Health Policy最新文献

{"title":"The WHO Pandemic Agreement should be more specific about when and how to enable global access to technology","authors":"Susi Geiger ,&nbsp;Barbara Prainsack ,&nbsp;Hendrik Wagenaar","doi":"10.1016/j.healthpol.2024.105112","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105112","url":null,"abstract":"<div><p>Timeliness is repeatedly referenced in the World Health Organization (WHO) Pandemic Agreement negotiation draft, published in March 2024. However, the draft remains vague with regard to what is considered timely. Health policymaking should be much more conscious of the time scales it evokes and implements in order to support global equity and solidarity. The Pandemic Agreement negotiation draft could be made more specific to foster global synchronicity by: (1) replacing ‘best endeavor’ language with enforceable timelines, particularly for benefit sharing mechanisms, (2) mandating an automatically triggered time-bound IP waiver for pandemic health technologies to accelerate manufacturing and distribution scale-up to global levels, and (3) strengthening the pandemic fund and debt relief mechanisms to safeguard financial resources to enable global synchronicity for future pandemic prevention, preparedness, and response. In summary, global solidarity during a pandemic requires more attention to synchronicity by ensuring the simultaneous implementation and rollout of measures to prevent, contain, or end a pandemic in different countries or regions.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"146 ","pages":"Article 105112"},"PeriodicalIF":3.3,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303211","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":"Sampson and Cookson's commentary: What is it good for?","authors":"K Claxton ,&nbsp;J Lomas ,&nbsp;F Longo ,&nbsp;A Salas Ortiz","doi":"10.1016/j.healthpol.2024.105100","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105100","url":null,"abstract":"","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"146 ","pages":"Article 105100"},"PeriodicalIF":3.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141323938","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":"Personal protective equipment for healthcare workers during COVID-19: Developing and applying a questionnaire and assessing associations between infection rates and shortages across 19 countries","authors":"Madelon Kroneman ,&nbsp;Gemma A. Williams ,&nbsp;Juliane Winkelmann ,&nbsp;Peter Spreeuwenberg ,&nbsp;Krisztina Davidovics ,&nbsp;Peter P. Groenewegen","doi":"10.1016/j.healthpol.2024.105097","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105097","url":null,"abstract":"<div><p>This study aimed to assess the preparedness of European countries regarding personal protective equipment (PPE) for health and care workers (HCWs), the COVID-19 infection rates of HCWs compared to the general working age population, and the association between these. We developed a PPE-preparedness scale based on responses to a questionnaire from experts in the Health Systems and Policy Monitor network, with a response rate of 19 out of 31 countries. COVID-19 infection data were retrieved form the European center for Disease Prevention and Control. Shortages of PPE were found in most countries, in particular in home care and long-term care. HCW infection rates, compared to the general population, varied strongly between countries, influenced by different testing regimes. We found no relationships between HCW infection rates, PPE preparedness and shortages of PPE. Improved surveillance in the population as well as for HCWS are needed to be able to better assess these relationships.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"146 ","pages":"Article 105097"},"PeriodicalIF":3.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168851024001076/pdfft?md5=c632870a8d0dbb4150709d5531f55a70&pid=1-s2.0-S0168851024001076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312984","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}

{"title":"Preconditions for efficiency and affordability in competitive healthcare markets: Are they fulfilled in Belgium, Germany, Israel, the Netherlands and Switzerland? Ten years later","authors":"Wynand P.M.M. van de Ven ,&nbsp;Konstantin Beck ,&nbsp;Florian Buchner ,&nbsp;Erik Schokkaert ,&nbsp;Frederik T. Schut ,&nbsp;Amir Shmueli ,&nbsp;Juergen Wasem","doi":"10.1016/j.healthpol.2024.105099","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105099","url":null,"abstract":"<div><p>From the mid-1990s several countries have introduced elements of the model of regulated competition in healthcare. In 2012 we assessed the extent to which in five countries ten important preconditions for achieving efficiency and affordability in competitive healthcare markets were fulfilled. In this paper we assess to what extent the fulfilment of these preconditions has changed ten years later.