Pub Date : 2025-10-01DOI: 10.1016/j.healthpol.2025.105456
Keren Semyonov-Tal
Background
Although physicians recognize the importance of providing quality and respectful treatment, many physicians face organizational barriers and constraints that hinder responsive and respectful care. While theoretical literature on the issue underscores a variety of organizational barriers that obstruct the delivery of medical treatment in healthcare settings, there has been limited research on the obstacles to responsiveness.
Objective
To explore physicians' perceptions of the obstacles they encounter in delivering dignified and responsive medical care.
Methods
A qualitative thematic analysis of twenty in-depth, semi-structured interviews with physicians employed in Israeli public hospitals.
Results
The findings highlight the barriers that physicians encounter when implementing dignified, responsive treatment. The barriers are classified at three levels: organizational (macro), group (meso), and individual (micro). The organizational limitations (macro) are associated with the size of the hospital and budgetary and financial constraints; the group-level constraints (meso) include employment conditions (wages, workload, burnout, and excessive administrative and bureaucratic requirements); and the individual-level barriers (micro) focus mostly on personal skills of the physicians.
Conclusions
By identifying the barriers to providing responsive treatment, hospital management and physicians can take steps to minimize and remove such barriers and, by doing so, to ensure that patients receive the respectful care they deserve.
{"title":"Barriers to Responsiveness and Provision of Dignified care: A qualitative study of Israeli Physicians","authors":"Keren Semyonov-Tal","doi":"10.1016/j.healthpol.2025.105456","DOIUrl":"10.1016/j.healthpol.2025.105456","url":null,"abstract":"<div><h3>Background</h3><div>Although physicians recognize the importance of providing quality and respectful treatment, many physicians face organizational barriers and constraints that hinder responsive and respectful care. While theoretical literature on the issue underscores a variety of organizational barriers that obstruct the delivery of medical treatment in healthcare settings, there has been limited research on the obstacles to responsiveness.</div></div><div><h3>Objective</h3><div>To explore physicians' perceptions of the obstacles they encounter in delivering dignified and responsive medical care.</div></div><div><h3>Methods</h3><div>A qualitative thematic analysis of twenty in-depth, semi-structured interviews with physicians employed in Israeli public hospitals.</div></div><div><h3>Results</h3><div>The findings highlight the barriers that physicians encounter when implementing dignified, responsive treatment. The barriers are classified at three levels: organizational (macro), group (<em>meso</em>), and individual (micro). The organizational limitations (macro) are associated with the size of the hospital and budgetary and financial constraints; the group-level constraints (<em>meso</em>) include employment conditions (wages, workload, burnout, and excessive administrative and bureaucratic requirements); and the individual-level barriers (micro) focus mostly on personal skills of the physicians.</div></div><div><h3>Conclusions</h3><div>By identifying the barriers to providing responsive treatment, hospital management and physicians can take steps to minimize and remove such barriers and, by doing so, to ensure that patients receive the respectful care they deserve.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105456"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259789","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}
The rising complexity of the population's needs has made health and social care integration a priority for the future. Despite the presence of supporting policies and funding, the number of successful experiences that endure over time is limited.
Objective
This work aims to investigate how health and social care integration occur and identify factors facilitating its endurance.
Methods
We conducted a multiple case study on four long-lasting health and social care integration cases in Italy, where a new policy for enhancing integration was introduced. 20 senior managers employed in the four cases were interviewed and 33 official documents and websites were collected. The interviews’ transcripts and documents were coded using an abductive approach.
Results
The modalities of health and social care integration can vary according to the level of integration, type of network governance, and level of customization. There is no one predominant solution as the modalities depend on the specific context. To support policy-makers and health and social care providers in designing and implementing a sustainable health and social care integration in their contexts, this study provides six possible macro factors that clarify the priorities for integration.
Conclusions
This paper clarifies the modalities of integration and provides macro factors for enduring health and social care integration over time, providing avenues for future supporting policies.
