Health Policy最新文献

{"title":"The 2023 European Commission proposal and the 2024 European Parliament proposal for the EU pharmaceutical legislation: policy content analysis","authors":"Simona Gamba ,&nbsp;Laura Magazzini ,&nbsp;Paolo Pertile","doi":"10.1016/j.healthpol.2025.105408","DOIUrl":"10.1016/j.healthpol.2025.105408","url":null,"abstract":"<div><div>A revision of the pharmaceutical legislation is ongoing at the European Level. The European Commission proposed a first draft in April 2023, and the European Parliament has adopted a position on the proposal in April 2024. The proposal consists of a new Directive and a new Regulation, with the aim of integrating different provisions that have been introduced over time. The proposal aims at encouraging the industry in conducting research and developing technologies that reach patients, while addressing market failures. We discuss both general and targeted incentives that are proposed, as well as the provisions to foster access to medicines for all patients in the European Union. Although the legislative process has not been completed yet, an analysis of the texts that have been debated in the early stages, vis-à-vis the legislation in force, can inform on the most relevant and debated issues and on the aspects the reform is most likely to affect.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105408"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861257","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":"Corrigendum to “Impact of territorial case management on hospital admissions for complex chronic patients in Catalonia (Spain)” [Health Policy 159 (2025) 105384]","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.2025.105405","DOIUrl":"10.1016/j.healthpol.2025.105405","url":null,"abstract":"","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105405"},"PeriodicalIF":3.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671085","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 effects of private equity ownership in U.S. nursing homes quality and financial performance: A systematic review","authors":"Gregory N. Orewa ,&nbsp;Aizhan Karabukayeva ,&nbsp;Rohit Pradhan ,&nbsp;Itopa Jimoh ,&nbsp;Robert Weech-Maldonado","doi":"10.1016/j.healthpol.2025.105388","DOIUrl":"10.1016/j.healthpol.2025.105388","url":null,"abstract":"<div><h3>Background</h3><div>Private equity (PE) investment in U.S. nursing homes has increased significantly over the past two decades. The emergence of this novel ownership model has prompted concerns regarding its effects on nursing home performance, especially quality.</div></div><div><h3>Objective</h3><div>This systematic review examined the impact of PE ownership on U.S. nursing homes, focusing on quality of care and financial performance. The review was conceptually informed by agency theory and the structure-process-outcome (SPO) framework.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, a systematic search across five databases identified 12 studies published between 2000 and 2024. Eligible studies examined the effects of PE ownership on nursing home quality or financial performance. Data were extracted and synthesized across these two dimensions.</div></div><div><h3>Results</h3><div>Across studies, PE ownership was linked to higher number of deficiencies, increased hospitalization rates, and higher mortality, although some improvements in care processes were noted. Financial outcomes showed initial financial gains but long-term challenges, primarily due to high debt loads.</div></div><div><h3>Conclusions</h3><div>Findings suggest that PE strategies may prioritize short-term profitability, which may compromise quality of care in some instances. These findings highlight the need for financial transparency, and reimbursement models that incentivize long-term quality.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105388"},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714475","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":"Accounting for morbidity in capitation payments: A person-based workload formula for primary medical care in England","authors":"Laura Anselmi ,&nbsp;Shaolin Wang ,&nbsp;Yiu-Shing Lau ,&nbsp;Michael Anderson ,&nbsp;Evangelos Kontopantelis ,&nbsp;Matt Sutton","doi":"10.1016/j.healthpol.2025.105406","DOIUrl":"10.1016/j.healthpol.2025.105406","url":null,"abstract":"<div><h3>Background</h3><div>Accurate needs-based capitation is key to effective and equitable primary care funding. Most capitation schemes use only basic demographic and area characteristics.</div></div><div><h3>Objective</h3><div>We developed capitation weights for general practices in England using morbidity indicators recorded in primary and secondary care.