Health Policy最新文献

{"title":"Corrigendum to “Mitigating the regressivity of private mechanisms of financing healthcare: An Assessment of 29 countries” [Health Policy 143 (2024) 105058]","authors":"Ruth Waitzberg , Sara Allin , Michel Grignon , Åsa Ljungvall , Katharina Habimana , Marios Kantaris , Steve Thomas , Thomas Rice","doi":"10.1016/j.healthpol.2025.105446","DOIUrl":"10.1016/j.healthpol.2025.105446","url":null,"abstract":"","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105446"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202310","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":"Governance of nonpowdered firearms across high-income countries: Results of a scoping review","authors":"Nardin Kirolos ,&nbsp;Rachel Strauss ,&nbsp;Tharani Raveendran ,&nbsp;Charlotte Moore Hepburn ,&nbsp;Natasha Saunders","doi":"10.1016/j.healthpol.2025.105450","DOIUrl":"10.1016/j.healthpol.2025.105450","url":null,"abstract":"<div><h3>Background</h3><div>Nonpowdered firearms are commonly used in recreation but their projectiles can cause serious injuries. Understanding how nonpowdered firearms are governed is essential for injury prevention.</div></div><div><h3>Objective</h3><div>We aimed to describe legislative, regulatory, and prevention strategies that govern nonpowdered firearms in Organization for Economic Co-Operation and Development (OECD) countries.</div></div><div><h3>Methods</h3><div>We searched multiple academic databases and grey literature for information on nonpowdered firearm governance. Data were extracted and grouped into themes: weapon definitions, licensure, age restrictions, permitted locations for use, storage and transport, sale and transfer, imitation firearms, import/export, manufacturing, advertising, and monitoring systems. We conducted a comparative analysis of legislative frameworks, regulatory standards, and enforcement strategies.</div></div><div><h3>Results</h3><div>Our findings revealed that 31 OECD countries (84%) have documented governance of nonpowdered firearms. Definitions for what constitutes a nonpowdered firearm varied based on the projectile mechanism (air, spring) and specific muzzle energy/velocity. In 61% of countries, licensure and age restrictions were mandatory. Regulations on use locations, storage, sale, and transfer were found in 26–32% of countries. Monitoring systems for production, sale, or possession existed in 13 countries. Injury surveillance systems were not readily identified.</div></div><div><h3>Conclusions</h3><div>While commonalities exist nonpowdered firearm governance, substantial heterogeneity and gaps remain in legislation. This becomes problematic when governance approaches lack a foundation in clinical or physical evidence, limiting effective injury prevention. Evidence-informed definitions and methods to assess injury potential are essential for improving surveillance and guiding regulation. Strategies such as age and marketing restrictions, licensure, and safety equipment (eye protection) should be grounded in science. International guidance can support coherent, adaptable approaches across jurisdictions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105450"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227536","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":"Emotions associated with teleconsultation: An analysis of users' messages on X (Twitter) in Chile","authors":"Patricio E. Ramírez-Correa ,&nbsp;F. Javier Rondán-Cataluña ,&nbsp;Jorge Arenas-Gaitán","doi":"10.1016/j.healthpol.2025.105449","DOIUrl":"10.1016/j.healthpol.2025.105449","url":null,"abstract":"<div><h3>Background</h3><div>Digital healthcare transformation requires incorporating patient perspectives. Increasingly proactive citizens utilize teleconsultation, fostering doctor–patient–technology integration that enhances system efficiency, service quality, and sustainable healthcare management.</div></div><div><h3>Objective</h3><div>This study focuses on exploring perceptions of satisfaction related to teleconsultation, using emotions detected on X (Twitter) as a reference.</div></div><div><h3>Methods</h3><div>First, an analysis of the predominant emotions in the posts (tweets) of users belonging to the three main metropolitan areas is carried out. Then, using one type of structural equation modelling that is Partial Least Square (PLS-SEM), we identify the emotions that have the most significant influence on the variability of satisfaction, taking into account geographical differences.</div></div><div><h3>Results</h3><div>The results highlight trust as the most relevant emotion to explain the variation in satisfaction and reveal statistically significant differences between the different areas analysed. A considerable proportion of the population is not satisfied with this mode of healthcare provision.