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HEALTH AND SAFETY (544 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 12)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 23)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 38)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 30)
American Journal of Health Promotion     Hybrid Journal   (Followers: 26)
American Journal of Health Sciences     Open Access   (Followers: 7)
American Journal of Health Studies     Full-text available via subscription   (Followers: 11)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 27)
American Journal of Public Health     Full-text available via subscription   (Followers: 207)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 4)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 12)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 3)
Archive of Community Health     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 9)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 3)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 3)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 7)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 6)
BMC Pregnancy and Childbirth     Open Access   (Followers: 21)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 10)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 16)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 9)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 19)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 15)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 3)
Conflict and Health     Open Access   (Followers: 7)
Contraception and Reproductive Medicine     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 4)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 3)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 11)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 17)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 19)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 6)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 4)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 4)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 6)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Food and Public Health     Open Access   (Followers: 12)
Food Quality and Safety     Open Access  
Frontiers in Public Health     Open Access   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 6)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 6)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 9)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 55)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 15)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 17)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 42)
Health Policy and Technology     Hybrid Journal   (Followers: 4)
Health Professional Student Journal     Open Access   (Followers: 2)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8)
Health Promotion Practice     Hybrid Journal   (Followers: 16)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 50)
Health Psychology Research     Open Access   (Followers: 19)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 13)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 4)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 12)
Health, Risk & Society     Hybrid Journal   (Followers: 12)
Healthcare     Open Access   (Followers: 3)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthcare Technology Letters     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 12)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 3)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Public Health     Open Access  
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 2)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 6)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 34)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)

        1 2 3 | Last

Journal Cover Health Policy and Technology
  [SJR: 0.271]   [H-I: 6]   [4 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2211-8837
   Published by Elsevier Homepage  [3177 journals]
  • Resolving gaps and challenges for health policy to protect the heart and
    • Authors: Donald R.J. Singer
      Pages: 1 - 2
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): Donald R.J. Singer

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.005
  • Healthcare problems cannot be solved using health technologies alone: The
           example of precision medicine
    • Authors: W. Ken Redekop; Lytske J. Bakker; Jos Aarts
      Pages: 3 - 4
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): W. Ken Redekop, Lytske J. Bakker, Jos Aarts

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.006
  • Brexit and the decision to move the European Medicines Agency to Amsterdam
    • Authors: Donald RJ Singer
      Pages: 5 - 6
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): Donald RJ Singer

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.011
  • Utilization of film and social media for full practice authority for
           advanced practice registered nurses in Texas
    • Authors: Katherine Kleinsteuber
      Pages: 23 - 25
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): Katherine Kleinsteuber
      Objective Legislation granting full practice authority (FPA) for Advanced Practice Registered Nurses (APRNs) in Texas has not passed. APRNs need to take advantage of social media as one medium in educating policymakers and the public to foster support for FPA and improve patients’ access to care. Methods Through the development, implementation, and use of technology a video was produced and disseminated through prominent social media venues including YouTube, Facebook, Texas Nurse Practitioners Association, Texas Nurse Practitioner Political Action Committee (PAC) Show Your Force Facebook Page, Texas Team, and a Facebook page for Full Practice Authority for Nurse Practitioners. All venues assisted with dissemination of the video on their respective social media sites resulting in increased awareness. Results The number of video hits on social media sites emphasized the magnitude of dissemination which APRNs can have with healthcare advocacy and policy change. Unfortunately, the issue of FPA advocacy and policy change continues. Conclusions It is essential for APRNs to understand dissemination of knowledge through social media is significant and must be utilized.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.007
  • Trust for pharmaceutical company direct-to-consumer prescription
           medication advertisements
    • Authors: Joshua Fogel; Mohamed Adnan
      Pages: 26 - 34
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): Joshua Fogel, Mohamed Adnan
      Objectives We are not aware of research on trust for social media direct-to-consumer prescription medication advertisements (DTCA). We study (n = 626) the association of DTCA trust with exposure to DTCA in non-digital print, radio, television, Internet, and social media venues. Methods The 626 participants were asked no/yes questions about their exposure to 17 different types of DTCA advertisements and completed a trust scale for DTCA. Analyses of variance compared trust mean differences for exposure to the different DTCA seen or heard as compared to no exposure to that particular type of DTCA. Multivariate linear regression analyses were performed for trust and adjusted for age, gender, race/ethnicity, and attitudes. Results Viewing television DTCA was associated with less DTCA trust. Viewing Twitter video or print DTCA were each associated with more DTCA trust. Asian/Asian Americans and South Asians each had more trust for DTCA than Caucasians. Conclusions Pharmaceutical brand managers should revise their current marketing policy and consider budgeting greater advertising amounts for social media advertising on Twitter. Also, pharmaceutical brand managers should work on improving the trust appeal content on television so that these DTCA are perceived as more trustworthy.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.002
  • Promoting transparency and accountability with district league tables in
           Sierra Leone and Malawi
    • Authors: Johan Ivar Sæbø; Christon Mesheck Moyo; Petter Nielsen
      Pages: 35 - 43
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): Johan Ivar Sæbø, Christon Mesheck Moyo, Petter Nielsen
      Objectives This paper looks at the effects on transparency and accountability of introducing league tables in the health sector in Sierra Leone and Malawi. Methods Drawing on long-term action research in the two countries, we have supported development of league tables at district levels. Our practical aim of this work has been to design and develop a tool that helps districts create and change league tables as they please, based on indicators relevant for them. This has been done in a participative manner. The research covers 3 years in Sierra Leone and 2 years in Malawi. Results Our findings show that such tools have positive immediate effects, most notably on providing new information about relative performance, and improving data quality. They contribute to understanding of health indicators, their applicability, reliability, and relevance at various levels of the health sector. League tables are also suitable for communicating priorities, giving higher levels a way to signal what health facilities are held accountable by Conclusion League tables are a promising tool for advancing transparency and accountability at district levels. An implication for policy is that access to peer data is necessary to evaluate your own performance. The true benefits of league tables at district level can only be reaped when they are easily changed and replicated, becoming an integral part of routine district monitoring and evaluation.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.003
  • Grand challenges of public health: How can health information systems
           support facing them'
    • Authors: Sundeep Sahay; Petter Nielsen; Murodillo Latifov
      Pages: 81 - 87
      Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1
      Author(s): Sundeep Sahay, Petter Nielsen, Murodillo Latifov
      Objectives Achieving Universal Health Coverage (UHC) and establishing robust Civil Registration and Vital Statistics (CRVS) systems are two urgent priorities and grand challenges of global health, especially in Low and Middle Income Countries (LMICs). It is argued that addressing both these priorities requires strong supportive Health Information Systems (HIS), which to date have been elusive to develop. Methods Two case studies are presented and discussed. The first concerns an Indian state's effort to implement a UHC HIS in primary health care while the second relates to the efforts of the Tajikistan national ministry to develop a HIS for CRVS. Results UHC and CRVS can benefit by learning from the domain of information systems research and practice, especially relating to the design of large-scale and complex systems. From this perspective, key areas of concern in strengthening UHC and CRVS include: the role of primary health care, the role of existing systems and practices, and the fragility of technical infrastructure in LMICs. Conclusion Implications for policymakers can be found on three levels: anchoring HIS in primary health care, renewing what already exists, and adopting hybrid rather than fully Internet-dependent systems.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.009
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: March 2018
      Source:Health Policy and Technology, Volume 7, Issue 1