</p><p>In 2022, as in 2012, in none of the five countries all preconditions are completely fulfilled. In the period 2012–2022 on balance there have been some improvements in the fulfillment of the preconditions, although to a different extent in the five countries. The only preconditions that were improved in most countries were ‘consumer information and transparency’ and ‘cross-subsidies without incentives for risk selection’. On balance the Netherlands and Switzerland made most progress in the number of better fulfilled preconditions. For Belgium these preconditions no longer seem relevant because the idea of regulated competition has been completely abandoned. In Germany, Israel and Switzerland, the preconditions ‘effective competition policy’ and ‘contestability of the markets’ are not sufficiently fulfilled in 2022, just as in 2012. In Germany and Switzerland this also holds for the precondition ‘freedom to contract and integrate’. Overall, the progress towards realizing the preconditions has been limited.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"146 ","pages":"Article 105099"},"PeriodicalIF":3.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S016885102400109X/pdfft?md5=eb0ae95b5a48a2d3179a5742ed5e4195&pid=1-s2.0-S016885102400109X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303212","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}

{"title":"Long-term impact of unhealthy food tax on consumption and the drivers behind: A longitudinal study in Hungary","authors":"Zombor Berezvai ,&nbsp;József Vitrai ,&nbsp;Gergely Tóth ,&nbsp;Zoltán Brys ,&nbsp;Márta Bakacs ,&nbsp;Tamás Joó","doi":"10.1016/j.healthpol.2024.105098","DOIUrl":"10.1016/j.healthpol.2024.105098","url":null,"abstract":"<div><p>Several countries have introduced public health product taxes with the objective of reducing the absolute amount of consumption of unhealthy food and tackling obesity. This study aims to estimate the long-term impact of the Hungarian public health product tax introduced in 2011.</p><p>To achieve this, a unique consumer purchase dataset was analysed to examine daily fast-moving consumer goods purchases from a representative sample of 2,000 households from 2010 to 2018. The results indicate that the tax has been fully reflected in consumer prices. A decline in consumption was observed initially, consistent with previous experiences in Hungary and other countries. However, over time, the data suggests a recovery and even an increase in line with the growth of disposable income. The proportion of taxed products in total fast-moving consumer goods purchases increased from 5.9 % (95 % CI: 5.7 % to 6.0 %) in 2010 to 7.4 % (95 % CI: 7.3 % to 7.6 %) in 2018. Furthermore, the tax has contributed to increased inequality as low-income households spend a higher proportion of their total expenditure on it.</p><p>Although taxes on unhealthy foods have proven effective in the short-term, they may not be adequate for reducing overall consumption in the long-term, particularly as disposable income increases. In conclusion, implementing complex interventions is necessary to achieve sustainable positive changes in dietary habits.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"146 ","pages":"Article 105098"},"PeriodicalIF":3.3,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168851024001088/pdfft?md5=33a1328951d3e5308e96810362019f99&pid=1-s2.0-S0168851024001088-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293983","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}

{"title":"Rural healthcare workforce preparation, response, and work during the COVID-19 pandemic in Australia: Lessons learned from in-depth interviews with rural health service leaders","authors":"Vanessa J. Watkins ,&nbsp;Anna Wong Shee ,&nbsp;Michael Field ,&nbsp;Laura Alston ,&nbsp;Danny Hills ,&nbsp;Simon L. Albrecht ,&nbsp;Cherene Ockerby ,&nbsp;Alison M. Hutchinson","doi":"10.1016/j.healthpol.2024.105085","DOIUrl":"10.1016/j.healthpol.2024.105085","url":null,"abstract":"<div><h3>Background</h3><p>Low population density, geographic spread, limited infrastructure and higher costs are unique challenges in the delivery of healthcare in rural areas. During the COVID-19 pandemic, emergency powers adopted globally to slow the spread of transmission of the virus included population-wide lockdowns and restrictions upon movement, testing, contact tracing and vaccination programs. The aim of this research was to document the experiences of rural health service leaders as they prepared for the emergency pandemic response, and to derive from this the lessons learned for workforce preparedness to inform recommendations for future policy and emergency planning.</p></div><div><h3>Methodology and methods</h3><p>Interviews were conducted with leaders from two rural public health services in Australia, one small (500 staff) and one large (3000 staff). Data were inductively coded and analysed thematically.