Health Policy最新文献_第10页

Which factors influence the decision of hospitals to provide procedures on an outpatient basis? –Mixed-methods evidence from Germany 哪些因素影响医院决定在门诊提供手术？-来自德国的混合方法证据。

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-25 DOI: 10.1016/j.healthpol.2024.105193

Robert Messerle , Fenja Hoogestraat , Eva-Maria Wild

{"title":"Which factors influence the decision of hospitals to provide procedures on an outpatient basis? –Mixed-methods evidence from Germany","authors":"Robert Messerle , Fenja Hoogestraat , Eva-Maria Wild","doi":"10.1016/j.healthpol.2024.105193","DOIUrl":"10.1016/j.healthpol.2024.105193","url":null,"abstract":"<div><div>Shifting care from the resource-intensive inpatient setting to the more economically efficient outpatient sector is being promoted internationally by policymakers. Financial incentives are a major focus of such efforts because low levels of hospital outpatient care are attributed to differences in payment for inpatient and outpatient services. In Germany, however, there is significant variation in the extent to which hospitals provide outpatient care despite a uniform payment system. Therefore, other factors must be influencing German hospitals’ strategic decisions whether to offer outpatient care. While most research has focused on specific procedures or lacks empirical support, our study provides a comprehensive analysis of the factors beyond financial incentives that influence the provision of hospital outpatient services in Germany. We employed a mixed-methods approach, first contacting health care experts with in-depth knowledge of the hospital outpatient landscape to identify possible influencing factors and then conducting a comprehensive quantitative analysis of all German hospitals. Our findings suggest that policymakers seeking to promote hospital outpatient care should consider a broad range of factors. We found that a hospital's service mix, size, procedure volume, and emergency care infrastructure significantly affected the proportion of outpatient services it offered. Strategic hospital planning emphasizing specialization and adherence to minimum volume standards might therefore be a valuable policy tool. Our analysis also highlights the importance of demographic and socioeconomic factors, such as the regional share of single-person households, suggesting that a comprehensive policy framework should account for broader population characteristics and not just elements directly related to hospital care.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105193"},"PeriodicalIF":3.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564778","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

Variation in attendance at emergency departments in England across local areas: A system under unequal pressure 英格兰各地区急诊室就诊人数的差异：压力不均的系统

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-22 DOI: 10.1016/j.healthpol.2024.105186

Nikita Jacob , Martin Chalkley , Rita Santos , Luigi Siciliani

{"title":"Variation in attendance at emergency departments in England across local areas: A system under unequal pressure","authors":"Nikita Jacob , Martin Chalkley , Rita Santos , Luigi Siciliani","doi":"10.1016/j.healthpol.2024.105186","DOIUrl":"10.1016/j.healthpol.2024.105186","url":null,"abstract":"<div><h3>Background</h3><div>Crowding in Accident and Emergency Departments (AEDs) and long waiting times are critical issues contributing to adverse patient outcomes and system inefficiencies. These challenges are exacerbated by varying levels of AED attendance across different local areas, which may reflect underlying disparities in primary care provision and population characteristics.</div></div><div><h3>Method</h3><div>We used regression analysis to determine how much variation across local areas in England of attendance at emergency departments remained after controlling for population risk factors and alternative urgent care provision.</div></div><div><h3>Findings</h3><div>There is substantial residual variation of the order of 3 to 1 (highest to lowest) in per person attendance rate across different areas. This is not related to in-hospital capacity as proxied by the per person number of hospital emergency doctors in an area.</div></div><div><h3>Conclusion</h3><div>Some areas in England have emergency departments that are under much greater pressure than others, and this cannot be explained in terms of their population characteristics or the availability of alternative treatment options. It is imperative to better understand the drivers of this variation so that effective interventions to address utilisation can be designed.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105186"},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552417","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

RSV prevention options for infants and older adults: A specific expanding competitive arena 婴儿和老年人 RSV 预防方案：不断扩大的特定竞争领域。

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-20 DOI: 10.1016/j.healthpol.2024.105187

