Health policy, reform, governance and law

Inspecting teams’ and organisations’ expectations regarding external inspections in health care: a qualitative study

There is a gap in the literature regarding what takes place between the announcement of a regulatory intervention, such as an external inspection of a health care organisation, and the inspecting body’s site v...

Authors: Einar Hovlid, Inger Lise Teig, Kjersti Halvorsen and Jan C. Frich

Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies

Although several diabetes management and control programmes are introduced in Iran, many patients do not achieve diabetes-related clinical goals as recommended. The aim of this study was to identify the qualit...

Authors: Mohammad Mohseni, Tahereh Shams Ghoreishi, Sousan Houshmandi, Ahmad Moosavi, Saber Azami-Aghdash and Zoleykha Asgarlou

Impacts of the zero mark-up drug policy on hospitalization expenses of COPD inpatients in Sichuan province, western China: an interrupted time series analysis

Since 1950, the hospitals had been permitted to take a 15% mark-up of drug purchase price to remedy the loss of public hospitals and doctors’ salaries in China due to tight government budget. This policy resul...

Authors: Junman Wang, Peiyi Li and Jin Wen

Decommissioning in a local healthcare system in Sweden: responses to fiscal stress

Drawing on the literature on cutback management, this article deals with healthcare decommissioning in times of austerity. Politicians and decision-makers are typically reluctant to decommission healthcare, an...

Authors: Linda Moberg and Mio Fredriksson

‘There is no such thing as getting sick justly or unjustly’ – a qualitative study of clinicians’ beliefs on the relevance of personal responsibility as a basis for health prioritisation

Concerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known abo...

Authors: Gloria Traina and Eli Feiring

Impact of family physician integrated care program on decreasing utilization of emergency department visit and hospital admission: a population-based retrospective cohort study

Hospital admission and emergency department(ED) visits are a massive burden in medical expenditures. In 2003, the Taiwanese government developed Family Physician Integrated Care Program (FPIC) to increase the ...

Authors: Po-Tsung Huang, Pei-Tseng Kung, Wen-Yin Kuo and Wen-Chen Tsai

Rethinking workforce planning for integrated care: using scenario analysis to facilitate policy development

A goal of health workforce planning is to have the most appropriate workforce available to meet prevailing needs. However, this is a difficult task when considering integrated care, as future workforces may re...

Authors: Gareth H. Rees, Peter Crampton, Robin Gauld and Stephen MacDonell

Does disease management for diabetic nephropathy reduce medical expenditure? Evidence from a three-period difference-in-differences analysis

To discriminatively evaluate the cost-saving effects of a disease management program for diabetic nephropathy patients through care process rectification and, subsequently, improved health outcomes.

Authors: Hiroyuki Kawaguchi, Michiko Moriyama and Hideki Hashimoto

Effect of two major health reforms on health care cost and utilization in Fars Province of Iran: family physician program and health transformation plan

Family physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran’s health system in recent. The present study was aimed at evaluating the impact of t...

Authors: Mohsen Bayati, Khosro Keshavarz, Farhad Lotfi, Abbas KebriaeeZadeh, Omid Barati, Shahram Zareian, Akbar Amiri and Sajad Delavari

Does the chronically ill population in the Netherlands switch their health insurer as often as the general population? Empirical evidence from a nationwide survey study

Consumer mobility is an important aspect of a health insurance system based on managed competition. Both the general population and insured with a chronic illness should enjoy an equal opportunity to switch th...

Authors: Wouter van der Schors, Anne E. M. Brabers and Judith D. De Jong

Eliciting patient views on the allocation of limited healthcare resources: a deliberation on hepatitis C treatment in the Veterans Health Administration

In response to the development of highly effective but expensive new medications, policymakers, payors, and health systems are considering novel and pragmatic ways to provide these medications to patients. One...

Authors: Akbar K. Waljee, Kerry A. Ryan, Chris D. Krenz, George N. Ioannou, Lauren A. Beste, Monica A. Tincopa, Sameer D. Saini, Grace L. Su, Maria E. Arasim, Patti T. Roman, Brahmajee K. Nallamothu and Raymond De Vries

Integrating public preferences into national reimbursement decisions: a descriptive comparison of approaches in Belgium and New Zealand

Public health care payer organizations face increasing pressures to make transparent and sustainable coverage decisions about ever more expensive prescription drugs, suggesting a need for public engagement in ...

Authors: Christine Leopold, Christine Y. Lu and Anita K. Wagner

‘Wait and wait, that is the only thing they can say’: a qualitative study exploring experiences of immigrated Syrian doctors applying for medical license in Germany

Due to the civil war in Syria, many Syrian citizens have had to flee their country during recent years, among them many physicians. Germany is among the preferred immigration countries. Immigrant Syrian physic...

