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  Subjects -> HEALTH AND SAFETY (Total: 1424 journals)
    - CIVIL DEFENSE (23 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (626 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (387 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (107 journals)
    - PHYSICAL FITNESS AND HYGIENE (112 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (626 journals)                  1 2 3 4 | 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: 24)
African Health Sciences     Open Access   (Followers: 3)
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: 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: 15)
American Journal of Health Education     Hybrid Journal   (Followers: 32)
American Journal of Health Promotion     Hybrid Journal   (Followers: 30)
American Journal of Health Sciences     Open Access   (Followers: 8)
American Journal of Health Studies     Full-text available via subscription   (Followers: 12)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 28)
American Journal of Public Health     Full-text available via subscription   (Followers: 241)
American Journal of Public Health Research     Open Access   (Followers: 28)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5)
Annales des Sciences de la Santé     Open Access  
Annals of Global Health     Open Access   (Followers: 10)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 13)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 3)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
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: 10)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 9)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
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: 7)
Autism & Developmental Language Impairments     Open Access   (Followers: 9)
Behavioral Healthcare     Full-text available via subscription   (Followers: 7)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
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: 10)
Boletin Médico de Postgrado     Open Access  
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: 18)
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: 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: 22)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
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   (Followers: 2)
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 y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 3)
Conflict and Health     Open Access   (Followers: 7)
Contraception and Reproductive Medicine     Open Access   (Followers: 1)
Cuadernos de la Escuela de Salud Pública     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 9)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 4)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 13)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Open Access   (Followers: 1)
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: 21)
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: 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: 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: 3)
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 19)
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: 13)
Eurasian Journal of Health Technology Assessment     Open Access  
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 3)
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: 8)
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: 13)
Family Medicine and Community Health     Open Access   (Followers: 9)
Family Relations     Partially Free   (Followers: 13)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 16)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Public Health     Open Access   (Followers: 7)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
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: 8)
Global Reproductive Health     Open Access  
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  
Hastane Öncesi Dergisi     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: 10)
Health and Human Rights     Free   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 57)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 15)
Health Equity     Open Access  
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 23)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 43)
Health Policy and Technology     Hybrid Journal   (Followers: 4)
Health Professional Student Journal     Open Access   (Followers: 4)
Health Promotion International     Hybrid Journal   (Followers: 22)
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: 53)
Health Psychology Bulletin     Open Access   (Followers: 1)
Health Psychology Research     Open Access   (Followers: 20)
Health Psychology Review     Hybrid Journal   (Followers: 42)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 14)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Security     Hybrid Journal  
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: 14)
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  
Healthy Aging Research     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  

        1 2 3 4 | Last

Similar Journals
Journal Cover
Health Policy
Journal Prestige (SJR): 1.252
Citation Impact (citeScore): 2
Number of Followers: 43  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0168-8510
Published by Elsevier Homepage  [3184 journals]
  • “What’s fair to an individual is not always fair to a population”: a
           qualitative study of patients and their health professionals using the
           Cancer Drugs Fund
    • Abstract: Publication date: Available online 21 June 2019Source: Health PolicyAuthor(s): Charlotte Chamberlain, Amanda Owen-Smith, Fiona MacKichan, Jenny L. Donovan, William Hollingworth ObjectiveTo understand the values attached to cancer treatment at the end of life(EoL) to inform policy decisions around the Cancer Drugs Fund(CDF) and the National Institute for Health and Care Excellence(NICE) EoL criterion.DesignSemi-structured interviews with patients and health professionals.Purposive recruitment was performed iteratively alongside analysis of interview transcripts using constant comparison.ParticipantsPatients with incurable prostate and colorectal cancer(n = 22) who received drugs funded through the CDF and oncologists and palliative care professionals(n = 16) treating patients on CDF drugs.ResultsWhile the majority of patient and oncologist participants expressed gratitude for access to the CDF, some patient participants reported experiencing a sense of guilt, and many oncologists admitted to concern about the justice of a ring-fenced fund solely for anti-cancer drugs. For patient and professional participants, cancer drugs were not necessarily seen as a funding priority over other calls on the NHS purse. Overall,patients and health professionals emphasised prioritising quality over quantity at the end of life, with only a minority describing improved quality of life at the end of life which added value.ConclusionWhile patients and oncologists appreciated the drugs available through the CDF, most expressed concern about its fairness. Competing participant views about the added value of the end of life is challenging for resource allocation.
       