Livio Garattini , Antonio Clavenna

{"title":"RSV prevention options for infants and older adults: A specific expanding competitive arena","authors":"Livio Garattini , Antonio Clavenna","doi":"10.1016/j.healthpol.2024.105187","DOIUrl":"10.1016/j.healthpol.2024.105187","url":null,"abstract":"<div><div>Respiratory Syncytial Virus (RSV) is an ubiquitous respiratory virus, which spreads like seasonal influenza throughout winter time in temperate climate countries. RSV infections are usually mild in healthy children and adults, but may be severe in premature infants, young children with congenital heart disease or chronic lung disease, immunocompromised individuals and frail elderly people.</div><div>At present, the pharmaceutical options to prevent RSV negative effects can be divided into monoclonal antibodies (mABs) and vaccines (active immunization). The two mABs licensed so far are indicated only for infants, while the first vaccines approved are mainly recommended for older adults.</div><div>The pharmaceutical competitive arena of products to prevent RSV negative effects has recently become very crowded after more than two decades with only one mAB as the unique option. Here, we try to put order in the dramatically increasing mix of very different products which have been recently launched. The aim of our effort is to provide some suggestions for European policy makers in order to limit the potentially relevant financial impact of these new expensive options on public pharmaceutical expenditures. We hope the suggested strategies might help to avoid transforming RSV from an apparently underscored health issue into a clearly overestimated health risk for the whole population in European countries. This dramatic change could be driven by a bunch of powerful multinational companies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105187"},"PeriodicalIF":3.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513278","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

Social innovation management to support integrated care: Insights from an Italian revelatory case study. 支持综合护理的社会创新管理：意大利启示性案例研究的启示。

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-19 DOI: 10.1016/j.healthpol.2024.105188

Francesca Costanza, Giada Li Calzi

{"title":"Social innovation management to support integrated care: Insights from an Italian revelatory case study.","authors":"Francesca Costanza, Giada Li Calzi","doi":"10.1016/j.healthpol.2024.105188","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105188","url":null,"abstract":"<p><p>This research deals with Social Innovation (SI) and integrated and connected care in the hospital care, presenting a successful experience of telemedicine's implementation within the Italian context. Nowadays integrated care and connected care are relevant concepts for delivering people-centered healthcare; though their operationalization is challenging and requires accounting for systems' complexity. In this regard, SI may be a catalyst, since it consists in a kind of innovation motivated by social needs. Extant research on SI in healthcare is scant and fragmentary, overlooking operational features and enabling conditions. Considering these gaps, the paper investigates the potential contribution of SI management to integrated and connected care. For the purpose, it offers a revelatory case study, concerning the pediatric research hospital Gaslini (Genoa, Italy), which is, to our knowledge, the first Italian public hospital to have hired a SI manager. By referring to a telemedicine pilot project, the study analyzes main features of the SI management process and its approach to promote integrated and connected care. Research data are analyzed by combining Gioia methodology and systems thinking. The resulting grounded theory model is causal loops-shaped and highlights virtuous mechanisms of SI unveiling generative voids and existing skills.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":" ","pages":"105188"},"PeriodicalIF":3.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549030","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

Does financial incentive for diabetes management in the primary care setting reduce avoidable hospitalizations and mortality in high-income countries? A systematic review 在高收入国家，对基层医疗机构的糖尿病管理进行经济激励是否能降低可避免的住院率和死亡率？系统回顾

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-18 DOI: 10.1016/j.healthpol.2024.105189

Thaksha Thavam , Michael Hong , Rose Anne Devlin , Kristin K Clemens , Sisira Sarma

{"title":"Does financial incentive for diabetes management in the primary care setting reduce avoidable hospitalizations and mortality in high-income countries? A systematic review","authors":"Thaksha Thavam , Michael Hong , Rose Anne Devlin , Kristin K Clemens , Sisira Sarma","doi":"10.1016/j.healthpol.2024.105189","DOIUrl":"10.1016/j.healthpol.2024.105189","url":null,"abstract":"<div><div>Effective diabetes management can prevent avoidable diabetes-related hospitalizations. This review examines the impact of financial incentives for diabetes management in primary care settings on diabetes-related hospitalizations, hospitalization costs, and premature mortality. To assess the evidence, we conducted a literature search of studies using five databases: Medline, Embase, Scopus, CINAHL and Web of Science. We examined the results by health insurance system, study quality or diabetes population (newly diagnosed diabetes). We identified 32 articles ranging from fair- to high-quality: 19 articles assessed the relationship between financial incentives for diabetes management and hospitalizations, 8 assessed hospitalization costs, and 15 assessed mortality. Many studies found that financial incentives for diabetes management reduced hospitalizations, while a few found no effects. Similar findings were evident for hospitalization costs and mortality. The results did not differ by the type of health insurance system, but the quality of the studies did matter; most high-quality studies reported reduced hospitalizations and/or mortality. We also found that financial incentives tend to be beneficial for patients with newly diagnosed diabetes. We conclude that well-designed diabetes management incentives can reduce diabetes-related hospitalizations, especially for newly diagnosed diabetes patients.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105189"},"PeriodicalIF":3.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592568","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

German centralization strategy during COVID-19: Continuing or interrupting a trend? COVID-19 期间德国的集权战略：延续还是中断趋势？

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-08 DOI: 10.1016/j.healthpol.2024.105177

