Health systems and reform最新文献_第6页

The Future of Health Technology Assessment in Low- and Middle-Income Countries. 中低收入国家卫生技术评估的未来。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-10-28 DOI: 10.1080/23288604.2024.2400399

Javier Guzman, Victoria Y Fan, Peter Baker

{"title":"The Future of Health Technology Assessment in Low- and Middle-Income Countries.","authors":"Javier Guzman, Victoria Y Fan, Peter Baker","doi":"10.1080/23288604.2024.2400399","DOIUrl":"https://doi.org/10.1080/23288604.2024.2400399","url":null,"abstract":"In recent decades, low- and middle-income countries (LMICs) have turned to health technology assessment (HTA) to prioritize health care interventions in pursuit of universal health coverage. HTA has demonstrated its value through significant cost savings, as shown by Thailand and Brazil, where HTA processes facilitated substantial government savings and drug price reductions. Despite these successes, many LMICs still struggle with insufficient capacity to conduct HTA or incorporate its findings into policy decisions. Only 53 percent of countries surveyed by the World Health Organization (WHO) have a legislative requirement to consider HTA results in coverage decisions. The COVID-19 pandemic highlighted the need for efficient health expenditure, prompting LMICs to seek greater value for money by investing in cost-effective interventions. To achieve this, countries will need to change the way they use HTA in the future, accounting for three important elements: agile leapfrogging past traditional HTA methodologies, aid localization to enhance country ownership and accountability, and regional collaboration to overcome common limitations such as data scarcity and limited local capacity. By addressing these elements, LMICs can optimize health spending, improve health outcomes, and ensure sustainable financing for health care systems, ultimately strengthening global health security and resilience.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2400399"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523784","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

Evolution of Health Technology Assessment in Indonesia: Supply Landscape, Implementation, and Future Directions. 印度尼西亚卫生技术评估的演变：供应格局、实施和未来方向。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-07-15 DOI: 10.1080/23288604.2024.2371470

Budi Hidayat

{"title":"Evolution of Health Technology Assessment in Indonesia: Supply Landscape, Implementation, and Future Directions.","authors":"Budi Hidayat","doi":"10.1080/23288604.2024.2371470","DOIUrl":"10.1080/23288604.2024.2371470","url":null,"abstract":"In 2014, Indonesia's Ministry of Health established the Indonesian Health Technology Assessment Committee (InaHTAC) to prioritize evidence-based health care technology for inclusion in the national health insurance benefits package. This commentary provides an overview of the current state of the health care technology supply landscape in Indonesia, as well as the impact of HTA studies on priority-setting decisions. Indonesia's decision-making process for health care technology approval and patient access involves multiple stakeholders and follows several evaluation principles. The licensing, inclusion, and evaluation of health care technology is complex and time consuming, however, requiring input from stakeholders with different roles and interests. Although efforts have been made to establish an HTA ecosystem by, for example, engaging in capacity-building activities and issuing guidelines, challenges remain, including a lack of infrastructure, financial resources, and technical capacity and inadequate stakeholder involvement. Additionally, the current position of the HTA unit, which is connected to the Ministry of Health (MOH), and political pressures from the pharmaceutical industry can result in delayed or ignored HTA recommendations. Therefore, the establishment of an independent and robust HTA body that can inform policy makers about health technology development, licensing, dissemination, and use, along with strong regulations to ensure harmonization and coordination among stakeholders, is necessary. This requires a step-by-step approach to address inadequate overall HTA resources.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2371470"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622144","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

Health Emergencies Provide an Opportunity to Strengthen Rehabilitation within Health Systems. 突发卫生事件为加强卫生系统内的康复提供了机会。

Health systems and reform Pub Date : 2023-12-31 DOI: 10.1080/23288604.2023.2207306

Justine Gosling, Pauline Kleinitz, Marlee Quinn, Satish Mishra

引用次数: 0

Harnessing Health Technology Assessment in Latin America and the Caribbean: Keeping the Region on Course. 利用拉丁美洲及加勒比地区的卫生技术评估：保持该地区的发展方向。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-07 DOI: 10.1080/23288604.2024.2314482

