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- Ahmad Kiadaliri, Aliasghar
(author)
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A Comparison of Iran and UK EQ-5D-3L Value Sets Based on Visual Analogue Scale
- 2017
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In: International Journal of Health Policy and Management. - : Maad Rayan Publishing Company. - 2322-5939. ; 6:5, s. 267-272
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Journal article (peer-reviewed)abstract
- Background: Preference weights for EQ-5D-3L based on visual analogue scale (VAS) has recently been developed in Iran. The aim of the current study was to compare performance of this value set against the UK VAS-based value set. Methods: The mean scores for all possible 243 health states were compared using Student t test. Absolute agreement and consistency were investigated using concordance correlation coefficient (CCC) and Bland-Altman plot. Health gains for 29 403 possible transitions between pairs of EQ-5D-3L health states were compared. Responsiveness to change and discriminative ability across subgroups of health transitions were assessed. Results: The mean EQ-5D-3L scores were similar for two value sets (mean = 0.31, P = 1.00). For 36% of health states, the absolute differences were greater than 0.10. There were three pairwise logical inconsistencies in the Iranian value set. The Iranian scores were lower (higher) for severe (mild) health states than the United Kingdom. The CCC (95% CI) was 0.85 (0.81 to 0.88) and Bland-Altman plot showed good agreement. The mean health gain for all possible transitions predicted by the Iranian value set was higher (0.22 vs. 0.20, P < .001) and two value sets predicted opposite transitions in 15% of transitions. The responsiveness of these two value sets were similar with lower discriminative ability for Iranian value set. Conclusion: The Iranian value set attribute lower values to most severe health states and higher values to mild health states compared with the UK value set. Such systematic differences might translate into discrepant health gains and cost-effectiveness which should be taking into account for informed decision-making. [ABSTRACT FROM AUTHOR]
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- Andersson Bäck, Monica, 1969
(author)
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Risks and Opportunities of Reforms Putting Primary Care in the Driver’s Seat. Comment on “Governance, Government, and the Search for New Provider Models”
- 2016
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In: International Journal of Health Policy and Management. - : Maad Rayan Publishing Company. - 2322-5939. ; 5:8, s. 511-513
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Journal article (peer-reviewed)abstract
- Recognizing the advantages of primary care as a means of improving the entire health system, this text comments on reforms of publicly funded primary health centers, and the rapid development of private for-profit providers in Sweden. Many goals and expectations are connected to such reforms, which equally require critical analyses of scarce resources, professional trust/motivation and business logic in the wake of freedom and control of ownership and management. In line with Saltman and Duran, this article calls for research and a methodologically developed approach to capture everyday practice in-depth and how regulation, market incentives and patient demands are met by professionals and primary care leaders.
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| 3. |
- Andersson, Thomas, 1970-
(author)
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If It Is Complex, Let It Be Complex - Dealing With Institutional Complexity in Hospitals : Comment on "Dual Agency in Hospitals: What Strategies Do Managers and Physicians Apply to Reconcile Dilemmas Between Clinical and Economic Considerations?"
- 2022
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In: International Journal of Health Policy and Management. - : Kerman University of Medical Sciences. - 2322-5939. ; 11:10, s. 2346-2348
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Journal article (peer-reviewed)abstract
- Waitzberg and colleagues identified strategies that managers and physicians in hospitals apply to reconcile dilemmas between clinical and economic considerations. Contributions that actually acknowledge the institutional complexity of hospitals and describe how to deal with it are rare. This comment explains the reason behind the institutional complexity in healthcare organizations and argues that institutional complexity is a good foundation for a well-functioning and sustainable healthcare, as long as we are able to deal with this complexity. This point underscores the importance of their contribution. However, even if the identified strategies on how to reconcile and balance different, competing demands are important, they are not easy to apply in practice. First, the strategies require frequent and high-quality interaction between different actors adhering to different institutional logics. Second, even when the strategies are applied successfully, it is difficult to make them sustainable since they rest on a fragile balance between competing logics. However, these are important avenues for future research for researchers who want to follow the route of Waitzberg and colleagues.
