Aim (enhancing patient experience, improving healthcare provider experience, promoting population health, optimising the value of healthcare services, and advancing health equity) may be enhanced with the use of a Learning Health Systems approach that fosters the real-time use of data and evidence to inform improvement efforts and harnesses embedded researchers to co-produce timely, relevant evidence to address priorities. Training programs have emerged to build embedded research capacity within health system organisations and have focused predominantly on the postdoctoral career stage, with little attention paid to the early career researcher (ECR) stage. The objective of this study was to understand ECR training and mentorship needs in the embedded research context to inform the creation new or adaptation of existing programs to build embedded ECR capacity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study used a qualitative approach to garner insight from embedded and applied scholars and health systems leaders in Canada from various professional backgrounds and at various career stages using a combination of focus group discussions, key informant interviews, and an online survey. Thematic content analysis was used to examine the responses of study participants within the interview themes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Twenty-six (26) participants were included in the study. Results were organised according to four key themes: (1) key competencies and skills needed by embedded ECRs; (2) additional training and capacity development needs; (3) training delivery approaches; and (4) enablers and challenges faced by embedded ECRs. Results highlight the importance of supporting ECRs to develop their leadership and organisational management capabilities; their knowledge of and ability to use research approaches that are well-suited to real-world, complex, evolving environments; and their opportunities to learn with and from each other and mentors. Results underscore the perceived importance of context, including being embedded in a supportive environment that values research and evidence and of academic incentives that recognise and value real-world research impact. The challenges of responding to shifting organisational and system priorities were identified. Additional insights from health systems leaders were also highlighted.&lt;/p&gt;\u0000 ","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1277-1297"},"PeriodicalIF":1.9,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adopting telemedicine in the fight against antimicrobial resistance in West Africa","authors":"Babatunde Jamiu Dauda,&nbsp;Michael Chukwubuikem Offor,&nbsp;Olakulehin Adebusuyi,&nbsp;Caleb Promise Owolabi","doi":"10.1002/hpm.3799","DOIUrl":"10.1002/hpm.3799","url":null,"abstract":"<p>The detrimental effects of antimicrobial resistance (AMR) have called for several approaches in the fight against it in West Africa, where telemedicine is still in its infancy. In West Africa, self-medication is prevalent because the majority of these medications are easily accessible due to insufficient regulatory structures that control their production, distribution, and consumption. Also, access to healthcare facilities and professionals is limited. All of these and other inadequacies consequently result in the emergence of antimicrobial-resistant organisms. AMR, which is now a major global health crisis according to the WHO, may cause the deaths of about 10 million people before 2050, and Africa may make up 41% of these deaths, with the Western part of this continent affected the most. While several approaches have been adopted, unlike in other regions of the world, the use of telemedicine in West Africa to fight AMR has rarely been studied or considered and where it is now in partial use, its efficacy is constrained by several factors. This paper discusses the roles of telemedicine, the limitations to its application in the fight against AMR, and suggests remedies for these limitations.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1626-1632"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling social inequalities in health: Assessing contexts for implementing integrated health access for people with severe mental illness","authors":"Sofie Buch Mejsner,&nbsp;Mickael Bech,&nbsp;Michael Fehsenfeld,&nbsp;Luna Lundberg,&nbsp;Caroline Louise Westergaard,&nbsp;Kathrine Vixø,&nbsp;Viola Burau","doi":"10.1002/hpm.3798","DOIUrl":"10.1002/hpm.3798","url":null,"abstract":"<p>Social inequalities in health are a complex problem that often emerge at the interfaces between different sectors, such as health and social care, and the corresponding transitions between different provider organisations. Vulnerable people are typically in greater need of accessing different sectors of the health system and therefore often experience lack of coherence in their treatment pathway. We aimed to examine the contexts of health systems that influence initiatives concerned with integrated health access. We used the theory of Organizational Fields to study the contexts for implementing Flexible Assertive Community Treatment (FACT) in Central Denmark Region and three municipalities in the region. We collected 33 documents and conducted six qualitative interviews with professionals involved in FACT to understand the contexts of implementing integrated health access. We found that contexts for implementing FACT are highly complex, as they are divided between health and social care (horizontal complexity) and between national and the sub-national levels of the region and the municipalities (vertical complexity). This leads to conflicting demands on implementation. Local contexts of collaboration may offer a lever to handle these demands, but these are likely to vary. Analysis of how complex health system contexts influence implementation is important to understand how changes might become sustainable and help to tackle social inequalities in health.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1261-1276"},"PeriodicalIF":1.9,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public health priorities for the Gulf states","authors":"Rasha Alfawaz,&nbsp;Raghad Alhumud,&nbsp;Andrew Joseph Amato-Gauci,&nbsp;Pasi Penttinen","doi":"10.1002/hpm.3797","DOIUrl":"10.1002/hpm.3797","url":null,"abstract":"<p>The newly established Gulf Center for Disease Prevention and Control (Gulf CDC) has to identify priorities to tackle in the first 2 years of operation. A rapid situational assessment involving a selected sample of national stakeholders, an objective study of the strengths and gaps in the national public health programmes and a study estimating the burden of the main disease/risk factors were carried out. The findings of an objective ranking survey, followed by consensus discussion in an in-person meeting for senior Gulf states' experts, were combined with the evidence available from the previous three studies to result in a short list of the most pressing priority topics for the Gulf CDC to tackle. Both communicable (lead priorities: antimicrobial resistance and immunisation) and non-communicable diseases (leads: cardiovascular disease, then cancer, diabetes, and mental health) are the consensus priorities. Also, the risks associated with non-communicable diseases (high BMI, blood sugar, high blood pressure) and unhealthy lifestyle (poor diet, low physical activity and tobacco use) were also highlighted as top priorities to tackle.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1603-1611"},"PeriodicalIF":1.9,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}