Health systems and reform最新文献_第4页

Preparedness, Challenges, and Opportunities for Digital Intervention for Chronic Disease Management: A Qualitative Study in Rural Areas of South Korea. 慢性病管理数字化干预的准备情况、挑战和机遇：韩国农村地区的定性研究。

Health systems and reform Pub Date : 2024-12-17 Epub Date: 2024-10-22 DOI: 10.1080/23288604.2024.2378503

Hwa-Young Lee, Minji Ju, Minah Kang, Heejung Lee, Juho Choi, Juhwan Oh

{"title":"Preparedness, Challenges, and Opportunities for Digital Intervention for Chronic Disease Management: A Qualitative Study in Rural Areas of South Korea.","authors":"Hwa-Young Lee, Minji Ju, Minah Kang, Heejung Lee, Juho Choi, Juhwan Oh","doi":"10.1080/23288604.2024.2378503","DOIUrl":"https://doi.org/10.1080/23288604.2024.2378503","url":null,"abstract":"Motivated by the prevalence of an aging population and the associated increase in chronic diseases, coupled with rising medical expenditure, the Korean government initiated a pilot project in Pyeongchang-gun, Gangwon-do, a rural area, to implement a \"smart online-to-offline (O2O) digital health care model\" aimed at managing and preventing chronic diseases. However, there is limited understanding regarding perspectives and levels of preparedness for digital health among stakeholders at various levels. In-depth focus group interviews were conducted with elderly and non-elderly community members, health care providers, and staff members at Pyeongchang Health and Medical Center. The study found the presence of both positive and negative perceptions and a lack of preparedness across different levels. At the end-user level, it was observed that community members, especially the elderly, have low levels of health and digital literacy, compounded by limited access to social support. At the health care provider level, there was uncertainty about the acceptance of the digital health program. At the area level, the need to bolster health staff members and enhance their capacity was observed. Recommendations include: customizing the design of the online and offline service components by considering end-user factors (such as age, occupation, and household type) that may contribute to disparities in health; establishing a platform for providers to share their experiences to facilitate the effective incorporation of digital health into their practices; and preparing an appropriate provider payment mechanism.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 2","pages":"2378503"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514152","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

Policies, Progress, and Prospects for Internet Telemedicine in China. 中国互联网远程医疗的政策、进展和前景。

Health systems and reform Pub Date : 2024-12-17 Epub Date: 2024-10-22 DOI: 10.1080/23288604.2024.2389570

Terence C Cheng, Winnie Yip

{"title":"Policies, Progress, and Prospects for Internet Telemedicine in China.","authors":"Terence C Cheng, Winnie Yip","doi":"10.1080/23288604.2024.2389570","DOIUrl":"https://doi.org/10.1080/23288604.2024.2389570","url":null,"abstract":"Around the world, the adoption of digital technologies in health care has accelerated considerably in the wake of the COVID-19 pandemic. Prior to the emergence of the pandemic, China had already embarked on a private sector, technology enterprise-led creation of an innovative internet health care ecosystem, which has dramatically transformed China's health care landscape. In this article, we describe the evolution of China's internet health market, focusing on internet telemedicine. We trace its early origins with the establishment of information networks in the 1980s, to the emergence of a fast-growing internet health market in the 2010s that leveraged the capabilities of technology enterprises in e-commerce, logistics, and payment systems. Private health care platforms have played a central role throughout this transformative process. The supplyside of the market has a unique public-private mix structure, with the coexistence of public and private internet hospitals, and with the majority of telemedicine services provided by public hospital doctors working on private platforms in a dual practice capacity. We conclude with a discussion of the prospects of internet telemedicine, including how it should be optimized and harnessed to improve China's health system. Finally, we set out areas where more research is needed.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 2","pages":"2389570"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514149","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

Introduction to the Special Issue on Digital Health: Opportunities and Challenges for Global Health. 数字健康特刊导言：数字健康：全球健康的机遇与挑战》特刊导言。

Health systems and reform Pub Date : 2024-12-17 Epub Date: 2024-10-22 DOI: 10.1080/23288604.2024.2400722

