Health Policy最新文献

{"title":"Corrigendum to “Impact of territorial case management on hospital admissions for complex chronic patients in Catalonia (Spain)” [Health Policy 159 (2025) 105384]","authors":"Jesús Antonio Vaquero Cruzado , Nuria Gutiérrez Jiménez , Laura Carrillo Ciércoles , Eva García Tarrida , María Jesús Megido Badía , Nuria Fabrellas Padrés","doi":"10.1016/j.healthpol.2025.105405","DOIUrl":"10.1016/j.healthpol.2025.105405","url":null,"abstract":"","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105405"},"PeriodicalIF":3.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671085","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":"A new integrated conceptual framework of health insurance literacy: Results of a critical interpretive synthesis","authors":"Reut Ron ,&nbsp;Paula Feder-Bubis ,&nbsp;Kierstin Trocha ,&nbsp;Moriah Ellen","doi":"10.1016/j.healthpol.2025.105394","DOIUrl":"10.1016/j.healthpol.2025.105394","url":null,"abstract":"<div><div>Health insurance literacy (HIL) is the knowledge, ability, and confidence to find and understand health insurance information, and choose, purchase and use an insurance plan. Despite the increasing volume of research on HIL, the approaches to this field remain fragmented.</div><div>This review paper aims to develop a conceptual framework delineating the attributes, personal contexts, and environmental influences, which either influence or are influenced by an individual's HIL level.</div><div>We have adopted a critical interpretive synthesis approach with purposive sampling and inductive analysis, integrating all existing models from the literature, with additional findings. The CIS methodology emphasizes iterative data synthesis to generate theory from diverse sources, ceasing data extraction upon achieving theoretical saturation. This reflects the stage at which further data collection no longer yields new conceptual insights.</div><div>Four databases were systematically screened in September 2020 and July 2023, yielding 6096 articles. Following a review of titles and abstracts, 388 papers were deemed relevant, and 76 were included in the final synthesis. The resulting framework consists of eight categories, 17 subcategories, and 129 codes, with HIL level as its core. Other components include individual predictors, external influences, skills and abilities, perceptions and beliefs, preferences, decision-making processes, and outcomes.</div><div>This framework provides a comprehensive tool for guiding interventions and research aimed at improving HIL. It allows researchers and policymakers to address the diverse and interconnected factors influencing HIL and to develop targeted, evidence-based strategies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105394"},"PeriodicalIF":3.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634555","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":"Under what conditions do people accept health inequality? A cross-national regression analysis of OECD countries","authors":"Minjung Kim,&nbsp;Young Jun Choi","doi":"10.1016/j.healthpol.2025.105398","DOIUrl":"10.1016/j.healthpol.2025.105398","url":null,"abstract":"<div><h3>Background</h3><div>Health inequality remains a persistent challenge for welfare states. Over the past two decades (1999–2019), neoliberal policies and rising inequality have significantly influenced these attitudes.</div></div><div><h3>Objective</h3><div>The study investigates the evolution of public attitudes towards health inequality in OECD countries and evaluates the interaction between institutional structures and societal norms over time.</div></div><div><h3>Methods</h3><div>This study employs a longitudinal quantitative design utilizing data from the International Social Survey Programme (ISSP) Social Inequality module (1999, 2009, 2019) across 12 OECD countries. Descriptive analysis and multiple linear regression models were conducted to test grievance and policy feedback theories.</div></div><div><h3>Results</h3><div>In 1999, countries with lower public healthcare spending and higher inequality exhibited strong opposition to health inequality. However, by 2019, attitudes shifted, with opposition decreasing in highly unequal societies and increasing in countries with robust public healthcare spending. Regression analyses revealed significant changes over time, suggesting a transition from grievance-based responses to inequality toward acceptance influenced by policy feedback effects.</div></div><div><h3>Conclusions</h3><div>The findings underscore the need for policymakers to consider long-term policy impacts on public perceptions. Institutional frameworks fostering equitable healthcare access can counter the normalization of inequality, thereby promoting societal resistance to health disparities.