In many countries, including China, private insurers are increasingly involved in public long-term care insurance (LTCI) to stimulate its functioning. Our article examines this novel approach from an economic perspective. We then use this framework to evaluate the risk differentiation and control practices of China's 15 LTCI pilots. Using these practical cases, we find that the private insurers' strategies for risk differentiation and control of adverse selection should be restricted, as they may contradict the public policy goals of solidarity and equal access to long-term care. Conversely, the strategies to address moral hazard, particularly in case of small risks and when carefully designed, could better reconcile the public policy goal with the economic goals of cost reduction and providing incentives to avoid overutilisation. Overall, a better strategy may enable private insurers to efficiently utilise their risk management capacity, without severely undermining the public aims of LTCI.
{"title":"Can Private Insurers Stimulate the Function of Public Long-Term Care Insurance? Insights From China","authors":"Yu Yan, Michael G. Faure","doi":"10.1002/hpm.3933","DOIUrl":"10.1002/hpm.3933","url":null,"abstract":"<div>\u0000 \u0000 <p>In many countries, including China, private insurers are increasingly involved in public long-term care insurance (LTCI) to stimulate its functioning. Our article examines this novel approach from an economic perspective. We then use this framework to evaluate the risk differentiation and control practices of China's 15 LTCI pilots. Using these practical cases, we find that the private insurers' strategies for risk differentiation and control of adverse selection should be restricted, as they may contradict the public policy goals of solidarity and equal access to long-term care. Conversely, the strategies to address moral hazard, particularly in case of small risks and when carefully designed, could better reconcile the public policy goal with the economic goals of cost reduction and providing incentives to avoid overutilisation. Overall, a better strategy may enable private insurers to efficiently utilise their risk management capacity, without severely undermining the public aims of LTCI.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"923-934"},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765416","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}
Giorgi Aladashvili, Mariam Kirvalidze, Aleksandre Tskitishvili, Nikoloz Chelidze, Nikoloz Tvildiani, Giorgi Pkhakadze, Thomas J. Bossert, Karsten Lunze, Ilia Nadareishvili
Health workforce planning is essential for ensuring a resilient and well-functioning healthcare system capable of addressing population needs and responding to crises. In Georgia, an upper-middle-income country, significant challenges remain in the strategic planning, regulation, and management of the health workforce. This policy analysis evaluated health workforce planning approaches in Georgia's dynamic health system context. Health workforce planning in Georgia, guided by the National Health Strategy 2022–2030, prioritises needs-based workforce planning, professional qualifications, and nursing development. However, Georgia faces data inconsistencies, workforce imbalances, and an uneven geographic distribution of healthcare professionals, limiting the efficacy of current policies. The lack of formal health workforce planning, reliance on market-driven approaches, and weak retention strategies contribute to workforce shortages and migration. A centralised planning body, and enhancement in data collection and management, could facilitate the gradual introduction of context-relevant, evidence-based workforce planning methods. By integrating rigorous, long-term workforce planning with intersectoral collaboration and adopting innovative methods like workload-based modelling and hybrid planning methods, Georgia can create a sustainable health workforce aligned with its health system's evolving needs.