</div></div><div><h3>Methods</h3><div>We used primary care records from the Clinical Practice Research Datalink (CPRD) linked with Hospital Episode Statistics (HES) for 12,667,755 patients registered with 1397 general practices on 1 April 2018. Using linear regression models, we estimated the effects on cost-weighted clinical appointments of patient age and gender, ethnicity, area-level deprivation, new registration, and morbidity (four sets of indicators covering 20 to 209 conditions). We included practice fixed-effects to adjust for differences in capacity and productivity. We applied the coefficients on patient characteristics as need-weights to data available nationally and we calculated weighted-patients for all 6892 practices in England.</div></div><div><h3>Results</h3><div>Most patients (71 %) had at least one appointment per-year. The average annual workload per-patient was £110, with large variations across patients (range £0-£882) and practices (£47-£179). Workload increased with age and with deprivation, but their direct effects halved when including morbidity in the model. Including morbidity widened the range of weighted-patient between practices at the 5th and 95th percentiles (from 0.84–1.14 to 0.79–1.16) and in the least and most deprived deciles (from 0.96–1.04 to 0.95–1.06).</div></div><div><h3>Conclusion</h3><div>Needs-based capitation weights accounting for morbidity and adjusting for unexplained variations in practice capacity and productivity increase workload differentiation and direct resources toward practices in more deprived areas.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105406"},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704275","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 integrated conceptual framework of health insurance literacy: Results of a critical interpretive synthesis","authors":"Reut Ron ,&nbsp;Paula Feder-Bubis ,&nbsp;Kierstin Trocha ,&nbsp;Moriah Ellen","doi":"10.1016/j.healthpol.2025.105394","DOIUrl":"10.1016/j.healthpol.2025.105394","url":null,"abstract":"<div><div>Health insurance literacy (HIL) is the knowledge, ability, and confidence to find and understand health insurance information, and choose, purchase and use an insurance plan. Despite the increasing volume of research on HIL, the approaches to this field remain fragmented.</div><div>This review paper aims to develop a conceptual framework delineating the attributes, personal contexts, and environmental influences, which either influence or are influenced by an individual's HIL level.</div><div>We have adopted a critical interpretive synthesis approach with purposive sampling and inductive analysis, integrating all existing models from the literature, with additional findings. The CIS methodology emphasizes iterative data synthesis to generate theory from diverse sources, ceasing data extraction upon achieving theoretical saturation. This reflects the stage at which further data collection no longer yields new conceptual insights.</div><div>Four databases were systematically screened in September 2020 and July 2023, yielding 6096 articles. Following a review of titles and abstracts, 388 papers were deemed relevant, and 76 were included in the final synthesis. The resulting framework consists of eight categories, 17 subcategories, and 129 codes, with HIL level as its core. Other components include individual predictors, external influences, skills and abilities, perceptions and beliefs, preferences, decision-making processes, and outcomes.</div><div>This framework provides a comprehensive tool for guiding interventions and research aimed at improving HIL. It allows researchers and policymakers to address the diverse and interconnected factors influencing HIL and to develop targeted, evidence-based strategies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105394"},"PeriodicalIF":3.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634555","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":"Under what conditions do people accept health inequality? A cross-national regression analysis of OECD countries","authors":"Minjung Kim,&nbsp;Young Jun Choi","doi":"10.1016/j.healthpol.2025.105398","DOIUrl":"10.1016/j.healthpol.2025.105398","url":null,"abstract":"<div><h3>Background</h3><div>Health inequality remains a persistent challenge for welfare states. Over the past two decades (1999–2019), neoliberal policies and rising inequality have significantly influenced these attitudes.</div></div><div><h3>Objective</h3><div>The study investigates the evolution of public attitudes towards health inequality in OECD countries and evaluates the interaction between institutional structures and societal norms over time.</div></div><div><h3>Methods</h3><div>This study employs a longitudinal quantitative design utilizing data from the International Social Survey Programme (ISSP) Social Inequality module (1999, 2009, 2019) across 12 OECD countries. Descriptive analysis and multiple linear regression models were conducted to test grievance and policy feedback theories.</div></div><div><h3>Results</h3><div>In 1999, countries with lower public healthcare spending and higher inequality exhibited strong opposition to health inequality. However, by 2019, attitudes shifted, with opposition decreasing in highly unequal societies and increasing in countries with robust public healthcare spending. Regression analyses revealed significant changes over time, suggesting a transition from grievance-based responses to inequality toward acceptance influenced by policy feedback effects.