Health Policy最新文献

{"title":"Financial penalty associated with a decline in hospital-acquired complications in Australia","authors":"Luke Slawomirski ,&nbsp;Petr Otahal ,&nbsp;Martin Hensher ,&nbsp;Julie Campbell ,&nbsp;Stephanie Newell ,&nbsp;Barbara de Graaff","doi":"10.1016/j.healthpol.2025.105416","DOIUrl":"10.1016/j.healthpol.2025.105416","url":null,"abstract":"<div><h3>Background</h3><div>Adverse events during hospital care are a global concern. The evidence for addressing unsafe acute care using pay-for-performance (p4p) is inconclusive.</div></div><div><h3>Objective</h3><div>To examine association between the introduction of a financial penalty on 1 July 2018 and the prevalence of 13 high-priority hospital-acquired complications (HACs) in Australian public hospitals.</div></div><div><h3>Methods</h3><div>Administrative data on every Australian public hospital separation (age &gt;17 years) between 1 January 2014 and 30 June 2021 was used to analyse changes in quarterly HAC prevalence (per 1000 multi-day separations), standardized to the study population, using two interrupted time series methods: generalized least squares (GLS) with autoregressive moving average (ARMA) errors, and a Bayesian structured time series.</div></div><div><h3>Results</h3><div>Just under 20 million separations took place over the study period with 947,057 (4.7%) (mean age 69 (SD: 18), 48% female) recording at least one HAC and 1,263,646 HACs overall. Our GLS model estimated a decline of 17% (95% CI 12 – 22%) in HAC prevalence associated with the introduction of the penalty. The Bayesian model estimated a 26% (23 – 29%) decline. Most of the decline occurred during a 12-month roll-in period. Results suggest that 98,970 fewer inpatients experienced a HAC from 1 July 2018 to 30 June 2021 compared to the modelled counterfactual.</div></div><div><h3>Conclusions</h3><div>Implementation of a financial penalty was associated with a substantial decline in HACs. Few other p4p policies have been associated with reductions in inpatient harm. Future research should examine local HAC trends and investigate what other factors may have contributed to the change.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105416"},"PeriodicalIF":3.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851959","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 challenge of the first 1000 days. The dynamics of early-life health inequalities in a universal healthcare system: Evidence from Italy.","authors":"Paolo Berta, Gilberto Turati","doi":"10.1016/j.healthpol.2025.105390","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105390","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Research in context: &lt;/strong&gt;(1) What is already known about the topic? Low birth weight (LBW) is a key marker of early-life health disadvantage, associated with increased mortality, delayed development, and long-term socioeconomic challenges. Health disparities related to LBW are predictive of future health outcomes and life trajectories. Although universal healthcare systems can mitigate such inequalities, their effectiveness varies across health domains and population subgroups. (2) What does this study add to the literature? This study examines how LBW-related health disparities evolve during early childhood within the universal healthcare system of Lombardy, Italy. Using robust statistical approaches, including twin fixed-effect models, the study shows that initial disadvantages in hospitalization rates and severity substantially decrease within the first 1000 days of life, particularly for nervous and digestive system conditions. However, disparities persist in respiratory diseases, indicating uneven mitigation across health domains. The study contributes new evidence on how universal healthcare can promote health equity in early life, while highlighting residual areas of concern. (3) What are the policy implications? The findings suggest that universal healthcare systems can significantly reduce health inequalities linked to LBW, but targeted interventions are necessary to address persistent disparities-especially in respiratory health. Policymakers should consider strengthening prenatal and neonatal care and designing condition-specific strategies that extend beyond infancy. Tailored support for LBW infants can further improve long-term outcomes and enhance the overall effectiveness of universal healthcare in promoting equitable health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early-life health inequalities can shape long-term health outcomes. This study examines disparities in hospitalization rates and severity between low- and normal-birth-weight children aged 0-3 years in Lombardy, Italy, under a universal public healthcare system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the evolution of early-life health inequalities in hospitalization rates and severity between low- and normal-birth-weight children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective longitudinal study leveraging a unique administrative dataset that integrates birth records and hospital discharge data for a large cohort of children in Lombardy. This approach allows for a robust analysis of hospitalization probabilities, total reimbursement costs, and hospital length of stay over the critical first 1000 days of life. Subgroup analyses focus on nervous, digestive, and respiratory diseases. Twin birth data are used to strengthen causal inference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Low-birth-weight children experience higher hospitalization rates and greater severity in the first year of life, but disparities substantially decline over time, with no significant diffe","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"105390"},"PeriodicalIF":3.