Authors: Julika Loss, Yamen Aldoughle, Alexandra Sauter and Julia von Sommoggy

Trends in anticoagulant prescribing: a review of local policies in English primary care

Oral anticoagulants are prescribed for stroke prophylaxis in patients with atrial fibrillation, which is the most common heart arrhythmia worldwide. The vitamin K antagonist (VKA) warfarin is a long-establishe...

Authors: Katherine H. Ho, Maria van Hove and Gillian Leng

Is social capital protective against hospital readmissions?

To evaluate the association between social capital and 30-day readmission to the hospital among Medicare beneficiaries overall, beneficiaries with dementia and related memory disorders, and beneficiaries with ...

Authors: Hanna Zlotnick, Geoffrey J. Hoffman, Ushapoorna Nuliyalu, Tedi A. Engler, Kenneth M. Langa and Andrew M. Ryan

The role of mediation in solving medical disputes in China

Medical litigation represents a growing cost to healthcare systems. Mediation, arbitration, and other alternative dispute resolution (ADR) methods are increasingly used to help solve the disputes and improve h...

Authors: Mengxiao Wang, Gordon G. Liu, Hanqing Zhao, Thomas Butt, Maorui Yang and Yujie Cui

Is insurance instability associated with hypertension outcomes and does this vary by race/ethnicity?

Stable health insurance is often associated with better chronic disease care and outcomes. Racial/ethnic health disparities in outcomes are prevalent and may be associated with insurance instability, particula...

Authors: Nancy R. Kressin, Norma Terrin, Amresh D. Hanchate, Lori Lyn Price, Alejandro Moreno-Koehler, Amy LeClair, Jillian Suzukida, Sucharita Kher and Karen M. Freund

Understanding the conditions that influence the roles of midwives in Ontario, Canada’s health system: an embedded single-case study

Despite the significant variability in the role and integration of midwifery across provincial and territorial health systems, there has been limited scholarly inquiry into whether, how and under what conditio...

Authors: Cristina A. Mattison, John N. Lavis, Eileen K. Hutton, Michelle L. Dion and Michael G. Wilson

Responsive evaluation of stakeholder dialogue as a worksite health promotion intervention to contribute to the reduction of SEP related health inequalities: a study protocol

Large health inequalities exist in the Netherlands among individuals with a high compared to a low socioeconomic position. Worksite health promotion interventions are considered promising to reduce these inequ...

Authors: Hanneke van Heijster, Jantien van Berkel, Tineke Abma, Cécile R. L. Boot and Emely de Vet

A discrete choice experiment to identify the most efficient quality indicators for the supervision of psychiatric hospitals

In the Netherlands, health care is regulated by the Health and Youth Care Inspectorate. Forty-six indicators are used to prioritize supervision of psychiatric hospitals. The objective of this study is to defin...

Authors: Pieter van Dijk, Ron Schellings, Brigitte A. B. Essers, Alfons G. Kessels, Ian Leistikow and Maurice P. Zeegers

Policy levers and priority-setting in universal health coverage: a qualitative analysis of healthcare financing agenda setting in Kenya

Competing priorities in health systems necessitate difficult choices on which health actions and investments to fund: decisions that are complex, value-based, and highly political. In light of the centrality o...

Authors: Tessa Oraro-Lawrence and Kaspar Wyss

The relationship of nursing practice laws to suicide and homicide rates: a longitudinal analysis of US states from 2012 to 2016

Nursing resources can have a protective effect on patient outcomes, but nurses and nursing scope of practice have not been studied in relation to injury outcomes. The purpose of this study was to examine wheth...

Authors: Kristen R. Choi, Sae Takada, Altaf Saadi, Molly C. Easterlin, Liza S. Buchbinder, Shaw Natsui and Frederick J. Zimmerman

Rehabilitation Is a Global Health Priority

Authors: Allen W. Heinemann, Michael Feuerstein, Walter R. Frontera, Steven A. Gard, Leonard A. Kaminsky, Stefano Negrini, Lorie Gage Richards and Catherine Vallée

Challenges in turning a great idea into great health policy: the case of integrated care

In the organization of health care and health care systems, there is an increasing trend towards integrated care. Policy-makers from different countries are creating policies intended to promote cooperation an...

Authors: Kasper Raus, Eric Mortier and Kristof Eeckloo

Does health insurance coverage reduce informal payments? Evidence from the “red envelopes” in China

Representing a major threat to both equity and efficiency of health systems, the corrupt practice of informal payments is widely found in developing and transition countries. As informal payments are more like...

