scholarly journals Health Priority Setting in Iran: Evaluating Against the Social Values Framework

2016 ◽  
Vol 8 (10) ◽  
pp. 212
Author(s):  
Hakimeh Mostafavi ◽  
Arash Rashidian ◽  
Mohammad Arab ◽  
Mohammad R. V. Mahdavi ◽  
Kioomars Ashtarian
Keyword(s):  
Health Care ◽  
Health System ◽  
Priority Setting ◽  
Social Values ◽  
City Council ◽  
Decision Makers ◽  
The Public ◽  
Health Technologies ◽  
Health Priority ◽  
The Social

<p><strong>Background:</strong> Health systems, as part of the social system, consider public values. This study was conducted to examine the role of social values in the health priority setting in the Iranian health system.</p><p><strong>Methods:</strong> In this qualitative case study, three main data sources were used: literature, national documents, and key informants who were purposefully selected from health care organizations and other related institutions. Data was analyzed and interpreted using the Clark-Weale Framework.</p><p><strong>Results:</strong> According to our results, the public indirectly participates in decision-making. The public representatives participate in the meetings of the health priority setting as parliament members, representatives of some unions, members of the city council, and donors. The transparency of the decisions and the accountability of the decision makers are low. Decision makers only respond to complaints of the Audit Court and the Inspection Organization. Individual choice, although respected in hospitals and clinics, is limited in health care networks because of the referral system. Clinical effectiveness is considered in insurance companies and some hospitals. There are no technical abilities to determine the cost-effectiveness of health technologies; however, some international experiences are employed. Equity and solidarity are considered in different levels of the health system.</p><p><strong>Conclusion:</strong> Social values are considered in the health priority decisions in limited ways. It seems that the lack of an appropriate value-based framework for priority setting and also the lack of public participation are the major defects of the health system. It is recommended that health policymakers invite different groups of people and stakeholders for active involvement in health priority decisions. </p>

Participation in health care priority-setting through the eyes of the participants

2002 ◽  
Vol 7 (4) ◽  
pp. 222-229 ◽  
Author(s):  
Douglas Martin ◽  
Julia Abelson ◽  
Peter Singer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Priority Setting ◽  
Decision Makers ◽  
Medical Specialist ◽  
Committee Chair ◽  
The Public ◽  
Health Care Priority Setting ◽  
Patient Representative

Objectives: The literature on participation in priority-setting has three key gaps: it focuses on techniques for obtaining public input into priority-setting that are consultative mechanisms and do not involve the public directly in decision-making; it focuses primarily on the public's role in priority-setting, not on all potential participants; and the range of roles that various participants play in a group making priority decisions has not been described. To begin addressing these gaps, we interviewed individuals who participated on two priority-setting committees to identify key insights from participants about participation. Methods: A qualitative study consisting of interviews with decision-makers, including patients and members of the public. Results: Members of the public can contribute directly to important aspects of priority-setting. The participants described six specific priority-setting roles: committee chair, administrator, medical specialist, medical generalist, public representative and patient representative. They also described the contributions of each role to priority-setting. Conclusions: Using the insights from decision-makers, we have described lessons related to direct involvement of members of the public and patients in priority-setting, and have identified six roles and the contributions of each role.

Value congruence in health care priority setting: social values, institutions and decisions in three countries

2014 ◽  
Vol 10 (2) ◽  
pp. 113-132 ◽  
Author(s):  
Claudia Landwehr ◽  
Dorothea Klinnert
Keyword(s):  
Public Health ◽  
Health Care ◽  
Priority Setting ◽  
Institutional Design ◽  
Social Values ◽  
Public Acceptance ◽  
Value Judgments ◽  
The Public ◽  
The United Kingdom ◽  
Health Care Priority Setting

AbstractMost developed democracies have faced the challenge of priority setting in health care by setting up specialized agencies to take decisions on which medical services to include in public health baskets. Under the influence of Daniels and Sabin’s seminal work on the topic, agencies increasingly aim to fulfil criteria of procedural justice, such as accountability and transparency. We assume, however, that the institutional design of agencies also and necessarily reflects substantial value judgments on the respective weight of distributive principles such as efficiency, need and equality. The public acceptance of prioritization decisions, and eventually of the health care system at large, will ultimately depend not only on considerations of procedural fairness, but also on the congruence between a society’s values and its institutions. We study social values, institutions and decisions in three countries (France, Germany and the United Kingdom) in order to assess such congruence and formulate expectations on its effects.

