Health systems and reform最新文献_第6页

The Evolution of Health Benefits Packages in Colombia: Thirty Years of Successes and Failures. 哥伦比亚医疗福利方案的演变：三十年的成败。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-07 DOI: 10.1080/23288604.2024.2343174

Marcela Brun Vergara, Johnattan Garcia Ruiz, Javier Guzman

引用次数: 0

Health Technology Assessment in China's Health Care Sector: Development and Applications. 中国医疗保健领域的卫生技术评估：发展与应用》。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2024-05-08 DOI: 10.1080/23288604.2024.2327099

Wudong Guo, Peimeng Wang, Yuzheng Zhang, Xue Li, Yaoling Wang, Kun Zhao, Francis Ruiz, Rui Li, Feiyi Xiao, Xuefei Gu, Mao You, Qiang Fu

{"title":"Health Technology Assessment in China's Health Care Sector: Development and Applications.","authors":"Wudong Guo, Peimeng Wang, Yuzheng Zhang, Xue Li, Yaoling Wang, Kun Zhao, Francis Ruiz, Rui Li, Feiyi Xiao, Xuefei Gu, Mao You, Qiang Fu","doi":"10.1080/23288604.2024.2327099","DOIUrl":"10.1080/23288604.2024.2327099","url":null,"abstract":"China's health system is facing severe challenges from social transition and the double burden of population aging and non-communicable diseases. Addressing the tension between the public's increasing demand for health services and the limited availability of medical resources has become a critical issue for health care policymakers and medical insurance fund administrators. In promoting its medical insurance system reform, China is actively developing health technology assessment (HTA) with principles and applications adapted to the Chinese context. This study aims to analyze the evolution of HTA in China with a focus on context, actors, process, content, and challenges encountered through applying a modified verson of Walt and Gilson's policy triangle framework. Currently, HTA plays an indispensable part in the reform of China's health care and medical insurance system, especially in the formulation and adjustment of the National Reimbursement Drug List (NRDL). While HTA is increasingly used in China, there remain challenges, such as the slow development of HTA related disciplines, lack of an independent national HTA authority, and limited scope in the use of HTA. Despite the identified challenges, HTA has the potential to support a wide range of applications in China's health care sector, building on the progress achieved over the last three decades.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 3","pages":"2327099"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892764","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

County Hospital Responses to Funding Reforms in Zhejiang, China: An Interrupted Time-Series Analysis. 浙江省县级医院对经费改革的响应：中断时间序列分析。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2023-10-03 DOI: 10.1080/23288604.2023.2258770

Tao Zhang, Jing Liu, Xiaohe Wang, Chaojie Liu

{"title":"County Hospital Responses to Funding Reforms in Zhejiang, China: An Interrupted Time-Series Analysis.","authors":"Tao Zhang, Jing Liu, Xiaohe Wang, Chaojie Liu","doi":"10.1080/23288604.2023.2258770","DOIUrl":"https://doi.org/10.1080/23288604.2023.2258770","url":null,"abstract":"This study aimed to assess the effects of a two-stage funding reform, involving DRGs-based (Diagnostic Related Groups) payments for inpatient care and capitation funding for outpatient care, respectively, on services volume and care expenditure of county hospitals in Zhejiang province, China. A quasi-experimental design was adopted, involving 6 hospitals from 2 counties in the intervention group and 12 hospitals from 5 counties in the control group. The DRGs-based payments for inpatient care and capitation funding for outpatient care were introduced in January 2018 and January 2019, respectively. Controlled interrupted time-series analyses were performed to determine the effects of the funding reforms using monthly data over the period from January 2017 to December 2019. The volume of inpatient care decreased after the introduction of the first-stage DRGs-based payments, which was accompanied by an increase in the volume of outpatient visits. The DRGs-based payments led to a reduction of on average 1390 Yuan total expenditure per episode of inpatient care and 1116 Yuan out-of-pocket (OOP) payment per episode of inpatient care. However, the average outpatient expenditure per visit increased. So did the corresponding OOP payment per outpatient visit. The introduction of the second-stage capitation funding for outpatient care reversed the increasing trend of outpatient care. The average expenditure and OOP payment per outpatient visit decreased. The funding reforms create a significant effect on service volumes and expenditures in county hospitals. A coordinated approach to both inpatient and outpatient funding mechanisms is needed to minimize cost-shifting between inpatient and outpatient care and to achieve the intended policy outcomes.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 1","pages":"2258770"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41222136","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