Ines Marina Niehaus , Andreas Lehr , André Kaiser , Helena Sophie Müller , Ludwig Kuntz

{"title":"German centralization strategy during COVID-19: Continuing or interrupting a trend?","authors":"Ines Marina Niehaus , Andreas Lehr , André Kaiser , Helena Sophie Müller , Ludwig Kuntz","doi":"10.1016/j.healthpol.2024.105177","DOIUrl":"10.1016/j.healthpol.2024.105177","url":null,"abstract":"<div><div>In response to the COVID-19 pandemic, many countries applied centralization strategies to the distribution of power between national government and regional/local governments over responsibility for regulatory tasks. As a result, health-policy decision-making competences were shifted from the regional level to the national level (vertical shift of decision-making competences). This centralization trend for the purpose of infection control is evident in Germany. We conducted a quantitative and qualitative analysis of health-policy regulatory measures (March 2018 to March 2020) in order to investigate whether the vertical shift in decision-making competences was already a trend in Germany before the COVID-19 pandemic and beyond infection control. Our results show that the centralization strategy observed during COVID-19 does not continue a trend. Before the COVID-19 pandemic, what was most important was the distribution of power at national level between government and non-government institutions (horizontal allocation of decision-making competences). This long-term trend strengthens the decision-making competences of government institutions and weakens non-government institutions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105177"},"PeriodicalIF":3.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592564","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

Impact of local sports policies in the prevalence of cardiovascular disease: An assessment with spatial data analysis 地方体育政策对心血管疾病发病率的影响：空间数据分析评估

IF 3.6 3区医学

Health Policy Pub Date : 2024-10-06 DOI: 10.1016/j.healthpol.2024.105179

Miguel Viegas , João Valente dos Santos , Manuel João Coelho e Silva

{"title":"Impact of local sports policies in the prevalence of cardiovascular disease: An assessment with spatial data analysis","authors":"Miguel Viegas , João Valente dos Santos , Manuel João Coelho e Silva","doi":"10.1016/j.healthpol.2024.105179","DOIUrl":"10.1016/j.healthpol.2024.105179","url":null,"abstract":"<div><div>According to the World Health Organization, 17 million people die every year of cardiovascular diseases (CVD), particularly heart attacks and strokes. More than half of all deaths across the Europe are caused by CVDs. 80 % of premature deaths from these causes could be avoided by controlling the main risk factors: tobacco, unhealthy diet and physical inactivity.</div><div>Local authorities provide sport and recreation facilities to their communities. They also have a central role in forging partnerships with public and private sector to enhance the local sport delivery system.</div><div>The present paper consists of an empirical exercise about the statistical relationship between the financial effort of Portuguese municipalities in the implementation of sports policies and the prevalence of CVDs. The estimation of a Spatial Autocorrelation Model confirms the strong spatial dependence between neighbouring municipalities and validates the existence of a positive impact of local sports policies on mortality rate from cardiovascular diseases. The results raise the need to reinforce local policies to promote active living based on holistic approaches to combating heart disease and promoting healthy lifestyles in partnerships with health professionals, educators, and community leaders.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105179"},"PeriodicalIF":3.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442278","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

Voluntarily stopping eating and drinking (VSED): A systematic mixed-methods review focusing on the carers’ experiences 自愿停止饮食（VSED）：以照顾者的经历为重点的系统性混合方法综述。

IF 3.6 3区医学

Health Policy Pub Date : 2024-09-30 DOI: 10.1016/j.healthpol.2024.105174

Christina Mensger , Yang Jiao , Maximiliane Jansky , Christian Banse , Friedemann Nauck , Monika Nothacker , Henrikje Stanze

{"title":"Voluntarily stopping eating and drinking (VSED): A systematic mixed-methods review focusing on the carers’ experiences","authors":"Christina Mensger , Yang Jiao , Maximiliane Jansky , Christian Banse , Friedemann Nauck , Monika Nothacker , Henrikje Stanze","doi":"10.1016/j.healthpol.2024.105174","DOIUrl":"10.1016/j.healthpol.2024.105174","url":null,"abstract":"<div><h3>Background</h3><div>Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED.</div></div><div><h3>Methods</h3><div>In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021. We included quantitative and qualitative research examining the experiences, attitudes, and knowledge of people confronted with VSED. We inductively analyzed the data after quantitative data transformation. We assessed quality and confidence using the Mixed-Methods Appraisal Tool and GRADE-CERQual approach, respectively. This study was registered in PROSPERO (CRD42022283743).</div></div><div><h3>Findings</h3><div>We identified 22 eligible articles, comprising 16 studies. The participants were healthcare professionals and relatives, but not individuals undertaking VSED. We present here our findings on the challenges of accompanying VSED, positive experiences with VSED, and the identified needs. Support during VSED is needed at multiple levels (medical care, family relief, course planning), and the willingness to accompany VSED is very high among healthcare professionals. However, there are several problems, the most obvious being the lack of knowledge and expertise regarding VSED, placing a great burden on families and professionals. The confidence in the review findings ranged from moderate to low.</div></div><div><h3>Interpretation</h3><div>Evidence-based guidance, in-depth knowledge, and training of healthcare professionals can greatly reduce the burden and fear among individuals accompanying VSED.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105174"},"PeriodicalIF":3.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395429","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 long-run effect of COVID-19 on hospital emergency department attendances:evidence from statistical analysis of hospital data from England COVID-19 对医院急诊室就诊人数的长期影响：英格兰医院数据统计分析的证据

