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Association of demographic characteristics of COVID-19 patients with RPA Virtual Hospital service utilization in 2020-22 2020- 2022年COVID-19患者人口学特征与RPA虚拟医院服务利用的关系
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-09-09 DOI: 10.1016/j.hlpt.2025.101117
Yuetong Ren , Huilan Xu , Sue Amanatidis , Limin Mao , Miranda Shaw , Lisa Simone , Li Ming Wen
<div><h3>Objectives</h3><div>The rapid adoption of telemedicine during the COVID-19 pandemic has transformed healthcare delivery. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. However, the uptake of virtual care among non-English-speaking patients remains understudied. This study aimed to profile COVID-19 patients cared for by rpavirtual and examine the association between patients’ demographics and service utilization.</div></div><div><h3>Method</h3><div>A retrospective study was conducted using routinely collected electronic medical records. Participants were 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. Multiple logistic regression models were built to examine the association between service utilization and preferred language and other demographics. Subgroup analyses were conducted by patients’ age group and preferred language.</div></div><div><h3>Results</h3><div>Compared to English-speaking patients, non-English-speaking patients were less likely to register with rpavirtual ≥ 2 times (adjusted odds ratio (AOR) 0.86, 95 % CI 0.77 – 0.96), receive ≥ 3 services (AOR 0.92, 95 % CI 0.85 – 1.00), and have service duration ≥76 min (AOR 0.92, 95 % CI 0.85 – 0.99). Among patients aged 50 years or older, these associations were particularly pronounced, with AOR 0.77 (95 % CI 0.66 – 0.89), AOR 0.86 (95 % CI 0.78 – 0.96), and AOR 0.86 (95 % CI 0.78 – 0.95) for number of registrations and services and total service duration, respectively. Among non-English-speaking patients, interpreter use was strongly associated with increased service utilization.</div></div><div><h3>Conclusion</h3><div>Preferred language shapes virtual care utilization patterns. Providing language support improves equitable access and engagement in virtual care platforms.</div></div><div><h3>Lay summary</h3><div>There was a significant pivot towards virtual care during the COVID-19 pandemic. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. This study analyzed routinely collected electronic medical records of 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. The study found that COVID-19 patients’ demographics were associated with rpavirtual utilization, and interpreter use was strongly associated with increased service utilization. There were significant disparities in utilization between non-English-speaking and English-speaking patients. Non-English-speaking patients were less likely to register with rpavirtual multiple times, receive more services, and have longer service duration. The associations of preferred language with service utilization were particularly pronounced among patients aged 50 years or older. The results suggest that preferred language shapes virtual care utilization. Language support is
在2019冠状病毒病大流行期间,远程医疗的迅速普及改变了医疗保健服务。在澳大利亚,RPA虚拟医院(rpavirual)已成为远程医疗的关键医疗保健提供者。然而,非英语患者对虚拟护理的接受程度仍未得到充分研究。本研究旨在分析由虚拟医院护理的COVID-19患者,并检查患者人口统计数据与服务利用率之间的关系。方法采用常规收集的电子病历资料进行回顾性研究。参与者是2020年7月1日至2022年6月30日在新南威尔士州悉尼地方卫生区注册的21814名COVID-19患者。建立了多个逻辑回归模型来检验服务利用率与首选语言和其他人口统计学之间的关系。按患者年龄和首选语言进行亚组分析。结果与英语患者相比,非英语患者登记≥2次(调整优势比(AOR) 0.86, 95% CI 0.77 ~ 0.96),接受≥3次服务(AOR 0.92, 95% CI 0.85 ~ 1.00),服务时间≥76 min (AOR 0.92, 95% CI 0.85 ~ 0.99)的可能性较小。在50岁及以上的患者中,这些关联尤为明显,分别为AOR 0.77 (95% CI 0.66 - 0.89)、AOR 0.86 (95% CI 0.78 - 0.96)和AOR 0.86 (95% CI 0.78 - 0.95)。在非英语患者中,口译员的使用与服务利用率的增加密切相关。结论首选语言塑造了虚拟护理使用模式。提供语言支持可改善虚拟护理平台的公平获取和参与。在2019冠状病毒病大流行期间,出现了向虚拟医疗的重大转变。在澳大利亚,RPA虚拟医院(rpavirual)已成为远程医疗的关键医疗保健提供者。本研究分析了2020年7月1日至2022年6月30日期间在新南威尔士州悉尼地方卫生区注册的21814名COVID-19患者的常规电子病历。研究发现,COVID-19患者的人口统计数据与虚拟服务的利用率有关,口译员的使用与服务利用率的提高密切相关。非英语患者和英语患者在用药方面存在显著差异。非英语患者不太可能多次登记,接受更多的服务,服务时间更长。在50岁或以上的患者中,首选语言与服务利用的关联尤为明显。结果表明,首选语言影响虚拟护理的利用。语言支持是提高虚拟护理可及性和参与度的关键。
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引用次数: 0
Digital COVID-19 symptom screening and SARS-CoV-2 testing through RT-LAMP saliva of students and asymptomatic employees in a public school in Brazil 巴西某公立学校学生和无症状员工的数字COVID-19症状筛查及RT-LAMP唾液检测
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-07-16 DOI: 10.1016/j.hlpt.2025.101069
Beatriz Araujo Oliveira , Erika Regina Manuli , Fábio Eudes Leal , Edgar Casado Barreta Souza , Ana Paula Illi , Ana Paula Barreto de Paiva , Camila da Silva Fachini , Beatriz Aparecida Munhoz Cano , Priscila de Lima Barros , Ligia Capuani , Helves Humberto Domingues , Maria Rita dos Santos e Passos-Bueno , Ester Cerdeira Sabino , Silvia Figueiredo Costa
Children were the last that were vaccinated during the COVID-19 pandemic. In this scenario, schools were the site of amplification and spread of COVID-19 and new variants during the pandemia.