Michael R Reich

引用次数: 0

Digital Transformation in the Health Product Supply Chain: A Framework for Analysis. 保健产品供应链的数字化转型：分析框架》。

Health systems and reform Pub Date : 2024-12-17 Epub Date: 2024-10-22 DOI: 10.1080/23288604.2024.2386041

Prashant Yadav

{"title":"Digital Transformation in the Health Product Supply Chain: A Framework for Analysis.","authors":"Prashant Yadav","doi":"10.1080/23288604.2024.2386041","DOIUrl":"https://doi.org/10.1080/23288604.2024.2386041","url":null,"abstract":"Well-functioning supply chains for medicines and other health products are vital for a health system's goals of ensuring access, quality, and efficiency. However, in several countries the performance of government-run supply chains for health products remains subpar. The widespread adoption of digital technology presents new opportunities for enhancing the performance of the health product supply chain. This paper aims to provide a practical and systematic analysis of digital initiatives within health product supply chains. It provides examples of successful digital interventions in each of the Enable, Plan, Source, and Deliver categories of the Supply Chain Operations Reference model. The examples provide clear evidence that the use of digital technology in the health supply chain can improve access and affordability; in some instances, use of digital technology can lead to faster health product adoption and alter the overall architecture of decision making. While many digital interventions in the public sector supply chain target the collection of data and its analysis and use for reporting, the long-term effectiveness of digital solutions hinges on their ability to enhance the agency of supply chain actors. A thorough and systematic inquiry about the logic model of how a particular digital solution enhances agency and improves accountability is essential at the outset. In developing roadmaps to prioritize and sequence digital solutions in health supply chains, governments should start by asking where lack of information is the primary constraint impeding supply chain performance.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 2","pages":"2386041"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514146","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

The Consolidation of Risk Pools in the National Health Insurance Program of the Republic of Korea: Analysis of the Political Processes. 大韩民国国民健康保险计划中风险池的整合：政治进程分析。

Health systems and reform Pub Date : 2024-12-16 Epub Date: 2024-08-19 DOI: 10.1080/23288604.2024.2375101

Green Bae, Minah Kang, Michael R Reich

{"title":"The Consolidation of Risk Pools in the National Health Insurance Program of the Republic of Korea: Analysis of the Political Processes.","authors":"Green Bae, Minah Kang, Michael R Reich","doi":"10.1080/23288604.2024.2375101","DOIUrl":"10.1080/23288604.2024.2375101","url":null,"abstract":"South Korea is one of the few countries that has successfully consolidated its national risk pools into a single-payer health insurance system. This study analyzes national health insurance (NHI) consolidation in South Korea between 1980 and 2003, drawing lessons for countries seeking to consolidate their risk pools. The paper contextualizes the development of the South Korean national health insurance system and the consolidation of its risk pools in the changes in the political environment, particularly the processes of political democratization. It examines how these processes have affected the societal meanings and roles of the health insurance system. The paper focuses on two policy stages. During the agenda-setting stage, the government and employers emphasized the efficiency of the health insurance system. This emphasis contributed to the failure of a consolidation plan that emphasized equity over efficiency. However, as democratization expanded, the power of civil society movements and the popular demand for equity grew stronger. During the policy adoption phase, consolidation of health insurance trusts in South Korea was achieved through social and political processes that influenced public opinion, expanded civil society participation in decision-making, and worked with the government to integrate health insurance organizations and funds.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2375101"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006084","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

An Assessment of Provider Payment Mechanisms (PPMs) in Ethiopia: Implications for Redesign of PPMs and Progress Toward Universal Health Coverage. 埃塞俄比亚医疗服务提供者付款机制（PPMs）评估：对重新设计提供方付费机制和实现全民医保的影响》。

Health systems and reform Pub Date : 2024-12-16 Epub Date: 2024-07-19 DOI: 10.1080/23288604.2024.2377620

Mideksa Koricho, Tseday Zerayacob, Firehiwot Abebe, Muluken Argaw, Dereje Mengistu, Felegush Birhane, Shewa Negash, Amanuel Haileselassie, Agnes Gatome-Munyua

