Health Policy and Technology最新文献

{"title":"Value-centred commissioning in primary health care: reform lessons from the Portuguese experience","authors":"Paulo Santos ,&nbsp;Isabel Nazaré ,&nbsp;Luísa Sá","doi":"10.1016/j.hlpt.2025.101133","DOIUrl":"10.1016/j.hlpt.2025.101133","url":null,"abstract":"<div><h3>Background</h3><div>Portuguese Primary Health Care commissioning has transitioned from centrally managed agreements to performance-based models. Despite this evolution, persistent structural and procedural inefficiencies limit its capacity to generate value. Comparative European experiences highlight alternative frameworks that emphasise outcome relevance, decentralisation, and system learning.</div></div><div><h3>Objective</h3><div>To propose a conceptual model for primary health care commissioning aligned with structure–process–outcome logic.</div></div><div><h3>Methods</h3><div>We conducted a narrative review to trace the evolution of commissioning in Portuguese Primary Health Care, focusing on its regulatory, financial, and performance roles. We used several sources, including legislation, policy documents, national and European reports, and academic literature. Analysis followed a structure–process–outcome framework. Comparative insights highlighted governance models, incentive structures, and reform opportunities aligned with value-based care and European benchmarks.</div></div><div><h3>Results</h3><div>Portuguese commissioning systems lack clinically meaningful outcome indicators and remain rigid in design. The new model offers a framework for aligning commissioning processes with population health needs, clinical relevance, and system adaptability. Comparative analysis shows that decentralised, context-sensitive models from other European countries are applicable and promising.</div></div><div><h3>Conclusions</h3><div>Commissioning reforms should centre around auditable, evidence-based outcome indicators tailored to local contexts. These indicators can enhance motivation, accountability, and continuous learning. Reforms are achievable within current organisational structures and planning cycles. Policymakers should consider decentralisation and a value-oriented approach to improve Primary Health Care delivery and responsiveness, particularly in systems facing similar structural constraints.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101133"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does a tiered diagnosis and treatment system enhance self-rated health outcomes among middle-aged and older patients with hypertension or diabetes? Evidence from China","authors":"Wen He","doi":"10.1016/j.hlpt.2025.101137","DOIUrl":"10.1016/j.hlpt.2025.101137","url":null,"abstract":"<div><h3>Objective</h3><div>Addressing healthcare challenges in aging societies represents a pressing global priority for countries worldwide. To increase healthcare accessibility and equity, China introduced its tiered diagnosis and treatment (TDT) system in 2015. This study examines the impacts of this policy change on self-rated health outcomes among middle-aged and older patients with hypertension or diabetes.</div></div><div><h3>Methods</h3><div>Under a quasi-experimental framework, this study leveraged longitudinal data from four waves (2011–2018) of the China Health and Retirement Longitudinal Study (CHARLS) and employed a difference-in-differences (DID) approach to identify the impacts. To supplement this analysis, a moderating effects model was implemented to explore the potential moderating influence of health insurance coverage, primary care utilization, and treatment compliance.</div></div><div><h3>Results</h3><div>The findings revealed that following the implementation of TDT, middle-aged and older patients with hypertension or diabetes experienced a marked 31.03% enhancement in self-rated health outcomes (<em>P</em> &lt; 0.05), with effects intensifying progressively over time. Additionally, moderating analysis demonstrated that patients' health insurance coverage (<em>P</em> &lt; 0.01), expanded insurance benefits (<em>P</em> &lt; 0.05), heightened primary care utilization (<em>P</em> &lt; 0.1), and enhanced treatment compliance (<em>P</em> &lt; 0.01) collectively amplified the positive health impacts.</div></div><div><h3>Conclusions</h3><div>This study offers compelling new causal evidence that strengthening primary care systems and strategically refining healthcare resource allocation have provided tangible health benefits to vulnerable populations. Notably, as China's TDT operates on a voluntary basis, its experience provides valuable insights for countries grappling with escalating medical demands alongside fragmented healthcare systems.