Health Policy and Technology最新文献

{"title":"The minimum data set of electronic personal health records for Alzheimer's disease using design science methodology","authors":"Parastoo Amiri ,&nbsp;Zahra Niazkhani ,&nbsp;Habibollah Pirnejad ,&nbsp;Kambiz Bahaadinbeigy ,&nbsp;Mahdie Shojaei Baghini","doi":"10.1016/j.hlpt.2023.100785","DOIUrl":"https://doi.org/10.1016/j.hlpt.2023.100785","url":null,"abstract":"<div><h3>Objective</h3><p>Long-term management of healthcare information for chronic patients such as Alzheimer's is complex and tedious. An electronic Personal Health Record (ePHR) can help patients by maintaining a history of healthcare data from various centers. The purposes of this research were to develop a minimum data set (MDS) to design an ePHR for caregivers of patients with Alzheimer's disease (AD) using design science methodology and to identify the necessary measures for a smooth ePHR implementation in Iran.</p></div><div><h3>Methods</h3><p>This study was performed in Kerman from February 2020 to October 2021. To inform caregivers about ePHRs, information sessions were held and a pictorial method was used. Then, 20 semi-structured interviews were conducted with seven physicians and 13 caregivers involved in the care of Alzheimer's patients. Using thematic analysis based on the Information System Research (ISR) framework, the data were encoded and analyzed.</p></div><div><h3>Results</h3><p>The MDS of an ePHR for AD contained 178 data elements, categorized into six main sections. The participants considered the use of an ePHR essential to achieve quality care. Using an ePHR can serve as the main method of collecting accurate histories of each Alzheimer's patient in different disease stages and monitoring their behavioral changes. Data confidentiality and security were considered as one of the main measures for AD ePHR implementation.</p></div><div><h3>Conclusion</h3><p>This study identified an AD-specific MDS, as the first major step in launching ePHRs for Alzheimer's patients in the future. The MDS was developed based on the requirements of neurologists and caregivers.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50172742","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":"Partisan self-identification predicts attitudes of South Dakota nurses toward COVID-19 vaccine mandate for healthcare workers","authors":"Filip Viskupič,&nbsp;David L. Wiltse","doi":"10.1016/j.hlpt.2023.100777","DOIUrl":"10.1016/j.hlpt.2023.100777","url":null,"abstract":"<div><h3>Objectives</h3><p>Nurses are at greater risk of infection from COVID-19. However, mistrust of the vaccine exists even among this group. In the United States, the government implemented a vaccine mandate for health care workers to increase vaccination rates. This study investigated the drivers of nurses’ attitudes toward the mandate.</p></div><div><h3>Methods</h3><p>We fielded a survey to study the attitudes of nurses toward COVID-19 vaccine mandate for HCWs. We contacted nurses in South Dakota, United States, based on the information from the South Dakota Board of Nursing. The survey was open in June and July 2022. We conducted a multivariate regression analysis to identify the factors that predict attitudes toward this regulation.</p></div><div><h3>Results</h3><p>We received 1,084 responses. Results of regression analysis showed statistically significant relationships between partisan self-identification, evangelical identity, gender, and COVID-19 vaccination status and support for COVID-19 vaccine mandate for healthcare workers. Age, time with patients, positive COIVD-19 test in the last year, education, and nurse classification variables were not statistically significant.</p></div><div><h3>Conclusions</h3><p>The same factors that drive people's attitudes toward COVID-19 mitigation policies also explain nurses’ attitudes toward a vaccine mandate for healthcare workers. The politicization of the COVID-19 pandemic is present also among nurses. Health care officials should be mindful of the influence of these biases as they evaluate the vaccine mandate and develop new regulations.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10098571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 on primary care accessibility and the role of telehealth for patients with chronic conditions","authors":"Christian Boxley ,&nbsp;Ram Dixit ,&nbsp;Katharine Adams ,&nbsp;Ryan Anderson ,&nbsp;Raj M. Ratwani ,&nbsp;Ethan Booker","doi":"10.1016/j.hlpt.2023.100772","DOIUrl":"10.1016/j.hlpt.2023.100772","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study is to quantify how long patients took to complete their rescheduled primary care appointment pre-pandemic (2019) and during an initial pandemic period (2020). In doing so, the study evaluates telehealth's role in helping primary care patients – particularly in patients with chronic conditions – withstand COVID's significant disruption in care.