</div></div><div><h3>Conclusions</h3><div>This study highlights key factors influencing the integration of teleconsultation into healthcare systems. Patient perspectives and emotional responses—particularly trust, anticipation, fear, and sadness—are critical for successful implementation. Findings reveal regional disparities in satisfaction, with more developed areas providing superior teleconsultation experiences, likely due to stronger infrastructure and resources. Moreover, variations were identified in how emotions affect satisfaction across regions, underscoring the need for context-specific approaches. Strategies that enhance trust and mitigate fear in less developed regions appear essential. These insights emphasize the importance of aligning digital healthcare initiatives with patient-centered, regionally tailored management practices.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105449"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227585","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":"Gender differences in healthcare utilization across Europe: Evidence from the European Health Interview Survey","authors":"Davide Golinelli ,&nbsp;Francesco Sanmarchi ,&nbsp;Giovanni Guarducci ,&nbsp;Jacopo Palombarini ,&nbsp;Paolo Benetti ,&nbsp;Simona Rosa ,&nbsp;Jacopo Lenzi","doi":"10.1016/j.healthpol.2025.105448","DOIUrl":"10.1016/j.healthpol.2025.105448","url":null,"abstract":"<div><h3>Background</h3><div>Understanding gender-based disparities in healthcare utilization is crucial for informing equitable health policy. However, cross-national evidence across multiple service domains in Europe remains limited.</div></div><div><h3>Objective</h3><div>To examine gender differences in healthcare utilization across 27 European countries and explore variability across service types.</div></div><div><h3>Methods</h3><div>We analyzed data from 257,388 adults in the third wave of the European Health Interview Survey (2019–2020). Twelve healthcare utilization indicators were evaluated, including hospital admissions, outpatient care, mental health services, and medication use. Gender disparities were estimated using regression models with inverse probability weighting based on random forest propensity scores.</div></div><div><h3>Results</h3><div>Women had significantly higher odds of using nearly all outpatient and preventive services, including general practitioners, specialists, dental care, physiotherapy, psychotherapy, and home care. They also reported higher use of both prescribed and non-prescribed medications. No significant gender differences were observed in hospitalization rates. Sensitivity analyses adjusting for health needs confirmed these findings. Considerable heterogeneity emerged across countries and service domains: Latvia, Lithuania, and Poland showed the largest disparities (e.g., ORs 1.52–1.75 for recent specialist visits), while Denmark, the Netherlands, and Ireland displayed relatively small overall gaps but large differences for specific services, such as psychotherapy and home care.</div></div><div><h3>Conclusions</h3><div>Women consistently utilize more non-acute healthcare services than men, while comparable hospitalization rates suggest differences in disease severity or care-seeking behaviors. The magnitude of these disparities varies considerably across European countries, highlighting the need for context-sensitive policies to address gender inequities in healthcare utilization.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105448"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193927","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 same, but different: Understanding responsibility attributions for depression with a cross-national survey in the United States and Germany","authors":"Anna Wagner ,&nbsp;Doreen Reifegerste ,&nbsp;Sebastian Scherr","doi":"10.1016/j.healthpol.2025.105445","DOIUrl":"10.1016/j.healthpol.2025.105445","url":null,"abstract":"<div><div>Understanding how the population attributes responsibility for depression is crucial for shaping the treatment of depressed individuals in society and influencing support for health-related policies. International findings suggest that responsibility attributions generally differ between countries and cultures. However, it is unknown whether they also differ between different healthcare systems within individualistic cultures. To address this research gap, we compared different responsibility attributions for depression (individual, genetic, social) in the United States (individual-based healthcare system) and Germany (solidarity-based healthcare system) in a cross-sectional online survey with 2,168 participants. Additionally, we examined factors associated with these attributions in both countries, including the use of health information sources such as alternative and social media, since media use – and the media frames conveyed through it – is linked to responsibility attributions. Results show that social context-attributions were most prevalent in both countries, but significantly more pronounced in Germany. In contrast, individual and genetic responsibility attributions were higher in the U.S. In both samples, the use of alternative media for health information-seeking was positively associated with individual attributions, while depression knowledge was linked to greater social and genetic attributions. Healthism attitudes were positively related to all three types of responsibility attributions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105445"},"PeriodicalIF":3.