Health Policy最新文献

Equity in healthcare financing: A review of evidence. 医疗融资公平性：证据综述

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-11-28 DOI: 10.1016/j.healthpol.2024.105218

Emilia Luyten, Sandy Tubeuf

{"title":"Equity in healthcare financing: A review of evidence.","authors":"Emilia Luyten, Sandy Tubeuf","doi":"10.1016/j.healthpol.2024.105218","DOIUrl":"10.1016/j.healthpol.2024.105218","url":null,"abstract":"This review summarises empirical studies on the progressivity and redistributive effects of healthcare financing mechanisms. The evidence varies significantly across countries and financing sources. Tax-based systems exhibit high progressivity, as direct taxes contribute to a favourable redistribution toward low-income households, often offsetting the regressive nature of indirect taxes. Social insurance systems are found to be progressive but may be regressive in practice due to contribution ceilings and exemptions for high-income earners. This creates disparities where high-income taxpayers benefit from social protection while contributing less proportionally to their total income, limiting the overall positive redistributive effect on income inequalities. Most health systems with co-payments use flat rates rather than income-based rates, disproportionately affecting lower-income individuals and potentially leading to catastrophic expenses. This review highlights a lack of recent research on healthcare financing in high-income countries, while recent studies in low- and middle-income countries align with commitment to deliver universal health coverage. Continuous analysis of the redistributive effects of the health system is essential to ensure that health financing systems not only fund healthcare effectively but also contribute to broader social equity goals.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105218"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911143","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}

引用次数: 0

Immigration of medical personnel from Ukraine to Poland - Context, regulations, and trends. 从乌克兰到波兰的医疗人员移民——背景、法规和趋势。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-19 DOI: 10.1016/j.healthpol.2024.105241

Liudmyla Andriiashenko, Michał Zabdyr-Jamróz, Paweł Lipowski, Alicja Domagała

{"title":"Immigration of medical personnel from Ukraine to Poland - Context, regulations, and trends.","authors":"Liudmyla Andriiashenko, Michał Zabdyr-Jamróz, Paweł Lipowski, Alicja Domagała","doi":"10.1016/j.healthpol.2024.105241","DOIUrl":"10.1016/j.healthpol.2024.105241","url":null,"abstract":"Background: The migration of healthcare professionals is common phenomenon and shows upwards trends. Poland, which used to be a source country with marginal immigration, has in the past few years received more immigrants due to the simplified access to the labour market for professionals from outside the European Union. We aimed to analyse the immigration of healthcare workforce to Poland with an emphasis on legislative changes regarding the right to practice of medical personnel from outside the EU (mainly from Ukraine).Methods: This analysis included the description of legislative changes in the recognition of qualifications of doctors, dentists, nurses, and midwives. Data on the number of non-EU citizens who took up employment in Poland were analysed concerning three periods reflecting these changes: (1) before 2020, (2) during the Covid-19 pandemic (2020-2022), and (3) after the Russian invasion of Ukraine (since February 2022). Also, the medical education systems in Poland and Ukraine were compared.Results: The number of Ukrainian health workers seeking employment in Poland has increased significantly in recent years, mainly due to the geopolitical context of the war in Ukraine. This has been supported by the simplification of legal regulations for obtaining a licence to practice.Conclusions: It is necessary to implement a comprehensive adaptation process for migrant health workers to maintain the quality of provided services and patient safety.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105241"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985535","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}

引用次数: 0

A good start for all children: Integrating early-life course medical and social care through Solid Start, the Netherlands' nationwide action programme. 所有儿童都有一个良好的开端：通过荷兰的全国行动方案“扎实起步”，将生命早期阶段的医疗和社会护理结合起来。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-04 DOI: 10.1016/j.healthpol.2024.105219