{"title":"What mechanisms lead to the endurance of health and social care integration? A multiple case study in Italy","authors":"Eleonora Gheduzzi , Silvia Mitidieri , Maria Picco , Federica Segato","doi":"10.1016/j.healthpol.2024.105234","DOIUrl":"10.1016/j.healthpol.2024.105234","url":null,"abstract":"<div><h3>Background</h3><div>The rising complexity of the population's needs has made health and social care integration a priority for the future. Despite the presence of supporting policies and funding, the number of successful experiences that endure over time is limited.</div></div><div><h3>Objective</h3><div>This work aims to investigate how health and social care integration occur and identify factors facilitating its endurance.</div></div><div><h3>Methods</h3><div>We conducted a multiple case study on four long-lasting health and social care integration cases in Italy, where a new policy for enhancing integration was introduced. 20 senior managers employed in the four cases were interviewed and 33 official documents and websites were collected. The interviews’ transcripts and documents were coded using an abductive approach.</div></div><div><h3>Results</h3><div>The modalities of health and social care integration can vary according to the level of integration, type of network governance, and level of customization. There is no one predominant solution as the modalities depend on the specific context. To support policy-makers and health and social care providers in designing and implementing a sustainable health and social care integration in their contexts, this study provides six possible macro factors that clarify the priorities for integration.</div></div><div><h3>Conclusions</h3><div>This paper clarifies the modalities of integration and provides macro factors for enduring health and social care integration over time, providing avenues for future supporting policies.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"160 ","pages":"Article 105234"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824920","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}
Globally, one billion people suffer from mental health disorders. Migrant populations face high prevalence rates of some disorders and significant barriers in accessing mental healthcare, including language-related barriers. However, knowledge about specific communication difficulties arising from language barriers and mitigation strategies is limited, as is knowledge about country-specific differences.
Objective
This study explores health and social care providers’ (HSCPs’) perceptions of mental health service accessibility for migrants, language-related communication difficulties, mitigation strategies and their perceived effectiveness, and the effectiveness of HSCP training in working with migrants.
Methods
We conducted a cross-sectional survey of HSCPs in nine European countries (n = 629).
Results
HSCPs perceive mental health services as largely inaccessible for migrants facing language barriers. Cross-regional comparative analysis identified differences in the frequency of HSCPs’ interactions with migrants seeking support for their mental health where language barriers are present and in how often HSCPs’ reported experiencing communication difficulties when doing so. HSCPs report a lack of training in communicating with migrants across language barriers, with recent training associated with more positive perceptions of its usefulness. Communication difficulties were encountered throughout the care journey. Informal strategies, such as assistance from family and friends, and machine translation, are commonly used but seen as ineffective. Onsite professional/trained interpreters are deemed most effective, yet their availability is limited.
Conclusions
Findings highlight the urgent need for better communication strategies and awareness of the benefits and drawbacks of different strategies to enhance mental health service accessibility for migrants.
{"title":"Communication difficulties and strategies in migrant mental healthcare: A European survey of health and social care professionals","authors":"Graham Hieke , Demi Krystallidou , Özlem Temizöz , Fang Wang , Cristina Álvaro Aranda , Łucja Biel , Agnieszka Biernacka , Antoon Cox , Katarzyna Czarnocka-Gołębiewska , Silviya Damianova Radeva , Melanie de Looper , Nora Gattiglia , Saskia Hanft-Robert , Soňa Hodáková , Ily Hollebeke , Koen Kerremans , Raquel Lázaro Gutiérrez , Dalia Mankauskienė , Mike Mösko , Urszula Okulska-Łukawska , Sabine Braun","doi":"10.1016/j.healthpol.2025.105453","DOIUrl":"10.1016/j.healthpol.2025.105453","url":null,"abstract":"<div><h3>Background</h3><div>Globally, one billion people suffer from mental health disorders. Migrant populations face high prevalence rates of some disorders and significant barriers in accessing mental healthcare, including language-related barriers. However, knowledge about specific communication difficulties arising from language barriers and mitigation strategies is limited, as is knowledge about country-specific differences.</div></div><div><h3>Objective</h3><div>This study explores health and social care providers’ (HSCPs’) perceptions of mental health service accessibility for migrants, language-related communication difficulties, mitigation strategies and their perceived effectiveness, and the effectiveness of HSCP training in working with migrants.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey of HSCPs in nine European countries (<em>n</em> = 629).</div></div><div><h3>Results</h3><div>HSCPs perceive mental health services as largely inaccessible for migrants facing language barriers. Cross-regional comparative analysis identified differences in the frequency of HSCPs’ interactions with migrants seeking support for their mental health where language barriers are present and in how often HSCPs’ reported experiencing communication difficulties when doing so. HSCPs report a lack of training in communicating with migrants across language barriers, with recent training associated with more positive perceptions of its usefulness. Communication difficulties were encountered throughout the care journey. Informal strategies, such as assistance from family and friends, and machine translation, are commonly used but seen as ineffective. Onsite professional/trained interpreters are deemed most effective, yet their availability is limited.</div></div><div><h3>Conclusions</h3><div>Findings highlight the urgent need for better communication strategies and awareness of the benefits and drawbacks of different strategies to enhance mental health service accessibility for migrants.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105453"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269913","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}
Pub Date : 2025-09-29DOI: 10.1016/j.healthpol.2025.105454
Luigi Siciliani , Jonathan Cylus
Background
While the effects of other sectors on health outcomes have been recognised, the co-benefits that arise from health or health systems to other sectors have received far less attention.
