Subjects -> HEALTH AND SAFETY (Total: 1508 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (704 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (385 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (123 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (704 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 3)
Acta Informatica Medica     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 27)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 1)
African Health Sciences     Open Access   (Followers: 4)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 43)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 6)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access  
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 18)
American Journal of Health Education     Hybrid Journal   (Followers: 34)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 10)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 29)
American Journal of Public Health     Full-text available via subscription   (Followers: 264)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 6)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 12)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 14)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 4)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 4)
Archives of Suicide Research     Hybrid Journal   (Followers: 7)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 10)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 5)
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: 12)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 12)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 49)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access  
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 12)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 23)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 23)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
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: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access  
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 3)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 2)
Cuadernos de la Escuela de Salud Pública     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 5)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 15)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 23)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 22)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 8)
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: 5)
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: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 2)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 4)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
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: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 14)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 17)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Frontiers of Health Services Management     Partially Free   (Followers: 2)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access   (Followers: 1)
Global Health Promotion     Hybrid Journal   (Followers: 17)
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: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 8)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 13)
Health and Human Rights     Open Access   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 69)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 16)
Health Equity     Open Access  
Health Inform     Full-text available via subscription  

        1 2 3 4 | Last

Similar Journals
Journal Cover
Health Policy and Technology
Journal Prestige (SJR): 0.322
Citation Impact (citeScore): 1
Number of Followers: 5  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2211-8837
Published by Elsevier Homepage  [3203 journals]
  • Employee-driven Digitalization in Healthcare: Codesigning Services that
           Deliver
    • Abstract: Publication date: Available online 18 March 2020Source: Health Policy and TechnologyAuthor(s): Niels Frederik Garmann-Johnsen, Migle Helmersen, Tom Roar Eikebrokk
       
  • The Shifting Trends Towards a Robotically-Assisted Surgical Interface:
           Clinical and Financial Implications
    • Abstract: Publication date: Available online 17 March 2020Source: Health Policy and TechnologyAuthor(s): Jeremie Abitbol, Aqsa Munir, Jeffrey How, Susie Lau, Shannon Salvador, Liron Kogan, Roy Kessous, Leslie Breitner, Russell Fran, Beste Kucukyazici, Walter H. Gotlieb
       
  • How should we evaluate the cost-effectiveness of CAR T-cell therapies'
    • Abstract: Publication date: Available online 12 March 2020Source: Health Policy and TechnologyAuthor(s): Nishma Patel, Suzanne S. Farid, Stephen Morris
       
  • An Innovation Platform for Diffusing Public Health Practices across a
           Global Network
    • Abstract: Publication date: Available online 26 February 2020Source: Health Policy and TechnologyAuthor(s): Alexander Plum, Mohan Tanniru, Jiban Khuntia
       
  • Implementing healthcare services on a large scale: Challenges and remedies
           based on blockchain technology
    • Abstract: Publication date: Available online 15 January 2020Source: Health Policy and TechnologyAuthor(s): Prateek Pandey, Ratnesh Litoriya
       
  • Enhancing skills to promote the utilization of medical laboratory
           equipment in low resource settings
    • Abstract: Publication date: Available online 9 January 2020Source: Health Policy and TechnologyAuthor(s): Solomon Oshabaheebwa, Lucy K Namuli, Martha S Tusabe, Jesca Nantume, Louise H Ackers, Robert T Ssekitoleko
       
  • How medicines are used in Italy: Data from the National Report 2018
    • Abstract: Publication date: Available online 6 December 2019Source: Health Policy and TechnologyAuthor(s): Agnese Cangini, Federico Villa, Federica Mammarella, Francesco Trotta, Working group of the National Observatory for Medicines Use Monitoring
       
  • Assessment of efficiency levels of training and research hospitals in
           Turkey and the factors affecting their efficiencies
    • Abstract: Publication date: December 2019Source: Health Policy and Technology, Volume 8, Issue 4Author(s): Gülnur İlgün, Murat Konca
       
  • Budget impact of incorporating non-invasive prenatal testing in prenatal
           screening for Down syndrome in Turkey
    • Abstract: Publication date: December 2019Source: Health Policy and Technology, Volume 8, Issue 4Author(s): Zeynep Guldem Okem, Gokcen Orgul, Berna Tari Kasnakoglu, Mehmet Cakar, Mehmet Sinan Beksac
       
  • The impact of implemented regulations on biosimilars in Slovakia
    • Abstract: Publication date: December 2019Source: Health Policy and Technology, Volume 8, Issue 4Author(s): Tomas Tesar, Peter Golias, András Inotai, Paweł Kawalec, Martin Wawruch
       
  • Current and future perspectives for the implementation of health
           technology assessment in Romania
    • Abstract: Publication date: Available online 25 November 2019Source: Health Policy and TechnologyAuthor(s): Cristina Rais, Zoltán Kaló, Marcell Csanádi, Vlad Negulescu
       
  • Establishing a national biobank. Biobanking infrastructure initiative in
           Slovakia - Public policy, legal and ethical issues
    • Abstract: Publication date: Available online 19 November 2019Source: Health Policy and TechnologyAuthor(s): Jozef Glasa, Drahomír Kollár, Peter Čvapek, Helena Glasová, Martina Antošová, Daniel Pella, Ivica Kvietiková
       
  • Assessing Factors Critical to Smart Technology Applications to Mobile
           Health Care − the FGM-FAHP Approach
    • Abstract: Publication date: Available online 15 February 2020Source: Health Policy and TechnologyAuthor(s): Toly ChenAbstractSmart technologies present numerous opportunities for enhancing mobile health care. However, some concerns regarding the viability of smart technology applications must be addressed. This study investigated these concerns by reviewing the current practices of smart technology applications to mobile health care. As a result, five factors critical to the applicability of a smart technology to mobile health care are identified, and the fuzzy geometric mean-fuzzy analytic hierarchy process (FGM-FAHP) approach is proposed to assess the relative importance levels of the identified factors. The experimental results showed that the three most critical factors identified include: (a) the relaxation of the related medical laws; (b) unobtrusiveness; and (c) the precise need and situation of a user. Accordingly, approximately 44%, 26%, and 15% of the budget should be allocated to the realization of the three critical factors, respectively. In addition, the challenges involved and opportunities for enhancing the effectiveness of existing applications are discussed.
       
