Health Policy最新文献

{"title":"Policy makers must adopt agile signal detection tools to strengthen epidemiological surveillance and improve pandemic preparedness","authors":"Cédric Mahé ,&nbsp;Aimo Kannt ,&nbsp;AIOLOS consortium","doi":"10.1016/j.healthpol.2025.105386","DOIUrl":"10.1016/j.healthpol.2025.105386","url":null,"abstract":"<div><div>The SARS-COV2 pandemic has highlighted the urgent need for agile and responsive disease surveillance systems. To strengthen epidemiological surveillance and improve pandemic preparedness, policymakers must adopt real-time signal detection tools that integrate multisource data, including non-traditional health data, advanced analytics, and artificial intelligence (AI). Such approaches enable more efficient monitoring and decision-making through collaborative networks. Expanding these agile tools across Europe under a supranational mandate would enhance public health outcomes, support healthcare system efficiency, and increase business resilience. Leveraging private sector data and ensuring modularity for gradual scale-up are essential to maintaining adaptability and responsiveness.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105386"},"PeriodicalIF":3.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522220","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":"Exploring differences in performance management across public and private providers in primary care: Evidence from Finland and Sweden","authors":"Anna Häger Glenngård ,&nbsp;Teemu Malmi","doi":"10.1016/j.healthpol.2025.105383","DOIUrl":"10.1016/j.healthpol.2025.105383","url":null,"abstract":"<div><div>We employ a qualitative approach to explore whether and how the use of performance measurement systems differs between public and private providers in Swedish and Finnish primary care, from the perspective of primary care centre managers. The two settings are similar in terms of decentralised healthcare systems but differ in terms of organisation of primary care and governance principles for public and private providers. Our findings highlight the importance of considering contextual factors when interpreting results on differences between public and private providers. We observe a) increased goal clarity and an increased use of management controls when payment is separated from provision, b) a similar use of control practices between public and private providers when they operate under the same governance principles, and c) differences in control practices when the “rules of the game” differ. We identify two actions that can facilitate performance management at the provider level. One is for purchasers or owners to clearly communicate the scope of services for which providers are responsible for to improve their goal clarity. The other is for an actor at the national level to facilitate access to reliable data to enhance appropriate performance management and the sharing of experiences among providers.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105383"},"PeriodicalIF":3.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of territorial case management on hospital admissions for complex chronic patients in Catalonia (Spain)","authors":"Jesús Antonio Vaquero Cruzado ,&nbsp;Nuria Gutiérrez Jiménez ,&nbsp;Laura Carrillo Ciércoles ,&nbsp;Eva García Tarrida ,&nbsp;María Jesús Megido Badía ,&nbsp;Nuria Fabrellas Padrés","doi":"10.1016/j.healthpol.2025.105384","DOIUrl":"10.1016/j.healthpol.2025.105384","url":null,"abstract":"<div><h3>Background</h3><div>Chronic diseases are the most frequent health problem in the population. The development of case management, as an advanced care practice, is a basic strategy in the care of complex chronicity. The Catalan Health Plan establishes general guidelines for chronic care, linked to the role of the nurse case management.</div></div><div><h3>Objective</h3><div>The objective is to analyse the impact on the health system of shared monitoring, by the chronicity care team and its primary care reference team, in patients identified as complex chronic diseases (CCP) or with advanced disease (MACA), in regarding hospital admissions.</div></div><div><h3>Methods</h3><div>Retrospective quasi-experimental intervention study, with pre-post analysis, comparing each patient one year before and one year after being incorporated into the case management portfolio of a team made up of 14 nurses, 2 family medicine specialists and one social worker, with attention 365 days a year, 24 h a day.</div></div><div><h3>Results</h3><div>Regarding the decrease in hospital admissions, an average decrease (2013–2021) of 56 % was observed for MACA and 53 % in CCP. Statistical analysis based on a Poisson regression model with offset demonstrates that the intervention program had a significant effect on reducing hospital admissions, from a team formed from primary care itself.</div></div><div><h3>Conclusions</h3><div>The organization and structure of a chronic care team such as the one described, in an integrated manner with other levels of care, allows for a significant reduction in hospital admissions<strong>.</strong></div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105384"},"PeriodicalIF":3.