Objective

To evaluate a respiratory symptoms screening system and test asymptomatic individuals (high school students and employees) at a public school in Brazil.

Methods

An online COVID-19 symptom surveillance platform was implemented for employees and students answered a questionnaire by mobile phone and/or website before going to school. Symptomatic individuals were referred to primary care unit. SARS-CoV-2 reverse transcription loop- mediated isothermal amplification (RT-LAMP) of saliva samples was performed weekly. The test cost was estimated.

Results

A total of 969 samples were tested (mean of 108 tests per week). A professor was symptomatic and tested positive during the study period. However, no asymptomatic participants tested positive for COVID-19, and no cases of SARS-CoV-2 transmission occurred at school despite the high transmissibility of the Delta variant, the local predominant variant at the time of the study and several outbreaks that occurred in public schools in Brazil. The average cost of our test was $13,6 per test.

Conclusion

Implementation of an online system of COVID-19 respiratory symptom screening and testing SARS-CoV-2 through saliva in asymptomatic individuals is a feasible, low-cost and practical option to be used, especially in low-income countries.
儿童是COVID-19大流行期间最后一批接种疫苗的人。在这种情况下,学校是COVID-19和新变种在大流行期间扩增和传播的场所。目的评价巴西一所公立学校的呼吸道症状筛查系统,并对无症状个体(高中生和教职工)进行检测。方法建立新冠肺炎症状在线监测平台,对员工和学生在上学前通过手机和(或)网站填写问卷。有症状的个体被转介到初级保健单位。每周对唾液样本进行SARS-CoV-2逆转录环介导的等温扩增(RT-LAMP)。估算了测试成本。结果共检测样本969份,平均每周检测108份。一位教授在研究期间出现症状并检测呈阳性。然而,没有无症状的参与者在COVID-19检测中呈阳性,并且在学校没有发生SARS-CoV-2传播病例,尽管Delta变体(研究时当地的主要变体)具有高传播性,并且在巴西的公立学校发生了几次暴发。我们每次测试的平均成本是13.6美元。结论在无症状人群中实施COVID-19呼吸道症状在线筛查和唾液检测系统是一种可行、低成本和实用的选择,特别是在低收入国家。
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引用次数: 0
Digital innovation readiness of Dutch healthcare organizations: an interview study with multiple stakeholders 荷兰医疗保健组织的数字创新准备:与多个利益相关者的访谈研究
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-08-08 DOI: 10.1016/j.hlpt.2025.101105
Tom Brandsma , Rogier van de Wetering , Jol Stoffers

Objectives

Increasing healthcare organizations’ digital innovation readiness is crucial to ensuring future availability, accessibility, affordability, and quality of healthcare. This study identifies themes that contribute to the digital innovation readiness of healthcare organizations.