{"title":"Strengthening Health Workforce in Georgia: Identifying Gaps and Integrating Evidence-Based Strategic Planning","authors":"Giorgi Aladashvili, Mariam Kirvalidze, Aleksandre Tskitishvili, Nikoloz Chelidze, Nikoloz Tvildiani, Giorgi Pkhakadze, Thomas J. Bossert, Karsten Lunze, Ilia Nadareishvili","doi":"10.1002/hpm.3922","DOIUrl":"10.1002/hpm.3922","url":null,"abstract":"<p>Health workforce planning is essential for ensuring a resilient and well-functioning healthcare system capable of addressing population needs and responding to crises. In Georgia, an upper-middle-income country, significant challenges remain in the strategic planning, regulation, and management of the health workforce. This policy analysis evaluated health workforce planning approaches in Georgia's dynamic health system context. Health workforce planning in Georgia, guided by the National Health Strategy 2022–2030, prioritises needs-based workforce planning, professional qualifications, and nursing development. However, Georgia faces data inconsistencies, workforce imbalances, and an uneven geographic distribution of healthcare professionals, limiting the efficacy of current policies. The lack of formal health workforce planning, reliance on market-driven approaches, and weak retention strategies contribute to workforce shortages and migration. A centralised planning body, and enhancement in data collection and management, could facilitate the gradual introduction of context-relevant, evidence-based workforce planning methods. By integrating rigorous, long-term workforce planning with intersectoral collaboration and adopting innovative methods like workload-based modelling and hybrid planning methods, Georgia can create a sustainable health workforce aligned with its health system's evolving needs.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"993-1001"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755091","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}
Odii A, Hutchinson E, Onwujekwe O, et al. ‘Government don't know me and if I stop, they won't know’: A qualitative study on the lived experiences of volunteer health workers in the Nigerian health system and their implications for the sustainable development goals. Int J Health Plann Mgmt. 2024; 39(3): 689–707. https://doi.org/10.1002/hpm.3783.
The acknowledgement is currently incorrect.
It currently reads:
This work was supported by a research grant from the Health Systems Research Initiative with funding from the UK Department for International Development, the UK Medical Research Council and the Wellcome Trust with support from the UK Economic and Social Research Council (grant no. MR/T023589/1). We thank all the participants for taking out time to participate in the study.
It should read:
This work was supported by a research grant from the Health Systems Research Initiative with funding from the UK Foreign, Commonwealth & Development Office (FCDO), the Medical Research Council (MRC) and Wellcome, with support from the UK Economic and Social Research Council, (grant number MR/T023589/1). We thank all the participants for taking out time to participate in the study.
We apologise for this error.
Odii A, Hutchinson E， Onwujekwe O等人。“政府不认识我，如果我停止，他们也不会知道”：尼日利亚卫生系统志愿卫生工作者的生活经历及其对可持续发展目标的影响的定性研究。国际卫生计划管理。2024；39(3): 689 - 707。https://doi.org/10.1002/hpm.3783.The确认目前不正确。它目前是这样写的：这项工作得到了卫生系统研究计划的研究资助，由英国国际发展部、英国医学研究理事会和威康信托基金资助，并得到了英国经济和社会研究理事会的支持(资助号：先生/ T023589/1)。感谢所有参与者抽出宝贵时间参与本次研究。它应该是这样写的：这项工作得到了卫生系统研究倡议的研究资助，资金来自英国外交，联邦和；发展办公室（FCDO）、医学研究委员会（MRC）和惠康基金会，在英国经济和社会研究委员会的支持下（资助号MR/T023589/1）。感谢所有参与者抽出宝贵时间参与本次研究。我们为这个错误道歉。
{"title":"Correction to ‘Government Don't Know Me and if I Stop, They Won't Know’: A Qualitative Study on the Lived Experiences of Volunteer Health Workers in the Nigerian Health System and Their Implications for the Sustainable Development Goal","authors":"","doi":"10.1002/hpm.3930","DOIUrl":"10.1002/hpm.3930","url":null,"abstract":"<p>Odii A, Hutchinson E, Onwujekwe O, et al. ‘Government don't know me and if I stop, they won't know’: A qualitative study on the lived experiences of volunteer health workers in the Nigerian health system and their implications for the sustainable development goals. <i>Int J Health Plann Mgmt</i>. 2024; 39(3): 689–707. https://doi.org/10.1002/hpm.3783.</p><p>The acknowledgement is currently incorrect.</p><p>It currently reads:</p><p>This work was supported by a research grant from the Health Systems Research Initiative with funding from the <b>UK Department for International Development</b>, the UK Medical Research Council and the Wellcome Trust with support from the UK Economic and Social Research Council (grant no. MR/T023589/1). We thank all the participants for taking out time to participate in the study.</p><p>It should read:</p><p>This work was supported by a research grant from the Health Systems Research Initiative with funding from the UK Foreign, Commonwealth & Development Office (FCDO), the Medical Research Council (MRC) and Wellcome, with support from the UK Economic and Social Research Council, (grant number MR/T023589/1). We thank all the participants for taking out time to participate in the study.</p><p>We apologise for this error.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693947","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}
Alex Braybrooke, Melissa Pegg, Rebecca Naylor, James Bailey, James Scott, Roanna Burgess, Dahai Yu, Simon Wathall, Kelvin P. Jordan, Robert Malcolm, Hayden Holmes, George Peat, Anirban Banerjee, Jonathan C. Hill
Background
Healthcare accounts for up to 5% of worldwide carbon emissions and costs global economies an estimated $9 trillion annually. Primary care accounts for up to one-fifth of all NHS carbon emissions, with musculoskeletal (MSK) pain accounting for 14%–30% of all primary care consultations.
