Health Policy最新文献_第2页

Global health and care worker migration requires a global response

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-28 DOI: 10.1016/j.healthpol.2025.105305

Ellen Kuhlmann , Michelle Falkenbach , Tiago Correia , Niamh Humphries , Eleanor Hutchinson , Gareth H Rees , Marius-Ionut Ungureanu , Tomas Zapata , Julia Lohmann

{"title":"Global health and care worker migration requires a global response","authors":"Ellen Kuhlmann , Michelle Falkenbach , Tiago Correia , Niamh Humphries , Eleanor Hutchinson , Gareth H Rees , Marius-Ionut Ungureanu , Tomas Zapata , Julia Lohmann","doi":"10.1016/j.healthpol.2025.105305","DOIUrl":"10.1016/j.healthpol.2025.105305","url":null,"abstract":"<div><div>The global migration of the health and care workforce (HCWF) has intensified, leading to complex policy scenarios and diverse migration patterns. While the traditional narrative of individual health and care workers (HCWs) migrating from low- and middle-income countries to high-income countries in search of higher income, career prospects and working conditions remains relevant, it now coexists with many other drivers, incentives, and dynamics at individual and policy level. The evolving dynamics of HCW migration have profound implications extending far beyond health labour markets, influencing broader societal and political landscapes. Despite their significance, the qualitative shifts in HCWF migration patterns and the governance challenges they present are poorly understood and under-researched, and policies have thus been limited in their effectiveness. In this policy comment we argue for a global response and an enhanced focus on policy implementation, using selected case studies to illustrate the argument. The cases highlight complexities of HCW migration patterns and opportunities for strengthening implementation of the WHO Global Code of Practice to respond effectively to the diverse needs of health systems and individual HCWs.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"155 ","pages":"Article 105305"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760878","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

From policy to practice: Rolling out the clinical nurse specialist role in Portugal

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-26 DOI: 10.1016/j.healthpol.2025.105308

Mário Amorim-Lopes , Sofia Cruz-Gomes , Elisa Doldi , Bernardo Almada-Lobo

{"title":"From policy to practice: Rolling out the clinical nurse specialist role in Portugal","authors":"Mário Amorim-Lopes , Sofia Cruz-Gomes , Elisa Doldi , Bernardo Almada-Lobo","doi":"10.1016/j.healthpol.2025.105308","DOIUrl":"10.1016/j.healthpol.2025.105308","url":null,"abstract":"<div><div>The specialization of Health Human Resources (HHR) is increasingly recognized as essential for addressing evolving healthcare demands. This paper presents a comprehensive policy framework for assisting with the implementation of Clinical Nurse Specialist (CNS) roles at the national or regional level, integrating key dimensions including barriers and enablers, regulation and governance, education and training requirements, career development, workforce planning, and economic analysis. The framework was applied to the implementation of CNS roles in Portugal, resulting in the issuance of a decree-law by the government.</div><div>Our findings demonstrate that the economic analysis step was critical in addressing concerns from government authorities and health system funders regarding the potential budgetary impact of CNS implementation. By providing evidence-based projections of costs and benefits, the economic analysis facilitated smoother negotiations and consensus-building among stakeholders, including nursing unions. Furthermore, the integration of workforce planning ensured the alignment of educational capacity with workforce needs, thus avoiding potential implementation bottlenecks.</div><div>The application of the framework also revealed important feedback relationships between its dimensions, highlighting the interdependent nature of the implementation process. This dynamic approach, which adapts to real-time feedback and stakeholder input, underscores the necessity of a holistic and iterative strategy for successful CNS role integration. The insights gained from the Portuguese case underscore the utility of this policy framework in guiding the implementation of advanced nursing roles in diverse healthcare contexts.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"155 ","pages":"Article 105308"},"PeriodicalIF":3.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747154","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 does OTC drugs consumption relate to prescribed drugs and health care consultations in Europe?

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-23 DOI: 10.1016/j.healthpol.2025.105307

Aida Isabel Tavares

引用次数: 0

Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions.