  • Why do physicians prescribe new antidiabetic drugs' A qualitative
           study in the Greek healthcare setting
    • Abstract: Publication date: Available online 14 February 2020Source: Health Policy and TechnologyAuthor(s): Eleftheria Karampli, Kyriakos Souliotis, Nikolaos Polyzos, Ekaterini ChatzakiAbstractObjectivesUnderstanding the process of new drug adoption can inform the development of policies to promote appropriate diffusion of new drugs that result in improved outcomes and are cost-effective. The present study aims to explore factors influencing adoption of new antidiabetic drugs for T2DM in the Greek setting.MethodsThe study employs a qualitative descriptive approach. Semi-structured interviews were performed with physicians involved in management of T2DM in adults. Eligible participants were identified using generic purposive sampling. Interviews were audio-recorded, transcribed verbatim and analyzed using framework analysis. Rogers’ Diffusion of Innovations theory informed the development of the interview guide and the coding scheme.Results10 physicians were interviewed. The mean interview duration was 44 minutes. Three main themes were derived: 1) Factors influencing prescribing of new medicines for T2DM, 2) Perceptions on pharmaceutical innovation, 3) Use of information sources during the new drug adoption process. The attributes of the new drug, patient-related factors, external influences and prescriber needs and characteristics affected the adoption decision. Physicians reported utilizing information from a variety of sources in the process of adoption.ConclusionsThe present study brought forward the importance of relative advantage and compatibility in the adoption of new antidiabetic agents and also highlighted that adoption is a process during which new drug attributes are continuously re-evaluated.
       
  • Challenges with Coverage with Evidence Development Schemes for Medical
           Devices: A Systematic Review
    • Abstract: Publication date: Available online 13 February 2020Source: Health Policy and TechnologyAuthor(s): Vivian Reckers-Droog, Carlo Federici, Werner Brouwer, Michael DrummondABSTRACTObjectivesCoverage with evidence development (CED) schemes are particularly relevant for medical devices (MDs), since clinical evidence is often limited at the time of launch and their long-term (cost-) effectiveness heavily depends on how they are adopted into routine clinical practice. The objective of this study was to identify and describe the challenges that payers and manufacturers might face when assessing the desirability of, choosing the research design for, implementing, and evaluating CED schemes for MDs.MethodsA systematic literature review was performed on six databases following PRISMA guidelines. Two independent reviewers assessed the eligibility of studies based on predefined criteria and extracted data from the included articles by using a pre-defined extraction template. The data were synthesised in a narrative review.ResultsThe systematic search yielded 4,293 articles of which 27 were eligible for inclusion. We identified 20 challenges that are associated with CED schemes for MDs. Five of these challenges relate directly to the characteristics of MDs, and hence are specific to MDs. These challenges concern deciding on whether a CED scheme is required, understanding the relevant uncertainties and risks, identifying meaningful outcomes, defining an adequate duration for a scheme, and market entry of new technologies.ConclusionsPayers and manufacturers of MDs have to address the identified challenges to improve a CED scheme's chance of success. This can be further improved by public sharing of information about the outcome of applied schemes and way in which stakeholders have addressed the challenges they faced when applying a CED scheme.
       
  • Trusted writing in social media: FPM International Awards for Medical
           Writing in Social Media
    • Abstract: Publication date: Available online 7 February 2020Source: Health Policy and TechnologyAuthor(s): Donald RJ Singer, Ken Redekop, Bernard Cheung
       
  • More value from health IT in low and middle-income countries
    • Abstract: Publication date: Available online 7 February 2020Source: Health Policy and TechnologyAuthor(s): Seyyed Meysam Mousavi, Amirhossein Takian
       
  • What is ahead for health policy and technology in the 2020s'
    • Abstract: Publication date: Available online 5 February 2020Source: Health Policy and TechnologyAuthor(s): Donald R.J. Singer, Ken Redekop
       
  • A new pandemic out of China: the Wuhan coronavirus syndrome
    • Abstract: Publication date: Available online 4 February 2020Source: Health Policy and TechnologyAuthor(s): Donald R.J. Singer
       
  • Possibility of Introducing Telemedicine Services in Asian and African
           Countries
    • Abstract: Publication date: Available online 22 January 2020Source: Health Policy and TechnologyAuthor(s): Teppei Suzuki, Jyuri Hotta, Tomomi Kuwabara, Hiroko Yamashina, Tomoki Ishikawa, Yuji Tani, Katsuhiko OgasawaraAbstractObjectives: In some developing countries, despite advancements in Information Technology (IT), medical resources are scarce; hence, introduction of telemedicine services can solve this problem. In this study, we examined the possibility of introducing telemedicine-based services in developing countries utilizing the available data.Methods: In Asia, the study was conducted in nine developing countries, excluding those where data were unavailable. In Africa, thirteen countries whose per capita Gross Domestic Product (GDP) was less than USD 1,000, and where data were unavailable, were also excluded. We chose the number of doctors, nurses, and midwives as indicators of the healthcare environment. We used the number of internet contracts and mobile phone contracts as indicators of IT penetration, and set per capita GDP and its growth rate as economic indicators. We combined the two continents’ data and performed a principal component analysis (PCA) and cluster analysis.Results: We used cluster analysis to classify the target countries into the following five clusters: Cluster A: Algeria, Egypt, Morocco, Indonesia, Ghana, Tunisia, Madagascar, Nigeria, and Thailand; Cluster B: Bangladesh, Ethiopia, Kenya, Uganda, India, and Pakistan; Cluster C: Sudan, Malaysia, Vietnam, Tanzania, Philippines, and China; Cluster D: South Africa, and Cluster E: Japan and Singapore. As a result of conducting PCA, Cluster A emerged as the region with the highest progressiveness and development possibility.Conclusions: Introduction of telemedicine services has been visualized by using cluster analysis and PCA. However, it is necessary to incorporate future medical needs as indicators to make a more appropriate assessment of its potential.
       
