Health Policy and Technology最新文献

{"title":"Bridging the gap: Understanding preferences and perceived benefits of an mHealth app for GDM self-management","authors":"Yosefa Birati , Enav Yefet , Lilach Y. Shavit , Sivan Spitzer","doi":"10.1016/j.hlpt.2025.101011","DOIUrl":"10.1016/j.hlpt.2025.101011","url":null,"abstract":"<div><h3>Objectives</h3><div>Mobile health (mHealth) solutions to support pregnant women's self-management are increasing. Concerns exist on the extent real-world design and implementation of mHealth applications for pregnant women account for diverse cultural backgrounds and religious practices. This study aimed to (1) explore the challenges in complying and adhering to Gestational diabetes mellitus (GDM) self-management regimens for women from diverse backgrounds; and (2) women's perceptions of culturally tailored features for GDM mHealth apps and their possible contribution in addressing the challenges they experience.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted on pregnant women diagnosed with GDM in a diabetes-in-pregnancy clinic located in Israel's northern periphery. A content analysis method was used to analyze and interpret the data, and code it into themes.</div></div><div><h3>Results</h3><div>A total of 24 pregnant women diagnosed with GDM participated in the study. Of the 24 women, 18 (75 %) were Jewish, 5 (21 %) were Muslims, and 1 (4 %) was Christian. Four main themes were derived from the interviews: (1) GDM self-management challenges (2) Cultural and religious conflicts (3) Experience with the use of digital technologies, and (4) Desirable mHealth features. Common needs included better communication with healthcare providers and dietary guidance. Unique challenges and conflicts arose from cultural and religious practices, such as Ramadan fasting schedules, avoiding technology on the Sabbath for blood sugar monitoring, and unavailable kosher-certified food products that aligned with dietary recommendations. Some women also found apps “too secular” and preferred culturally sensitive features.</div></div><div><h3>Conclusions</h3><div>mHealth can improve GDM self-management by integrating culturally tailored features such as fasting-specific guidance, Sabbath-compliant modes, or searchable databases for culturally appropriate nutritional options. Addressing these barriers may enhance adherence and support GDM self-management.</div></div><div><h3>Lay Summary</h3><div>Gestational diabetes mellitus (GDM) is a common complication during pregnancy, requiring self-care and lifestyle changes for better control of blood sugar levels. While mobile health (mHealth) solutions supporting healthcare providers and women for improving self-management are becoming popular, existing apps often do not address women's personal or cultural needs. We interviewed pregnant women regarding their experience with digital tools. Women expressed that dietary restrictions and cultural beliefs made it difficult to self-manage their GDM. Yet, they identified that if mHealth apps addressed their personalized treatment plan and allowed asynchronous communication with the healthcare providers it would assist them in managing their GDM. Therefore, mHealth app developers along with health policy, need to promote development and impleme","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101011"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828832","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":"Diverse structures and methods of national health technology assessment organizations: A scoping review","authors":"Celina Borges Migliavaca ,&nbsp;Verônica Colpani ,&nbsp;Miriam Allein Zago Marcolino ,&nbsp;Maicon Falavigna ,&nbsp;Carisi Anne Polanczyk","doi":"10.1016/j.hlpt.2025.101009","DOIUrl":"10.1016/j.hlpt.2025.101009","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the structure and methods of health technology assessment (HTA) organizations.</div></div><div><h3>Methods</h3><div>We included organizations that conduct HTA to inform coverage/reimbursement decisions nationally in any country. Eligible organizations were identified through a systematic search of well-known HTA networks (International Network for Agencies for HTA [INAHTA], European Network for Health Technology Assessment [EUnetHTA], <em>Red de Evaluación de Tecnologías en Salud de las Americas</em> [RedETSA], HTAsiaLink) and references from previous studies evaluating HTA organizations.