Ursula Giedion, Manuel Antonio Espinoza, Pamela Góngora-Salazar, Abha Mehndiratta, Dan Ollendorff

引用次数: 0

Institutionalizing Health Technology Assessment in South Africa-An Opportunity in National Health Insurance. 南非卫生技术评估制度化--全国医疗保险的机遇。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-07 DOI: 10.1080/23288604.2024.2327098

Janine Jugathpal, Andrew Parrish, Khadija Jamaloodien, Mark Blecher, Jonatan Daven

{"title":"Institutionalizing Health Technology Assessment in South Africa-An Opportunity in National Health Insurance.","authors":"Janine Jugathpal, Andrew Parrish, Khadija Jamaloodien, Mark Blecher, Jonatan Daven","doi":"10.1080/23288604.2024.2327098","DOIUrl":"10.1080/23288604.2024.2327098","url":null,"abstract":"While South Africa has some experience in various forms of health technology assessment (HTA), it is currently fragmented across numerous players. Additionally, there is a lack of systematic and consistently applied HTA processes that inform priority-setting and budget allocations. To address this, the country is journeying toward more institutionalized use of HTA. This will begin with the establishment of a Ministerial Advisory Committee on HTA for National Health Insurance (NHI) and will gradually embed HTA processes in decision-making. The goal is to create an independent HTA agency. Although these reforms will be intrinsically linked to the wider health financing reforms envisaged under NHI, such as formulating the benefits package, they will also assist in strengthening South Africa's health system. As a country facing a highly constrained fiscal environment, with limited space for additional funding for the health sector, evidence-based priority-setting will be critical to ensure that value for money is achieved in the government's investments in health care services in NHI.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2327098"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878093","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

Organizational Formation for Priority Setting: Historical Perspectives and Thematic Analysis of India's Health Technology Assessment Agency. 确定优先事项的组织形式：印度卫生技术评估机构的历史视角和专题分析。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-07 DOI: 10.1080/23288604.2024.2327414

Victoria Y Fan, Abha Mehndiratta, Jubilee Ahazie, Javier Guzman, Shankar Prinja, T Sundararaman, Soumya Swaminathan

{"title":"Organizational Formation for Priority Setting: Historical Perspectives and Thematic Analysis of India's Health Technology Assessment Agency.","authors":"Victoria Y Fan, Abha Mehndiratta, Jubilee Ahazie, Javier Guzman, Shankar Prinja, T Sundararaman, Soumya Swaminathan","doi":"10.1080/23288604.2024.2327414","DOIUrl":"10.1080/23288604.2024.2327414","url":null,"abstract":"Countries pursuing universal health coverage must set priorities to determine which benefits to add to a national health program, but the roles that organizations play are less understood. This article investigates the case of the formation of an organization with a mandate for choice of technology for public health interventions and priorities, the Health Technology Assessment India. First, we narrate a chronology of agenda setting and adoption of national policy for organizational formation drawing on historical documentation, publicly available literature, and lived experiences from coauthors. Next, we conduct a thematic analysis that examines windows of opportunity, enabling factors, barriers and conditions, roles of stakeholders, messaging and framing, and specific administrative and bureaucratic tools that facilitated organization formation. This case study shows that organizational formation relied on the identification of multiple champions with sufficient seniority and political authority across a wide group of organizations, forming a coalition of broad base support, who were keen to advance health technology assessment policy development and organizational placement or formation. The champions in turn could use their roles for policy decisions that used private and public events to raise priority and commitment to the decisions, carefully considered organizational placement and formation, and developed the network of organizations for the generation of technical evidence and capacity building for health technology assessment, strengthened by international networks and organizations with financing, expertise, and policymaker relationships.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2327414"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878096","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

Establishing a Health Technology Assessment Evidence Ecosystem in India's Pradhan Mantri Jan Arogya Yojana. 在印度 Pradhan Mantri Jan Arogya Yojana 计划中建立卫生技术评估证据生态系统。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-07 DOI: 10.1080/23288604.2024.2327097