</div></div><div><h3>Conclusions</h3><div>The findings underscore the need for policymakers to consider long-term policy impacts on public perceptions. Institutional frameworks fostering equitable healthcare access can counter the normalization of inequality, thereby promoting societal resistance to health disparities.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105398"},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663663","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":"Strengthening primary health care: The new contribution of midwives to gynecological care in France","authors":"Quitterie Roquebert ,&nbsp;Henri Panjo ,&nbsp;Carine Franc","doi":"10.1016/j.healthpol.2025.105397","DOIUrl":"10.1016/j.healthpol.2025.105397","url":null,"abstract":"<div><div>Many OECD countries are implementing reforms that redefine the roles of healthcare professionals to improve access to care and enhance the efficiency of the healthcare sector. In 2009, in a context of a shortage of gynecological primary care, France introduced a reform that expanded midwives’ scope of practice to include gynecological care for non-pregnant women, alongside their traditional roles in pregnancy and childbirth. This paper explores the effect of this reform on women’s healthcare utilization and examines how this effect varies according to women’s characteristics. Using administrative data on healthcare utilization among French women, we analyze changes in the probability of consulting a midwife between 2007 and 2017 among non-pregnant women aged 15 to 55. Our results show an increase in midwives’ use following the reform, particularly among recently pregnant women and those living in areas with poor access to healthcare services. Overall, the effect of the reform extending the primary care roles of health professionals on the use of care depends strongly on the provision of information about these new skills to the general public. Furthermore, we show that this reform is likely to strengthen the gynecological primary care supply in disadvantaged areas.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105397"},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654453","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 associations between prices and taxes and the use of tobacco products in Latin America and the Caribbean: a systematic review and meta-analysis","authors":"G. Emmanuel Guindon ,&nbsp;Ignacio Finot Cornejo ,&nbsp;Mauricio Flores Muñoz ,&nbsp;Luca Pruzzo ,&nbsp;Guillermo Paraje","doi":"10.1016/j.healthpol.2025.105396","DOIUrl":"10.1016/j.healthpol.2025.105396","url":null,"abstract":"<div><h3>Background</h3><div>Although taxes that raise retail tobacco prices and industry-initiated price increases have been shown to decrease tobacco consumption, the scarcity of studies in Latin America and the Caribbean using household- or individual-level data in existing reviews limits their policy relevance.</div></div><div><h3>Objective</h3><div>To conduct a systematic review and meta-analysis to assess the association between prices and taxes and the use of tobacco products in Latin America and the Caribbean.</div></div><div><h3>Methods</h3><div>We searched six electronic bibliographic databases, two online search engines, two working paper repositories, and hand-searched seven journals. We included all quantitative studies that used any measures of individual or household tobacco use as an outcome, written in English, Portuguese or Spanish. We used random-effects meta-analyses to pool results across studies.</div></div><div><h3>Results</h3><div>We found consistent evidence that in Latin American countries, higher cigarette prices were associated with lower cigarette smoking participation, consumption and initiation and that effect sizes were large enough to be policy meaningful. Pooled own-price elasticities indicate that higher prices were associated with a less than proportional decrease in tobacco use (pooled own-price elasticities, participation: 0.14 [95% CI –0.22, –0.06]; consumption: 0.54 [95% CI –0.75, –0.34]; total: 0.75 [95% CI -1.14, -0.36]). We found no consistent evidence that socioeconomic status, age, sex, rurality, or geographic regions affected price responsiveness.</div></div><div><h3>Conclusions</h3><div>Our review confirms that taxes that raise tobacco prices can effectively lower tobacco use. Moreover, raising tobacco prices through increased taxes is anticipated to boost tax revenue due to the inelastic nature of the demand for tobacco.