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-22 DOI: 10.1016/j.healthpol.2025.105304

Mohammad Hamiduzzaman, Vanette McLennan, Harry Gaffney, Sarah Miles, Sarah Crook, Lewis Grove, Matthew Gray, Victoria Flood

{"title":"Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions.","authors":"Mohammad Hamiduzzaman, Vanette McLennan, Harry Gaffney, Sarah Miles, Sarah Crook, Lewis Grove, Matthew Gray, Victoria Flood","doi":"10.1016/j.healthpol.2025.105304","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105304","url":null,"abstract":"<p><p>Our review examines the operational dynamics and effectiveness of integrated healthcare models in Australia, focusing on their relevance for older rural adults with preventable chronic diseases. Using Whittemore and Knafl's (2005) systematic integrative review methods, we conducted a search across five databases, including Medline-EBSCO, PubMed, CINAHL, EMBASE, and SCOPUS. The Sustainable Integrated Chronic Care Models for Multimorbidity (SELFIE) framework, established by Leijten et al. (2018), was used for reflexive thematic synthesis. A two-stage screening process identified 15 integrated healthcare models, with five RCTs evaluating their effects on chronic conditions. The analysis revealed two key themes: aspects of care integration (service delivery, leadership, workforce, technology, and finance) and changes in patient and healthcare outcomes. Care coordination and multidisciplinary team care were common features, bridging gaps between health and social services for older patients. Despite challenges such as irregular funding and underutilisation of technology, several models demonstrated positive patient and healthcare outcomes. Virtual care platforms and remote monitoring systems have shown promise in improving patient engagement and enabling real-time care adjustments, particularly in rural areas with limited healthcare access. Our review highlights the need for integrated healthcare for older rural Australians with preventable chronic conditions, revealing the complexity of service models. Policy shifts towards coordinated services and changes in leadership and healthcare practices are essential to ensure this demographic receives integrated care that meets their needs.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":" ","pages":"105304"},"PeriodicalIF":3.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744457","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

Framing the loss: Preferences for vaccine hesitancy and gender effect in France and Italy

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-17 DOI: 10.1016/j.healthpol.2025.105301

Anna Rinaldi , Pierfrancesco Dellino , Massimo Paradiso

引用次数: 0

Commentary on “The learning rehabilitation system: Strengthening an intersectoral strategy to improve functioning of an ageing population” by Bickenbach et al.

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-12 DOI: 10.1016/j.healthpol.2025.105303

Nicola Manocchio , Concetta Ljoka , Valerio Ferdinandi , Lucia Cicchi , Calogero Foti

{"title":"Commentary on “The learning rehabilitation system: Strengthening an intersectoral strategy to improve functioning of an ageing population” by Bickenbach et al.","authors":"Nicola Manocchio , Concetta Ljoka , Valerio Ferdinandi , Lucia Cicchi , Calogero Foti","doi":"10.1016/j.healthpol.2025.105303","DOIUrl":"10.1016/j.healthpol.2025.105303","url":null,"abstract":"<div><div>Bickenbach et al. in their paper propose the transformation of the Learning Health System paradigm into a Learning Rehabilitation System. The shift towards Rehabilitation, as opposed to the traditional anatomical-physiological approach, holds paramount importance in healthcare since Rehabilitation, as defined by the World Health Organization, centers on the individual, emphasizing the optimization of functioning and reduction of disability. In this commentary we would like to add some concepts to the discussion. When establishing an Individual Rehabilitation Project, the environment in which patients live and healthcare workers operate should be considered, since the broad context could be very different. We believe that a smooth and successful transition through a Learning Rehabilitation System needs an ethical and not moralistic educational system, solid international political stability and an active prevention perspective by health organizations. A new “health pyramid” grounded in the concept of human functioning of the single individual, should be the compass guiding future health interventions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"155 ","pages":"Article 105303"},"PeriodicalIF":3.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629103","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

Strengthening diagnostic services in Latin America requires regional leadership, sustainable funding, and enhanced data sharing

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-11 DOI: 10.1016/j.healthpol.2025.105287

Andres Moreira-Soto , Nils Gade , Bert Hoffmann , Jan Felix Drexler

引用次数: 0

Physicians’ responses to time pressure: Experimental evidence on treatment quality and documentation behaviour

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-11 DOI: 10.1016/j.healthpol.2025.105302

