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Health Policy

George W Leeson
Increasingly, age of death is postponed until very old age, and care of those who are dying is challenged by medical co-morbidities and the presence of dementia. Although most people would prefer to die at home, currently in England and Wales only about 20 per cent of those aged 65 years and over die at home, and this proportion falls to about 10 per cent among those aged over 85 years. To explore recent and likely future trends in age and place of death, mortality statistics from 2006 to 2013 were analysed and projected to 2050 using age- and gender-specific rates...
February 2, 2019: Health Policy
Micaela Comendeiro-Maaløe, Manuel Ridao-López, Sophie Gorgemans, Enrique Bernal-Delgado
In the statutory Spanish National Health System (SNHS), the role of public provision is prominent. Nonetheless, since the inception of the SNHS, Regional Health Authorities have also purchased hospital care from private not-for-profit or for-profit providers, usually complementing public provision. Over the years, the autonomous community of Valencia has championed the use of Public Private Partnerships (PPP) in the form of administrative concessions (AC) awarded to private providers. In the La Ribera Health Department, which includes Alzira, the company Ribera Salud held the concession to provide hospital and primary care to the registered population since 1999 - and this became known as the Alzira model...
February 2, 2019: Health Policy
Yu-Ying Huang, Shou-Hsia Cheng
Due to the increasing prevalence of multimorbidity, the percentage of heavy users of health care services increased rapidly. To contain inappropriate outpatient visits and improve better medication management of high utilizers, the National Health Insurance Administration in Taiwan launched a community pharmacist home visit (CPHV) project for high utilizers in 2010. We employed a natural experimental design to evaluate the preliminary effects of the CPHV project. The intervention group consisted of patients enrolled in the CPHV project during 2010 and 2013...
January 30, 2019: Health Policy
Van Hoye, Vandoorne, Absil, Lecomte, Fallon, Lombrail, Vuillemin
Despite evidence on the benefits of health enhancing physical activity (HEPA), only few countries have developed "health in all policies" and specifically integrated HEPA policies. Paucity of studies have questioned the role of public national actors in PA policies enactment and delivery, the barriers and levers for adopting cross-sectoral HEPA. The present work seeks at comparing France and Belgium in regard to their competencies of ministries promoting HEPA, the presence of leadership and coordination in HEPA policies implementation, their key public legal entities working on HEPA...
January 24, 2019: Health Policy
Atia Sultana, Grant Lewison, Elena Pallari
Mental disorders are a major contributor to the disease burden in Europe. We studied how research on them was communicated to British and Irish newspaper readers through an analysis of stories in the Daily Mail (DML) and The Guardian (GDN) in the UK and the Irish Times (IET) in Ireland, in 2002-13, and whether the coverage reflected the relative burdens of mental disorders, or the amount of research, in the two countries. The cited papers were identified through the newspapers' archive or the Factiva database, and their details and those of the research they cited from the Web of Science, with 1,128 stories in total...
January 15, 2019: Health Policy
Carina Mnich
Physical inactivity is a problem in Europe, contributing to various non-communicable diseases (NCDs). While health sciences offer data and models for preventing the development of NCDs through health promotion, they do not explain the dynamics between the different institutions and actors in the health field. Neofunctionalism refers to these different actors and suggests that their interaction leads to the construction of a supranational authority, allowing the actors to cooperate on common policies, rules and institutions, resulting in integration and Europeanization...
January 14, 2019: Health Policy
Nicoline van Leersum, Peter Bennemeer, Marcel Otten, Sander Visser, Ab Klink, Jan A M Kremer
Containing costs is a major challenge in health care. Cost and quality are often seen as trade-offs, but high quality and low costs can go hand-in-hand as waste exists in unnecessary and unfounded care. In the Netherlands, two healthcare insurers and a hospital collaborate to improve quality of care and decrease healthcare costs. Their aim is to reduce unnecessary care by shifting the business model and culture from a focus on volume to a focus on quality. Key drivers to support this are taking time for integrated diagnosis ('first time right'), the right care at the right place and shared decision making between doctor and patient...
January 11, 2019: Health Policy
Vishal S Arora, Martin M McKee, David Stuckler
Web search engines have become pervasive in recent years, obtaining information easily on a variety of topics, from customer services and goods to practical information. Beyond these search interests, however, there is growing interest in obtaining health advice or information online. As a result, health and health policy researchers are starting to take note of potential data sources for surveillance and research, such as Google Trends™, a publicly available repository of information on real-time user search patterns...
January 11, 2019: Health Policy
Hans Maarse, Patrick Jeurissen
A central element of the 2006 health insurance reform in the Netherlands is strategic purchasing by health insurers. After a brief elaboration of the concept of trust this article discusses the trust of insured in the new purchasing role of health insurers. There are various indications of a trust problem or credible commitment problem in Dutch health care. Insured say to trust their own health insurer (specific trust) but also say to have little trust in the behaviour of health insurers in general(institutional trust)...
January 3, 2019: Health Policy
Susan P Jacups, Kate M McConnon
INTRODUCTION: Many specialist waitlists in Australian hospitals are long. One reason anecdotally reported for this is poor alignment of referrals with current recommended guidelines. This paper reports the findings of an audit undertaken in 2017 for ear, nose and throat (ENT) surgeon referrals submitted by primary health centres within Cape York, Australia. MATERIALS AND METHODS: 54 long-wait ENT referrals were reviewed against referral criteria for ENT presentations using the Clinical Prioritization Criteria (CPC) and two routinely applied clinical primary health care guidelines; with findings reported alongside patient demography...