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105396"},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704276","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":"Unraveling the policies, legislations, and regulations of psychedelics in Australia, Canada, Netherlands, New Zealand, and India","authors":"Ramesh Joga ,&nbsp;Sravani Yerram ,&nbsp;Jayasri Devi Patnam ,&nbsp;Khushbhoo K. Choudhary ,&nbsp;Priya Varpe ,&nbsp;Rajeev Singh Raghuvanshi ,&nbsp;Saurabh Srivastava","doi":"10.1016/j.healthpol.2025.105392","DOIUrl":"10.1016/j.healthpol.2025.105392","url":null,"abstract":"<div><h3>Background</h3><div>Research into psychedelics has gained renewed interest due to their potential to address psychiatric, neurological, and other peripheral conditions. These substances offer long-term therapeutic benefits, contrasting with the side effects and limitations of current psychiatric medicines.</div></div><div><h3>Objective</h3><div>This study examines the legislations and regulatory frameworks for psychedelics in Australia, Canada, The Netherlands, New Zealand, and India, highlighting their varied approaches to legalization, medical use, and integration into healthcare systems.</div></div><div><h3>Methods</h3><div>A comparative analysis of the regulatory landscapes in the selected countries was conducted, focusing on policies, clinical trial practices, and the ethical considerations surrounding psychedelics. Data were drawn from government documents, regulatory databases, and peer-reviewed literature.</div></div><div><h3>Results</h3><div>Australia legalized MDMA for post-traumatic stress disorder and psilocybin for treatment-resistant depression, establishing a structured prescription system for authorized psychiatrists. Canada and The Netherlands supports therapeutic use through regulated clinical trials and limited exemptions under strict controls, reflecting cautious but progressive approaches. New Zealand demonstrates exploratory interest in psychedelics within a controlled regulatory framework. India maintains stringent prohibitions with severe penalties for possession and use, despite emerging research indicating potential medical benefits.</div></div><div><h3>Conclusions</h3><div>Australia, Canada, The Netherlands, and New Zealand have taken pioneering steps in integrating psychedelics into medical practice, guided by evolving scientific evidence and ethical considerations. In contrast, India's conservative regulatory stance highlights significant barriers to exploring the medical potential of psychedelics. As global perspectives shift, balancing scientific advancements with robust regulatory measures will be crucial for shaping public health policies and fostering therapeutic innovation.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105392"},"PeriodicalIF":3.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678999","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":"Mental health as a determinant of work: a scoping review on the impact of mental health on precarious employment","authors":"Claire de Oliveira ,&nbsp;Margaret Jamieson ,&nbsp;Sara Bonato","doi":"10.1016/j.healthpol.2025.105395","DOIUrl":"10.1016/j.healthpol.2025.105395","url":null,"abstract":"<div><h3>Background</h3><div>While many studies have examined the impact of precarious employment on mental health, the reverse relationship has received less attention.</div></div><div><h3>Objectives</h3><div>The objectives of this scoping review were to ascertain the existing literature examining the impact of mental health on precarious employment and to describe, synthesise, and critically appraise it.</div></div><div><h3>Methods</h3><div>Business Source Premier, EconLit, Embase, MEDLINE, PsycINFO, and Web of Science were searched from 1 January 1980 to 30 August 2024. Additionally, searches were undertaken in Google and specific websites; references of key papers were also examined. Relevant data were extracted from studies, and their quality was assessed, namely whether they accounted for endogeneity. Evidence was synthesised by mental disorder/illness/problem using a narrative synthesis approach.</div></div><div><h3>Results</h3><div>After duplicates were removed, the search yielded 10,048 unique records; ultimately, 19 relevant papers, corresponding to 20 unique studies, were deemed relevant. Few specifically focused on mental health as a determinant of precarious employment and/or recognised the potential presence of endogeneity. Studies found mixed evidence on the relationship between mental health and precarious employment. While the evidence suggests that psychological distress and mental health complaints likely increase the probability of precarious employment, anxiety and emotional exhaustion likely do not. The evidence on depressive disorders is mixed/inconclusive.</div></div><div><h3>Conclusion</h3><div>Some of the existing literature suggests that people with poor mental health may be at a higher risk of precarious employment; however, in some instances, the evidence was either mixed/inconclusive or absent. More high-quality studies are needed to inform clear policy recommendations.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"161 ","pages":"Article 105395"},"PeriodicalIF":3.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588131","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}