      PubDate: 2018-04-15T08:27:39Z
  • Penetration factors and introduction possibility for image diagnostic
    • Authors: Teppei Suzuki; Yusuke Isomi; Shintaro Tsuji; Yuji Tani; Takumi Tanikawa; Hiroko Yamasina; Katsuhiko Ogasawara
      Abstract: Publication date: Available online 21 February 2018
      Source:Health Policy and Technology
      Author(s): Teppei Suzuki, Yusuke Isomi, Shintaro Tsuji, Yuji Tani, Takumi Tanikawa, Hiroko Yamasina, Katsuhiko Ogasawara
      Background This study investigated and analyzed the relationship between medical resources and economic conditions of OECD member countries and extracted factors for introducing imaging diagnostic equipment in each country. We also investigated the possibility of introducing diagnostic imaging equipment. Methods A principal component analysis was conducted from medical environment indices and economic situation indices; the results were visualized on a graph with the extracted two principal components as axes, and the target nations were categorized according to the possibility of introducing diagnostic imaging equipment. Next, with the number of CTs and MRIs as response variables, we visualized the probability results on a graph by conducting a multiple regression analysis with the indices as explanatory variables and extracting the most influential factors on the number of diagnostic imaging equipment introduced. Results We classified 29 countries into four groups according to medical environment and economic situation indices. By extracting from the four groups a group with a high possibility for introducing medical equipment then conducting a multiple regression analysis with CT and MRI unit counts as objective variables and other medical environment and economic situation indices as explanatory variables, it became clear that the factor with the greatest influence on CT and MRI unit counts is the number of hospital beds. Conclusion As topics of future studies, we would like to clarify the factors behind as well as the probability for the introduction of medical equipment in each nation by researching high-growth medical equipment markets.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.008
  • A quasi-experimental study for inappropriate laboratory utilization from a
           payer perspective in Cyprus
    • Authors: Panagiotis Petrou
      Abstract: Publication date: Available online 13 February 2018
      Source:Health Policy and Technology
      Author(s): Panagiotis Petrou
      Objective Laboratory tests have progressively acquired a dominant role in screening, diagnosis, disease monitoring and outcome assessment. This trend has also adversely led to the inappropriate ordering of laboratory tests, the results of which are highly unlikely to establish or change diagnosis, and, in extent, influence the treatment decision-making of a specific disease. This practice raises the cost of healthcare while it exposes patients to unjustified risk as healthcare professionals may be led to perform unnecessary procedures. Study Design A quasi-experimental study in the form of an interrupted time series analysis was performed to assess the potential impact of introduction of co-payment on cholesterol test ordering. Methods This study was performed using public health care sector data from Nicosia General Hospital and Nicosia primary health care centers. Daily ordering for all outpatient cholesterol tests were tracked for 43 consecutive months; 33 months prior to, and 10 months after the introduction of this measure. Results Co-payment resulted in an instant and significant reduction in cholesterol test ordering. The measure's impact remained unchanged throughout the observation period. Conclusion Co-payment can be considered to be a potent and durable measure to successfully contain inappropriate laboratory ordering. However, the long–term effect of this measure must be assessed to ensure that co-payment does not exert a negative effect on public health.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2017.11.006
  • Safe innovation: On medical device legislation in Europe and Africa
    • Authors: Carmelo De Maria; Licia Di Pietro; Andrés Díaz Lantada; June Madete; Philippa Ngaju Makobore; Mannan Mridha; Alice Ravizza; Janno Torop; Arti Ahluwalia
      Abstract: Publication date: Available online 9 February 2018
      Source:Health Policy and Technology
      Author(s): Carmelo De Maria, Licia Di Pietro, Andrés Díaz Lantada, June Madete, Philippa Ngaju Makobore, Mannan Mridha, Alice Ravizza, Janno Torop, Arti Ahluwalia
      Objectives The principal motivation for regulating medical devices is to protect patients and users. Complying with regulations may result in an increase in development, manufacturing and service costs for medical companies and ultimately for healthcare providers and patients, limiting the access to adequate medical equipment. On the other hand, poor regulatory control has resulted in the use of substandard devices. This study aims at comparing the certification route that manufactures have to respect for marketing a medical device in some African Countries and in European Union. Methods We examined and compared the current and future regulations on medical devices in the European Union and in some countries in Africa. Contextually we proposed future approaches to open design strategies supported by emerging technologies as a means to enhance economically sustainable healthcare system driven by innovation. Results African medical device regulations have an affinity to European directives, despite the fact that the latter are particularly strict. Several states have also implemented or harmonized directives to medical device regulation, or have expressed interest in establishing them in their legislation. Open Source Medical Devices hold a great promise to reduce costs but do need a high level of supervision, to control their quality and to guarantee their respect for safety standards. Conclusion Harmonization across the two continents could be leveraged to optimize the costs of device manufacture and sale. Regulated open design strategies can enhance economically sustainable innovation.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.012
  • Segmented regression analysis of emergency departments patient visits from
           Septicemia in Taiwan
    • Authors: I.-Shiang Tzeng; Kuo-Liong Chien; Yu-Kang Tu; Jau-Yuan Chen; Chau Yee Ng; Cheng-Yu Chien; Jih-Chang Chen; Chung-Hsien Chaou; Giou-Teng Yiang
      Abstract: Publication date: Available online 31 January 2018
      Source:Health Policy and Technology
      Author(s): I.-Shiang Tzeng, Kuo-Liong Chien, Yu-Kang Tu, Jau-Yuan Chen, Chau Yee Ng, Cheng-Yu Chien, Jih-Chang Chen, Chung-Hsien Chaou, Giou-Teng Yiang
      Background The protocol for early goal-directed therapy (EGDT) is effective for improving both the costs and outcomes of septicemia treatment, including a significant reduction in case fatality. However, this complicated protocol may have a downside. Furthermore, the Joint Taiwan Critical Care Medicine Committee has launched a nationwide educational program after the publication of the Surviving Sepsis Campaign (SSC) to improve the overall survival rate from septicemia in the emergency care system of Taiwan. Objectives To assess the impact of the EGDT protocol and SSC education programs on island-wide septicemia-related emergency department (ED) visits. Methods Segmented regression techniques were utilized to assess the differences in annual rates and changes in septicemia-related ED visits between 1998 and 2012. We considered annual incidence of two medical comorbidities as potential confounders: metastatic malignant neoplasms and malignant neoplasms of the lymphatic and hematopoietic tissues. Results The EGDT protocol was associated with decreased septicemia-related ED visits in 2002 (level change; p < 0.001), while the SSC education program led to a slight increase in septicemia-related ED visits in 2007 (slope change; p < 0.001). For the EGDT protocol, the number of patient visits decreased by 32.9% after the protocol was implemented in 2002 compared with the expected number without the intervention. For the SSC education program, the number of patient visits increased by 20.2% (compared with the predicted number) in 2007 after the education program was implemented. Conclusions The EGDT protocol and SSC education program were associated with significant immediate changes and lagged intervention effects on island-wide septicemia-related ED visits.