Methods

A qualitative study was conducted using 17 semi-structured interviews among multiple stakeholders, clustered into 5 groups—academics, consultants, (top) managers (e.g., CIO/CEO), digital innovation managers, and primary care workers with digital innovation as a field of interest. Thematic analysis was used to analyze data.

Results

Five themes that contribute to digital innovation readiness of healthcare organizations were identified—strategic guidance, organization, adaptive climate, leading digital innovation, and digital foundation.

Conclusions

This study identifies themes that contribute to digital innovation readiness of healthcare organizations, helping such organizations prepare to innovate using digital technologies. Future research should validate these themes and explore interrelationships among them.
提高医疗保健组织的数字创新准备程度对于确保医疗保健的未来可用性、可及性、可负担性和质量至关重要。本研究确定了有助于医疗保健组织做好数字创新准备的主题。方法采用17个半结构化访谈对多个利益相关者进行定性研究,这些利益相关者被分为5组:学者、顾问、(高层)管理人员(如CIO/CEO)、数字创新管理人员和以数字创新为兴趣领域的初级保健工作者。采用主题分析法对数据进行分析。结果确定了影响医疗机构数字化创新准备的五个主题:战略指导、组织、适应性气候、领先的数字化创新和数字化基础。本研究确定了有助于医疗保健组织数字创新准备的主题,帮助这些组织准备使用数字技术进行创新。未来的研究应该验证这些主题,并探索它们之间的相互关系。
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引用次数: 0
Beyond checkbox participation: The radical promise of reflective stakeholder engagement in medical device assessment 超越复选框参与:反思利益相关者参与医疗器械评估的激进承诺
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-09-23 DOI: 10.1016/j.hlpt.2025.101118
Y. Tony Yang
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引用次数: 0
Determinants of EHR systems’ usability and provider satisfaction in public primary healthcare facilities in Tanzania 坦桑尼亚公共初级卫生保健设施中EHR系统可用性和提供者满意度的决定因素
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-07-18 DOI: 10.1016/j.hlpt.2025.101076
Augustino Mwogosi

Background

Tanzania has prioritized EHR systems adoption through systems like GoTHoMIS to enhance healthcare delivery and data management. However, the success of EHR implementation depends critically on system usability and healthcare providers’ satisfaction, which influence system acceptance and continued use.

Objectives

This study assessed the determinants of EHR system usability and satisfaction among healthcare providers in Tanzania’s public primary healthcare facilities. Specific objectives were to examine the influence of EHR system usability on provider satisfaction, the role of organizational factors, the contribution of usability to frequency of system use, and variations across demographic and professional groups.

Methods

A cross-sectional quantitative survey was conducted among 288 healthcare providers in Dodoma and Dar es Salaam regions. The regions were purposively selected to represent urban, peri‑urban and rural settings based on EHR system implementation maturity. Data were collected through a structured questionnaire administered via Google Forms. Google Forms data were encrypted and complied with Tanzania’s Data Protection Act 2022. Multiple linear regression and Structural Equation Modeling using SmartPLS were employed to analyze factors associated with EHR systems satisfaction and usage frequency.

Results

Improvement in work efficiency was the strongest predictor of provider satisfaction (β = 0.258, p < 0.001), followed by system reliability, adequate training, and organizational support. Factors such as ease of integration into clinical workflows and enhancement of collaboration significantly predicted the frequency of EHR system use. Demographic variables had limited moderating effects. Generally, system usability, organizational environment, and perceived efficiency gains were critical for successful EHR adoption.

Conclusion

Effective EHR systems implementation in primary healthcare settings in Tanzania requires a complex approach addressing not only technical usability but also organizational support, user training, and workflow integration. Policy interventions should prioritize these areas to enhance user satisfaction and system sustainability.