Eric A P Steegers, Jeroen N Struijs, Angela J M Uijtdewilligen, Tessa J Roseboom

{"title":"A good start for all children: Integrating early-life course medical and social care through Solid Start, the Netherlands' nationwide action programme.","authors":"Eric A P Steegers, Jeroen N Struijs, Angela J M Uijtdewilligen, Tessa J Roseboom","doi":"10.1016/j.healthpol.2024.105219","DOIUrl":"10.1016/j.healthpol.2024.105219","url":null,"abstract":"The foundations of human wellbeing are laid in early life during the preconception stage and the 1,000-days of life from conception to the child's second birthday. This period is therefore receiving scrutiny as a concept for guiding pregnancy-care innovation and public health policy. The Dutch government took responsibility to invest in this. In September 2018, the Dutch Ministry of Health, Welfare, and Sport launched the Solid Start action programme. Coordinated nationally, the programme is implemented locally through coalitions in all 342 Dutch municipalities involving collaboration between medical and social-care professionals, policymakers, parents and organisations. The programme has generated a nationwide movement in which medical and social-care professionals now develop forms of structural collaboration that support (future) parents by offering evidence-based interventions that simultaneously enhance early healthy human development and prevent unwanted pregnancies. Although monitoring of the programme does not currently make it possible to address the causal effects of the programme itself, lessons can be distilled which have contributed to the successful implementation of this nationwide programme. These lessons include 1) having and maintaining an unambiguous narrative, 2) creating a lasting sense of urgency among stakeholders, and 3) ensuring that the programme is multi-sectoral.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105219"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796517","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}

引用次数: 0

Caregiver preferences and willingness-to-pay for home care services for older people with dementia: A discrete choice experiment in the Milan metropolitan area. 照顾者对老年痴呆症患者家庭护理服务的偏好和支付意愿：米兰大都会地区的离散选择实验。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-03 DOI: 10.1016/j.healthpol.2024.105220

Michela Meregaglia, Simone Manfredi, Eleonora Perobelli, Andrea Rotolo, Elisabetta Donati, Elisabetta Notarnicola

{"title":"Caregiver preferences and willingness-to-pay for home care services for older people with dementia: A discrete choice experiment in the Milan metropolitan area.","authors":"Michela Meregaglia, Simone Manfredi, Eleonora Perobelli, Andrea Rotolo, Elisabetta Donati, Elisabetta Notarnicola","doi":"10.1016/j.healthpol.2024.105220","DOIUrl":"10.1016/j.healthpol.2024.105220","url":null,"abstract":"Objectives: Dementia is a major health and social care challenge in high-income countries where most people are cared for in their own homes. This study aimed to elicit caregiver preferences for alternative bundles of home care services in the Milan metropolitan area.Methods: A binary discrete choice experiment was administered to a sample of informal caregivers of people with dementia recruited through a network of non-profit organizations. The experiment included four attributes: 1) number of home care hours per month; 2) type of care; 3) caregiver peer support group organization; 4) monthly family's cost (in euros), each articulated into three levels. A mixed logit model was applied to analyze the responses using Stata.Results: A total of 93 self-administered questionnaires were collected in January-April 2023. Two-thirds of both caregivers (67.7 %) and care recipients (65.6 %) were female, with a mean age of 59.0 (±12.1) years and 82.2 (±6.5) years, respectively. The experiment showed that increased home care hours, mixed health and social home care, caregiver meetings with professional support and lower monthly costs were mostly valued by caregivers. Some preference heterogeneity was detected in relation to care recipient's characteristics (e.g., age).Conclusions: These results are expected to inform policymakers about caregiver priorities in the field of dementia based on the values placed on hypothetical public home care services.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105220"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814916","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}

引用次数: 0

A conceptual framework to assess the health, socioeconomic and environmental burden of chronic kidney disease. 评估慢性肾脏疾病的健康、社会经济和环境负担的概念框架。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-26 DOI: 10.1016/j.healthpol.2024.105244

Charlotte Johnston-Webber, Isaac Bencomo-Bermudez, George Wharton, Robin van Kessel, Salvatore Barone, Francisco Brotons Muntó, Steven Chadban, Juan Jose Garcia Sanchez, Janwillem W H Kocks, Kyra Obolensky, Petra Sandow, Neil Skolnik, Ming-Hui Zhao, Alexei Volaco, David C Wheeler, Alistair McGuire, Elias Mossialos

