Health Policy最新文献_第10页

Urban–rural disparities in hospital admissions for depression in Austria 奥地利因抑郁症入院的城乡差异

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-19 DOI: 10.1016/j.healthpol.2024.105209

Michael Berger , Martin Zuba , Judit Simon

{"title":"Urban–rural disparities in hospital admissions for depression in Austria","authors":"Michael Berger , Martin Zuba , Judit Simon","doi":"10.1016/j.healthpol.2024.105209","DOIUrl":"10.1016/j.healthpol.2024.105209","url":null,"abstract":"<div><div>Medical practice variation in mental healthcare is a useful indicator for policymakers aiming to improve the efficiency of healthcare delivery. Previous studies have shown strong regional variation in healthcare utilisation in Austria, which seems to be a by-product of regionalised institutional rules and healthcare service mix rather than epidemiology. We use a set of routine municipality-level healthcare data on hospital admissions for depressive episodes of adult Austrian patients from 2009 to 2014 to examine spatial patterns in healthcare utilisation in mental health. Our data contains 93,302 hospital episodes by 65,908 adult patients across 2114 municipalities. We estimate a random-effects spatial autoregressive combined model to regress log hospital admission rates on hospital supply and urbanicity as proxies for municipality healthcare service mix alongside demographic and socioeconomic controls. We find that admissions for depression are substantially higher in suburban municipalities compared to rural areas and in municipalities with hospitals compared to those without. The spatial structure suggests positive spatial spillovers between neighbouring municipalities. Our main results are stable across virtually all model specifications used for robustness and show that healthcare service mix and supply of hospital services strongly correlate with spatial patterns of hospital admission rates in the population. Promoting timely access to high-quality primary care and early-stage treatments may reduce the burden of avoidable depression-related hospitalisations for patients and public budgets, and close a gap of unmet need for care of vulnerable populations.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"151 ","pages":"Article 105209"},"PeriodicalIF":3.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699580","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}

引用次数: 0

Mental health of Australian frontline nurses during the COVID-19 pandemic: Results of a large national survey COVID-19 大流行期间澳大利亚一线护士的心理健康：全国性大型调查的结果

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-19 DOI: 10.1016/j.healthpol.2024.105214

Akbar Zamanzadeh , Marion Eckert , Nadia Corsini , Pam Adelson , Greg Sharplin

{"title":"Mental health of Australian frontline nurses during the COVID-19 pandemic: Results of a large national survey","authors":"Akbar Zamanzadeh , Marion Eckert , Nadia Corsini , Pam Adelson , Greg Sharplin","doi":"10.1016/j.healthpol.2024.105214","DOIUrl":"10.1016/j.healthpol.2024.105214","url":null,"abstract":"<div><div>This paper investigates the effects of work demands on burnout indices of emotional exhaustion, depersonalization and personal accomplishment, and mental health indices of anxiety, depression and stress, among Australian nurses and midwives. We used de-identified self-reported survey data from approximately 11,000 Australian nurses and midwives during the pandemic. Linear and quantile regression analyses explored how working conditions affect different aspects of nurses and midwives' burnout and mental health. Results show how working conditions affect burnout and mental health heterogeneously depending on the severity of the mental health symptoms. Increased quantitative and emotional work demands significantly impact occupational burnout indices of emotional exhaustion and depersonalization, and mental health indices of anxiety, depression, and stress among Australian nurses and midwives. Quantitative and emotional demands have more significant effects on people with higher levels of anxiety, depression, stress, and depersonalization than on those with milder or lesser symptoms. Given recent national and international policy focus on psychosocial hazards at work, this paper suggests that governments and health care providers need to monitor such hazards among nurses and midwives and introduce policies that reduce excessive quantitative or emotional burden to minimise risk of burnout and poor mental health and support good mental health among nurses and midwives.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"151 ","pages":"Article 105214"},"PeriodicalIF":3.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699581","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}

引用次数: 0

The influenza vaccination's impact elderly's health outcomes in Catalonia (Spain) 流感疫苗接种对加泰罗尼亚（西班牙）老年人健康状况的影响。

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-14 DOI: 10.1016/j.healthpol.2024.105213