  • Characteristics of Trials and Regulatory Pathways Leading to US Approval
           of Innovative Vs. Non-Innovative Oncology Drugs
    • Abstract: Publication date: Available online 12 June 2019Source: Health PolicyAuthor(s): Kerstin Noëlle Vokinger, Aaron S. Kesselheim BackgroundSuccessful first-generation drugs can be converted with small alterations to "second-generation drugs," which are cheaper to develop and may pose less financial risk for manufacturers due to already validated action mechanism and a well-defined consumer market.MethodsWe found four classes of cancer drugs for first- and secondgeneration products approved in the US: BCR-ABL tyrosine kinase inhibitors (TKI) for treatment of CML, ALK + TKI for NSCLC, CD20 monoclonal antibodies for CLL, and HER2 monoclonal antibodies for breast cancer. We analyzed the characteristics of the clinical trials and the approval pathways for these 14 drugs.ResultsFirst-generation and 4 out of 5 second-generation BCR-ABL TKI drugs were granted expedited approval, while all drugs were approved based on single-arm trials. Both ALK + TKI drugs were based on single-arm trials and expedited approval. The first-generation CD20 monoclonal antibody drug was approved based on single-arm trials, and one of the second-generation drugs had pivotal trials that were randomized. All benefited from expedited approval. All HER2 monoclonal antibodies in the sample were based on randomized trials and expedited pathways.ConclusionSecond-generation TKI and monoclonal antibodies were often approved through expedited regulatory pathways and studied in single-arm trials. This helps to facilitate the approval for earlier use by patients, but is also associated with greater risk of post-approval safety-related labeling changes or unanticipated adverse events.
       
  • No unmet needs without needs! Assessing the role of social capital using
           data from European Social Survey 2014
    • Abstract: Publication date: Available online 8 June 2019Source: Health PolicyAuthor(s): Carlota Quintal, Óscar Lourenço, Luís Moura Ramos, Micaela Antunes This paper examines the determinants of unmet healthcare needs in Europe. Special emphasis is put on the impact of social capital.Data come from the European Social Survey, 2014. Our study includes 32,868 respondents in 20 countries. Because unmet needs are observed only in those individuals who are exposed to, and recognise, the need of medical care, sample selection can be an issue. To address it, we analyse the data using the bivariate sample selection model. When there is no need, there is no assessment of access to healthcare. Accordingly, in this situation, our model assumes that unmet need is unobserved.The magnitude and statistical significance of the error correlation support our modelling strategy. A high proportion (18.4%) of individuals in need in Europe reported unmet needs. Informal connections seem to mitigate barriers to access as well as trust in other people and institutions, particularly in health services. Financial strain still is a strong predictor of unmet needs. Other vulnerable groups include informal carers, minorities and individuals feeling discriminated. Unmet needs might also arise due to persistent needs of healthcare as it seems to be the case of individuals with lower health status and chronic conditions. A result that merits further research concerns the positive impact of civic engagement on unmet needs.
       
  • Understanding the impetus for major systems change: A multiple case study
           of decisions and non-decisions to reconfigure emergency and urgent care
           services
    • Abstract: Publication date: Available online 1 June 2019Source: Health PolicyAuthor(s): Sheena McHugh, E. Droog, C. Foley, M. Boyce, O. Healy, J.P. Browne ObjectiveThe optimal organisation of emergency and urgent care services (EUCS) is a perennial problem internationally. Similar to other countries, the Health Service Executive in Ireland pursued EUCS reconfiguration in response to quality and safety concerns, unsustainable costs and workforce issues. However, the implementation of reconfiguration has been inconsistent at a regional level. Our aim was to identify the factors that led to this inconsistency.MethodsUsing a multiple case study design, six case study regions represented full, partial and little/no reconfiguration at emergency departments (EDs). Data from documents and key stakeholder interviews were analysed using a framework approach with cross-case analysis.ResultsThe impetus to reconfigure ED services was triggered by patient safety events, and to a lesser extent by having a region-specific plan and an obvious starting point for changes. However, the complexity of the next steps and political influence impeded reconfiguration in several regions. Implementation was more strategic in regions that reconfigured later, facilitated by clinical leadership and “lead-in time” to plan and sell changes.ConclusionWhile the global shift towards centralisation of EUCS is driven by universal challenges, decisions about when, where and how much to implement are influenced by local drivers including context, people and politics. This can contribute to a public perception of inequity and distrust in proposals for major systems change.
       