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105398"},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663663","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":"Strengthening primary health care: The new contribution of midwives to gynecological care in France","authors":"Quitterie Roquebert ,&nbsp;Henri Panjo ,&nbsp;Carine Franc","doi":"10.1016/j.healthpol.2025.105397","DOIUrl":"10.1016/j.healthpol.2025.105397","url":null,"abstract":"<div><div>Many OECD countries are implementing reforms that redefine the roles of healthcare professionals to improve access to care and enhance the efficiency of the healthcare sector. In 2009, in a context of a shortage of gynecological primary care, France introduced a reform that expanded midwives’ scope of practice to include gynecological care for non-pregnant women, alongside their traditional roles in pregnancy and childbirth. This paper explores the effect of this reform on women’s healthcare utilization and examines how this effect varies according to women’s characteristics. Using administrative data on healthcare utilization among French women, we analyze changes in the probability of consulting a midwife between 2007 and 2017 among non-pregnant women aged 15 to 55. Our results show an increase in midwives’ use following the reform, particularly among recently pregnant women and those living in areas with poor access to healthcare services. Overall, the effect of the reform extending the primary care roles of health professionals on the use of care depends strongly on the provision of information about these new skills to the general public. Furthermore, we show that this reform is likely to strengthen the gynecological primary care supply in disadvantaged areas.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105397"},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654453","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":"Unraveling the policies, legislations, and regulations of psychedelics in Australia, Canada, Netherlands, New Zealand, and India","authors":"Ramesh Joga ,&nbsp;Sravani Yerram ,&nbsp;Jayasri Devi Patnam ,&nbsp;Khushbhoo K. Choudhary ,&nbsp;Priya Varpe ,&nbsp;Rajeev Singh Raghuvanshi ,&nbsp;Saurabh Srivastava","doi":"10.1016/j.healthpol.2025.105392","DOIUrl":"10.1016/j.healthpol.2025.105392","url":null,"abstract":"<div><h3>Background</h3><div>Research into psychedelics has gained renewed interest due to their potential to address psychiatric, neurological, and other peripheral conditions. These substances offer long-term therapeutic benefits, contrasting with the side effects and limitations of current psychiatric medicines.</div></div><div><h3>Objective</h3><div>This study examines the legislations and regulatory frameworks for psychedelics in Australia, Canada, The Netherlands, New Zealand, and India, highlighting their varied approaches to legalization, medical use, and integration into healthcare systems.</div></div><div><h3>Methods</h3><div>A comparative analysis of the regulatory landscapes in the selected countries was conducted, focusing on policies, clinical trial practices, and the ethical considerations surrounding psychedelics. Data were drawn from government documents, regulatory databases, and peer-reviewed literature.</div></div><div><h3>Results</h3><div>Australia legalized MDMA for post-traumatic stress disorder and psilocybin for treatment-resistant depression, establishing a structured prescription system for authorized psychiatrists. Canada and The Netherlands supports therapeutic use through regulated clinical trials and limited exemptions under strict controls, reflecting cautious but progressive approaches. New Zealand demonstrates exploratory interest in psychedelics within a controlled regulatory framework. India maintains stringent prohibitions with severe penalties for possession and use, despite emerging research indicating potential medical benefits.</div></div><div><h3>Conclusions</h3><div>Australia, Canada, The Netherlands, and New Zealand have taken pioneering steps in integrating psychedelics into medical practice, guided by evolving scientific evidence and ethical considerations. In contrast, India's conservative regulatory stance highlights significant barriers to exploring the medical potential of psychedelics. As global perspectives shift, balancing scientific advancements with robust regulatory measures will be crucial for shaping public health policies and fostering therapeutic innovation.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105392"},"PeriodicalIF":3.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678999","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":"Mental health as a determinant of work: a scoping review on the impact of mental health on precarious employment","authors":"Claire de Oliveira ,&nbsp;Margaret Jamieson ,&nbsp;Sara Bonato","doi":"10.1016/j.healthpol.2025.105395","DOIUrl":"10.1016/j.healthpol.2025.105395","url":null,"abstract":"<div><h3>Background</h3><div>While many studies have examined the impact of precarious employment on mental health, the reverse relationship has received less attention.</div></div><div><h3>Objectives</h3><div>The objectives of this scoping review were to ascertain the existing literature examining the impact of mental health on precarious employment and to describe, synthesise, and critically appraise it.