Toni Mora , Montserrat Martínez-Marcos , Carmen Cabezas-Peña

引用次数: 0

Derek Parfit, personal identity, and the obligation to reduce others' Suffering 德里克-帕菲特、个人身份以及减少他人痛苦的义务。

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-09 DOI: 10.1016/j.healthpol.2024.105201

Akshay Pendyal

引用次数: 0

Predictors of Croatian nurses' turnover intention: A cross-sectional study 克罗地亚护士离职意向的预测因素：横断面研究。

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-08 DOI: 10.1016/j.healthpol.2024.105198

Ivana Gusar , Dragan Šijan , Tomislav Sorić , Sonja Šare , Mediana Županović , Marija Ljubičić

{"title":"Predictors of Croatian nurses' turnover intention: A cross-sectional study","authors":"Ivana Gusar , Dragan Šijan , Tomislav Sorić , Sonja Šare , Mediana Županović , Marija Ljubičić","doi":"10.1016/j.healthpol.2024.105198","DOIUrl":"10.1016/j.healthpol.2024.105198","url":null,"abstract":"<div><div>The turnover intention rate among nurses is very high both worldwide, and in Europe. It is related to personal and professional factors that contribute to the decision to leave or stay. This descriptive cross-sectional study aimed to identify the personal and professional predictors that contribute to nurses’ turnover intention in Croatia. A convenient sample of 448 nurses employed in public general hospitals was used. The Practice Environment Scale of the Nursing Work Index questionnaire and the Turnover Intention Scale were applied. A logistic regression model was used to determine the associations between nurses' turnover intention and their personal and professional factors. The results indicate that both types of factors can influence nurses’ turnover intention. The associations between turnover intention and personal factors such as age (<em>p</em> = 0.033), gender (<em>p</em> = 0.023), job satisfaction (<em>p</em> < 0.001), and social satisfaction (<em>p</em> = 0.006), were recorded. Nurse participation in hospital affairs (<em>p</em> = 0.026), and the nurse manager ability, leadership, and support of nurses (<em>p</em> = 0.002), which are professional factors were also associated with turnover intention. In order to prevent turnover intention, continuous measures need to be planned and implemented to increase nurses' satisfaction and improve their working environment.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"151 ","pages":"Article 105198"},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640323","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

Physical activity policy implementation and physical activity levels in the European Union: Are we on track to close the gap between policy and practice? 欧盟的体育活动政策实施和体育活动水平：我们是否正在缩小政策与实践之间的差距？

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-08 DOI: 10.1016/j.healthpol.2024.105200

Stephen Whiting , Karim Abu-Omar , Peter Gelius , João Firmino-Machado , Ivo Rakovac , Romeu Mendes

{"title":"Physical activity policy implementation and physical activity levels in the European Union: Are we on track to close the gap between policy and practice?","authors":"Stephen Whiting , Karim Abu-Omar , Peter Gelius , João Firmino-Machado , Ivo Rakovac , Romeu Mendes","doi":"10.1016/j.healthpol.2024.105200","DOIUrl":"10.1016/j.healthpol.2024.105200","url":null,"abstract":"<div><div>National policies are a key starting point to achieve changes in population health. This study aimed to provide an overview of the relationship between physical activity policy implementation and the levels of sufficient physical activity across the European Union over the last decade.</div><div>Data from the 23 indicators of the European Union Health-Enhancing Physical Activity Monitoring Framework established to monitor country implementation of the European Union Physical Activity Guidelines from 2015, 2018 and 2021, and physical activity prevalence data from the Special Eurobarometer on Sport and Physical Activity in 2013, 2017 and 2022 were analysed.</div><div>European Union Member States significantly increased their physical activity policy implementation from 2015 to 2021 by 13.2 % (63.30 ± 18.89 versus 76.51 ± 14.94 %, <em>p</em> < 0.001, 95 % CI [-19.97, -6.45]). However, no significant change in levels of sufficient physical activity was found between 2013 and 2022 (60.59 ± 15.67 versus 61.70 ± 17.67 %, <em>p</em> = 0.360, 95 % CI [-3.61, 1.39]). Additionally, most European Union countries are not on track to meet the targeted 10 % relative reduction in levels of insufficient physical activity by 2025.</div><div>Physical activity policies in the European Union do not appear to be related with the intended goal of increasing levels of physical activity. Policies may need to be reviewed and policy monitoring expanded, strengthened, and better integrated.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"151 ","pages":"Article 105200"},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649876","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