</div></div><div><h3>Results</h3><div>We identified 69 organizations, from 56 countries. Most organizations are European (<em>n</em> = 39, 56 %) and governmental (<em>n</em> = 53, 77 %). Fifty-one (74 %) advise health authorities, while 13 (19 %) are the ultimate decision-making authority. Of 62 organizations with known funding, all use public resources, and 12 (17 %) charge a fee for evaluation. Healthcare technologies evaluated are medicines (<em>n</em> = 61, 88 %), devices (<em>n</em> = 47, 68 %), and procedures (<em>n</em> = 33, 48 %). Sixty-six organizations (96 %) consider economic factors, with cost-effectiveness and budget impact analyses being the most conducted evaluations. HTA is usually initiated upon the manufacturer's request (<em>n</em> = 45, 65 %). Patient involvement is not clearly described in 32 organizations (46 %), and 2 (3 %) report no involvement; among the remaining, for most (<em>n</em> = 29, 42 %), the role of patients is to provide information to be considered during the decision-making process.</div></div><div><h3>Conclusions</h3><div>Our results underscore the diverse landscape of HTA organizations, highlighting both shared methodologies and unique adaptations, a knowledge that is valuable for countries looking to establish or refine their HTA organizations.</div></div><div><h3>Lay summary</h3><div>Health technology assessment (HTA) is crucial for guiding healthcare decisions and policies around the world. We analyzed 69 organizations from 56 countries that use HTA to inform national coverage and reimbursement decisions. These organizations, primarily government-affiliated, advise on which healthcare technologies—like medications and medical devices—should be funded based mainly on their effectiveness and cost. Despite their common goals, we found significant variation in how they operate, especially in the criteria they use to make recommendations and how they involve stakeholders. Understanding these global practices helps countries improving their own HTA processes, ensuring better healthcare outcomes.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101009"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864017","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":"Implementing a clinical decision support system in an Aboriginal health service – A qualitative case study","authors":"Sophie Pascoe ,&nbsp;Debbie-Ann Gillon ,&nbsp;Paul Kamler ,&nbsp;Asanga Abeyaratne ,&nbsp;Natasha Pavlin ,&nbsp;Gillian Gorham","doi":"10.1016/j.hlpt.2025.101010","DOIUrl":"10.1016/j.hlpt.2025.101010","url":null,"abstract":"<div><h3>Objective</h3><div>This qualitative case study aims to evaluate the implementation of a clinical decision support system (CDSS) – Territory Kidney Care (TKC) – at an Aboriginal health service in the Northern Territory (NT) of Australia. This research aims to contribute understandings about the challenges clinicians face when navigating electronic systems within an Aboriginal health service setting and enablers and barriers to the implementation of CDSS.</div></div><div><h3>Methods</h3><div>Within a larger evaluation of TKC, this qualitative case study involved 13 baseline semi-structured interviews completed between October 2022 and January 2023 and seven follow up interviews conducted in June 2023. Through purposive sampling, clinicians in a range of primary care roles participated in the study. Interview transcripts were inductively and iteratively coded by two researchers using a thematic analysis approach.</div></div><div><h3>Results</h3><div>The baseline evaluation found that clinicians working in an Aboriginal health service used multiple electronic health systems, spent considerable time collating patient data across systems and faced challenges related to missing information, technological issues and limited training. The process evaluation of TKC implementation identified that adequate training, a funded Implementation Officer role and supportive leadership were central enablers, while competing clinical priorities, time limitations, staff shortages, access processes were key barriers to uptake and usage.</div></div><div><h3>Conclusions</h3><div>This case study highlights the need for integrated data tools in Aboriginal health services to bridge the gaps between primary, tertiary, government and non-government services. The evaluation emphasises the importance of embedding CDSS within workflows and ensuring there are dedicated staff and resources to facilitate implementation.