Separation of Maternal and Newborn Care in US Hospitals: A Systemic Threat to Survival, Health and Well-Being. 美国医院母婴分离护理：对生存、健康和幸福的系统性威胁。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2023-10-27 DOI: 10.1080/23288604.2023.2267255

Kavya I Anjur, Gary L Darmstadt

{"title":"Separation of Maternal and Newborn Care in US Hospitals: A Systemic Threat to Survival, Health and Well-Being.","authors":"Kavya I Anjur, Gary L Darmstadt","doi":"10.1080/23288604.2023.2267255","DOIUrl":"10.1080/23288604.2023.2267255","url":null,"abstract":"Through greater understanding of past social, cultural, economic, political, scientific and technological forces which shaped our current health systems to separate mothers and newborn infants, we can begin to devise effective approaches to reshape these systems to meet the needs of mothers and newborn infants today. Medical science and technology have evolved vastly in the last century; however, effects of historical factors persist in our current health care systems, reflected in separate maternal and neonatal care in different departments with distinct guidelines, providers, and treatment locations. This separation prevents maternal-infant skin-to-skin contact and bonding, which significantly affects infant development, well-being, and that of their caregivers. We explore historical precedents for the separation of maternal-newborn care, including the transition from midwifery home care to hospital obstetric care, reasons for the increase in hospital births and hospital nursery development, and the effects of world wars, federal acts, health insurance, rooming-in practices, and the development of medical advances such as antibiotics, on hospital infrastructure. This information is evaluated in the context of modern scientific advancements to show that the conditions which shaped health systems to separate mothers and newborns in the past no longer hold. The insights gained will help to identify strategic actions to reshape health care systems to enable more integrated maternal-newborn care and the practice of Kangaroo Mother Care, and to improve survival outcomes and well-being for mothers, families, and their newborn infants.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 1","pages":"2267255"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61566735","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 Cervical Cancer Treatment Gap in Mexico Under Seguro Popular, 2006-2016. 2006-2016年墨西哥在Seguro普及下的宫颈癌症治疗差距。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2023-11-09 DOI: 10.1080/23288604.2023.2272371

Sean P McClellan, Karla Unger-Saldaña, Priscilla Espinosa-Tamez, Erick Suazo-Zepeda, Michael B Potter, Salim Abraham Barquet-Muñoz, Leticia Torres-Ibarra, Hector Lamadrid-Figueroa, Martín Lajous

{"title":"The Cervical Cancer Treatment Gap in Mexico Under Seguro Popular, 2006-2016.","authors":"Sean P McClellan, Karla Unger-Saldaña, Priscilla Espinosa-Tamez, Erick Suazo-Zepeda, Michael B Potter, Salim Abraham Barquet-Muñoz, Leticia Torres-Ibarra, Hector Lamadrid-Figueroa, Martín Lajous","doi":"10.1080/23288604.2023.2272371","DOIUrl":"10.1080/23288604.2023.2272371","url":null,"abstract":"From 2005 to 2019, the Mexican government financed cervical cancer treatment for individuals without social security insurance through Seguro Popular's Fund for Protection against Catastrophic Health Expenses. To better understand the impact of this program on access to treatment, we estimated the cervical cancer treatment gap (the proportion of patients with cervical cancer in this population who did not receive treatment). To calculate the expected number of incident cervical cancer cases we used national surveys with information on insurance affiliation and incidence estimates from the Global Burden of Disease study. We used a national claims database to determine the number of cases whose treatment was financed by Seguro Popular. From 2006 to 2016, the national cervical cancer treatment gap changed from 0.61 (95% CI 0.59 to 0.62) to 0.45 (95% CI 0.43 to 0.48), with an average yearly reduction of -0.012 (95% CI -0.024 to -0.001). The gap was greater in states with higher levels of marginalization and in the youngest and oldest age groups. Although the cervical cancer treatment gap among individuals eligible for Seguro Popular decreased after the introduction of public financing for treatment, it remained high. Seguro Popular was eliminated in 2019; however, individuals without social security have continued to receive cancer care financed by the government in the same healthcare facilities. These results suggest that barriers to care persisted after the introduction of public financing for treatment. These barriers must be reduced to improve cervical cancer care in Mexico, particularly in states with high levels of marginalization.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"9 1","pages":"2272371"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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