Primary prevention in hospitals in 20 high-income countries in Europe – A case of not “Making Every Contact Count”? 欧洲 20 个高收入国家医院的初级预防--没有 "让每次接触都有价值"？

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-08 DOI: 10.1016/j.healthpol.2024.105199

Bernd Rechel , Béatrice Durvy , Gonçalo Figueiredo Augusto , Isabelle Aujoulat , Daiga Behmane , Anne-Carole Bensadon , Sara Burke , Melissa D'Agostino , Krisztina Davidovics , Mark Dayan , Antonio Giulio De Belvis , Judith de Jong , Katarzyna Dubas-Jakóbczyk , Inês Fronteira , Elena Gabriel , Giuseppe Greco , Peter Groenewegen , Signe Smith Jervelund , Marios Kantaris , Madelon Kroneman , Tuija Ylitörmänen

{"title":"Primary prevention in hospitals in 20 high-income countries in Europe – A case of not “Making Every Contact Count”?","authors":"Bernd Rechel , Béatrice Durvy , Gonçalo Figueiredo Augusto , Isabelle Aujoulat , Daiga Behmane , Anne-Carole Bensadon , Sara Burke , Melissa D'Agostino , Krisztina Davidovics , Mark Dayan , Antonio Giulio De Belvis , Judith de Jong , Katarzyna Dubas-Jakóbczyk , Inês Fronteira , Elena Gabriel , Giuseppe Greco , Peter Groenewegen , Signe Smith Jervelund , Marios Kantaris , Madelon Kroneman , Tuija Ylitörmänen","doi":"10.1016/j.healthpol.2024.105199","DOIUrl":"10.1016/j.healthpol.2024.105199","url":null,"abstract":"<div><div>This article provides a snapshot of primary prevention activities in hospitals in 20 European high-income countries, based on inputs from experts of the Observatory's Health Systems and Policies Monitor (HSPM) network using a structured questionnaire. We found that in the vast majority of countries (15), there are no systematic national policies on primary prevention in hospitals. Five countries (Cyprus, Finland, Ireland, Romania and the United Kingdom) reported systematic primary prevention activities in hospitals, although in one of them (Cyprus) this was due to the fact that small hospitals in rural areas or less populated districts host providers of primary care. In two of the five countries with systematic national policies on primary prevention, there are no incentives (financial or otherwise) to provide these interventions. The remaining three countries (Finland, Romania and the United Kingdom) report the existence of incentives, but only two of them (Romania and the United Kingdom) provide financial incentives in the form of additional funding. Only two of the 20 countries (Ireland and the United Kingdom) make explicit use of the Making Every Contact Count (MECC) approach. Overall, it can be concluded that there is little focus on primary prevention in hospitals in Europe, which may be seen as a missed opportunity.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"151 ","pages":"Article 105199"},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649878","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

NHS action on social and economic development in England: Vague national policy expectations 英国国家医疗服务体系在社会和经济发展方面的行动：模糊的国家政策期望。

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-02 DOI: 10.1016/j.healthpol.2024.105194

Phoebe Dunn, Lucinda Allen, Luisa Buzelli, Leo Ewbank, Hugh Alderwick

{"title":"NHS action on social and economic development in England: Vague national policy expectations","authors":"Phoebe Dunn, Lucinda Allen, Luisa Buzelli, Leo Ewbank, Hugh Alderwick","doi":"10.1016/j.healthpol.2024.105194","DOIUrl":"10.1016/j.healthpol.2024.105194","url":null,"abstract":"<div><div>Under recent reforms to the National Health Service (NHS) in England, NHS organizations have been given new objectives to contribute to social and economic development. Health systems in other high-income countries are pursuing related approaches. This paper analyses national policy documents to understand the framing of the NHS's new policy priorities on social and economic development. We focus on the role of NHS integrated care systems—area-based planning bodies responsible for managing NHS resources and coordinating local services. National policy is vague about what social and economic development means in practice. There is limited guidance on which approaches local organizations should prioritize, and which organisations are responsible for implementation. Greater clarity from national policymakers and an overarching framework to guide local action is needed to reduce the risk of inaction, poorly targeted interventions, and missed opportunities for learning and evaluation. Policymakers and health system leaders also need to be realistic about the limits of local action given the importance of national public policy choices in shaping the social determinants of health. Coordinated policy action and investment across government is needed to address underlying social and economic conditions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"151 ","pages":"Article 105194"},"PeriodicalIF":3.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632337","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}