  • Telemedicine in Chronic Care –A Case of Diabetes Management
    • Abstract: Publication date: Available online 22 January 2020Source: Health Policy and TechnologyAuthor(s): Vinaytosh MishraAbstractBackground: Chronic diseases like diabetes are becoming major health care challenges in various parts of the world. The treatment of diabetes requires an integrated approach in which a team of various health care professionals works under the guidance of a diabetes specialist. If implemented appropriately, telemedicine has the potential to solve the dual problem of availability and affordability associated with health care. This paper aims to provide a phased approach to the implementation of telemedicine in diabetes care.Methods: The study used an unstructured interview of a diabetes specialist to find out the major components of diabetes care. Once the various components of diabetes care were identified, a focus group of two physicians, two diabetes educators, and one dietician was formed to identify the various factors affecting telemedicine adaptation. The same focus group was used to find the rating of 13 identified components for three identified factors. Finally, components of diabetes care were divided into homogeneous groups, using the hierarchical clustering method.Results: This study identifies thirteen components of diabetes care and rates these components based on three factors, namely (1) importance (2) physical presence, and (3) frequency. k-means clustering was used to divide these components into two groups, (1) appropriate for telemedicine (ATM) and (2) not appropriate for telemedicine (NATM).Discussion: The components of diabetes care, which are appropriate for telemedicine, can be delivered using telemedicine first. The paper gives a phased approach for the adaptation of telemedicine in case of a chronic disease like diabetes. The phased approach reduces the risk of implementation and increases the adaptation.
       
  • COSTS ANALYSIS OF DIABETES MELLITUS: A STUDY BASED ON HOSPITAL INVOICES
           AND DIAGNOSIS RELATED GROUPS
    • Abstract: Publication date: Available online 20 January 2020Source: Health Policy and TechnologyAuthor(s): Mehmet Top, Hüseyin Aslan, Çağdaş Erkan Akyürek, Emine Çetin AslanAbstractObjectivesDM (Diabetes mellitus) is a serious community health problem and considered a burden of disease for social security institutions, households, and society. The objective was to analyse the costs of inpatients with diabetes mellitus.Study DesignThis study has a descriptive, cross-sectional and retrospective research approach.MethodIn the study, diagnosis related groups (DRGs) related with diabetes mellitus were analysed with regard to hospital invoices and DRG costing. This is a retrospective study on 649 patients who were hospitalized with the diagnosis of Type 1 (83 patients) and Type 2 diabetes mellitus (566 patients) in the year of 2013 at Ankara Numune Education and Research Hospital in Turkey. The study included patients with diagnoses of “E10” Type 1 diabetes mellitus and “E11” Type 2 diabetes mellitus. Type 1 and Type 2 DM costs were calculated by examining inpatient treatment invoices of related patients. DM treatment costs were limited according to hospital services.ResultsThe average age of diabetes mellitus patients in the study was 57.24 ±15.79 years old and the average length of stay for these patients was calculated as 9.56 ±10.35 days. The average amount of service activity invoice was calculated as $714.90 and average DRG amount was $1223.40 for 649 inpatients with the diagnosis of diabetes mellitus in 2013. A significant difference was found in average hospital costs between Type 1 and Type 2 diabetes mellitus patients.ConclusionDisease cost analyses in hospitals are required in order to prioritize healthcare services, use resources efficiently and decrease the financial burden of diseases on the society.
       
  • The Role of Fifth-Generation Mobile Technology in Prehospital Emergency
           Care: An Opportunity to Support Paramedics
    • Abstract: Publication date: Available online 17 January 2020Source: Health Policy and TechnologyAuthor(s): Hyunmin Kim, Sung-Woo Kim, Eunjeong Park, Ji Hoon Kim, HyukJae ChangAbstractPrehospital paramedics play a critical role in the process of making decisions about patient safety, prehospital transportation, and treatments/procedures. There has been an increase in efforts to improve emergency medical services (EMSs) using new technologies and mechanisms. Notably, fifth-generation (5G) mobile technology has many beneficial features (e.g., a high-speed and broader network, ultra-reliable low-latency communication, improved privacy and security), which can help prehospital paramedics provide better EMSs. This innovative technology can help streamline prehospital emergency care by enhancing the timeliness and efficiency of EMSs delivery and facilitating the provision of appropriate patient care, which in turn may improve patient outcomes. Despite its beneficial features, 5G technology entails several issues and challenges, such as the following: (1) limited regulations and privacy and security concerns about the transmission of patient information through a 5G network; (2) insufficient robust evidence upon which policies that aim to reform EMSs using 5G technology can be founded; and (3) a lack of access to 5G networks in many medically underserved and remote rural areas. These issues should be addressed by policymakers, technology developers, practitioners, and other stakeholders because their resolution is likely to improve healthcare quality and outcomes.
       
  • Adoption of New Medical Technologies: The Effects of Insurance Coverage vs
           Continuing Medical Education
    • Abstract: Publication date: Available online 15 January 2020Source: Health Policy and TechnologyAuthor(s): Amir T. Namin, Vahab Vahdat, Catherine DiGennaro, Roham Amid, Mohammad S. JalaliAbstractMedical technologies innovate rapidly and responsively to patient needs, but the adoption of the latest technologies in practice can be delayed by lack of knowledge and ability to pay. Customized individually made (CIM) knee implants potentially provide an option for individuals to maintain moderate to high activity levels with fewer surgical revisions following a total knee replacement, however they are costlier upfront. Not only is the technology more expensive, but insurance typically covers around 50% (versus 90% for older off-the-shelf knee implants). We used a recent simulation model and analyzed the effects on overall adoption of CIM through 2026 and found that continuing medical education (CME)—a common intervention to increase the adoption of new medical technologies through increasing practitioner knowledge and comfort with the new technologies—can increase the adoption of CIM to 48% in the short term, but increasing insurance coverage to be equal to OTS knee replacement coverage increases the adoption to 87% in the sustained long term. Efforts to implement CME are well-placed and will increase the rate of adoption, however the combination of CME and increased insurance coverage provides the most benefit, with the technology reaching 80% of the population undergoing total knee replacement by 2021.
       
