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Health Policy and Management - Volume:6 Issue: 12, Dec 2017

International Journal of Health Policy and Management
Volume:6 Issue: 12, Dec 2017

  • تاریخ انتشار: 1396/08/22
  • تعداد عناوین: 10
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  • Russell Mannion *, Jeffrey Braithwaite Pages 685-689
    In response to a weight of evidence that patients are frequently harmed as a result of their care, there have been concerted efforts to make healthcare safer, with health systems across the globe investing significant resources in policies and programmes designed to reduce adverse events. Yet, despite extensive efforts, improvements in safety have proved difficult to sustain and spread, with studies confirming there has been no measurable, systemslevel improvement in the overall rates of preventable harm. Here, we highlight the limitations of the thinking which underpins current efforts to make healthcare systems safer and point to new and emerging approaches to understanding and addressing patient safety in complex, dynamic health systems.
    Keywords: Health System, Patient Safety, Adverse Events, Preventable Harm, System Thinking
  • Meghan Rossiter *, Jennifer Verma, Jean-Louis Denis, Stephen Samis, Richard Wedge, Chris Power Pages 691-694
    The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) Quality Improvement Collaborative (QIC) in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements.
    Keywords: Governance, Executive Leadership, Systems Change, Quality Improvement, Chronic Disease, Healthcare Improvement
  • Konosuke Noto*, Takao Kojo, Ichiro Innami Pages 695-700
    BackgroundMany of public hospitals in Japan have had a deficit for a long time. Japanese local governments have been encouraging public hospitals to use group purchasing of drugs to benefit from the economies of scale, and increase their bargaining power for obtaining discounts in drug purchasing, thus improving their financial situation. In this study, we empirically investigate whether or not the scale of public hospitals actually affects their bargaining power.
    MethodsUsing micro-level panel data on public hospitals, we examine the effect of the scale of public hospitals (in terms of the number of occupancy beds) on drug purchasing efficiency (DPE) (the average discount rate in purchasing drugs) as a proxy variable of the bargaining power. Additionally, we evaluate the effect of the presence or absence of management responsibility in public hospital for economic efficiency as the proxy variable of an economic incentive and its interaction with the hospital scales on the bargaining power. In the estimations, we use the fixed effects model to control the heterogeneity of each hospital in order to estimate reliable parameters.
    ResultsThe scale of public hospitals does not positively correlate with bargaining power, whereas the management responsibility for economic efficiency does. Additionally, scale does not interact with management responsibility.
    ConclusionGiving management responsibility for economic efficiency to public hospitals is a more reliable way of gaining bargaining power in drug purchasing, rather than promoting the increase in scale of these public hospitals.
    Keywords: Public Hospitals, Economies of Scale, Bargaining Power, Management Responsibility, Management Efficiency
  • Rishi R. Patel *, Harald Schmidt Pages 701-706
    BackgroundIncreasingly, healthcare and non-healthcare employers prohibit or penalize the use of tobacco products among current and new employees in the United States. Despite this trend, and for a range of different reasons, around half of states currently legally protect employees from being denied positions, or having employment contracts terminated, due to tobacco use.
    MethodsWe undertook a conceptual analysis of legal provisions in all 50 states.
    ResultsWe found ethically relevant variations in terms of how tobacco is defined, which employee populations are protected, and to what extent they are protected. Furthermore, the underlying ethical rationales for smoker protection differ, and can be grouped into two main categories: prevention of discrimination and protection of privacy.
    ConclusionWe critically discuss these rationales and the role of their advocates and argue that enabling equality of opportunity is a more adequate overarching concept for preventing employers from disadvantaging smokers.
    Keywords: Tobacco Policy, Health Law, Ethics, Employment Discrimination, Denormalization
  • Lauren Wallace, Lydia Kapiriri * Pages 707-720
    BackgroundTo date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin’s conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV).
    MethodsThis was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin’s conceptual framework was used to evaluate the prioritization process.
    ResultsPriority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH.
    ConclusionPriority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are involved. Kapiriri and Martin’s framework has the potential to guide priority setting evaluation efforts, however, evaluation should be built into the priority setting process a priori such that information on priority setting is gathered throughout the implementation cycle.
    Keywords: Priority Setting, New Vaccines, Human Papilloma Virus (HPV) Vaccine, Pneumococcal Conjugate Vaccine, (PCV), Low-Income Countries, Uganda
  • Nassim Parvizi *, Sahar Parvizi Pages 721-722
    New health technologies require development and evaluation ahead of being incorporated into the patient care pathway. In light of the recent publication by Lehoux et al who discuss the role of entrepreneurs, investors and regulators in providing value to new health technologies, we summarise the processes involved in making new health technologies available for use in the United Kingdom.
    Keywords: Health Technology, Health Technology Assessment (HTA), National Institute of Health Research, (NIHR), National Institute for Health, Care Excellence (NICE)
  • Martin Powell * Pages 723-725
    This is a commentary on the article ‘The rise of post-truth populism in pluralist liberal democracies: challenges for health policy.’ It critically examines two of its key concepts: populism and ‘post truth.’ This commentary argues that there are different types of populism, with unclear links to impacts, and that in some ways, ‘post-truth’ has resonances with arguments advanced in the period at the beginning of the British National Health Service (NHS). In short, ‘post-truth’ populism’ may be ‘déjà vu all over again,’ and there are multiple (post) truths: this is my (post) truth, tell me yours.
    Keywords: Populism, UK National Health Service (NHS), Post-Truth Politics, Health Policy
  • Helen L. Walls *, Gorik Ooms Pages 727-728
    Addressing the increasingly globalised determinants of many important problems affecting human health is a complex task requiring collective action. We suggest that part of the solution to addressing intractable global health issues indeed lies with the role of new legal instruments in the form of globally binding treaties, as described in the recent article of Nikogosian and Kickbusch. However, in addition to the use of international law to develop new treaties, another part of the solution may lie in innovative use of existing legal instruments. A 2015 court ruling in The Hague, which ordered the Dutch government to cut greenhouse gas emissions by at least 25% within five years, complements this perspective, suggesting a way forward for addressing global health problems that critically involves civil society and innovative use of existing domestic legal instruments.
    Keywords: Governance, Policy, Law, Global Health
  • Kayvon Modjarrad*, Sten H. Vermund Pages 729-732
    In this commentary, we elaborate on the main points that Karamouzian and colleagues have made about HIV data scarcity in Middle Eastern and North African (MENA) countries. Without accessible and reliable data, no epidemic can be managed effectively or efficiently. Clearly, increased investments are needed to bolster capabilities to capture and interpret HIV surveillance data. We believe that this enhanced capacity can be achieved, in part, by leveraging and repurposing existing data platforms, technologies and patient cohorts. An immediate modest investment that capitalizes on available infrastructure can generate data on the HIV burden and spread that can be persuasive for MENA policy-makers to intensify efforts to track and contain the growing HIV epidemic in this region. A focus on key populations will yield the most valuable data, including among men who have sex with men (MSM), transgender women and men, persons who inject drugs (PWIDs), female partners of high risk men and female sex workers.
    Keywords: HIV, Surveillance, Middle East, North Africa, Data Accuracy, Health Policy
  • Should Priority Setting Also Be Concerned About Profound Socio-Economic Transformations? A Response to Recent Commentary
    Brayan V. Seixas *, Craig Mitton, Marion Danis, Iestyn Williams, Marthe Gold, Rob Baltussen Pages 733-734