scholarly journals Strategies for reducing out of pocket payments in the health system: a scoping review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Faride Sadat Jalali ◽  
Parisa Bikineh ◽  
Sajad Delavari
Keyword(s):  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
Health Financing ◽  
Developed Countries ◽  
Vulnerable Groups ◽  
System A ◽  
Out Of Pocket Payments ◽  
Review Study ◽  
Developing And Developed Countries

Abstract Background Direct out-of-pocket payments (OOP) are among the most important financing mechanisms in many health systems, especially in developing countries, adversely affecting equality and leading vulnerable groups to poverty. Therefore, this scoping review study was conducted to identify the strategies involving OOP reduction in health systems. Methods Articles published in English on strategies related to out-of-pocket payments were Searched and retrieved in the Web of Science, Scopus, PubMed, and Embase databases between January 2000 and November 2020, following PRISMA guidelines. As a result, 3710 papers were retrieved initially, and 40 were selected for full-text assessment. Results Out of 40 papers included, 22 (55%) and 18 (45%) of the study were conducted in developing and developed countries, respectively. The strategies were divided into four categories based on health system functions: health system stewardship, creating resources, health financing mechanisms, and delivering health services.As well, developing and developed countries applied different types of strategies to reduce OOP. Conclusion The present review identified some strategies that affect the OOP payments According to the health system functions framework. Considering the importance of stewardship, creating resources, the health financing mechanisms, and delivering health services in reducing OOP, this study could help policymakers make better decisions for reducing OOP expenditures.

scholarly journals The Relationships and Configuration of Universal and Optional Healthcare Financing Schemes in Czechia

2018 ◽  
Vol 9 (3) ◽  
pp. 177-192
Author(s):  
Jan Mertl
Keyword(s):  
Health System ◽  
Swot Analysis ◽  
Health Financing ◽  
Developed Countries ◽  
Comparative Approach ◽  
Health System Financing ◽  
System A ◽  
Analysis And Synthesis ◽  
Health Programmes ◽  
Financing Schemes

Abstract In developed countries, both universal and optional parts of healthcare exist. This article shows the importance and fiscal position of universally available care and suggests where it can be extended by optional financing schemes such as prepaid health programmes. We use a comparative approach, SWOT analysis and synthesis of individual mechanisms of health financing into a single health system. A simple scheme of possible health system financing configuration is created, and we classify the financial resources and schemes used accordingly. Overall this article introduces a theoretically substantiated overview of health policy options for Czechia based on principles of universally available care, solidarity, fiscal neutrality, adequate fiscal space for health and voluntary private health expenditure.

scholarly journals What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Natural Hazards ◽  
Health Systems ◽  
Scoping Review ◽  
Disease Outbreaks ◽  
World Health ◽  
Infectious Disease Outbreaks ◽  
System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

scholarly journals Methods for assessing the need for health financing: international experience (analytical review)

2021 ◽  
Vol 65 (3) ◽  
pp. 261-268
Author(s):  
Elena G. Potapchik
Keyword(s):  
Health System ◽  
Health Spending ◽  
Demographic Factors ◽  
Health Financing ◽  
Developed Countries ◽  
International Experience ◽  
World Health ◽  
Free Text ◽  
Spending Growth ◽  
The Government

There has been an active discussion on estimating the need for public funding of the domestic health system. An analysis of international experience can be helpful to determine methodological approaches to estimate the market for government spending on the Russian health system. Aim. To systemize and summarize approaches and methods used in international practice to estimate the need for health financing; to highlight the most important factors dictating the need for additional funding. Material and methods. A systematic search with the developed protocol for publications, a comprehensive analysis and systematization of the obtained information. The protocol included databases of peer-reviewed publications, search terms, and search restrictions. The search for publications was carried out in the databases of Embase, Pubmed, Medline, Global Health, etc., on the websites of international organizations (World Health Organization (WHO), Organization for Economic Cooperation and Development (OECD), etc.). The search strategy included a combination of the terms “free text” and “Medical subject heading”, which refer to the definition of the need for health financing. The main limitations of the search were the language of publications (English and Russian) and the date of publication (not earlier than 2000). Results. Of the two used in international practice approaches to estimate the need for health financing, a system based on the use of the current level of funding and its forecasting under several factors is used in developed countries. Forecasting health expenditures is one of the most effective tools to identify critical factors affecting needs for sector financing. Despite the variety of indicators and methods used, most studies agree that non-demographic factors, such as GDP growth and technology development, influence health spending growth to the greatest extent. Demographic factors per se, including population ageing, affect health spending growth to a lesser extent. Conclusion. Conducting scenario forecasts contributes to a better understanding of what can happen in the future if the government does not act. This also contributes to a more clear determining of the main spheres for government interventions in the health sector.

scholarly journals BREAST CYTOPATHOLOGY REPORTING USING THE NEWLY PROPOSED IAC YOKOHAMA SYSTEM: A SINGLE INSTITUTIONAL RETROSPECTIVE STUDY OF THE APPLICATION OF THE SYSTEM AND UTILITY OF BREAST FNAC.