  • Gait Quantification and Visualization for Digital Healthcare
    • Abstract: Publication date: Available online 30 December 2019Source: Health Policy and TechnologyAuthor(s): Arif Reza Anwary, Hongnian Yu, Michael VassalloAbstractGait abnormalities are common in clinical practice and there is a global imperative to improve technologies that facilitate their detection, evaluation, monitoring and management. Real time evaluation using digital technology supports the development of digital healthcare. Currently gait assessment relies on visual observation of structured clinical tests such as the “Timed Get up and Go Test.” Gold standard methods such as “Qualisys Motion Capture System” require sophisticated equipment in gait laboratories. These are not widely available due to expense, analysis time and requirement of trained technicians. Developing low cost, portable, easy to use digital technology is important to enable sophisticated assessment of gait at home or in clinics. Common measures for quantification of gait include symmetry angle, ratio and index. These measurements may be difficult to interpret by users as stand-alone values. To facilitate the evaluation and interpretation of locomotive information, a tool to visualize gait in real-time is proposed. The proposed tool consists of five approaches (1: Real-time dial visualization, 2: Visualization of individual leg time variation, 3: Visualization of both legs asymmetry, 4: Boxplot visualization, and 5: Evaluation considering all features). Results show that wearable Inertial Measurement Unit (IMU) can be used for extraction of objective gait features. This system opens possibilities for home-based assessment of gait without the requirement and expense of an elaborate laboratory setup and supports the development of digital healthcare.
       
  • Cost-effectiveness of a mobile-phone text messaging intervention on type 2
           diabetes—A randomized-controlled trial
    • Abstract: Publication date: Available online 16 December 2019Source: Health Policy and TechnologyAuthor(s): Sheikh Mohammed Shariful Islam, Ralph Peiffer, Clara K Chow, Ralph Maddison, Andreas Lechner, Rolf Holle, Louis Niessen, Michael LaxyAbstractAimsTo evaluate the cost-effectiveness of a mobile phone text messaging program for people with type 2 diabetes mellitus.MethodsWe performed a generalized cost-effectiveness analysis in a randomized controlled trial in Bangladesh. Patients with type 2 diabetes were randomized (1:1) to a text messaging intervention plus standard-care or standard-care alone. Intervention participants received a text message daily for 6 months encouraging healthy lifestyles. Costs to users and the health systems were measured. The EQ-5D-3L was used to measure improvements in health-related quality-adjusted life years (QALYs). Intervention costs were expressed as average cost-effectiveness ratios (cost-per 1% unit-reduction in glycated haemoglobin HbA1c and cost per QALY gained), based on the World Health Organization cost effectiveness and strategic planning (WHO-CHOICE) method.ResultsIn 236 patients [mean age 48 (SD9.6) years] the adjusted difference in accumulated QALYs between the intervention and the control group over the 6-month period was 0.010 (95%CI: 0.000; 0.021). Additional costs per-patient averaged 24 international dollars (Intl.$), resulting in incremental cost-effectiveness ratios of 38 Intl.$ per % glycated haemoglobin (HbA1c) reduction and 2406 Intl.$ per QALY gained. The total intervention costs for the mobile phone text messaging program was 2842 Int.$.ConclusionText messaging might be a valuable addition to standard treatment for diabetes care in low-resource settings and predicted to lead an overall saving in health systems costs. Studies with longer follow-up and larger samples are needed to draw reliable conclusions.
       
  • Technical efficiency of healthcare systems in African countries: An
           application based on data envelopment analysis
    • Abstract: Publication date: Available online 4 December 2019Source: Health Policy and TechnologyAuthor(s): Mehmet Top, Murat Konca, Bülent SapazAbstractAimThis study aimed to measure the healthcare system efficiency of 36 African countries and to compare efficiency levels between countries.MethodData envelopment analysis (DEA) was used to evaluate efficiency. The input variables employed within the scope of DEA consisted of the proportion of total health expenditures in the gross domestic product (HE); the number of physicians (PHY), nurses (NUR) and hospital beds (BN) per 1000 people; the unemployment rate (UN); and the Gini coefficient (Gini). The study's output variables were life expectancy at birth and 1/(infant mortality rate). After DEA, the variables affecting the performance of national healthcare systems were identified using a Tobit regression model.ResultsAccording to DEA results, 21 (58.33%) of 36 African healthcare systems were found to be efficient. Among the efficient countries, Senegal was the country most referenced for inefficient countries. According to the Tobit regression analysis results, the number of nurses per 1000 people and Gini coefficient variables statistically significantly affected the inefficiency of national healthcare systems.ConclusionThis study's results suggest that in order to achieve the same health outcomes, national healthcare systems need to use public and private health resources more effectively and efficiently. By assessing the efficiency of countries’ healthcare systems and health services through international comparison, effectiveness and efficiency can be ensured within these systems.
       
  • A SMART framework for HTA capability development: Lessons from India
    • Abstract: Publication date: Available online 3 December 2019Source: Health Policy and TechnologyAuthor(s): Kanchan Mukherjee
       
  • Rationalizing Personal Health Management (PHM) Policy: Identifying Health
           IT Use Patterns via Observations of Daily Living (ODLs) Data
    • Abstract: Publication date: Available online 28 November 2019Source: Health Policy and TechnologyAuthor(s): Hyeyoung Hah, Jiban Khuntia, Abhishek Kathuria, Joseph TanABSTRACTObjectivesManaging personal health information is mainly dependent upon individual users’ adoption and use of new health technology. Despite the increasing popularity of mobile health apps, recent endeavors of self-health management have been somewhat limited to fitness management whose apps have selective features and capabilities. Under this context, it raises a question as to whether health consumers are capable of adopting and utilizing mobile health apps with varying features and capabilities in order to manage both medical and fitness health information.MethodsBorrowing from a theoretical lens of observations of daily living (ODLs), the authors posit that if individual health consumers can record their daily activities with both health and non-health related mobile IT, such self-tracking information can then serve as an evaluation tool for measuring their future capabilities of new health IT adoption. To explore the phenomenon, we administered an online survey to collect technology-related ODL data from 226 international health consumers with known ODL survey items.ResultsBy applying confirmatory factor analysis and K-means cluster analysis, we found health consumers’ use of social and finance-related technology are closely linked to the use of mobile health technology in their daily living. Moreover, health consumers who actively use all three technologies (i.e., social, financial and health technologies) tend to have affinitive perceptions toward health management outcomes.ConclusionThe findings of this study can inform health policymakers to vie for more effective mobile health technology in rationalizing personal health management (PHM) policy.
       