{"title":"An Assessment of Provider Payment Mechanisms (PPMs) in Ethiopia: Implications for Redesign of PPMs and Progress Toward Universal Health Coverage.","authors":"Mideksa Koricho, Tseday Zerayacob, Firehiwot Abebe, Muluken Argaw, Dereje Mengistu, Felegush Birhane, Shewa Negash, Amanuel Haileselassie, Agnes Gatome-Munyua","doi":"10.1080/23288604.2024.2377620","DOIUrl":"10.1080/23288604.2024.2377620","url":null,"abstract":"Ethiopia has made great strides in improving population health but sustaining health system and population health improvements in the current fiscal environment is challenging. Provider payment, as a function of purchasing, is a tool to use limited health resources better. This study describes the design and implementation of Ethiopia's provider payment mechanisms (PPMs) and how they influence health system objectives and contribute to universal health coverage goals. The research team adapted the framework and analytical tools of the Joint Learning Network for Universal Health Coverage guide for assessing PPMs. Data were collected through literature review and key informant interviews with 11 purchasers and 17 health care providers. Content analysis was used to describe PPM design and implementation arrangements, and thematic analysis was used to distill effects on equity in resource distribution and access to care, efficiency, quality of care, and financial sustainability. The study revealed the PPMs had positive and negative consequences. Line-item budgets were perceived to be predictable and sustainable but had little effect on efficiency and provider performance. Fee-for-service was perceived to have negative effects on efficiency and financial sustainability but viewed positively on its ability to incentivize quality health services. Capitation and performance-based financing effects were viewed positively on equity in distribution of resources and quality respectively, but both were perceived negatively on their high administrative burden to providers. Ethiopia may consider a more nuanced approach to design blended provider payment to mitigate negative consequences while providing incentives for better quality of care and efficiency.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2377620"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728395","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

Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study. 在塞内加尔扩大部门医疗保险单位：混合方法研究。

Health systems and reform Pub Date : 2024-12-16 Epub Date: 2024-09-30 DOI: 10.1080/23288604.2024.2402084

Valéry Ridde, Mouhamadou Faly Ba, Babacar Kane, Anouk Chouaïd, Adama Faye

{"title":"Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study.","authors":"Valéry Ridde, Mouhamadou Faly Ba, Babacar Kane, Anouk Chouaïd, Adama Faye","doi":"10.1080/23288604.2024.2402084","DOIUrl":"https://doi.org/10.1080/23288604.2024.2402084","url":null,"abstract":"In response to the failure of community-based health insurance (CBHI) at the municipal level, some African countries are implementing district or departmental CBHIs to improve universal health coverage. After creating two CBHIs at the departmental level in 2014, Senegal launched a campaign to disseminate the model in 2022. This article presents the stakeholders' perspectives on the factors and challenges of scaling up CBHI departmentalization in Senegal. The study uses a mixed-methods approach, utilizing concept mapping and a focus group to examine scaling up departmentalization. The sample size consists of 22 individuals involved in the process. The quantitative analysis includes hierarchical cluster analysis, multidimensional scaling analysis, and the Pearson coefficient test. The qualitative analysis involves content analysis to triangulate the findings. Participants identified 125 factors to consider for the departmentalization of CBHI. They were categorized into nine clusters according to their degree of importance (I) and ease to organize (F): service package (I: 4.07; F: 2,26), communication (I: 4.05; F: 2.96), governance (I: 3.96; F: 2,94), human and logistical resources (I: 3.94; F: 2,82), financing (I: 3.90; F: 2,31), involvement of the authorities (I: 3.82; F: 2.75), community involvement (I: 3.81; F: 2.76), membership (I: 3.70; F: 2.24, strategic planning and implementation (I: 3.57; F: 2,62). The main challenges faced were a process perceived as precipitous and vertical and needing more negotiation and consultation. The conditions for accompaniment and public funding availability need to be sufficiently considered. The study proposes avenues for action to promote the scaling up of CBHI departmentalization in Senegal.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2402084"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333816","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

Battle to Survive: The Association Between Accountability and Chinese Local Government Response to COVID-19. 为生存而战：问责制与中国地方政府应对 COVID-19 的关联》。

Health systems and reform Pub Date : 2024-12-16 Epub Date: 2024-09-30 DOI: 10.1080/23288604.2024.2400725