Method
A cost-carbon calculator model was used to undertake a retrospective economic and environmental analysis of resource use for non-inflammatory MSK pain primary care consulters. Data used to populate the model was derived from Electronic Health Records and patient surveys collected during The Multi-level Integrated Data for Musculoskeletal Health Intelligence and ActionS GP Study. The model was utilised to estimate the mean (with 95%CI's) cost and carbon output per MSK consulter, while also examining variations at two levels: (a) the Primary Care Network (PCN), and (b) the consulter's index MSK pain site.
Results
One thousand eight hundred seventy-five individuals from 30 NHS primary care practices across 13 PCNs were eligible for EHR and survey data analysis. The mean carbon and cost output per person (over 6 months) was 46.91 kg CO2e (95% CIs; 45.02, 48.81 kg CO2e) and £182.65 (95% CIs; £178.69, £190.62), respectively, with substantial variation observed across PCNs. The resource category with the highest carbon footprint was consistently pharmacological intervention across all PCNs. Individuals who consulted for multisite/widespread pain and back pain had the highest mean carbon and cost output respectively.
Conclusion
This is the first study, we are aware of, that presents data on both the environmental and economic impact of the primary care of non-inflammatory MSK pain. Future work should focus on benchmarking the cost and carbon output of MSK care pathways and standardising methods that are implemented to influence sustainable practice and policy development.
背景：医疗保健占全球碳排放量的5%，每年给全球经济造成约9万亿美元的损失。初级保健占NHS所有碳排放量的五分之一，肌肉骨骼（MSK）疼痛占所有初级保健咨询的14%-30%。方法：采用成本-碳计算器模型对非炎症性MSK疼痛初级保健咨询师的资源使用进行回顾性经济和环境分析。用于填充模型的数据来自电子健康记录和患者调查，这些数据是在“肌肉骨骼健康情报和行动GP研究的多层次集成数据”中收集的。该模型用于估计每个MSK咨询师的平均（95%CI）成本和碳排放量，同时还检查了两个水平的变化：(a)初级保健网络（PCN）和(b)咨询师的MSK疼痛部位指数。结果：来自13个pcn的30个NHS初级保健实践的1875个人符合电子病历和调查数据分析的条件。每人（超过6个月）的平均碳和成本产出为46.91 kg CO2e (95% ci；45.02, 48.81千克二氧化碳当量)和182.65英镑(95% ci；分别为178.69英镑和190.62英镑)，不同pcn之间的差异很大。在所有pcn中，碳足迹最高的资源类别始终是药物干预。咨询多部位/广泛性疼痛和背部疼痛的个体分别具有最高的平均碳和成本产出。结论：这是我们所知的第一项研究，提供了非炎症性MSK疼痛初级保健对环境和经济影响的数据。未来的工作应侧重于确定MSK护理途径的成本和碳排放基准，并使实施的方法标准化，以影响可持续实践和政策制定。
{"title":"Estimating the Cost and Carbon Output of Musculoskeletal Primary Care Management Decisions: A Retrospective Analysis of Electronic Health Records","authors":"Alex Braybrooke, Melissa Pegg, Rebecca Naylor, James Bailey, James Scott, Roanna Burgess, Dahai Yu, Simon Wathall, Kelvin P. Jordan, Robert Malcolm, Hayden Holmes, George Peat, Anirban Banerjee, Jonathan C. Hill","doi":"10.1002/hpm.3919","DOIUrl":"10.1002/hpm.3919","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Healthcare accounts for up to 5% of worldwide carbon emissions and costs global economies an estimated $9 trillion annually. Primary care accounts for up to one-fifth of all NHS carbon emissions, with musculoskeletal (MSK) pain accounting for 14%–30% of all primary care consultations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A cost-carbon calculator model was used to undertake a retrospective economic and environmental analysis of resource use for non-inflammatory MSK pain primary care consulters. Data used to populate the model was derived from Electronic Health Records and patient surveys collected during The Multi-level Integrated Data for Musculoskeletal Health Intelligence and ActionS GP Study. The model was utilised to estimate the mean (with 95%CI's) cost and carbon output per MSK consulter, while also examining variations at two levels: (a) the Primary Care Network (PCN), and (b) the consulter's index MSK pain site.