Health systems and reform最新文献_第2页

Health Policy and Systems Research: Where Are We and What Does the Future Hold? 卫生政策和系统研究：我们在哪里，未来会怎样？

IF 1.9

Health systems and reform Pub Date : 2026-12-31 Epub Date: 2026-06-03 DOI: 10.1080/23288604.2026.2668734

Tolib Mirzoev, Ana B Amaya, David Daniels, Rumana Huque, Aku Kwamie, Robert Marten, Zubin Cyrus Shroff, Goran Zangana, Kumanan Rasanathan

{"title":"Health Policy and Systems Research: Where Are We and What Does the Future Hold?","authors":"Tolib Mirzoev, Ana B Amaya, David Daniels, Rumana Huque, Aku Kwamie, Robert Marten, Zubin Cyrus Shroff, Goran Zangana, Kumanan Rasanathan","doi":"10.1080/23288604.2026.2668734","DOIUrl":"10.1080/23288604.2026.2668734","url":null,"abstract":"Health policy and systems research (HPSR) is a relatively young and multidisciplinary field of applied and policy-relevant science. It bridges the worlds of research, practice, and advocacy, and is dedicated to producing evidence to improve health policies and systems, while maintaining a focus on equity and social justice. The evidence around HPSR has grown significantly, but there is a paucity of reflections on HPSR as a field in a context of multiple inter-linked crises. This commentary reflects on key thematic, methodological, and value-driven trends in HPSR to underline its utility within the global health discourse and inform its prioritization. Key HPSR trends include increasingly multidisciplinary, participatory, and inclusive approaches and efforts toward decolonization. These reflect national and global societal priorities and respond to shifting burdens of communicable and non-communicable diseases, aging populations, rapid and uncontrolled urbanization, epidemics of infectious diseases, and climate emergency. Improved prioritization of HPSR nationally and globally, including dedicated and diversified funding for research and strengthening of local research and implementation capacities for HPSR, are particularly important in the current context of geopolitical and fiscal changes. Sustaining and growing HPSR can inform strong health systems and, ultimately, contribute to improved health and wellbeing.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"12 1","pages":"2668734"},"PeriodicalIF":1.9,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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From Data to Policy: Strengthening Kuwait's Health Insurance for Sustainability and Equity. 从数据到政策：加强科威特健康保险，促进可持续性和公平性。

IF 1.9

Health systems and reform Pub Date : 2026-12-31 Epub Date: 2026-08-24 DOI: 10.1080/23288604.2026.2704239

Jade Khalife, Batoul Dawi, Abdulrahman Alqashaan, Hisham Kelendar, Henry Doctor, Abdulaziz Alhenaidi

引用次数: 0

Health Systems Research for a New Era: Launch Editorial. 新时代的卫生系统研究：启动社论。

IF 1.9

Health systems and reform Pub Date : 2026-12-31 Epub Date: 2026-07-06 DOI: 10.1080/23288604.2026.2688953

Michael R Reich, Corrina Moucheraud, Pablo Villalobos, Veronika J Wirtz, Abdo Yazbeck, Yarlini Balarajan

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Framing Overtreatment as Consumer Fraud: Analysis and Implications of China's First Civil Public Interest Litigation in Healthcare. 将过度治疗定性为消费者欺诈：中国首例医疗民事公益诉讼分析及启示。

IF 1.9

Health systems and reform Pub Date : 2026-12-31 Epub Date: 2026-04-06 DOI: 10.1080/23288604.2026.2648262

Jiayi Jiang, Mushiyi Yang

引用次数: 0

Quantifying the Intangible: Evidence from Nigeria on the Impact of Supervision, Autonomy, and Management Practices on PHC Performance in the Context of Direct Facility Financing. 量化无形资产：来自尼日利亚的证据：在直接融资的背景下，监督、自治和管理实践对初级保健绩效的影响。

IF 1.9

Health systems and reform Pub Date : 2026-12-31 Epub Date: 2026-01-27 DOI: 10.1080/23288604.2025.2609358