</p></div><div><h3>Participants</h3><p>Thirty-three participants included health service leaders in executive, clinical, and administrative roles.</p></div><div><h3>Findings</h3><p>Six major themes were identified: <em>Working towards a common goal, Delivery of care, Education and training, Organizational governance and leadership, Personal and psychological impacts,</em> and <em>Working with the Local Community</em>. Findings informed the development of a applied framework.</p></div><div><h3>Conclusion</h3><p>The study findings emphasise the critical importance of leadership, teamwork and community engagement in preparing the emergency pandemic response in rural areas. Informed by this research, recommendations were made to guide future rural pandemic emergency responses or health crises around the world.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"145 ","pages":"Article 105085"},"PeriodicalIF":3.3,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168851024000952/pdfft?md5=cd6973c05293cca3fdb29ed0a690ab84&pid=1-s2.0-S0168851024000952-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130657","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}

{"title":"Germany's national public health gets reorganized: A new institute shall take center stage","authors":"Nicolai Savaskan ,&nbsp;Benedikt M.J. Lampl ,&nbsp;Mesut Yavuz ,&nbsp;Peter Tinnemann","doi":"10.1016/j.healthpol.2024.105084","DOIUrl":"10.1016/j.healthpol.2024.105084","url":null,"abstract":"<div><p>In the aftermath of the COVID-19 pandemic, the German federal government recently orchestrated a fundamental change to its public health infrastructure. This reconstruction centers around the founding of a National Institute for Prevention and Education in Medicine (Bundesinstitut für Prävention und Aufklärung in der Medizin, BIPAM) at the cost of two federal institutions, the Robert Koch-Institute (RKI) and the Federal Center for Health Education (Bundeszentrale für gesundheitliche Aufklärung, BzGA). Thus, the Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) plans to dissolve the BzGA and integrate its personnel into the future BIPAM. Further, all RKI research and surveillance activities related to non-communicable diseases, including AI methods development will be transferred into the BIPAM. The RKI responsibilities will solely focus on infectious diseases. According to announced plans of the BMG the primary objective for establishing the BIPAM is to address non-communicable diseases and enhance overall population health. However, the medical specialist training for public health remains non-academic at a state institution. Simultaneously the BMG already replaced two thirds of experts of the permanent commission on vaccination (Ständige Impfkommission, STIKO) and determined new procedures for appointing future expert commissioners. With these changes, Germany embarks on an extraordinary reshuffling of its national public health organizations and responsibilities, by fundamentally separating all issues around non-communicable diseases from those of infectious diseases. Germany's unraveled research tasks of public health authorities however remains unmet. Thus, 2024 marks a pivotal caesura for public health in the modern history of Germany.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"145 ","pages":"Article 105084"},"PeriodicalIF":3.3,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142366","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":"Enforcing the right to health in private health systems through Judicialization what can we learn from the scoping review of the cross-national perspective?","authors":"Evandro Antonio Sbalcheiro Mariot ,&nbsp;Stela Barbas ,&nbsp;Rui Nunes","doi":"10.1016/j.healthpol.2024.105096","DOIUrl":"10.1016/j.healthpol.2024.105096","url":null,"abstract":"<div><h3>Background</h3><p>Private sector acting in healthcare does not remove the public nature of a health system, nor mitigate the right to health as a human right.</p></div><div><h3>Methods</h3><p>This scoping review aims to answer the question: what factors influence the pattern of lawsuits seeking to enforce the right to health in private healthcare systems? The search was carried out in Pubmed, SciELO, DOAJ and Scopus.</p></div><div><h3>Results</h3><p>Out of 464 articles found, after inclusion and exclusion criteria, 30 articles were included. The survey covered 36 different countries and four main factors were identified. The socioeconomic context, the health system model, the incorporation of the right to health in legislation, and the model of regulation of private health.