</div></div><div><h3>Lay Summary</h3><div>This study focuses on how a clinical decision support system was implemented in an Aboriginal health service in the Northern Territory of Australia. Through interviews with clinicians, we identify key barriers and enablers to accessing clinical decision support, as an adjunct to electronic health records. Clinicians in Aboriginal health services must use multiple systems and spend a lot of time looking for information about their patients; a new integrated data platform called Territory Kidney Care was implemented to pull information together from different health services. This research highlights the importance of ensuring there are dedicated staff and resources to help implement new systems.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101010"},"PeriodicalIF":3.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823224","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":"Evaluation of health resources and service utilization in traditional Chinese medicine hospitals in China based on WHO's comprehensive evaluation model","authors":"Man-ci Zhou ,&nbsp;Bing Liu ,&nbsp;Qian-tai Gao ,&nbsp;Guo-lin Guo ,&nbsp;Xuan Wang ,&nbsp;Hui-juan Cao ,&nbsp;Yu-tong Fei ,&nbsp;Jian-ping Liu ,&nbsp;Hong-guo Rong","doi":"10.1016/j.hlpt.2025.100998","DOIUrl":"10.1016/j.hlpt.2025.100998","url":null,"abstract":"<div><h3>Background</h3><div>Traditional Chinese medicine (TCM) could contribute to achieving universal health coverage as part of essential healthcare services. This study aimed to evaluate the health resources and services utilization of TCM hospitals in China from 2002 to 2021.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data related to physical resources (hospitals, and beds), human resources (practitioners, licensed (assistant) TCM doctors, and TCM pharmacists), services utilization (outpatient and emergency visits, admission and discharged patients), bed utilization, and health needs of TCM hospitals in China from 2002 to 2021. Data of TCM hospital resources and services utilization were extracted from the China Statistical Yearbooks of Chinese Medicine. The incidence of Class A and B data notifiable infectious diseases were sourced from the National Bureau of Disease Prevention and Control, while maternal and infant mortality rates were obtained from the China Health Statistical Yearbooks. WHO's comprehensive evaluation model and the Rank Sum Ratio (RSR) method were used to rank, and categorize the services provided by TCM hospitals from 2002 to 2021.</div></div><div><h3>Results</h3><div>The number of TCM hospitals, beds, and practitioners in China grew annually, but their proportion was modest, at 15.63 %, 16.15 %, and 16.73 % in 2021. The number of outpatient visits, emergency visits, discharged patients, and admissions in TCM hospitals increased from 253,007 thousand, 15,976 thousand, 8,163 thousand, and 8,205 thousand visits in 2007 to 611,615 thousand, 53,795 thousand, 31,519 thousand, and 31,620 thousand visits in 2021, respectively. The bed occupancy rate in TCM hospitals has been consistently below 85 % since 2015, showing a gradual decrease over time. Between 2007 and 2021, the RSR values for resources and health needs showed continuous growth, reaching over 0.95 in 2021. WHO's comprehensive evaluation model indicated that TCM hospitals experienced high health needs and resources but medium services utilization in 2020 and 2021.</div></div><div><h3>Conclusions</h3><div>Health resources and services utilization of TCM hospitals in China have snowballed, but their share has remained low. Meanwhile, the healthcare services in TCM hospitals have been underutilized. In the future, China should strengthen the provision and utilization of TCM medical services, and improve the utilization rate of healthcare services in TCM hospitals.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 100998"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704585","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":"HTA between theory and practice: Exploring boundary work in broadening HTA For MedTech governance","authors":"Renee Else Michels ,&nbsp;Diana Maria Johanna Delnoij ,&nbsp;Martinus Bertram de Graaff","doi":"10.1016/j.hlpt.2025.101008","DOIUrl":"10.1016/j.hlpt.2025.101008","url":null,"abstract":"<div><h3>Objectives</h3><div>In this paper, we explore the social and political practices involved in broadening health technology assessment (HTA) for medical technology (MedTech) governance. We take as our case study the Dutch HTA Methodology 2021–2024 Program, which aimed to broaden HTA methodologies to the assessment of MedTech, and in so doing, broadened the stakeholders involved. Our research question is as follows: How do stakeholders involved in the program interpret HTA (methodologies) for MedTech, and how do they envision multi-stakeholder collaboration on HTA (methodologies)?