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand eight hundred seventy-five individuals from 30 NHS primary care practices across 13 PCNs were eligible for EHR and survey data analysis. The mean carbon and cost output per person (over 6 months) was 46.91 kg CO<sub>2</sub>e (95% CIs; 45.02, 48.81 kg CO<sub>2</sub>e) and £182.65 (95% CIs; £178.69, £190.62), respectively, with substantial variation observed across PCNs. The resource category with the highest carbon footprint was consistently pharmacological intervention across all PCNs. Individuals who consulted for multisite/widespread pain and back pain had the highest mean carbon and cost output respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study, we are aware of, that presents data on both the environmental and economic impact of the primary care of non-inflammatory MSK pain. Future work should focus on benchmarking the cost and carbon output of MSK care pathways and standardising methods that are implemented to influence sustainable practice and policy development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"907-922"},"PeriodicalIF":1.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693969","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}
Katharina Achstetter, Miriam Blümel, Julia Röttger, Julia Köppen, Katherine Polin, Reinhard Busse
Background
Person-centredness in health systems puts patients and their preferences at the centre of healthcare. However, there is not an ‘one size fits all’ approach as patients are heterogenous and have varying interactions with and perceptions of healthcare, and assessments of the health system performance. This study aims to explore these patient differences by (1) identifying core attributes of patients that shape their general approach to and interactions with healthcare and (2) deriving specific patient types based on these core attributes.
Methods
The qualitative study included content analysis of semi-structured, problem-oriented interviews with 27 participants selected with the aim of maximum variation and heterogeneity (e.g., regarding age, gender, health status, place of living) from the Berlin-Brandenburg region of Germany.
Results
Based on the interviews with the participants, three core patient attributes were found that shape interactions with healthcare: (1) taking care of health and illness, (2) the self-assigned patient role, and (3) the patient-assigned healthcare provider role. Seven patient types were identified across (opposing) manifestations of these core attributes, ranging from ‘sovereign self-proclaimed experts’ (focussing–autonomous–fulfiller) to ‘impressionable sceptics’ (ignoring–heteronomous–seller).
Conclusion
Consideration of the identified patient types and their different ways of engaging with healthcare providers and their varying perceptions of the health system can help to develop strategies to promote person-centredness in health systems. Furthermore, this typology can inform providers about the diverse ways in which patients may perceive healthcare interactions, and it can be useful for the training of future physicians and other healthcare professionals.