Public interest summary

This study looked at how healthcare providers in Tanzania use electronic health record systems, which are digital tools for storing patient information. The results showed that healthcare workers were more satisfied and used the systems more often when the records were reliable, easy to use, and supported by strong training and leadership. These insights could help healthcare organizations improve digital systems and make healthcare services better for patients
坦桑尼亚通过GoTHoMIS等系统优先采用电子病历系统,以加强医疗保健服务和数据管理。然而,EHR实施的成功主要取决于系统可用性和医疗保健提供者的满意度,这影响系统的接受度和持续使用。目的:本研究评估坦桑尼亚公共初级卫生保健机构医疗服务提供者的电子病历系统可用性和满意度的决定因素。具体目标是检查EHR系统可用性对提供者满意度的影响,组织因素的作用,可用性对系统使用频率的贡献,以及人口统计学和专业群体之间的差异。方法对多马和达累斯萨拉姆地区288名医疗服务提供者进行横断面定量调查。根据EHR系统实施成熟度,有目的地选择代表城市、城郊和农村的区域。数据通过谷歌表格进行结构化问卷调查收集。谷歌表单数据经过加密,并符合坦桑尼亚2022年数据保护法。采用多元线性回归和SmartPLS结构方程模型分析影响电子病历系统满意度和使用频率的因素。结果工作效率的提高是服务提供者满意度的最强预测因子(β = 0.258, p <;0.001),其次是系统可靠性、充分的培训和组织支持。整合到临床工作流程的便利性和加强协作等因素显著预测了电子病历系统的使用频率。人口统计变量的调节作用有限。一般来说,系统可用性、组织环境和可感知的效率收益对于成功采用EHR至关重要。结论:在坦桑尼亚初级卫生保健机构实施有效的电子病历系统需要一个复杂的方法,不仅要解决技术可用性问题,还要解决组织支持、用户培训和工作流程集成问题。政策干预应优先考虑这些领域,以提高用户满意度和系统可持续性。本研究着眼于坦桑尼亚的医疗保健提供者如何使用电子健康记录系统,这是存储患者信息的数字工具。结果表明,当记录可靠、易于使用,并得到强有力的培训和领导支持时,卫生保健工作者更满意并更频繁地使用系统。这些见解可以帮助医疗机构改进数字系统,为患者提供更好的医疗服务
{"title":"Determinants of EHR systems’ usability and provider satisfaction in public primary healthcare facilities in Tanzania","authors":"Augustino Mwogosi","doi":"10.1016/j.hlpt.2025.101076","DOIUrl":"10.1016/j.hlpt.2025.101076","url":null,"abstract":"<div><h3>Background</h3><div>Tanzania has prioritized EHR systems adoption through systems like GoTHoMIS to enhance healthcare delivery and data management. However, the success of EHR implementation depends critically on system usability and healthcare providers’ satisfaction, which influence system acceptance and continued use.</div></div><div><h3>Objectives</h3><div>This study assessed the determinants of EHR system usability and satisfaction among healthcare providers in Tanzania’s public primary healthcare facilities. Specific objectives were to examine the influence of EHR system usability on provider satisfaction, the role of organizational factors, the contribution of usability to frequency of system use, and variations across demographic and professional groups.</div></div><div><h3>Methods</h3><div>A cross-sectional quantitative survey was conducted among 288 healthcare providers in Dodoma and Dar es Salaam regions. The regions were purposively selected to represent urban, peri‑urban and rural settings based on EHR system implementation maturity. Data were collected through a structured questionnaire administered via Google Forms. Google Forms data were encrypted and complied with Tanzania’s Data Protection Act 2022. Multiple linear regression and Structural Equation Modeling using SmartPLS were employed to analyze factors associated with EHR systems satisfaction and usage frequency.</div></div><div><h3>Results</h3><div>Improvement in work efficiency was the strongest predictor of provider satisfaction (β = 0.258, <em>p</em> &lt; 0.001), followed by system reliability, adequate training, and organizational support. Factors such as ease of integration into clinical workflows and enhancement of collaboration significantly predicted the frequency of EHR system use. Demographic variables had limited moderating effects. Generally, system usability, organizational environment, and perceived efficiency gains were critical for successful EHR adoption.</div></div><div><h3>Conclusion</h3><div>Effective EHR systems implementation in primary healthcare settings in Tanzania requires a complex approach addressing not only technical usability but also organizational support, user training, and workflow integration. Policy interventions should prioritize these areas to enhance user satisfaction and system sustainability.</div></div><div><h3>Public interest summary</h3><div>This study looked at how healthcare providers in Tanzania use electronic health record systems, which are digital tools for storing patient information. The results showed that healthcare workers were more satisfied and used the systems more often when the records were reliable, easy to use, and supported by strong training and leadership. These insights could help healthcare organizations improve digital systems and make healthcare services better for patients</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101076"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721586","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}
引用次数: 0
Computer assisted history taking in elective and acute care: Systematic review 计算机辅助择期和急症护理的病史记录:系统回顾
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-08-30 DOI: 10.1016/j.hlpt.2025.101108
Casper Craamer , Thomas Timmers , Walter van der Weegen , Rudolf B Kool

Background

Computer-assisted history taking (CAHT) could increase patient flow efficiency and healthcare resources optimization. By assessing reported clinical and patient-reported outcomes, we can clarify the benefits, limitations, and practical considerations of CAHT in clinical care. This systematic review synthesizes literature on CAHT in acute and elective care.