</p></div><div><h3>Methods</h3><p>Cancelled and completed primary care appointments for adult patients were extracted from the beginning of the pandemic (March 1 to July 31, 2020) and a similar period pre-pandemic (March 1 to July 31, 2019). Days to the subsequent completed visit after cancellation (through June 30, 2021) and appointment modality (in-person, phone, video) were examined. Statistical testing was done to determine statistical significance, and a linear regression was run to control for effects of other study variables.</p></div><div><h3>Results</h3><p>Pre-pandemic patients with chronic conditions needed 52.3 days on average to reschedule their cancelled in-person appointment. During the early pandemic period, chronic condition patients who saw their provider in-person took on average 78.8 days. During the same pre-pandemic period, patients with chronic conditions had their average wait time decrease to 51.5 days when rescheduling via telehealth. These differences were similar for patients without chronic conditions.</p></div><div><h3>Conclusions</h3><p>This analysis shows that telehealth created return to care timelines comparable to the pre-pandemic period which is especially important for patients with chronic conditions.</p></div><div><h3>Public interest summary</h3><p>Telehealth visits (i.e., talking with a physician via phone or video call) help patients continue to receive the medical care they need – especially during disruptive periods such as the COVID pandemic. Access to telehealth is the strongest predictor in determining how soon a patient will complete their reschedule primary care appointment. Because telehealth is so important, health care providers and systems need to continue to offer patients the ability to talk with their physician via phone or video call.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10098575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health professionals’ experiences with a patient portal pre and post launch: A qualitative study","authors":"Anna Janssen ,&nbsp;Melanie Keep ,&nbsp;Hiran Selvadurai ,&nbsp;Tim Shaw","doi":"10.1016/j.hlpt.2023.100761","DOIUrl":"10.1016/j.hlpt.2023.100761","url":null,"abstract":"<div><h3>Objectives</h3><p>Digital technologies are extending existing healthcare models, and increasingly supporting delivery of new care models. One such technology are patient portals, which are digital platforms that are integrated with clinical information systems<span> like Electronic Health Records<span>. They are designed to provide patients/carers access to a range of features including communication with their healthcare team, and access to information in their health record such as test results and prescriptions. The aim of the study described in this manuscript was to compare hospital staff perceptions of a patient portal before and after implementation at a paediatric hospital.</span></span></p></div><div><h3>Method</h3><p>A qualitative methodology using semi-structured interviews was used to understand the perceptions of clinical and administrative hospital staff before and three months after the implementation of the patient portal. Interviews were undertaken with 12 participants pre-launch, and 8 participants’ post-launch.</p></div><div><h3>Results</h3><p>Post-implementation health professionals who felt there was greater uptake of the patient portal by patients/carers tended to be more positive about its benefits than those who reported lower patient/family uptake. Likewise, concerns about integrating the tool into the workflow may be overcome if the patient portal would improve management of care for patient/carers.</p></div><div><h3>Conclusions</h3><p>When health professionals are actively involved in the design and implementation of patient portals, they had more realistic and positive expectations of their benefits to patients/carers. Similarly, if benefits can be conferred to patients/carers, health professionals are less likely to have concerns about barriers to uptake such as perceived increase to workload in relation to the patient portal.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46894004","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":"Benchmarking countries' technical efficiency using AHP-based weighted slack-based measurement (W-SBM): A cross-national perspective","authors":"Birol Yetim ,&nbsp;Seda Sönmez ,&nbsp;Murat Konca ,&nbsp;Gülnur İlgün","doi":"10.1016/j.hlpt.2023.100782","DOIUrl":"10.1016/j.hlpt.2023.100782","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of the research is to assess the technical efficiency of national health systems in OECD member countries and to provide ideas to improve the efficiency of health systems in countries that have been identified as having a lower degree of efficiency as a result of the findings.</p></div><div><h3>Methods</h3><p>The technical efficiency scores were calculated using one of the data envelopment analyses (DEA), the Weighted Slack-Based Measure (W-SBM). The Analytic Hierarchy Process was used to establish the aforementioned weights (AHP). Weights are calculated separately for both input and output variables.