Brittany Hagedorn, Benjamin Loevinsohn, Oluwole Odutolu

{"title":"Quantifying the Intangible: Evidence from Nigeria on the Impact of Supervision, Autonomy, and Management Practices on PHC Performance in the Context of Direct Facility Financing.","authors":"Brittany Hagedorn, Benjamin Loevinsohn, Oluwole Odutolu","doi":"10.1080/23288604.2025.2609358","DOIUrl":"10.1080/23288604.2025.2609358","url":null,"abstract":"Previous studies have shown that facility autonomy, especially control over budget allocation, and management practices can have a modest positive effect on health facility performance, but the evidence is limited and often qualitative. Data from the evaluation of the Nigeria States Health Investment Project (NSHIP), a study that examined the effects of direct facility and performance-based financing, offers a novel opportunity to quantitatively examine these relationships in the context of a lower middle-income country. We utilize non-parametric statistics and regression methods to test the hypothesis that autonomy, supervision, and management affected facility performance. Results show that facilities with greater autonomy, more budget control, and better management practices generally outperform their peers on a range of facility readiness and service delivery measures. For example, regressions show that facilities with high autonomy held an additional 2.1 outreach sessions per month and facilities with a business plan offered 1.8 additional outreach services (p < 0.05). Supervision practices, including visit frequency and a quantitative checklist, are associated with 26% higher productivity and up to a 29% increase in equipment availability (p < 0.05). Sensitivity analyses validated that results are robust. We conclude that facility-level autonomy and especially budget control can improve primary healthcare facility readiness and service availability. Further, management practices that are reinforced through supportive supervision and routine monitoring can maximize the benefits that accrue from even small amounts of incremental financing. This shows that these policies and practices can contribute critically to efficiently achieving the goals of universal healthcare policies in the context of limited resources.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"12 1","pages":"2609358"},"PeriodicalIF":1.9,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study. 数字化和超竞争研究文化时代的高效和有效的糖尿病护理：西太平洋地区以马来西亚为例的重点回顾。

IF 1.9

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-01-06 DOI: 10.1080/23288604.2024.2417788

Boon-How Chew, Pauline Siew Mei Lai, Dhashani A/P Sivaratnam, Nurul Iftida Basri, Geeta Appannah, Barakatun Nisak Mohd Yusof, Subashini C Thambiah, Zubaidah Nor Hanipah, Ping-Foo Wong, Li-Cheng Chang

{"title":"Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study.","authors":"Boon-How Chew, Pauline Siew Mei Lai, Dhashani A/P Sivaratnam, Nurul Iftida Basri, Geeta Appannah, Barakatun Nisak Mohd Yusof, Subashini C Thambiah, Zubaidah Nor Hanipah, Ping-Foo Wong, Li-Cheng Chang","doi":"10.1080/23288604.2024.2417788","DOIUrl":"10.1080/23288604.2024.2417788","url":null,"abstract":"There are approximately 220 million (about 12% regional prevalence) adults living with diabetes mellitus (DM) with its related complications, and morbidity knowingly or unconsciously in the Western Pacific Region (WP). The estimated healthcare cost in the WP and Malaysia was 240 billion USD and 1.0 billion USD in 2021 and 2017, respectively, with unmeasurable suffering and loss of health quality and economic productivity. This urgently calls for nothing less than concerted and preventive efforts from all stakeholders to invest in transforming healthcare professionals and reforming the healthcare system that prioritizes primary medical care setting, empowering allied health professionals, improvising health organization for the healthcare providers, improving health facilities and non-medical support for the people with DM. This article alludes to challenges in optimal diabetes care and proposes evidence-based initiatives over a 5-year period in a detailed roadmap to bring about dynamic and efficient healthcare services that are effective in managing people with DM using Malaysia as a case study for reference of other countries with similar backgrounds and issues. This includes a scanning on the landscape of clinical research in DM, dimensions and spectrum of research misconducts, possible common biases along the whole research process, key preventive strategies, implementation and limitations toward high-quality research. Lastly, digital medicine and how artificial intelligence could contribute to diabetes care and open science practices in research are also discussed.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2417788"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Do Pro-Competition Healthcare Reforms Always Bring Health Benefits? Evidence from China. 支持竞争的医疗改革总能带来健康效益吗？来自中国的证据。

IF 1.9

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-06-09 DOI: 10.1080/23288604.2025.2507975

Zixuan Peng, Audrey Laporte, Xiaolin Wei, Jay Pan, Peter C Coyte

{"title":"Do Pro-Competition Healthcare Reforms Always Bring Health Benefits? Evidence from China.","authors":"Zixuan Peng, Audrey Laporte, Xiaolin Wei, Jay Pan, Peter C Coyte","doi":"10.1080/23288604.2025.2507975","DOIUrl":"10.1080/23288604.2025.2507975","url":null,"abstract":"It is already a common practice for many health care systems in the world to opt for mixed markets where different types of health care facilities compete against each other to offer high-quality health care to patients. Nevertheless, little is known about the effects of the interaction between hospitals of the same or different type on patient health outcomes. This study estimated the impacts of aggregate and specific types of hospital competition by hospital-type on the quality of inpatient care using an analysis dataset comprising 267,183 individuals from China. The Herfindahl-Hirschman index was employed to measure the degree of hospital competition, with length of stay, readmission and mortality being used to measure the quality of inpatient care. The Poisson and binomial logistic models combined with the instrumental variable approach were constructed to estimate the impacts of hospital competition. This study generated three key findings: 1) aggregate hospital competition reduced the quality of inpatient care, as evidenced by a rise in the odds of readmission and length of stay; 2) intra-type hospital competition reduced the quality of inpatient care and in general had larger effects on reducing the quality of inpatient care than inter-type hospital competition; and 3) the only exception was in the way that competition between private nonprofit hospitals contributed to better quality of inpatient care. The overarching suggestion is that instead of treating competition as a panacea for improving health, a flexible plan tailored to specific conditions is needed.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2507975"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correcting Market and Government Failures in Tackling the Global Growth of Type 2 Diabetes: Application of WHO's Common Goods for Health Approach. 纠正市场和政府在应对2型糖尿病全球增长方面的失灵：应用世卫组织的“卫生共同产品”方针。