      PubDate: 2018-04-15T08:27:39Z
      DOI: 10.1016/j.hlpt.2018.01.010
    • Authors: Michael Bächle; Stephan Daurer; Andreas Judt; Tobias Mettler
      Abstract: Publication date: Available online 29 December 2017
      Source:Health Policy and Technology
      Author(s): Michael Bächle, Stephan Daurer, Andreas Judt, Tobias Mettler
      Background Recent advancement in assistive technologies (AT) have fueled the debate on new, IT-reliant ways of providing cure and care of dementia. Still the impact on practice has been little. With this paper, we want to find out to which extent current studies have discussed the impacts of AT for dementia. Methods We conduct a scoping review of the literature on impacts of AT usage in the context of dementia. We search disciplinary (ACM, EMBASE, PsycInfo) as well as cross-disciplinary databases (EBSCO, Web of Science). Based on the identified relevant papers, we extract a list of original statements, which we aggregate to stylized facts. The method of stylized facts is a common research method to derive knowledge in the form of generalized and simplified statements describing interesting characteristics and relationships concerning empirically observable phenomena. Results We identify n=539 unique articles, out of which n=36 report impacts of AT usage in the context of dementia. We aggregate 6 stylized facts that describe common findings. Furthermore, we identify research gaps in this domain. There is little known about the suitable design of social systems around assistive technologies. Conclusions While the identified stylized facts indicate how much evidence there is behind certain common statements in the reviewed literature, we additionally find that studies in the area of AT for dementia often neglect the socio-economic and ethical dimension. These are important research gaps for future work.

      PubDate: 2018-01-09T22:38:40Z
      DOI: 10.1016/j.hlpt.2017.12.002
  • Mapping the dimensions of Health Policy and Technology
    • Authors: W. Ken Redekop; Donald R.J. Singer
      Pages: 121 - 123
      Abstract: Publication date: June 2017
      Source:Health Policy and Technology, Volume 6, Issue 2
      Author(s): W. Ken Redekop, Donald R.J. Singer

      PubDate: 2017-06-08T09:07:00Z
      DOI: 10.1016/j.hlpt.2017.05.001
    • Authors: Tim A Kanters; W Ken Redekop; Leona Hakkaart
      Abstract: Publication date: Available online 14 December 2017
      Source:Health Policy and Technology
      Author(s): Tim A Kanters, W Ken Redekop, Leona Hakkaart
      Objectives Reimbursement recommendations on (orphan) drugs are usually made at a national level and this can lead to variation in patient access to the same drug in different countries. We compared differences in patient access to ultra-orphan drugs between countries. Furthermore, we describe how reimbursed and non-reimbursed orphan drugs differ with respect to pharmacoeconomic properties. Methods We studied patient access to eight high-priced inpatient ultra-orphan drugs in nine countries. In addition, we determined whether differences with respect to cost per patient, budget impact and cost-effectiveness existed between orphan drugs with a positive and negative reimbursement status. Results Reimbursement status was available for 78 orphan drugs, of which 56 (72%) were positive. Large differences were observed between countries; while two countries had a positive status for two out of nine ultra-orphan drugs, four countries had positive status all drugs it assessed. A number of drugs were reimbursed only after price negotiations and/or through specific orphan drug policies. The average cost per patient, budget impact and incremental cost-effectiveness ratios were lower for ultra-orphan drugs with a positive reimbursement status than for those with a negative status, although there were no statistically significant differences. Conclusions Large differences in patient access to ultra-orphan drugs were observed between countries. Future research should examine if similar findings can be seen in other countries and with other orphan drugs, and it should also determine which other factors play a role in reimbursement status of orphan drugs.

      PubDate: 2017-12-26T20:12:02Z
      DOI: 10.1016/j.hlpt.2017.12.001
  • Enablers and inhibitors: A review of the situation regarding mHealth
           adoption in low- and middle-income countries
    • Authors: Javariya Aamir; Syed Mustafa Ali; Maged N. Kamel Boulos; Naveed Anjum; Muhammad Ishaq
      Abstract: Publication date: Available online 6 December 2017
      Source:Health Policy and Technology
      Author(s): Javariya Aamir, Syed Mustafa Ali, Maged N. Kamel Boulos, Naveed Anjum, Muhammad Ishaq
      Objective The objective of this review is to identify enabling and inhibiting factors for mHealth adoption in low resource settings, by giving emphasis on the stakeholders representing the caregiving side. Another objective of this study is to support implementation agencies (governmental and non-governmental) in designing scalable mHealth interventions. Methods A PEO (Population, Exposure, Outcome) approach was used to formulate the review question. A pre-defined search strategy was implemented; Google Scholar, PubMed and gray literature were searched using alternate terms for “mHealth”, “adoption” and “developing countries”. CASP [7] tools were used to assess the quality of selected evidence. After applying inclusion and exclusion criteria on search results and critical appraisal of the selected evidence, twelve studies were selected for the review. Results Adoption factors operated at the levels of organization, facility-based service provider and frontline health worker. Engagement of end users during design phase, informed clinical decision making, utilization of mHealth evidence, employers’ tolerance of some personal use of devices, automation of tasks and user-friendliness of application are key enabling factors for mHealth adoption in developing countries. On the contrary, absence of national policy on mHealth, poor knowledge base on mHealth, using two systems in parallel, duplication of efforts, poor Internet connectivity and shortage of electricity are important inhibiting factors for mHealth adoption. Conclusions The review provides an insight about the challenges and opportunities related to mHealth adoption in developing countries. Implementation agencies should give careful consideration to these factors before designing and deploying any mHealth-enabled intervention. It is also important to understand the concept of incremental innovation so that resources spent on pilot interventions are optimized and full potential is achieved.