</p></div><div><h3>Results</h3><p>The technical efficiency of the relevant countries' health systems is around 0.79, according to the data, and just 13 (36.1%) of the 36 countries have a fairly efficient health system.</p></div><div><h3>Conclusions</h3><p>The outcomes of the study were supposed to aid health policymakers and management in improving system efficiency. In addition, since the number of studies examining the health systems of OECD countries with the W-SBM method is limited, it is thought that this study will make an important contribution to the literature.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48227648","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":"Digital Health Applications (DiHA): Approaches to develop a reimbursement process for the statutory health insurance in Austria","authors":"Gregor Goetz ,&nbsp;Reinhard Jeindl ,&nbsp;Dimitra Panteli ,&nbsp;Reinhard Busse ,&nbsp;Claudia Wild","doi":"10.1016/j.hlpt.2023.100780","DOIUrl":"10.1016/j.hlpt.2023.100780","url":null,"abstract":"<div><h3>Purpose</h3><p>To elaborate a concept for implementing digital health applications (DiHA), including prioritisation criteria (PC) for the Austrian context and an overview of available prioritised DiHAs.</p></div><div><h3>Methods</h3><p>Based on European DiHA-listings and input by Austrian experts, a categorised meta-directory of DiHAs was created. PC were developed to reflect, inter alia, the provisions of the Austrian General Insurance Act, and were applied to the meta-directory to identify DiHAs potentially relevant for the Austrian statutory health insurance. An iterative process with expert involvement was used to tailor an existing reimbursement framework to the Austrian setting.</p></div><div><h3>Results</h3><p>The meta-directory comprised 132 DiHAs. Developed PC focused on plausibility (German language) and legal aspects (treatment/monitoring of chronic conditions), while other criteria (e.g. interoperability standards) were considered optional. After applying the PC, 38 DiHAs were potentially relevant in the Austrian setting. Of these, only seven supported current health record integration. Most of the prioritised DiHAs reported on CE marking (29/38) and data protection (35/38), while reporting on risk class (10/38) and technical algorithms (0/38) was sparse. For DiHA reimbursement, a four-step process is proposed: identification (ideally based on needs assessment); filtering based on PC; review of technical, regulatory and evidentiary requirements; and health technology assessment.</p></div><div><h3>Conclusion</h3><p>The proposed concept can offer guidance for policy makers (e.g., on prioritising available DiHAs) and may further foster scientific debate with regard to DiHA implementation. Further discussion on how to fully incorporate regulatory, technical, and evidentiary criteria is needed. Attention should be given to national implementation requirements, re-assessment criteria, and appropriate remuneration schemes.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10507816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmaceutical pricing and managed entry agreements: An exploratory study on future perspectives in Europe","authors":"Claudio Jommi ,&nbsp;Arianna Bertolani ,&nbsp;Patrizio Armeni ,&nbsp;Francesco Costa ,&nbsp;Monica Otto","doi":"10.1016/j.hlpt.2023.100771","DOIUrl":"10.1016/j.hlpt.2023.100771","url":null,"abstract":"<div><h3>Objectives</h3><p>This paper illustrates the results of a research aimed at investigating the opinions collected from selected European payers (HTA organisations, authorities/committees assessing, appraising and negotiating drug prices) and experts (researchers/consultants identified through LinkedIn groups) on drug price regulation, managed entry agreements, transparency and HTA advice.</p></div><div><h3>Methods</h3><p>Expert and payer opinions were gathered through a structured questionnaire, validated by three potential respondents and self-administered online between July and November 2021.</p></div><div><h3>Results</h3><p>Respondents totalled 39 (response rate 29%). The response rate was higher among the experts than the payers. Respondents mostly agreed that price regulation should award drug value through a multiple criteria approach (21 respondents) or cost-effectiveness evidence (14). For most respondents the added therapeutic value and the comparative safety profile should be the main drivers of a premium price. A quite high proportion of respondents supported the use of cost-effectiveness, and suggest relying on the perspective of the health care system. Most respondents expect larger diffusion of outcome-based and financial-based managed entry agreements in the future. Finally, respondents advocated for higher transparency of the negotiation process rather than net price transparency, and expressed the belief that HTA advice could be useful in reaching consensus on the level of unmet need, the comparators to consider, and the dimension of the target population.