2020 ◽  
pp. 1-3
Author(s):  
Bhawna Agnani ◽  
Deepika * Hemrajani ◽  
Kusum Mathur ◽  
Sankalp Agnani
Keyword(s):  
High Sensitivity ◽  
Cost Effective ◽  
Developed Countries ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
System A ◽  
Common Cancer ◽  
Needle Aspiration Cytology ◽  
International Academy ◽  
Developing And Developed Countries

Breast carcinoma is the second most common cancer in females in developing and developed countries. Recently the International academy of cytology (IAC) proposed a new reporting system for breast ne needle aspiration cytology. We aimed to categorize the breast FNAC samples according to the IACYokohama guidelines and obtain the cyto-histopath correlation. Breast FNAC specimens (n=603) received at our institution from 1st January 2017 to 31st December 2017 were reclassied according to the newly proposed IACYokohama reporting system.Among 603 aspirates, 448 caseswere reported as benign breastlesions. 21 caseswere reported as atypia and 16cases assuspicious and41caseswereofmalignancy.Histopathological conrmationwas obtainedin100cases.Statistical analysiswas done. FNAC is an effective modality for the diagnosis of breast lesions. It is safe, simple and cost effective outpatient procedure with high sensitivity, specicity and accuracy.

scholarly journals Country-Wide Resilience Model for the Health System: A Case Study on Iran, under Coronavirus Outbreak

2021 ◽  
Author(s):  
Nazanin Pilevari ◽  
Mahyar Valeh Shiva
Keyword(s):  
Health System ◽  
Health Systems ◽  
Dynamic Capabilities ◽  
Health Information System ◽  
National Health System ◽  
Building Blocks ◽  
Interpretive Structural Modeling ◽  
System A ◽  
The Impact

Background: The outbreak of the COVID-19 virus has had many destructive impacts on socio-economic and health systems. The health systems of countries could be supportive in crisis management, but they also are affected by the impact of the crisis, consequently, their operational level has declined. This study pursued resilience in an overall national health system under pandemic stress. Methods: Based on WHO building blocks, by interviewing informants of the Ministry of Health and Medical Education, in Tehran-Iran, early 2021 a rich picture of the current situation depicted, the resilience model was extracted via a mixed method of Soft System Methodology (SSM) and total interpretive structural modeling (TISM). Dynamic capabilities were applied for the orchestration of the Iranian health system. Results: Particular functional and structural suggestions applicable for designing a ubiquitous resilience model for the country-wide health system are presented in this study. The variables of crisis sensing, opportunity seizing, and reconfiguration are the cornerstones of health system resilience. Conclusion: Well-suited health technology assessment (HTA) and health information system (HIS) play significant roles in the overall strengthening of the health system. All reforms for resilience will have a lasting result when the capabilities created by the resilience model are learned and reused in a dynamic cycle.

scholarly journals Health System Resilience: What Are We Talking About? A Scoping Review Mapping Characteristics and Keywords

2019 ◽  
Vol 9 (1) ◽  
pp. 6-16 ◽  
Author(s):  
My Fridell ◽  
Sanna Edwin ◽  
Johan von Schreeb ◽  
Dell D. Saulnier
Keyword(s):  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
World Health ◽  
Systems Research ◽  
Quality Health ◽  
System Resilience ◽  
Health Organization ◽  
Key Terms

Background: Health systems are based on 6 functions that need to work together at all times to effectively deliver safe and quality health services. These functions are vulnerable to shocks and changes; if a health system is unable to withstand the pressure from a shock, it may cease to function or collapse. The concept of resilience has been introduced with the goal of strengthening health systems to avoid disruption or collapse. The concept is new within health systems research, and no common description exists to describe its meaning. The aim of this study is to summarize and characterize the existing descriptions of health system resilience to improve understanding of the concept. Methods and Analysis: A scoping review was undertaken to identify the descriptions and characteristics of health system resilience. Four databases and gray literature were searched using the keywords "health system" and "resilience" for published documents that included descriptions, frameworks or characteristics of health system resilience. Additional documents were identified from reference lists. Four expert consultations were conducted to gain a broader perspective. Descriptions were analysed by studying the frequency of key terms and were characterized by using the World Health Organization (WHO) health system framework. The scoping review identified eleven sources with descriptions and 24 sources that presented characteristics of health system resilience. Frequently used terms that were identified in the literature were shock, adapt, maintain, absorb and respond. Change and learning were also identified when combining the findings from the descriptions, characteristics and expert consultations. Leadership and governance were recognized as the most important building block for creating health system resilience. Discussion: No single description of health system resilience was used consistently. A variation was observed on how resilience is described and to what depth it was explained in the existing literature. The descriptions of health system resilience primarily focus on major shocks. Adjustments to long-term changes and the element of learning should be considered for a better understating of health system resilience.

scholarly journals Innovation, Demand, and Responsibility: Some Fundamental Questions About Health Systems Comment on "What Health System Challenges Should Responsible Innovation in Health Address? Insights From an International Scoping Review"

2019 ◽  
Vol 8 (9) ◽  
pp. 567-569 ◽  
Author(s):  
Harro van Lente
Keyword(s):  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
Responsible Innovation