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510981","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":"Does pay for performance affect socioeconomic inequalities in access? Evidence from hospital specialised care in England.","authors":"Alberto Núñez-Elvira, Yan Feng, Søren Rud Kristensen, Paula Lorgelly, Rachel Meacock, Luigi Siciliani, Matt Sutton","doi":"10.1016/j.healthpol.2025.105365","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105365","url":null,"abstract":"<p><p>Pay for performance aims to improve quality and efficiency in the health sector but may widen inequalities. We investigate how pay for performance for specialised hospital care in England affected socioeconomic inequalities in access. We focus on two clinical areas: trauma care aimed at reducing delayed discharges from adult critical care; and internal medicine aimed at reducing in-hospital waiting time and length of stay for patients requiring urgent coronary bypass grafting. Both were part of the Prescribed Specialised Services Commissioning for Quality and Innovation. Using patient-level administrative data from Hospital Episodes Statistics in 2012/13-2016/17, we employ difference-in-difference models to estimate the impact of these schemes across socioeconomic status. Our treatment group comprises hospitals that adopted the scheme, and our control group the remaining eligible hospitals. For trauma care, we measure the impact of the scheme on discharge delays and the probability of an overnight discharge. For urgent coronary bypass, we measure pre-surgery inpatient waiting time, length of stay, 30-day and one-year mortality, and hospital-acquired infections. For trauma care we find the scheme widened inequalities by reducing delays that favoured more patients in the least income-deprived quintile (by 2.4 h or 30.4 % at the sample mean) than in the most income-deprived quintile (by 1.3 h). We find no effect or socioeconomic differences across outcomes for patients requiring an urgent coronary bypass.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":" ","pages":"105365"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644188","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":"Implications of multiprofessional collaboration in primary care – benefits for all? A quantitative study of effects on resource utilization of a team-based primary care practice in Sweden","authors":"Anna H Glenngård,&nbsp;Mattias Haraldsson","doi":"10.1016/j.healthpol.2025.105382","DOIUrl":"10.1016/j.healthpol.2025.105382","url":null,"abstract":"<div><div>We investigate differences in resource utilization between a multiprofessional team-based primary care practice and standard care for elderly patients with complex needs, from the perspective of different actors involved in healthcare delivery. The study is based on a mobile care team reform in a Swedish region, that spans across both organisational boundaries and different legislation. Our findings suggest that a shift towards a more proactive approach to outpatient care initially may lead to higher resource utilization and prevent hospital care and contribute to a more effective use of resources in the long run. The pattern observed is consistent the intentions behind the implementation of interventions aimed at shifting care closer to patients. Therefore, when implementing such interventions, it is important for decision-makers to be prepared to accept increased resource use initially in order to potentially benefit in the future. Our study highlights the challenges of measuring and comparing resource utilization across different actors. When implementing healthcare reforms that span across organisational borders, it is crucial to systematically collect and compile comparable data. Reliable information on the costs and patient outcomes associated with new ways of providing care, is important from both a management and a policy perspective.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105382"},"PeriodicalIF":3.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491879","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 progressivity of health care revenue financing in 29 countries: A comparison","authors":"Andres Võrk ,&nbsp;Peter Pažitný ,&nbsp;Ruth Waitzberg ,&nbsp;Sara Allin ,&nbsp;Daiga Behmane ,&nbsp;Nicolas Bouckaert ,&nbsp;Damien Bricard ,&nbsp;Lucie Bryndová ,&nbsp;Antoniya Dimova ,&nbsp;Fidelia Cascini ,&nbsp;Péter Gaál ,&nbsp;Katharina Habimana ,&nbsp;Marios Kantaris ,&nbsp;Ewa Kocot ,&nbsp;Madelon Kroneman ,&nbsp;Liubovė Murauskienė ,&nbsp;Zeynep Or ,&nbsp;Carlo de Pietro ,&nbsp;Ingrid S. Saunes ,&nbsp;Steve Thomas ,&nbsp;Thomas Rice","doi":"10.1016/j.healthpol.2025.105381","DOIUrl":"10.1016/j.healthpol.2025.105381","url":null,"abstract":"<div><h3>Background</h3><div>This study assesses progressivity in public and private health care revenue collection among 29 high-income countries by combining the results of two previous articles comprising this special section of <em>Health Policy</em>. In those studies, we developed qualitatively based scores regarding revenue collection policies for three public revenue sources (income taxes, social insurance contributions, consumption taxes) and two private revenue sources (voluntary health insurance, out-of-pocket payments).