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| 4. |
- Angeler, David
(author)
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Adaptation, Transformation and Resilience in Healthcare; Comment on "Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada"
- 2022
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In: International Journal of Health Policy and Management. - : Maad Rayan Publishing Company. - 2322-5939. ; 11, s. 1949-1952
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Journal article (peer-reviewed)abstract
- Adaptive capacity is a critical component of building resilience in healthcare. Adaptive capacity comprises the ability of a system to cope with and adapt to disturbances. However, "shocks", such as the current Covid-19 pandemic, can potentially exceed critical adaptation thresholds and lead to systemic collapse. To effectively manage healthcare systems during periods of crises, both adaptive and transformative changes are necessary. This commentary discusses adaptation and transformation as two complementary, integral components of resilience and applies them to healthcare. We treat resilience as an emergent property of complex systems that accounts for multiple, often disparately distinct regimes in which multiple processes (e.g., adaptation, recovery) are subsumed and operate. We argue that Convergence Mental Health and other transdisciplinary paradigms such as Brain Capital and One Health can facilitate resilience planning and management in healthcare systems.
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| 8. |
- Baroudi, Mazen, et al.
(author)
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Access of Migrant Youths in Sweden to Sexual and Reproductive Healthcare : A Cross-sectional Survey
- 2022
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In: International Journal of Health Policy and Management. - : Kerman University of Medical Sciences. - 2322-5939. ; 11:3, s. 287-298
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Journal article (peer-reviewed)abstract
- Background: This study aims to assess migrant youths’ access to sexual and reproductive healthcare (SRHC) in Sweden, to examine the socioeconomic differences in their access, and to explore the reasons behind not seeking SRHC. Methods: A cross-sectional survey was conducted for 1739 migrant youths 16 to 29 years-old during 2018. The survey was self-administered through: ordinary post, web survey and visits to schools and other venues. We measured access as a 4-stage process including: healthcare needs, perception of needs, utilisation of services and met needs. Results: Migrant youths faced difficulties in accessing SRHC services. Around 30% of the participants needed SRHC last year, but only one-third of them fulfilled their needs. Men and women had the same need (27.4% of men [95% CI: 24.2, 30.7] vs. 32.7% of women [95% CI: 28.2, 37.1]), but men faced more difficulties in access. Those who did not categorise themselves as men or women (50.9% [95% CI: 34.0, 67.9]), born in South Asia (SA) (39% [95% CI: 31.7, 46.4]), were waiting for residence permit (45.1% [95% CI: 36.2, 54.0]) or experienced economic stress (34.5% [95% CI: 30.7, 38.3]) had a greater need and found more difficulties in access. The main difficulties were in the step between the perception of needs and utilisation of services. The most commonly reported reasons for refraining from seeking SRHC were the lack of knowledge about the Swedish health system and available SRHC services (23%), long waiting times (7.8%), language difficulties (7.4%) and unable to afford the costs (6.4%). Conclusion: There is an urgent need to improve migrant youths’ access to SRHC in Sweden. Interventions could include: increasing migrant youths’ knowledge about their rights and the available SRHC services; improving the acceptability and cultural responsiveness of available services, especially youth clinics; and improving the quality of language assistance services.
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| 9. |
- Burstrom, B
(author)
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Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"
- 2022
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In: International journal of health policy and management. - : Maad Rayan Publishing Company. - 2322-5939. ; 11:5, s. 714-716
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Journal article (peer-reviewed)abstract
- This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.
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| 10. |
- Byskov, Jens, et al.
(author)
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The Need for Global Application of the Accountability for Reasonableness Approach to Support Sustainable Outcomes Comment on "Expanded HTA Enhancing Fairness and Legitimacy"
- 2017
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In: International Journal of Health Policy and Management. - : Kerman University of Medical Sciences. - 2322-5939. ; 6:2, s. 115-118
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Journal article (peer-reviewed)abstract
- The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. This has again influenced the development of the concept, but not led to universal application. The potential use in health technology assessments (HTAs) has recently been identified by Daniels et al as yet another excellent justification for AFR-based process guidance that refers to both qualitative and a broader participatory input for HTA, but it has raised concerns from those who primarily support the consistency and objectivity of more quantitative and reproducible evidence. With reference to studies of AFR-based interventions and the through these repeatedly documented motivation for their consolidation, we argue that it can even be unethical not to take AFR conditions beyond their still mainly formative stage and test their application within routine health systems management for their expected support to more sustainable health improvements. The ever increasing evidence and technical expertise are necessary but at times contradictory and do not in isolation lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. Legitimacy, accountability and fairness do not come about without an inclusive and agreed process guidance that can reconcile differences of opinion and indeed differences in evidence to arrive at a by all understood, accepted, but not necessarily agreed compromise in a current context -until major premises for the decision change. AFR should be widely adopted in projects and services under close monitoring and frequent reviews.
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