Authors: Ning Liu, Guoxian Bao and Alex Jingwei He

Dissonances and disconnects: the life and times of community-based accountability in the National Rural Health Mission in Tamil Nadu, India

There are increasing calls for developing robust processes of community-based accountability as key components of health system strengthening. However, implementation of these processes have shown mixed result...

Authors: Rakhal Gaitonde, Miguel San Sebastian and Anna-Karin Hurtig

Reasons for allowing and refusing generic substitution and factors determining the choice of an interchangeable prescription medicine: a survey among pharmacy customers in Finland

Generic substitution (GS) was introduced in Finland in 2003 and supplemented with a reference price system (RPS) in 2009. Patients play a vital role in the acceptance of GS and the use of less expensive generi...

Authors: Henriikka Nokelainen, Elina Lämsä, Riitta Ahonen and Johanna Timonen

Combining health insurance funds in a fragmented context: what kind of challenges should be considered?

Iran’s Parliament passed a Law in 2010 to merge the existing health insurance schemes to boost risk pooling. Merging can be challenging as there are differences among health insurance schemes in various aspect...

Authors: Mohammad Bazyar, Arash Rashidian, Minoo Alipouri Sakha, Mohammad Reza Vaez Mahdavi and Leila Doshmangir

Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors

Having a tax-funded and supposedly ‘National’ Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS ...

Authors: Sheena Asthana, Ray Jones and Rod Sheaff

Influencing factors of physicians’ prescription behavior in selecting essential medicines: a cross-sectional survey in Chinese county hospitals

To explore the key factors affecting prescription practices of essential medicines in Chinese county hospital. National essential medicine policy (NEMP) plays important roles in health care system, especially ...

Authors: Xin Zhou, Xueting Zhang, Linsheng Yang, Xu Hu, Aizong Shen, Xiaohui Huang and Xuefeng Xie

An empirical study of how the Dutch healthcare regulator first formulates the concept of trust and then puts it into practice

Responsive regulation assumes that the parties being regulated are trustworthy and motivated by social responsibility. This assumes that regulation based upon trust will improve the regulated organization more...

Authors: Sandra Spronk, Annemiek Stoopendaal and Paul B. M. Robben

The role of real-world data in the development of treatment guidelines: a case study on guideline developers’ opinions about using observational data on antibiotic prescribing in primary care

Antimicrobial resistance (AMR) is a prominent threat to public health. Although many guidelines have been developed over the years to tackle this issue, their impact on health care practice varies. Guidelines ...

Authors: Stephanie Steels and Tjeerd Pieter van Staa

Short-term and long-term unintended impacts of a pilot reform on Beijing’s zero markup drug policy: a propensity score-matched study

In September 2012, Beijing, the capital of China, selected five tertiary hospitals as pilots to remove the previously allowed 15% markup for drug sales. However, while most research demonstrated the significan...

Authors: Jianying Zeng, Xiwen Chen, Hongqiao Fu, Ming Lu and Weiyan Jian

“We just get paid for 12 hours a day, but we work 24”: home health aide restrictions and work related stress

Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research...

Authors: Jillian L. Shotwell, Eve Wool, Andrzej Kozikowski, Renee Pekmezaris, Jill Slaboda, Gregory Norman, Karin Rhodes and Kristofer Smith

What is the long term impact of voucher scheme on primary care? Findings from a repeated cross sectional study using propensity score matching

Vouchers are increasingly used as a demand-side subsidy to reduce financial hardship and improve quality of services. Elderly Healthcare Voucher Scheme has been introduced by the Hong Kong Government since 200...

Authors: Carrie H. K. Yam, Eliza L. Y. Wong, Valerie L. H. Fung, Sian M. Griffiths and Eng-Kiong Yeoh

Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations

It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations.

Authors: Joshua R. Zadro, John Farey, Ian A. Harris and Christopher G. Maher

Effects of a mandatory DRG payment system in South Korea: Analysis of multi-year nationwide hospital claims data

In 2002, a voluntary diagnosis-related groups (DRGs) payment system was introduced in South Korea for seven disease groups, and participation in the DRGs was mandated for all hospitals beginning in 2013. The p...

Authors: Jae Woo Choi, Seung-Ju Kim, Hye-Ki Park, Sung-In Jang, Tae Hyun Kim and Eun-Cheol Park

The effects of reimbursement reform of antidiabetic medicines from the patients’ perspective – a survey among patients with type 2 diabetes in Finland

In Finland, the reimbursement rate for antidiabetic medicines other than insulins was lowered from 100 to 65% at the beginning of 2017. The objective of this study was to examine the effects of this reform exp...

