Health Policy and Technology最新文献

{"title":"Increase in the number of female physicians and the geographical maldistribution of physicians in Japan","authors":"Kunichika Matsumoto,&nbsp;Kanako Seto,&nbsp;Yosuke Hatakeyama,&nbsp;Ryo Onishi,&nbsp;Koki Hirata,&nbsp;Tomonori Hasegawa","doi":"10.1016/j.hlpt.2024.100843","DOIUrl":"10.1016/j.hlpt.2024.100843","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>: In recent years, the geographical maldistribution of physicians has become a major problem in Japan, and prefectures are formulating plans to secure additional physicians. During the same period, the percentage of female physicians in Japan has been continuously increasing, and they now account for 40 % of the total enrollment in medical schools. The purpose of this study is to clarify the impact of the increasing proportion of female physicians on the maldistribution of physicians.</p></div><div><h3>METHODS</h3><p>: We used individual data from the surveys of physicians, dentists, and pharmacists from 1996 to 2018 and government-aggregated data with the same statistics from 1996 to 2020. The Gini coefficient was used to measure geographic maldistribution. Physicians were divided into four groups according to age and gender: men under 40, females under 40, men over 40, and females over 40, and the temporal trends in the maldistribution and contribution ratio of each group were calculated.</p></div><div><h3>RESULTS</h3><p>: Physician geographical maldistribution worsened after 2006 and continued to worsen until 2016. The contribution ratio of female physicians to the worsening geographical maldistribution exceeded 100 % for both under 40 and over 40 age groups. However, geographical maldistribution within female physicians has become more stable in recent years.</p></div><div><h3>Conclusion</h3><p>: The large contribution of the female physician group to the deterioration of the Gini coefficient for all physicians may be due to the greater weight of these groups. However, the Gini coefficient for the female group tended to be stable.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139475818","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":"Bias due to re-used databases: Coding in hospital for extremely vulnerable patients","authors":"Carine Milcent","doi":"10.1016/j.hlpt.2024.100851","DOIUrl":"10.1016/j.hlpt.2024.100851","url":null,"abstract":"<div><h3>Objective</h3><p>This paper interrogates bias caused by heterogeneity in coding processes through an analysis of electronic medical records EMR databases in France. In general, researchers and professionals often apply data not only for its primary function but also for multiple alternative purposes. However, how they code information might be inconsistent with alternative purposes that exploit existing databases.</p></div><div><h3>Methods</h3><p>Using the EMR acute care and the EMR rehabilitation care databases, we select more than 800,000 patients coded as socially vulnerable during their rehabilitation stay. Statistical analysis was conducted to describe the types of heterogeneity and to compare the distribution of vulnerability coding processes across different hospital statuses and individual social vulnerability roles. Coding process rates were also analyzed.</p></div><div><h3>Results</h3><p>This paper shows the heterogeneity in this process of social vulnerability coding, exploiting acute care database and rehabilitation care database. For groups of patients with ICD-10 coded as socially vulnerable during their rehabilitation stays, the probability of being previously coded as such during their acute care stay is 11.4 % higher in the public sector than in the private one.</p></div><div><h3>Conclusion</h3><p>Implementing the EMR system leads to heterogeneity in the coding process. The paper concludes by arguing that heterogeneity in coding is not random but rather calculated. Applying this database in epidemiologic studies or health economics projects that factor in patients’ vulnerability information may lead to unintended biased results. These findings might also be useful for policymakers using EMR to plan for implementing new reforms in many healthcare settings.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139919410","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":"COVID-19 in Polish-language social media - misinformation vs government information","authors":"Przemysław Waszak ,&nbsp;Ewelina Łuszczak ,&nbsp;Paweł Zagożdżon","doi":"10.1016/j.hlpt.2024.100871","DOIUrl":"10.1016/j.hlpt.2024.100871","url":null,"abstract":"<div><h3>Background</h3><p>During the COVID-19 pandemic, a surge of conspiracy theories and misinformation proliferated across social media platforms. Recognizing the severity of the issue, medical associations began to regard it as a significant threat to public health systems. The objective of this study was to quantify the proportion of COVID-19 misinformation and official government information within the most frequently shared items on Polish social media.