  • Regulatory Issues for Orphan Medicines: a review
    • Abstract: Publication date: Available online 27 November 2019Source: Health Policy and TechnologyAuthor(s): Maria Luísa Bouwman, João José Simões Sousa, Maria Eugénia Tavares PinaAbstractOrphan medicines are medicinal products intended for diagnosis, prevention or treatment of life-threatening or debilitating rare diseases. They are ‘orphans’ because the pharmaceutical industry has little interest under normal market conditions in developing and marketing drugs intended for only a small number of patients suffering from very rare conditions. Successful development of new treatments for rare diseases and their sustainable patient access require overcoming a series of challenges related to research and health technology assessment.The orphan drugs legislation provides a set of incentives and conditions to the pharmaceutical industry to develop medicines for the treatment of rare diseases. In fact, the number of orphan products approved (centralized level) is far exceeding anything seen before the orphan drug legislation. However, the final stage relates to whether a patient is able to receive treatment in a timely and reimbursed manner occurs at the payers’ level (decentralized process), which, leads to inconsistency in patient access between European countries. The challenge of regulatory authorities, patient groups, pharmaceutical companies, legislators and payers is to provide access to new therapies, without geographic or economic discrimination. Despite the progress in the field of rare diseases there is still a need of investment.So, the main objective of this paper is to describe the regulatory framework of orphan medicines in the USA and the EU, including specific legislation and guidelines, orphan medicine designation process, economic encouragements and impact of these in market approval, to improve the consistency, effectiveness and sustainability of orphan medicines value assessment.
       
  • Quality and scientific accuracy of patient-oriented information on the
           internet on minimally invasive surgery for colorectal cancer
    • Abstract: Publication date: Available online 19 November 2019Source: Health Policy and TechnologyAuthor(s): Ruvindu Hasamal Waidyasekera, Umesh Jayarajah, Dharmabandhu Nandadeva SamarasekeraAbstractObjectivesAppropriate information on minimally invasive surgery for colorectal cancer would help the patients and their caretakers to understand the treatment process. We aimed to assess the readability, quality and scientific content of patient-oriented information on minimally invasive surgery for colorectal cancer on the internet.MethodsInternet search on “minimally invasive surgery for colorectal cancer”, “laparoscopic surgery for colorectal cancer” and “robotic surgery for colorectal cancer” was performed on search engines (Google, Yahoo! and Bing). Quality and readability were assessed by DISCERN instrument and validated Flesch Reading Ease Score (FRES) respectively.ResultsFifty-five websites were analysed. The median DISCERN score was 41(range:24-66) and the median FRES score was 33.9(range:10.4-59.8) indicating low readability. Twenty-seven sites (49.1%) were affiliated with hospitals or clinics. Benefits of surgery and the surgical procedure were mentioned in 76.4% and 81.8% respectively. However, pre-op preparation, surgical complications, and quality of life were not mentioned in 49(82.1%), 42(76.4%) and 44(80%) sites respectively. Overall on DISCERN, 7(12.73%) were identified as “Excellent”, 25(45.45%) as “Good” or “Moderate” and 23(41.82%) as “Poor”.ConclusionAnalysis of the quality and scientific content of patient information on MIS for CRC revealed a considerable deficiency in the information provided and sub-standard readability. Several aspects such as pre-op preparation, surgical complications and post-operative quality of life which are of concern to the patient were not discussed in a considerable proportion of articles. As the internet is expanding as a readily available source of information, steps should be taken to ensure the highest quality information.
       
  • Validation of a self-implemented Walkway system for gait speed measurement
           in usual clinical care
    • Abstract: Publication date: Available online 19 November 2019Source: Health Policy and TechnologyAuthor(s): Pedro Abizanda, Luis Carlos Venegas, Gunnar M. Andersen, Héctor Caulín Roldán, Melisa López Utiel, Mariano Esbrí VíctorABSTRACTObjectivesValidation of an infrared healthcare technology aimed at measuring gait speed in older adults.DesignValidation study.SettingGeriatric DepartmentParticipants90 patients from the Falls Unit of the Geriatrics Department for the validation assessment, and 5,328 patients of the Outpatient Clinic under usual care conditions for technology validation.MeasurementsWalking speed was measured manually with a stopwatch as part of the Short Physical Performance Battery (SPPB), using the GAITRite™ (first, second and mean of 5 walks) and with the Walkway system. Agreement was determined with the Bland-Altman method.ResultsMean gait speed with the SPPB, GAITRite™ (first, second and mean of 5 walks) and Walkway were 0.68 m/s, 0.77 m/s, 0.81 m/s, 0.71 m/s, and 0.70 m/s respectively. Pearson correlations between the Walkway system and SPPB, GAITRite™ first walk, GAITRite™ second walk, and GAITRite™ mean of 5 walks were 0.822 (p
       
  • 2019 Hippocrates Prize
    • Abstract: Publication date: Available online 15 November 2019Source: Health Policy and TechnologyAuthor(s):
       
  • Toward Quality Transparency in Healthcare: Exploring Hospital-Operated
           Online Physician Review Systems in Northeastern United States
    • Abstract: Publication date: Available online 12 November 2019Source: Health Policy and TechnologyAuthor(s): Nima KordzadehAbstractObjective: Hospitals are increasingly offering patient review systems to help prospective patients make informed physician selection decisions. Accordingly, this study sought to determine what types and percentage of hospitals in the northeastern United States presented online physician reviews and which measures were used most and least frequently in the hospitals’ patient satisfaction surveys.Materials and Methods: We visited the websites of 1,007 hospitals and collected information about whether/how they provided online physician reviews. We then performed descriptive and comparative analysis.Results: Nearly 7% of the hospitals published patient reviews of physicians on their websites. The hospitals that 1) were non-profit, 2) were located in Pennsylvania, or 3) provided general care services were most likely to provide online physician reviews. Those hospitals mostly adapted either a government-provided survey instrument or its extended version offered by Press Ganey Associates. However, the types and number of measures used varied across hospitals.DiscussionHospitals located in Connecticut, Maine, New Hampshire, Rhode Island, and Vermont do not yet offer online physician review systems. Moreover, non-acute, specialty care hospitals and government-owned medical centers rarely provide such systems, suggesting that driving factors such as incentive programs should be offered at the government and state levels to motivate them to implement patient-centered quality assessment and transparency mechanisms. Furthermore, efforts should be made to standardize those systems to make physician reviews useful and comparable across healthcare providers.ConclusionFuture research should examine how to improve the quality and usability of these systems to better empower patients in their decision-making.
       