Authors: Taika Suviranta, Johanna Timonen, Janne Martikainen and Emma Aarnio

Implementation of a national policy for improving health and social care: a comparative case study using the Consolidated Framework for Implementation Research

Comprehensive policies are becoming common for addressing wicked problems in health and social care. Success of these policies often varies between target organizations. This variation can often be attributed ...

Authors: Helena Strehlenert, Johan Hansson, Monica Elisabeth Nyström and Henna Hasson

Policy analysis of the Iranian Health Transformation Plan in primary healthcare

Health systems reform is inevitable due to the never-ending changing nature of societal health needs and policy dynamism. Today, the Health Transformation Plan (HTP) remains the major tool to facilitate the ac...

Authors: Leila Doshmangir, Esmaeil Moshiri, Hakimeh Mostafavi, Minoo Alipouri Sakha and Abraham Assan

Implementing the skilled birth attendance strategy in Uganda: a policy analysis

Uganda, a low resource country, implemented the skilled attendance at birth strategy, to meet a key target of the 5th Millenium Development Goal (MDG), 75% reduction in maternal mortality ratio. Maternal morta...

Authors: Susan Munabi-Babigumira, Harriet Nabudere, Delius Asiimwe, Atle Fretheim and Kristin Sandberg

Can integration reduce inequity in healthcare utilization? Evidence and hurdles in China

Integration of medical insurance schemes has been prioritized as one of the key strategies to address inequity in China’s health system. The first pilot attempt to integrate started in 2003 and later expanded ...

Authors: Miaomiao Zhao, Baohua Liu, Linghan Shan, Cui Li, Qunhong Wu, Yanhua Hao, Zhuo Chen, Lan Lan, Zheng Kang, Libo Liang, Ning Ning and Mingli Jiao

Effects of implementing free maternity service policy in Kenya: an interrupted time series analysis

Maternal and perinatal mortality is a major public health concern across the globe and more so in low and middle-income countries. In Kenya, more than 6000 maternal deaths, and 35,000 stillbirths occur each ye...

Authors: Evaline Lang’at, Lillian Mwanri and Marleen Temmerman

Beyond hybrid professionals: evidence from the hospital sector

The involvement of doctors in managerial roles seems to be the solution to reducing the friction between traditional professionalism and modern organizational paradigms. However, these “hybrid” professionals r...

Authors: Marco Sartirana

Collective constructions of ‘waste’: epistemic practices for disinvestment in the context of Dutch social health insurance

Faced with growing budget pressure, policymakers worldwide recognize the necessity of strategic disinvestment from ineffective, inefficient or harmful medical practices. However, disinvestment programs face su...

Authors: Floortje Moes, Eddy Houwaart, Diana Delnoij and Klasien Horstman

Competency building for lay health workers is an intangible force driving basic public health services in Southwest China

Providing universal basic public health services (BPHS) for residents is the main goal of the new health reform in China. Lay health workers (LHWs) in primary health care (PHC) sectors play key roles in BPHS d...

Authors: Shengxiang Liang, Haoyue Deng, Shili Liu, Geng Wang, Li Li, Mei Wang, Jie Pu, Wei Xing, Xingneng Luo, John Ehiri, Yueying Xiang and Ying Li

‘Participation is integral’: understanding the levers and barriers to the implementation of community participation in primary healthcare: a qualitative study using normalisation process theory

Many international health policies recognise the World Health Organization’s (2008) vision that communities should be involved in shaping primary healthcare services. However, researchers continue to debate de...

Authors: Rachel McEvoy, Edel Tierney and Anne MacFarlane

Defining the clinician’s role in early health technology assessment during medical device innovation – a systematic review

Early Health Technology Assessment (EHTA) is an evolving field in health policy which aims to provide decision support and mitigate risk during early medical device innovation. The clinician is a key stakehold...

Authors: Vinayak Smith, Ritesh Warty, Amrish Nair, Sathya Krishnan, Joel Arun Sursas, Fabricio da Silva Costa, Beverley Vollenhoven and Euan Morrison Wallace

Analysing the landscape for prescription to non-prescription reclassification (switch) in Germany: an interview study of committee members and stakeholders

Non-prescription medicines are increasingly used in Germany, aided by prescription-to-non-prescription reclassification (or switch). This study aimed to examine the barriers and enablers to reclassification of...

Authors: Natalie J. Gauld

Effectiveness of Medicare cost-sharing elimination for Cancer screening on utilization

The Patient Protection and Affordable Care Act (ACA) eliminated the cost-sharing requirement for several preventive cancer screenings. This study examined the cancer screening utilization of mammogram, Pap sme...

Authors: Wendy Yi Xu, Thomas M. Wickizer and Jeah Kyoungrae Jung