      PubDate: 2017-12-26T20:12:02Z
      DOI: 10.1016/j.hlpt.2017.11.005
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: December 2017
      Source:Health Policy and Technology, Volume 6, Issue 4

      PubDate: 2017-12-26T20:12:02Z
  • Discourse and politics in Alberta's Health System: An analysis of mobile
           technology policy
    • Authors: Kari Krell
      Abstract: Publication date: Available online 24 November 2017
      Source:Health Policy and Technology
      Author(s): Kari Krell
      Advances in technology are changing the way healthcare professionals communicate with peers and with patients. Although healthcare professionals are increasingly utilizing mobile health technologies to successfully support their practices, healthcare organizations are slow to embrace and support the use of mobile technologies in the provision of health services. This paper uses a case study to highlight how the adoption and use of mobile technologies in clinical practice is impacted when there is a paucity of clear polices to provide direction. The localized approach is limited in its generalizability but is useful to provide a deeper understanding of the roles organizational discourse and politics have in technology acceptance. By reframing the circumstances present in the case study and analyzing the underlying issues of power and discourse, the goal is to better understand barriers to HIT approval and diffusion within a health system.

      PubDate: 2017-12-26T20:12:02Z
      DOI: 10.1016/j.hlpt.2017.11.004
  • Patient Access to Electronic Health Records: Differences Across Ten
    • Authors: Anna Essén; Isabella Scandurra; Reinie Gerrits; Gayl Humphrey; Monika Alise Johansen; Patrick Kiergegaard; Jani Koskinen; Siaw-Teng Liaw; Souad Odeh; Peeter Ross; Jessica S. Ancker
      Abstract: Publication date: Available online 21 November 2017
      Source:Health Policy and Technology
      Author(s): Anna Essén, Isabella Scandurra, Reinie Gerrits, Gayl Humphrey, Monika Alise Johansen, Patrick Kiergegaard, Jani Koskinen, Siaw-Teng Liaw, Souad Odeh, Peeter Ross, Jessica S. Ancker
      Objectives Patient-accessible electronic health records (PAEHRs) are being implemented at international scale. Comparing policies and systems could allow countries to learn from each other to address global and nation-specific challenges. We compare national PAEHR policy (hard and soft regulation) and services in 10 countries. Methods PAEHR policy and system documentation was gathered from Australia, Denmark, Estonia, Finland, France, the Netherlands, New Zealand, Norway, Sweden and the United States. A basic analytic model for policy analysis was used to delimit our focus to policy content, followed by an inductive thematic analysis across countries, in which we clustered initial themes into a set of categories of PAEHR service “approaches” related to three specific content areas. Results Although all 10 countries ensured some patient rights to access medical records, policies and systems were highly variable, as were the technological processes arising from these. In particular, three policy areas showed great variability. Depending upon country of origin, a patient would encounter differences in: login procedures (security), access to own and other patients’ data during adolescence (user rights), and types of medical data made available to the patient (data sets). Conclusions Individuals encounter very different access rights to their health data depending on where they live. Countries may be able to develop improved policies by examining how other nations have solved common problems. Harmonizing policies is also an initial step likely to be needed before cross-national PAEHRs could be possible.

      PubDate: 2017-11-23T03:08:51Z
      DOI: 10.1016/j.hlpt.2017.11.003
  • Promoting China's mHealth Market: A Policy Perspective
    • Authors: Xiaofei Zhang; Kee-hung Lai; Xitong Guo
      Abstract: Publication date: Available online 10 November 2017
      Source:Health Policy and Technology
      Author(s): Xiaofei Zhang, Kee-hung Lai, Xitong Guo
      Background The mobile health (mHealth) service is experiencing worldwide escalation due to the invaluable support it provides to a rapidly expanding elderly population and patients with chronic conditions. However, the mHealth market in China is aberrated in comparison with other countries in two major aspects: 1) the monitoring service is a minority market; and 2) the potential users (the elderly and patients with chronic conditions) lack the interest for using this service. Method To explain this understated condition, we examine the specific policies on the mHealth service and the current healthcare system in China, with suggestions for forming mHealth policies. Results Based on our policy analysis, this research proposes several political and practical suggestions for mHealth implementation in China. Along with the characteristics of the mHealth market, this research further develops a healthcare ecosystem connecting major stakeholders, including the government, the community, service providers, health professionals, drug manufacturers, and data-analysis organizations. Our suggestions will be beneficial to China's mHealth market in the business sense and provide insights for policymakers on how to regulate the market.

      PubDate: 2017-11-10T21:07:14Z
      DOI: 10.1016/j.hlpt.2017.11.002
  • Evolving Large Scale Healthcare Applications using Open Standards
    • Authors: Shelly Sachdeva; Shivani Batra; Subhash Bhalla
      Abstract: Publication date: Available online 8 November 2017
      Source:Health Policy and Technology
      Author(s): Shelly Sachdeva, Shivani Batra, Subhash Bhalla
      Electronic Health Records (EHRs) are becoming more prevalent in health care. Worldwide exchange of healthcare data demands adherence to semantic interoperable standards to overcome the language and platform barriers. Various healthcare organizations in developing countries such as, India adopt their own independent information systems without adhering to standard guidelines. Thus, this tends to sacrifice interoperability. This affects permanent persistence of longitudinal health records for future reference and research purpose. Current research implements a standard based clinical application to be used for healthcare domain in India. The study has been done for enhancing the data quality through standardization. It aims at providing a generic permanent persistence to track life-long interoperable health records of patients. This is the first effort for exploring its adoption for various regional languages in India. The user interfaces have been generated for various Indian languages for testing on a sample set of archetypes. The clinical application deployed in ‘Hindi’ language can be easily deployed for other people in ‘Tamil’ language, while maintaining semantic interoperability. The persistence will also be maintained, with the same meaning (of data) for both the regions. Implementing these standard based healthcare applications helps in reducing the costs while enhancing patient care. Thus, this study aims to build a standard based, and platform independent healthcare application to provide support for interoperability, usability and generic persistence.

