Health Policy and Technology最新文献

{"title":"Current evidence on the use of mHealth approaches in Sub-Saharan Africa: A scoping review","authors":"Genet Tadese Aboye ,&nbsp;Martijn Vande Walle ,&nbsp;Gizeaddis Lamesgin Simegn ,&nbsp;Jean-Marie Aerts","doi":"10.1016/j.hlpt.2023.100806","DOIUrl":"10.1016/j.hlpt.2023.100806","url":null,"abstract":"<div><h3>Background</h3><p>Mobile health (mHealth) approaches are especially beneficial to Sub-Saharan Africa (SSA), which has a disproportionate disease burden and a scarcity of healthcare workers.</p></div><div><h3>Objective</h3><p>This study aims to assess the availability, stage, and targeted health issues of mHealth interventions in SSA and to identify the gaps.</p></div><div><h3>Methods</h3><p>The study employed a scoping review guided by Arksey and O'Malley's framework to explore the use of mHealth in SSA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to report the review in a transparent and comprehensive manner. Articles published from 2000 to 2021 were searched in PUBMED, IEEE, SCOPUS, and Web of Science and evaluated with set of inclusion criteria. Data from the included publications were retrieved and synthesized.</p></div><div><h3>Results</h3><p>A total of 1020 articles were found. 59 of these have met the criteria for inclusion. The results show the implementation of mHealth interventions in 21 SSA nations. Only 1 (2%) mHealth interventions used a wearable sensor-based approach. 13 (22%) were SMS text-based interventions, 17 (29%) were app-based mHealth approaches, 18 (30%) were telemedicine-based approaches, and 10 (17%) were mixed approaches. HIV, cancer, and maternal and child health problems are the most commonly discussed health issues. Proof of concept, design and development, a pilot test were the frequently documented stages of mHealth interventions.</p></div><div><h3>Conclusion</h3><p>Less than half of SSA countries incorporate mHealth platforms, highlighting the need for further development. Integrating wearable based platforms for real-time monitoring of physiological parameters demands careful consideration.</p></div><div><h3>Public Interest Summary</h3><p>Mobile health (mHealth) technology is believed to be very beneficial for Sub-Saharan Africa (SSA) nations where there is a high disease burden but  inadequate healthcare system. Evidence-based data on the use and implementation of mHealth systems is needed to trace implementation and fill existing gaps. We performed a scoping review to determine the current availability, use, and stage of mHealth interventions and targeted health services in SSA. 21 SSA nations made (few) attempts in designing and implementing of mHealth systems. HIV, cancer, and maternal and child health are some of the health services among others. Though few large-scale implementations were reported, most interventions are at an early stage. mHealth solution should be designed to be both economical and simple to use to increase its uptake and incorporate wearables for real-time monitoring of physiological parameters.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000825/pdfft?md5=9370a35f12f646886dd0c8ab3ead2271&pid=1-s2.0-S2211883723000825-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135347253","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":"Cost-of-illness and associated factors among persons with type 2 diabetes: Findings from a tertiary care center in South India","authors":"Jeby Jose Olickal ,&nbsp;Palanivel Chinnakali ,&nbsp;BS Suryanarayana ,&nbsp;Ganesh Kumar Saya ,&nbsp;Kalaiselvan Ganapathy ,&nbsp;DKS Subrahmanyam","doi":"10.1016/j.hlpt.2023.100807","DOIUrl":"10.1016/j.hlpt.2023.100807","url":null,"abstract":"<div><h3>Objective</h3><p>Our aim was to estimate the cost of illness (COI) from the patient's perspective among individuals with type 2 diabetes (PWDs) attending a public tertiary care center in southern India.</p></div><div><h3>Methods</h3><p>This cross-sectional analytical study included PWDs on treatment for at least one year. Interviews captured direct medical costs (hospitalization, tests, medications), direct non-medical costs (meals, travel), and indirect costs (wage loss). Median regression analyses examined factors associated with total COI.