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812690","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":"Meso-organisational determinants of healthcare workers’ resilience: results of a scoping review","authors":"Natalia Oprea ,&nbsp;Giorgio Giacomelli ,&nbsp;Marco Sartirana ,&nbsp;Elisabetta Trinchero ,&nbsp;Irène Georgescu","doi":"10.1016/j.healthpol.2025.105412","DOIUrl":"10.1016/j.healthpol.2025.105412","url":null,"abstract":"<div><h3>Background</h3><div>Recent financial, environmental, and health crises have underscored the critical—but often overlooked—role of healthcare workers (HCWs) for health system resilience. Given the ongoing physical and psychological demands placed on this workforce, understanding the factors that influence their resilience is essential.</div></div><div><h3>Objective</h3><div>This scoping review aimed to map and synthesise multidisciplinary evidence on meso-level organisational factors that influence individual resilience among HCWs. Specifically, we focused on identifying workplace-related risk and protective factors within the immediate organisational environment.</div></div><div><h3>Methods</h3><div>A scoping review was conducted across multidisciplinary literature, targeting studies that examined individual resilience outcomes in relation to meso-level workplace factors. This approach allowed for the inclusion of diverse study designs and disciplinary perspectives relevant to the research question.</div></div><div><h3>Results</h3><div>A total of 66 studies met the inclusion criteria. The analysis highlighted the importance of intermediate organisational factors—such as job characteristics and empowerment, interpersonal dynamics (e.g., team cohesion, supervisory support), and psychosocial workplace conditions—in shaping HCW resilience.</div></div><div><h3>Conclusion</h3><div>Although resilience is often viewed as an individual trait, this review demonstrates the critical role of meso-level organisational environments in fostering and sustaining HCW resilience. The findings support the need for policies and interventions that strengthen team functioning and workplace climate. Future research should focus on operationalising these insights into actionable strategies that bridge individual and systemic approaches to workforce resilience.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105412"},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988588","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 use of social return on investment approaches to evaluate integrated long-term care in high-income countries: A scoping review","authors":"Susana Ramalho Marques ,&nbsp;Ricardo Rodrigues ,&nbsp;Jürgen Zerth ,&nbsp;Carola Orrego","doi":"10.1016/j.healthpol.2025.105414","DOIUrl":"10.1016/j.healthpol.2025.105414","url":null,"abstract":"<div><h3>Background</h3><div>The increasing number of older adults with complex care needs underscores the urgent need for improved coordination between health and social services, emphasizing the importance of integrated care models. The Social Return on Investment (SROI) framework is a valuable tool for evaluating the social, economic, and environmental impact of healthcare interventions, including integrated long-term care (LTC) solutions. However, a gap remains in reviews specifically analyzing its application to integrated LTC interventions.</div></div><div><h3>Objective</h3><div>To examine how SROI has been used to evaluate integrated LTC interventions, particularly for older adults.</div></div><div><h3>Methods</h3><div>A scoping review of peer-reviewed and grey literature was conducted, covering January 2012 to June 2024, through MEDLINE, CINAHL, Google Scholar, and citation searches. Three independent reviewers assessed study eligibility, following PRISMA guidelines. Data were extracted using PICOS terms and organized into summary tables detailing study characteristics and SROI findings.</div></div><div><h3>Results</h3><div>Out of 556 screened papers, only 11 studies met the inclusion criteria, with most conducted in the UK. SROI evaluations focused on Personal and Community Resources, such as improved physical and mental health and social connections, while Public Resource benefits, including reduced healthcare workloads, were noted in seven studies. Financial proxies came from sources like HACT Social Value Bank and Global Value Exchange. All studies reported positive SROI ratios, though methodological limitations affect interpretation.</div></div><div><h3>Conclusions</h3><div>The application of SROI to integrated LTC remains limited, primarily UK-based and reliant on context-specific methodologies. Expanding its use requires standardized methods, broader geographic representation, and localized proxies for more accurate evaluations.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105414"},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852167","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 population-based exploration of immigrants undergoing general surgery procedures in British Columbia: Do immigrants present for emergency surgeries more than non-immigrants?","authors":"Michael Guo, Nicolas Mourad, Ahmer Karimuddin, Jason M Sutherland","doi":"10.1016/j.healthpol.2025.105410","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105410","url":null,"abstract":"<p><strong>Background: </strong>Canada's growing immigrant population faces language and cultural barriers that hinder timely access to healthcare. The balance between elective and emergency general surgery (EGS) reflects immigrant's access to healthcare since many EGS cases are avoidable through treatment as elective procedures.</p><p><strong>Objective: </strong>This study examines whether immigrants are more likely to undergo EGS than non-immigrants and measures whether language proficiency or access to primary care plays a role in disparity in access to care.