</div></div><div><h3>Methods</h3><div>We conducted 19 semi-structured interviews with program participants, including committee members and grant applicants. We also spent 120 hours observing program meetings as non-participants and conducted document analysis.</div></div><div><h3>Results</h3><div>Using boundary work as a sensitizing concept, we describe how broadening the actors involved both introduced and exposed different interpretations of HTA and HTA methodologies for MedTech. We describe three ways in which participants envisioned (potential) integration of these interpretations, which we term collaboration hybrids. Each collaboration hybrid encapsulates a way of navigating across boundaries.</div></div><div><h3>Conclusions</h3><div>Our findings highlight that attempts to broaden HTA into a more prominent aspect of MedTech governance challenge the boundaries of what is understood as proper HTA. We argue that reflecting explicitly on these different interpretations, and the diverse ways to integrate them, increases the relevance of the HTA methodologies developed and the collaborations initiated in the governance of MedTech through HTA.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101008"},"PeriodicalIF":3.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785823","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":"Telemedicine uptake behaviors and predictors of its acceptance among community-dwelling older adults with chronic diseases","authors":"Su Wei Wan ,&nbsp;Lina Choe ,&nbsp;Gretel Jianlin Wong ,&nbsp;Wee Ling Koh ,&nbsp;Janelle Shaina Ng ,&nbsp;Wee Hian Tan ,&nbsp;Joanna Li Xin Ooi ,&nbsp;Jacquelyn Melody ,&nbsp;Jerrald Lau ,&nbsp;Ker Kan Tan","doi":"10.1016/j.hlpt.2025.101007","DOIUrl":"10.1016/j.hlpt.2025.101007","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify the determinants of telemedicine acceptance among older adults with chronic disease in the primary care setting, for the purpose of promoting their adoption of these remote care approaches in future unprecedented global health emergencies.</div></div><div><h3>Methods</h3><div>A cross-sectional quantitative assessment of telemedicine acceptance and perception was conducted among 200 outpatients ≥ 65 years conveniently sampled from two primary care centres in Singapore. Multivariate linear regressions were used to identify significant predictors of intention-to-use behaviors.</div></div><div><h3>Results</h3><div>Moderate levels of acceptability and perception were observed and about half of them (49 %) agreed to integrate telemedicine into existing care processes. Those with higher income (<em>p</em> = 0.003) or were more convinced of its benefits, ease of use, validation, plus a facilitative environment and positive impression of technology were more likely to utilise telemedicine (<em>r</em> = 0.19 to 0.84; all <em>p</em> &lt; 0.05). Among these factors, the perceived ability of telemedicine to enhance care was the strongest determinant (<em>β</em> = 0.39; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Findings show that continued efforts to demonstrate the impact of telemedicine in improving patient-reported outcomes are desperately needed alongside attempts to maximise its potential and eliminate barriers to its uptake.</div></div><div><h3>Public interest summary</h3><div>Telemedicine remains a promising care coordination modality for the older population provided it can function and perform up to the desired expectations and needs. Given deep concerns about how telemedicine might affect care involvement, quality and the status of their clinical conditions, greater efforts to propel this transition through various avenues such as offering telemedicine as a complementary service will be essential.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101007"},"PeriodicalIF":3.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632090","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":"Does age matter? The impact of social media exposure on people's mental health","authors":"Yi-Hui Christine Huang,&nbsp;Ruoheng Liu,&nbsp;Leyi Zhang","doi":"10.1016/j.hlpt.2025.100997","DOIUrl":"10.1016/j.hlpt.2025.100997","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates how social media exposure has affected individuals’ mental health during the COVID-19 pandemic, with a particular emphasis on age differences. Given the contentious nature of this effect observed in previous research, the study innovatively tackles the issue through two approaches. Drawing on the <strong>protection motivation theory (PMT)</strong>, the study demonstrates the indirect effect of social media exposure via threat and coping appraisals, finding that the impact of social media on mental health largely depends on individuals’ concerns about the information exposed. Second, the study considers <strong>age</strong> as a contextual factor, examining the unique patterns observed within different age groups (young, middle-aged, and elderly).