</div></div><div><h3>Objective</h3><div>The current study sums these scores, weighted by the shares of each revenue source in each country, to calculate an overall progressivity score for each country.</div></div><div><h3>Methods</h3><div>We derived weights for each revenue source using publicly available OECD and Eurostat macrolevel data on the structure of health care financing and government revenues.</div></div><div><h3>Results</h3><div>France was the country that had the most progressive system, and Latvia, Hungary, and Bulgaria, the least progressive.</div></div><div><h3>Conclusions</h3><div>Countries relying more on out-of-pocket payments tend to be more regressive overall, suggesting that, from an equity perspective, their role should remain limited. Tax-based systems do not inherently ensure progressivity, especially when relying heavily on regressive consumption taxes. While wealthier countries and those with less income inequality tend to be more progressive, in contrast, Switzerland and Germany both scored among the more regressive countries. Our study shows that policy matters in promoting progressivity in health system revenue collection. Both public and private sources can be regressive if nothing is done. Yet, there are policy instruments that can mitigate regressivity, and even private sources of funds can be made less regressive.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105381"},"PeriodicalIF":3.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581228","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":"Urban NO2-pollution and health outcomes: Evidence from a natural experiment in Italy on the simulated benefits of the EU zero-emission-vehicles resolution","authors":"Daniele Bondonio ,&nbsp;Paolo Chirico ,&nbsp;Massimiliano Piacenza ,&nbsp;Simone Robbiano","doi":"10.1016/j.healthpol.2025.105376","DOIUrl":"10.1016/j.healthpol.2025.105376","url":null,"abstract":"<div><h3>Background</h3><div>The EU “Fit-For-55″ resolution provisions the banning of fossil-fuel-vehicle sales beyond 2035, sparking a heated debate due to its uncertain effectiveness in reducing CO₂ emissions globally. Nevertheless, the EU shift towards zero-emission vehicles has the potential to decrease urban nitrogen dioxide (NO₂) pollution that is closely linked to respiratory and cardiovascular diseases and to increased mortality.</div></div><div><h3>Objective</h3><div>This paper aims to simulate the impact that the EU zero-emission-mobility policy is expected to have, post-transitional period, on urban NO₂ and health outcomes.</div></div><div><h3>Methods</h3><div>The analysis exploits some unique features of Northern-Italy air-pollution data and the Italian Covid-19 lockdown that is leveraged as a natural experiment to mimic the fossil-fuel traffic abatement expected by the policy. Our estimates are obtained by developing a novel intertemporal-statistical-matching approach specifically suited for quasi-experimental evaluations in the context of air-pollution multivariate time series.</div></div><div><h3>Results</h3><div>We find that the lockdown led to a mean NO₂ reduction of 13.62 μg/m³ (53 % from a baseline of 25.8 μg/m³), translating into a simulated reduction in the relative risk of total, cardiovascular, and respiratory mortality by 8.3, 7.5 and 3.8 percentage points, respectively. We also estimate impact heterogeneity, with log-linearly larger reductions in NO₂ and mortality risk at higher baseline-pollution levels.</div></div><div><h3>Conclusions</h3><div>These results imply that the EU zero-emission mobility policy is expected to improve air-quality and public health in urban areas with high traffic density, though benefits may vary across regions due to differences in meteorological conditions and urban/orographic characteristics, supporting a spatially differentiated policy implementation.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105376"},"PeriodicalIF":3.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330531","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 integrative organizational health literacy framework for preventive action through intersectoral collaboration: Results of a landscape review","authors":"Francisco Javier Ferreira-Alfaya,&nbsp;Yasmin Cura,&nbsp;María José Zarzuelo-Romero","doi":"10.1016/j.healthpol.2025.105380","DOIUrl":"10.1016/j.healthpol.2025.105380","url":null,"abstract":"<div><h3>Background</h3><div>Organizational Health Literacy (OHL) refers to the extent to which organizations facilitate equitable access, comprehension, and use of health information and services for informed decision-making.</div></div><div><h3>Objective</h3><div>This study aimed to (1) review and map existing OHL frameworks and (2) propose an innovative OHL framework that addresses gaps identified in current models.</div></div><div><h3>Methods</h3><div>A systematic search of academic (Web of Science, Scopus, MEDLINE) and grey literature from the past 15 years was conducted to identify OHL frameworks. This scoping review followed the PRISMA-ScR guidelines and the Arksey and O’Malley model. A new OHL intervention framework was developed to address gaps in existing models, based on the principles of preventive medicine and the public health action cycle.