</p><p><strong>Methods: </strong>All general surgery procedures performed in British Columbia, Canada between 2013 and 2021 were identified using a population-based longitudinal administrative data that linked immigration data with physician billing and hospital data. The primary outcome was whether patients' surgery was elective or EGS and the primary exposure was immigrant status. The odds of EGS between immigrants and non-immigrants was estimated adjusting for patient and system-level differences. The analysis compared immigrants with and without English proficiency on arrival to Canada.</p><p><strong>Results: </strong>Of 237,054 general surgery procedures, 30.7 % were EGS and 15.2 % involved immigrants. Immigrants had slightly higher odds of undergoing emergency general surgery (EGS) than non-immigrants. Immigrants not fluent in English had 16 % higher odds of EGS (OR: 1.16, 95 %CI 1.03-1.32). Immigrants with fewer GP contacts were more likely to undergo EGS (45.5 % versus 42.2 %, p < 0.01).</p><p><strong>Conclusions: </strong>Immigrants with language barriers and who accessed primary care less often were more likely to require EGS. These findings highlight the need for system-level interventions to reduce immigrants' reliance on emergency surgical care.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"105410"},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805273","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":"Understanding physician prescription behaviors: a systematic review and meta-analysis of macro, meso, and micro-level influences.","authors":"Giaele Moretti, Francesca Ferrè, Alma Martelli, Paola Cantarelli","doi":"10.1016/j.healthpol.2025.105415","DOIUrl":"https://doi.org/10.1016/j.healthpol.2025.105415","url":null,"abstract":"<p><strong>Background: </strong>Prescription is a complex act that reflects the physician's expertise and authority. While some factors affecting prescription decisions have been studied, empirical findings often conflict, leaving our understanding of prescription behaviors limited and fragmented.</p><p><strong>Objective: </strong>To assess the factors influencing physicians' drug prescribing habits by applying Strong Structuration Theory. Factors are categorized at: physician, practice, patient, industry, and system level.</p><p><strong>Methods: </strong>Pubmed, Scopus, and ISI Web of Science were searched from inception to June 2025. Peer-reviewed studies were included if they were published in English, empirical, and assessed at least one factor influencing physicians' prescribing behaviors. Studies reporting the effect of covariates on prescriptions using Odds Ratios were included in the meta-analysis.</p><p><strong>Results: </strong>146 studies were selected for the review. At the macro-level, physicians were more likely to prescribe after being exposed to marketing activities by pharmaceutical industries, and for privately insured patients. Meso-level factors, such as practice ownership and setting, showed conflicting results, with no significant effect observed in the meta-analysis. Micro-level influences were the most prevalent in literature. Patient requests had a significant positive effect on prescriptions. Physician-level influences were inconsistent across most variables, except gender, where male physicians were more likely to prescribe. This effect was not confirmed by the meta-analysis, which showed heterogeneity across studies.</p><p><strong>Conclusion: </strong>This study highlights the complexity of prescribing behaviors and the challenges in designing effective micro-level policies. Policymakers should therefore consider the multiple influences on prescribing to design targeted interventions that promote high-quality prescribing practices.</p>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"105415"},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812691","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 scoping review of transformational leadership development in health-related PhD programs","authors":"Barbara Maria Löfflad-Bürkin ,&nbsp;Anja Matthiä ,&nbsp;Heather Krasna ,&nbsp;Nino Künzli ,&nbsp;Julia Bohlius ,&nbsp;Katarzyna Czabanowska","doi":"10.1016/j.healthpol.2025.105411","DOIUrl":"10.1016/j.healthpol.2025.105411","url":null,"abstract":"<div><h3>Background</h3><div>A competent public health workforce is essential for resilient health systems, where transformational leadership helps navigate complexity, drive innovation, and foster collective action. However, leadership development remains underrepresented in health-related PhD curricula, limiting their capacity to prepare future leaders. Existing evidence is sparse and often limited to clinical contexts in high-income countries, offering little guidance for broader public health needs.</div></div><div><h3>Objective</h3><div>To explore how transformational leadership can be developed in health-related PhD programs and assess the effects of curricular elements, including content and teaching techniques.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following PRISMA-ScR and Joanna Briggs Institute guidelines, with a registered protocol on the Open Science Framework. We systematically searched Medline, PsycInfo, and ERIC (2000–2024), including peer-reviewed studies assessing how mentorship, experiential learning, and collaboration contribute to transformational leadership development. Multiple reviewers independently screened and extracted data. A narrative synthesis was conducted, and methodological quality was appraised using the Mixed Methods Appraisal Tool.</div></div><div><h3>Results</h3><div>Of 394 records screened, seven studies met inclusion criteria. Four focused on transformational leadership; three used alternative models. All used experiential learning and collaborative feedback. Common themes included leadership, teamwork, and personal growth. Only one study used a validated tool (MLQ); others used reflective or descriptive evaluations. Most reported positive impacts, with mentoring, group learning, and reflection identified as key drivers.