Objective
This study summarizes findings from a special issue in Health Policy documenting evidence of co-benefits from health and health systems to other Sustainable Development Goals: poverty, education, work and economic growth, gender equality, reducing inequalities, responsible meat consumption, climate action, and strong institutions.
Methods
After providing a conceptual framework, we summarise evidence on co-benefits from the nine articles of the special issue, which were written as narrative reviews.
Results
The articles generally find strong evidence of co-benefits from health and health systems to other SDGs. Positive effects of health and health systems were consistently found for education and labour market outcomes, both of which contribute to poverty reduction. Health contributes towards better and inclusive institutions by promoting social capital, political participation and supporting peace. Improved maternal, reproductive, and sexual health lead to enhanced labour participation and educational investment among women. Health system financing has redistributive properties which can serve to reduce inequalities. Health effects on macroeconomic growth were more difficult to establish empirically, though recent evidence is supportive. Health and health systems can also generate environmental co-benefits. Green interventions can reduce carbon footprint of health care. Promotion of healthy behaviours that reduce meat consumption can generate environmental co-benefits through their impact on climate, biodiversity, water use and pollution.
Conclusions
Overall, this evidence suggests that investing in health contributes to achieving other societal goals.
{"title":"The contribution of health and health systems to other sustainable development goals. An overview of the evidence on co-benefits","authors":"Luigi Siciliani , Jonathan Cylus","doi":"10.1016/j.healthpol.2025.105454","DOIUrl":"10.1016/j.healthpol.2025.105454","url":null,"abstract":"<div><h3>Background</h3><div>While the effects of other sectors on health outcomes have been recognised, the co-benefits that arise from health or health systems to other sectors have received far less attention.</div></div><div><h3>Objective</h3><div>This study summarizes findings from a special issue in Health Policy documenting evidence of co-benefits from health and health systems to other Sustainable Development Goals: poverty, education, work and economic growth, gender equality, reducing inequalities, responsible meat consumption, climate action, and strong institutions.</div></div><div><h3>Methods</h3><div>After providing a conceptual framework, we summarise evidence on co-benefits from the nine articles of the special issue, which were written as narrative reviews.</div></div><div><h3>Results</h3><div>The articles generally find strong evidence of co-benefits from health and health systems to other SDGs. Positive effects of health and health systems were consistently found for education and labour market outcomes, both of which contribute to poverty reduction. Health contributes towards better and inclusive institutions by promoting social capital, political participation and supporting peace. Improved maternal, reproductive, and sexual health lead to enhanced labour participation and educational investment among women. Health system financing has redistributive properties which can serve to reduce inequalities. Health effects on macroeconomic growth were more difficult to establish empirically, though recent evidence is supportive. Health and health systems can also generate environmental co-benefits. Green interventions can reduce carbon footprint of health care. Promotion of healthy behaviours that reduce meat consumption can generate environmental co-benefits through their impact on climate, biodiversity, water use and pollution.</div></div><div><h3>Conclusions</h3><div>Overall, this evidence suggests that investing in health contributes to achieving other societal goals.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105454"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259882","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}
Pub Date : 2025-09-26DOI: 10.1016/j.healthpol.2025.105450
Nardin Kirolos , Rachel Strauss , Tharani Raveendran , Charlotte Moore Hepburn , Natasha Saunders
Background
Nonpowdered firearms are commonly used in recreation but their projectiles can cause serious injuries. Understanding how nonpowdered firearms are governed is essential for injury prevention.