</div></div><div><h3>Public Interest Summary</h3><div>This study explored the impacts of the tiered diagnosis and treatment reform in China on self-rated health outcomes among middle-aged and older patients with hypertension or diabetes. By leveraging longitudinal data from a national survey and conducting a DID analysis, it provides novel evidence that the policy reform significantly enhanced the health status of this vulnerable population, with health insurance coverage and benefits, primary care utilization, and treatment compliance acting as pivotal factors in amplifying these health benefits.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101137"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health services and rural healthcare access: Evidence from China","authors":"Xizi Wan ,&nbsp;Yiyu Ao ,&nbsp;Zhongmou Huang ,&nbsp;Miao Yu","doi":"10.1016/j.hlpt.2025.101123","DOIUrl":"10.1016/j.hlpt.2025.101123","url":null,"abstract":"<div><h3>Objectives</h3><div>Digital health technologies hold potential to address persistent healthcare access inequities in rural China by overcoming geographic and temporal barriers. Empirical evidence regarding their implementation efficacy remains essential to guide policy development in rural health services. This study investigates whether the adoption of digital health technologies improves healthcare accessibility among rural populations in China.</div></div><div><h3>Methods</h3><div>Using nationally representative data from 2021 Chinese Livelihood Status Survey, we employed a probit regression model to assess the effects of digital health on healthcare accessibility. Methodological rigor was ensured through comprehensive robustness testing, including dependent variable substitution, instrumental variable (IV) analysis addressing endogeneity concerns, propensity score matching (PSM) to mitigate selection bias, and sensitivity analyses for omitted variables. Additionally, heterogeneity analyses were conducted to assess differential effects of digital health across key demographic and socioeconomic subgroups within rural communities.</div></div><div><h3>Results</h3><div>Our findings indicate that digital health adoption significantly improves healthcare accessibility among rural residents by 4.5 %. This result remains consistent across all robustness tests. Heterogeneity analyses reveal substantially larger gains for marginalized subgroups, particularly elderly individuals, those with lower educational attainment, low-income households, and residents in underserved areas characterized by physician shortages or underdeveloped care systems. The positive effect is further strengthened in regions with more advanced broadband infrastructure.</div></div><div><h3>Conclusions</h3><div>Digital health significantly improves healthcare access for rural populations in China, supplementing traditional services in resource-scarce settings. These results support the need for nationally coordinated and contextually tailored digital health initiatives to effectively reduce disparities in both technological access and healthcare delivery.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101123"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-world comparison of outcomes and healthcare resource utilization of Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR)","authors":"Giaele Moretti ,&nbsp;Chiara Seghieri ,&nbsp;Claudio Passino ,&nbsp;Milena Vainieri","doi":"10.1016/j.hlpt.2025.101129","DOIUrl":"10.1016/j.hlpt.2025.101129","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to assess and compare the real-world outcomes and healthcare resource utilization of Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) procedures, acknowledging the challenges associated with medical device evaluations.</div></div><div><h3>Methods</h3><div>The two cohorts of TAVI and SAVR patients were identified using individual-level administrative data in the Tuscany region of Italy from 2016 to 2021. Patients in treatment cohorts were followed for up to one-year post-procedure, with outcomes and costs assessed. Clinical indicators were selected from the Valve Academic Research Consortium-3 (VARC-3) consensus document. Follow-up costs, in euros (€), were calculated for each patient up to three years post-procedure, from the perspective of the Italian National Healthcare System.</div></div><div><h3>Results</h3><div>No significant differences in 30-day and 1-year mortality were found between TAVI and SAVR, though TAVI showed a slight increase in 3-year mortality (OR 1.05, <em>p</em> = 0.004). TAVI patients had higher rates of conduction disturbances and pacemaker implantation at all time points. They also experienced more ER admissions and hospital readmissions at 3 years, but shorter hospital stays. At 1 year, TAVI incurred in €234 higher total costs, driven mainly by higher ER costs, while pharmaceutical costs were similar. At 3 years, total costs were €2132 for TAVI and €1915 for SAVR, with higher ambulatory and ER costs in the TAVI group but lower pharmaceutical costs.</div></div><div><h3>Conclusion</h3><div>The study explores the potential of Real-World Evidence to inform the clinical and economic evaluation of new technologies and procedures. The study differs from some prior randomized controlled trial-based studies, highlighting the impact of diverse analytical approaches and patient populations.