</p></div><div><h3>Conclusions</h3><p>Understanding these patterns help understanding the difficulties of implementing and guaranteeing universal health. Health systems must be based on responsibility, solidarity, equity, and distributive justice, since the sum of these values generates mutualism. Judicial decision-making regarding to health access must be reasoned on equity and distributive justice, scientific evidence and ethical factors. Even private health systems must be funded in a well-defined ethical platform and social moral valuation.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"145 ","pages":"Article 105096"},"PeriodicalIF":3.3,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132318","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":"Are Polish doctors ready to start working right after graduation? The 2023 modification to physicians’ postgraduate internship and possible paths forward","authors":"Robert Kupis ,&nbsp;Alicja Domagała","doi":"10.1016/j.healthpol.2024.105083","DOIUrl":"https://doi.org/10.1016/j.healthpol.2024.105083","url":null,"abstract":"<div><p>The Polish healthcare system faces many problems, among which the shortage of healthcare professionals is one of the most urgent. In less than ten years, more than twenty Higher Education Institutions (HEIs) have been allowed to add medical programmes to their offer, aiming to increase the number of doctors in Poland. Recently, the healthcare system was faced with a proposal to abolish the mandatory postgraduate internship which has been a mandatory component of medical training for years.</p><p>Two main reforms were considered. The first one focused on the programme of the internship and aimed to update it. The second one recommended an abolition of the internship. The authors of this article analysed the opinions and positions of key players within the system regarding the postgraduate internship.</p><p>Opinions in this regard are diverse, leading to the conclusion that additional actions would be required prior to the internship abolition. Undergraduate training has changed and currently students are taught in modern facilities, using new teaching methods. On the other hand, internship allows trainees to improve or even acquire skills they may not have obtained during their studies. The postgraduate internship is an essential part of doctors’ training. However, in Poland, there is still a lack of a well-thought, long-term policy or strategy for physicians' workforce development. Our study presents a Polish perspective on common challenges in medical training and workforce policy, highlighting the clash over the growing demand for physicians and the limitations of the existing system.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"145 ","pages":"Article 105083"},"PeriodicalIF":3.3,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141078604","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":"Political determinants of COVID-19 restrictions and vaccine rollouts: The case of regional elections in Italy and Spain","authors":"Pablo Arija Prieto ,&nbsp;Marcello Antonini ,&nbsp;Mehdi Ammi ,&nbsp;Mesfin Genie ,&nbsp;Francesco Paolucci","doi":"10.1016/j.healthpol.2024.105082","DOIUrl":"10.1016/j.healthpol.2024.105082","url":null,"abstract":"<div><p>The COVID-19 pandemic is one of the most significant public health crises in modern history, with considerable impacts on the policy frameworks of national governments. In response to the pandemic, non-pharmaceutical interventions (NPIs) and mass vaccination campaigns have been employed to protect vulnerable groups. Through the lens of Political Budget Cycle (PBC) theory, this study explores the interplay between incumbent electoral concerns and political dynamics in influencing the implementation of NPIs and vaccination rollout within the administrative regions of Italy and Spain during the period spanning June 2020 to July 2021. The results reveal that incumbents up for the next scheduled election are 5.8 % more likely to increase the stringency of containment measures than those that face a term limit. The findings also demonstrate that the seats of the incumbent and coalition parties in parliament and the number of parties in the coalition have a negative effect on both the efficiency of the vaccination rollout and the stringency of NPIs. Additionally, the competitiveness of the election emerges as an important predictor of the strictness of NPIs. Therefore, our results suggest that incumbents may strategically manipulate COVID-19 policy measures to optimize electoral outcomes. The study underscores the substantive influence of political incentives, competitive electoral environments, and government coalitions on policy formulation during health emergencies.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"145 ","pages":"Article 105082"},"PeriodicalIF":3.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168851024000927/pdfft?md5=df19be176e3510ccf8e0aa36d5a0546e&pid=1-s2.0-S0168851024000927-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141043656","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}