Objective
We aimed to describe legislative, regulatory, and prevention strategies that govern nonpowdered firearms in Organization for Economic Co-Operation and Development (OECD) countries.
Methods
We searched multiple academic databases and grey literature for information on nonpowdered firearm governance. Data were extracted and grouped into themes: weapon definitions, licensure, age restrictions, permitted locations for use, storage and transport, sale and transfer, imitation firearms, import/export, manufacturing, advertising, and monitoring systems. We conducted a comparative analysis of legislative frameworks, regulatory standards, and enforcement strategies.
Results
Our findings revealed that 31 OECD countries (84%) have documented governance of nonpowdered firearms. Definitions for what constitutes a nonpowdered firearm varied based on the projectile mechanism (air, spring) and specific muzzle energy/velocity. In 61% of countries, licensure and age restrictions were mandatory. Regulations on use locations, storage, sale, and transfer were found in 26–32% of countries. Monitoring systems for production, sale, or possession existed in 13 countries. Injury surveillance systems were not readily identified.
Conclusions
While commonalities exist nonpowdered firearm governance, substantial heterogeneity and gaps remain in legislation. This becomes problematic when governance approaches lack a foundation in clinical or physical evidence, limiting effective injury prevention. Evidence-informed definitions and methods to assess injury potential are essential for improving surveillance and guiding regulation. Strategies such as age and marketing restrictions, licensure, and safety equipment (eye protection) should be grounded in science. International guidance can support coherent, adaptable approaches across jurisdictions.
{"title":"Governance of nonpowdered firearms across high-income countries: Results of a scoping review","authors":"Nardin Kirolos , Rachel Strauss , Tharani Raveendran , Charlotte Moore Hepburn , Natasha Saunders","doi":"10.1016/j.healthpol.2025.105450","DOIUrl":"10.1016/j.healthpol.2025.105450","url":null,"abstract":"<div><h3>Background</h3><div>Nonpowdered firearms are commonly used in recreation but their projectiles can cause serious injuries. Understanding how nonpowdered firearms are governed is essential for injury prevention.</div></div><div><h3>Objective</h3><div>We aimed to describe legislative, regulatory, and prevention strategies that govern nonpowdered firearms in Organization for Economic Co-Operation and Development (OECD) countries.</div></div><div><h3>Methods</h3><div>We searched multiple academic databases and grey literature for information on nonpowdered firearm governance. Data were extracted and grouped into themes: weapon definitions, licensure, age restrictions, permitted locations for use, storage and transport, sale and transfer, imitation firearms, import/export, manufacturing, advertising, and monitoring systems. We conducted a comparative analysis of legislative frameworks, regulatory standards, and enforcement strategies.</div></div><div><h3>Results</h3><div>Our findings revealed that 31 OECD countries (84%) have documented governance of nonpowdered firearms. Definitions for what constitutes a nonpowdered firearm varied based on the projectile mechanism (air, spring) and specific muzzle energy/velocity. In 61% of countries, licensure and age restrictions were mandatory. Regulations on use locations, storage, sale, and transfer were found in 26–32% of countries. Monitoring systems for production, sale, or possession existed in 13 countries. Injury surveillance systems were not readily identified.</div></div><div><h3>Conclusions</h3><div>While commonalities exist nonpowdered firearm governance, substantial heterogeneity and gaps remain in legislation. This becomes problematic when governance approaches lack a foundation in clinical or physical evidence, limiting effective injury prevention. Evidence-informed definitions and methods to assess injury potential are essential for improving surveillance and guiding regulation. Strategies such as age and marketing restrictions, licensure, and safety equipment (eye protection) should be grounded in science. International guidance can support coherent, adaptable approaches across jurisdictions.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105450"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227536","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}
Pub Date : 2025-09-26DOI: 10.1016/j.healthpol.2025.105451
Simone Diamandis, Tracey Thornley, Shalom Charlie Benrimoj, Kevin Ou, Sarah Dineen-Griffin
Background
Health policies are established to address a specific health need, however, are not always the result of a rational process of evaluation or developed using established policy frameworks, theories or models (FTMs). Greater utilisation of FTMs in health policy making may provide further insight into policy development and overcome barriers to policy inaction.