</p></div><div><h3>Conclusions</h3><p>Despite the limited number of respondents, the paper provides very interesting exploratory insights into much-debated topics related to drug price regulation. The opinions of European payers and experts are very useful for future regulation of drug pricing in Europe.</p></div><div><h3>Public interest summary</h3><p>Our research aimed at gathering the opinions of payers and experts on drug price regulation. The main findings are that pricing should reflect the value of medicines, that a premium price should be awarded only to those drugs that provide for an added therapeutic value and/o a better safety profile, even if other value dimensions (patient preferences and organisational impact) should be not disregarded. Experts and payers expect a larger role of managed entry agreements in the future, despite they may impose an important administrative burden. Finally, transparency of price negotiation is prioritized compared to net price transparency.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44527192","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":"Evidence and methods for a safe resumption of neuroscience activities at the time of COVID-19","authors":"Laura Angioletti ,&nbsp;Michela Balconi","doi":"10.1016/j.hlpt.2023.100787","DOIUrl":"10.1016/j.hlpt.2023.100787","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49469897","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":"Viability of European cross-border access opportunities to streamline access to ATMPs","authors":"Luigi Angelillo ,&nbsp;Cécile van Steen ,&nbsp;Kirsty Ross-Stewart ,&nbsp;Justus Dehnen ,&nbsp;Walter Colasante","doi":"10.1016/j.hlpt.2023.100752","DOIUrl":"10.1016/j.hlpt.2023.100752","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the viability of several cross-border access opportunities to streamline patient access to advanced therapy medicinal products (ATMPs) in the context of the new Regulation on Health Technology<span><span> assessment (HTA). The regulation, proposed by the European Commission and adopted in December 2021strongly advocates joint European collaboration to make innovative, life-changing therapies, such as ATMPs, more widely available to patients in Europe. ATMPsoffer ground-breaking new opportunities for the treatment of various </span>diseases. However, healthcare systems are often required to undergo significant adaptation in terms of infrastructure development, adoption of new legislation or implementation of alternative reimbursement solutions before access to patients can be granted. This calls for new cross-border access pathways to streamline access, especially in non-EU4+UK countries.</span></p></div><div><h3>Methods</h3><p>Desk research and 60-minute interviews with regulatory and payer experts were conducted to evaluate new access pathways for ATMPs.</p></div><div><h3>Results</h3><p>Some pathways, such as cross country collaborations (e.g. joint treatment centers) have the potential to provide long-term access to ATMPs. However, several important challenges were identified that currently prevent cross-border access from being viable options for routine access to ATMPs, especially for SMEs.</p></div><div><h3>Conclusions</h3><p>Through open communication and collaboration between manufacturers, payers and policy makers to overcome challenges associated with currently available access pathways for ATMPs, cross-border solutions could represent real opportunities for manufacturers, including SMEs, to expedite reimbursed patient access to ATMPs.</p></div><div><h3>Public Interest Summary</h3><p>In December 2021, a new regulation was adopted on a European level to promote cross-European collaboration to make innovative treatments more widely available to patients. Making sure patients have access to innovative, potentially life-changing, treatments is associated with many challenges. As a result, patients, especially those who live outside of the four biggest countries in the European Union (EU), also known as the EU4:  (France, Germany, Italy and Spain) and the UK where the necessary infrastructure is often lacking, can experience difficulty accessing the innovative treatments they need. We conducted interviews with experts (payers and regulators) to evaluate new pathways to make sure (non-EU4 + UK) patients get better access to innovative therapies. Collaboration and open communication between countries, manufacturers, payers and regulators presents a viable way of achieving this.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44360495","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":"A concept for digital transformation for improved patient care in the UK","authors":"Antoni Chan","doi":"10.1016/j.hlpt.2023.100775","DOIUrl":"10.1016/j.hlpt.2023.100775","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42925476","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}