Pub Date : 2023-02-28DOI: 10.1108/ijhg-11-2022-0098
Joanna Barbara Baluszek, K. Brønnick, S. Wiig
PurposeThe purpose of this rapid review was to present current evidence on relations between resilience and self-efficacy among healthcare practitioners in the context of COVID-19 pandemic.Design/methodology/approachLiterature searches were conducted in February/2022 in the online database MEDLINE EBSCO and not date/time limited. Eligibility criteria were as follows: population – healthcare practitioners, interest – relations between resilience and self-efficacy and context – COVID-19.FindingsSix eligible studies from Italy, China, United Kingdom, India, Pakistan and Spain, published between 2020 and 2021 were included in the review. All studies used quantitative methods. The relations between resilience and self-efficacy were identified in contexts of resilience programs, measuring mental health of frontline nurses, measuring nurses' and nursing students' perception of psychological preparedness for pandemic management, perception of COVID-19 severity and mediating roles of self-efficacy and resilience between stress and both physical and mental quality of life. Findings indicated limited research on this topic and a need for more research.Practical implicationsBroader understanding of the relations between resilience and self-efficacy may help healthcare organizations' leaders/managers aiming to support resilience of their employers under challenging circumstances such as future pandemic.Originality/valueThe latest COVID-19 pandemic presented the opportunity to research relations between resilience and self-efficacy and enrich existed research in a new and extraordinary context.
{"title":"The relations between resilience and self-efficacy among healthcare practitioners in context of the COVID-19 pandemic – a rapid review","authors":"Joanna Barbara Baluszek, K. Brønnick, S. Wiig","doi":"10.1108/ijhg-11-2022-0098","DOIUrl":"https://doi.org/10.1108/ijhg-11-2022-0098","url":null,"abstract":"PurposeThe purpose of this rapid review was to present current evidence on relations between resilience and self-efficacy among healthcare practitioners in the context of COVID-19 pandemic.Design/methodology/approachLiterature searches were conducted in February/2022 in the online database MEDLINE EBSCO and not date/time limited. Eligibility criteria were as follows: population – healthcare practitioners, interest – relations between resilience and self-efficacy and context – COVID-19.FindingsSix eligible studies from Italy, China, United Kingdom, India, Pakistan and Spain, published between 2020 and 2021 were included in the review. All studies used quantitative methods. The relations between resilience and self-efficacy were identified in contexts of resilience programs, measuring mental health of frontline nurses, measuring nurses' and nursing students' perception of psychological preparedness for pandemic management, perception of COVID-19 severity and mediating roles of self-efficacy and resilience between stress and both physical and mental quality of life. Findings indicated limited research on this topic and a need for more research.Practical implicationsBroader understanding of the relations between resilience and self-efficacy may help healthcare organizations' leaders/managers aiming to support resilience of their employers under challenging circumstances such as future pandemic.Originality/valueThe latest COVID-19 pandemic presented the opportunity to research relations between resilience and self-efficacy and enrich existed research in a new and extraordinary context.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49477748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-28DOI: 10.1108/ijhg-07-2022-0069
Srujana Boddu, Anagha Tobi
PurposeThe paper demonstrates prejudicial effects of the rising private participation and the lacuna of state in ensuring the accessibility and affordability of healthcare.Design/methodology/approachSecondary data analysis from national and international databases is employed to demonstrate the low government spending and the alternate healthcare financing mechanisms in the country. The company reports of six Indian pharma companies are examined to map the profits and revenues, and also taking into account the sales growth and return on investment.FindingsThe paper observes the pharmaceutical sector, via its spiralling drug prices, is the primary contributor to the huge out-of-pocket expenses borne by households. The study findings indicate that there is an increased divergence between the out-of-pocket expenses of households and exorbitant profits of the private drug companies in the country over the years.Research limitations/implicationsAmidst debates on the importance of public health in the aftermath of the pandemic, the paper examines the rising hands of private sector in healthcare, and implores – who benefits? The authors study the implications via looking into the rise in the wealth of pharma giants; at the time of crisis when the lives of common citizens in the country were at stake.Originality/valueThe paper emphasises the repercussions of the higher markup of the pharma industry in raising the healthcare costs of households. The authors emphasise that the nonregulation of the pharma sector leads to high medical debts/poverty, in the wake of growing out-of-pocket expenditures of the citizens.