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121304","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":"Large language models in radiology workflows: An exploratory study of generative AI for non-visual tasks in the German healthcare system","authors":"Stefanie Steinhauser ,&nbsp;Sabrina Welsch","doi":"10.1016/j.healthpol.2025.105444","DOIUrl":"10.1016/j.healthpol.2025.105444","url":null,"abstract":"<div><h3>Background</h3><div>Large language models (LLMs) are gaining attention for their potential to enhance radiology workflows by addressing challenges such as increasing workloads and staff shortages. However, limited knowledge among radiologists and concerns about their practical implementation and ethical implications present challenges.</div></div><div><h3>Objective</h3><div>This study investigates radiologists' perspectives on the use of LLMs, exploring their potential benefits, challenges, and impact on workflows and professional roles.</div></div><div><h3>Methods</h3><div>An exploratory, qualitative study was conducted using 12 semi-structured interviews with radiology experts. Data were analyzed to assess participants' awareness, attitudes, and perceived applications of LLMs in radiology.</div></div><div><h3>Results</h3><div>LLMs were identified as promising tools for reducing workloads by streamlining tasks like summarizing clinical histories and generating standardized reports, improving communication and efficiency. Participants expressed openness to LLM integration but noted concerns about their impact on human interaction, ethical standards, and liability. The role of radiologists is expected to evolve with LLM adoption, with a shift toward data stewardship and interprofessional collaboration. Barriers to implementation included limited awareness, regulatory constraints, and outdated infrastructure.</div></div><div><h3>Conclusions</h3><div>The integration of LLMs is hindered by regulatory challenges, outdated infrastructure, and limited awareness among radiologists. Policymakers should establish clear, practical regulations to address liability and ethical concerns while ensuring compliance with privacy standards. Investments in modernizing clinical infrastructure and expanding training programs are critical to enable radiologists to effectively use these tools. By addressing these barriers, LLMs can enhance efficiency, reduce workloads, and improve patient care, while preserving the central role of radiologists in diagnostic and therapeutic processes.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105444"},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093015","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":"Are long-term care systems aligned with person-centered integrated care? Evidence from the Western Pacific","authors":"Dongkyu Lee ,&nbsp;Soojung Kim ,&nbsp;Soonman Kwon ,&nbsp;Sunghun Yun ,&nbsp;Mikiko Kanda ,&nbsp;Siwon Lee ,&nbsp;Nicole Sutton ,&nbsp;Paul Ong ,&nbsp;Andy Inder","doi":"10.1016/j.healthpol.2025.105442","DOIUrl":"10.1016/j.healthpol.2025.105442","url":null,"abstract":"<div><h3>Background</h3><div>Many Western Pacific countries have established long-term care (LTC) systems to support their rapidly aging populations. However, the extent to which these systems align with integrated care principles that enable individuals to age in place (AIP) remains unclear. Effective integration of LTC with healthcare is essential to enhance continuity of care, improve outcomes, and support AIP.</div></div><div><h3>Objective</h3><div>This study examines the alignment of LTC policies in five Western Pacific countries—Australia, Japan, New Zealand, Republic of Korea, and Singapore—with integrated LTC principles. The analysis identifies systemic enablers and challenges in governance, financing, workforce, service delivery, information, monitoring &amp; evaluation (IM&amp;E), and innovation &amp; research.</div></div><div><h3>Methods</h3><div>Using an adapted World Health Organization LTC framework, we conducted a comparative analysis of the selected countries’ LTC policies.</div></div><div><h3>Results</h3><div>All five countries emphasize aging in place and provide both institutional and community-based LTC services. However, key enablers of integration are often lacking. Fragmentation between LTC and healthcare is common, and coordination mechanisms such as care planning are hindered by inadequate accountability mechanisms due to misaligned incentives, challenges in funding integration, and often underdeveloped information systems for monitoring integrated care.</div></div><div><h3>Conclusion</h3><div>Western Pacific LTC systems are not yet fully aligned with effective integrated LTC. Strengthening coordinated and accountable governance, integrating financing streams and incentive, enhancing IM&amp;E systems for performance management, and leveraging innovation are crucial to enhancing integrated LTC in the region.