Methods

This systematic review followed PRISMA guidelines. A comprehensive search of MEDLINE, Embase, CINAHL, and Web of Science identified studies published between January 2014 and December 2024. Two reviewers independently screened articles, assessed study quality, and extracted data narratively.

Results

In total, 19 studies (involving 11,885 unique patients and 151 healthcare providers) were included. CAHT-questionnaire completion rates were high (75–95%) in larger samples but lower (51–67%) in smaller ones. Satisfaction was consistently high across different delivery methods and devices. Positive outcomes on patient engagement, such as active involvement and enhanced communication, were demonstrated. Clinical efficiency did improve in terms of streamlined workflows and resource utilization. Mixed results were reported on consultation duration. Finally, improved diagnostic accuracy was reported through comprehensive data capture and better alignment with clinical standards.

Conclusion

CAHT offers opportunities to contribute to patient engagement, workflows, and diagnostic accuracy, with high completion rates. We need sound implementation studies to explore how CAHT-systems can streamline processes and minimize needed resources. Future implementations should ensure integration into electronic health records and address digital inclusion across age groups and regions to realize CAHT’s potential in routine, patient-centered care.
计算机辅助历史记录(CAHT)可以提高患者流程效率并优化医疗资源。通过评估报告的临床和患者报告的结果,我们可以澄清临床护理中CAHT的益处、局限性和实际考虑。本系统综述综合了CAHT在急性和择期护理方面的文献。方法本系统评价遵循PRISMA指南。对MEDLINE, Embase, CINAHL和Web of Science进行全面搜索,确定了2014年1月至2024年12月之间发表的研究。两位审稿人独立筛选文章,评估研究质量,并以叙述方式提取数据。结果共纳入19项研究,涉及11,885名特殊患者和151名医护人员。caht问卷完成率在较大样本中较高(75-95%),而在较小样本中较低(51-67%)。在不同的交付方式和设备中,满意度始终很高。患者参与的积极结果,如积极参与和加强沟通,被证明。在简化工作流程和资源利用方面,临床效率确实有所提高。关于咨询时间的报告结果好坏参半。最后,通过全面的数据采集和更好地符合临床标准,提高了诊断的准确性。结论caht提供了促进患者参与、工作流程和诊断准确性的机会,并具有高完成率。我们需要进行合理的实施研究,以探索caht系统如何简化流程并最大限度地减少所需资源。未来的实施应确保整合到电子健康记录中,并解决跨年龄组和地区的数字包容问题,以实现CAHT在以患者为中心的常规护理中的潜力。
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引用次数: 0
Wearable pre-impact fall protection system: a scoping review 可穿戴预冲击跌落保护系统:范围审查
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-08-23 DOI: 10.1016/j.hlpt.2025.101107
Yuwen Liu, Zheng Zhang, Yige Chen, Kexin Du, Weiguang Ma

Objective

To review wearable protective devices for individuals at high risk of falling and to analyze the feasibility of these wearable protective tools in reducing fall-related harm.

Design

A systematic search was conducted across 7 databases to identify studies that met the inclusion criteria for analysis.

Results

A total of 31 studies were included. 28 studies involved the design of pre-impact fall protective devices, while 3 studies utilized commercially available products. The primary target population was the elderly, with some designed for children, blind person, and patients with craniocerebral disease. The wearing methods mainly included clothing, accessories, and protective gears. The protective areas primarily focused on the hip or head. The core components of these tools were airbags triggered by falls or protective layers made of special materials. 11 devices included emergency call systems. 7 studies conducted clinical trials for empirical, showing protective tools had certain effectiveness in mitigating injuries caused by falls, but some of these devices exhibit poor wearing comfort and compliance among users.