</div></div><div><h3>Methods</h3><div>A two-wave longitudinal panel study was conducted in Hong Kong from November 2021 to April 2022 (N = 1,153) to test the proposed framework.</div></div><div><h3>Results</h3><div>Our findings support the utility of two appraisals as mediators and indicates that the young generation (aged 20–34) tends to adopt the coping appraisal to enhance their mental health. In contrast, middle-aged and elderly individuals employ threat appraisals to the detriment of their mental health.</div></div><div><h3>Conclusions</h3><div>These findings make theoretical contributions for the extension of the PMT on individuals’ mental health outcomes and provide valuable practical guidelines. Policymakers and health organizations should implement targeted communication strategies that emphasize coping appraisals for the general public. Also, crisis information should be tailored for different age groups, offering resilience techniques for younger populations and a balanced approach for middle-aged and elderly individuals.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 100997"},"PeriodicalIF":3.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628371","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":"Overcoming vaccine hesitancy: Evidence from Italy during the COVID-19 pandemic","authors":"Alessandro Del Ponte ,&nbsp;Audrey De Dominicis ,&nbsp;Paolo Canofari","doi":"10.1016/j.hlpt.2025.100996","DOIUrl":"10.1016/j.hlpt.2025.100996","url":null,"abstract":"<div><h3>Objectives</h3><div>Here we investigate whether releasing COVID-19 vaccines at open-day events boosted Italy's vaccination campaign in 2021. This strategy exploits insights from psychology.</div></div><div><h3>Study design</h3><div>We built an original dataset covering 200 days of vaccination data in Italy, including “open day” events. Open-day events (in short: open days) are instances where COVID-19 vaccines were released only for a specific day at a specified location (usually, a large pavilion or a public building). Importantly, releasing vaccines through open days instead of the usual appointment channel leaves the supply of vaccines unaltered. Our dependent variables are the number of total and first doses administered in proportion to the eligible population. Our key independent variable is the presence of open-day events in a given region on a specific day.</div></div><div><h3>Methods</h3><div>We analyzed the data using regression with fixed effects for time and region. The analysis was robust to alternative model specifications.</div></div><div><h3>Results</h3><div>We find that when an open day event was organized, in proportion to the eligible population, there was an average 0.39–0.44 percentage point increase in total doses administered and a 0.30–0.33 percentage point increase in first doses administered. These figures correspond to an average increase of 10,455–11,796 in total doses administered and 8,043–8,847 in the first doses administered.</div></div><div><h3>Conclusions</h3><div>Releasing vaccines by organizing open-day events was associated with an increase in COVID-19 vaccinations in most Italian regions. These results call for further study of the effectiveness of open days to increase vaccinations and protect against other infectious diseases or future pandemics.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 100996"},"PeriodicalIF":3.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593430","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":"Barriers to access to insulin pumps in Chile: A qualitative study of a high-cost technology","authors":"Báltica Cabieses ,&nbsp;Alexandra Obach ,&nbsp;Paula Madrid ,&nbsp;Daniela Paredes","doi":"10.1016/j.hlpt.2025.100992","DOIUrl":"10.1016/j.hlpt.2025.100992","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the barriers to accessing advanced insulin delivery system from the experiences of patients with type 1 diabetes (T1DM), family members, and treatment teams.</div></div><div><h3>Methods</h3><div>A qualitative study, taking a comprehensive approach, investigated a person's experience with T1DM and receiving insulin pump treatment, emphasizing the barriers to accessing it. A case study was conducted, considering a diverse range of individuals, including young patients, adult patients, family members or caregivers, and health professionals. Twenty-nine semi-structured individual interviews provided a rich and varied perspective on the issue.