Bingqing Guo, Karen Ann Grépin

{"title":"Battle to Survive: The Association Between Accountability and Chinese Local Government Response to COVID-19.","authors":"Bingqing Guo, Karen Ann Grépin","doi":"10.1080/23288604.2024.2400725","DOIUrl":"10.1080/23288604.2024.2400725","url":null,"abstract":"China's ability to sustain the zero-COVID strategy over three years has garnered global attention, but little is known about the factors contributing to its long-term adherence. Based on the political promotion tournament model, this article theorizes that China's strict administrative accountability system, which tied local officials' career prospects to their performance in crucial policy goals, incentivized local governments to sustain COVID-19 policies. Using data from the Oxford COVID-19 Government Response Tracker and major official Chinese media outlets, we performed interrupted time series analysis (ITSA) to examine whether the accountability events affected the local government's COVID-19 responses. Noticeably, our analyses found that from May 4, 2020, to September 30, 2022, when an accountability event happened, officials in the affected (local effects) and unaffected (spillover effects) provinces all increased their containment responses and decreased their economic support responses. This is true even for provinces without new localized outbreaks. The effects of accountability events increased with decreasing geographical distance. These findings remain consistent after several robustness checks. The administrative accountability system is a key institutional factor in implementing China's zero-COVID strategy, which contributed to the global literature about the pandemic policy process in centralized countries.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2400725"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333815","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

Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography. COVID-19 大流行期间社区心理健康系统中的角色和动态：定性系统综述和 Meta-Ethnography。

Health systems and reform Pub Date : 2024-04-10 DOI: 10.1080/23288604.2024.2314525

Cheryl Su Ling Sim, P. Asharani, Mythily Subramaniam, Huso Yi

{"title":"Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography.","authors":"Cheryl Su Ling Sim, P. Asharani, Mythily Subramaniam, Huso Yi","doi":"10.1080/23288604.2024.2314525","DOIUrl":"https://doi.org/10.1080/23288604.2024.2314525","url":null,"abstract":"Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2314525"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140716313","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

Effect of the Implementation of the French Hospital Regionalization Policy on Patient Mobility. 法国医院区域化政策的实施对患者流动性的影响。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2023-10-27 DOI: 10.1080/23288604.2023.2267256

Jan Chrusciel, Marie-Caroline Clément, Sandra Steunou, Thierry Prost, Antoine Duclos, Stéphane Sanchez

{"title":"Effect of the Implementation of the French Hospital Regionalization Policy on Patient Mobility.","authors":"Jan Chrusciel, Marie-Caroline Clément, Sandra Steunou, Thierry Prost, Antoine Duclos, Stéphane Sanchez","doi":"10.1080/23288604.2023.2267256","DOIUrl":"10.1080/23288604.2023.2267256","url":null,"abstract":"A new law was voted in France in 2016 to increase cooperation between public sector hospitals. Hospitals were encouraged to work under the leadership of local referral centers and to share their support functions (e.g., information systems) with newly created hospital groups, called \"Regional Hospital Groups.\" The law made it compulsory for each public sector hospital to become affiliated with one of 136 newly created hospital groups. The policy's aim was to ensure that all patients were sent to the hospital best qualified to treat their unique condition, among the hospitals available at the regional level. Therefore, we aimed to assess whether this regionalization policy was associated with changes in observed patterns of patient mobility between hospitals. This nationwide observational study followed an interrupted time series design. For each stay occurring from 2014 to 2019, we ascertained whether or not the stay was followed by mobility toward another hospital within 90 days, and whether or not the receiving hospital was part of the same Regional Hospital Group as the sender hospital. The proportion of mobility directed toward the same regional hospital group increased from 22.9% in 2014 (95% CI 22.7-23.1) to 24.6% in 2019 (95% CI 24.4-24.8). However, the absence of discontinuity during the policy change year was consistent with the hypothesis of a preexisting trend toward regionalization. Therefore, the policy did not achieve major changes in patterns of mobility between hospitals. Other objectives of the reform, including long-term consequences on the healthcare offer, remain to be assessed.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 1","pages":"2267256"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61566734","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