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Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

Globally, hepatitis C treatment uptake is lower among people who are homeless or unstably housed compared to those who are housed. Understanding and addressing this is essential to ensure no one is left behind in hepatitis C elimination efforts. This study aims to explore peoples’ experiences of unstable housing and health care, and how these experiences influenced engagement in hepatitis C treatment.

Purposive sampling was used to recruit people with lived experience of injection drug use, hepatitis C and unstable housing in Melbourne, Australia. In-depth semistructured interviews were conducted and a case study approach with interpretative phenomenological analysis was used to identify personal experiential themes and group experiential themes.

Four people were interviewed. The precarious nature of housing for women who inject drugs was a group experiential theme, however, this did not appear to be a direct barrier to hepatitis C treatment. Rather, competing priorities, including caregiving, were personal experiential themes and these created barriers to treatment. Another group experiential theme was “right place, right time, right people” with these three elements required to facilitate hepatitis C treatment.

There is limited research providing in-depth insight into how personal experiences with unstable housing and health care shape engagement with hepatitis C treatment. The analyses indicate there is a need to move beyond a “one size fits-all” approach to hepatitis C care. Instead, care should be tailored to the needs of individuals and their personal circumstances and regularly facilitated. This includes giving greater attention to gender in intervention design and evaluation, and research more broadly.

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

Many European countries suspended mandatory conscription after the Cold War, and especially between 2000 and 2010. However, with the changing security situation in Europe, more and more countries are considering the re-introduction of the draft. That is why, it is important to evaluate the impact of conscription on draftees, including its effect on fertility outcomes. Additionally, fertility is of particular interest because birth rates have been below replacement levels in most European countries at least in the last two decades. This, combined with the increase in life expectancy, has contributed to aging population and raises concerns about the future economic prospects and sustainability of the continent. Military service could be related to fertility in several ways. Compulsory service for men would affect the marriage market and subsequently child-bearing outcomes. For example, men who serve in the military would have to delay higher education at least by a year, given that they plan to continue their education after high school. One possibility is that this leads to older men meeting younger women if partners meet at college. Alternatively, in case the partners know each other prior to the draft, service could delay marriage by up to a year due to the conscription, postponing planning and having children, and potentially having fewer children as women might be less able or less willing to have a child after a certain age. Finally, some men who plan and would otherwise continue their education might choose to not do so or to further postpone it once they disattach from studying during their service. For some men, this might influence their marital and subsequent fertility outcomes. In either of these scenarios, a draft or its suspension is likely to be connected to fertility.

This study examines the effect of the suspension of the draft in Spain in December 2001 on three fertility outcomes of men that would have been drafted in the absence of the suspension. The author performs the analysis in a difference-in-differences framework. Potential concerns and policy implications are also discussed.

The findings suggest that after the suspension of the draft, individuals started to have their first child earlier given that they decide to have children. Consistent with the overall time trend, they became less likely to have a child and started to have fewer children. However, the age at birth of the first child decreased while the number of children and the likelihood of having a child increased for men relative to women, after compared to before the suspension of the mandatory draft.

The author extends prior literature by investigating the effect of the abolition of compulsory military service in Spain in December 2001 on fertility. This is novel is several ways. First, to the best of the author’s knowledge, previous literature has examined the effect of this Spanish reform only on labor market outcomes prior to men's conscription. Second, even for other countries that terminated the compulsory draft, fertility has been under-studied, providing an opportunity for further exploration. Third, this analysis is based on rich Census data, representative of the population in Spain. Finally, given the inconclusive findings of previous studies for other countries and the proposed re-introduction of the draft in some parts of Europe, additional evidence of the effect of the conscription has important policy implications necessary for the evaluation of future military service policy decisions.

This study is a radical interactionist analysis of family conflict. Drawing on both a negotiated order perspective and Athen's theory of complex dominative encounters, this study analyzes the role that domination plays in conflicts among intimates. As the family engages in repeated conflicts over roles, the family also engages in negotiations over the family order, what role each party should play, interpretations of past events, and plans for the future. These conflicts take place against a backdrop of patriarchy that asymmetrically distributes power in the family to determine the family order. The data from this study come from a content analysis of mothers with substance use problems as depicted in the reality television show Intervention. The conflicts in these families reveal that these families develop a grinding family order in which families engaged in repeated conflict but also continued to operate as and identify as a family. These conflicts are shaped by and reinforce patriarchal expectations that mothers are central to family operation. The intervention at the end of each episode offered an opportunity for the family to engage in a concerted campaign to try to force the mother into treatment and reestablish the family order.

The environment in which users acquire medical and health information has changed dramatically, with online health communities (OHCs) emerging as an essential means for accessing health information. It is imperative to comprehend the factors that shape the users' compliance willingness (UCW) to health information in OHCs.

This study adopted the information adoption model (IAM) and theory of planned behavior (TPB) to investigate the influence of argument quality (AQ), source credibility (SC) and subjective norms (SN) on UCW while considering the two types of online health information – mature and emerging treatments. The authors conducted an explanatory-predictive study based on a 2 (treatment types: mature vs. emerging) * 2 (AQ: high vs. low) * 2 (SC: high vs. low) scenario-based experiment, using the partial least squares structural equation modeling (PLS-SEM).

SC positively influences AQ. AQ, SC and SN contribute to information usefulness (IU). These factors positively affect UCW through the mediation of IU. SN were found to improve UCW directly. Moreover, the moderating effect of SC on AQ and IU was more substantial for emerging treatments.

The research model integrates IAM and TPB, considering information types as an additional variable. The approach and findings provide a valuable explanation for UCW to health information in OHCs.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

This literature review aims to assess the current research on healthcare job availability and skilled professionals. The objective of this research is to identify challenges caused by the imbalance between healthcare service demand and qualified professionals and propose potential solutions and future research directions.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed as the guiding framework for conducting this review. A qualitative research design analyzed 38 peer-reviewed, evidence-based research works from 50 journal publications. Inclusion criteria focused on empirical studies, observational research and comprehensive reviews published within the last ten years. Thematic and discourse analysis categorized themes and factors explored in selected publications.

The findings highlight significant challenges in the healthcare sector regarding job availability and skilled professionals. Developed countries face understaffed healthcare facilities, resulting in increased workloads and compromised care. Developing countries experience high rates of unemployment among healthcare graduates due to limited resources and mentorship.

Improving educational infrastructure, expanding training opportunities and increasing healthcare investments are crucial for nurturing a skilled workforce. Implementing effective retention policies, fostering international collaborations and addressing socioeconomic determinants can create a sustainable job market.

The healthcare sector faces critical challenges in balancing job availability and skilled professionals. Strategic solutions are proposed to create a sustainable and equitable healthcare workforce. By implementing recommendations and conducting further research, access to quality healthcare and global public health outcomes can be improved.

This study aims to assess the impact of participation in self-help group (SHG) on the psychological empowerment of rural tribal women.

Primary data was collected using multistage random sampling from the rural women of Jharkhand, India. The propensity score matching method was adopted using the psmatch2 command in STATA.

The results show a significant positive change in women’s self-esteem, self-confidence, self-efficacy, autonomy, knowledge and skills, reduction in agony and quality of life after participation in SHG. This reveals that participation in SHG has a significant positive impact on the psychological empowerment of rural tribal women.

Despite the numerous studies on rural women’s empowerment, there is little evidence of literature focusing on the impact of participation in SHG on psychological empowerment, specifically in the tribal context. This study primarily focuses on women belonging to the scheduled tribe category of Jharkhand, one of the poorest states of India.