Andrea Bonomi Savignon, Lorenzo Costumato, Fabiana Scalabrini, Maddalena Sanchietti
Purpose
Bouckaert and Halligan (2008) proposed four ideal types of performance management systems, ranging from a disconnected and input-led approach (performance administration) to a model in which performance management is fully integrated with both the internal and external context of an organisation (performance governance). This article empirically analyzes performance plans issued by Italian Local Health Units (LHUs) to provide a first nationwide snapshot of the different ideal-types of performance management that each (LHUs) have reached, in a ‘performance governance’-oriented perspective.
Design
This paper employs a qualitative methodology based on document analysis. The model orienting the analysis features six dimensions capturing the ideal-types characteristics and what the Italian performance regulations prescribe. Data was derived from the performance plans adopted by the Italian LHUs on the condition that they made the documentation necessary for the analysis public on their institutional website.
Findings
For a ‘performance governance’ oriented approach, two elements are considered relevant: familiarity with the analysis of stakeholders and context. In our sample, consisting of 63 performance plans out of 99 Italian LHUs, it was challenging to identify specific territorial clusters, due to significant heterogeneity. The role of strategic objectives, integration between cycles, and context analysis seems to positively influence the orientation towards a ‘performance governance’ approach.
Originality/Value
The application of Bouckaert and Halligan's ideal-types has only been episodically investigated in the healthcare sector, mainly at the individual health unit or Region level. This article's innovative contribution consists of conducting a qualitative analysis based on a replicable taxonomy that enables further national comparisons. Furthermore, it highlights the need for public healthcare systems to engage more with external stakeholders to improve the quality of their performance governance.
{"title":"Towards performance governance in healthcare: An analysis of Italian local health units","authors":"Andrea Bonomi Savignon, Lorenzo Costumato, Fabiana Scalabrini, Maddalena Sanchietti","doi":"10.1002/hpm.3844","DOIUrl":"10.1002/hpm.3844","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Bouckaert and Halligan (2008) proposed four ideal types of performance management systems, ranging from a disconnected and input-led approach (performance administration) to a model in which performance management is fully integrated with both the internal and external context of an organisation (performance governance). This article empirically analyzes performance plans issued by Italian Local Health Units (LHUs) to provide a first nationwide snapshot of the different ideal-types of performance management that each (LHUs) have reached, in a ‘performance governance’-oriented perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This paper employs a qualitative methodology based on document analysis. The model orienting the analysis features six dimensions capturing the ideal-types characteristics and what the Italian performance regulations prescribe. Data was derived from the performance plans adopted by the Italian LHUs on the condition that they made the documentation necessary for the analysis public on their institutional website.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>For a ‘performance governance’ oriented approach, two elements are considered relevant: familiarity with the analysis of stakeholders and context. In our sample, consisting of 63 performance plans out of 99 Italian LHUs, it was challenging to identify specific territorial clusters, due to significant heterogeneity. The role of strategic objectives, integration between cycles, and context analysis seems to positively influence the orientation towards a ‘performance governance’ approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Originality/Value</h3>\u0000 \u0000 <p>The application of Bouckaert and Halligan's ideal-types has only been episodically investigated in the healthcare sector, mainly at the individual health unit or Region level. This article's innovative contribution consists of conducting a qualitative analysis based on a replicable taxonomy that enables further national comparisons. Furthermore, it highlights the need for public healthcare systems to engage more with external stakeholders to improve the quality of their performance governance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1819-1839"},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ariane Bauernfeind, John Reid, Alison Mccallum, Mohamud Sheek-Hussein, Avi Magid, Henrique Lopes, Colette Cunningham, Manfred S. Green, Meri Koivusalo, Amitabha Sarkar, John Middleton, Nadav Davidovitch