  • Physical exercise versus shorter life expectancy' An investigation
           
    • Abstract: Publication date: Available online 28 May 2019Source: Health PolicyAuthor(s): Trine Kjær, Betina Højgaard, Dorte Gyrd-Hansen The positive life-prolonging effect of physical activity is often used as a promotion argument to motivate people to change their behaviour. Yet the decision of investing in health by exercising depends not only on the potential health effect but also on the costs of physical activity including time costs and the individual’s (dis)utility of performing physical activity. The objective of this study was to investigate the trade-off between costs and benefits of engaging in physical activity. A web-based stated preference experiment was conducted to elicit individual preferences for physical activity among a representative sample of the Danish population, 18-60 years of age, categorised as moderately physically active or physically inactive. The results of the study suggest that perceived negative quality of life impact of physical activity is an important predictor of the choice of not attending physical activity, and hence should be acknowledged as a barrier to engaging in physical activity. Furthermore, we find time costs to have a significant impact on stated uptake. For individuals categorised as moderately active, the marginal health effect of physical activity is significant but minor. For inactive individuals, this effect is insignificant suggesting that information on long-term health effects does not work as motivation for engaging in exercise for this group. Instead, focus should be on reducing the perceived disutility of physical activity.
       
  • EFFECTIVENESS OF PRO-ACTIVE ORGANIZATIONAL MODELS IN PRIMARY CARE FOR
           DIABETES PATIENTS
    • Abstract: Publication date: Available online 28 May 2019Source: Health PolicyAuthor(s): Alessandra Buja, Riccardo Fusinato, Mirko Claus, Rosa Gini, Mario Braga, Mimma Cosentino, Giovanna Boccuzzo, Paolo Francesconi, Vincenzo Baldo, Valeria D. Tozzi, Verdiana Morando, Mariadonata Bellentani, Gianfranco Damiani BackgroundDemographic changes and chronicity are posing new challenges to health care systems. Our study aimed to examine how effectively the three different types of proactive primary care models adopted by three different regional health care systems in Italy were improving the quality of diabetes management by general practitionersMethodsA coordinated Italian nationwide project to compare systematically the new proactive organizational models implemented at regional and local level (the MEDINA Project) involved several regions and their local health units (LHUs). A quasi-experimental study was conducted on a large dataset obtained by processing administrative databases. A combined indicator was developed to assess the quality of care delivered by primary care physicians, based on adherence to recommendations concerning patient monitoring and treatment.ResultThe study concerned 602 Italian general practitioners (GPs), 174 of them female, who were caring for a total of 753,366 patients (47,575 of them diabetic). Analyzing a total score, representing global adherence to a quality management of patients with diabetes, confirmed that GPs who had adopted the new model of care for their diabetic patients obtained better results than those who had not, so the new policy was generally effective.ConclusionOur study showed that introducing new, proactive primary care models could sustain efforts made around the world to guarantee good-quality chronic disease management in the primary care setting.
       
  • Gender Differences in the Incomes of Self-Employed French Physicians: The
           Role of Family Structure
    • Abstract: Publication date: Available online 21 May 2019Source: Health PolicyAuthor(s): Fanny Mikol, Carine Franc In most developed countries, the average income of female physicians remains much lower than that of their male counterparts. This paper analyses how much of the gender earnings gap among French self-employed physicians can be attributed to women’s family responsibilities, choice of medical specialty, and opportunity to charge extra billings. The question is of growing concern for regulators because it may influence patients’ future access to care. We used an exhaustive administrative database that merges information on the medical activity, earnings, and family structure of self-employed doctors in 2005, 2008, and 2011. Using the 2011 database, results suggest that when demographic and professional characteristics are controlled, female physicians still exhibit an annual earnings gap that varies according to family structure: having young children worsens the situation of female physicians, particularly GPs. Using our panel datasets from 2005, we show that there is a ‘carer effect’ of having children for female doctors that exacerbates the gender income gap, particularly for GPs. We do not highlight any real strategic behaviour of female specialists authorised to charge extra fees to increase their extra billings after a birth to maintain their previous income.
       