</div></div><div><h3>Conclusions</h3><div>Strengthening transformational leadership in PhD education is key to preparing a future-ready public health workforce. While promising practices exist, clearer frameworks, stronger evaluation tools, and research on context-specific approaches are needed.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105411"},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841501","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 the 2012 pharmaceutical co-payment reform on drug consumption among children in Catalonia: Evidence from a regression discontinuity design","authors":"Toni Mora","doi":"10.1016/j.healthpol.2025.105413","DOIUrl":"10.1016/j.healthpol.2025.105413","url":null,"abstract":"<div><h3>Background</h3><div>Poor childhood health negatively affects health and socioeconomic status later in life. One crucial policy tool is the modification of co-payment conditions, which can cause parents to experience more rigid budget constraints and cause reductions in the number of prescription drugs given to their children.</div></div><div><h3>Objective</h3><div>This study estimates the price sensitivity of prescription drug demand using data on all prescription drug purchases for the non-adult population in Catalonia from 2010 to 2015.</div></div><div><h3>Methods</h3><div>We use a sharp regression discontinuity design (RDD) with no bandwidth, exploiting 2012 reforms in Catalonia (Spain).</div></div><div><h3>Results</h3><div>Our results indicate overall reductions in the defined daily dose (DDD) consumption over three years post-reform for children of parents who experienced increases in their co-payment levels (8.1 % for a 10 % increase). In contrast, those whose parents did not experience a reduction in co-payment rates had a 7.0 percentage point increase in the number of prescriptions used. We corroborated our findings by considering drug stockpiling. Interestingly, prescriptions related to females showed higher reductions than those for males. Disentangling drug consumption by type of condition, we show that drug purchases related to respiratory health conditions experienced smaller reductions and, more specifically, the ones associated with asthma, compared to mental health diseases such as Attention-Deficit/Hyperactivity Disorder.</div></div><div><h3>Conclusions</h3><div>We evidence significant changes in overall drug consumption for young people in Spain following the reforms of co-payments.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105413"},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763637","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":"New government, old habits? The opportunity for a turning point in prevention health policies in Germany is now!","authors":"Marike Andreas,&nbsp;Lisa Kellermann,&nbsp;Ludgera Lewerich,&nbsp;Falko F. Sniehotta","doi":"10.1016/j.healthpol.2025.105409","DOIUrl":"10.1016/j.healthpol.2025.105409","url":null,"abstract":"<div><div>Germany has long lagged behind other high-income countries in terms of implementing evidence-based prevention policies. This is reflected by the relatively low life expectancy of the population, high numbers of non-communicable diseases and health inequality in the country. Against this backdrop, we discuss the initial plans of the new German government for prevention, and suggest a way forward. By shifting from a focus on curative measures to evidence-based, population-level interventions, Germany can improve health outcomes, reduce inequalities, and save costs. Strategic leadership and a coherent national prevention strategy are essential to achieve this transformation.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105409"},"PeriodicalIF":3.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757631","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":"Overview of Australia’s state-wide cardiovascular program and reflections on its piloting between 2021 and 2024","authors":"N.N. Khan ,&nbsp;S. Jennings ,&nbsp;E. Lugg ,&nbsp;A. Beauchamp ,&nbsp;J. Ellis ,&nbsp;S. Ghasemian ,&nbsp;H. Vaniotis ,&nbsp;S. Rafferty ,&nbsp;S. Yong ,&nbsp;A. Wandke ,&nbsp;R. Brown ,&nbsp;K Yakimov ,&nbsp;B. Morris ,&nbsp;H. Collins ,&nbsp;S. Cheung ,&nbsp;S. Chung ,&nbsp;A. Driscoll","doi":"10.1016/j.healthpol.2025.105407","DOIUrl":"10.1016/j.healthpol.2025.105407","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) remains a leading cause of death worldwide. Large-scale health system reforms, including new models of care are needed to reduce the burden of CVD. Between 2021 and 2024, Safer Care Victoria, together with the Victorian State and Australian Commonwealth governments, piloted an innovative Cardiovascular Program (Program) across the state of Victoria. The Program aimed to reduce avoidable readmissions for Victorians with CVD and improve access to CVD care for those living in regional and rural areas. The Program consisted of a range of initiatives including piloting rapid access clinics and virtual care pathways, as well as new roles to facilitate inpatient management and improve transition into the community. Across 30 health services, 10,670 people diagnosed with or at risk of CVDs received care through the Program. Compared to the pre-Program period, the Program generally reduced 30-day all-cause hospital readmissions for CVD by 1% to 14% (depending on condition type and initiative), and improved access to CVD care, including for people living in regional and rural areas. Critical success factors included seed funding, workforce buy-in and adaptability of initiatives. For long-term sustainability, the Program should consider resourcing, technical requirements, optimisation of data collection and relevance to diverse populations. Lessons learned from this pilot Program may prove useful for those jurisdictions where efforts to reduce readmission rates and improve access to cardiovascular care among rural patients have faced challenges.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105407"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724267","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}