<p>The 77th World Health Assembly (WHA) concluded in June 2024, and global leaders have shared their reflections, drawing lessons from COVID-19 that highlight common shortcomings. These include deficiencies in research and development, technology transfer, access and benefit-sharing, supply chain logistics, regulatory enhancements, and international coordination and communication.<span><sup>1</sup></span> Ironically, these very issues have stalled progress on the pandemic agreement. What lies ahead? Will delays in preparation prove costly?</p><p>While not meeting treaty or convention status, the Pandemic Agreement is evolving into a comprehensive global framework for pandemic prevention, preparedness, and response. From a global public health and security perspective, expanding beyond superficial statements of readiness is necessary. Critical aspects must accelerate. We consider five key challenges below:</p><p>Global pandemic preparedness demands greater urgency and unity, to ensure an early Pandemic Agreement that allows strong measurable progress. The former co-chairs of the Independent Panel for Pandemic Preparedness and Response (IPPR) urged leaders to unite,<span><sup>2</sup></span> act promptly during the interpandemic period, and there is ‘no time to gamble’.<span><sup>3</sup></span> The Association of Schools of Public Health in the European Region (ASPHER), with the Global Network for Academic Public Health (GNAPH), advocates for strengthening national and global health systems to enhance preparedness, response, and resilience against future pandemics. This involves substantial investment in healthcare infrastructure, workforce training, public health surveillance systems and research, development and improvements in practice.<span><sup>4</sup></span></p><p>Timely implementation of multiple preparedness measures is crucial to prevent and mitigate the impacts of future pandemics. Building and maintaining public trust through transparent communication and community engagement is fundamental. ASPHER underscores the role of public health institutions in fostering trust and confidence in pandemic-related health measures. Modern public health countermeasures and health technologies helped mitigate losses during COVID-19 compared to historic plagues, but preparedness and response could have been much better.</p><p>The proposed Pandemic Agreement needs concrete action and should complement International Health Regulations, and other WHO and UN treaties, aiming for a cohesive approach to global health emergencies and wider disasters, as outlined in the Sendai Framework for Disaster Risk Reduction (DRR).<span><sup>5</sup></span> The Global Assessment Report 2023 on DRR <span><sup>6</sup></span> highlights how conflicts and humanitarian disasters are reversing global development, indicating the need to link pandemic preparedness to wider threats where possible.</p><p>Countries need to prioritise pandemic responses based on their populations' needs
{"title":"No time to lose: Pandemic agreement—Urgency over complacency; unity over fragmentation","authors":"Ariane Bauernfeind, John Reid, Alison Mccallum, Mohamud Sheek-Hussein, Avi Magid, Henrique Lopes, Colette Cunningham, Manfred S. Green, Meri Koivusalo, Amitabha Sarkar, John Middleton, Nadav Davidovitch","doi":"10.1002/hpm.3847","DOIUrl":"10.1002/hpm.3847","url":null,"abstract":"<p>The 77th World Health Assembly (WHA) concluded in June 2024, and global leaders have shared their reflections, drawing lessons from COVID-19 that highlight common shortcomings. These include deficiencies in research and development, technology transfer, access and benefit-sharing, supply chain logistics, regulatory enhancements, and international coordination and communication.<span><sup>1</sup></span> Ironically, these very issues have stalled progress on the pandemic agreement. What lies ahead? Will delays in preparation prove costly?</p><p>While not meeting treaty or convention status, the Pandemic Agreement is evolving into a comprehensive global framework for pandemic prevention, preparedness, and response. From a global public health and security perspective, expanding beyond superficial statements of readiness is necessary. Critical aspects must accelerate. We consider five key challenges below:</p><p>Global pandemic preparedness demands greater urgency and unity, to ensure an early Pandemic Agreement that allows strong measurable progress. The former co-chairs of the Independent Panel for Pandemic Preparedness and Response (IPPR) urged leaders to unite,<span><sup>2</sup></span> act promptly during the interpandemic period, and there is ‘no time to gamble’.<span><sup>3</sup></span> The Association of Schools of Public Health in the European Region (ASPHER), with the Global Network for Academic Public Health (GNAPH), advocates for strengthening national and global health systems to enhance preparedness, response, and resilience against future pandemics. This involves substantial investment in healthcare infrastructure, workforce training, public health surveillance systems and research, development and improvements in practice.<span><sup>4</sup></span></p><p>Timely implementation of multiple preparedness measures is crucial to prevent and mitigate the impacts of future pandemics. Building and maintaining public trust through transparent communication and community engagement is fundamental. ASPHER underscores the role of public health institutions in fostering trust and confidence in pandemic-related health measures. Modern public health countermeasures and health technologies helped mitigate losses during COVID-19 compared to historic plagues, but preparedness and response could have been much better.