Health Policy最新文献

Background: Healthcare systems globally are working to reduce their environmental impact, with the NHS committing to becoming the first carbon-neutral national health system. The Health and Care Act 2022 introduced statutory duties for NHS trusts and integrated care boards to consider climate change in their operations, requiring all trusts to develop board-approved Green Plans aligned with national net zero targets. Staff engagement is crucial for implementing sustainability initiatives; however, the extent to which healthcare workers are aware of and engaged with institutional green plans remains less known.

Objective: To assess staff awareness, knowledge, and engagement with the Northern Care Alliance NHS Foundation Trust (NCA) Green Plan 2021.

Methods: A cross-sectional survey of NCA staff (January-February 2025) assessed awareness and engagement with the Green Plan. Data on awareness levels, knowledge of targets, training experience, and implementation barriers were gathered, and suggestions for improvement were provided. Statistical significance was set at p < 0.05 for all analyses. Thematic analysis of open-ended responses followed Braun and Clarke's approach.

Results: Among 175 respondents, 96 (55 %) were unaware of the Green Plan, with 2 (1 %) "extremely aware." Knowledge gaps were evident: 124 (71 %) had not read the plan or knew where to find it; 122-149 (70-85 %) could not identify when it started, or its targets. Only 5 (3 %) received Green Plan training. While 153 (87 %) viewed it as important for NCA's future, just 46 (26 %) changed their work practices. Staff aware of the Green Plan were significantly more likely to change practices than those unaware (53 % vs 2 %, p < 0·001). Barriers to engagement included lack of information (median score 5/5), unclear guidance, limited time, and competing priorities (all scoring 4/5).

Conclusions: Findings reveal gaps in awareness, knowledge, and implementation of NCA's Green Plan, despite strong support for sustainability initiatives. The correlation between awareness and behaviour change indicates that targeted communication and training could enhance staff engagement with sustainability efforts.

Background: Ageing in place (AIP) policies seek to address the growing demand for healthcare needs among ageing populations. Loneliness has been identified as a challenge to AIP, as the number of people living alone at home is growing.

Objective: To understand older adults' perspectives on loneliness associated with AIP and to use these insights to inform health professional practice and health policy for the development of patient-centered solutions.

Methods: To identify issues of significance to the participants, we employed collaborative focus group discussions (FGD). From a set of eight topics presented, participants selected topics to discuss. Loneliness emerged as a prominent theme in the discussions. Six FGDs among twenty-seven older adults and patients of rehabilitation clinics were conducted.

Results: The methodological approach provided unparalleled access to older adults' experiences of loneliness. The study's participants experience poor quality of social contact and associate loneliness with negative physical and mental consequences. While mobility loss and physical inaccessibility are described as factors for becoming lonely, preventive strategies, such as reevaluating social contacts in the absence of intimacy, suggest that the distinction between emotional and social loneliness may coincide in lived experience, indicating that preventive measures should consider their fluid boundaries.

Conclusion: Assessing loneliness requires taking individual perspectives into account, as mere quantification of social contacts is insufficient for evaluation or intervention design. To help cope with loneliness, health professionals are an important social interface and can become a substitute for close relationships. This should be reflected in professional roles and in developing complementary technologies and policies.

Background: Shortage of healthcare workers is a growing challenge and financial remuneration may influence recruitment efforts. In Austria, self-employed physicians can either work as contracted or non-contracted physicians. While non-contracted practices are expanding, sickness funds face increasing difficulties in recruiting contracted physicians.

Objective: To analyze physician income, its key determinants and whether financial incentives could help SHI funds address recruitment challenges.

Methods: We used data from the Federal Ministry of Finance and the Federation of Social Security Institutions to derive descriptive statistics for self-employed physicians. In-depth data on contracted physicians enabled us to explore determinants of their income using quantile regressions.

Results: In 2022, contracted GPs had median annual earnings of EUR 191,649 before taxes, while contracted specialists earned EUR 210,988. Among GPs, an additional consultation was associated with an increase in earnings of EUR 11.70. Being a male GP corresponded with higher earnings of EUR 6763 compared to female GPs. For specialists, each additional consultation increased earnings by EUR 27.94, and being female was associated with decreased earnings of EUR 13,413. Due to missing data on key variables, regression analysis was not possible for non-contracted physicians, but their median income was EUR 100,849.

Conclusion: Given higher earnings of contracted physicians compared to their non-contracted peers, it seems unlikely that increased financial incentives would help SHI funds in recruiting contracted physicians.

Background: As global reliance on Asian production of active pharmaceutical ingredients (APIs) grows, the relocation of API production to Europe (reshoring) has been discussed as a potential solution to decrease dependency on Asia and potentially prevent future medicine shortages. However, it is not yet well understood whether its implementation would be feasible, and under which conditions.

Objective: This study aims to explore expert and stakeholder assessment of the feasibility of reshoring API production to Europe based on identified barriers, enablers and prerequisites for implementing this measure.

Methods: A literature review of peer-reviewed articles and grey literature was complemented by focus group interviews with stakeholders from Austria, France, and Spain, representing policy-makers, industry, and researchers.

Results: The findings suggest that reshoring is considered feasible if certain conditions are met, such as financial incentives and committed stakeholder support. A coordinated European policy approach and advancements in production technologies are perceived as further enabling factors. However, challenges such as higher production costs and perceived lower profits in Europe compared to Asian markets may impede the reshoring of API production. The stakeholders' assessments also varied across countries: French and Spanish stakeholders considered reshoring as realistic, whereas Austrian stakeholders tended to be more hesitant. Stakeholders of all studied countries stressed the importance of strengthening existing local API production.

Conclusion: While reshoring may increase the resilience of the supply chain, it is rather a supportive measure for supply chain stability than a standalone solution to prevent medicine shortages.