Conclusions

The targeted design of the application population and the design of wearable pre-impact fall protection system need to be further improved. The effectiveness of these devices in practical application needs to be verified by more clinical studies.
目的综述针对跌倒高危人群的可穿戴防护装置,分析可穿戴防护工具在减少跌倒相关伤害方面的可行性。DesignA对7个数据库进行系统检索,以确定符合纳入标准的研究进行分析。结果共纳入31项研究。28项研究涉及撞击前坠落保护装置的设计,3项研究使用了市售产品。主要目标人群为老年人,部分人群为儿童、盲人和颅脑疾病患者。穿戴方式主要包括服装、配饰、护具等。保护区域主要集中在臀部或头部。这些工具的核心部件是由跌落触发的安全气囊或由特殊材料制成的保护层。11个装置包括紧急呼叫系统。7项研究进行了临床试验,表明保护工具在减轻跌倒造成的伤害方面具有一定的有效性,但其中一些设备的佩戴舒适性和使用者的依从性较差。结论应用人群的针对性设计和穿戴式预冲击坠落防护系统的设计有待进一步完善。这些装置在实际应用中的有效性需要更多的临床研究来验证。
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引用次数: 0
Willingness to pay for remote and self-monitoring: Comparing patients and non-patients in gestational hypertensive care 支付远程和自我监测的意愿:比较患者和非患者在妊娠期高血压护理
IF 3.4 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-07-13 DOI: 10.1016/j.hlpt.2025.101071
Marie-Lien Gerits, Samantha Bielen

Objectives

Contingent valuation (CV) is widely used in health economics, as it enables the quantification of diverse benefits within a single monetary measure. However, a key methodological debate that remains underexplored is whether patients or non-patients should complete the CV task and how this choice may influence willingness to pay (WTP) estimates. This study aimed to investigate that question in the context of two home blood pressure (BP) monitoring approaches for pregnant women at risk of gestational hypertensive disorders, remote monitoring (RM) and patient self-monitoring (PSM). We also examined the role of patient status and treatment experience in shaping WTP.

Methods

The WTP of 199 patients and 222 non-patients was examined using a CV survey, combining a payment card and open-ended question. Propensity score matching analysis with regression adjustment assessed WTP differences between patients and non-patients. Subgroup analyses explored whether these differences were driven solely by being a patient or also by home BP monitoring experience.

Results

The mean WTP was €130 for RM and €85 for PSM. Patients exhibited a €31 higher WTP for RM compared to non-patients, a difference that was marginally significant at the 10 % level. This effect was driven by treatment experience status. We found no significant difference in WTP PSM between patients and non-patients.

Conclusions

Simply being a patient does not affect WTP for home BP monitoring. When patients have treatment experience, this can increase WTP compared to non-patients, but not for approaches for which the potential benefits are apparent without experiencing them, like PSM.
条件评估(CV)在卫生经济学中被广泛使用,因为它可以在单一货币措施中量化各种效益。然而,一个关键的方法论争论仍未得到充分探讨,即患者或非患者是否应该完成CV任务,以及这种选择如何影响支付意愿(WTP)估计。本研究旨在通过对妊娠期高血压疾病风险孕妇的两种家庭血压监测方法——远程监测(RM)和患者自我监测(PSM)来探讨这一问题。我们还研究了患者状态和治疗经验在形成WTP中的作用。方法采用支付卡和开放式问题相结合的CV调查方法,对199例患者和222例非患者的WTP进行检测。倾向评分匹配分析与回归调整评估患者和非患者的WTP差异。亚组分析探讨了这些差异是否仅仅是由患者驱动的,还是由家庭血压监测经验驱动的。结果RM的平均WTP为130欧元,PSM的平均WTP为85欧元。与非患者相比,RM患者的WTP高出31欧元,差异在10%的水平下显着。该效应受治疗经验状态的驱动。我们发现患者与非患者的WTP PSM无显著差异。结论单纯的患者身份不影响家庭血压监测的WTP。当患者有治疗经验时,与非患者相比,这可以增加WTP,但对于那些没有经历就能明显获益的方法,如PSM,则不是这样。
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引用次数: 0
Cost-utility analysis of add-on SGLT2 inhibitors for heart failure with reduced ejection fraction in India 印度附加SGLT2抑制剂治疗心力衰竭伴射血分数降低的成本-效用分析
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-07-26 DOI: 10.1016/j.hlpt.2025.101077
Akhil Sasidharan , Sajith Kumar S , Suchitralakshmi G , Kavitha Rajsekar , Bhavani Shankara Bagepally

Background

Heart failure with reduced ejection fraction (HFrEF) imposes significant clinical burden and costs in India. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated clinical benefits, their cost-effectiveness within the Indian healthcare perspective remains unassessed.