{"title":"Is rising pharma market a new burden? Introspecting the implications of India’s healthcare journey from public to a private good","authors":"Srujana Boddu, Anagha Tobi","doi":"10.1108/ijhg-07-2022-0069","DOIUrl":"https://doi.org/10.1108/ijhg-07-2022-0069","url":null,"abstract":"PurposeThe paper demonstrates prejudicial effects of the rising private participation and the lacuna of state in ensuring the accessibility and affordability of healthcare.Design/methodology/approachSecondary data analysis from national and international databases is employed to demonstrate the low government spending and the alternate healthcare financing mechanisms in the country. The company reports of six Indian pharma companies are examined to map the profits and revenues, and also taking into account the sales growth and return on investment.FindingsThe paper observes the pharmaceutical sector, via its spiralling drug prices, is the primary contributor to the huge out-of-pocket expenses borne by households. The study findings indicate that there is an increased divergence between the out-of-pocket expenses of households and exorbitant profits of the private drug companies in the country over the years.Research limitations/implicationsAmidst debates on the importance of public health in the aftermath of the pandemic, the paper examines the rising hands of private sector in healthcare, and implores – who benefits? The authors study the implications via looking into the rise in the wealth of pharma giants; at the time of crisis when the lives of common citizens in the country were at stake.Originality/valueThe paper emphasises the repercussions of the higher markup of the pharma industry in raising the healthcare costs of households. The authors emphasise that the nonregulation of the pharma sector leads to high medical debts/poverty, in the wake of growing out-of-pocket expenditures of the citizens.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47953478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-02DOI: 10.1108/ijhg-11-2022-0106
Malin Rosell Magerøy, S. Wiig
PurposeThe purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.Design/methodology/approachThe paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.FindingsIdentified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.Originality/valueA major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.
{"title":"The effect of full-time culture on quality and safety of care – a literature review","authors":"Malin Rosell Magerøy, S. Wiig","doi":"10.1108/ijhg-11-2022-0106","DOIUrl":"https://doi.org/10.1108/ijhg-11-2022-0106","url":null,"abstract":"PurposeThe purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.Design/methodology/approachThe paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.FindingsIdentified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.Originality/valueA major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41755638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-24DOI: 10.1108/ijhg-12-2022-0108
Mohammad Azhar Ud Din, Muzffar Hussain Dar, S. Haseen
PurposeThe study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending across the 21 selected states of India.Design/methodology/approachThe tools of absolute β-and σ-convergence are used in the analysis to test the regional convergence. The average annual growth rate across the states is the dependent variable for β-convergence, and time is the second dependent variable but is used for s-convergence. In contrast, the initial value of NRHM expenditure and the coefficient of variation of NRHM expenditure are used as independent variables, respectively. Descriptive statistics are also used for the study. The data are annual and cover the panel from 2007 to 2020.FindingsThe study attests to the hypothesis of β-and σ-convergence for the selected states in the period mentioned. The observed convergence in NRHM expenditure is due to the shift in the government's attention from the non-high focus high focus states to high states through the national rural health mission policy. The coefficient of variation across the states also shows a declining trend and provides the robustness of the σ-convergence.Originality/valueAs far as the literature is concerned, none of the existing studies examines the convergence of a public health expenditure scheme like the National Rural Health Mission across the Indian states by applying the techniques of β-and σ-convergence. The novelty of the study is using the newly updated dataset and validating the convergence hypotheses in the National Rural Health Mission expenditure case.