</p><p>The proposed Pandemic Agreement needs concrete action and should complement International Health Regulations, and other WHO and UN treaties, aiming for a cohesive approach to global health emergencies and wider disasters, as outlined in the Sendai Framework for Disaster Risk Reduction (DRR).<span><sup>5</sup></span> The Global Assessment Report 2023 on DRR <span><sup>6</sup></span> highlights how conflicts and humanitarian disasters are reversing global development, indicating the need to link pandemic preparedness to wider threats where possible.</p><p>Countries need to prioritise pandemic responses based on their populations' needs","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1810-1818"},"PeriodicalIF":1.9,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3847","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinicians in the emergency department (ED) frequently encounter seriously ill patients at a time when advance directives may be pivotal in improved clinician decision-making. The objectives of this study were to identify the prevalence of advanced directives in ED patients, as well as patterns of advance care discussions between patients and providers. This study describes patients' perceptions and expectations of such serious illness discussions in an emergency care setting with the expectation of including patients as strategic members of the care team.
Methods
Trained research assistants in two emergency departments surveyed patients over age 65, or their caregivers, from July 2016 to August 2018. Patients were verbally administered a standard survey tool related to advance directives and advance care planning.
Results
497 out of 877 patients completed surveys (59.4%). 50% of patients reported having an advance care planning document. The large majority (92%) of patients with an advance directive had not been asked about it during their ED visit. When questioned about their personal preferences, 79% of patients thought emergency physicians should be aware of their wishes regarding life-sustaining treatments and end-of-life care. Paradoxically, only 38% expressed a desire to discuss advance care plans with an ED clinician.
Conclusions
Older patients expect emergency clinicians to be aware of their care preferences, yet most are not asked about these care preferences in the ED. The large gap between patient preference and reality suggests the need for more targeted discussion by ED clinicians and translation of patient perspectives into system healthcare improvements. Future studies should explore barriers to advance care planning in the ED as well as patient preferences for these conversations to support a true healthcare learning system.
{"title":"Care conundrum in the emergency department: The gap between clinician awareness and patient expectations surrounding advance directives","authors":"Rita A. Manfredi, Jessica Riley, Beverly Lunsford","doi":"10.1002/hpm.3833","DOIUrl":"10.1002/hpm.3833","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Clinicians in the emergency department (ED) frequently encounter seriously ill patients at a time when advance directives may be pivotal in improved clinician decision-making. The objectives of this study were to identify the prevalence of advanced directives in ED patients, as well as patterns of advance care discussions between patients and providers. This study describes patients' perceptions and expectations of such serious illness discussions in an emergency care setting with the expectation of including patients as strategic members of the care team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Trained research assistants in two emergency departments surveyed patients over age 65, or their caregivers, from July 2016 to August 2018. Patients were verbally administered a standard survey tool related to advance directives and advance care planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>497 out of 877 patients completed surveys (59.4%). 50% of patients reported having an advance care planning document. The large majority (92%) of patients with an advance directive had not been asked about it during their ED visit. When questioned about their personal preferences, 79% of patients thought emergency physicians should be aware of their wishes regarding life-sustaining treatments and end-of-life care. Paradoxically, only 38% expressed a desire to discuss advance care plans with an ED clinician.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older patients expect emergency clinicians to be aware of their care preferences, yet most are not asked about these care preferences in the ED. The large gap between patient preference and reality suggests the need for more targeted discussion by ED clinicians and translation of patient perspectives into system healthcare improvements. Future studies should explore barriers to advance care planning in the ED as well as patient preferences for these conversations to support a true healthcare learning system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1778-1789"},"PeriodicalIF":1.9,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Flávio de Freitas Almeida, Samuel Vieira Conceição, Virgínia Silva Magalhães, Márcia Mascarenhas Alemão