  • The Antecedents and Results of Seniors’ Use of Activity Tracking
           Wearable Devices
    • Abstract: Publication date: Available online 9 November 2019Source: Health Policy and TechnologyAuthor(s): Mohamed Abouzahra, Maryam GhasemaghaeiAbstractObjectiveWearable devices have potential benefits for seniors healthcare. However, the rate of adoption of these devices is very low for seniors compared to other age groups. This study aims at examining the factors that influence seniors’ use of wearable devices and the effect of these devices on seniors’ behavior.MethodsThis study uses qualitative methods to address the research questions. We conducted 26 interviews of seniors who have never used wearable devices before. We interviewed seniors before and after using activity tracking wearable devices. Furthermore, we collected wearable device quantitative data to support interview results.ResultsSeniors adoption of wearable devices involve several factors that can be categorized as technology related factors such as the complexity and customizability of wearable devices and individual related factors such as social influence, self-efficacy. Furthermore, the effects of using wearable devices vary among seniors depending on their activity patterns and exercise schedule.Conclusionseniors’ use of wearable devices is a complex process that involves the interactions of social, psychological, and technological factors. By understanding these factors, we can develop strategies to enhance seniors’ use of wearable devices and improve their overall health and quality of life.
       
  • Biases and imperatives in handling medical technology
    • Abstract: Publication date: Available online 5 November 2019Source: Health Policy and TechnologyAuthor(s): Bjørn HofmannAbstractObjectivesFor a long time key actors in health care have conceived of medical technology as a rational science-based means to obtain specific human goals, such as reducing suffering and increasing health. However, this appears paradoxical as medical technologies are handled in ways that appear non-rational by the standards of the field itself, e.g., by implementing non-efficient technologies and by not abandoning harmful or low-value technologies. The objective of this article is to investigate this apparent paradox. How can it be explained' Accordingly, the research question is: What biases and imperatives are involved in the handling of medical technology that counter and hamper what is conceived of as rational handling of such technology in medicine and health care'MethodsKahneman's framework of System 1 and 2 modes of thinking from cognitive psychology is applied and combined with Mazarr's analysis of imperatives in order to study and develop a typology of irrational implementation of technology. Examples from health care are found by targeted searches in PubMed.ResultsHealth policy on technology assessment and implementation is based on measures, such as safety, effectiveness, and efficiency. Nevertheless, a range of technologies are implemented and used without obtaining such goals. This can be explained by, a range of affective biases, such as the Identifiability Effect, Affective Forecasting, and Impact bias, as well as cognitive biases, such as the Focusing Illusion, Prominence Effect, Status Quo Bias, Endowment Effect, Availability Heuristics, Anchoring Effect and others. Various imperatives also contribute to this, such as Positive feedback loops, Imperative of Action, Technology Placebo Effect, Imperative of Knowledge, the Boys and Toys Effect and others. Examples illustrate how all of these effects can distort rational technology implementation and policy.ConclusionWe need to include biases and imperatives in our theories and our strategies to handle medical technologies. Believing and acting as if we implement and use technology in health care as external means to our internal goals may be treacherous. Understanding technology indeed includes understanding of ourselves.
       
  • Product Service Platform to improve care systems for elderly living at
           home
    • Abstract: Publication date: Available online 31 October 2019Source: Health Policy and TechnologyAuthor(s): Roberto Menghi, Alessandra Papetti, Michele GermaniAbstractBackgroundPopulation aging is inducing governments to redesign their healthcare models. One policy measure aimed at reducing healthcare expenditures and improving services is to encourage people to age-in-place. Scientific research has been trying to find ICT-enabled solutions to the growing problem of elderly home care. However, such research is often technology-oriented and neglects the end-user perspective. It does not consider the real needs of older people and all stakeholders involved in their healthcare.MethodA user-centered design approach was adopted with the involvement of older people, experts dealing with the aging population, and the whole stakeholders’ chain. Through surveys, focus groups, and brainstorming sessions, it was possible to determine the main features of the product service platform.ResultsStarting from a large-scale survey of elderly people living in Italy, this paper presents the requirements and the architecture of a product service platform aimed at improving the independence and elderly quality of life. This work proposes an elderly-centered platform that works as an aggregation point of an articulated social health system, provides multiple tailored services, and optimizes the use of local resources.ConclusionsThe involvement of the end-user and all the stakeholders allowed for the consideration of different perspectives and the creation of a value network that aggregates existing services, resources, and information with new opportunities to achieve common benefits. This work provides guidelines on how to develop this type of platform by exploiting the potential of each stakeholder without creating new barriers. Technology, caregivers, and society are combined synergistically to provide tailored services able to satisfy specific users’ needs.
       
  • Usability and Cognitive Load in the Design of a Personal Health Record
    • Abstract: Publication date: Available online 24 October 2019Source: Health Policy and TechnologyAuthor(s): Martina A. Clarke, Ryan M. Schuetzler, John R. Windle, Emily Pachunka, Ann FruhlingAbstractWhile personal health records (PHRs) carry an array of potential benefits such as increased patient engagement, poor usability remains a significant barrier to patients’ adoption of PHRs. In this mixed-methods study, we evaluate the usability of an important PHR feature, a patient intake form called the pre-visit summary, from the perspective of cognitive load using real cardiovascular patients in vivo. A validated measure for cognitive load, the NASA Task Load Index, was used along with retrospective interviews to identify tasks within the pre-visit summary that were more mentally challenging for patients. Participants experienced higher cognitive load on the Medications, Immunizations, Active Health Concerns, and Family History pages because these pages required a higher recall of personal health information and due to some user interface design issues. This research is significant because it uses validated measures of cognitive load to study real patients interacting with a PHR in vivo.
       