Pelaksanaan Jaminan Kesehatan Oleh BPJS Kesehatan Dalam Perspektif Syariah

Liquidity ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 110-118
Author(s):  
Iwan Subandi ◽  
Fathurrahman Djamil
Keyword(s):  
Health Care ◽  
Financial Institution ◽  
Social Supports ◽  
Religious Leaders ◽  
The Public ◽  
The People ◽  
The Social ◽  
Ministry Of Finance ◽  
Health Support ◽  
The Government

Health is the basic right for everybody, therefore every citizen is entitled to get the health care. In enforcing the regulation for Jaringan Kesehatan Nasional (National Health Supports), it is heavily influenced by the foreign interests. Economically, this program does not reduce the people’s burdens, on the contrary, it will increase them. This means the health supports in which should place the government as the guarantor of the public health, but the people themselves that should pay for the health care. In the realization of the health support the are elements against the Syariah principles. Indonesian Muslim Religious Leaders (MUI) only say that the BPJS Kesehatan (Sosial Support Institution for Health) does not conform with the syariah. The society is asked to register and continue the participation in the program of Social Supports Institution for Health. The best solution is to enforce the mechanism which is in accordance with the syariah principles. The establishment of BPJS based on syariah has to be carried out in cooperation from the elements of Social Supports Institution (BPJS), Indonesian Muslim Religious (MUI), Financial Institution Authorities, National Social Supports Council, Ministry of Health, and Ministry of Finance. Accordingly, the Social Supports Institution for Helath (BPJS Kesehatan) based on syariah principles could be obtained and could became the solution of the polemics in the society.

Kuntoutukseen osallistuminen ja eri osajärjestelmien ristikkäiskäyttö

Kuntoutus ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 6-20
Author(s):  
Hanna Rinne ◽  
Jenni Blomgren
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Social Insurance ◽  
Pension System ◽  
Rehabilitation Services ◽  
Occupational Health Care ◽  
The Public ◽  
Social Insurance Institution ◽  
The Social ◽  
The City