{"title":"A conceptual framework to assess the health, socioeconomic and environmental burden of chronic kidney disease.","authors":"Charlotte Johnston-Webber, Isaac Bencomo-Bermudez, George Wharton, Robin van Kessel, Salvatore Barone, Francisco Brotons Muntó, Steven Chadban, Juan Jose Garcia Sanchez, Janwillem W H Kocks, Kyra Obolensky, Petra Sandow, Neil Skolnik, Ming-Hui Zhao, Alexei Volaco, David C Wheeler, Alistair McGuire, Elias Mossialos","doi":"10.1016/j.healthpol.2024.105244","DOIUrl":"10.1016/j.healthpol.2024.105244","url":null,"abstract":"Chronic kidney disease (CKD) is a global health challenge that affects patients, caregivers, healthcare systems, the environment and national economies. Despite its far-reaching impact, there is no framework to systematically evaluate national CKD prevention and management programmes or evaluate the societal burden of disease. This paper has two objectives: first, to introduce a comprehensive framework to assess national programmes, which recognises gaps and weaknesses and identifies feasible policy interventions to reduce overall CKD burden; second, to present some key challenges and success stories in delivering CKD services delivered in eight different country settings. A literature review informed an initial version of the framework, which was further developed and refined via collaboration with a panel of UK experts across relevant disciplines. This framework was then presented to seven other country expert panels (Australia, Brazil, China, Germany, the Netherlands, Spain and the USA) that made further refinements based on their country perspective. The resultant framework covers all health system levels, from preventive public health measures to primary, secondary and tertiary care, including dialysis, transplantation and palliative care. Furthermore, it evaluates the disease burden from economic, social and environmental perspectives. Each panel also discussed challenges regarding providing CKD services in their country and provided success stories, generating valuable insights into areas where policy initiatives could have positive impact on the various components of burden of disease.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105244"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016805","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}

引用次数: 0

The role of socio-economic determinants in the interregional allocation of healthcare resources: Some insights from the 2023 reform in the Italian NHS. 社会经济决定因素在医疗资源区域间分配中的作用：2023年意大利NHS改革的一些见解。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-27 DOI: 10.1016/j.healthpol.2024.105240

Roberto Fantozzi, Stefania Gabriele, Alberto Zanardi

{"title":"The role of socio-economic determinants in the interregional allocation of healthcare resources: Some insights from the 2023 reform in the Italian NHS.","authors":"Roberto Fantozzi, Stefania Gabriele, Alberto Zanardi","doi":"10.1016/j.healthpol.2024.105240","DOIUrl":"10.1016/j.healthpol.2024.105240","url":null,"abstract":"This paper discusses a reform recently implemented in the Italian National Health Service, aimed at adding some socio-economic indicators to the criteria adopted for allocating healthcare funding to Regions. The reform is based on international experience in healthcare financing in decentralized settings and provides a case study of special interest since Italy is a country with significant territorial disparities and severe budget constraints. The paper first discusses the long-standing debate between Italian Regions which led to the reform. Second, it reviews the main features of the reform which provides for the inclusion of socio-economic indicators via a simplified formula. Moreover, a possible revision of the reform is proposed, fully exploiting the information on the heterogeneity of health needs according to age and socio-economic indicators. By integrating the information on deprivation inside the risk adjustment mechanism, the weight of the different drivers is determined by the distribution of needs and not on a discretionary basis. Simulating the proposed revision suggests that more resources could be allocated to the Regions with higher levels of deprivation compared to a scenario that closely replicates the reform.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105240"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933319","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}

引用次数: 0

A historical overview of policy perspectives towards informal care in Taiwan (1996-2023). 台湾非正式照护政策展望之历史回顾（1996-2023）。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2025-01-20 DOI: 10.1016/j.healthpol.2024.105239

Yu-Ching Liu, Chen-Fen Chen

{"title":"A historical overview of policy perspectives towards informal care in Taiwan (1996-2023).","authors":"Yu-Ching Liu, Chen-Fen Chen","doi":"10.1016/j.healthpol.2024.105239","DOIUrl":"10.1016/j.healthpol.2024.105239","url":null,"abstract":"This paper examines the evolution of policy perspectives towards informal care in Taiwan, focusing on the development of carer support services. It traces the transition from self-funded services by the Taiwan Association of Family Caregivers (a nonprofit organisation), to services funded by the government. Taiwan's approach highlights the considerable changes brought about by the implementation of the Long-Term Care Services Act which elevated the legal status of carers. Other reforms include the establishment of community-based carer support centres, the introduction of a carer referral mechanisms, and the decentralisation of services to local governments. Carer policies in Taiwan have increasingly embraced the perspective of carers as co-clients, not only recognising their crucial role in the care ecosystem but also raising the profile of informal care in public policy. However, ensuring sustainable funding from the central government, which is vital for the continuation and expansion of carer support, presents a considerable challenge for future policy considerations. The Taiwanese experiences of integrating carers into the long-term care policy context and of decentralisation of carer support services to local governments, serve as a reference for other countries developing carer policies.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105239"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016799","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}