{"title":"From ‘Sovereign Self-Proclaimed Experts’ to ‘Impressionable Sceptics’–Developing a Patient Typology to Distinguish Patients' Interactions With Healthcare: A Qualitative Study in Germany","authors":"Katharina Achstetter, Miriam Blümel, Julia Röttger, Julia Köppen, Katherine Polin, Reinhard Busse","doi":"10.1002/hpm.3923","DOIUrl":"10.1002/hpm.3923","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Person-centredness in health systems puts patients and their preferences at the centre of healthcare. However, there is not an ‘one size fits all’ approach as patients are heterogenous and have varying interactions with and perceptions of healthcare, and assessments of the health system performance. This study aims to explore these patient differences by (1) identifying core attributes of patients that shape their general approach to and interactions with healthcare and (2) deriving specific patient types based on these core attributes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The qualitative study included content analysis of semi-structured, problem-oriented interviews with 27 participants selected with the aim of maximum variation and heterogeneity (e.g., regarding age, gender, health status, place of living) from the Berlin-Brandenburg region of Germany.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on the interviews with the participants, three core patient attributes were found that shape interactions with healthcare: (1) taking care of health and illness, (2) the self-assigned patient role, and (3) the patient-assigned healthcare provider role. Seven patient types were identified across (opposing) manifestations of these core attributes, ranging from ‘sovereign self-proclaimed experts’ (focussing–autonomous–fulfiller) to ‘impressionable sceptics’ (ignoring–heteronomous–seller).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Consideration of the identified patient types and their different ways of engaging with healthcare providers and their varying perceptions of the health system can help to develop strategies to promote person-centredness in health systems. Furthermore, this typology can inform providers about the diverse ways in which patients may perceive healthcare interactions, and it can be useful for the training of future physicians and other healthcare professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"896-906"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3923","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671404","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}
Tiago S. Jesus, Dongwook Lee, Manrui Zhang, Brocha Z. Stern, Jan Struhar, Allen W. Heinemann, Neil Jordan, Anne Deutsch
Background
Healthcare managers and administrators increasingly need to develop systems, structures and operations capable of improving the patient experience performance of their organisations or service delivery units.
Aim
To systematically review the effectiveness of organizational and service management interventions on standardized patient experience measure scores.
Methods
Six scientific databases, speciality journals and snowballing were used to identify English-language, peer-reviewed, contemporary studies (2015–2023) that examined the impact of service management or organizational interventions on the patient experience as a primary outcome. The studies needed to include inferential statistics on standardized, patient-reported experience measures. Two independent reviewers performed the eligibility decisions and risk-of-bias appraisals.
Results
Nine papers were finally included. Three papers were on discrete, service-level interventions, including two randomized controlled trials (RCTs) and one pre-post study; one RCT achieved significant improvements by delaying the timing of bedside rounding versus maintaining the early morning schedule. One non-randomized controlled study and two pre-post studies addressed organisation-wide approaches. Among those, one pre-post study achieved significant improvements by having site managers meet regularly with an organizational oversight committee to compare the units' patient-experience performance and setting improvement expectations. Finally, three observational, multi-site comparative studies were included. These addressed self-reported improvement approaches, implementation of a nursing excellence certification programme, and implementation of Patient Experience Offices. The latter was significantly associated with improved patient experience performance.
Conclusion
Selected discrete service-level interventions and organizational approaches can lead to better patient experience outcomes, even though the evidence from the pre-post and observational studies should be interpreted with caution.
{"title":"Organizational and Service Management Interventions for Improving the Patient Experience With Care: Systematic Review of the Effectiveness","authors":"Tiago S. Jesus, Dongwook Lee, Manrui Zhang, Brocha Z. Stern, Jan Struhar, Allen W. Heinemann, Neil Jordan, Anne Deutsch","doi":"10.1002/hpm.3916","DOIUrl":"10.1002/hpm.3916","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Healthcare managers and administrators increasingly need to develop systems, structures and operations capable of improving the patient experience performance of their organisations or service delivery units.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To systematically review the effectiveness of organizational and service management interventions on standardized patient experience measure scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six scientific databases, speciality journals and snowballing were used to identify English-language, peer-reviewed, contemporary studies (2015–2023) that examined the impact of service management or organizational interventions on the patient experience as a primary outcome. The studies needed to include inferential statistics on standardized, patient-reported experience measures. Two independent reviewers performed the eligibility decisions and risk-of-bias appraisals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine papers were finally included. Three papers were on discrete, service-level interventions, including two randomized controlled trials (RCTs) and one pre-post study; one RCT achieved significant improvements by delaying the timing of bedside rounding versus maintaining the early morning schedule. One non-randomized controlled study and two pre-post studies addressed organisation-wide approaches. Among those, one pre-post study achieved significant improvements by having site managers meet regularly with an organizational oversight committee to compare the units' patient-experience performance and setting improvement expectations. Finally, three observational, multi-site comparative studies were included. These addressed self-reported improvement approaches, implementation of a nursing excellence certification programme, and implementation of Patient Experience Offices. The latter was significantly associated with improved patient experience performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Selected discrete service-level interventions and organizational approaches can lead to better patient experience outcomes, even though the evidence from the pre-post and observational studies should be interpreted with caution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"883-895"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671423","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}
M. A. Meijer, A. E. M. Brabers, N. Stadhouders, J.D. De Jong
Background
Rising healthcare costs could undermine people's willingness to contribute to the healthcare system. Therefore, we investigated people's willingness to pay (WTP) for basic health insurance. We also studied reasons for the willingness or unwillingness to pay.