</div></div><div><h3>Methods</h3><div>Business Source Premier, EconLit, Embase, MEDLINE, PsycINFO, and Web of Science were searched from 1 January 1980 to 30 August 2024. Additionally, searches were undertaken in Google and specific websites; references of key papers were also examined. Relevant data were extracted from studies, and their quality was assessed, namely whether they accounted for endogeneity. Evidence was synthesised by mental disorder/illness/problem using a narrative synthesis approach.</div></div><div><h3>Results</h3><div>After duplicates were removed, the search yielded 10,048 unique records; ultimately, 19 relevant papers, corresponding to 20 unique studies, were deemed relevant. Few specifically focused on mental health as a determinant of precarious employment and/or recognised the potential presence of endogeneity. Studies found mixed evidence on the relationship between mental health and precarious employment. While the evidence suggests that psychological distress and mental health complaints likely increase the probability of precarious employment, anxiety and emotional exhaustion likely do not. The evidence on depressive disorders is mixed/inconclusive.</div></div><div><h3>Conclusion</h3><div>Some of the existing literature suggests that people with poor mental health may be at a higher risk of precarious employment; however, in some instances, the evidence was either mixed/inconclusive or absent. More high-quality studies are needed to inform clear policy recommendations.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105395"},"PeriodicalIF":3.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588131","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":"Operationalising public trust for health policymakers - A qualitative study in the EU, France, Italy, and Switzerland","authors":"Federica Zavattaro ,&nbsp;Viktor von Wyl ,&nbsp;Felix Gille","doi":"10.1016/j.healthpol.2025.105393","DOIUrl":"10.1016/j.healthpol.2025.105393","url":null,"abstract":"<div><h3>Background</h3><div>Public trust is crucial for the success of health data-sharing initiatives (HDSIs), as it influences public participation. Although the potential for policies to actively foster trust is widely acknowledged, recent policy analyses suggest that this opportunity is often overlooked in practice.</div></div><div><h3>Objective</h3><div>To investigate if and how health policymakers at the European Union level and in France, Italy, and Switzerland prioritise and integrate public trust into their policy work, identifying key gaps and providing preliminary guidance to bridge them.</div></div><div><h3>Methods</h3><div>We conducted 57 semi-structured online interviews with policymakers involved in HDSIs at different stages of the policy process: 20 at the European level, 11 in France, 13 in Italy, and 13 in Switzerland. An inductive thematic approach was employed to identify emerging themes.</div></div><div><h3>Results</h3><div>Policymakers recognise public trust as crucial for public participation in HDSIs, yet no shared definition of trust in health data-sharing emerged. In France, trust-building is treated as a policy priority and embedded in stakeholder and public engagement processes prior to legislation. At the European, Italian, and Swiss levels, trust remains a vague concept, addressed implicitly without clear strategies. Policymakers highlighted the absence of specific guidance on trust-building and called for its development.</div></div><div><h3>Conclusions</h3><div>We identified a lack of harmonisation among policymakers regarding the definition of public trust and its translation into policy. In response, we propose a working definition of public trust in health data-sharing and highlight the urgent need for concrete, actionable tools to support policymakers in integrating trust-building principles into health data-sharing policies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105393"},"PeriodicalIF":3.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604805","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":"Developing recommendations and actions for integrated services delivery through primary health care teams in Canada: a deliberative dialogue approach for a national knowledge translation event.","authors":"Nelly D Oelke, Ashmita Rai, Peter Hirschkorn, Breton Mylaine, Catherine Donnelly, Stephanie Montesanti, Gaboury Isabelle, Karin Maiwald, Paul Wankah","doi":"10.1016/j.healthpol.2025.105391","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105391","url":null,"abstract":"<p><p>Primary health care teams are a key strategy in providing integrated care, particularly for patients with multiple chronic conditions. Despite a strong commitment to improving primary health care through team-based care globally, challenges to its implementation remain. A comparative policy analysis was conducted in four Canadian provinces (British Columbia, Alberta, Ontario, and Quebec) to examine the policies and structures supporting service integration for patients with two or more chronic conditions through primary health care teams. Results are reported on Phase 3 of the project, including a national knowledge translation event to refine recommendations and develop actions for implementing recommendations related to team-based primary health care in policy and practice. Our virtual knowledge translation event took place in June 2022; with 25 participants including policymakers, decision-makers, providers, patients and researchers. Eight key recommendations were discussed and revised with feedback and strategies for implementation developed. Five themes were identified from the discussions: 1) composition of the team and access; 2) communication and electronic health records; 3) remuneration; 4) patient engagement; and performance measurement. Recommendations for policy and practice are outlined and compared to existing Canadian and international literature.