  • Relationship between accessibility and resources to treat acute ischemic
           stroke. Hokkaido, Japan: Analysis of inequality and coverage using
           geographic information systems
    • Abstract: Publication date: Available online 16 October 2019Source: Health Policy and TechnologyAuthor(s): Tomoki Ishikawa, Hiro Mizuguchi, Hiroshi Murayama, Kensuke Fujiwara, Takumi Tanikawa, Eiichi Kobayashi, Katsuhiko OgasawaraAbstractObjectivesThis study aimed to clarify the relationship between the institution and resident with respect to accessibility to acute ischemic stroke (AIS) treatment in Hokkaido and to propose new methodology monitoring for accessibility to healthcare resources.MethodsThis study involves the use of geographic information system (GIS) network analysis. We established hospital/clinic with one of the following conditions as resources for AIS treatment: (1) medical facility practicing AIS treatment, (2) having computed tomography (CT) equipment, (3) having angiography equipment, and (4) having AIS specialists (neurosurgeons). We evaluated the coverage of population resources using transport time between ambulance departure and arrival at the healthcare facility. Furthermore, we compared the population coverage rate using available resources and calculated a Gini coefficient to analyze its relation with inequality. Empirical analysis was performed, and public database for data collection was utilized. We calculated the rate of population coverage with a transport time within 10 minutes as an indicator of accessibility to medical resources by GIS.ResultsThe Gini coefficients of practicable facilities, CT, angiography, and neurosurgeons are 0.35, 0.16, 0.18, and 0.30, respectively. The inequality of accessibility differs depending on the resources, and Gini coefficients indicate that hospital/clinic and neurosurgeons were considered to have higher allocation inequalities than CT and angiography.ConclusionsCombining Gini coefficient and GIS network analysis in accessibility can be useful in quantifying and monitoring variation by region. We propose this combination as a new method for helping the government to make evidence-based healthcare planning.
       
  • Taking the CON out of Pennsylvania: Did Hip/Knee Replacement Patients
           Benefit' A retrospective analysis
    • Abstract: Publication date: Available online 10 October 2019Source: Health Policy and TechnologyAuthor(s): Susan L. Averett, Sabrina Terrizzi, Yang WangAbstractWe analyze the effects of Certificate of Need (CON) laws on outcomes for hip and knee replacement procedures. Federal CON programs began in 1974 to stem rising health care costs by limiting hospital expansion and acquisition of equipment. The federal requirement for CON programs ended in 1987; however, 36 states and DC still maintain various forms of CON programs.In 1996, Pennsylvania (PA) let its CON law expire. We use data from the National Inpatient Survey from HCUP for the years 1993-1999 and examine four outcomes: hospital acquired infections, mortality, length of stay, and total charges. We use a difference-in-differences estimation method leveraging the expiration of PA's law to compare outcomes between patients in PA with patients in states that continued to have a CON law. We control for a number of covariates and pre-treatment trends in our analysis.We focus on hip and knee replacement surgeries — two procedures that have expanded greatly, have contributed increasingly to growing health care costs, and have not been well studied in the literature —for a population that includes Medicare beneficiaries and patients with other payment methods.Our results provide new evidence of the effects of CON (de)regulation. We find that the expiration of CON laws in PA increased length of stay within the patient population and reduced the probability of dying. The CON laws did not have statistically significant effects on hospital acquired infections or total charges.
       
  • Emergency department ergonomic design evaluation: A case study using fuzzy
           DEMATEL-focused two-stage methodology
    • Abstract: Publication date: Available online 9 October 2019Source: Health Policy and TechnologyAuthor(s): Muhammet GulAbstractObjectivesAn emergency department (ED) is a unit of a hospital that is designed, staffed, and equipped to treat injured people and those afflicted with sudden and severe illness. Evaluation of ergonomic design of these departments with respect to specific criteria/standards is expected to contribute to the improvement of productivity and service quality since EDs have too much complexity and volume in the patient flow. Therefore, this paper proposes a two-stage methodology for evaluation of ED ergonomic design.MethodsThe first stage provides a check-list with 137 items on six main headings to evaluate the ergonomics of ED physical design with the opinions of medical staff. The second stage offers a fuzzy-based casual and effect decision-making model for the decreased items assessed in the first stage. In this stage, a fuzzy decision-making trial and evaluation laboratory (FDEMATEL) is used since the decision-making process involves the vagueness of human judgments.ResultsConsidering the interdependence among items, proposed FDEMATEL reflects the causal relationships among criteria through a cause-effect relationship diagram. A case study is carried out a training and research hospital ED in Istanbul, Turkey.ConclusionIn conclusion, several suggestions are offered that the ED needs interventions on accessibility, patient and personnel accommodations, and personnel privacy.
       
  • Correction of patient medical record errors through a file control method
    • Abstract: Publication date: Available online 2 October 2019Source: Health Policy and TechnologyAuthor(s): Cuma Sungur, Levent Sonğur, Ayşegül Çopur Çiçek, Mehmet TopAbstractAimThe purpose of this study was to reduce the errors that might occur in the medical practice records to the lowest possible level, thereby contributing to a better quality of health care services. The aim of this study is to reduce the errors and deficiencies in the patient files by providing training related to medical records and patient files to the personnel who are responsible for filling the patient files. This study was based on medical record errors in patient files.MethodThe study was carried out in a training and research hospital in the Turkish health sector, and 360 physicians, nurses, and medical secretaries took part. In this context, the mistakes in the patient files were monitored and recorded, the recordings were analyzed to determine error areas, and the participants were trained to enter patient files correctly and completely.ResultsThe error-free patient file rate was 9% in the first month of the study. In the second month of the study, the participants were trained to properly complete the patient's files. The error-free patient files rate increased to 35%, 41%, 69% in the second, third, and fourth month of the study, respectively.ConclusionOur data demonstrate the importance of educating health workers to prevent mistakes in medical records. Our data also demonstrate the necessity of using electronic medical recording systems. All health institutions should move into regular, accurate, and complete recording systems to prevent medical errors that might arise in terms of patient and employee safety, thereby helping to fulfill their legal responsibilities.
       