</p></div><div><h3>Methods</h3><p>The analysis utilized the BuzzSumo Enterprise Application. Polish-language social media posts from January 1 to June 30, 2022, were scrutinized using keywords such as \"COVID,\" \"koronawirus,\" or \"SARS-CoV-2.\" A comprehensive report was generated, encompassing shares, comments, likes, and reactions (engagements). We analyzed the top 40 items that generated the most engagement. To ensure accuracy, two of the authors, both medical doctors, independently assessed each of them for potential misinformation.</p></div><div><h3>Results</h3><p>We identified 161,404 items in the Polish language that were shared on social media, representing 41,432,352 engagements. The top 40 items (0.02 % of all items) accounted for 7.71 % of engagements (3,194,900). Four items classified as misinformation accounted for 7.7 % of the Top 40 items, accumulating 244,700 engagements. All identified items were labeled as \"manipulated news\" due to their reliance on unverified or inappropriately interpreted data; none were classified as fabricated news. Government sources accounted for 4.1 % of the Top 40 items, accumulating 130,800 engagements.</p></div><div><h3>Conclusions</h3><p>This study highlights the significant prevalence of COVID-19 misinformation. Remedial measures should be implemented, addressing both social media platforms and real-life contexts, to enhance public health literacy.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000340/pdfft?md5=8ab8cd233770f28992b0a6c4d1123ab3&pid=1-s2.0-S2211883724000340-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141042845","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":"Societal preferences for granting orphan drugs special status in reimbursement decisions","authors":"Vivian Reckers-Droog ,&nbsp;Lucas Goossens ,&nbsp;Job van Exel ,&nbsp;Werner Brouwer","doi":"10.1016/j.hlpt.2024.100870","DOIUrl":"https://doi.org/10.1016/j.hlpt.2024.100870","url":null,"abstract":"<div><h3>Background</h3><p>Orphan drugs, for patients with a rare disease, are increasingly available but often do not meet standard cost-effectiveness criteria for reimbursement. Consequently, policymakers regularly face the dilemma whether to relax these criteria for reimbursing orphan drugs. We examined whether—and why—there would be societal support for such differential treatment of orphan drugs.</p></div><div><h3>Methods</h3><p>We conducted a labelled discrete choice experiment in a sample of the adult population (<em>n</em> = 1,172) in the Netherlands. Respondents were presented with ten choices on whether to reimburse an orphan drug given that a non-orphan drug with similar characteristics would not be reimbursed, because it was not cost-effective, and asked to explain their choices. We used random-intercept logit regression models and inductive coding for analysing the quantitative and qualitative data.</p></div><div><h3>Results</h3><p>Of the respondents, 36.4% consistently chose <em>for</em> reimbursing the orphan drug, mostly because “everyone is entitled to live a healthy life and good quality healthcare”, and 17.3% consistently for <em>not</em> reimbursing the orphan drug, mostly because “[this] is unfair to patients with a common disease”. The remaining 46.3% made alternating choices and were more likely to choose <em>for</em> reimbursing orphan drugs when patients were aged between 1 and 70 years, had moderate disease severity, and considerable health gain from treatment.</p></div><div><h3>Conclusions</h3><p>This study finds considerable support but also strong preference heterogeneity amongst members of the public in the Netherlands for differential treatment of orphan drugs in reimbursement decisions, when these drugs do not meet common cost-effectiveness criteria. However, a substantial minority opposes differential treatment, mostly on moral grounds.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000339/pdfft?md5=8e7144945430e817a9ac7d0914663b56&pid=1-s2.0-S2211883724000339-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140947973","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":"Acceptability of Chinese Medicine Information Sharing in electronic Health Record Sharing System (eHRSS) in Chinese medicine practitioners: A mixed-method study","authors":"Junjie Huang ,&nbsp;Sze Chai Chan ,&nbsp;Fung Yu Mak ,&nbsp;Yuet Yan Wong ,&nbsp;Corey Lam ,&nbsp;Kam Fung Chung ,&nbsp;Luva Lui ,&nbsp;Clement SK Cheung ,&nbsp;Wing Nam Wong ,&nbsp;Ngai Tseung Cheung ,&nbsp;Martin CS Wong","doi":"10.1016/j.hlpt.2024.100869","DOIUrl":"10.1016/j.hlpt.2024.100869","url":null,"abstract":"<div><p><em>Background and objectives</em> The Stage Two Development of eHRSS aimed to broaden the scope of sharable data and advance technical capability for sharing of Chinese Medicine (CM) information. This study aims to evaluate the adoption level and perceived difficulties of Chinese medicine practitioners (CMPs) towards EC Connect, and its impact on CM services.