  • Alternative access schemes for pharmaceuticals in Europe: towards an
           emerging typology
    • Abstract: Publication date: Available online 20 May 2019Source: Health PolicyAuthor(s): Olga Löblová, Marcell Csanádi, Piotr Ozierański, Zoltán Kaló, Lawrence King, Martin McKee European governments employ sophisticated health technology assessment and regulatory procedures to identify which pharmaceuticals to fund publicly. However, there are persisting demands from patients for those drugs excluded from positive reimbursement lists, leading to the emergence of what are here termed “alternative access schemes”. This paper presents a purposive review of these schemes based on available scholarly and grey literature, illustrated with real-world examples from recent practice. It puts forward an original typology of alternative access schemes based on their marketing authorization (regulation) and reimbursement (redistribution) status. We describe the complex, multidimensional policy trade-offs between the principles of patient freedom of choice, clinical autonomy, encouragement of innovation, evidence-informed decisions on safety and quality, access to treatment, and financial sustainability, involved in marketing authorization and reimbursement decisions. We discuss the ways in which alternative access schemes differ and conclude that our typology can illuminate salient policy dilemmas raised by alternative access schemes in national drug reimbursement systems.
       
  • National Health Insurance: a conceptual framework from conflicting
           typologies
    • Abstract: Publication date: Available online 18 May 2019Source: Health PolicyAuthor(s): Cristóbal Cuadrado, Francisca Crispi, Matías Libuy, Gregory Marchildon, Camilo Cid
       
  • The Swiss Hepatitis Strategy as a model for facing future health policy
           challenges
    • Abstract: Publication date: Available online 16 May 2019Source: Health PolicyAuthor(s): Raoul Blindenbacher, Bettina Maeschli, Philip Bruggmann Driven by the increasing evidence of the public health burden of viral hepatitis and the passivity of the health authorities, the Swiss Hepatitis Strategy (SHS) was launched by private initiative with the vision of eliminating viral hepatitis by 2030. The strategy applied the Governmental Learning Spiral method, an approach designed to overcome political barriers and to enhance innovation in the political context. This participative process, where those who develop are also those who implement, enhances a sense of social belonging among the people involved, which leads to the alignment of different viewpoints as well as to the creation of social networks. In consequence, a broader audience becomes involved; this creates feedback loops that lead to the continuous improvement of the strategy process. Within less than five years the SHS has been able to achieve significant goals within the scope of its vision: the implementation of universal access to HCV therapies has been enforced; increased attention within the general population has been achieved by using progressively more media coverage about therapies, a patient organisation has been founded and the national health authorities have begun to support the strategy financially. The case of the SHS proves, that a carefully designed political learning process is an efficient and innovative tool in the face of today’s health policy challenges such as the HCV epidemic.
       
  • New model for prioritised adoption and use of hospital medicine in Denmark
           since 2017: Challenges and perspectives
    • Abstract: Publication date: Available online 16 May 2019Source: Health PolicyAuthor(s): Sarah Wadmann, Jakob Kjellberg Technological innovation creates new treatment opportunities, while also putting healthcare budgets under strain. To deal with the rising costs of hospital medicines, the regional governments in Denmark have developed a new model for prioritising the adoption and use of hospital medicine. Marking a shift from previous policies, the new model formalises the evaluation of clinical benefit, adds an assessment of treatment costs and ensures a relatively high degree of direct stakeholder involvement. In international comparison, the new model is ambitious in terms of stakeholder involvement and adherence with principles advocated to ensure procedural justice and fair decision-making processes. However, these procedural innovations have also created new challenges. Notably, the newly formed assessment body, the Danish Medicines Council, is faced with a very high caseload and limited options to prioritise the use of its analytical resources.
       