{"title":"Inter-state disparities in government health expenditure in India: a study of national rural health mission","authors":"Mohammad Azhar Ud Din, Muzffar Hussain Dar, S. Haseen","doi":"10.1108/ijhg-12-2022-0108","DOIUrl":"https://doi.org/10.1108/ijhg-12-2022-0108","url":null,"abstract":"PurposeThe study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending across the 21 selected states of India.Design/methodology/approachThe tools of absolute β-and σ-convergence are used in the analysis to test the regional convergence. The average annual growth rate across the states is the dependent variable for β-convergence, and time is the second dependent variable but is used for s-convergence. In contrast, the initial value of NRHM expenditure and the coefficient of variation of NRHM expenditure are used as independent variables, respectively. Descriptive statistics are also used for the study. The data are annual and cover the panel from 2007 to 2020.FindingsThe study attests to the hypothesis of β-and σ-convergence for the selected states in the period mentioned. The observed convergence in NRHM expenditure is due to the shift in the government's attention from the non-high focus high focus states to high states through the national rural health mission policy. The coefficient of variation across the states also shows a declining trend and provides the robustness of the σ-convergence.Originality/valueAs far as the literature is concerned, none of the existing studies examines the convergence of a public health expenditure scheme like the National Rural Health Mission across the Indian states by applying the techniques of β-and σ-convergence. The novelty of the study is using the newly updated dataset and validating the convergence hypotheses in the National Rural Health Mission expenditure case.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46059787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-29DOI: 10.1108/ijhg-07-2022-0068
S. Wiig, Cecilie Haraldseid-Driftland, Heidi Dombestein, Hilda Bø Lyng, E. Ree, Birte Fagerdal, Lene Schibevaag, Veslemøy Guise
PurposeResilience in healthcare is fundamental for what constitutes quality in healthcare. To understand healthcare resilience, resilience research needs a multilevel perspective, diverse research designs, and taking advantage of different data sources. However, approaching resilience researchers as a data source is a new approach within this field and needs careful consideration to ensure that research is trustworthy and ethically sound. The aim of this short “backstage” general review paper is to give a snapshot of how the Resilience in Healthcare (RiH) research program identified and dealt with potential methodological and ethical challenges in researching researcher colleagues.Design/methodology/approachThe authors first provide an overview of the main challenges and benefits from the literature on researching researcher colleagues. Second, the authors demonstrate how this literature was used to guide strategies and principles adopted in the RiH research process.FindingsThe paper describes established principles and a checklist for data collection and analysis to overcome potential dilemmas and challenges to ensure trustworthiness and transparency in the process.Originality/valueMining the knowledge and experience of resilience researchers is fundamental for taking the research field to the next step, and furthermore an approach that is relevant across different research fields. This paper provides guidance on how other research projects can approach researcher colleagues in similar ways to gain new insight, build theory and advance their research field based on insider competence.
{"title":"Backstage researching resilience researchers – dilemmas and principles for data collection in the resilience in healthcare research program","authors":"S. Wiig, Cecilie Haraldseid-Driftland, Heidi Dombestein, Hilda Bø Lyng, E. Ree, Birte Fagerdal, Lene Schibevaag, Veslemøy Guise","doi":"10.1108/ijhg-07-2022-0068","DOIUrl":"https://doi.org/10.1108/ijhg-07-2022-0068","url":null,"abstract":"PurposeResilience in healthcare is fundamental for what constitutes quality in healthcare. To understand healthcare resilience, resilience research needs a multilevel perspective, diverse research designs, and taking advantage of different data sources. However, approaching resilience researchers as a data source is a new approach within this field and needs careful consideration to ensure that research is trustworthy and ethically sound. The aim of this short “backstage” general review paper is to give a snapshot of how the Resilience in Healthcare (RiH) research program identified and dealt with potential methodological and ethical challenges in researching researcher colleagues.Design/methodology/approachThe authors first provide an overview of the main challenges and benefits from the literature on researching researcher colleagues. Second, the authors demonstrate how this literature was used to guide strategies and principles adopted in the RiH research process.FindingsThe paper describes established principles and a checklist for data collection and analysis to overcome potential dilemmas and challenges to ensure trustworthiness and transparency in the process.Originality/valueMining the knowledge and experience of resilience researchers is fundamental for taking the research field to the next step, and furthermore an approach that is relevant across different research fields. This paper provides guidance on how other research projects can approach researcher colleagues in similar ways to gain new insight, build theory and advance their research field based on insider competence.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45705827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-27DOI: 10.1108/ijhg-04-2022-0043
Yassmine Mourajid, Asmaa Ghafili, M. Chahboune, A. Hilali, Chaima Fihri Fassi