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105442"},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202327","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":"Health impact assessments should be mandatory for all relevant government policies","authors":"Heidi Lynch ,&nbsp;Ian Holdroyd ,&nbsp;Martin Birley ,&nbsp;Daniel Black ,&nbsp;Ben Cave ,&nbsp;Margaret Douglas ,&nbsp;Rowena Ekermawi ,&nbsp;Liz Green ,&nbsp;Fiona Haigh ,&nbsp;Ben Harris-Roxas ,&nbsp;Monica O'Mullane ,&nbsp;Joanna Purdy ,&nbsp;Anna Stevenson ,&nbsp;Salim Vohra ,&nbsp;John Ford","doi":"10.1016/j.healthpol.2025.105436","DOIUrl":"10.1016/j.healthpol.2025.105436","url":null,"abstract":"<div><div>Consistent and systematic integration of health considerations in upstream political decision making is needed to improve population health and enhance health equity. Previous research supports the effectiveness of Health Impact Assessments (HIA), as a key component of a Health in All Policies (HiAP) approach, demonstrating its ability to influence cross-government policies that affect health and health equity. HiAP is an approach to embedding health and health equity in multi-sector decision making. Despite proven potential, HIA has historically been used sporadically and opportunistically rather than as a part of routine policy making. Here we argue that mandatory HIA in national policy, as part of an overall HiAP approach, is needed to achieve effective and sustained cross-government action on health and equity. Implementing mandatory HIAs would ensure that health considerations are routinely evaluated in policy decisions, enabling governments to proactively address health disparities and improve public well-being. Harnessing the benefits of HIA requires political commitment to an evidence-informed approach to population health, with dedicated civil service support, and a mandatory screening and assessment process for significant policies. A systematic and obligatory approach would foster accountability, enhance policy coherence and ultimately promote health and equity. It would also send a clear message that consideration of health is a non-negotiable in every policy decision.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105436"},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160294","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":"Impact of midwifery-led units in Spain: lessons from the first 5 years","authors":"Roser Palau-Costafreda ,&nbsp;Lluna Orus-Covisa ,&nbsp;Edgar Vicente-Castellví ,&nbsp;Xavier Espada-Trespalacios ,&nbsp;Albert Medina Català ,&nbsp;Carlota Alcover ,&nbsp;Noemí Obregón Gutiérrez ,&nbsp;Ramon Escuriet ,&nbsp;Eva Padrosa","doi":"10.1016/j.healthpol.2025.105441","DOIUrl":"10.1016/j.healthpol.2025.105441","url":null,"abstract":"<div><h3>Background</h3><div>There has been a growing concern over rising medical interventions during childbirth, particularly caesarean sections, without corresponding improvements in maternal or neonatal outcomes. Midwifery-led units (MLUs) offer a model that promotes physiological birth while reducing unnecessary interventions. In Spain, where maternity care is predominantly hospital-based and obstetrician-led, the first public MLU opened in Catalonia in 2017. Its temporary closure after five years offers a unique opportunity to assess its impact on interventions and outcomes.</div></div><div><h3>Objective</h3><div>To evaluate the MLU’s implementation and its effect on childbirth interventions within the unit and across the host hospital.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional trend study of childbirth data (2018–2023) from all public Catalan hospitals, and a retrospective cohort study of women contacting the MLU (2017–2022).</div></div><div><h3>Results</h3><div>MLU demand tripled between 2018 and 2022. Among 1286 attendees, 64.8 % were nulliparous and predominantly had low risk pregnancies. Half who planned an MLU birth began labour there, achieving 92.3 % spontaneous vaginal births and 4.1 % caesareans. Hospital-wide, caesarean rates fell from 23.5 % to 13.5 % (2019–2021), while spontaneous births rose to 78.7 %, suggesting a spill-over effect beyond the MLU. These trends reversed after closure in 2022.</div></div><div><h3>Conclusion</h3><div>Spain’s first public MLU was successfully implemented, safely reducing interventions and influencing wider hospital practices. Its closure and subsequent regression in birth outcomes highlight the need for sustained support and investment. MLUs can be an effective strategy for lowering intervention rates in highly medicalised systems, benefiting both unit users and the broader maternity care environment.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105441"},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160295","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 role of private equity funds in healthcare: trends, impact and policy responses","authors":"Bernd Rechel ,&nbsp;Florian Tille ,&nbsp;Julien Mercille ,&nbsp;Peter Groenewegen ,&nbsp;Rob Timans","doi":"10.1016/j.healthpol.2025.105439","DOIUrl":"10.1016/j.healthpol.2025.105439","url":null,"abstract":"","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105439"},"PeriodicalIF":3.4,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202264","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}