Methods

A Markov model with a lifetime horizon and one-year cycles was developed to evaluate the cost-effectiveness of SGLT2i as an add-on therapy to standard of care (SoC) compared to SoC alone in patients with HFrEF in India. The analysis adopted an abridged societal perspective, incorporating direct medical and non-medical costs, as well as out-of-pocket expenditures. Clinical efficacy data were obtained from meta-analyses while cost data were sourced from published Indian studies and databases. Costs (2024) and Quality-Adjusted Life Years (QALYs) were used to determine the incremental cost-utility ratio (ICURs). A willingness-to-pay (WTP) threshold of one time India’s GDP per capita [₹2,26,765 (US$2,710)] per QALY was used. Uncertainty was assessed through one-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA). Scenario analyses were conducted to test structural assumptions, and a price threshold analysis was performed to estimate the price at which SGLT2i would become cost-effective.

Results

Despite additional gains in QALYs, add-on SGLT2i were not cost-effective at their current market prices, with an ICUR of ₹6,12,406 (US$7,318) per QALY. Cost-effectiveness estimates were sensitive to variations in drug pricing. PSA confirmed the robustness of these findings. Price threshold analysis indicated that a 71 % reduction in the average market prices for SGLT2i would be required for cost-effectiveness.

Conclusions

While SGLT2i improve clinical outcomes in HFrEF, their current cost renders them not cost-effective in the Indian healthcare setting. Substantial price reductions, potentially through price negotiations with manufacturers, are necessary to enhance their affordability and optimize resource allocation for Heart failure management in India.
背景:心力衰竭伴射血分数降低(HFrEF)在印度造成了巨大的临床负担和费用。虽然钠-葡萄糖共转运蛋白-2抑制剂(SGLT2i)已显示出临床益处,但其在印度医疗保健方面的成本效益仍未得到评估。方法建立了一个具有生命周期和一年周期的马尔可夫模型,以评估SGLT2i作为标准治疗(SoC)的附加治疗与单独使用SoC在印度HFrEF患者中的成本效益。该分析采用了简略的社会观点,纳入了直接医疗和非医疗费用以及自付费用。临床疗效数据来自荟萃分析,而成本数据来自已发表的印度研究和数据库。使用成本(2024年)和质量调整寿命年(QALYs)来确定增量成本效用比(ICURs)。每个QALY的支付意愿(WTP)阈值为印度人均GDP的一倍[2,26,765卢比(2,710美元)]。通过单向敏感性分析(OWSA)和概率敏感性分析(PSA)评估不确定性。进行情景分析以检验结构假设,并进行价格阈值分析以估计sgltti具有成本效益的价格。结果尽管QALY有额外的收益,但附加的SGLT2i在目前的市场价格上并不具有成本效益,每个QALY的ICUR为6,12,406卢比(7,318美元)。成本效益估计对药品定价的变化很敏感。PSA证实了这些发现的稳健性。价格阈值分析表明,SGLT2i的平均市场价格需要降低71%才能达到成本效益。结论:虽然SGLT2i改善了HFrEF的临床结果,但其目前的成本使其在印度医疗保健环境中不具有成本效益。在印度,有必要通过与制造商进行价格谈判来大幅降低价格,以提高他们的负担能力,并优化心力衰竭管理的资源配置。
{"title":"Cost-utility analysis of add-on SGLT2 inhibitors for heart failure with reduced ejection fraction in India","authors":"Akhil Sasidharan ,&nbsp;Sajith Kumar S ,&nbsp;Suchitralakshmi G ,&nbsp;Kavitha Rajsekar ,&nbsp;Bhavani Shankara Bagepally","doi":"10.1016/j.hlpt.2025.101077","DOIUrl":"10.1016/j.hlpt.2025.101077","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with reduced ejection fraction (HFrEF) imposes significant clinical burden and costs in India. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated clinical benefits, their cost-effectiveness within the Indian healthcare perspective remains unassessed.</div></div><div><h3>Methods</h3><div>A Markov model with a lifetime horizon and one-year cycles was developed to evaluate the cost-effectiveness of SGLT2i as an add-on therapy to standard of care (SoC) compared to SoC alone in patients with HFrEF in India. The analysis adopted an abridged societal perspective, incorporating direct medical and non-medical costs, as well as out-of-pocket expenditures. Clinical efficacy data were obtained from meta-analyses while cost data were sourced from published Indian studies and databases. Costs (2024) and Quality-Adjusted Life Years (QALYs) were used to determine the incremental cost-utility ratio (ICURs). A willingness-to-pay (WTP) threshold of one time India’s GDP per capita [₹2,26,765 (US$2,710)] per QALY was used. Uncertainty was assessed through one-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA). Scenario analyses were conducted to test structural assumptions, and a price threshold analysis was performed to estimate the price at which SGLT2i would become cost-effective.</div></div><div><h3>Results</h3><div>Despite additional gains in QALYs, add-on SGLT2i were not cost-effective at their current market prices, with an ICUR of ₹6,12,406 (US$7,318) per QALY. Cost-effectiveness estimates were sensitive to variations in drug pricing. PSA confirmed the robustness of these findings. Price threshold analysis indicated that a 71 % reduction in the average market prices for SGLT2i would be required for cost-effectiveness.</div></div><div><h3>Conclusions</h3><div>While SGLT2i improve clinical outcomes in HFrEF, their current cost renders them not cost-effective in the Indian healthcare setting. Substantial price reductions, potentially through price negotiations with manufacturers, are necessary to enhance their affordability and optimize resource allocation for Heart failure management in India.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101077"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772788","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}
引用次数: 0
Mexico city monitoring system during the COVID-19 pandemic: A case-study 2019冠状病毒病大流行期间墨西哥城监测系统:案例研究
IF 3.7 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 Epub Date: 2025-09-09 DOI: 10.1016/j.hlpt.2025.101115
Pablo Gaitán-Rossi , Jair Yañez-Santaolalla , Andrea Jiménez-Ortiz , Brenda Zaira Tapia-Hernández , Hortensia Reyes-Morales