PurposeThe purpose of this paper is to analyse the framework of hospital governance in order to understanding the persistence of dysfunctions that have caused the deterioration of the image and quality of Moroccan public hospital services.Design/methodology/approachThe analysis of the hospital governance model has used a conceptual framework examining four dimensions: institutional, financial, accountability and decision-making dimensions. This framework operationalization was highlighted through a documentary review of the main regulatory and legal texts as well as multiple case studies, using semi-structured interviews with the key stakeholders, considering their expertise and implication in the governance process.FindingsThe study was able to highlight that the governance structure of Moroccan public hospitals has been subject to numerous legislative provisions and modern management instruments. However, the limited autonomy, the resources shortage, dilapidated equipment, the chronic budget deficit, staff demotivation, the lack of accountability mechanisms have led to the deterioration of the quality of care and, hence, to patient's dissatisfaction.Practical implicationsThe analysis formed the basis for a series of recommendations. These were mainly aimed at rethinking the current governance model by setting up an institutional policy to improve the current governance structures and monitoring mechanisms of hospitals, as well as revising the instruments for planning and evaluating the provision of care and services according to the real needs of the population, taking into account the financial limits.Social implicationsThe hospital governance framework is proving to be a powerful tool for identifying the problems contributing to sub-optimal hospital performance, and calls for policy interventions to improve the organisation organization and delivery of hospital services with greater patient involvement.Originality/valueThis study was the first to analyse the Moroccan hospital governance model, using a comprehensive and structured evaluation methodology designed for public hospitals and supported by extensive data collection which made it possible to offer a broad and in-depth view of the actual functioning of these institutions.
{"title":"Governance in Moroccan public hospitals: critical analysis and perspectives for action","authors":"Yassmine Mourajid, Asmaa Ghafili, M. Chahboune, A. Hilali, Chaima Fihri Fassi","doi":"10.1108/ijhg-04-2022-0043","DOIUrl":"https://doi.org/10.1108/ijhg-04-2022-0043","url":null,"abstract":"PurposeThe purpose of this paper is to analyse the framework of hospital governance in order to understanding the persistence of dysfunctions that have caused the deterioration of the image and quality of Moroccan public hospital services.Design/methodology/approachThe analysis of the hospital governance model has used a conceptual framework examining four dimensions: institutional, financial, accountability and decision-making dimensions. This framework operationalization was highlighted through a documentary review of the main regulatory and legal texts as well as multiple case studies, using semi-structured interviews with the key stakeholders, considering their expertise and implication in the governance process.FindingsThe study was able to highlight that the governance structure of Moroccan public hospitals has been subject to numerous legislative provisions and modern management instruments. However, the limited autonomy, the resources shortage, dilapidated equipment, the chronic budget deficit, staff demotivation, the lack of accountability mechanisms have led to the deterioration of the quality of care and, hence, to patient's dissatisfaction.Practical implicationsThe analysis formed the basis for a series of recommendations. These were mainly aimed at rethinking the current governance model by setting up an institutional policy to improve the current governance structures and monitoring mechanisms of hospitals, as well as revising the instruments for planning and evaluating the provision of care and services according to the real needs of the population, taking into account the financial limits.Social implicationsThe hospital governance framework is proving to be a powerful tool for identifying the problems contributing to sub-optimal hospital performance, and calls for policy interventions to improve the organisation organization and delivery of hospital services with greater patient involvement.Originality/valueThis study was the first to analyse the Moroccan hospital governance model, using a comprehensive and structured evaluation methodology designed for public hospitals and supported by extensive data collection which made it possible to offer a broad and in-depth view of the actual functioning of these institutions.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41498098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PurposeThe unresolved crisis scenario and a prolonged COVID-19 pandemic increased social inequalities, mainly affecting the most vulnerable groups to access health services. The data in Pakistan show that health coverage benefits less than half of the population and a weak health system forces households to finance their health with out-of-pocket expenses. Therefore, it is a pending task to guarantee universal health coverage and design sustainable and inclusive policies to finance and provide health services. This study aims to offer a unique solution for health financing to Pakistan.Design/methodology/approachThis study uses the VECM model by employing the data from Pakistan to indicate sustainable policies for health financing.FindingsThe results of this research show that direct taxes have a positive impact on public health expenditure; on the contrary, indirect taxes have a negative impact; it also confirms the importance of considering the direct tax based on high-income quintiles to guarantee equality and Access to health for all that contributes to human development.Practical implicationsThis article leads to the design of a new health system that will be useful for improving the health of Pakistan by presenting a solution to enhance health financing. Meanwhile, Pakistan will experience better conditions in the face of health crises.Social implicationsImproving health financing through the equality approach can provide public access to the health system and strengthen the positive effects of the health system on socio-economic relations.Originality/valueThis paper provides a unique solution for the ministry of health of Pakistan, International organisations and national authorities to reach a high level of health coverage without any cost to the financial system and increase the cost of living of the Pakistani people.HighlightsIncrease efficient health financing by integrating health coverage programmes.Implementing direct taxes based on income quintiles improves health equality.Indirect tax policies will not positively contribute to health financing.Improving health financing efficiency decreases health inequality.