      PubDate: 2017-11-10T21:07:14Z
      DOI: 10.1016/j.hlpt.2017.10.001
  • Patient Health Records: An Exploratory Study of Patient Satisfaction
    • Authors: Michele Heath; Tracy H. Porter
      Abstract: Publication date: Available online 8 November 2017
      Source:Health Policy and Technology
      Author(s): Michele Heath, Tracy H. Porter
      Objective This study seeks to understand what factors might influence a patient's perception of PHRs in early adoption. We draw from social contagion theory to examine how beliefs and behaviors are subject to those who are important to them. Methods This is a quantitative study with data collected information from a self-selected patient panel residing in the United States. Cross-sectional data were used to examine a patient beliefs and behaviors as they use personal health records. Results The findings demonstrated patient skills and abilities to conduct PHR tasks plays a role in the feelings developed toward the change. Behavioral resistance was shown to negatively impact patient satisfaction. Cognitive resistance was significant but, not in the hypothesized direction. We found a strong relationship between affective and cognitive resistance. This research suggests when affective is high, cognitive scope is out shadow and whereas affective is low, cognitive scope will broaden. Discussion After adoption, a patient might still resistance the PHR system. Hospitals and physicians should emphasize the importance of PHR to every patient, seek to offer training opportunities, offer avenues for discussion, and recognize the existence of resistance factors. Conclusion This study illustrates the need for physicians and hospitals to reshape patient's beliefs about PHRs by helping individuals understand and internalize the change toward PHRs. To ensure the promotion and engagement of the PHR system, all interested parties (hospital administrators, government agencies, policy makers, and physicians) must communicate and publicize a consistent message related to the importance of PHR use.

      PubDate: 2017-11-10T21:07:14Z
      DOI: 10.1016/j.hlpt.2017.10.002
  • Maximizing Returns for Public Funding of Medical Research with Open-source
    • Authors: J.M. Pearce
      Abstract: Publication date: Available online 6 October 2017
      Source:Health Policy and Technology
      Author(s): J.M. Pearce

      PubDate: 2017-10-13T03:31:32Z
      DOI: 10.1016/j.hlpt.2017.09.001
  • The impact of healthcare informatics competencies on dynamic capabilities:
           A multilevel study of paramedic services
    • Authors: Michael S. Dohan; Marlene Green; Joseph Tan
      Abstract: Publication date: Available online 14 September 2017
      Source:Health Policy and Technology
      Author(s): Michael S. Dohan, Marlene Green, Joseph Tan
      Objectives Despite the importance placed on technology in healthcare, there is a lack of studies that link technology-related skillsets of healthcare professionals to the ability of an organization to innovate. This research investigates the role of Healthcare Informatics Competencies (HICs) of front-line healthcare workers for the ability of their healthcare organizations to innovate. This research employs a multilevel perspective, nesting paramedics within their respective services, and measuring the impact of group-level HICs on Dynamic Capabilities. Methods Data from Canadian paramedic services (n = 43) and paramedics (n = 502) was analyzed. Exploratory Factor Analysis (EFA) was used to detect factors from the competency models, which were then aggregated to the group level. Partial Least Squares (PLS) was used to measure the impact of group-level competency on organization-level dynamic capabilities, specifically sensing, learning, integrating and coordinating capabilities. Results Three factors emerged from the paramedic competency data, labeled “Technology Application Competencies” (TAC), “Information Processing Competencies” (IPC), and “Understanding of the Workings of Technology” (UWT). At the group-level, TAC significantly impacted learning, integrating and coordinating capabilities, and UWT impacted sensing and coordinating capabilities. Conclusions Results suggest that paramedics who possess an understanding of technology and where it can be applied in a paramedicine context contribute to the innovativeness of their paramedic services. This research underlines the importance of HICs as an organizational resource in both paramedicine and healthcare, and draws attention to their importance to policy makers. This study also advances the use of HICs as part of an evidence-based approach to studying technology adoption in healthcare.

      PubDate: 2017-09-15T21:51:08Z
      DOI: 10.1016/j.hlpt.2017.07.009
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: September 2017
      Source:Health Policy and Technology, Volume 6, Issue 3

      PubDate: 2017-09-03T20:49:03Z
  • Erratum to “Assessing eHealth skills across Europeans” [Health Policy
           Technol. 6/2 (2017) 161–168]
    • Authors: María Rosalía Vicente; Gary Madden
      Abstract: Publication date: Available online 25 July 2017
      Source:Health Policy and Technology
      Author(s): María Rosalía Vicente, Gary Madden

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.008
  • Evaluating the Current Situation of Oral and Dental Healthcare Services in
           Turkey and Recommending Solutions
    • Authors: Omer Ekici; Dilaver Tengilimoglu; Oguz Isik
      Abstract: Publication date: Available online 20 July 2017
      Source:Health Policy and Technology
      Author(s): Omer Ekici, Dilaver Tengilimoglu, Oguz Isik
      Objectives To identify issues with Turkey's oral and dental healthcare services and develop recommendations for their effective resolution. Methods This study analyzes Turkey's oral and dental healthcare system and its problematic issues and surveys other systems and reform strategies being implemented worldwide. The questionnaire-based field survey asked 560 dentists and 84 managers working in public oral and dental healthcare centers in 12 different regions and 52 central and chamber directors affiliated with the Turkish Dental Association about dental health issues and potential restructuring in dental healthcare in Turkey. The survey comprised four sections that, in addition to gathering participant information, inquired into the current overall condition of the Turkish dental healthcare system, the problems necessitating system restructuring, and recommendations to resolve these problems. Results Participants agree that there are structural and functional problems in Turkey's dental healthcare system. Although there is an overall consensus in regard to the recommendations for resolving the problems, priorities differ among participant groups. However, participants do agree that preventive services in Turkey are insufficient and require improvement. Conclusions This study exposed issues in oral and dental healthcare services in Turkey that fall into four categories: management and organization, service delivery, human resources, and financing. Based on the results, we propose a new organization model for oral and dental healthcare in Turkey that is integrated within the healthcare system using a public health approach and that prioritizes preventive healthcare services.