</div></div><div><h3>Public interest abstract</h3><div>Aortic stenosis (AS) is a common heart valve disease in the elderly, whose standard treatment consists of Surgical Aortic Valve Replacement (SAVR). For patients that are ineligible for surgery due to high risk or comorbidities, Transcatheter Aortic Valve Implantation (TAVI), has emerged as a less invasive option. This study used real-world data from Tuscany, Italy, to compare clinical outcomes and costs. We found no significant difference in mortality rates between TAVI and SAVR at 30 days and one year and higher mortality at 3 years. TAVI patients were more likely to experience conduction disturbances, often requiring pacemaker implantation. Cost differences were modest, with TAVI patients incurring €234 more in total healthcare expenses over one year and €217 at three years. These findings highlight the value of real-world evidence in assessing the safety, effectiveness, and financial sustainability of new treatments like TAVI.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101129"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare providers’ perspectives of first-tier NIPS' implementation in Canada","authors":"Tierry M. Laforce ,&nbsp;Vardit Ravitsky ,&nbsp;Marie-Christine Roy ,&nbsp;Anne-Marie Laberge","doi":"10.1016/j.hlpt.2025.101127","DOIUrl":"10.1016/j.hlpt.2025.101127","url":null,"abstract":"<div><h3>Objective</h3><div>This article presents an analysis of barriers and facilitators concerning the implementation of first-tier non-invasive prenatal screening (NIPS) in Canada, as identified by healthcare providers, using the Consolidated Framework for Implementation Research (CFIR).</div></div><div><h3>Study Design</h3><div>Semi-structured interviews were conducted with 16 healthcare professionals. Obstetricians-Gynecologists (OBGYN), family physicians, geneticist, midwives, and genetic counselors from 5 provinces were recruited. CFIR was used both for the interview guide and the coding dictionary. Discourse analysis was done for all interviews after data saturation was attained.</div></div><div><h3>Results</h3><div>The findings reveal a contrast in participant perspectives. While NIPS is perceived as a superior screening tool with the potential to replace traditional screening, concerns linger regarding its impact on pregnant individuals and the healthcare system. Participants acknowledge the positive perception of NIPS and its potential to replace traditional screening. They emphasize that NIPS does not address a gap in the screening pathway since other methods already detect the screened conditions. Despite facilitators like positive perceptions and increased accessibility to information, it necessitates careful consideration concerning NIPS' place in the prenatal screening pathway. Access to NIPS is considered a facilitator, potentially reducing inequalities, but widespread availability may compromise care for some pregnant individuals. Barriers include the lack of novelty in NIPS information and its inability to replace diagnostic tests.</div></div><div><h3>Conclusion</h3><div>Our research offers a comprehensive understanding of barriers and facilitators, aiding anticipation of potential implementation as a first-tier test and maximizing the likelihood of successful implementation. The use of CFIR to analyze the prenatal screening pathway provides a structured approach to identify possible tensions in implementing first-tier NIPS, and actionable insights. This research provides valuable insights for policymakers and decision-makers, underscoring the importance of education and deliberate consideration when determining NIPS's appropriate role in prenatal screening.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101127"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"...it saves so much time\": A qualitative exploration of the use of Generative Artificial Intelligence by the health workforce","authors":"Mia Nazir ,&nbsp;Jane Ellen Carland ,&nbsp;Melanie Keep ,&nbsp;Anna Janssen","doi":"10.1016/j.hlpt.2025.101136","DOIUrl":"10.1016/j.hlpt.2025.101136","url":null,"abstract":"<div><h3>Objectives</h3><div>Generative Artificial Intelligence (Gen AI) has become an increasingly prevalent conversation in healthcare over the past few years. Though there have been research projects and articles exploring the administrative and clinical uses of such technologies, there has been little exploration of health professional perspectives, hopes and concerns. This study sought to explore perspectives and examine the barriers and enablers of Gen AI in healthcare.</div></div><div><h3>Methodology</h3><div>Australian health professionals participated in a mixed-methods study. A survey (n=31) explored the Six Dimensions of Healthcare Quality Framework, capturing quantitative (Likert-scale responses) and qualitative (free-text) data. Semi-structured interviews (n=10) explored participant perceptions of Gen AI. Quantitative data was analysed using descriptive statistics. Qualitative data was thematically analysed.