{"title":"Inclusive policies for health financing towards universal health coverage in Pakistan: direct or indirect taxes","authors":"Amirreza Kazemikhasragh, Marianna Vanessa Buoni Pineda","doi":"10.1108/ijhg-06-2022-0054","DOIUrl":"https://doi.org/10.1108/ijhg-06-2022-0054","url":null,"abstract":"PurposeThe unresolved crisis scenario and a prolonged COVID-19 pandemic increased social inequalities, mainly affecting the most vulnerable groups to access health services. The data in Pakistan show that health coverage benefits less than half of the population and a weak health system forces households to finance their health with out-of-pocket expenses. Therefore, it is a pending task to guarantee universal health coverage and design sustainable and inclusive policies to finance and provide health services. This study aims to offer a unique solution for health financing to Pakistan.Design/methodology/approachThis study uses the VECM model by employing the data from Pakistan to indicate sustainable policies for health financing.FindingsThe results of this research show that direct taxes have a positive impact on public health expenditure; on the contrary, indirect taxes have a negative impact; it also confirms the importance of considering the direct tax based on high-income quintiles to guarantee equality and Access to health for all that contributes to human development.Practical implicationsThis article leads to the design of a new health system that will be useful for improving the health of Pakistan by presenting a solution to enhance health financing. Meanwhile, Pakistan will experience better conditions in the face of health crises.Social implicationsImproving health financing through the equality approach can provide public access to the health system and strengthen the positive effects of the health system on socio-economic relations.Originality/valueThis paper provides a unique solution for the ministry of health of Pakistan, International organisations and national authorities to reach a high level of health coverage without any cost to the financial system and increase the cost of living of the Pakistani people.HighlightsIncrease efficient health financing by integrating health coverage programmes.Implementing direct taxes based on income quintiles improves health equality.Indirect tax policies will not positively contribute to health financing.Improving health financing efficiency decreases health inequality.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48635132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-22DOI: 10.1108/ijhg-12-2021-0123
Lu Liu
PurposeThis research studies the effect of deregulation of price cap in pharmaceutical market. Price regulation (either through price cap or reference price) is common practice in the pharmaceutical market but recently there are increasing voices calling for deregulation claiming that deregulation could help in lowering drug price and increase revenue of pharmaceutical firms. Upon those callings, Chinese government removed the price cap regulation in June 2015. The author uses this natural policy experiment to study this effect.Design/methodology/approachIn this study, the author applied the interrupted time series analysis (ITSA) on the revenue data of nine categories of both generic and branded drugs in China from March 2011 to August 2016 (the time frame includes both before and after of the initialization of the deregulation) and analyzed the effect of deregulation.FindingsThe results showed that, whether the revenue of drugs will increase or decrease after the deregulation of price cap depends on the level of competition and the change of patterns of the branded and generic drugs are different. When HHI (Herfindahl–Hirschman index) is sufficiently low (competition is high), revenue does not change as a result of deregulation, when HHI is moderately low (moderate competition), revenue from generic drugs will decrease significantly and revenue from branded drugs will increase significantly, and when HHI is high (low competition), revenue from generic drugs will increase significantly and revenue from branded drugs will decrease significantly.Originality/valueThis is a unique study with a unique data set. Most previous studies focus on regulation of drug price and analyze how this may affect drug revenue; however, this is a natural policy experiment of de-regulation. Moreover, previously most studies focus on reference pricing regulation and this is price-cap, a different mechanism that is rarely studied. The originality/value is high of this article.