IF 1.9

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-10-07 DOI: 10.1080/23288604.2025.2550883

Agnes L Soucat, Sylvestre Gaudin, Abdo S Yazbeck

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Public Policy and Health System Responses to Diabetes Mellitus in Nigeria: A Call for Reform. 尼日利亚对糖尿病的公共政策和卫生系统反应：呼吁改革。

IF 1.9

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-03-12 DOI: 10.1080/23288604.2025.2477941

Friday Okonofua, Lorretta Favour Ntoimo, Rosemary Ogu, Maradona Isikhuemen

{"title":"Public Policy and Health System Responses to Diabetes Mellitus in Nigeria: A Call for Reform.","authors":"Friday Okonofua, Lorretta Favour Ntoimo, Rosemary Ogu, Maradona Isikhuemen","doi":"10.1080/23288604.2025.2477941","DOIUrl":"10.1080/23288604.2025.2477941","url":null,"abstract":"Diabetes mellitus, once a rare diagnosis in precolonial and early post-colonial Nigeria, now has the highest prevalence and fatality rates in sub-Saharan Africa. This increased prevalence is attributed to rising population affluence characterized by sedentary lifestyles and higher consumption of processed and ultra-processed foods. The burden is further exacerbated by a poorly responsive healthcare system. Currently, less than 50% of affected individuals are aware of their condition. Factors such as misconceptions about the disease, a preference for unproven traditional herbal treatments, and the high cost of treatment hinder effective secondary responses. Health system challenges in diabetes management in Nigeria include inadequate implementation of existing policies and guidelines, high out-of-pocket payments, poor quality of healthcare, and limited public education about the disease. To address these issues, we recommend a policy focus on: 1) Implementing actionable policies and guidelines for diabetes prevention and care; 2) Improving the pre-paid care system to reduce out-of-pocket payments; 3) Enhancing the quality of services at all healthcare levels, with the establishment of centers of excellence for specialized diabetes management; 4) Continuing the training, retraining, motivation, and expansion of the workforce responsible for diabetes care; and 5) Health promotion and health awareness aimed at the public to address inaccurate beliefs and practices about diabetes. Addressing these multifaceted factors will help to reduce the rising incidence of diabetes in Nigeria.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2477941"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Implementation of NCD Care in Low- and Middle-Income Countries: The Case of Fixed Dose Combinations for Hypertension in Kenya. 改善低收入和中等收入国家非传染性疾病护理的实施：肯尼亚高血压固定剂量联合治疗的案例。

IF 1.9

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-02-04 DOI: 10.1080/23288604.2024.2448862

Adrianna Murphy, Daniel Mbuthia, Ruth Willis, Benjamin Tsofa, Mary Gichagua, Peter Mugo, Kara Hanson, Michael R Reich

{"title":"Improving Implementation of NCD Care in Low- and Middle-Income Countries: The Case of Fixed Dose Combinations for Hypertension in Kenya.","authors":"Adrianna Murphy, Daniel Mbuthia, Ruth Willis, Benjamin Tsofa, Mary Gichagua, Peter Mugo, Kara Hanson, Michael R Reich","doi":"10.1080/23288604.2024.2448862","DOIUrl":"10.1080/23288604.2024.2448862","url":null,"abstract":"Health systems in low- and middle-income countries face the challenge of addressing the growing burden of non-communicable diseases (NCDs) with scarce resources to do so. There are cost-effective interventions that can improve management of the most common NCDs, but many remain poorly implemented. One example is fixed dose combinations (FDCs) of medications for hypertension. Included in WHO's Essential Medicines List, FDCs combine two or more blood pressure lowering agents into one pill and can reduce burden on patients and the health system. However, implementation of FDCs globally is poor. We aimed to identify health systems factors affecting implementation of evidence-based interventions for NCDs, and opportunities to address these, using the case study of FDCs in Kenya. We conducted semi-structured interviews with 39 policy-makers and healthcare workers involved in hypertension treatment policy and identified through snowball sampling. Interview data were analyzed thematically, using the Access Framework to categorize themes. Our interviews identified factors operating at the global, national, county, and provider levels. These include lack of global implementation guidance, context specific cost-effectiveness data, or prioritization by procurement agencies and clinical guidelines; perceived high cost; poor data for demand forecasting; insufficient budget for procurement of NCD medications; absence of prescriber training and awareness of clinical guidelines; and habitual prescribing behavior and understaffing limiting capacity for change. We propose specific strategies to address these. The findings of this work can inform efforts to improve implementation of other evidence-based interventions for NCDs in low-income settings.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2448862"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0