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.006
  • Paramedics Declare Death – A Lifesaving decision
    • Authors: Eli Jaffe; Roman Sonkin; Jillian Goldberg; Refael Strugo
      Abstract: Publication date: Available online 20 July 2017
      Source:Health Policy and Technology
      Author(s): Eli Jaffe, Roman Sonkin, Jillian Goldberg, Refael Strugo
      Objective Mobile Intensive Care Units (MICUs) are a valuable resource and their effective use is essential. In May 2012 Magen David Adom (Israeli National EMS) paramedics were allowed to declare and document death. The aim of this study is to assess if allowing paramedics to declare death leads to better utilization of MICUs. Methods Records were retrospectively analyzed before and after the adoption of the new directive allowing paramedics to declare and document death. MICU dispatches to declare death were retrospectively analyzed to evaluate dispatch times and call quantity difference. Results A total of 31,096 cases were evaluated where a MICU was dispatched to declare death. Average time on scene of the MICU pre-protocol was 63.14 minutes (N=15,408, sd=28.77), compared to a post-protocol time of 67.31 minutes (N=15,688, p=0.024, sd=28.30). A total of 110.44 minutes was used to declare death pre-protocol. These 110.44 minutes are significantly longer than the post-protocol average of 68.56 minutes (p<0.01; 95% CI (35.94, 47.81)) conservatively saving 41.88 minutes per call. In addition, there were 2,196 cases of ROSC (Return of Spontaneous Circulation). Conclusion Applying the 41.88 excess minutes to the yearly 2,543 calls pre-protocol extra yearly 1,828 valuable hours have been saved. A recent study in Jerusalem concluded the percentage of survival to discharge was 6.1%, of whom 3.4% were neurologically intact. Applying these findings to this study we find that approximately 25 more patients per year survive to discharge neurologically intact post-protocol, therefore such guidelines not only save time, but might also save lives.

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.005
  • Investigation of Physicians' Awareness and Use of mHealth Apps: A Mixed
           Method Study
    • Authors: Emre Sezgin; Sevgi Özkan-Yildirim; Soner Yildirim
      Abstract: Publication date: Available online 19 July 2017
      Source:Health Policy and Technology
      Author(s): Emre Sezgin, Sevgi Özkan-Yildirim, Soner Yildirim
      Objective The study aims to understand physicians’ awareness of mobile health (mHealth) apps and their intentions to use these apps in medical practice. Method Mobile Health Technology Acceptance Model (M-TAM) was tested employing the sequential explanatory mixed method. An online survey and focus group interviews were conducted for data collection. Physicians were invited to participate in the survey. Structural Equation Modeling (SEM) was used in quantitative data analysis. Qualitative data were analyzed using coding, memo, and contextual analyses. Results 151 physicians participated in the survey, representing a 15% response rate. The model was able to explain physicians’ intention to use mHealth apps by explaining 59% of the total variance. Performance Expectancy, Mobile Anxiety, Perceived Service Availability and Personal Innovativeness were major influencing factors of Behavioral Intention. Qualitative codes outlined that information gathering and communication purposes were the major enablers in mHealth app usage. In that regard, Communication and Consulting, Clinical Decision Making, Reference and Information Gathering, and Information Management are the most popular app categories. On the other hand, lack of knowledge and lack of investment were seen as the major barriers to mHealth app usage. Conclusions User perception and intentions are important factors in technology use. Thus, the preferences, expectations, and characteristics of physicians which were outlined in this research could be significant inputs for researchers, app developers, managers and policymakers.

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.007
    • Authors: Jorge Osma; Michaela Sprenger; Tobias Mettler
      Abstract: Publication date: Available online 14 July 2017
      Source:Health Policy and Technology
      Author(s): Jorge Osma, Michaela Sprenger, Tobias Mettler
      Objectives Evidence exists that e-mental health applications for maternal depression could assist in diagnosing such conditions in an early stage. This study explores the intention of health professionals to use and recommend e-mental health applications and how they think these applications should be integrated in the national health system. Methods We applied an exploratory sequential mixed-method research design. First, we collect and analyze responses from 131 health professionals in the field of pregnancy and maternal care. Based on these findings, we conduct semi-structured interviews with 16 experts for expanding and broadening the initial results. Results Our study reveals that health professionals would in general intend to recommend and use e-mental health applications. However, their attitude towards e-mental health applications varies with respect to the coverage of the mental health process. Conclusion The results are of relevance for research and practice. Two scenarios are described that show how health professionals perceive an introduction of e-mental health to be useful.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.001
  • Telemedicine services: how to make them last over time
    • Authors: Federica Segato; Cristina Masella
      Abstract: Publication date: Available online 13 July 2017
      Source:Health Policy and Technology
      Author(s): Federica Segato, Cristina Masella
      Objectives Telemedicine is extensively used in healthcare settings, although we still lack knowledge on how to make telemedicine services last over time. This study aims to: investigate how the factors supporting the implementation of telemedicine services affect their duration over time; explore if further factors need to be considered, to foster the services duration. Methods We conducted a six-year in-depth study on three Italian cases of telemedicine services lasting more than 10 years. Dimensions explaining the duration of services over time are explored and discussed against existing literature. Results The three cases show that, to support the duration over time, financial and organizational stability should be set before the “champion” leaves the service. Financial stability was reached through different strategies. About organizational stability, we found that providing opportunities to enrich the competences and getting more responsibilities over the patients enhanced the professionals’ acceptance, which, in turn, supports the organizational stability of the service over time. About patients, to meet their crucial needs for their health and to receive the nurses’ support on the use of technologies contains the abandon and increases the chances for the service to last over time. Last, the three services observed pursued a strategy of focalization on a specific need. Conclusions The findings provide insights for policy makers and hospital managers on how to set effective services and avoid service abandon, thus reducing waste of resources, and on how to motivate the professionals and patients, by increasing the chances of duration of the services over time.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.003
  • Health and well-being of middle age Indonesians: An application of
           seemingly unrelated regression (SUR) models
    • Authors: Hui-Peng Liew
      Abstract: Publication date: Available online 12 July 2017
      Source:Health Policy and Technology
      Author(s): Hui-Peng Liew
      Objective This study used multiple indicators of health simultaneously to examine how the socio-demographic characteristics of an individual (age, gender, education, marital status, etc.) affect health and well-being in Indonesia. Methods The empirical work of this study is based on data from the 2007 Indonesian Family Life Survey (IFLS4). This study used seemingly unrelated regression (SUR) to examine how the socio-demographic characteristics of an individual (age, gender, education, marital status, etc.) affect health and well-being in Indonesia. Results Findings from the seemingly unrelated regression (SUR) suggest that physical, cognitive, and mental health functioning problems co-occur more commonly than expected. Conclusion: Indonesian women, those with two or more comorbid conditions, smokers, those who are divorced or separated, and those with low education should be the main targets of policy interventions designed to reduce health inequality because they experience more barriers to health and socioeconomic well-being.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.002
  • From policy towards pharmacy practice: A review of the intended use of
           ehealth in pharmacy in Scotland
    • Authors: Katie MacLure; Derek Stewart
      Abstract: Publication date: Available online 12 July 2017
      Source:Health Policy and Technology
      Author(s): Katie MacLure, Derek Stewart
      Background Policy-driven ehealth underpins the delivery of healthcare in which pharmacy practice plays an increasingly integral role. As health is a devolved matter within the UK, responsibility for policy development and service delivery lies with the parliament of each of the home nations. Aim The aim of this research was to describe the policy-driven intended use of ehealth as the landscape of pharmacy practice evolves in Scotland. Methods A content analysis of current policy and strategy documents was conducted. A framework approach was applied (transcribing, familiarising, coding, developing/applying analytical framework, mapping data to the framework, interpreting patterns across and within constructs) from which a conceptual model of the intended use of technology in pharmacy was developed along with this explanatory narrative. Results Four key documents were identified for inclusion with a subsequent policy refresh incorporated. Key constructs were identified with associated sub-themes inducted from the data: Patient care: safety, partnership, integration, resources; Education and training: fit-for-future needs, multidisciplinary, delivery mode; Information governance: systems, staff; Implementation: accessibility, interoperability, support for role development. Conclusions The policy-driven strategy for ehealth in pharmacy practice in Scotland values the pharmacy team and promotes their role in multidisciplinary healthcare delivery. The clearly described intention is to facilitate and develop the patient-facing clinical role of the pharmacist and more integrated role of pharmacy in Scotland. This integrated role for pharmacy practice within the healthcare team, based on a secure, shared EHR, is a 2020 target for Scotland moving policy towards pharmacy practice.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.004
  • Technology supporting cooperative practice: A Norwegian municipality's
           implementation of electronic plan
    • Authors: Mary Genevieve Billington; Brita Gjerstad; Svein Ingve Nødland
      Abstract: Publication date: Available online 1 July 2017
      Source:Health Policy and Technology
      Author(s): Mary Genevieve Billington, Brita Gjerstad, Svein Ingve Nødland
      Objectives This research explores, primarily from a user perspective, the introduction of the electronic individual plan, eIP, in a municipality in Norway. Individual plans are tools designed to coordinate the range of healthcare, welfare and other support services required by individual citizens over a longer term. The plan should empower the main user and support cooperative practices amongst instances involved in care and support. The concepts of affordances and constraints provide a theoretical framework to structure the analysis. According to Greeno [1], affordances are attributes of a setting that provide potential for action while constraints are the conditions and relationships that provide structure and guidance for action. Methods An embedded case study of one municipality, based on semi-structured interviews with plan owners and with representatives from their service providers. Results and conclusions In general, the electronic plans were used only sporadically. Use was impeded by practical limitations such as technical problems and insufficient time and by personal preferences for more familiar and personal forms of communication, such as telephone and e-post. The various user groups voiced differing perceptions of the potential for action inherent in the electronic plan but all were well attuned to the structural impositions of the welfare system. The theoretical framework is presented as a useful tool for understanding and interpreting phenomena around the introduction of new technology into the healthcare and social welfare systems.