{"title":"Deregulation on branded and generic drugs price and its effect: a study of Chinese pharmaceutical market","authors":"Lu Liu","doi":"10.1108/ijhg-12-2021-0123","DOIUrl":"https://doi.org/10.1108/ijhg-12-2021-0123","url":null,"abstract":"PurposeThis research studies the effect of deregulation of price cap in pharmaceutical market. Price regulation (either through price cap or reference price) is common practice in the pharmaceutical market but recently there are increasing voices calling for deregulation claiming that deregulation could help in lowering drug price and increase revenue of pharmaceutical firms. Upon those callings, Chinese government removed the price cap regulation in June 2015. The author uses this natural policy experiment to study this effect.Design/methodology/approachIn this study, the author applied the interrupted time series analysis (ITSA) on the revenue data of nine categories of both generic and branded drugs in China from March 2011 to August 2016 (the time frame includes both before and after of the initialization of the deregulation) and analyzed the effect of deregulation.FindingsThe results showed that, whether the revenue of drugs will increase or decrease after the deregulation of price cap depends on the level of competition and the change of patterns of the branded and generic drugs are different. When HHI (Herfindahl–Hirschman index) is sufficiently low (competition is high), revenue does not change as a result of deregulation, when HHI is moderately low (moderate competition), revenue from generic drugs will decrease significantly and revenue from branded drugs will increase significantly, and when HHI is high (low competition), revenue from generic drugs will increase significantly and revenue from branded drugs will decrease significantly.Originality/valueThis is a unique study with a unique data set. Most previous studies focus on regulation of drug price and analyze how this may affect drug revenue; however, this is a natural policy experiment of de-regulation. Moreover, previously most studies focus on reference pricing regulation and this is price-cap, a different mechanism that is rarely studied. The originality/value is high of this article.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44673845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.1108/ijhg-12-2022-150
F. M. MacVane Phipps
{"title":"IJHG 27.4 Review","authors":"F. M. MacVane Phipps","doi":"10.1108/ijhg-12-2022-150","DOIUrl":"https://doi.org/10.1108/ijhg-12-2022-150","url":null,"abstract":"","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46494730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-12DOI: 10.1108/ijhg-07-2022-0072
Margarita Peonides, V. Knoll, Nina Gerstner, Raffael Heiss, Markus Frischhut, N. Gokani
PurposeThis review explores the phenomenon of front-of-pack nutrition labels (FoPNLs) in the European Union (EU). FoPNLs highlight the nutritional quality of food and non-alcoholic beverages and help consumers to make healthier choices. The review explores different types of FoPNLs and evaluates their effectiveness.Design/methodology/approachA policy analysis was conducted, relying on extant academic literature, grey literature and policy documents. The use of current FoPNLs is interpreted in light of national and economic interests.FindingsOur review identifies and describes seven government endorsed FoPNLs that are currently used in the EU. Five are positive endorsement labels (Croatia, Czech Republic, Denmark, Lithuania, Slovenia and Sweden), which only provide a positive indication on more healthy products. The Keyhole is used in three EU countries (Denmark, Lithuania and Sweden), while the others are used in one country each. The Nutri-Score represents a summary label, which provides an overall grade of how healthy a product is. It is used in six countries (Belgium, France, Germany, Netherlands, Spain and Luxembourg). Finally, the Nutrinform battery is a nutrient-specific non-interpretive scheme, indicating the content of nutrients in a portion of a food product. All identified labels are only used on a voluntary basis, encouraging selective use.Originality/valueThis review contributes to a significant discussion about food labeling in the EU. It summarizes existing approaches and evaluates them in terms of their effectiveness. The current schemes in use reflect regional clustering. The most common scheme is the Nutri-Score. This is predominantly found in western EU states. Another major label is the Keyhole, with summary endorsement schemes being prevalent in northern EU states. The least common is Nutrinform, which has some support in southern EU states. The Nutri-score is most effective although economic interests are pushing for the Nutrinform battery in a small number of states. Finally, the review suggests that all existing FoPNLs are voluntary, these labels fail to provide consumers with adequate information about nutrition quality of food products. The EU needs to mobilize support to agree on a single one.
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