While the estimate of hospital costs concerns the past, its planning focuses on the future. However, in many low and middle-income countries, public hospitals do not have robust accounting health systems to evaluate and project their expenses. In Brazil, public hospitals are funded based on government estimates of available hospital infrastructure, historical expenditures and population needs. However, these pieces of information are not always readily available for all hospitals. To solve this challenge, we propose a flexible simulation-based optimisation algorithm that integrates this dual task: estimating and planning hospital costs. The method was applied to a network of 17 public hospitals in Brazil to produce the estimates. Setting the model parameters for population needs and future hospital infrastructure can be used as a cost-projection tool for divestment, maintenance, or investment. Results show that the method can aid health managers in hospitals' global budgeting and policymakers in improving fairness in hospitals' financing.
{"title":"Estimating and planning hospital costs of public hospitals in Brazil","authors":"João Flávio de Freitas Almeida, Samuel Vieira Conceição, Virgínia Silva Magalhães, Márcia Mascarenhas Alemão","doi":"10.1002/hpm.3840","DOIUrl":"10.1002/hpm.3840","url":null,"abstract":"<p>While the estimate of hospital costs concerns the past, its planning focuses on the future. However, in many low and middle-income countries, public hospitals do not have robust accounting health systems to evaluate and project their expenses. In Brazil, public hospitals are funded based on government estimates of available hospital infrastructure, historical expenditures and population needs. However, these pieces of information are not always readily available for all hospitals. To solve this challenge, we propose a flexible simulation-based optimisation algorithm that integrates this dual task: estimating and planning hospital costs. The method was applied to a network of 17 public hospitals in Brazil to produce the estimates. Setting the model parameters for population needs and future hospital infrastructure can be used as a cost-projection tool for divestment, maintenance, or investment. Results show that the method can aid health managers in hospitals' global budgeting and policymakers in improving fairness in hospitals' financing.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1790-1809"},"PeriodicalIF":1.9,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the Trump administration it was widely asserted in the news media that the administration's agency appointees were less professional than appointees from previous administrations. Using qualitative data from 35 interviews with lobbyists, congressional staffers, and executive branch officials, and quantitative and qualitative data on years of relevant experience and job type at the date of nomination, it is demonstrated that indeed the Trump administration attracted less talent than the Obama and Biden administrations, which resulted in less supply and demand for expertise and thus a diminished role of expertise in the policymaking process.
{"title":"Variation in levels of professionalism in healthcare policymaking during the Obama, Trump, and Biden administrations","authors":"Sergei S. Kostiaev","doi":"10.1002/hpm.3841","DOIUrl":"10.1002/hpm.3841","url":null,"abstract":"<p>During the Trump administration it was widely asserted in the news media that the administration's agency appointees were less professional than appointees from previous administrations. Using qualitative data from 35 interviews with lobbyists, congressional staffers, and executive branch officials, and quantitative and qualitative data on years of relevant experience and job type at the date of nomination, it is demonstrated that indeed the Trump administration attracted less talent than the Obama and Biden administrations, which resulted in less supply and demand for expertise and thus a diminished role of expertise in the policymaking process.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1771-1777"},"PeriodicalIF":1.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Ahmed Abdullah, Babar Tasneem Shaikh, Shahzad Ali Khan
Pakistan's health system has a critical role to play in global health security, however, it faces numerous structural and systemic challenges while contributing to international health efforts. Understanding the dynamics of health system is essential for developing effective strategies to prevent, detect, and respond to health emergencies, ensuring regional stability, and the overall global health security This paper documents the strengths and weaknesses of Pakistan's health systems, the impact of the COVID-19 pandemic, challenges such as funding constraints and fragmented healthcare delivery, threats including antimicrobial resistance, and the importance of international collaboration. Anti-microbial particularly multi-drug resistance, food safety in emergencies, surge capacity of the frontline workforce, patient safety at the health care facilities to curtail healthcare associated infections, and strengthening the points of entry are still the areas that need special attention. To optimise the system's performance, governance and accountability mechanisms are necessary to be put in place under the auspices of national public health agency. Pakistan has the potential to transform its health system by addressing these critical areas and improve its preparedness and readiness for any future health emergency of this scale.
