Health policy, reform, governance and law

Synergy of policies to strengthen primary care: evidence from a national repeated cross-sectional study

People bypass primary healthcare (PHC) institutions to seek expensive healthcare at high-level hospitals, leading to escalating medical costs and inefficient use of resources. In 2009, China launched nationwid...

Authors: Yinzi Jin, Jin Xu, Weiming Zhu, Yaoguang Zhang, Ling Xu and Qingyue Meng

Effect of health insurance program for the poor on out-of-pocket inpatient care cost in India: evidence from a nationally representative cross-sectional survey

In India, Out-of-pocket expenses accounts for about 62.6% of total health expenditure - one of the highest in the world. Lack of health insurance coverage and inadequate coverage are important reasons for high...

Authors: Shyamkumar Sriram and M. Mahmud Khan

Individual, institutional, and scientific environment factors associated with questionable research practices in the reporting of messages and conclusions in scientific health services research publications

Health Services Research findings (HSR) reported in scientific publications may become part of the decision-making process on healthcare. This study aimed to explore associations between researcher’s individua...

Authors: Reinie G. Gerrits, Joko Mulyanto, Joost D. Wammes, Michael J. van den Berg, Niek S. Klazinga and Dionne S. Kringos

The impact of revised diagnostic criteria on hospital trends in gestational diabetes mellitus rates in a high income country

In 2010, national guidelines were published in Ireland recommending more sensitive criteria for the diagnosis of Gestational Diabetes Mellitus (GDM). The criteria were based on the 2008 Hyperglycemia and Adver...

Authors: Léan E. McMahon, Eimer G. O’Malley, Ciara M. E. Reynolds and Michael J. Turner

Challenges in health service delivery under public-private partnership in Tanzania: stakeholders’ views from Dar es Salaam region

Public-private partnership in the health sector was introduced to improve the delivery of health services in Tanzania. Contrary, the expected outcomes have not been fully realised. This study aimed at investig...

Authors: Said Nuhu, Chakupewa Joseph Mpambije and Kinamhala Ngussa

Exploring links between resilience and the macro-level development of healthcare regulation- a Norwegian case study

The relationship between quality and safety regulation and resilience in healthcare has received little systematic scrutiny. Accordingly, this study examines the introduction of a new regulatory framework (the...

Authors: Sina Furnes Øyri, Geir Sverre Braut, Carl Macrae and Siri Wiig

Certificate of need laws: a systematic review and cost-effectiveness analysis

Certificate of Need (CON) laws, currently in place in 35 US states, require certain health care providers to obtain a certification of their economic necessity from a state board before opening or undertaking ...

Authors: Christopher J. Conover and James Bailey

Certification as support for resilience? Behind the curtains of a certification body — a qualitative study

Certification in healthcare often involves independent private sector bodies performing legally required or voluntary external assurance activities. These certification practices are embedded in international ...

Authors: Dag Tomas Sagen Johannesen, Preben Hempel Lindøe and Siri Wiig

Health insurance benefit package in Iran: a qualitative policy process analysis

Insufficient transparency in prioritization of health services, multiple health insurance organizations with various and not-aligned policies, plus limited resources to provide comprehensive health coverage ar...

Authors: Efat Mohamadi, Amirhossein Takian, Alireza Olyaeemanesh, Arash Rashidian, Ali Hassanzadeh, Moaven Razavi and Sadegh Ghazanfari

Developing a model for prevention of malnutrition among children under 5 years old

Serious consequences leading to the increase of infectious diseases and mortality of children justifies the importance of interventions for eradication of malnutrition. Thus, this study aimed to provide a mode...

Authors: Mohammad Mohseni and Aidin Aryankhesal

Drug switching in the Netherlands: a cohort study of 20 active substances

For a patient, drug switches are not desirable (either between a brand-name drug and a generic drug, or between two generic drugs of the same active substance). Research into the causes of drug switches, and r...

Authors: Pieter J. Glerum, Marc Maliepaard, Vincent de Valk, David M. Burger and Kees Neef

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