Methods
A mixed methods study was performed. An online survey was sent out to 1500 members of the Dutch Health Care Consumer Panel in May 2023 (51% response rate, N = 760). WTP was assessed using the contingent valuation methodology. Reasons for the willingness or unwillingness to pay were obtained via 15 semi-structured interviews. Thematic analysis was used to analyse the interviews.
Results
People were, on average, willing to pay €160 per month for basic health insurance (€153–167 95% CI). Of the respondents, 58% (N = 443) was willing to pay more than the lowest monthly premium of €140 in 2023. WTP was positively correlated to income, age, and education. The interviews indicated that the ability to pay, healthcare consumption, care included in the basic health insurance package, organisation of the health insurance system, coverage of risk, and accessibility of care play a role in people's willingness or unwillingness to pay.
Conclusions
Most people in the Netherlands were willing to pay more for basic health insurance than the current lowest premium. People valued that health insurance allowed them and others to access healthcare services. As the premium is expected to increase in the coming years, support for the healthcare system may erode, as interviews indicated that the ability to pay is an important condition of the WTP.
{"title":"The Willingness to Pay for Basic Health Insurance in the Netherlands: Quantitative and Qualitative Insights","authors":"M. A. Meijer, A. E. M. Brabers, N. Stadhouders, J.D. De Jong","doi":"10.1002/hpm.3926","DOIUrl":"10.1002/hpm.3926","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rising healthcare costs could undermine people's willingness to contribute to the healthcare system. Therefore, we investigated people's willingness to pay (WTP) for basic health insurance. We also studied reasons for the willingness or unwillingness to pay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed methods study was performed. An online survey was sent out to 1500 members of the Dutch Health Care Consumer Panel in May 2023 (51% response rate, <i>N</i> = 760). WTP was assessed using the contingent valuation methodology. Reasons for the willingness or unwillingness to pay were obtained via 15 semi-structured interviews. Thematic analysis was used to analyse the interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>People were, on average, willing to pay €160 per month for basic health insurance (€153–167 95% CI). Of the respondents, 58% (<i>N</i> = 443) was willing to pay more than the lowest monthly premium of €140 in 2023. WTP was positively correlated to income, age, and education. The interviews indicated that the ability to pay, healthcare consumption, care included in the basic health insurance package, organisation of the health insurance system, coverage of risk, and accessibility of care play a role in people's willingness or unwillingness to pay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most people in the Netherlands were willing to pay more for basic health insurance than the current lowest premium. People valued that health insurance allowed them and others to access healthcare services. As the premium is expected to increase in the coming years, support for the healthcare system may erode, as interviews indicated that the ability to pay is an important condition of the WTP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"871-882"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651214","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}
In August 2023, a tragic case in Kobe City, Japan, highlighted the severe working conditions faced by resident physicians. A resident specialising in internal medicine died by suicide after experiencing extraordinary workloads, including 236 h of overtime in the month before his death. This case underscores the broader systemic issue of excessive working hours in Japan's medical profession, exacerbated by the country's ‘passion pay’ culture, which exploits young physicians' dedication. Surveys indicate that 28% of residents experience burnout, with long hours, inefficient task allocation and poor workplace communication as key stressors. Addressing excessive workloads requires restructuring physician responsibilities. Research shows that full-time physicians under 50 spend significant time on non-medical tasks that could be delegated to other professionals. The primary physician model, which holds doctors responsible for patients beyond their shifts, further extends work hours. Transitioning to a time-based task allocation system and implementing task-shifting strategies could alleviate these burdens. Workplace communication also requires improvement. Limited supervisory support and hierarchical barriers prevent open discussions about well-being. We underscore that drawing insights from corporate strategies, such as Marui Group's task optimisation policies and TOYOTA's anonymous feedback system, hospitals could implement structured well-being initiatives for physicians. Physician well-being directly correlates with patient satisfaction and treatment adherence. Addressing burnout through workload reduction and improved communication is essential for maintaining both doctor and patient health. Hospitals must prioritise physician well-being alongside patient care, fostering a sustainable working environment for medical professionals.