{"title":"Piecing together Pakistan's health system and global health security","authors":"Muhammad Ahmed Abdullah, Babar Tasneem Shaikh, Shahzad Ali Khan","doi":"10.1002/hpm.3845","DOIUrl":"10.1002/hpm.3845","url":null,"abstract":"<p>Pakistan's health system has a critical role to play in global health security, however, it faces numerous structural and systemic challenges while contributing to international health efforts. Understanding the dynamics of health system is essential for developing effective strategies to prevent, detect, and respond to health emergencies, ensuring regional stability, and the overall global health security This paper documents the strengths and weaknesses of Pakistan's health systems, the impact of the COVID-19 pandemic, challenges such as funding constraints and fragmented healthcare delivery, threats including antimicrobial resistance, and the importance of international collaboration. Anti-microbial particularly multi-drug resistance, food safety in emergencies, surge capacity of the frontline workforce, patient safety at the health care facilities to curtail healthcare associated infections, and strengthening the points of entry are still the areas that need special attention. To optimise the system's performance, governance and accountability mechanisms are necessary to be put in place under the auspices of national public health agency. Pakistan has the potential to transform its health system by addressing these critical areas and improve its preparedness and readiness for any future health emergency of this scale.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1766-1770"},"PeriodicalIF":1.9,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christos Ntais, Polidefkis Stavrou, John Fanourgiakis, Michael A. Talias, Nikolaos Kontodimopoulos
Background
The aim of this study is to examine the perceptions of Cypriot medical tourism experts regarding the phenomenon of medical tourism, as well as to emphasise the benefits and opportunities for Cyprus to become a highly competitive global healthcare destination.
Methods
A Delphi study was conducted in Cyprus, with the participation of 20 experts in the field of medical tourism. At first, 20 experts took part in semi-structured interviews. Based on their feedback provided during that phase, a structured questionnaire was drawn up and completed, addressing a wide variety of medical tourism-related issues, such as benefits and losses from the development of medical tourism in Cyprus, advantages and disadvantages of Cyprus in attracting international patients, the key elements of a medium- to long-term strategic plan for the development of medical tourism in Cyprus, the role of the public and private sector and the importance of international accreditation of private and public hospitals.
Results
Cyprus appears to have some very favourable qualities when it comes to its listing as a competitive destination for medical travellers. Undeniably, the growth of medical tourism improves all sectors of the economy and society, but the healthcare industry is the one that benefits most. On the opposite end, medical tourism could potentially impact the access of local people to healthcare services. No clear answers were given by the expert respondents on the need for international accreditation of healthcare providers in Cyprus.
Conclusion
The competent authorities should promote Cyprus to international markets as a medical tourism destination of choice, upgrading the quality of healthcare services it provides having due regard in parallel to any potential impacts to the access of local population to the healthcare system.