Claudia Souček , Tommaso Reggiani , Nadja Kairies-Schwarz

{"title":"Physicians’ responses to time pressure: Experimental evidence on treatment quality and documentation behaviour","authors":"Claudia Souček , Tommaso Reggiani , Nadja Kairies-Schwarz","doi":"10.1016/j.healthpol.2025.105302","DOIUrl":"10.1016/j.healthpol.2025.105302","url":null,"abstract":"<div><h3>Background</h3><div>In hospitals, decisions are often made under time pressure. There is, however, little evidence on how time pressure affects the quality of treatment and the documentation behaviour of physicians.</div></div><div><h3>Setting</h3><div>We implemented a controlled laboratory experiment with a healthcare framing in which international medical students in the Czech Republic treated patients in the role of hospital physicians. We varied the presence of time pressure and a documentation task.</div></div><div><h3>Results</h3><div>We observed worse treatment quality when individuals were faced with a combination of a documentation task and time pressure. In line with the concept of the speed-accuracy trade-off, we showed that quality changes are likely driven by less accuracy. Finally, we showed that while documentation quality was relatively high overall, time pressure significantly lowered the latter leading to a higher hypothetical profit loss for the hospital.</div></div><div><h3>Conclusions</h3><div>Our results suggest that policy reforms aimed at increasing staffing and promoting novel technologies that facilitate physicians' treatment decisions and support their documentation work in the hospital sector might be promising means of improving the treatment quality and reducing inefficiencies potentially caused by documentation errors.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"155 ","pages":"Article 105302"},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760879","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

'Uncharted territory': The experiences of health and social care practitioners in a multi-agency collaboration to support integrated service provision for children and young people in a disadvantaged community.

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-08 DOI: 10.1016/j.healthpol.2025.105299

Cris Townley, Rebekah Grace, Tuval Keidar

{"title":"'Uncharted territory': The experiences of health and social care practitioners in a multi-agency collaboration to support integrated service provision for children and young people in a disadvantaged community.","authors":"Cris Townley, Rebekah Grace, Tuval Keidar","doi":"10.1016/j.healthpol.2025.105299","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105299","url":null,"abstract":"<p><p>This paper explores an Australian place-based collaboration of ten agencies to reform the delivery of integrated health and social care services to children and families with complex health and social challenges. Data comprises interview transcripts of semi-structured individual interviews with 17 employees across the six most-engaged agencies in late 2022. Employing thematic analysis, we found that whilst there was agreement on the vision of creative, trust-based collaboration to drive, implement and scale up service delivery reform, points of tension highlighted complexities that acted contrary to this vision. These tensions suggest the need to clarify the governance role of the collaboration, attend to project maturation processes, revise the strategic direction as collaborations evolve, maintain communication and agency involvement, and continue to listen to consumer and clinician voices. We conclude that, in a complex service system environment, it is crucial to maintain and review a shared vision, clear strategies and a healthy collaborative environment. These conclusions may inform other interagency collaborations and policies with the goal of integrating health and social care.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":" ","pages":"105299"},"PeriodicalIF":3.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626872","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

Rapid evaluation of the NHS Recovery Support Programme (RSP) in England: Implementing intensive national improvement support for challenged healthcare providers and systems

IF 3.6 3区医学

Health Policy Pub Date : 2025-03-08 DOI: 10.1016/j.healthpol.2025.105300

Maartje Kletter, Stephanie Gillibrand, Elaine Harkness, Jo Dumville, Paul Wilson

{"title":"Rapid evaluation of the NHS Recovery Support Programme (RSP) in England: Implementing intensive national improvement support for challenged healthcare providers and systems","authors":"Maartje Kletter, Stephanie Gillibrand, Elaine Harkness, Jo Dumville, Paul Wilson","doi":"10.1016/j.healthpol.2025.105300","DOIUrl":"10.1016/j.healthpol.2025.105300","url":null,"abstract":"<div><div>Launched in 2021, the Recovery Support Programme (RSP) provides mandated intensive improvement support to NHS healthcare providers and systems in England experiencing significant financial, quality or safety failings. The aim is to prevent further deterioration, embed improvement and to enable sustained stabilisation. We conducted a rapid multi-method study to evaluate the early implementation of the RSP to understand initial impact and identify further developments which could improve its delivery. We found that whilst the RSP is generally perceived as more supportive and less punitive than the special measures regime it replaced, there are areas where its delivery could be enhanced. There is variation in how the programme is delivered across regions and several core processes could be standardised to enable more structured assessment of system capability and development of capacity to support change. The presence of cross system collective leadership and external facilitation may be the core-enabling features necessary to embed improvement and enable sustained stabilisation in NHS organisations.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"155 ","pages":"Article 105300"},"PeriodicalIF":3.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643771","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