</p><p><em>Methods</em> All registered or listed CMPs were recruited in study 1. Descriptive analysis included age, gender, socioeconomic status, and past medical history was performed with multiple logistic regression models. In-depth interviews were conducted among EC Connect Users and Healthcare Providers (HCP) who upload information of Chinese Medicine to eHRSS.</p><p><em>Results</em> A total of 420 participants were included in this study. The majority of the respondents were in the 31–40 years age group (<em>N</em> = 133, 31.7 %) and practicing in private clinic (<em>N</em> = 311, 74.0 %). Respondents whom agreed that the expansion of sharing scope would be helpful to various stakeholders were 5 times more likely to be interested in joining eHRSS (aOR = 5.01, 95 % CI = 2.73–9.20, <em>p</em> &lt; 0.001). Study 2 found that eHRSS allowed CMPs to share and record medical data, and to access patients’ western medical records while inconsistency of medical systems between Western and Chinese medicine should be considered.</p><p>Conclusions We found that accessing and sharing medical records was important to CMPs. eHRSS helped to facilitate more accurate association between Western and Chinese medical doctors, while more efforts were needed to increase the acknowledgement among the general public.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141027320","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":"Broadening the HTA of medical AI: A review of the literature to inform a tailored approach","authors":"Bart-Jan Boverhof ,&nbsp;W. Ken Redekop ,&nbsp;Jacob J. Visser ,&nbsp;Carin A. Uyl-de Groot ,&nbsp;Maureen P.M.H. Rutten-van Mölken","doi":"10.1016/j.hlpt.2024.100868","DOIUrl":"https://doi.org/10.1016/j.hlpt.2024.100868","url":null,"abstract":"<div><h3>Objectives</h3><p>As current health technology assessment (HTA) frameworks do not provide specific guidance on the assessment of medical artificial intelligence (AI), this study aimed to propose a conceptual framework for a broad HTA of medical AI.</p></div><div><h3>Methods</h3><p>A systematic literature review and a targeted search of policy documents was conducted to distill the relevant medical AI assessment elements. Three exemplary cases were selected to illustrate various elements: (1) An application supporting radiologists in stroke-care (2) A natural language processing application for clinical data abstraction (3) An ICU-discharge decision-making application.</p></div><div><h3>Results</h3><p>A total of 31 policy documents and 9 academic publications were selected, from which a list of 29 issues was distilled. The issues were grouped by four focus areas: (1) Technology &amp; Performance, (2) Human &amp; Organizational, (3) Legal &amp; Ethical and (4) Transparency &amp; Usability. Each assessment element was extensively discussed in the test, and the elements clinical effectiveness, clinical workflow, workforce, interoperability, fairness and explainability were further highlighted through the exemplary cases.</p></div><div><h3>Conclusion</h3><p>The current methodology of HTA requires extension to make it suitable for a broad evaluation of medical AI technologies. The 29-item assessment list that we propose needs a tailored approach for distinct types of medical AI, since the conceptualisation of the issues differs across applications.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000315/pdfft?md5=04f79e9b441dc321ec2e43d52e5e04eb&pid=1-s2.0-S2211883724000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893969","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":"Access and use of mobile health applications among Medicaid-insured pregnant and postpartum individuals","authors":"Naleef Fareed ,&nbsp;Shirley Dong ,&nbsp;Jiqiang Wu ,&nbsp;Anastasia Matthews ,&nbsp;Anna Bartholomew ,&nbsp;Courtney D. Lynch ,&nbsp;William A Grobman ,&nbsp;Kartik K Venkatesh","doi":"10.1016/j.hlpt.2024.100867","DOIUrl":"https://doi.org/10.1016/j.hlpt.2024.100867","url":null,"abstract":"<div><p>Mobile health applications can address health disparities in prenatal care due to adverse social determinants of health<strong>.</strong> We assessed the uptake and use of, preferences for, and barriers to mobile health applications among Medicaid-insured pregnant and postpartum individuals enrolled in prenatal care from March to May 2021. Medicaid-insured pregnant and postpartum individuals frequently used (56 %) and were potentially interested in using (90 %) mobile health applications for health-related tasks and had reliable internet access to do so (94 %). Over two fifths (44 %) reported barriers to using mobile health applications. Further research is needed to understand whether using mobile health applications to address social needs in the peripartum period can affect prenatal care utilization and decrease health disparities.