{"title":"Sustainable medical tourism in the global competitive environment: The case of Cyprus","authors":"Christos Ntais, Polidefkis Stavrou, John Fanourgiakis, Michael A. Talias, Nikolaos Kontodimopoulos","doi":"10.1002/hpm.3843","DOIUrl":"10.1002/hpm.3843","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study is to examine the perceptions of Cypriot medical tourism experts regarding the phenomenon of medical tourism, as well as to emphasise the benefits and opportunities for Cyprus to become a highly competitive global healthcare destination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Delphi study was conducted in Cyprus, with the participation of 20 experts in the field of medical tourism. At first, 20 experts took part in semi-structured interviews. Based on their feedback provided during that phase, a structured questionnaire was drawn up and completed, addressing a wide variety of medical tourism-related issues, such as benefits and losses from the development of medical tourism in Cyprus, advantages and disadvantages of Cyprus in attracting international patients, the key elements of a medium- to long-term strategic plan for the development of medical tourism in Cyprus, the role of the public and private sector and the importance of international accreditation of private and public hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cyprus appears to have some very favourable qualities when it comes to its listing as a competitive destination for medical travellers. Undeniably, the growth of medical tourism improves all sectors of the economy and society, but the healthcare industry is the one that benefits most. On the opposite end, medical tourism could potentially impact the access of local people to healthcare services. No clear answers were given by the expert respondents on the need for international accreditation of healthcare providers in Cyprus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The competent authorities should promote Cyprus to international markets as a medical tourism destination of choice, upgrading the quality of healthcare services it provides having due regard in parallel to any potential impacts to the access of local population to the healthcare system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1757-1765"},"PeriodicalIF":1.9,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing over-the-counter headache medicine counselling: Lessons from Germany and implications for Taiwan","authors":"Lien-Chung Wei","doi":"10.1002/hpm.3842","DOIUrl":"10.1002/hpm.3842","url":null,"abstract":"","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1755-1756"},"PeriodicalIF":1.9,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Struhar, Taylor Walters, Kristen Gracz, Mansi Sheth, Andrea Fernandez, Courtney Lopez, Tiago S. Jesus
Purpose
Near real-time patient experience feedback (NRTPEF) can enable a patient-centric, immediate service recovery but has not been widely used in inpatient rehabilitation. We 1) assess the utility, feasibility, and acceptability of implementing a new NRTPEF, perceived by patients and providers; and 2) understand how the NRTPEF became embedded into routine provider practices.
Materials and Methods
Mixed methods process evaluation of the 8-month implementation of an innovative NRTPEF in an inpatient rehabilitation unit, using interviews and focus groups with all the service-unit leaders and interviews with a randomised sample of patients. Beyond descriptive statistics and content analysis, the Normalisation Process Theory (NPT) informed a framework analysis.
Results
Patients and service-unit leaders perceived high utility in the NRTPEF (median: 9 for both; 0–10 scale) and qualitative comments emphasised the value of providing/obtaining timely feedback. The system was found feasible and acceptable for patients (median: 9.5), but with an improvement margin for providers (median: 7.3). Suggestions include strengthening the data-relay format. Even in the pilot form, providers found the NRTPEF became embedded into practice (median 10; average: 8.6). The analysis based on the NPT shows how providers saw differential value, engaged with, and used the patient feedback into reconfigured practices.
Conclusion
An innovative NRTPEF was found useful, feasible and acceptable, but with refinement opportunities before scale-up.