      PubDate: 2017-07-03T13:03:38Z
      DOI: 10.1016/j.hlpt.2017.06.002
  • Patient access to electronic psychiatric records: A pilot study
    • Authors: Pamela Peck; John Torous; Meghan Shanahan; Alan Fossa; William Greenberg
      Abstract: Publication date: Available online 23 June 2017
      Source:Health Policy and Technology
      Author(s): Pamela Peck, John Torous, Meghan Shanahan, Alan Fossa, William Greenberg
      Background OpenNotes, a national movement offering patients access to their doctor׳s notes, lies at the intersection of health policy and health technology. Despite interest in OpenNotes, little is known about how such may be implemented in psychiatry departments using electronic medical records. This study reports on the first pilot project to examine the experience of patients and clinicians when open access to psychiatric records was provided within an ongoing treatment relationship. Methods Fifteen clinicians in an outpatient psychiatry clinic in a Boston medical center agreed to participate in the study and 52 of their patients to participate. Those patients had the opportunity to read their progress notes through a patient site linked to an electronic medical record. Patients and clinicians were surveyed 20 months later. Results Results from this select group suggest that open access to notes was perceived as helpful to patients and did not negatively impact the patients or the treatment relationship. In addition, our experience was that mental health clinicians could be engaged in the process of OpenNotes. Conclusion This is the first study to implement and assess the impact of patients’ access to psychiatric records in an outpatient setting. Although many questions remain to be studied and a more diverse sample is needed for future research, the potential impact to enhance mental health treatment and the patient-clinician relationship is suggested for selected psychiatric patients. Policy around providing psychiatry patients access to their notes can be informed by reactions of both clinicians and patients.

      PubDate: 2017-07-03T13:03:38Z
      DOI: 10.1016/j.hlpt.2017.06.003
  • Development and performance of the external reference pricing system in
           Slovenia from 2007 to 2012
    • Authors: Nika Marđetko; Nika Rijavec; Mitja Kos
      Abstract: Publication date: Available online 21 June 2017
      Source:Health Policy and Technology
      Author(s): Nika Marđetko, Nika Rijavec, Mitja Kos
      Background From 2007 to 2012 five changes of the Rules defining Slovenian external reference pricing (ERP) were introduced to reduce medicine expenditure. Objective To assess the cost-saving effect of five ERP updates and the cost-saving effect of specific price reduction agreements, and to identify potential inconsistencies in determining the maximum allowed prices (MAPs) based on ERP. Methods To obtain MAPs from 2012 and four sets of MAPs that would be valid if ERP upgrades did not occur, Rules from 2012 and four previous Rules were applied to the same data on prices in reference countries. To assess the ERP updates cost-saving effect, one-year validity of each Rules was assumed. The assumed annual medicine expenditure was calculated considering MAPs according to each Rules and medicine consumption. To detect inconsistencies in determining MAPs, the official MAPs were compared to the MAPs calculated within the study. Results The total cost-saving effect resulting from the difference in assumed medicine expenditure based on the 2012 Rules and 2007 Rules was 5.45%. The greatest cost-saving effect of 3.59% was observed for the 2012 Rules compared to the 2010 Rules, while a 2.28% cost increase was detected when comparing the 2009 Rules to those from 2008. Specific price reduction agreements contributed to 2.32%, 4.51% and 6.74% expenditure reductions, respectively. Inconsistences in the formulation of MAPs were found as 4.75% lower monthly expenditure based on the calculated MAPs. Conclusions ERP system upgrades affected medicine expenditure; however, specific price reduction agreements were shown as a more effective cost-containment measure.