  • Cost-utility of screening for depression among asylum seekers: a modelling
           study in Germany
    • Abstract: Publication date: Available online 16 May 2019Source: Health PolicyAuthor(s): Louise Biddle, Alec Miners, Kayvan Bozorgmehr BackgroundAsylum seekers have a high burden of mental illness owing to traumatic experiences before, during and after flight. Screening has been suggested to identify asylum seekers with psychosocial needs. However, little is known about the costs of screening relative to expected gains. We assessed the cost-effectiveness of population-based screening for depression in German asylum reception centres compared to case-finding by self-referral.MethodsExplorative modelling study using a decision tree over 15 months to estimate the incremental cost per Quality-Adjusted Life-Year gained. Data points were taken from the published literature. Deterministic and probabilistic sensitivity analyses were used to address uncertainty around parameter estimates. Value of information analyses were performed to indicate the value of future research.ResultsThe model demonstrates a high probability (p = 83%) of the screening intervention being cost-effective at a Є 50,000/QALY threshold. Cost-utility depends on the process of care following screening: when acceptability and adherence parameters were decreased by 40%, the resulting ICER increased by 27-131%. Eliminating uncertainty was most valuable for the screening process and cost parameters, at Є 3·0 and Є 4·4 million respectively.ConclusionsScreening asylum seekers for depression may be a cost-effective strategy to identify those in need of care. However, there is considerable value in conducting further research in this area, especially regarding resource requirements and the process of care following screening.
       
  • Involving the public in decision-making about large-scale changes to
           health services: a scoping review
    • Abstract: Publication date: Available online 14 May 2019Source: Health PolicyAuthor(s): Nehla Djellouli, Lorelei Jones, Helen Barratt, Angus I.G. Ramsay, Steven Towndrow, Sandy Oliver BackgroundPublic involvement in large-scale changes (LSC) to health services is strongly promoted – and even mandated – in several health systems. This scoping review aimed to describe the evidence about how public involvement is conceptualised and conducted in LSC, with what impact, and how different stakeholders perceived this process.MethodsAfter searching eight databases, 34 publications were included. Data were extracted and charted using a standardised form. Findings from the literature were discussed with frontline stakeholders.ResultsPublic involvement remains poorly defined and its aims lack clarity in LSC. Public meetings are most often used to gather public views but raise the issue of representativeness. However, evidence in the literature is scarce about which involvement methods – informative and deliberative – are appropriate for the different stages of the LSC and with what impact. In several cases, the involved public felt they had no influence on decision-making regarding LSC proposals, sometimes leading to an environment of mistrust. In those instances, the public understood the technical arguments for change and actively questioned them, opposed LSC plans and sought alternative routes to voice their views.ConclusionMore research and consideration are needed regarding who should be involved, with what purpose and how. We argue that in practice two models of involvement, invited and uninvited participation, coexist and therefore interactions between the two should be given further consideration in LSC.
       
  • Is having private health insurance associated with less support for public
           healthcare' Evidence from the Norwegian NHS
    • Abstract: Publication date: Available online 13 May 2019Source: Health PolicyAuthor(s): Pål E. Martinussen, Jon Magnussen The purpose of this study was to investigate whether increased uptake of private health insurance (PHI) in a traditionally NHS type system is likely to affect support for the public healthcare system.Using the Norwegian healthcare system as our case, and building on a survey among 7500 citizens, with 2688 respondents, we employed multivariate analysis to uncover whether the preferences for public health services are associated with having PHI, controlling for key predictors such as socio-economic background, self-rated health and perceived health service quality, as well as age and gender. The basis for our analysis was the following two propositions related to the role of public healthcare, which the respondents were asked to score on a 5-point Likert scale (1 = "totally disagree", 5 = "totally agree"): 1)"the responsibility of providing health services should mainly be public", and 2) "the activity of private commercial actors should be limited". The regression analyses showed that the willingness to increase the role of commercial private actors is positively associated with having a PHI. However, we found no relationship between holding a PHI and support for public provision of health services when other factors were controlled for.
       