In this commentary on the exercise of Lehoux et al (this volume) I argue that in discussions on the current challenges of health systems, a better diagnosis of the health system is required. The cause of responsible innovation in health (RIH) requires a better understanding of the dynamics of health systems, in particular how innovation, demand, and responsibility are manifested. Innovation brings its own dynamic to the health system; demands are linked to historical and social developments; responsibility brings contestations about what counts as good healthcare. Any attempt of RIH should include such reflections.

scholarly journals The global pool of simulation exercise materials in health emergency preparedness and response: a scoping review with a health system perspective

2019 ◽  
Vol 4 (4) ◽  
pp. e001687
Author(s):  
Geraldine McDarby ◽  
Lindy Reynolds ◽  
Zandile Zibwowa ◽  
Shams Syed ◽  
Ed Kelley ◽  
...  
Keyword(s):  
Health System ◽  
International Development ◽  
Health Systems ◽  
Scoping Review ◽  
Emergency Preparedness ◽  
Building Blocks ◽  
Health Security ◽  
System Perspective ◽  
Emergency Preparedness And Response ◽  
Health System Perspective

Simulation Exercises (SimEx) are an established tool in defence and allied security sectors, applied extensively in health security initiatives under national or international legislative requirements, particularly the International Health Regulations (2005). There is, however, a paucity of information on SimEx application to test the functionality of health systems alongside emergency preparedness, response and recovery. Given the important implications health services resilience has for the protection and improvement of human life, this scoping review was undertaken to determine how the publicly available body of existing global SimEx materials considers health systems, together with health security functions in the event of disruptive emergencies.The global review identified 668 articles from literature and 73 products from institutional sources. Relevant screening identified 51 materials suitable to examine from a health system lens using the six health system building blocks as per the WHO Health System Framework. Eight materials were identified for further examination of their ability to test health system functionality from a resilience perspective.SimEx are an effective approach used extensively within health security and emergency response sectors but is not yet adequately used to test health system resilience. Currently available SimEx materials lack an integrated health system perspective and have a limited focus on the quality of services delivered within the context of response to a public health emergency. The materials do not focus on the ability of systems to effectively maintain core services during response.Without adjustment of the scope and focus, currently available SimEx materials do not have the capacity to test health systems to support the development of resilient health systems. Dedicated SimEx materials are urgently needed to fill this gap and harness their potential as an operational tool to contribute to improvements in health systems. They can act as effective global goods to allow testing of different functional aspects of health systems and service delivery alongside emergency preparedness and response.The work was conducted within the scope of the Tackling Deadly Diseases in Africa Programme, funded by the UK Department for International Development, which seeks to strengthen collaboration between the health system and health security clusters to promote health security and build resilient health systems.

Antenatal care policies for low-risk pregnant women in high-income countries with a universal health system: a scoping review protocol

2020 ◽  
Vol 18 (7) ◽  
pp. 1537-1545
Author(s):  
Andreia Soares Goncalves ◽  
Isabel Maria Ferreira ◽  
Márcia Pestana-Santos ◽  
Ana Paula Prata ◽  
Christine McCourt
Keyword(s):  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Scoping Review ◽  
High Income ◽  
Low Risk ◽  
System A ◽  
Care Policies ◽  
Review Protocol ◽  
Universal Health

scholarly journals Reimagining community relationships for organizational learning: a scoping review with implications for a learning health system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Crystal Milligan ◽  
Whitney Berta
Keyword(s):  
Organizational Learning ◽  
Transformative Learning ◽  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
English Language ◽  
Explicit Knowledge ◽  
Grey Literature ◽  
Specific Patient ◽  
Learning Health System

Abstract Background Communities represent a highly relevant source of knowledge with regard to not only healthcare performance but also sociocultural context, yet their role in learning health systems has not been studied. Situating the learning health system as an organization, this paper explores the phenomenon of organizational learning from or with communities (defined as one of ‘the people,’ such as a town, a specific patient group or another group directly receiving a healthcare service). Methods We conducted a scoping review to determine what is known about organizational learning from or with communities that the organization serves, and to contribute to a more comprehensive evidence base for building and operating learning health systems. In March 2019, we systematically searched six academic databases and grey literature, applying no date limits, for English language materials that described organizational learning in relation to knowledge transfer between an organization and a community. Numerous variables were charted in Excel and synthesized using frequencies and thematic analysis. We updated this search in August 2020. Results In total, 42 documents were included in our analysis. We found a disproportionate emphasis on learning explicit knowledge from community rather than on tacit knowledge or learning in equal partnership with community. Our review also revealed inconsistently defined concepts, tenuously linked with their theoretical and empirical foundations. Our findings provide insight to understand the organization-community learning relationship, including motives and power differentials; types of knowledge to be learned; structures and processes for learning; and transformative learning outcomes. Conclusions Our review makes a singular contribution to organizational learning literatures by drawing from diverse research disciplines such as health services, business and education to map what is known about learning from or with community. Broadly speaking, learning health systems literature would benefit from additional research and theory-building within a sociological paradigm so as to establish key concepts and associations to understand the nature of learning with community, as well as the practices that make it happen.

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