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000303/pdfft?md5=8487e951f20e3cbb6e6128a0f0d11312&pid=1-s2.0-S2211883724000303-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893970","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":"Are telephone-triage services less safe and efficient for managing unplanned care needs of older adults?","authors":"Farah Islam ,&nbsp;Pieter Heeren ,&nbsp;Marc Sabbe ,&nbsp;Koen Milisen","doi":"10.1016/j.hlpt.2024.100866","DOIUrl":"https://doi.org/10.1016/j.hlpt.2024.100866","url":null,"abstract":"<div><h3>Background</h3><p>As part of the TRANS-SENIOR international training and research network, this study aimed to describe and compare the appropriateness of triage decisions (within the context of safety and efficiency) for real world patient records of younger and older patients dispatched by operators of a national out-of-hours (OOH) telephone triage service to receive further medical care by a general practitioner (GP).</p></div><div><h3>Methods</h3><p>A descriptive study was conducted using anonymized registry data obtained from the 1733 OOH telephone triage service in the Flemish region of Belgium linked with medical patient records made available via the Mediris platform. All calls received between May 24, 2019 and December 31, 2020 were analyzed. Appropriateness of triage decisions was assessed by comparing the level of urgency estimated by the 1733 telephone triage operator during the call versus the GP during follow-up physical triage of the patient (considered as the gold standard).</p></div><div><h3>Results</h3><p><em>N</em> = 8,664 calls were included for analysis. In total, 69.1% of calls involved children or younger adults while 30.9 % involved older adults (65 years and over). The majority of calls (83.5 %) dispatched by operators to receive an OOH GP home visit involved older adults. The total percentage of appropriately triaged calls were distributed as 98.5 % in children and 96.5 % in younger adults versus 72.5 % in older adults. The percentage of under-triage in older adults was distributed as 1.5 % (65 to 74 years), 3.9 % (75 to 84 years) and 3.0 % (≥ 85 years) versus over-triage in older adults distributed as 16.2 % (65 to 74 years), 22.0 % (75 to 84 years) and 29.6 % (≥ 85 years).</p></div><div><h3>Conclusion</h3><p>Our findings suggest that while the 1733 service may generally be a safe and efficient tool for managing unplanned care needs of the population, there is room for improvement with regards to the efficiency of these services, particularly for older adults. Fruitful research efforts should aim to evaluate and compare findings with calls dispatched to obtain care from emergency medical services using the 1733 service as well as further investigate the nature of over- and under- triaged calls.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140536043","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":"Payments to healthcare organisations reported by the medical device industry in Europe from 2017 to 2019: An observational study","authors":"James Larkin ,&nbsp;Shai Mulinari ,&nbsp;Piotr Ozieranski ,&nbsp;Kevin Lynch ,&nbsp;Tom Fahey ,&nbsp;Akihiko Ozaki ,&nbsp;Frank Moriarty","doi":"10.1016/j.hlpt.2024.100865","DOIUrl":"https://doi.org/10.1016/j.hlpt.2024.100865","url":null,"abstract":"<div><h3>Objective</h3><p>Medical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. <em>MedTech Europe</em>, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system.</p></div><div><h3>Methods</h3><p>An observational study of education-related payments to HCOs reported by the medical device industry in Europe was conducted. Data was manually extracted from transparentmedtech.eu. The primary outcome variable is the value of the payments, overall, and for each year, payment type, and country. The accessibility, availability and quality of the database was also analysed, using a proforma with 15 measures.</p></div><div><h3>Results</h3><p>Overall, 116 medical device companies reported education-related payments in 53 European and non-European countries, valuing over €425 million between 2017 and 2019, increasing in value between 2017 and 2019, from €93,798,419 to €175,414,302. Ten countries accounted for 94% of all payments and ten companies accounted for 80% of all payments. The accessibility, availability and quality of the database rated low for six measures, medium for six measures, and high for three measures.