  • Clustering patterns of behavioural risk factors for cardiovascular
           diseases in Bangladeshi adolescents: a population-based study
    • Abstract: Publication date: Available online 27 September 2019Source: Health Policy and TechnologyAuthor(s): Asaduzzaman Khan, Riaz Uddin, Sheikh Mohammed Shariful IslamAbstractObjectivesTo examine the clustering of major behavioural risk factors for cardiovascular diseases (CVD) among adolescents in Bangladesh.MethodsNationally representative data from the 2014 Bangladesh Global School-based Student Health Survey were analysed in 2,978 adolescents (mean age: 14.2 SD 0.99; 60.0% females). We compared the observed (O) to expected (E) prevalence ratios of 64 possible combinations of the six behavioural risk factors (i.e., physical inactivity, sedentary behaviour, tobacco smoking, alcohol drinking, low fruit and vegetable intake, and overweight/obesity) to determine their clustering patterns. Poisson regression was used to examine the associations.ResultsThe most common single risk factor was low fruit and vegetable intake followed by physical inactivity (87% and 59%, respectively). Overall, 18% of the adolescents had three or more risk factors, with males reporting higher prevalence than females (21% vs. 11%). The simultaneous occurrence of low fruit and vegetable intake, and physical inactivity was 30% greater in males (O/E ratio: 1.3, 95% CI: 1.2-1.4) and 20% greater in females (1.2, 1.2-1.3) than what was expected if there was no clustering. The analysis also demonstrated clustering of low fruit and vegetable, overweight/obesity, and high sedentary behaviour (2.5, 1.3-4.9), and low fruit and vegetable, overweight/obesity, and physical inactivity (1.4, 1.1-2.0) for males.ConclusionsThis study fills the gap in the scientific literature by providing evidence that behavioural risk factors tend to cluster among adolescents in Bangladesh. Early prevention programs with evidence-based strategies need to target adolescents who are at a greater risk of engaging in multiple risk behaviours.
       
  • Digital health: Cybersecurity is a value creation lever, not only a source
           of expenditure
    • Abstract: Publication date: Available online 18 September 2019Source: Health Policy and TechnologyAuthor(s): Hassane Alami, Marie-Pierre Gagnon, Mohamed Ali Ag Ahmed, Jean-Paul FortinAbstractDigital technologies have become an essential lever for developing patient-centered services and outcomes while ensuring financial sustainability in healthcare organizations and systems. They contribute to provide high quality, coordinated, and continuing care; to improve practices and support strategies for the management and monitoring of the population health; and to build collective responsibility for healthcare stakeholders to contain costs. However, digital technologies involve significant changes, sometimes breaking with what constitutes known commodities in healthcare organizations and systems (e.g., data governance, inter-operability, security and safety, literacy and training). The recent cyberattacks that have affected and disrupted many healthcare organizations and systems around the world are one of the illustrations. These events show that the issue of cybersecurity should not continue to be considered as a mere source of expenditure but as a source of value creation.
       
  • Factors influencing the download of mobile health apps: Content review cum
           regression analysis
    • Abstract: Publication date: Available online 18 September 2019Source: Health Policy and TechnologyAuthor(s): Gopinath Krishnan, Gowthaman SelvamAbstractObjectivesThe objective of this study was twofold: classifying diabetes smartphone apps using content review, and identifying the factors that influence the app download through regression analysis.MethodsFrom Google Play Store, a total of 5557 apps that matched the search criteria ‘diabetes’ were identified and extracted using a structured sheet. Purposeful sampling technique and selection criteria were applied to identify 500 apps, and content review was done to characterize the apps. Multiple regression analysis was employed to find the association between app download and app characteristics.ResultsContent analysis revealed that 464 out of the 500 apps (92.8%) were free. The most common app features were monitoring and tracking (39%), treatment information (23%) and nutrition (18%). Two-thirds of the apps were intended for patients. The most common business models were advertising (34%), freemium (20%), and razor-and-blade (19%). Regression results explained the preference for apps that provide nutrition, detection and prevention functions. As per the study results, factors that boost application download include: high ratings, frequent updating, long standing market presence, and those offered by US companies.ConclusionsContent review highlights the various self-management capabilities offered by diabetes apps. This study adds to the extant literature on mobile application classification by introducing the business model dimension.
       
  • Trust for online social media direct-to-consumer prescription medication
           advertisements
    • Abstract: Publication date: Available online 4 September 2019Source: Health Policy and TechnologyAuthor(s): Joshua Fogel, Mohamed AdnanAbstractObjectivesWe are not aware of research on the association of social factors with trust for online social media direct-to-consumer prescription medication advertisements (DTCA). We study the association of race/ethnicity and social factors with online social media DTCA trust.MethodsParticipants (n = 665) were asked no/yes questions about their exposure to online social media DTCA advertisements from any of the following online social media platforms of Facebook, Google+, Instagram, LinkedIn, Pinterest, Snapchat, Twitter, Tumblr, and YouTube. Multivariate linear regression analyses were performed for trust and included predictors of race/ethnicity and social factors.ResultsAsian/Asian American race/ethnicity (B = 6.71, SE = 1.63, p < 0.001), prescription medication use (B = 3.87, SE = 1.49, p = 0.01), and bonding social capital (B = 0.31, SE = 0.05, p < 0.001) were each positively associated with increased trust in online social media DTCA. Age and tie strength were each not associated with trust in online social media DTCA.ConclusionsWe recommend that pharmaceutical marketers revise their current marketing policy and allocate in their budgets funding for online social media DTCA that are tailored to Asians/Asian Americans and include topics relating to bonding social capital. Pharmaceutical marketers may also want to employ easily accessible approaches for sharing online social media DTCA so that those with strong bonding social capital can connect with each other.
       
 
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