Objective
The present review aimed to analyse the FTMs and their components underpinning health policy development, and health settings to which they are applied.
Method
A systematic review was conducted following the PRISMA guidelines. Several databases were searched using keywords and MeSH terms. Quality appraisal was undertaken using the AMSTAR tool.
Results
From 1059 citations, 18 systematic reviews were identified. Twenty-eight FTMs were identified with 15 key components, with policy actors (85 %) and policy context (71 %) being most frequently mentioned. Policy FTMs were applied predominantly in health equity, population and public health (n = 16), sexual, reproductive and women's health (n = 14), HIV (n = 12), and physical activity, obesity prevention and nutrition (n = 12).
Conclusion
The utilisation of health policy FTMs in the development of health policy may allow more targeted and relevant health policies to be developed. Further research into the critical components of health policy making may assist in developing a policy framework specific to health policy development.
{"title":"Frameworks, theories and models used in the development of health policies: A systematic review of systematic reviews","authors":"Simone Diamandis, Tracey Thornley, Shalom Charlie Benrimoj, Kevin Ou, Sarah Dineen-Griffin","doi":"10.1016/j.healthpol.2025.105451","DOIUrl":"10.1016/j.healthpol.2025.105451","url":null,"abstract":"<div><h3>Background</h3><div>Health policies are established to address a specific health need, however, are not always the result of a rational process of evaluation or developed using established policy frameworks, theories or models (FTMs). Greater utilisation of FTMs in health policy making may provide further insight into policy development and overcome barriers to policy inaction.</div></div><div><h3>Objective</h3><div>The present review aimed to analyse the FTMs and their components underpinning health policy development, and health settings to which they are applied.</div></div><div><h3>Method</h3><div>A systematic review was conducted following the PRISMA guidelines. Several databases were searched using keywords and MeSH terms. Quality appraisal was undertaken using the AMSTAR tool.</div></div><div><h3>Results</h3><div>From 1059 citations, 18 systematic reviews were identified. Twenty-eight FTMs were identified with 15 key components, with policy actors (85 %) and policy context (71 %) being most frequently mentioned. Policy FTMs were applied predominantly in health equity, population and public health (<em>n</em> = 16), sexual, reproductive and women's health (<em>n</em> = 14), HIV (<em>n</em> = 12), and physical activity, obesity prevention and nutrition (<em>n</em> = 12).</div></div><div><h3>Conclusion</h3><div>The utilisation of health policy FTMs in the development of health policy may allow more targeted and relevant health policies to be developed. Further research into the critical components of health policy making may assist in developing a policy framework specific to health policy development.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105451"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269911","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}
Pub Date : 2025-09-26DOI: 10.1016/j.healthpol.2025.105452
Kiffer G. Card , Jocelle Refol , Taylor G. Hill , Cecilia Benoit , Robert J. Coplan , Steve Joordens , Charlotte M. Roddick , John L. Oliffe , Erin Dej , Frances S. Chen , Elizabeth C. Pinel , Peter J. Helm , Shayna Skakoon-Sparling , Kwame McKenzie , Members of the Social Connection Guideline Development Expert Advisory Group
Background
Loneliness and social isolation are linked to increased morbidity and mortality, with health risks comparable to sedentary lifestyles and poor nutrition. Promoting social connection has therefore become a global public health priority. Evidence-based guidelines could help raise awareness of the health impacts of disconnection, shape individual behaviors, and inform community programs and policies.
Objective
This study aimed to develop recommended public health guidelines for social connection using a Delphi methodology.
Methods
Experts from diverse subfields of Psychology were recruited through networks, nominations, and targeted invitations. In Round 1, open-text responses identified key principles and potential guidelines for individuals and communities. A grounded thematic analysis synthesized these responses into draft guidelines. In subsequent rounds, experts rated their support for each statement. Guidelines with ≥80 % expert endorsement were refined through focus groups.