{"title":"Applying Corporate Well-Being Strategies to Medical Practice: Addressing Physician Burnout and Overwork","authors":"Sakumi Yamakawa, Maaya Ono, Kiyonobu Kusu, Hayase Hakariya","doi":"10.1002/hpm.3928","DOIUrl":"10.1002/hpm.3928","url":null,"abstract":"<div>\u0000 \u0000 <p>In August 2023, a tragic case in Kobe City, Japan, highlighted the severe working conditions faced by resident physicians. A resident specialising in internal medicine died by suicide after experiencing extraordinary workloads, including 236 h of overtime in the month before his death. This case underscores the broader systemic issue of excessive working hours in Japan's medical profession, exacerbated by the country's ‘<i>passion pay</i>’ culture, which exploits young physicians' dedication. Surveys indicate that 28% of residents experience burnout, with long hours, inefficient task allocation and poor workplace communication as key stressors. Addressing excessive workloads requires restructuring physician responsibilities. Research shows that full-time physicians under 50 spend significant time on non-medical tasks that could be delegated to other professionals. The primary physician model, which holds doctors responsible for patients beyond their shifts, further extends work hours. Transitioning to a time-based task allocation system and implementing task-shifting strategies could alleviate these burdens. Workplace communication also requires improvement. Limited supervisory support and hierarchical barriers prevent open discussions about well-being. We underscore that drawing insights from corporate strategies, such as Marui Group's task optimisation policies and TOYOTA's anonymous feedback system, hospitals could implement structured well-being initiatives for physicians. Physician well-being directly correlates with patient satisfaction and treatment adherence. Addressing burnout through workload reduction and improved communication is essential for maintaining both doctor and patient health. Hospitals must prioritise physician well-being alongside patient care, fostering a sustainable working environment for medical professionals.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"1018-1020"},"PeriodicalIF":1.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639681","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}
Venera Bekteshi, Mary van Hook, Eglantina Gjermeni, Jenn L. Bellamy
Background
Domestic violence (DV) encompasses a pattern of psychological, physical, sexual, financial, and/or emotional abuse, manifesting through assault, threats, and intimidation. Economic and social stressors in conjunction with the COVID-19 pandemic escalated DV cases worldwide, including those in Albania. Socioeconomic vulnerabilities worsened the situation, with DV-related complaints to non-governmental organizations (NGOs) in Albania increasing by 60% between March and May 2020, compared to the same period in 2019. Despite government efforts through a comprehensive anti-DV strategy, as the pandemic subsided, 2986 Albanian women still reported enduring DV.
Methods
Using the Contextual Influence in Acculturative Stress (CIAS) framework, this study identified key external and internal contextual factors contributing to DV in Albania. These factors were assessed to evaluate their integration into the national anti-DV policy and their potential for improving the policy's impact.