Objective

Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.

Methods

Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.

Results

At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.

Conclusions

The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.

Lay summary

During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.
目的健全的监测系统对于具有复原力的卫生系统和有效的危机管理至关重要。本研究考察了墨西哥城在2019冠状病毒病大流行的最初几个月里健康监测系统的设计和实施情况,强调了为未来危机提供的经验教训。方法采用描述性案例研究方法,我们对官方文件、新闻发布会评论和对关键线人的13小时采访进行了三角分析。结果大流行发生时,墨西哥城政府成立了卫生委员会,需要一个系统来为医院容量管理和及时决策提供可靠的信息。当地开发的监测系统集中了多个来源的数据,对关键指标进行了估计和预测,并为通报疫情状况和指导政策奠定了基础。该系统的仪表板成为部门间协作的关键工具,以减轻医院负担并改善决策——促进政府部门、非卫生部门和一般人群之间的协调。墨西哥城监测系统的实施表明,共享框架可以激励部门间合作,并为加强对未来紧急情况的准备和复原力提供重要见解。促进部门间协作的关键经验包括:在治理结构中必须有强有力的领导、就紧急情况评估工具达成共识、提供可操作的信息以及对伙伴能力的适应能力。在2019冠状病毒病大流行期间,墨西哥城开发了一个卫生监测系统,帮助管理医院容量并协调不同政府部门的决策。该系统提供了可靠和及时的信息,使当局更容易迅速有效地采取行动。这项研究表明,卫生当局、商业团体和其他各方如何共同努力,才能在危机中取得更好的结果。它还强调了明确沟通和透明度的重要性。这些经验可以帮助城市更好地为未来的突发卫生事件做好准备,最终保护公众的福祉。
{"title":"Mexico city monitoring system during the COVID-19 pandemic: A case-study","authors":"Pablo Gaitán-Rossi ,&nbsp;Jair Yañez-Santaolalla ,&nbsp;Andrea Jiménez-Ortiz ,&nbsp;Brenda Zaira Tapia-Hernández ,&nbsp;Hortensia Reyes-Morales","doi":"10.1016/j.hlpt.2025.101115","DOIUrl":"10.1016/j.hlpt.2025.101115","url":null,"abstract":"<div><h3>Objective</h3><div>Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.</div></div><div><h3>Methods</h3><div>Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.</div></div><div><h3>Results</h3><div>At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.</div></div><div><h3>Conclusions</h3><div>The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.</div></div><div><h3>Lay summary</h3><div>During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101115"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104703","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}
引用次数: 0
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Health Policy and Technology
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