IF 3.6 3区医学

Health Policy Pub Date : 2024-09-30 DOI: 10.1016/j.healthpol.2024.105168

Nikita Jacob, Rita Santos, Peter Sivey

{"title":"The long-run effect of COVID-19 on hospital emergency department attendances:evidence from statistical analysis of hospital data from England","authors":"Nikita Jacob, Rita Santos, Peter Sivey","doi":"10.1016/j.healthpol.2024.105168","DOIUrl":"10.1016/j.healthpol.2024.105168","url":null,"abstract":"<div><div>During the COVID-19 pandemic, hospital emergency departments worldwide experienced a pronounced fall in utilisation of emergency care, with a decrease of up to 40% in many countries. Evidence suggests the cause of these changes include both population fear of COVID-19 and the effects of lockdowns and the interaction of these two effects. We analyse a sub-sample of national data on Accident and Emergency (A&E) attendances in England over an extended period from April 2019 to March 2022 for different patient groups, including by age, mental/physical health status, acuity, and common clinical groupings. Our results showed that all patient groups experienced substantial declines in attendances during the first two waves of the pandemic, including high acuity and cardiovascular patients. Mental health patients were the only exception, with a smaller decline in attendances. Our findings suggest that policymakers should recognise the potential harmful effects of lockdowns, public messaging, and changes in health care provision on all patients during health emergencies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"150 ","pages":"Article 105168"},"PeriodicalIF":3.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434411","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

How general practitioners in France are coping with increased healthcare demand and physician shortages. A panel data survey and hierarchical clustering 法国全科医生如何应对日益增长的医疗需求和医生短缺问题。面板数据调查与分层聚类。

IF 3.6 3区医学

Health Policy Pub Date : 2024-09-29 DOI: 10.1016/j.healthpol.2024.105175

Bérengère Davin-Casalena , Dimitri Scronias , Yann Videau , Pierre Verger

{"title":"How general practitioners in France are coping with increased healthcare demand and physician shortages. A panel data survey and hierarchical clustering","authors":"Bérengère Davin-Casalena , Dimitri Scronias , Yann Videau , Pierre Verger","doi":"10.1016/j.healthpol.2024.105175","DOIUrl":"10.1016/j.healthpol.2024.105175","url":null,"abstract":"<div><h3>Background</h3><div>General practitioners (GPs) face quantitative and qualitative changes in patient demand and doctor shortages.</div></div><div><h3>Objectives</h3><div>To investigate how GPs cope with doctor shortage issues.</div></div><div><h3>Materials and methods</h3><div>Two cross-sectional surveys of a representative panel of 1530 GPs in 2019 and 2022 about their perceptions of physician shortages, working hours worked (WHW), and adaptive behaviors. Hierarchical clustering enabled identification of profiles with different adaptation patterns. Multiple Poisson or logistic regression models studied associations between GPs’ profiles and professional characteristics.</div></div><div><h3>Results</h3><div>87.4 % of GPs applied at least one adaptation to control patients’ healthcare demand. 24 % adopted task-shifting while their average WHW decreased by 3.6 h between 2019 and 2022. Four GP profiles were identified. “Low adapters/low workload” and “Low adapters/high workload” (25 % of the sample each) reported 2.4 adaptive measures: 75.5 % refused to be new patients' preferred doctor in the former group (vs 5.1 %). “High adapters/unchanged consultations” (30.7 %) and “High adapters/shortened consultations” (18.9 %) reported 4.8 and 6.1 adaptations, respectively. They were more likely to practice in medically underserved areas.</div></div><div><h3>Conclusion</h3><div>These results call into question GPs’ gatekeeper role in the French healthcare system. Moreover, the marked reduction in WHW in underserved areas is likely to exacerbate their uneven distribution nationwide. Encouraging vertical integration between HCPs while enhancing cooperation and task-shifting is probably a pathway toward improving the relative GP shortage.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"149 ","pages":"Article 105175"},"PeriodicalIF":3.6,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382518","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