{"title":"Implementing a real-time patient experience feedback in inpatient rehabilitation: Process evaluation informed by the normalisation process theory","authors":"Jan Struhar, Taylor Walters, Kristen Gracz, Mansi Sheth, Andrea Fernandez, Courtney Lopez, Tiago S. Jesus","doi":"10.1002/hpm.3832","DOIUrl":"10.1002/hpm.3832","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Near real-time patient experience feedback (NRTPEF) can enable a patient-centric, immediate service recovery but has not been widely used in inpatient rehabilitation. We 1) assess the utility, feasibility, and acceptability of implementing a new NRTPEF, perceived by patients and providers; and 2) understand how the NRTPEF became embedded into routine provider practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Mixed methods process evaluation of the 8-month implementation of an innovative NRTPEF in an inpatient rehabilitation unit, using interviews and focus groups with all the service-unit leaders and interviews with a randomised sample of patients. Beyond descriptive statistics and content analysis, the Normalisation Process Theory (NPT) informed a framework analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients and service-unit leaders perceived high utility in the NRTPEF (median: 9 for both; 0–10 scale) and qualitative comments emphasised the value of providing/obtaining timely feedback. The system was found feasible and acceptable for patients (median: 9.5), but with an improvement margin for providers (median: 7.3). Suggestions include strengthening the data-relay format. Even in the pilot form, providers found the NRTPEF became embedded into practice (median 10; average: 8.6). The analysis based on the NPT shows how providers saw differential value, engaged with, and used the patient feedback into reconfigured practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An innovative NRTPEF was found useful, feasible and acceptable, but with refinement opportunities before scale-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1737-1754"},"PeriodicalIF":1.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3832","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to determine the indicators of tobacco use in Türkiye within a multidimensional context as socio-demographic, physical, behavioural, and psychological as a response to the tobacco control policies.
Methods
The Turkish Health Survey data in 2014 and 2019 are employed within a probit model approach and the differences in tobacco are decomposed use by gender in order to reveal the gender differences. The samples in 2014 (total n = 19,129; males = 8 721, females = 10,408) and 2019 (total n = 17,084; males = 7 784, females = 9300) were restricted to 15-year-old and above.
Results
The findings indicate that being in the 30–49 age cohort, having lower education, and being married increase the likelihood of tobacco use. Future policies and campaigns should specifically target the single, pre-obese, employed males who consume alcohol. For females, the gender-specific policies should aim to reduce the prevalence of smoking, especially among separated or widows, obese, and out of the labour force. The contribution of mental health indicators on tobacco use has declined over the 5 years, which could be a result of the supportive free health services in Türkiye. The findings provide evidence for a significant and increasing gender difference in tobacco use in Türkiye along with reporting that the most significant contributors to gender differences in tobacco use are alcohol consumption and education level.
Conclusion
Even though the Ministry of Health and the government have been implementing anti-tobacco policies, legislations, and campaigns for years, the tobacco use prevalence has remained high and even increased in Türkiye.
{"title":"Tobacco control policies and the multidimensional context of tobacco use by gender: The case of Türkiye","authors":"Ebru Caglayan-Akay, Merve Ertok-Onurlu, Fulden Komuryakan","doi":"10.1002/hpm.3835","DOIUrl":"10.1002/hpm.3835","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine the indicators of tobacco use in Türkiye within a multidimensional context as socio-demographic, physical, behavioural, and psychological as a response to the tobacco control policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Turkish Health Survey data in 2014 and 2019 are employed within a probit model approach and the differences in tobacco are decomposed use by gender in order to reveal the gender differences. The samples in 2014 (total <i>n</i> = 19,129; males = 8 721, females = 10,408) and 2019 (total <i>n</i> = 17,084; males = 7 784, females = 9300) were restricted to 15-year-old and above.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicate that being in the 30–49 age cohort, having lower education, and being married increase the likelihood of tobacco use. Future policies and campaigns should specifically target the single, pre-obese, employed males who consume alcohol. For females, the gender-specific policies should aim to reduce the prevalence of smoking, especially among separated or widows, obese, and out of the labour force. The contribution of mental health indicators on tobacco use has declined over the 5 years, which could be a result of the supportive free health services in Türkiye. The findings provide evidence for a significant and increasing gender difference in tobacco use in Türkiye along with reporting that the most significant contributors to gender differences in tobacco use are alcohol consumption and education level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Even though the Ministry of Health and the government have been implementing anti-tobacco policies, legislations, and campaigns for years, the tobacco use prevalence has remained high and even increased in Türkiye.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1584-1602"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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