</p></div><div><h3>Conclusion</h3><p>There is a large amount of education-related payments from medical device companies to European HCOs, creating substantial potential for conflicts of interest. <em>MedTech Europe's</em> disclosure system has many shortcomings. A European-wide publicly mandated disclosure system for both the medical device and pharmaceutical industries should be introduced.</p></div><div><h3>Public interest summary</h3><p>The medical device industry pay healthcare organisations (e.g. hospitals) large amounts of money. Industry states that this money is to help pay for healthcare professionals’ education. However, these payments can have a negative impact on healthcare professionals’ decision-making. This study sought to examine a website run by <em>MedTech Europe</em>, a representative body for the medical device industry, which outlines details of some of these payments (www.transparentmedtech.eu). Our analysis found that between 2017 and 2019 the medical device industry made ‘education’ payments valuing €425 million to healthcare organisations in Europe. We also assessed how comprehensive and user-friendly the database was and found a range of issues. For example, the database is not downloadable and some other important types of payments, such as payments for consultancy, are not included. We concluded that a mandatory database for both the medical device and pharmaceutical industry run by the European Union, would significantly improve transparency.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000285/pdfft?md5=66282831ea8d60ac24853633e69387b9&pid=1-s2.0-S2211883724000285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140546074","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":"Denmark, the United States and Canada: Before, during and post vaccination rollout","authors":"Michelle Falkenbach ,&nbsp;Charley E. Willison ,&nbsp;Phillip M. Singer","doi":"10.1016/j.hlpt.2023.100791","DOIUrl":"10.1016/j.hlpt.2023.100791","url":null,"abstract":"<div><h3>Objectives</h3><p>We conduct a rapid review of the post-COVID-19 vaccination efforts undertaken by Denmark, the United States, and Canada. The main areas of focus are threefold: 1) To analyze the timeline of the rollout and access/barriers to vaccinations considering the changing dynamics of COVID-19 and the launch of new generation booster-vaccines across the case countries. 2) To examine sociopolitical factors related to this juxtaposition between lower booster acceptance, despite higher rates of initial vaccine series, in each of the three cases. 3) To determine how each country is moving forward with their ongoing COVID-19 strategies for long-term mitigation planning.</p></div><div><h3>Methods</h3><p>We followed a Most Similar Systems Design (MSSD) framework to select our cases. We analyze country responses amongst high-income, OECD countries, who shared Western or liberal Democracy, with a formal framework of rule of law, presence of a legal authority and the independence of the judiciary, but differ in their rollout and uptake of the vaccine booster.</p></div><div><h3>Results</h3><p>Despite variation in booster uptake, all three countries’ COVID-19 mitigation responses became more similar over time, and each country experienced lower than expected booster uptake.</p></div><div><h3>Conclusions</h3><p>Decline in booster doses across each country was related to broad declines in concern about the virus in each location. However, cases with higher uptake of the initial series and use of NPIs, in Denmark and Canada, continue to fare better in morbidity and mortality from COVID-19, despite dwindling booster uptake.</p></div><div><h3>Public Interest Summary</h3><p>This study looks at how three high income western democracies (Denmark, the United States and Canada) handled the COVID-19 pandemic and booster vaccinations. We briefly look at the initial outbreak of the pandemic, contextualize the initial (pre-booster) vaccination uptake and then assess the booster vaccine uptake. We find that although the countries differ in their approach during the initial stages of COVID-19 and vaccination policy, they all share similarly low booster vaccine uptake. Yet, even with a similarly low booster uptake, each of the countries continue to exhibit differences in morbidity, mortality and disparities associated with COVID-19. The implications of this research are clear – providing access to vaccinations, boosters, testing, and treatment are essential in combating inequalities in COVID-19 outcomes. Overlaying these implications is the importance of a continuously updated national strategy for future pandemics is important.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000679/pdfft?md5=e57e03445fce488f5e13a1638ebd9777&pid=1-s2.0-S2211883723000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42698774","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}