</div></div><div><h3>Results</h3><div>According to study participants, the main barriers to access to insulin pump treatment for T1DM patients in Chile were the following: (i) Geographic barriers, (ii) Socioeconomic barriers, (iii) Administrative barriers, and (iv) Barriers from health teams. Participants also identified emerging barriers related to the insulin pump's adaptation process.</div></div><div><h3>Conclusions</h3><div>Despite the barriers and bottlenecks identified, an effort to fill short gaps in access to insulin pump treatment by the Chilean health system is recognized. To keep improving in equitative access to high-cost treatments in T1DM and other chronic conditions, it is imperative to consider the active and meaningful participation of patients and their families in health decision-making. This can lead to more patient-centric and effective healthcare policies and practices.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 2","pages":"Article 100992"},"PeriodicalIF":3.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421446","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":"Factors associated with adoption of electronic health record sharing system (eHRSS) among private physicians","authors":"Junjie Huang ,&nbsp;Wing Sze Pang ,&nbsp;Fung Yu Mak ,&nbsp;Yuet Yan Wong ,&nbsp;Sze Chai Chan ,&nbsp;Yingxin Guan ,&nbsp;Jonathan Poon ,&nbsp;Ellen Tong ,&nbsp;Clement SK Cheung ,&nbsp;Wing Nam Wong ,&nbsp;Ngai Tseung Cheung ,&nbsp;Chung Ping Ho ,&nbsp;Martin CS Wong","doi":"10.1016/j.hlpt.2025.100995","DOIUrl":"10.1016/j.hlpt.2025.100995","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to examine the adoption level of the electronic Medical Record (eMR) and Electronic Health Record Sharing System (eHRSS) among private physicians, and to establish areas for service improvement by evaluating the perception of the eHealth App.</div></div><div><h3>Methods</h3><div>Invitation emails containing the self-administered questionnaires link were sent out to private physicians, by referring to the eHRSS list and internet resources. A descriptive analysis was performed, the outcome variables (eMR, eHRSS, eHealth App) were expressed as proportions. Binary logistic regression models were constructed for the primary outcome variable and the secondary outcome variable.</div></div><div><h3>Results</h3><div>A total of 744 surveys were received. 78.5 % of the respondents adopted the eMR and 91.9 % joined the eHRSS. Among them, more than 90 % visited eHRSS regularly. ‘More technical support on data upload (61.7 %), ‘improve the friendliness of the interface (46.2 %), and ‘more cooperation between eHRSS and other medical systems’ (45.0 %) were potential factors that encourage data uploading. Type of practising [with partners/group practice: adjusted odd rate (aOR): 2.64, p&lt;0.001], and participation in eHRSS (aOR: 6.66, p&lt;0.001) were significant factors that increased the adoption of the eMR. Younger (aged≤ 30, aOR: 0.157, p&lt;0.041) and older age group (aged≥ 61, aOR: 0.403, p&lt;0.001) were less likely to adopt eMR. 79.9 % of them were aware of the eHealth App.</div></div><div><h3>Conclusions</h3><div>A generally high recognition of the eHRSS was found among physicians. Most physicians had an understanding and positive perception towards the eHealth App. It was noted that participation in eHRSS was significantly associated with the adoption of eMR.</div></div><div><h3>Public Interest Summary</h3><div>This study aims to examine the adoption level of the electronic Medical Record (eMR) and eHRSS among private physicians, and to establish areas for service improvement by evaluating the perception of the eHealth App. The study adopts the form of questionnaire survey, and we will analyze the collected data. A generally high recognition of the eHRSS was found among physicians. Most physicians had an understanding and positive perception towards the eHealth App. Physicians demonstrated strong confidence in privacy and security, but were less satisfied with the technical support of the eHRSS. It was noted that participation in eHRSS was significantly associated with the adoption of eMR.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 2","pages":"Article 100995"},"PeriodicalIF":3.4,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474469","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}