Results
The final product included 12 guidelines: six for individuals and six for communities. Community guidelines focus on: (1) raising awareness of connection, (2) supporting social-emotional development, (3) prioritizing social health in policy, (4) designing connection-friendly environments, (5) promoting accessibility and inclusion, and (6) measuring social wellbeing. Individual guidelines emphasize: (1) making connection a lifelong priority, (2) cultivating a positive social outlook, (3) building diverse networks, (4) prioritizing meaningful interactions, (5) developing new relationships, and (6) using technology wisely.
Conclusions
These expert-informed guidelines may serve as a framework for advancing individual and population-level efforts to strengthen social wellbeing.
{"title":"Public Health Guidelines for Social Connection: An International Delphi Study","authors":"Kiffer G. Card , Jocelle Refol , Taylor G. Hill , Cecilia Benoit , Robert J. Coplan , Steve Joordens , Charlotte M. Roddick , John L. Oliffe , Erin Dej , Frances S. Chen , Elizabeth C. Pinel , Peter J. Helm , Shayna Skakoon-Sparling , Kwame McKenzie , Members of the Social Connection Guideline Development Expert Advisory Group","doi":"10.1016/j.healthpol.2025.105452","DOIUrl":"10.1016/j.healthpol.2025.105452","url":null,"abstract":"<div><h3>Background</h3><div>Loneliness and social isolation are linked to increased morbidity and mortality, with health risks comparable to sedentary lifestyles and poor nutrition. Promoting social connection has therefore become a global public health priority. Evidence-based guidelines could help raise awareness of the health impacts of disconnection, shape individual behaviors, and inform community programs and policies.</div></div><div><h3>Objective</h3><div>This study aimed to develop recommended public health guidelines for social connection using a Delphi methodology.</div></div><div><h3>Methods</h3><div>Experts from diverse subfields of Psychology were recruited through networks, nominations, and targeted invitations. In Round 1, open-text responses identified key principles and potential guidelines for individuals and communities. A grounded thematic analysis synthesized these responses into draft guidelines. In subsequent rounds, experts rated their support for each statement. Guidelines with ≥80 % expert endorsement were refined through focus groups.</div></div><div><h3>Results</h3><div>The final product included 12 guidelines: six for individuals and six for communities. Community guidelines focus on: (1) raising awareness of connection, (2) supporting social-emotional development, (3) prioritizing social health in policy, (4) designing connection-friendly environments, (5) promoting accessibility and inclusion, and (6) measuring social wellbeing. Individual guidelines emphasize: (1) making connection a lifelong priority, (2) cultivating a positive social outlook, (3) building diverse networks, (4) prioritizing meaningful interactions, (5) developing new relationships, and (6) using technology wisely.</div></div><div><h3>Conclusions</h3><div>These expert-informed guidelines may serve as a framework for advancing individual and population-level efforts to strengthen social wellbeing.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105452"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424748","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}
Pub Date : 2025-09-22DOI: 10.1016/j.healthpol.2025.105449
Patricio E. Ramírez-Correa , F. Javier Rondán-Cataluña , Jorge Arenas-Gaitán
Background
Digital healthcare transformation requires incorporating patient perspectives. Increasingly proactive citizens utilize teleconsultation, fostering doctor–patient–technology integration that enhances system efficiency, service quality, and sustainable healthcare management.
Objective
This study focuses on exploring perceptions of satisfaction related to teleconsultation, using emotions detected on X (Twitter) as a reference.
Methods
First, an analysis of the predominant emotions in the posts (tweets) of users belonging to the three main metropolitan areas is carried out. Then, using one type of structural equation modelling that is Partial Least Square (PLS-SEM), we identify the emotions that have the most significant influence on the variability of satisfaction, taking into account geographical differences.
Results
The results highlight trust as the most relevant emotion to explain the variation in satisfaction and reveal statistically significant differences between the different areas analysed. A considerable proportion of the population is not satisfied with this mode of healthcare provision.