</div></div><div><h3>Results</h3><div>Most survey respondents (74.14 %) reported having used Gen AI to support their work, but only a few (25.81 %) reported organisational supports for use of these technologies. Analysis of the qualitative data aligned with the survey responses. Five themes were generated through thematic analysis, aligning with health professional’s perceived use of Gen AI chatbots, benefits, risks, as well as drivers of safe use and opportunities for the future.</div></div><div><h3>Conclusion</h3><div>Health professionals see potential for using Gen AI to support their work, with enthusiasm about the potential of Gen AI to reduce workloads, particularly in offloading administrative tasks. There is also awareness that Gen AI chatbots pose risks both at the individual level such as limited capability in using these technologies and at the organisational level such as lack of training to support in upskilling, and systemic concerns around policy gaps.</div></div><div><h3>Public Interest Summary</h3><div>Generative Artificial Intelligence (Gen AI) is increasingly topical in all aspects of life, and the health sector is no exception. Though there have been research projects focusing on Gen AI in healthcare, there has been little exploration of health professional views and concerns. This study spoke to health professionals and found that though there is a lot of interest in potential applications of Gen AI in healthcare, particularly in administrative offloading and clinical support, however, the benefits don’t yet outweigh the risks. Software developers must work alongside health professionals in developing a substantially beneficial program to support the safe use of Gen AI in healthcare as well as be well supported on an organisational level. There are also opportunities to develop education to build health professionals capacity to use GenAI safely and effectively, and for health service organisations to develop guidance and policies to clearly articulate what safe use looks like.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101136"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biosimilar medicines in Malaysia: Unveiling new guidance for practice","authors":"N Saad,&nbsp;Coleen SB Choo,&nbsp;H Chandriah,&nbsp;N Ahmad","doi":"10.1016/j.hlpt.2025.101135","DOIUrl":"10.1016/j.hlpt.2025.101135","url":null,"abstract":"<div><h3>Background</h3><div>Biologics have transformed the treatment of chronic diseases, but their high-cost limits access and burdens healthcare budgets. Biosimilars, highly similar versions of approved biologics, offer a more affordable alternative. However, their complex nature necessitates distinct regulatory and clinical guidance to ensure their safe and effective use in the healthcare facilities.</div></div><div><h3>Objective</h3><div>This article highlights the policy initiatives undertaken by the Ministry of Health (MOH) Malaysia to develop a Position Statement, aimed at guiding the integration of biosimilars into Malaysia’s public healthcare system.</div></div><div><h3>Method</h3><div>A multi-stage process began in 2019 and involved structured stakeholder engagement, literature reviews, and consensus-building across medical and regulatory disciplines. Key areas addressed included interchangeability, switching, automatic substitution, prescribing, procurement, and pharmacovigilance. Two rounds of review were conducted, and stakeholder consensus was obtained through a binary survey, with a 70 % agreement threshold.</div></div><div><h3>Results</h3><div>Stakeholders from multiple specialties emphasized cautious but positive attitudes toward biosimilar use, especially for treatment-naïve or short-term therapy patients. The final guidance includes ten statements across five domains, emphasizing physician-led switching, prohibition of automatic substitution, indication-specific prescribing, and the need for robust pharmacovigilance. A total of 83 % of stakeholders supported the content, and 88 % endorsed its dissemination. The document was officially endorsed by the MOH Medicines Formulary Panel for implementation across all MOH facilities.</div></div><div><h3>Conclusion</h3><div>The position statements represent a critical step toward structured biosimilar adoption in Malaysia’s public healthcare. Ongoing implementation, education, and post-market evaluation will be essential to strengthen prescriber confidence, improve pharmacovigilance, and enhance patient trust in biosimilars.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101135"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of assistive technologies on caregiver burden and perseverance for people with dementia at home","authors":"G. Bagnasco ,&nbsp;J. van Exel","doi":"10.1016/j.hlpt.2025.101134","DOIUrl":"10.1016/j.hlpt.2025.101134","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the relationship between the use of assistive technologies and the burden and perseverance time of informal caregivers of community-dwelling people with dementia.