scholarly journals Bringing Greater Accuracy to Europe’s Healthcare Systems: The Unexploited Potential of Biomarker Testing in Oncology

2020 ◽  
Vol 5 (3) ◽  
pp. 1-42
Author(s):  
Denis Horgan ◽  
Gennaro Ciliberto ◽  
Pierfranco Conte ◽  
David Baldwin ◽  
Luis Seijo ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Universal Access ◽  
Personalised Medicine ◽  
National Policy ◽  
Healthcare Systems ◽  
Policy Framework ◽  
Colon Cancers ◽  
Biomarker Testing ◽  
The Many

Rapid and continuing advances in biomarker testing are not being matched by take-up in health systems, and this is hampering both patient care and innovation. It also risks costing health systems the opportunity to make their services more efficient and, over time, more economical. This paper sets out the potential of biomarker testing, the unfolding precision and range of possible diagnosis and prediction, and the many obstacles to adoption. It offers case studies of biomarker testing in breast, ovarian, prostate, lung, thyroid and colon cancers, and derives specific lessons as to the potential and actual use of each of them. It also draws lessons about how to improve access and alignment, and to remedy the data deficiencies that impede development. And it suggests solutions to outstanding issues – notably including funding and the tangled web of obtaining reimbursement or equivalent coverage that Europe’s fragmented health system implies. It urges a European evolution towards an initial minimum testing scenario, which would guarantee universal access to a suite of biomarker tests for the currently most common conditions, and, further into the future, to an optimum testing scenario in which a much wider range of biomarker tests would be introduced and become part of a more sophisticated health system articulated around personalised medicine. For exploiting genomics to the full, it argues the need for a new policy framework for Europe. Biomarker testing is not an issue that can be treated in isolation, since the purpose of testing is to improve health. Its use is therefore always closely linked to specific health challenges and needs to be viewed in the broader policy context in the EU and more widely. The paper is the result of extensive engagement with experts and decision makers to develop the framework, and consequently represents a wide consensus of views on how healthcare systems should respond from push and pull factors at local, national and cross-border and EU level. It contains strong views and clear recommendations springing from the convictions of patients, clinicians, academics, medicines authorities, HTA bodies, payers, the diagnostic, pharmaceutical and ICT industries, and national policy makers.

scholarly journals Bringing onco-innovation to Europe’s healthcare systems: the unexploited potential of biomarker testing, real world evidence and the potential of Tumour Agnostics. The lesson from BRCA1/2 genetic testing

2020 ◽  
Author(s):  
Denis Horgan ◽  
Gennaro CILIBERTO ◽  
Pierfranco Conte ◽  
Giuseppe CURIGLIANO ◽  
Luis Seijo ◽  
...  
Keyword(s):  
Health Systems ◽  
Real World ◽  
Universal Access ◽  
Personalised Medicine ◽  
Policy Framework ◽  
Real World Evidence ◽  
Biomarker Testing ◽  
Policy Alignment ◽  
Prostate Cancers

Rapid and continuing advances in biomarker testing are not being matched by take-up in health systems, and this is hampering both patient care and innovation. It also risks costing health systems the opportunity to make their services more efficient and, over time, more economical. The potential that genomics has brought to biomarker testing in diagnosis, prediction and research is being realised, pre-eminently in many cancers, but also in an ever-wider range of conditions. One of the paradigmatic examples is BRCA1/2 testing in ovarian, breast, pancreatic and prostate cancers. Nevertheless, development is impeded by data deficiencies, and lack of policy alignment on standards, approval – and the role of real-world evidence in the process - and reimbursement. The acute nature of the problem is compellingly illustrated by the particular challenges facing the development and use of tumour agnostic therapies, where the gaps in preparedness for taking advantage of this innovative approach to cancer therapy are sharply exposed. Europe should already have in place a guarantee of universal access to a minimum suite of biomarker tests and should be planning for an optimum testing scenario with a wider range of biomarker tests integrated into a more sophisticated health system articulated around personalised medicine. Improving healthcare and winning advantages for Europe's industrial competitiveness and innovation require an appropriate policy framework – starting with an update to outdated recommendations.

scholarly journals Bringing Onco-Innovation to Europe’s Healthcare Systems: The Potential of Biomarker Testing, Real World Evidence, Tumour Agnostic Therapies to Empower Personalised Medicine