</div></div><div><h3>Results</h3><div>A total of 19 records were included (10 from academic databases and 9 from grey literature), covering diverse approaches and contexts related to OHL. Four intervention levels were identified: integrating HL into formal education, implementing HL assessments, developing interventions for vulnerable populations, and enhancing accessibility to health resources. The proposed framework emphasizes intersectoral collaboration and communication pathways between education and healthcare sectors, facilitating information exchange to continuously adapt interventions to population needs.</div></div><div><h3>Conclusion</h3><div>OHL development requires intersectoral collaboration; however, interoperability between sectors remains unaddressed in existing frameworks. This study proposes an innovative model that fosters sectoral connections toward a shared goal, creating a truly collaborative framework.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105380"},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549607","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":"Shall we call for a doctor? How to build trust toward AI in healthcare: Insights from a Polish cross-sectional preference study","authors":"Katarzyna Kolasa ,&nbsp;Katarzyna Baliga-Nicholson ,&nbsp;Jaroslaw Wasniewski ,&nbsp;Nikola Laskowska ,&nbsp;Krystyna Milian ,&nbsp;Dominika Ciupek","doi":"10.1016/j.healthpol.2025.105379","DOIUrl":"10.1016/j.healthpol.2025.105379","url":null,"abstract":"<div><h3>Objectives</h3><div>This research aimed to investigate key success factors for the adoption of AI-driven health technologies, particularly in healthcare ecosystems of low digital literacy, such as Poland.</div></div><div><h3>Methods</h3><div>Conducted between January and August 2023, the \"AIValue4Health\" study engaged over 1,000 Polish nationals in a representative survey. The study revealed preferences with 15 general statements about AI and stated preferences, with two hypothetical trade-off experiments comparing traditional healthcare with AI-enhanced solutions.</div></div><div><h3>Results</h3><div>In addition to the strong support for AI demonstrated through direct questioning, 28% and 76% of participants shifted from their initial preference for standard care to favor AI solutions, given validation studies and positive feedback from doctors, as well as free access to AI tools. This left over 60% and 80% of participants favoring digital solutions in both experiments, respectively.</div></div><div><h3>Conclusions</h3><div>The results revealed how to ensure successful integration of AI in healthcare, emphasizing, however, the necessity of validation studies and targeted educational initiatives to enhance digital literacy and trust in AI. Most importantly, the findings underscore the essential role of medical professionals as leaders in the adoption of digital health solutions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105379"},"PeriodicalIF":3.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366039","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":"Private equity investment in long-term care: The case of Ireland","authors":"Nicholas O’Neill ,&nbsp;Julien Mercille","doi":"10.1016/j.healthpol.2025.105378","DOIUrl":"10.1016/j.healthpol.2025.105378","url":null,"abstract":"<div><h3>Background</h3><div>Private equity (PE) firms are key actors in the financialisation of health care systems. Yet, research rarely focuses directly on these firms and related private for-profit actors involved in financialisation. Moreover, existing work mostly concerns the United States, while several key health care sectors remain under-researched.</div></div><div><h3>Objective</h3><div>This study examines the factors driving PE investment in long-term care (LTC) and the strategies PE firms use to enter and expand within the sector.</div></div><div><h3>Methods</h3><div>We conduct a thematic analysis of 20 in-depth interviews with expert informants, including senior executives from PE firms, financial investors and private for-profit providers. These interviews shed light on the role of PE in Ireland’s LTC sector, specifically within nursing homes and home care.</div></div><div><h3>Results</h3><div>Five key factors attract PE investment in Irish LTC: demographic trends, market composition, risk diversification, and the characteristics of state funding and regulation. In nursing homes, PE uses the “OpCo/PropCo” (operating company/property company) model. In home care, PE enters via global investments in parent companies, direct acquisitions of Irish firms, and master franchise agreements.</div></div><div><h3>Conclusions</h3><div>Examining private for-profit actors through key officials central to PE growth in LTC provides valuable insights into the financialisation of health care systems. This approach enhances our understanding of business interests driving investment in European LTC.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105378"},"PeriodicalIF":3.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313349","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}