Tieto kuntoutuksen kentän kokonaisuudesta ja erilaisten kuntoutuspalveluiden käytöstä samoilla ihmisillä on varsin hajanaista ja puutteellista. Tutkimuksen tavoitteena on selvittää kuntoutukseen osallistumisen yleisyyttä ja päällekkäisyyttä eri osajärjestelmissä Oulun asukkailla vuonna 2018 laajalla rekisteriaineistolla (N = 192 844). Tutkimuksessa tarkastellaan julkisen sosiaali- ja terveyspalvelujärjestelmän kuntoutusta, Kelan kuntoutusta, työeläkekuntoutusta, työterveyshuollon fysioterapiaa ja Kelan korvaamaa yksityistä fysioterapiaa. Vuonna 2018 oululaisista 18 prosenttia sai vähintään yhden tutkitun osajärjestelmän kuntoutusta (N = 34 061). Yleisintä oli julkisen sosiaali- ja terveyspalvelujärjestelmän kuntoutus, harvinaisinta työeläkekuntoutus. Naiset osallistuivat kuntoutukseen miehiä yleisemmin. Kuntoutukseen osallistuminen oli miehillä yleisintä 65 vuotta täyttäneillä, naisilla 45–64-vuotiailla. Harvinaisinta se oli 16–24-vuotiailla miehillä ja alle 16-vuotiailla naisilla. Suurin osa (90 %) kuntoutukseen osallistuneista oli osallistunut vain yhden osajärjestelmän kuntoutukseen. Useamman osajärjestelmän kuntoutukseen osallistuminen oli naisilla miehiä yleisempää. Ikäryhmistä se oli yleisintä 45–64-vuotiailla ja harvinaisinta alle 16-vuotiailla. Vähintään kahden osajärjestelmän kuntoutukseen osallistuneet olivat keskimäärin vanhempia kuin vain yhden osajärjestelmän kuntoutukseen osallistuneet ja myös naisten osuus oli heillä suurempi. Rekisteritietoja kuntoutuksesta on hankala koota kattavasti, sillä järjestelmä on hyvin hajanainen ja toimijoita ja rekisterinpitäjiä on lukuisia. Myös kuntoutuksen määrittely aineistoista osoittautui vaikeaksi. Yhtenäiset tietojärjestelmät kuntoutuksesta palvelisivat paitsi tutkijoita, myös kuntoutujia. Abstract Prevalence and overlap of participation in rehabilitation in different subsystems – a register-based study among residents of the city of Oulu, Finland, in 2018 Knowledge of the whole spectrum of rehabilitation and of the use of different rehabilitation services by the same individuals is quite fragmented and incomplete. The aim of this study is to examine the prevalence and overlap of participation in rehabilitation in different subsystems among residents of the city of Oulu, Finland, in 2018 using extensive register-based data (N=192,844). The study examines rehabilitation organized by the public social and health care system, by the Social Insurance Institution of Finland, by the earnings-related pension system, as well as physiotherapy in occupational health care and private physiotherapy reimbursed by the Social Insurance Institution of Finland. In 2018, 18 per cent of the residents of Oulu received rehabilitation of at least one of the examined subsystems (N=34,061). Receiving rehabilitation of public social and health care was the most common; the rarest was rehabilitation within the earnings-related pension system. Women participated in rehabilitation more often than men. Using rehabilitation services was most common in men aged 65 and over, and in women aged 45–64. It was least common in men aged 16–24 years and in women under 16 years of age. The majority (90%) of those who participated in rehabilitation had participated in rehabilitation of only one subsystem. Participation in rehabilitation of several subsystems was more common in women than in men. It was most common in those aged 45–64 years and least common in those under 16 years of age. Those who received rehabilitation of at least two subsystems were, on average, older than those who received rehabilitation of only one subsystem, and more often women. It is difficult to compile comprehensive register data on rehabilitation, as the system is very fragmented and there are many organizers and registrars. Defining rehabilitation from the data also proved difficult. Unified information systems on rehabilitation would serve not only researchers but also rehabilitees. Keywords: rehabilitation, register-based research, Finland

The regulation of health care in Scandinavia: professionals, the public interest and trust

2018 ◽  
pp. 61-76
Author(s):  
Karsten Vrangbæk
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Health Insurance ◽  
Health System ◽  
Health Systems ◽  
Public Interest ◽  
State Level ◽  
Professional Regulation ◽  
The Public ◽  
Voluntary Health Insurance

Scandinavian health systems have traditionally been portrayed as relatively similar examples of decentralised, public integrated health systems. However, recent decades have seen significant public policy developments in the region that should lead us to modify our understanding. Several dimensions are important for understanding such developments. First, several of the countries have undergone structural reforms creating larger governance units and strengthening the state level capacity to regulate professionals and steer developments at the regional and municipal levels. Secondly, the three Nordic countries studied experienced an increase in the purchase of voluntary health insurance and the use of private providers. This introduces several issues for the equality of users and the efficiency of the system. This paper will investigate such trends and address the question: Is the Nordic health system model changing, and what are the consequences for trust, professional regulation and the public interest?

scholarly journals Announcing the Canadian Journal of Health Technologies — A New Journal From CADTH

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Nicole Mittmann
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Canadian Journal ◽  
Health Technology ◽  
Health Care Decision ◽  
Health Technologies ◽  
Care Decision

The COVID-19 pandemic has put a spotlight on science and reaffirmed the value of evidence in health care decision-making. CADTH is a major Canadian publisher of evidence, advice, and recommendations regarding the assessment and management of health technologies. The Canadian Journal of Health Technologies will publish CADTH work in a single, PubMed-indexed, online location, making it easier for our health system partners to search and find CADTH work. Through the Canadian Journal of Health Technologies, CADTH will expand its reach and its collaborations with producers and users of health technology assessments.