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 583
Author(s):  
Denis Horgan ◽  
Gennaro Ciliberto ◽  
Pierfranco Conte ◽  
Giuseppe Curigliano ◽  
Luis Seijo ◽  
...  
Keyword(s):  
Health Systems ◽  
Real World ◽  
Universal Access ◽  
Personalised Medicine ◽  
Policy Framework ◽  
Advisory Boards ◽  
Real World Evidence ◽  
Biomarker Testing ◽  
Policy Alignment ◽  
Prostate Cancers

Rapid and continuing advances in biomarker testing are not being matched by uptake in health systems, and this is hampering both patient care and innovation. It also risks costing health systems the opportunity to make their services more efficient and, over time, more economical. The potential that genomics has brought to biomarker testing in diagnosis, prediction and research is being realised, pre-eminently in many cancers, but also in an ever-wider range of conditions—notably BRCA1/2 testing in ovarian, breast, pancreatic and prostate cancers. Nevertheless, the implementation of genetic testing in clinical routine setting is still challenging. Development is impeded by country-related heterogeneity, data deficiencies, and lack of policy alignment on standards, approval—and the role of real-world evidence in the process—and reimbursement. The acute nature of the problem is compellingly illustrated by the particular challenges facing the development and use of tumour agnostic therapies, where the gaps in preparedness for taking advantage of this innovative approach to cancer therapy are sharply exposed. Europe should already have in place a guarantee of universal access to a minimum suite of biomarker tests and should be planning for an optimum testing scenario with a wider range of biomarker tests integrated into a more sophisticated health system articulated around personalised medicine. Improving healthcare and winning advantages for Europe’s industrial competitiveness and innovation require an appropriate policy framework—starting with an update to outdated recommendations. We show herein the main issues and proposals that emerged during the previous advisory boards organised by the European Alliance for Personalized Medicine which mainly focus on possible scenarios of harmonisation of both oncogenetic testing and management of cancer patients.

Differences in Antimicrobial Susceptibility Among Hospitals in an Integrated Health System

2001 ◽  
Vol 22 (6) ◽  
pp. 379-382 ◽  
Author(s):  
Teresa J. Lubowski ◽  
John L. Woon ◽  
Patricia Hogan ◽  
Ching-Chang Hwang
Keyword(s):  
Health System ◽  
Health Systems ◽  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Healthcare Systems ◽  
Integrated Healthcare ◽  
Susceptibility Data ◽  
Integrated Health ◽  
Susceptibility Patterns

AbstractWe evaluated the differences in antimicrobial susceptibility among hospitals in three different integrated healthcare systems. Each system provided antibiogram-susceptibility reports from representative hospitals. Reports were analyzed for statistically significant differences between hospitals in a given system for nine important organisms. We found numerous significant interhospital differences in antimicrobial-susceptibility patterns within health systems. For this reason, the practice of combining antibiotic-susceptibility data into a systemwide antibiogram should be discouraged.

Rights of access to healthcare for undocumented migrants: understanding the Italian and British national health systems

2018 ◽  
Vol 11 (4) ◽  
pp. 232-243 ◽  
Author(s):  
Danielle da Costa Leite Borges ◽  
Caterina Francesca Guidi
Keyword(s):  
Health System ◽  
Health Systems ◽  
National Health ◽  
Universal Access ◽  
Research Question ◽  
Access To Healthcare ◽  
Health Policies ◽  
Undocumented Migrants ◽  
Content Type ◽  
British Health

Purpose The purpose of this paper is to analyse the levels of access to healthcare available to undocumented migrants in the Italian and British health systems through a comparative analysis of health policies for this population in these two national health systems. Design/methodology/approach It builds on textual and legal analysis to explore the different meanings that the principle of universal access to healthcare might have according to literature and legal documents in the field, especially those from the human rights domain. Then, the concept of universal access, in theory, is contrasted with actual health policies in each of the selected countries to establish its meaning in practice and according to the social context. The analysis relies on policy papers, data on health expenditure, legal statutes and administrative regulations and is informed by one research question: What background conditions better explain more universal and comprehensive health systems for undocumented migrants? Findings By answering this research question the paper concludes that the Italian health system is more comprehensive than the British health system insofar it guarantees access free of charge to different levels of care, including primary, emergency, preventive and maternity care, while the rule in the British health system is the recovering of charges for the provision of services, with few exceptions. One possible legal explanation for the differences in access between Italy and UK is the fact that the right to health is not recognised as a fundamental constitutional right in the latter as it is in the former. Originality/value The paper contributes to ongoing debates on Universal Health Coverage and migration, and dialogues with recent discussions on social justice and welfare state typologies.