  • Worlds of Healthcare: A Healthcare System Typology of OECD Countries
    • Abstract: Publication date: Available online 11 May 2019Source: Health PolicyAuthor(s): Nadine Reibling, Mareike Ariaans, Claus Wendt In this paper, we present an extended typology of OECD healthcare systems. Our theoretical framework integrates the comparative-institutional perspective of existing classifications with current ideas from the international health policy research debate. We argue that combining these two perspectives provides a more comprehensive picture of modern healthcare systems and takes the past decade’s dynamic of reforms into account. Moreover, this approach makes the typology more beneficial in terms of understanding and explaining cross-national variation in population health and health inequalities. Empirically, we combine indicators on supply, public-private mix, and institutional access regulations from earlier typologies with information on primary care orientation and performance management in prevention and quality of care. The results from a series of cluster analyses indicate that at least five distinct types of healthcare systems can be identified. Moreover, we provide quantitative information on the consistency of cluster membership for individual countries via system types.
       
  • Health service accreditation stimulating change in clinical care and human
           resource management processes: a study of 311 Australian hospitals
    • Abstract: Publication date: Available online 3 May 2019Source: Health PolicyAuthor(s): David Greenfield, S.A. Lawrence, A Kellner, K. Townsend, A. Wilkinson ObjectiveThis study aimed to establish whether longitudinal participation in an accreditation program is translated into improvement in continuity of quality patient care and human resource management (HRM) processes outcomes.Materials and methodsThis was a secondary data analysis of accreditation panel data from acute hospitals participating in the Australian Council on Healthcare Standards’ Evaluation and Quality Improvement Program (EQuIP). EQuIP criteria data from 311 hospitals were collected by external surveyors across 2003-2006 (Time 1) and 2007-2010 (Time 2). Mandatory accreditation criteria ratings at Time 1 were used to determine hospital performance group membership (1 = below moderate, 2 = moderate, 3 = above moderate). Analysis was undertaken of ratings across continuity of quality patient care and HRM process criteria, at Time 1 and 2.ResultsContinuity of quality patient care and HRM processes improved across time in the three performance groups. Lower performing hospitals improved at a greater rate than moderate and higher performing hospitals. The groupings and performance order did not change over time.ConclusionsAn accreditation program is an external driver that facilitates continual and systemic quality improvement changes to sub-systems with an organisation.
       
  • Brexit threatens the UK’s ability to tackle illicit drugs and organised
           crime: what needs to happen now'
    • Abstract: Publication date: Available online 16 April 2019Source: Health PolicyAuthor(s): Andres Roman-Urrestarazu, Justin Yang, Roy Robertson, Alison McCallum, Christina Gray, Martin McKee, John Middleton BackgroundThe decision by the UK government to leave the European Union comes at a time when parts of the UK are experiencing a marked rise in reported gun and knife crimes. The health effects of Brexit will have serious consequences as to how the UK tackle this upsurge in drug-related crime.Health policy processesThe UK’s future participation with the EU’s specialised agencies will depend on the detail of any agreement reached on future collaboration with the EU and its drug agency, the EMCDDA.ContextThe EMCDDA provides the EU and its Member States with a factual overview of European drug problems and a solid evidence base to support debates on drugs policies. It also supports early warning initiatives and coordinates measures at national and supranational levels with Europol and supranational enforcement agenciesExpected outcomesWhile these arrangements might continue throughout any transition period, those working within the sector require guidance and assurances from the British government about its long-term intentions after any transition.ConclusionsThe scale of collaboration between the UK and European institutions is extensive. It is not clear how this might be replicated after Brexit. Yet an alternative framework of collaboration between the UK and the EU is clearly needed to facilitate shared and agreed approaches to data sharing and drug surveillance after Brexit.
       
  • Research evidence supports cancer policymaking but is insufficient for
           change: findings of key informant interviews from five countries
    • Abstract: Publication date: Available online 13 April 2019Source: Health PolicyAuthor(s): Rebecca J. Bergin, Jon Emery, Ruth Bollard, Victoria White Evidence-based policymaking values the use of research in the process of developing, implementing and evaluating policy. However, there is limited research attempting to understand how cancer policymaking occurs and the role of evidence in this process. Our study aimed to provide a deeper understanding of levers and challenges to the development and implementation of large-scale, health service policies or programs in cancer care. Within a realist framework, we conducted athematic analysis of interviews with 13 key informants from five countries: Australia, Canada, Scotland, Denmark and New Zealand. Results identified a complex array of program mechanisms and contextual factors influencing cancer health-service policymaking. Research evidence was important and could form a rationale for change, such as by identifying unwarranted variation in cancer outcomes across or within countries. However, other factors were equally important in driving policy change, including advocacy, leadership, stakeholder collaboration, program adaptability, clinician and consumer involvement, and the influential role of context. These findings resonate with political science theories and health service reform literature, while offering novel insight into specific factors that influence policymaking in cancer care, namely clinical engagement, consumer input and policy context. Although research evidence supports policymaking, the complex ways in which cancer policies are developed and implemented requires recognition and should be considered when designing new programs and promoting the use of evidence in policymaking.
       