</div></div><div><h3>Methods</h3><div>An online survey of 342 informal caregivers in the Netherlands assessed objective burden (tasks and time involved in caregiving), subjective burden (personal experience of stress and strain), current perseverance time (time expected to be able to continue providing care), and well-being (overall happiness). Data included demographics, housing, neighbourhood characteristics, assistive technology use, and preferences for additional technologies. Multiple logistic regressions examined associations between assistive technology categories and caregiver outcomes (i.e., below-median weekly caregiving hours, Self-Rated Burden score; above-median CarerQol-7D score, CarerQol-VAS score, and Current Perseverance Time in months). Furthermore, multiple logistic regressions estimated the impact of the most desired technology category on the likelihood of extending the perseverance time by more than six months. Analyses were stratified by caregiver living arrangement (co-residing vs living nearby).</div></div><div><h3>Results</h3><div>Among co-residing caregivers, daily living support technologies were associated with reduced caregiving hours, whereas risk prevention technologies were linked to longer current perseverance time but also higher self-rated burden. Risk response technologies were also associated with higher self-rated burden. Among caregivers living nearby, risk prevention technologies were associated with higher quality of life. Moreover, daily living support and risk response technologies most strongly extended perseverance time beyond six months in both groups.</div></div><div><h3>Conclusions</h3><div>Assistive technologies play a nuanced role in supporting informal caregivers of community-dwelling people with dementia, with impacts differing by living arrangement and technology type.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101134"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicare-covered innovation and U.S. disability, 1997–2019: Evidence from healthcare procedure codes and health survey data","authors":"Frank R. Lichtenberg ,&nbsp;Y. Tony Yang","doi":"10.1016/j.hlpt.2025.101125","DOIUrl":"10.1016/j.hlpt.2025.101125","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess whether innovation in medical procedures and products—proxied by the expansion of Healthcare Common Procedure Coding System (HCPCS) codes linked to Medicare Coverage Determinations (MCDs)—is associated with declines in disability among U.S. adults from 1997 to 2019.</div></div><div><h3>Methods</h3><div>We link HCPCS codes to ICD condition categories using Local Coverage Determinations (LCD) and merge these with Medical Expenditure Panel Survey (MEPS) data to construct 21 condition-year disability indicators. We estimate two-way fixed-effects models with distributed lags (0–15 years) at the condition-year level, controlling for prevalence, mean age, educational attainment, and comorbidity counts, with year and condition fixed effects; standard errors are clustered by condition. The analytic file includes ∼1.50 million condition observations from 317,000 people. This LCD-anchored mapping is a conservative lower bound because many services are paid case-by-case without an LCD.</div></div><div><h3>Results</h3><div>For 19 of 21 disability indicators, at least some lagged innovation coefficients are negative and statistically significant. The mean time from innovation to measurable disability reduction is 11.5 years, consistent with diffusion and time-to-benefit dynamics. Estimated 1997–2019 disability reductions attributable to prior innovation include: Supplemental Security Income (SSI) recipiency −21.3 % (largest effect), with double-digit declines for inability to work, Social Security recipiency, and school limitations; the median reduction across indicators is ∼7 %.</div></div><div><h3>Conclusions</h3><div>Growth in Medicare-covered technology—measured via HCPCS/MCD linkages—is associated with meaningful, long-run reductions in multiple dimensions of disability. Findings highlight the importance of accounting for diffusion lags in health technology assessment and suggest value in monitoring coverage-enabled innovation alongside real-world outcomes.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101125"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Applying artificial intelligence to clinical decision support in mental health: What have we learned?”","authors":"Alejandro García-Rudolph ,&nbsp;David Sanchez-Pinsach ,&nbsp;Eloy Opisso ,&nbsp;Beatriz Castaño","doi":"10.1016/j.hlpt.2025.101121","DOIUrl":"10.1016/j.hlpt.2025.101121","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101121"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}