引用次数: 0

How beliefs and policy characteristics shape the public acceptability of nutritional policies-A survey study in Germany. 信念和政策特征如何影响公众对营养政策的接受度--德国的调查研究。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-03 DOI: 10.1016/j.healthpol.2024.105221

Marike Andreas, Anna K Kaiser, Raenhha Dhami, Vincent Brugger, Falko F Sniehotta

{"title":"How beliefs and policy characteristics shape the public acceptability of nutritional policies-A survey study in Germany.","authors":"Marike Andreas, Anna K Kaiser, Raenhha Dhami, Vincent Brugger, Falko F Sniehotta","doi":"10.1016/j.healthpol.2024.105221","DOIUrl":"10.1016/j.healthpol.2024.105221","url":null,"abstract":"Background: Despite the high prevalence of obesity in Germany, few effective political measures have been implemented to protect population health and improve the sustainability of food systems. One argument frequently raised against policy implementation is the lack of acceptability for policy measures in the German population.Aim: We aimed to evaluate the acceptability of policy measures currently discussed in Germany's national nutrition strategy and how perceived policy characteristics and participant characteristics influence policy acceptability.Method: We conducted an online survey with 2001 participants between 06.12.2023 and 05.01.2024, in which we collected data on perceived policy characteristics (acceptability, equity, societal and personal effectiveness), as well as participant values and beliefs.Results: Most policies were highly acceptable, with policies such as the introduction of free school lunches (84 % acceptability), the introduction of a ban on fast food advertising aimed at children (71 %) or a sugar tax (53 %) being acceptable to a majority of the sample. The least acceptable policy was the introduction of a tax on animal products (36 %). Logistic regression analyses showed that perceived equity and societal and personal effectiveness predicted policy acceptability. Likewise, environmental values and beliefs about state intervention of participants influenced policy acceptability.Conclusion: The high acceptability observed in this study suggests an opportunity for German policymakers to implement evidence-based and acceptable nutritional strategies to improve population health.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105221"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822620","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}

引用次数: 0

The right to health for socioeconomically disadvantaged TB patients in South Korea: An AAAQ framework analysis. 韩国社会经济状况不佳的肺结核患者的健康权：AAAQ 框架分析。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2024-12-09 DOI: 10.1016/j.healthpol.2024.105236

Juyeon Lee, Yeori Park, Myoung-Hee Kim

{"title":"The right to health for socioeconomically disadvantaged TB patients in South Korea: An AAAQ framework analysis.","authors":"Juyeon Lee, Yeori Park, Myoung-Hee Kim","doi":"10.1016/j.healthpol.2024.105236","DOIUrl":"10.1016/j.healthpol.2024.105236","url":null,"abstract":"Tuberculosis, a disease of poverty, continues to disproportionately affect socioeconomically disadvantaged populations worldwide. This is particularly concerning given the recent resurgence of TB following the COVID-19 pandemic. In South Korea, despite substantial socioeconomic development, TB remains a prominent problem, ranking as the leading infectious killer in the country. The severe stigma associated with TB, coupled with the significant vulnerability of TB patients, has resulted in the voices of these patients being completely underrepresented in both policy and research. This article addresses this research gap by conducting a qualitative assessment of Korea's national TB control efforts through the lens of the UN's AAAQ (Availability, Accessibility, Acceptability, Quality) right to health framework. Through field observations and 20 in-depth interviews with TB patients, healthcare providers, policymakers, and advocates, we explore the lived experiences of socioeconomically disadvantaged TB patients in accessing care and support in Korea. Findings reveal that the failure to integrate the right to health into TB care and support, including inadequate availability, accessibility, acceptability, and quality of services tailored to the needs of this population, contributes significantly to Korea's TB burden. The findings have important implications for TB policy and practice in countries with high TB burdens or those experiencing a resurgence of TB. Prioritizing the right to health in TB care and support is crucial to effectively combat this disease.","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"152 ","pages":"105236"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822621","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}

引用次数: 0

National COVID-19 plans: Equity is unlikely without public participation and transparency. 国家COVID-19计划：没有公众参与和透明度，公平是不可能的。

IF 3.6 3区医学

Health Policy Pub Date : 2025-02-01 Epub Date: 2025-01-03 DOI: 10.1016/j.healthpol.2024.105242

Alain Braillon

引用次数: 0