  • CATASTROPHIC RISK ASSOCIATED WITH OUT-OF-POCKET PAYMENTS FOR LONG TERM
           CARE IN SPAIN
    • Abstract: Publication date: Available online 5 April 2019Source: Health PolicyAuthor(s): Raúl del Pozo-Rubio, Dolores Jiménez-Rubio ObjectivesThis study analyses the financial burden associated with the introduction of copayment for long term care (LTC) in Spain in 2012 for dependent individuals.Material and methodsWe analyse and identify households for which the dependency-related out-of-pocket payment exceeds the defined catastrophic threshold (incidence), and the gap between the copayment and the threshold for the catastrophic copayment (intensity), for the full population sample and for subsamples based on the level of long-term care dependency and on regional characteristics (regional income and political ideology of party ruling the region).ResultsThe results obtained show there is a higher risk of impoverishment due to copayment among relatively well-off dependents, although the financial burden falls more heavily on less well-off households. Our findings also reveal interesting regional patterns of inequity in financing and access to long-term care services, which appear to be explained by an uneven development of LTC services (monetary transfers versus formal services) and varying levels of copayment across regions.ConclusionsThe new copayment for long-term care dependency in Spain is an important factor of catastrophic risk, and more attention should be addressed to policies aimed at improving the progressivity of out-of-pocket payments for LTC services within and between regions. In addition, formal services should be prioritised in all regions in order to guarantee equal access for equal need.
       
  • Primary Care Reform in Manitoba, Canada, 2011-15: Balancing Accountability
           and Acceptability
    • Abstract: Publication date: Available online 27 March 2019Source: Health PolicyAuthor(s): Sara A. Kreindler, Colleen Metge, Ashley Struthers, Karen Harlos, Catherine Charette, Sunita Bapuji, Paul Beaudin, Ingrid Botting, Alan Katz, Shauna Zinnick Primary care reform cannot succeed without substantive change on the part of providers. In Canada, these are mostly fee-for-service physicians, who tend to regard themselves as independent professionals and not under managerial sway. Hence, policymakers must balance two conflicting imperatives: ensuring the acceptability of renewal efforts to these physicians while enforcing their accountability for defined actions or outcomes. In its 2011-15 strategy to improve access to primary care, the province of Manitoba introduced several linked initiatives, each striving to blend acceptability- and accountability-promoting elements. Clearly delimited initiatives that directly promoted a specific observable behaviour (accountability) through financial or non-financial support (acceptability) were most successfully implemented. System-wide initiatives with complicated designs (notably a primary care network model that established formal partnership among clinics and regional health authorities) encountered greater difficulties in recruiting and sustaining physician participation. Although such initiatives offered physicians considerable decision-making latitude (acceptability), many physicians questioned the meaningfulness of opportunities for voice within a predetermined structure (accountability). Moreover, policymakers struggled to enhance the acceptability of such initiatives without sacrificing strong accountability mechanisms. Policymakers must carefully consider how acceptability and accountability elements may interact, and design them in such a way as to minimize the risk of mutual interference.
       
  • A review of attitudes towards the reuse of health data among people in the
           European Union: the primacy of purpose and the common good
    • Abstract: Publication date: Available online 21 March 2019Source: Health PolicyAuthor(s): Lea L. Skovgaard, Sarah Wadmann, Klaus Hoeyer Health data are used for still more purposes, and policies are enacted to facilitate data reuse within the European Union. This literature synthesis explores attitudes among people living in the European Union towards the use of health data for purposes other than treatment. Our findings indicate that while a majority hold positive attitudes towards the use of health data for multiple purposes, the positive attitudes are typically conditional on the expectation that data will be used to further the common good. Concerns evolve around the commercialisation of data, data security and the use of data against the interests of the people providing the data. Studies of these issues are limited geographically as well as in scope. We therefore identify a need for cross-national exploration of attitudes among people living in the European Union to inform future policies in health data governance.
       