Shankar Prinja, Yashika Chugh, Nidhi Gupta, Vipul Aggarwal

{"title":"Establishing a Health Technology Assessment Evidence Ecosystem in India's Pradhan Mantri Jan Arogya Yojana.","authors":"Shankar Prinja, Yashika Chugh, Nidhi Gupta, Vipul Aggarwal","doi":"10.1080/23288604.2024.2327097","DOIUrl":"10.1080/23288604.2024.2327097","url":null,"abstract":"The introduction of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme in India was a significant step toward universal health coverage. The PM-JAY scheme has made notable progress since its inception, including increasing the number of people covered and expanding the range of services provided under the health benefit package (HBP). The creation of the Health Financing and Technology Assessment (HeFTA) unit within the National Health Authority (NHA) further enhanced evidence-based decision-making processes. We outline the journey of HeFTA and highlight significant cost savings to the PM-JAY as a result of health technology assessment (HTA). Our paper also discusses the application of HTA evidence for decisions related to inclusions or exclusions in HBP, framing standard treatment guidelines as well as other policies. We recommend that future financing reforms for strategic purchasing should strengthen strategic purchasing arrangements and adopt value-based pricing (VBP). Integrating HTA and VBP is a progressive approach toward health care financing reforms for large government-funded schemes like the PM-JAY.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2327097"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878087","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

Rethinking Japan's Health System Sustainability Under the Planetary Health Framework. 在全球健康框架下重新思考日本卫生系统的可持续性。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2023-11-21 DOI: 10.1080/23288604.2023.2268360

Akira Shimabukuro, Kenta Minamitani, Joji Sugawara

引用次数: 0

Health Technology Assessment in Taiwan: Reflections of the Last Twenty Years. 台湾的卫生技术评估：过去二十年的反思》。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-07 DOI: 10.1080/23288604.2024.2330348

Shih-Chung Chen

引用次数: 0

Hospital Resilience in Three COVID-19 Referral Hospitals in Brazil. 巴西三家COVID-19转诊医院的医院复原力

Health systems and reform Pub Date : 2023-06-15 DOI: 10.1080/23288604.2023.2205726

Karla Myrelle Paz de Sousa, Sydia Rosana de Araújo Oliveira, Betise Mery Alencar Sousa Macau Furtado, Ana Lucia Ribeiro de Vasconcelos, Stéphanie Gomes de Medeiros, Gisele Cazarin, Aletheia Soares Sampaio, Valéry Ridde

{"title":"Hospital Resilience in Three COVID-19 Referral Hospitals in Brazil.","authors":"Karla Myrelle Paz de Sousa, Sydia Rosana de Araújo Oliveira, Betise Mery Alencar Sousa Macau Furtado, Ana Lucia Ribeiro de Vasconcelos, Stéphanie Gomes de Medeiros, Gisele Cazarin, Aletheia Soares Sampaio, Valéry Ridde","doi":"10.1080/23288604.2023.2205726","DOIUrl":"https://doi.org/10.1080/23288604.2023.2205726","url":null,"abstract":"Health crises, such as the COVID-19 pandemic, challenge health systems in demonstrating resilience-the ability to cope with change, manage challenges, and adapt in order to retain their effectiveness. Understanding how such challenges affect and produce reactions in those involved in this response is extremely important. This study evaluated resilience in three referral hospitals in the city of Recife, Pernambuco, Brazil-one public, one private, and one philanthropic hospital-by examining the coping activities adopted by the nursing staff working on the COVID-19 frontline. A multiple case study was carried out, using a qualitative approach, triangulating data from direct observations, document analysis, and interviews with 21 nursing professionals working in management and care provision. Data were collected from April to October 2020. The interviews were transcribed and analyzed based on the resilience categories defined by Blanchet (2017): absorption capacity, adaptive capacity, and transformative capacity. Four themes were considered relevant to the objectives of this study: institutional support, access to personal protective equipment (PPE), work relationships, and fear and mental health. Adaptive capacity was demonstrated concerning the four themes analyzed, absorption capacity was demonstrated in two themes, and no transformative capacity was identified. The study highlighted that the health crisis was challenging for all the hospitals studied, regardless of their legal-administrative status. No differences were observed among them in terms of resilience.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 2","pages":"2205726"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744072","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: 1