Results
The Albanian government's response focused on four primary areas: legal protection, women's safety, economic well-being, and community awareness. However, many vulnerable groups remained underserved. Furthermore, economic assistance provided was insufficient to address the increased financial strain faced by victims. Educational and awareness campaigns were implemented, but despite these efforts, DV rates persisted at high levels throughout the pandemic.
Conclusion
The findings underscore the need for more targeted, comprehensive, and context-sensitive approaches to DV intervention. The Albanian government's anti-DV strategy could be strengthened by addressing micro-level needs, such as tailored counselling, culturally sensitive services, and more robust economic support measures. Incorporating these elements into future policies may better address the structural and cultural barriers that perpetuate DV, particularly among vulnerable populations.
{"title":"The Shadow Pandemic Contextualised: Albania's Response to Domestic Violence During COVID-19","authors":"Venera Bekteshi, Mary van Hook, Eglantina Gjermeni, Jenn L. Bellamy","doi":"10.1002/hpm.3884","DOIUrl":"10.1002/hpm.3884","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Domestic violence (DV) encompasses a pattern of psychological, physical, sexual, financial, and/or emotional abuse, manifesting through assault, threats, and intimidation. Economic and social stressors in conjunction with the COVID-19 pandemic escalated DV cases worldwide, including those in Albania. Socioeconomic vulnerabilities worsened the situation, with DV-related complaints to non-governmental organizations (NGOs) in Albania increasing by 60% between March and May 2020, compared to the same period in 2019. Despite government efforts through a comprehensive anti-DV strategy, as the pandemic subsided, 2986 Albanian women still reported enduring DV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Contextual Influence in Acculturative Stress (CIAS) framework, this study identified key external and internal contextual factors contributing to DV in Albania. These factors were assessed to evaluate their integration into the national anti-DV policy and their potential for improving the policy's impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Albanian government's response focused on four primary areas: legal protection, women's safety, economic well-being, and community awareness. However, many vulnerable groups remained underserved. Furthermore, economic assistance provided was insufficient to address the increased financial strain faced by victims. Educational and awareness campaigns were implemented, but despite these efforts, DV rates persisted at high levels throughout the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings underscore the need for more targeted, comprehensive, and context-sensitive approaches to DV intervention. The Albanian government's anti-DV strategy could be strengthened by addressing micro-level needs, such as tailored counselling, culturally sensitive services, and more robust economic support measures. Incorporating these elements into future policies may better address the structural and cultural barriers that perpetuate DV, particularly among vulnerable populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 3","pages":"716-729"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617210","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}
Abi Sriharan, Ellen Kuhlmann, Tiago Correia, Farhang Tahzib, Katarzyna Czabanowska, Marius-Ionuț Ungureanu, Bernadette Nirmal Kumar
Artificial Intelligence (AI) has emerged as a transformative force in healthcare, offering significant potential to address workforce challenges and improve patient outcomes. This perspective article presents a framework for responsible AI innovation, emphasising ethical governance, responsible leadership and a commitment to human-centred AI. It provides guidance for healthcare organisations to position AI as a strategic enabler, augmenting the health and care workforce and fostering sustainable, patient-centred advancements in healthcare.
{"title":"Artificial Intelligence in Healthcare: Balancing Technological Innovation With Health and Care Workforce Priorities","authors":"Abi Sriharan, Ellen Kuhlmann, Tiago Correia, Farhang Tahzib, Katarzyna Czabanowska, Marius-Ionuț Ungureanu, Bernadette Nirmal Kumar","doi":"10.1002/hpm.3927","DOIUrl":"10.1002/hpm.3927","url":null,"abstract":"<p>Artificial Intelligence (AI) has emerged as a transformative force in healthcare, offering significant potential to address workforce challenges and improve patient outcomes. This perspective article presents a framework for responsible AI innovation, emphasising ethical governance, responsible leadership and a commitment to human-centred AI. It provides guidance for healthcare organisations to position AI as a strategic enabler, augmenting the health and care workforce and fostering sustainable, patient-centred advancements in healthcare.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"987-992"},"PeriodicalIF":1.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3927","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617208","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号