Conclusions
This study highlights key factors influencing the integration of teleconsultation into healthcare systems. Patient perspectives and emotional responses—particularly trust, anticipation, fear, and sadness—are critical for successful implementation. Findings reveal regional disparities in satisfaction, with more developed areas providing superior teleconsultation experiences, likely due to stronger infrastructure and resources. Moreover, variations were identified in how emotions affect satisfaction across regions, underscoring the need for context-specific approaches. Strategies that enhance trust and mitigate fear in less developed regions appear essential. These insights emphasize the importance of aligning digital healthcare initiatives with patient-centered, regionally tailored management practices.
{"title":"Emotions associated with teleconsultation: An analysis of users' messages on X (Twitter) in Chile","authors":"Patricio E. Ramírez-Correa , F. Javier Rondán-Cataluña , Jorge Arenas-Gaitán","doi":"10.1016/j.healthpol.2025.105449","DOIUrl":"10.1016/j.healthpol.2025.105449","url":null,"abstract":"<div><h3>Background</h3><div>Digital healthcare transformation requires incorporating patient perspectives. Increasingly proactive citizens utilize teleconsultation, fostering doctor–patient–technology integration that enhances system efficiency, service quality, and sustainable healthcare management.</div></div><div><h3>Objective</h3><div>This study focuses on exploring perceptions of satisfaction related to teleconsultation, using emotions detected on X (Twitter) as a reference.</div></div><div><h3>Methods</h3><div>First, an analysis of the predominant emotions in the posts (tweets) of users belonging to the three main metropolitan areas is carried out. Then, using one type of structural equation modelling that is Partial Least Square (PLS-SEM), we identify the emotions that have the most significant influence on the variability of satisfaction, taking into account geographical differences.</div></div><div><h3>Results</h3><div>The results highlight trust as the most relevant emotion to explain the variation in satisfaction and reveal statistically significant differences between the different areas analysed. A considerable proportion of the population is not satisfied with this mode of healthcare provision.</div></div><div><h3>Conclusions</h3><div>This study highlights key factors influencing the integration of teleconsultation into healthcare systems. Patient perspectives and emotional responses—particularly trust, anticipation, fear, and sadness—are critical for successful implementation. Findings reveal regional disparities in satisfaction, with more developed areas providing superior teleconsultation experiences, likely due to stronger infrastructure and resources. Moreover, variations were identified in how emotions affect satisfaction across regions, underscoring the need for context-specific approaches. Strategies that enhance trust and mitigate fear in less developed regions appear essential. These insights emphasize the importance of aligning digital healthcare initiatives with patient-centered, regionally tailored management practices.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"162 ","pages":"Article 105449"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227585","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}
Pub Date : 2025-09-22DOI: 10.1016/j.healthpol.2025.105448
Davide Golinelli , Francesco Sanmarchi , Giovanni Guarducci , Jacopo Palombarini , Paolo Benetti , Simona Rosa , Jacopo Lenzi
Background
Understanding gender-based disparities in healthcare utilization is crucial for informing equitable health policy. However, cross-national evidence across multiple service domains in Europe remains limited.
Objective
To examine gender differences in healthcare utilization across 27 European countries and explore variability across service types.
Methods
We analyzed data from 257,388 adults in the third wave of the European Health Interview Survey (2019–2020). Twelve healthcare utilization indicators were evaluated, including hospital admissions, outpatient care, mental health services, and medication use. Gender disparities were estimated using regression models with inverse probability weighting based on random forest propensity scores.
Results
Women had significantly higher odds of using nearly all outpatient and preventive services, including general practitioners, specialists, dental care, physiotherapy, psychotherapy, and home care. They also reported higher use of both prescribed and non-prescribed medications. No significant gender differences were observed in hospitalization rates. Sensitivity analyses adjusting for health needs confirmed these findings. Considerable heterogeneity emerged across countries and service domains: Latvia, Lithuania, and Poland showed the largest disparities (e.g., ORs 1.52–1.75 for recent specialist visits), while Denmark, the Netherlands, and Ireland displayed relatively small overall gaps but large differences for specific services, such as psychotherapy and home care.
Conclusions
Women consistently utilize more non-acute healthcare services than men, while comparable hospitalization rates suggest differences in disease severity or care-seeking behaviors. The magnitude of these disparities varies considerably across European countries, highlighting the need for context-sensitive policies to address gender inequities in healthcare utilization.
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