      PubDate: 2017-06-22T11:46:09Z
      DOI: 10.1016/j.hlpt.2017.06.005
    • Authors: Pamphile Thierry Houngbo; Marjolein Zweekhorst; Joske Bunders; Harry Laurence Selby Coleman; Daton Medenou; Laurent Dakpanon; Tjard De Cock Buning
      Abstract: Publication date: Available online 20 June 2017
      Source:Health Policy and Technology
      Author(s): Pamphile Thierry Houngbo, Marjolein Zweekhorst, Joske Bunders, Harry Laurence Selby Coleman, Daton Medenou, Laurent Dakpanon, Tjard De Cock Buning
      This study aims to identify the root causes and solutions of main problems facing Healthcare Technology Management in Benin's public health sector. Conducted in Benin from 2008 to 2010, two surveys were used with key actors in Healthcare Technology Management. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at selected health facilities The findings of the two surveys show that the problems are based on both high- and low-level corruption, characterized by self-interest and unwillingness of the policy makers to solve healthcare care equipment and maintenance problems. Appropriate solutions include: (i) development of policy and management tools to guide distribution, (ii) the use of reference price lists for procuring equipment, (iii) development of policy and management tools to guide financial resource allocation on the life cycle cost of the equipment, (iv) creation of a healthcare equipment and maintenance directorate, (v) development of policy and management tools for obsolete equipment, and (iv) the development of a new healthcare technology management policy with a budgeted action plan. We suggest that much can be improved by the strict development and implementation of policy and management tools, as well as regulations at each level of the Healthcare Technology Management process. A key role has to be attributed to the technical specialists, and the end users of equipment in healthcare facilities. Furthermore, there is a need for capacity building in Healthcare Technology Management institutions.

      PubDate: 2017-06-22T11:46:09Z
      DOI: 10.1016/j.hlpt.2017.06.004
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: June 2017
      Source:Health Policy and Technology, Volume 6, Issue 2

      PubDate: 2017-06-08T09:07:00Z
  • Making Health Technology Assessment More Dynamic - Temporal Trend Analysis
           to Capture Performance Trajectories
    • Authors: Patrik Hidefjäll; Magnus Backheden
      Abstract: Publication date: Available online 23 April 2017
      Source:Health Policy and Technology
      Author(s): Patrik Hidefjäll, Magnus Backheden
      Objectives Health technology assessment (HTA) has an increasing role in evaluating not only drugs, but also medical devices. Assessing medical devices is more challenging as outcomes tend to improve substantially over time. This paper analyzes clinical outcomes over time of insulin pump therapy in adult type 1 diabetes. Meta-regression was used to capture outcome trends while considering innovation theory. Methods A systematic review of 4.297 studies was conducted covering a 35 year time period. To meet the need for a more dynamic evaluation method, temporal trend analysis was applied based on meta-regression of three extracted outcome parameters: HbA1c, incidence of severe hypoglycemia and ketoacidosis. Results The systematic review included 150 studies. Performance improvement in HbA1c and ketoacidosis was rapid during the 1980 and 90s.Thereafter the improvement trajectory of insulin pumps measured by HbA1c, ketoacidosis or severe hypoglycemia was essentially flat. Meta-regression of several covariates was performed showing publication year to be statistically significant. Retrospective recruitment and the percentage of female patients were also statistically significant. A technology cycle model analysis revealed convergence to a dominant design by the end 1990s, followed by slower progress in outcomes. Conclusions Insulin pump technology currently does not offer an improving performance trajectory according to key indicators HbA1c, incidence of severe hypoglycemia and ketoacidosis, but compares well to manual insulin injections in terms of quality of life. Applying temporal trend analysis is especially valuable in an early technology cycle stage when uncertainty is high, and when predicted improvements in future performance can influence the choice of technology.

      PubDate: 2017-04-27T10:54:40Z
      DOI: 10.1016/j.hlpt.2017.04.005
  • Development of Nationwide Electronic Health Record (ΝEHR): An
           international survey
    • Authors: Leonidas L. Fragidis; Prodromos D. Chatzoglou
      Abstract: Publication date: Available online 14 April 2017
      Source:Health Policy and Technology
      Author(s): Leonidas L. Fragidis, Prodromos D. Chatzoglou
      The primary aim of this research is to capture the existing experience from countries where nationwide EHR systems have already been implemented or the development is in a mature phase. To capture the necessary information, an international survey has been conducted with expert participants from 13 countries. The results of this research show that private vendors’ involvement in most of the system development lifecycle phases is inevitable. However, the phase where most private vendors are involved in during the development of an EHR system is System Design. Interestingly, their involvement does not depend on who has the responsibility of the EHR system development (either a national organization or a private vendor). Finally, examining the supported standards by EHR systems and their interoperability with other information systems, in respect to both technical and semantic interoperability, it is found that more efforts should be made for the integration of the most widely supported standards, and the enhancement of interoperability among health information systems, which will lead to the successful integration of a NEHR system.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.004
  • Dynamic capabilities in e-health innovation: Implications for policies
    • Authors: Niels Frederik Garmann-Johnsen; Tom Roar Eikebrokk
      Abstract: Publication date: Available online 24 February 2017
      Source:Health Policy and Technology
      Author(s): Niels Frederik Garmann-Johnsen, Tom Roar Eikebrokk
      Objective To mitigate the effect of caregiver shortage, collaborative networks in Norwegian municipalities are exploring the possibilities provided by e-health and welfare technologies. However, extracting benefits from such technologies depends on many factors. Methods In this study, an extensive literature review is performed to compare e-health and other sectors in terms of the critical success factors in collaborative business process management. Using the dynamic capabilities view as a general theoretical lens, and a process orientation framework for operationalization, these factors are then conceptualized and validated in a cross-sectional study of cases in the Norwegian municipal e-health sector. Results The study contributes to e-health research by identifying the key factors that influence performance. These factors are significantly driven by government policies and regulations. Our findings challenge the assumption that welfare technology networks can be built from the bottom up without government intervention. Regulatory interventions are needed, to obtain process performance metrics and foster viable, long-term business models for the participating institutions. Conclusion The findings have an impact on research and practice, especially in local public management, for predicting and prescribing future development in this context. There are indications of significant gaps in government policies and regulations. Further research should examine whether and how these findings transcend the chosen context.
      Graphical abstract image

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.003
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