scholarly journals Investigating Health Systems in the European Union: Outcomes and Fiscal Sustainability

2018 ◽  
Vol 10 (9) ◽  
pp. 3186 ◽  
Author(s):  
Madalina Popescu ◽  
Eva Militaru ◽  
Amalia Cristescu ◽  
Maria Vasilescu ◽  
Monica Maer Matei
Keyword(s):  
European Union ◽  
Health System ◽  
Health Systems ◽  
Composite Index ◽  
Healthcare Systems ◽  
Fiscal Sustainability ◽  
The European Union ◽  
Eu Countries ◽  
Health Performance ◽  
The Eu

Healthcare systems aim to provide access to good quality care, while ensuring equity and solidarity. The fiscal sustainability of healthcare systems has become a matter of concern in recent European Union (EU) debates, considering the ever increasing need for adequate healthcare determined by factors such as aging population, investments in technology and infrastructure, medical products and wages. Our paper seeks to measure the health system performances of the EU countries by building up a composite index, which will then be used as a tool in investigating the relationship between health performance and the fiscal sustainability of health systems. A principal components analysis (PCA) was applied to build the composite index through the use of the most relevant health indicators provided by Eurostat and the Sustainable Development Knowledge Platform. The composite index offers a comprehensive performance assessment and provides a clear ranking of the EU countries based on their health system performances. Further investigation of the link between health performance and fiscal sustainability revealed that higher ranks are associated with higher shares of health expenditures in gross domestic product (GDP), a large share of employment in the health sector, and higher duration of working life. These patterns are followed by efficient health systems, encountering reduced sustainability risks.

scholarly journals Resilience to dealing with COVID-19: university perspective in a low-income health Brazilian region

2021 ◽  
Vol 29 (111) ◽  
pp. 525-542
Author(s):  
Bruno Bastos Godoi ◽  
Delba Fonseca Santos
Keyword(s):  
Health System ◽  
Health Systems ◽  
Low Income ◽  
Universal Access ◽  
Lessons Learned ◽  
World Health ◽  
The People ◽  
Innovative Products ◽  
Quality Health ◽  
Health Organization

Abstract The COVID-19 pandemic draws into focus the need to rebuild resilient health systems with increased access to quality health services. Reaction ability to changing demand is crucial. Resilience is relevant because all countries have vulnerable communities. One could push the argument further, using as an example the resilience particularly present on the agenda of meetings of the World Health Organization. More critical than ever, it is to take stock of the lessons learned. The stakeholders need to work together to accelerate progress towards universal access to essential health information through resilience. Regarding major societal challenges, which have a local dimension, universities have a key role to play in the knowledge creation of innovative products and services. The need for timely, accurate, and reliable data about the Vale do Jequitinhonha in the health system is unarguably overdue for a real-time, technology-driven, surveillance and reporting infrastructure to respond effectively to public health emergencies. Health system resilience is one of the focuses in low-income region framework and it is an indispensable university strategy for managing the health risks of older adults, and chronic disease patients. COVID-19 can cause disruption in health systems. Disruptions to health service infrastructure can result in loss of life, negative economic impact, and harm to communities. Focused actions include investing in Primary Health Care (PHC) and this encompasses basic preventive, promotive, and curative health cares for enhancing the health status of the people by reducing morbidity and mortality rates. Given the key role of such information for health, the university located in a low-income health region has a fundamental role. The reflections and shreds of evidence showed during this essay can serve as a framework for health policies in post-pandemic reality and university acting in the population.

scholarly journals A Reviewing the Top Health Systems with Comparison to Iraqi Health System

2021 ◽  
Vol 63 (1) ◽  
pp. 43-49
Author(s):  
Hazim A Alhiti
Keyword(s):  
Health System ◽  
Health Systems ◽  
System Performance ◽  
Healthcare Systems ◽  
Performance Criteria ◽  
System Model ◽  
Health System Performance ◽  
Weak Points

Background: The assessments of performance in any health system is a challenging goal. Objectives: This article reviews the top healthcare systems then compares them to Iraqi health system. Patients and methods: The top 12 commercial Health Systems in 2020 ranked by a survey of more than 20,000 international citizens from 73 countries on 65 diverse metrics. These metrics vary from simple to critical health system performance criteria. Results: Up to January 2020, the review shows that Canada has the top Health System. Most other top countries are Europeans. There are some strong and weak points in each health system. Iraqi health system struggles with several obstacles that need a rehabilitation. Conclusions: Iraqi health system needs some improvements. The Netherlands Health system model improves the Iraqi health system.