December 31, 2018: Health Policy
M Maeda, H Fukuda, S Shimizu, T Ishizaki
OBJECTIVE: To explore the differences in mean treatment costs between home-based care and hospital-based care in enteral nutrition patients in Japan. METHODS: Using claims data from September 2013 to August 2014, we analyzed patients with recorded reimbursements for enteral nutrition at home or in a hospital. Treatment costs were compared using a panel data analysis with an individual fixed effects model that adjusted for the number of comorbidities and fiscal year...
December 28, 2018: Health Policy
Marwân-Al-Qays Bousmah, Jean-Baptiste Simon Combes, Mohammad Abu-Zaineh
The literature on immigration and health has provided mixed evidence on the health differentials between immigrants and citizens, while a growing body of evidence alludes to the unhealthy assimilation of immigrants. Relying on five different health measures, the present paper investigates the heterogeneity in health patterns between immigrants and citizens, and also between immigrants depending on their country of origin. We use panel data on more than 100,000 older adults living in nineteen European countries...
December 23, 2018: Health Policy
Lai Meng Ow Yong, Ailsa Cameron
The Singapore healthcare sector faces a myriad of challenges, including a rapidly ageing population, an increasing burden of chronic disease, and the rising cost of healthcare. The Ministry of Health has called for a restructuring and transformation of the current model of care to one that is more accessible, affordable and of higher quality, by the year 2020. In achieving quality health care, care integration through the Regional Health Systems (RHS) is seen as one approach to improving health and social outcomes, increasing healthcare utilisation and increasing satisfaction with healthcare providers...
December 15, 2018: Health Policy
Olina Efthymiadou, Jean Mossman, Panos Kanavos
BACKGROUND: In this paper we discuss and present evidence on whether a generic Health Related Quality of Life (HRQoL) measurement tool, the EQ-5D-5L, captures the dimensions of quality of life (QoL) which patients consider significant. METHODS: An online survey, of individuals with a chronic condition, mainly breast cancer (BC), blood cancers (BLC), rheumatoid arthritis (RA), asthma, and rare diseases (RD) was conducted to collect data on HRQoL and important QoL aspects that respondents thought were not captured by the EQ-5D-5L...
December 14, 2018: Health Policy
David Rudoler, Allie Peckham, Agnes Grudniewicz, Greg Marchildon
In this paper, we discuss the processes of policy layering as they relate to health care reform. We focus on efforts to achieve systems of coordinated primary care, and demonstrate that material change can be achieved through processes of incremental policy layering. Such processes also have a high potential for unintended consequences. Thus, we propose new principles of 'smart' policy layering to guide decision-makers to do incrementalism better. We then apply these principles to recent primary care reforms in Ontario, Canada...
December 14, 2018: Health Policy
Wiesława Dominika Wranik, Dorota Anna Zielińska, Liesl Gambold, Serperi Sevgur
BACKGROUND: Health Technology Assessment is used to support the process of drug appraisal and reimbursement decisions in a variety of health systems. Examples can be found in mature Western countries, such as Canada, and in emerging economies of Central and Eastern Europe, such as Poland. The value of HTA in the process is influenced by the evidence used and the stakeholders involved. METHODS: Qualitative interviews with 29 members of two appraisal committees were held in Canada and Poland between July 2017 and March 2018...
December 7, 2018: Health Policy
Peter P Groenewegen, Johan Hansen, Judith D de Jong
Trust is seen as an important condition for the smooth functioning of institutions, such as the health care system. In this article we describe the trust relationships between the three main actors in the Dutch health care system: patients/insured, healthcare providers and insurers. We used data from different surveys between 2006 and 2016. 2006 was the year of the introduction of an insurance reform in the Netherlands towards regulated competition. In the triangle of trust relationships between the three actors we found strong and mutual trust relationships between patients and healthcare providers and weak trust relationships between healthcare providers and insurers as well as between insured and insurance organisations...
November 30, 2018: Health Policy
J López-Bastida, J M Ramos-Goñi, I Aranda-Reneo, M Trapero-Bertran, P Kanavos, B Rodriguez Martin
OBJECTIVES: To pilot the feasibility of using a discrete choice experiment (DCE) design to investigate individual preferences from the decision-maker perspective regarding the use of public funding for orphan drugs and generate prior information for future experimental designs. METHODS: A DCE was used on a convenience sample of participants from five European countries (England, France, Germany, Italy and Spain), exploring their preferences in distinct healthcare scenarios involving orphan drugs...
November 29, 2018: Health Policy
Hao-Min Cheng, Ling-Jan Chiou, Tzu-Ching Chen, Shih-Hsien Sung, Chen-Huan Chen, Hui-Chu Lang
OBJECTIVE: To evaluate the cost-effectiveness of using drugeluting stents (DES) compared to bare-metal stents (BMS) for coronary heart disease (CHD). DATA SOURCES/STUDY SETTING: Data were obtained from the National Health Insurance Longitudinal Health Insurance Database, which contains claims data for 1,000,000 beneficiaries. The data were randomly sampled from all beneficiaries. STUDY DESIGN: A retrospective claims data analysis. DATA COLLECTION/EXTRACTION METHODS: Patients with stable coronary heart disease who underwent coronary stent implantation from 2007 to 2008 were recruited and followed to the end of 2013...
November 28, 2018: Health Policy
Micaela Comendeiro-Maaløe, Manuel Ridao-López, Sophie Gorgemans, Enrique Bernal-Delgado
BACKGROUND: Recently, the once archetype of the public private partnership (PPP) in the Spanish National Health System (SNHS), namely the Alzira's Model, has come to an end. Advocates defended the superiority of PPPs over public-tenured provision, in terms of quality and technical efficiency. This paper profiles and compares Alzira's life-cycle performance with similar public-tenured providers. METHODS: Observational study on secondary data from virtually all hospital care episodes produced in 51 integrated providers (i...
November 27, 2018: Health Policy
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