</p></div><div><h3>Results</h3><p>Of total 1002 PWDs included<strong>,</strong> the mean (SD) age was 56 (12) years. Majority were males and from rural areas. One-third had diabetes for more than ten years, half were on insulin therapy, and more than half had comorbidities. Median (IQR) reported household income was US$637 (US$318–US$1115)/year. The Median (IQR) annual COI was US$39 (US$20-US$67), of which 73% was direct costs with a median of US$28. Majority of the participants (<em>n</em>=818, 81.6%) spent on laboratory investigations as direct medical costs and travel (<em>n</em>=1000, 99.8%) as direct non-medical costs. Travel costs represented the largest share of total COI (41%), followed by wage loss. Median annual COI was higher for males, salaried PWDs, and PWDs on insulin.</p></div><div><h3>Conclusions</h3><p>Our findings highlight that PWDs attending a public tertiary care center bear significant out-of-pocket expenses for diabetes care, primarily due to direct costs. Particularly, travel costs were identified as the most substantial component of the total COI.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135346696","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":"Enterprise architecture requirements for standardising digital health in Uganda's health system","authors":"Joseph Wamema,&nbsp;Andrew Alunyu,&nbsp;Mercy Amiyo,&nbsp;Josephine Nabukenya","doi":"10.1016/j.hlpt.2023.100805","DOIUrl":"10.1016/j.hlpt.2023.100805","url":null,"abstract":"<div><h3>Objective</h3><p>This research aimed to develop and validate enterprise architecture (EA) requirements to standardise digital health (DH) in Uganda's health system. These requirements were generated from DH challenges identified in an earlier prerequisite empirical study that was conducted to explore the feasibility of contextualising existing international DH standards to improve data use in Uganda's health system.</p></div><div><h3>Methods</h3><p>The study followed a cross-sectional research design, with the HIV/AIDS and TB disease model as a case study. A walkthrough approach was adopted to validate the derived requirements using purposively selected participants at national and sub-national levels of Uganda's healthcare system. Questionnaires (Google forms) were used to collect validation responses, while quantitative data was analysed using MS Excel.</p></div><div><h3>Results</h3><p>The results show that the respondents agreed with the DH EA requirements for standardising Uganda's health system. The results represent views from 65.67% of the expected participants drawn from all Uganda's DH stakeholders. Although a few respondents (3.3%) did not agree, most (96.7%) agreed with the requirements as-is. Therefore, the derived EA requirements are deemed suitable for standardising and strengthening Uganda's DH system.</p></div><div><h3>Conclusion</h3><p>Proper implementation of the EA requirements is expected to produce efficient, cost-effective, quality and safe digital health initiatives for Uganda.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000813/pdfft?md5=e4f3bbf9ff41a0c638ac504cc2c6c1d0&pid=1-s2.0-S2211883723000813-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135346698","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":"Shared features of successful tele-ICU models–A narrative review of successful implementation with a focus on LMIC models","authors":"Sidney Hilker ,&nbsp;Sitarah Mathias ,&nbsp;Dileep Raman ,&nbsp;Sanu Anand ,&nbsp;Ryan Brewster ,&nbsp;Carl Britto","doi":"10.1016/j.hlpt.2023.100802","DOIUrl":"10.1016/j.hlpt.2023.100802","url":null,"abstract":"<div><p>The COVID-19 pandemic exposed multiple pre-existing frailties in healthcare systems including the shortage of critical care services and equipment in Low- and Middle-Income Countries (LMICs). The training of a critical care doctor is expensive and time intensive. Novel, low-cost solutions that optimize existing resources and enable the limited number of specialists to deliver care to more people are needed. Telemedicine can sustainably bridge the gaps in critical care services in LMICs. There are limited data on the use of telemedicine for critical care in LMICs. In this paper, we review the few well documented tele-ICU models, with a focus on a novel model in India, and highlight several key attributes including timely implementation, practical on the ground training, financial feasibility, adaptability to the local context, scalability, and quality data collection.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 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}