The ‘Top 10’ Challenges for Health Technology Assessment: INAHTA Viewpoint

2019 ◽  
Vol 36 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Brian O'Rourke ◽  
Sophie Söderholm Werkö ◽  
Tracy Merlin ◽  
Li Ying Huang ◽  
Tara Schuller
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Health System ◽  
Health Systems ◽  
Technology Assessment ◽  
Health Technology ◽  
Publicly Funded ◽  
Non Profit ◽  
The Many ◽  
National Governments

The International Network of Agencies for Health Technology Assessment (INAHTA) spans the globe as a network of 50 publicly-funded health technology assessment (HTA) agencies supporting health system decision making for 1.4 billion people in thirty countries. Agency members are non-profit HTA organizations that are part of, or directly support, regional or national governments. Recently, INAHTA surveyed its members to gather perspectives from agency leadership on the most important issues in HTA today. This paper describes the top 10 challenges identified by INAHTA members. Addressing these challenges requires a call for action from INAHTA member agencies and the many other actors involved in the HTA ecosystem. In opening this call for action, INAHTA will lead the way; however, a comprehensive undertaking from all players is needed to effectively address these challenges and to continue to evolve HTA in its role as a strong and effective contributor to health systems.

scholarly journals The COVID-19 pandemic and healthcare systems in Africa: a scoping review of preparedness, impact and response

2021 ◽  
Vol 6 (12) ◽  
pp. e007179
Author(s):  
Gizachew A Tessema ◽  
Yohannes Kinfu ◽  
Berihun Assefa Dachew ◽  
Azeb Gebresilassie Tesema ◽  
Yibeltal Assefa ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
Grey Literature ◽  
Healthcare Systems ◽  
Strengthen Health System ◽  
Global Engagement ◽  
Scoping Reviews ◽  
Meta Analyses

BackgroundThe COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic.MethodsWe conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O’Malley’s methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed.ResultsTwenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings.ConclusionsThe health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised.

scholarly journals Health system foundations for Sláintecare implementation in 2020 and beyond – co-producing a Sláintecare Living Implementation Framework with Evaluation: Learning from the Irish health system’s response to COVID-19. A mixed-methods study protocol

2020 ◽  
Vol 3 ◽  
pp. 70
Author(s):  
Sara Burke ◽  
Steve Thomas ◽  
Malgorzata Stach ◽  
Paul Kavanagh ◽  
Laura Magahy ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Quantitative Methods ◽  
Universal Access ◽  
Policy Research ◽  
World Health ◽  
System Reform ◽  
Programme Implementation ◽  
Implementation Framework ◽  
Health And Social Care

All over the world, health systems are responding to the major shock of the COVID-19 pandemic. The virus is causing urgent and fast-paced change in the delivery of health and social care as well as highlighting pre-existing deficiencies and inequalities in the health system and broader society. In Ireland, COVID-19 is occurring during the second full year of Sláintecare’s implementation – Ireland’s 10-year plan for health reform to deliver universal access to timely, integrated care. This research will coproduce a Living Implementation Framework with Evaluation (LIFE) linking evidence, policy and practice that feeds into real-world Sláintecare implementation. In partnership with senior leadership in the Sláintecare Programme Implementation Office, the Department of Health and the HSE, the researchers will scope, document, measure and analyse the Sláintecare relevant COVID-19 responses using qualitative and quantitative methods. The LIFE will initially take the form of a live spreadsheet which contains the COVID-19 responses most relevant to Sláintecare. For each response, 3-4 indicators will be collected which enables monitoring overtime. The spreadsheet will be accompanied by a series of rapid reviews, narrative descriptions of multiple case studies, research papers, stakeholder engagement and formative feedback. These collectively make up the ‘LIFE’, informing dialogue with the project partners, which is happening in real time (living), influencing health policy and system decision-making and implementation as the project progresses. The LIFE will inform health system reform in Ireland in the months and years after the emergence of COVID-19 as well as contributing to international health systems and policy research.

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