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":" ","pages":"105391"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621151","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 in the German outpatient sector","authors":"Beate Jochimsen ,&nbsp;Bernhard Gibis","doi":"10.1016/j.healthpol.2025.105389","DOIUrl":"10.1016/j.healthpol.2025.105389","url":null,"abstract":"<div><div>Outpatient medical care in Germany has traditionally been delivered by self-employed physicians, primarily in solo or small group practices. A 2004 reform allowed corporate private investors, to finance outpatient care for the first time. Since then, the establishment of so-called medical care centres (MCCs) has become a staple of public healthcare. From the outset, concerns have been raised that economic interests could conflict with the values of a public health system. However, there is a notable lack of empirical evidence to support this potential conflict. This study seeks to narrow the empirical gap using three methodological approaches: a scoping review, identification of relevant data sources, and a brief case study. Our findings indicate that, to date, there is no empirical evidence suggesting a decline in the quality or scope of healthcare services when MCCs are financed by private equity investors. Nonetheless, the potential emergence of oligopolistic structures and a lack of transparency in provider ownership and structure call for careful regulatory oversight. Policy recommendations include strengthening the data infrastructure with respect to medical outcomes, costs, and provider characteristics (e.g. ownership or affiliations), and safeguarding medical decision-making from profit-driven influence by owners. As rising private investment, including private-equity, in outpatient care is observed across nearly all healthcare systems, an internationally comparative approach is essential.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105389"},"PeriodicalIF":3.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654452","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 burden of disease estimates in European Union Health policymaking: A systematic analysis of EU legislation","authors":"José Chen-Xu ,&nbsp;Diana Grad ,&nbsp;Nour Mahrouseh ,&nbsp;João Vasco Santos ,&nbsp;Silvia Riva ,&nbsp;Federica Gazzelloni ,&nbsp;Brigid Unim ,&nbsp;Periklis Charalampous ,&nbsp;Enkeleint A. Mechili ,&nbsp;Sarah Cuschieri ,&nbsp;Vanessa Gorasso ,&nbsp;Henk Hilderink ,&nbsp;Orsolya Varga ,&nbsp;Susana Viegas","doi":"10.1016/j.healthpol.2025.105387","DOIUrl":"10.1016/j.healthpol.2025.105387","url":null,"abstract":"<div><h3>Background</h3><div>The use of burden of disease (BoD) metrics in policymaking is crucial for evidence-based decision-making. However, there is currently no information available regarding their utilisation in policies at the European level.</div></div><div><h3>Objective</h3><div>This study aimed to analyse the use of BoD metrics within the European legislation.</div></div><div><h3>Methods</h3><div>Systematic searches on EUR-Lex were conducted for documents published between 2004 and 2023, to account for European Union-25 (EU-25). Network and qualitative analyses of documents were conducted to assess the legislation content.</div></div><div><h3>Results</h3><div>In total, 2615 documents were found, of which 191 included BoD metrics. Among the selected documents, 131 (69 %) were published after 2018. Ten were legally binding documents. The most prevalent EuroVoc (EU’s multilingual and multidisciplinary thesaurus) domains were social questions and environment. The most frequent EuroVoc terms were climate change policy (<em>n</em> = 45), EU environmental policy (<em>n</em> = 32) and pollution control measures (<em>n</em> = 32). The most common EU institution responsible for the retrieved documents was the European Commission (<em>n</em> = 152). As for the purposes of usage, argument (<em>n</em> = 93) and impact assessment (<em>n</em> = 50) were most common. Most BoD metrics were localized in the main text (<em>n</em> = 122).</div></div><div><h3>Conclusion</h3><div>Despite growing recognition of BoD metrics in supporting policymaking, their use remains focused on environmental health topics. Further efforts in training policymakers, knowledge dissemination and policy-oriented research could enhance the uptake of BoD studies in EU policies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105387"},"PeriodicalIF":3.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581091","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}