引用次数: 0

Scaling up integrated care: Can community hospitals be an answer? A multiple-case study from the Emilia-Romagna region in Italy. 扩大综合护理：社区医院能解决问题吗？来自意大利艾米利亚-罗马涅大区的多案例研究。

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-01 DOI: 10.1016/j.healthpol.2024.105192

Francesca Meda, Michela Bobini, Michela Meregaglia, Giovanni Fattore

{"title":"Scaling up integrated care: Can community hospitals be an answer? A multiple-case study from the Emilia-Romagna region in Italy.","authors":"Francesca Meda, Michela Bobini, Michela Meregaglia, Giovanni Fattore","doi":"10.1016/j.healthpol.2024.105192","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105192","url":null,"abstract":"<p><p>Integrated care is considered to be essential in improving care for people with chronic conditions who need continuous care. In 2022, the Italian Government asked all regions to build or renovate a massive number of community care facilities, employing European Next Generation funds, to be spent by 2026. Under the theoretical lens of the Structural Contingency Theory, the paper aims at aims at describing the contextual and organizational factors underlying the interconnection between integrated care and community hospitals. The study employs a multiple-case study design, relying both on quantitative and qualitative data, conducted in a 6 months-period. It investigated seven community hospitals belonging to a single Local Health Authority in Emilia-Romagna region in Italy. The choice of the empirical context was driven by Emilia-Romagna's long- and well-established tradition of community-based care. Overall, our analysis shows that community hospitals offers opportunities of integrated care, including better integration between care sectors, between primary care and specialist staff, between healthcare structures and their local community. The study confirms the value of the Structural Contingency Theory and its key message: implementation is not a mechanical step of the policy cycle and requires important adjustments to the planning phase according to environment and organizational factors.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":" ","pages":"105192"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592333","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

Abolishing age criterion to determine organ transplant recipients in Israel: A qualitative study of medical staff perceptions 以色列取消器官移植受者年龄标准：对医务人员看法的定性研究。

IF 3.6 3区医学

Health Policy Pub Date : 2024-11-01 DOI: 10.1016/j.healthpol.2024.105197

Eyal Katvan , Orly Korin , Israel Issi Doron , Eytan Mor , Boaz Shnoor , Daniel Gelman , Tamar Ashkenazi

{"title":"Abolishing age criterion to determine organ transplant recipients in Israel: A qualitative study of medical staff perceptions","authors":"Eyal Katvan , Orly Korin , Israel Issi Doron , Eytan Mor , Boaz Shnoor , Daniel Gelman , Tamar Ashkenazi","doi":"10.1016/j.healthpol.2024.105197","DOIUrl":"10.1016/j.healthpol.2024.105197","url":null,"abstract":"<div><h3>Introduction</h3><div>Since April 2014 the age limitation on candidates listed for organ transplantation in Israel was abolished following the recommendations of a Public Committee. In this research the new policy was examined in light of scarce medical resources and the increased rate of aging in Israel.</div></div><div><h3>Methods</h3><div>The opinions of twelve medical staff regarding the policy change were analyzed by a qualitative methodology, using semi-structured interviews.</div></div><div><h3>Results</h3><div>Interviews with medical staff members revealed three main themes: 1. positive acceptance of the new policy; 2. concerns and problems regarding the change; and 3. the influence of the policy change on the organ transplant allocation system and patient-doctor relationships.</div></div><div><h3>Discussion and Conclusions</h3><div>The medical staff expressed positive views towards the new policy, based on age-free, individually determined admission to transplant waiting lists. However, some concerns were raised regarding the medical implications of this policy, thus potentially hindering its full application.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105197"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607506","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