Health Care Analysis最新文献

Long COVID is a condition that arose during the COVID-19 pandemic in individuals who developed the multi-system chronic condition after a COVID-19 infection. During the pandemic in the United States (U.S.), these "COVID long-haulers" navigated a complex and overburdened health care system in pursuit of diagnoses and treatments. This qualitative secondary analysis used the 2013 Levesque et al. Conceptual Model of Healthcare Access to examine multidimensional health care access issues faced by 29 COVID long-haulers in the U.S. Our analysis showed that long-haulers faced complementary issues from both individual and health systems perspectives related to the inability to get diagnoses or treatments, long waiting times for providers and difficulty reaching services, underinformed providers and biased interpersonal experiences, and struggles with the financial costs of treating the condition, which impacted care decisions. Interviewees also described relying on alternative medicine to provide symptom relief. Overall, this study extends international research by offering a comprehensive examination of Long COVID health care access issues in the U.S. and identifying specific insights related to health care access that made obtaining Long COVID care difficult, such as the mismatch between individual expectations of what health care should look like and how it actually operates. Our use of the full Conceptual Model of Healthcare Access provides new insights into the overlap across layers of access issues and offers suggestions for how public health and clinical health practitioners can collaborate to meet the needs of vulnerable populations such as these in future health emergencies.

According to a standard view, therapeutic misconception is a problem for informed consent and thereby respect for participant autonomy. This view is plausible given that therapeutic misconception refers to the mistaken beliefs of research participants regarding the nature and purpose of and their role in research. I do not disagree that therapeutic misconception can be a problem for informed consent and respect for autonomy; I disagree that it is only a problem for informed consent and respect for autonomy. The aim of this paper is to show that therapeutic misconception also harms participants, and as such, it is a matter of non-maleficence. I do this by showing that therapeutic misconception (often) fosters and sustains false hope, and since false hope harms people, therapeutic misconception is also a concern of non-maleficence.

Tobacco use remains a critical global public health challenge, representing the leading preventable cause of morbidity and mortality worldwide. The World Health Organisation's Framework Convention on Tobacco Control, ratified by 183 parties, includes Articles 9 and 10, which regulate the contents and emissions of tobacco products. Like many other WHO-FCTC articles, the implementation of these provisions faces significant challenges. These hurdles include tobacco industry interference, the proliferation of novel tobacco and nicotine products, the complexity of regulating product attractiveness, addictiveness, and toxicity, inadequate testing infrastructure, legal and political barriers, and coordination challenges among the regulatory authorities of different countries. Overcoming these impediments is crucial, as robust enforcement of Articles 9 and 10 holds the potential to reduce the substantial global burden of over 7 million annual deaths attributable to tobacco use. Effective implementation will require integrating these articles into domestic tobacco control legislation, establishing well-equipped testing facilities, fostering multi-sectoral coordination, and bolstering international research collaborations and capacity-building efforts. By surmounting these challenges, countries can harness the full power of the WHO-FCTC to curb the tobacco epidemic.

The recent tragic death of UnitedHealthcare CEO Brian Thompson has renewed public scrutiny of the US health care system and reignited debate over why Americans face disproportionately high health care costs. This essay examines both the widely recognized drivers of excessive costs and the deeper systemic issues that often remain unaddressed yet continue to sustain the crisis. It highlights two critical challenges: the need to target structural barriers and misaligned economic incentives in order to design sustainable reforms, and the persistent political polarization that impedes long-term, meaningful change. The paper concludes by outlining short-term strategies that can generate immediate improvements while laying the foundation for comprehensive and enduring reform.

This review synthesizes global trends, persistent challenges, and actionable pathways for overhauling public mental health systems, with a particular focus on low- and middle-income countries (LMICs). Thematic analysis of our review revealed that mental health disorders now affect nearly one in eight people worldwide, yet up to 75% of those in LMICs receive no treatment due to stigma, underfunding, workforce shortages, and fragmented systems, perpetuating a widening "treatment and care gap." Social inequities, harmful cultural norms, conflict, climate change, and gender disparities further amplify the risk and economic burden, projected to exceed US$6 trillion by 2030. Innovative financing approaches, including public-private partnerships and models from countries such as Norway and Australia, offer promising strategies for sustainable investments. The COVID-19 pandemic intensified mental health challenges but also raised global awareness, with leaders such as the United Nations Secretary-General and the United States Surgeon General foregrounding mental health crises in the public consciousness. Advocacy initiatives, including the FundaMentalSDG campaign, Lancet Commissions, Global Mental Health Action Network, and Global Mental Health Peer Network, have been pivotal in elevating mental health within the Sustainable Development Goals (SDGs) and linking it to social determinants. Emerging solutions include rights-based frameworks that emphasize participation and anti-discrimination, scaling up task-sharing and expanded roles for non-specialists through programs such as the World Health Organization's Mental Health Gap Action Programme, community-based interventions like Zimbabwe's Friendship Bench, and integration of mental health into primary care with dedicated counsellors, structured referral pathways, and digital innovations promising improved access and personalization. Sustained progress requires intersectoral collaboration across health, education, labor, and social sectors; embedding mental health into national health information systems; and investing in culturally adapted promotion and prevention interventions throughout the life course. Strengthening political commitment, global-local leadership, financing frameworks, and workforce capacity, particularly through continuous professional development and lived-experience participation, will accelerate progress toward the SDGs, underscoring the imperative for equitable financing and sustained political will globally.

Sustainable access to effective antibiotics is a main rationale for addressing antimicrobial resistance, for calls to enhance antibiotic supply security and for development support to promote health system capacity in low- and middle-income settings. Standard models for valuing pharmaceuticals fail to capture the full value of sustainable access to effective antibiotics. In effect, assessments of societal or corporate investments to promote such access underestimate their value and the cost of foregoing them. In effect, measures that could address existing sustainability problems in antibiotic supply systems are hampered. We review the features needed to avoid these problems and assess suggestions to address the flaws of existing approaches, such as the STEDI-model. On this basis, we propose the 3D Value Framework, a straightforward and comprehensive model that focusses directly on what types of valuable outcomes there can be related to having sustainable access to effective antibiotics. We also sketch how this model can be used in cost-effectiveness analysis grounding public decision-making and discuss further applications in other settings.

This study employs bibliometric and thematic analysis to evaluate the growing body of research on subjective well-being and quality of life during the COVID-19 pandemic. The findings underscore the pandemic's profound impacts on global health, evidenced by a notable increase in studies addressing mental health and quality of life, fostered by international scientific collaboration. Keyword analysis reveals critical themes, including the pandemic's influence on mental health, physical activity, and social support systems. This research provides valuable insights into the long-term consequences of the pandemic and highlights adaptive strategies for managing future crises. By identifying key trends and research gaps, the study serves as an essential resource for academics, policymakers, and public health practitioners, offering a roadmap for future investigations.