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.

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.

Israel's aging population and demographic growth have driven a surge in hospitalizations, prompting the Ministry of Health to expand community-based care. In 2019, a financial incentive was introduced, special payments to health maintenance organizations (HMOs) for Hospital at Home (HaH) services, implemented in 2020. This study examines changes in the volume and geographic distribution of HaH following this policy. We analyzed retrospective Ministry of Health data on all HaH admissions from 2017-2023, excluding COVID-19 cases. Data included length of stay, referral source (hospital vs. community), patient age, and residence. HMOs reported 70,203 HaH admissions during the study period, increasing from only 8 in 2017 to 33,141 in 2023. Growth was most rapid after the payment policy was introduced. The mean monthly HaH days rose sharply, reaching 2762 in 2023. Over time, the proportion of HaH admissions from central Israel increased, while peripheral areas saw a relative decline. Readmission rates to HaH were low-3% within 1 week, and 8%, 15%, and 23% within 1, 3, and 6 months, respectively. HaH could play a significant role in meeting Israel's growing demand for inpatient care. To maximize its impact, policy efforts should address barriers to expansion, particularly in peripheral regions, and promote more equitable geographic access.

The diagnosis and perception of autism have undergone significant transformations throughout history. Initially conceptualised as a symptom of schizophrenia, autism later emerged as a distinct diagnosis, evolving into the broader classification of autism spectrum disorder (ASD). This essay explores the main shifts in the understanding of autism throughout its history and different approaches to its treatment. While the traditional psychiatric perspective aligns with a naturalist view of disease, the Neurodiversity Movement advocates for a normative approach, emphasising societal adaptation over medical intervention. The study examines historical milestones, including the contributions of Eugen Bleuler, Grunya Sukhareva, Leo Kanner, and Hans Asperger, alongside the conceptual transition from low- and high-functioning autism to the spectrum model. It also discusses the implications of language in shaping autism discourse, highlighting the shift from person-first to identity-first terminology. The essay ultimately argues that the expansion of the autism diagnosis supports the neurodiversity paradigm, which fosters greater inclusion and empowerment of neurodivergent individuals. However, considerations of severity and linguistic framing remain crucial in advancing this perspective.

The COVID-19 pandemic presented unprecedented challenges for health and social care practice worldwide. Ensuring effective collaboration between health and social care is essential to meet population health needs- especially during crisis. Interprofessional education for collaborative practice (IPECP) during students' pre-licensure education is an important primer for collaboration in practice. Within IPECP, students are provided opportunities to learn about, with, and from each other, lending to professional and interprofessional socialization and processes of developing an interprofessional identity. Few studies have followed health professions graduates longitudinally from pre-licensure into professional practice to understand how IPECP supports new professionals' readiness for collaborative practice. The COVID-19 pandemic coincided with the timing of this longitudinal study of students' experiences of IPECP and collaboration upon entry to practice. This interpretive, narrative analysis provides novel insights to how collaboration was experienced during the pandemic and implications for interprofessional identity development. The participant narratives provide insight into the contexts, settings, and experiences that were critical catalysts for connection and collaboration between professionals. Findings support a need for IPECP throughout pre-licensure and into practice and provides important direction for innovative curricula, policy and practice development to prepare future collaborative practitioners and interprofessional teams.

In recent years, artificial intelligence (AI) has become more important in healthcare. It has the ability to completely change how patients are diagnosed, treated, and cared for. To make sure AI is properly supervised in healthcare, many problems need to be solved. This calls for a broad approach that includes policy, technology, and involving important people. This study investigates the governance of AI within healthcare, highlighting the importance of policy, technology, and stakeholder engagement. Adopting a mixed-methods research design, the study encompasses surveys, interviews, and document analysis to comprehensively explore diverse perspectives on AI governance. Purposive sampling techniques were employed to gather 897 valid samples, ensuring diversity across stakeholder groups. Surveys gathered quantitative data on demographic characteristics and attitudes toward AI governance, while interviews provided deeper insights into stakeholders' experiences and recommendations. Document analysis supplemented data collection by reviewing policy documents, guidelines, and academic literature related to AI governance. This study merges quantitative and qualitative data to thoroughly investigate AI governance, enabling the identification of policy implications and actionable recommendations. This study contributes novel insights by adopting a comprehensive approach to AI governance in healthcare, integrating policy, technology, and stakeholder engagement perspectives. Unlike previous studies focusing solely on individual aspects of AI governance, this research provides a holistic understanding of the complex dynamics involved. This research offers important insights into AI governance by investigating the impact of stakeholder engagement, ethical considerations, digital health disparities, governance structures, and health communication strategies on AI integration in healthcare, ultimately aiding in policy development and implementation.