  • Towards safe nurse staffing in England’s National Health Service:
           progress and pitfalls of policy evolution
    • Abstract: Publication date: Available online 19 March 2019Source: Health PolicyAuthor(s): J. Lawless, R Couch, P Griffiths, C. Burton, J. Ball In 2013, a national inquiry into care failings at a large public hospital in England resulted in major healthcare reforms that included targeting policy aimed at ensuring the adequacy of nurse staffing levels on hospital wards within NHS England. This paper uses a review of publicly available documents to provide a contextual account of the evolution of nurse staffing policy development prior to and following the inquiry. We found that securing safe staffing policy has been impacted by caveats and competing policy, evidence gaps, lack of coordination, and the absence of readily implementable solutions. Consequently, five years on, safe staffing policy for NHS England is described in aspirational terms that ascribes accountability to providers, but fails to adequately address barriers to delivery. Kingdon’s ‘policy windows’ model is used to explain why policy, even when driven by strong public concern and with high inter-sector support, may struggle to gain traction when the conditions necessary for success are not present, and in the face of practical or political constraints. The progress and pitfalls encountered are not unique and the experience of safe staffing policy in England may have lessons for other countries grappling with policy development or implementation in this area.
       
  • New partnerships, new perspectives: the relevance of sexual and
           reproductive health and rights for sustainable development
    • Abstract: Publication date: Available online 16 March 2019Source: Health PolicyAuthor(s): Susannah H. Mayhew, Karen Newman, David Johnson, Emily Clark, Michael Hammer, Vik Mohan, Sarah Ssali In the light of the opportunities presented by the Sustainable Development Goals (SDGs) debate is being reignited to understand the connections between human population dynamics (including rapid population growth) and sustainable development. Sustainable development is seriously affected by human population dynamics yet programme planners too often fail to consider them in development programming, casting doubt on the sustainability of such programming. Some innovative initiatives are attempting to cross sector boundaries once again, such as the Population Health and Environment (PHE) programmes, which are integrated programmes encompassing family planning service provision with broader public health services and environmental protection activities. These initiatives take on greater prominence in the context of the SDGs since they explicitly seek to provide cross-sector programming and governance to improve both human and planetary wellbeing. Yet such initiatives remain under-researched and under promoted.
       
  • Barriers to Health Care Access and Service Utilization of Refugees in
           Austria: Evidence from a Cross-Sectional Survey
    • Abstract: Publication date: Available online 6 March 2019Source: Health PolicyAuthor(s): Judith Kohlenberger, Isabella Buber-Ennser, Bernhard Rengs, Sebastian Leitner, Michael Landesmann This paper provides evidence on (1) refugees’ subjective well-being, (2) their access and barriers to health care utilization and (3) their perception of health care provision in Austria, one of the countries most heavily affected by the European ‘refugee crisis.’ It is based on primary data from the Refugee Health and Integration Survey (ReHIS), a cross-sectional survey of roughly five hundred Syrian, Iraqi and Afghan refugees. Results indicate that refugees’ self-rated health falls below the resident population’s, in particular for female and Afghan refugees. Whereas respondents state overall high satisfaction with the Austrian health system, two in ten male and four in ten female refugees report unmet health needs. Most frequently cited barriers include scheduling conflicts, long waiting lists, lack of knowledge about doctors, and language. Although treatment costs were not frequently considered as barriers, consultation of specialist medical services frequently associated with co-payment by patients, in particular dental care, are significantly less often consulted by refugees than by Austrians. Refugees reported comparably high utilization of hospital services, with daycare treatment more common than inpatient stays. We recommend to improve refugees’ access to health care in Austria by a) improving the information flow about available treatment, in particular specialists, b) fostering dental health care for refugees, and c) addressing language barriers by providing (web-based) interpretation services.
       
 
 
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