The Medical Technologies Evaluation Programme (Mtep): An Analysis Of Notifications, Decision-Making And The Interpretation Of Claimed Healthcare System Benefits

The main goal of the article is to identify the essence, role, premises and conditions of managing patient engagement in the process approach. Patient engagement is an important component of health services, covering a wide area of action at the systemic and organizational levels. A comprehensive and coherent approach to the processes related to patient involvement, especially in the area of care decision-making, is essential for the smooth functioning of the healthcare system.

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“What Bothers Me Most Is the Disparity between the Choices that People Have or Don’t Have”: A Qualitative Study on the Health Systems Responsiveness to Implementing the Assisted Decision-Making (Capacity) Act in Ireland

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093294 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3294 ◽

Cited By ~ 1

Author(s):

Éidín Ní Shé ◽

Deirdre O’Donnell ◽

Sarah Donnelly ◽

Carmel Davies ◽

Francesco Fattori ◽

...

Keyword(s):

Decision Making ◽

Older People ◽

Healthcare System ◽

Health Systems ◽

Critical Incident ◽

Family Carers ◽

Acute Setting ◽

Face To Face ◽

Health And Social Care ◽

Diagnosis Of Dementia

Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 in Ireland and will be commenced in 2021. This paper is focused on this pre-implementation stage within the acute setting and uses a health systems responsiveness framework. Methods: We conducted face-to-face interviews using a critical incident technique. We interviewed older people including those with a diagnosis of dementia (n = 8), family carers (n = 5) and health and social care professionals (HSCPs) working in the acute setting (n = 26). Results: The interviewees reflected upon a healthcare system that is currently under significant pressures. HSCPs are doing their best, but they are often halted from delivering on the will and preference of their patients. Many older people and family carers feel that they must be very assertive to have their preferences considered. All expressed concern about the strain on the healthcare system. There are significant environmental barriers that are hindering ADM practice. Conclusions: The commencement of ADM provides an opportunity to redefine the provision, practices, and priorities of healthcare in Ireland to enable improved patient-centred care. To facilitate implementation of ADM, it is therefore critical to identify and provide adequate resources and work towards solutions to ensure a seamless commencement of the legislation.

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Assets, Aims, Actions, Alignment, Audit: 5As in Diabetes

Journal of Social Health and Diabetes ◽

10.1055/s-0039-3402099 ◽

2019 ◽

Vol 7 (02) ◽

pp. 89-90

Author(s):

Ameya Joshi

Keyword(s):

Decision Making ◽

Healthcare System ◽

Care Provider ◽

Diabetes Care ◽

Planning Strategies

AbstractThis brief communication shares the importance of the Alignment of the 3As, that is Assets, Aims, and Actions, while managing diabetes. It describes the essence of asset analysis, target decision-making, and therapeutic planning strategies. Calling for regular Audits of diabetes care, it reinforces the importance of this policy at the level of the person with diabetes, diabetes care provider, and healthcare system.

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An Efficient Decision-Making Approach for the Planning of Diagnostic Services in a Segmented Healthcare System

International Journal of Information Technology & Decision Making ◽

10.1142/s0219622019500196 ◽

2019 ◽

Vol 18 (05) ◽

pp. 1631-1665 ◽

Cited By ~ 2

Author(s):

Rodolfo Mendoza-Gómez ◽

Roger Z. Ríos-Mercado ◽

Karla B. Valenzuela-Ocaña

Keyword(s):

Decision Making ◽

Healthcare System ◽

Mixed Integer ◽

Critical Parameters ◽

Medium Size ◽

Public Healthcare ◽

Second Phase ◽

Patient Acuity ◽

Private Providers ◽

Decision Making Problem

In this paper, we address a decision-making problem related to the requirement of costly equipment by medical diagnostic services in a segmented public healthcare system comprising several institutions and private providers. The problem is motivated by a real-world case of the Mexican healthcare system. The aim of this study is to determine which hospitals can provide the service, their capacity levels, the allocation of demand in each institution, and the referral of patients to other institutions or private providers while minimizing annual investment costs and operating costs required to satisfy demand. A mixed-integer linear programming model that takes into account different characteristics such as patient acuity levels, types of equipment, and demand variation through time is introduced. The model was empirically assessed to evaluate its impact on the decision-making process. A sensitivity analysis to evaluate solution behavior for variations of critical parameters was performed. The results showed that some values could generate a significant effect on the total costs for the service coverage and in the efficiency of the service, whereas overall results indicated the usefulness of the model. While this model is valuable to aid this decision-making problem, it is limited to medium-size instances of up to 90 facilities. To solve the problems with larger instances, a two-phase heuristic algorithm is proposed. In the first phase, the method uses a greedy construction mechanism, and in the second phase, it attempts to improve the solution. Empirical evidence on large instances shows that good solutions with low computing times are reached in comparison with the exact method.

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Introduction of emerging medical devices on the market: A new procedure in Belgium

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462307070687 ◽

2007 ◽

Vol 23 (4) ◽

pp. 449-454 ◽

Cited By ~ 7

Author(s):

Imgard Vinck ◽

Mattias Neyt ◽

Nancy Thiry ◽

Marleen Louagie ◽

Dirk Ramaekers

Keyword(s):

Health Care ◽

Decision Making ◽

Health Insurance ◽

Cost Effectiveness ◽

Medical Devices ◽

Clinical Effectiveness ◽

Added Value ◽

Scientific Evaluation ◽

Medical Technologies ◽

Organizational Issues

When new medical technologies enter the market, there is often uncertainty about the added value for the patient and for society, hampering well-considered decision making about reimbursement. Current Belgian legislation already offered opportunities for the managed uptake of possibly innovative emerging implants. However, it has also some shortcomings such as the lack of a clear research design, rendering the scientific evaluation of clinical effectiveness, cost-effectiveness, and patient or organizational issues more difficult. Against this background, a new procedure was elaborated by the Belgian health insurance institute and the Belgian Health Care Knowledge Centre.

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Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183479 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3479

Author(s):

Gao ◽

Wang

Keyword(s):

Decision Making ◽

Supply Chain ◽

Healthcare System ◽

Reference Price ◽

Medical Insurance ◽

Patient Choice ◽

Insurance Fund ◽

Supply Chain Network ◽

Price Effect ◽

The Social

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients’ choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital’s cooperative intentions which benefits the social healthcare system.

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