The public’s trust and information brokers in health care, public health and research

2019 ◽  
Vol 33 (7/8) ◽  
pp. 929-948 ◽  
Author(s):  
Jodyn Platt ◽  
Minakshi Raj ◽  
Sharon L.R. Kardia
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Information Sharing ◽  
Health Information ◽  
Health Care Providers ◽  
Care Providers ◽  
Content Type ◽  
The Public ◽  
Information Brokers

Purpose Nations such as the USA are investing in technologies such as electronic health records in order to collect, store and transfer information across boundaries of health care, public health and research. Health information brokers such as health care providers, public health departments and university researchers function as “access points” to manage relationships between the public and the health system. The relationship between the public and health information brokers is influenced by trust; and this relationship may predict the trust that the public has in the health system as a whole, which has implications for public trust in the system, and consequently, legitimacy of involved institutions, under circumstances of health information data sharing in the future. This paper aims to discuss these issues. Design/methodology/approach In this study, the authors aimed to examine characteristics of trustors (i.e. the public) that predict trust in health information brokers; and further, to identify the factors that influence trust in brokers that also predict system trust. The authors developed a survey that was administered to US respondents in 2014 using GfK’s nationally representative sample, with a final sample of 1,011 participants and conducted ordinary least squares regression for data analyses. Findings Results suggest that health care providers are the most trusted information brokers of those examined. Beliefs about medical deceptive behavior were negatively associated with trust in each of the information brokers examined; however, psychosocial factors were significantly associated with trust in brokers, suggesting that individual attitudes and beliefs are influential on trust in brokers. Positive views of information sharing and the expectation of benefits of information sharing for health outcomes and health care quality are associated with system trust. Originality/value This study suggests that demonstrating the benefits and value of information sharing could be beneficial for building public trust in the health system; however, trust in brokers of information are variable across the public; that is, knowledge, attitudes and beliefs are associated with the level of trust different individuals have in various health information brokers – suggesting that the need for a personalized approach to building trust.

scholarly journals A MOOC to disseminate key concepts related to the future challenges of the French health system

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C You ◽  
V Lissillour ◽  
A Lefébure
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Decision Makers ◽  
Teaching Staff ◽  
New Public Health ◽  
New Public ◽  
Wide Range ◽  
Public Health Challenges

Abstract Background The increase of life expectancy creates critical health needs that developed countries health systems have to deal with. They are also confronted to persistent health inequalities. A common vision of these issues may not be shared by the health care professionals, decision-makers and citizens. In the context of the launch of new public health laws in France, the French School of Public Health (EHESP) decided to offer a MOOC entitled “Public Health and Health System: transition and transformation” (2019). Objectives The MOOC intends to raise awareness and increase understanding of public health challenges. It is designed for a wide audience of professionals, decision-makers and citizens in the French speaking world. The content was designed by a multidisciplinary team of academics from the EHESP (N = 50) and a network of health professionals (N = 21). The 6 modules address major themes of the recent health policies, e.g. social and territorial inequalities in health, health care security, health pathways, innovation or health democracy. Results Over the course of 6 consecutive weeks, almost 7800 people have enrolled in this e-learning. They are provided with short teaching videos (109 capsules of 4-5’) and webinars, have access to a number of supplementary reading material and a variety of self-assessment. Active learning is enhanced via forum involving peers and teaching staff. The full course represents around 20 hours of teaching. So far, completion rate has attained 13% which compares well with usual rate for MOOCs. Participants include a wide range of professionals, students and citizens from 87 different countries (72% from France) and 50% had a master or higher degree. The overall satisfaction rate is 98%. Conclusions This MOOC attracted the attention of a wide and diverse audience regarding the major public health issues. Some public health agencies have expressed interest in implementing the MOOC into their professional development program of their staff. Key messages Health system reforms are constantly implemented to face new public health challenges. A multidisciplinary MOOC can help raise awareness and understanding of the issue being addressed by new policies.

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

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