Kerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301Global Developments in Priority Setting in Health127128331610.15171/ijhpm.2017.10ENRobBaltussenRadboud University Medical Center, Nijmegen, The Netherlands0000-0002-8364-2847CraigMittonUniversity
of British Columbia, Vancouver, BC, CanadaMarionDanisNational Institutes of Health,
Bethesda, MD, USA0000-0002-4749-4568IestynWilliamsUniversity of Birmingham, Birmingham, UK0000-0002-9462-9488MartheGoldNew York
Academy of Medicine, New York City, NY, USACity College, New York City,
NY, USAJournal Article20161221Countries around the world are experiencing an ever-increasing need to make choices in investments in health and healthcare. This makes it incumbent upon them to have formal processes in place to optimize the legitimacy of eventual decisions. There is now growing experience among countries of the implementation of stakeholder participation, and a developing convergence of methods to support decision-makers within health authorities in making tough decisions when faced with the stark reality of limited resources. We call for further interaction among health authorities, and the research community to develop best practices in order to confront the difficult choices that need to be made.https://www.ijhpm.com/article_3316_8ce5d989374d216a867cdc8871484b43.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301A Case for Open Network Health Systems: Systems as Networks in Public Mental Health129133330710.15171/ijhpm.2017.01ENMichael GrantRhodesMind Venture International, Maastricht, The NetherlandsMarten W.De VriesMind Venture International, Maastricht, The NetherlandsDepartment
of Psychiatry and Psychology and CAPHRI Research School, Maastricht
University, Maastricht, The NetherlandsJournal Article20161006Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH) services in the Netherlands. Decentralized under the (Community) Participation Act (2014), local governments must find resources to compensate for reduced central funding to such services or “innovate.” But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional “health system” definitions, literature and narratives, and operating assumptions in public (mental) health are ‘locked in’ constraining technical and organization innovations. If we view a “health system” as an adaptive system of economic and social “networks,” it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a “centralized hierarchical” or “tree” network. An overlooked alternative that breaks out of the established policy narratives is the view of a ‘health systems’ as a non-hierarchical organizational structure or ‘Open Network.’ In turn, this opens new technological and organizational possibilities in seeking policy solutions, and suggests an alternative governance model of huge potential value in public health both locally and globally.https://www.ijhpm.com/article_3307_d7aab42e6b85c49c0f1d3a115e939c74.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301The Importance of Community Consultations for Generating Evidence for Health Reform in Ukraine135145325510.15171/ijhpm.2016.104ENOlenaHankivskyLondon School of Hygiene and Tropical Medicine, London, UKSchool of
Public Policy, Simon Fraser University, Vancouver, BC, CanadaInstitute for
Intersectionality Research and Policy, Simon Fraser University, Vancouver,
BC, CanadaAnnaVorobyovaInstitute for
Intersectionality Research and Policy, Simon Fraser University, Vancouver,
BC, CanadaAnastasiyaSalnykovaInstitute for
Intersectionality Research and Policy, Simon Fraser University, Vancouver,
BC, CanadaSetarehRouhaniInstitute of Population Health, University of Ottawa, Ottawa, ON,
CanadaJournal Article20150907Background <br />The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH). <br /> <br />Methods <br />The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. <br /> <br /> <br />Results <br />The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP) payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine. <br /> <br />Conclusion <br />The study concludes that any meaningful reforms of the health sector in Ukraine must include a broad range of factors, including the healthcare system but importantly, must extend to SDH approach and include the prioritization of health promotion, limiting alcohol and tobacco availability and enforcing environmental protection.https://www.ijhpm.com/article_3255_2067e2650cd701ae71c68080f9dbbdc1.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls147153326010.15171/ijhpm.2016.107ENShahnazKohanNursing and Midwifery Care Research Center, Faculty of Nursing and
Midwifery, Isfahan University of Medical Sciences, Isfahan, IranFatemehMohammadiStudent
Research Center, Faculty of Nursing and Midwifery, Isfahan University
of Medical Sciences, Isfahan, IranFiroozehMostafaviDepartment of Health Education and
Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan,
IranAliGholamiDepartment of Islamic Sciences, Isfahan University of Medical Sciences,
Isfahan, IranJournal Article20160119Background <br />Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. <br /> <br />Methods <br />A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. <br /> <br />Results <br />Data analysis resulted in the development of three categories: ‘family’s attitudes and performance about single women’s reproductive healthcare,’ ‘socio-cultural factors influencing reproductive healthcare,’ and ‘cultural factors influencing being a single woman.’ <br /> <br />Conclusion <br />Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services.https://www.ijhpm.com/article_3260_d54ce9de9df77c579775a7b6b1a4bdc0.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301The Contribution of Ageing to Hospitalisation Days in Hong Kong: A Decomposition Analysis155164325610.15171/ijhpm.2016.108ENChi LeungKwokHKJC Centre for Suicide Research and Prevention, The University of
Hong Kong, Pokfulam, Hong KongCarmen KMLeeDepartment of Social Work and Social
Administration, The University of Hong Kong, Pokfulam, Hong KongWilliam TLLoKwai
Chung Hospital, Hospital Authority, Kwai Chung, Hong KongPaul SFYipHKJC Centre for Suicide Research and Prevention, The University of
Hong Kong, Pokfulam, Hong KongDepartment of Social Work and Social
Administration, The University of Hong Kong, Pokfulam, Hong KongJournal Article20151223Background <br />Ageing has become a serious challenge in Hong Kong and globally. It has serious implications for health expenditure, which accounts for nearly 20% of overall government expenditure. Here we assess the contribution of ageing and related factors to hospitalisation days in Hong Kong. We used hospital discharge data from all publicly funded hospitals in Hong Kong between 2001 and 2012. <br /> <br />Methods <br />A decomposition method was used to examine the factors that account for the change of total hospitalisation days during the two periods, 2001-2004 and 2004-2012. The five factors include two demographic factors – population size and age-gender composition – and three service components – hospital discharge rate, number of discharge episodes per patient, and average length of stay (LOS) – which are all measured at age-gender group level. In order to assess the health cost burden in the future, we also project the total hospitalisation days up to 2041, for a range of scenarios. <br /> <br />Results <br />During the decreasing period of hospitalisation days (2001-2004), the reduction of LOS contributed to about 60% of the reduction. For the period of increase (2004-2012), ageing is associated with an increase in total hospitalisation days of 1.03 million, followed by an increase in hospital discharge rates (0.67 million), an increase in the number of discharge episodes per patient (0.62 million), and population growth (0.43 million). The reduction of LOS has greatly offset these increases (-2.19 million days), and has become one of the most significant factors in containing the increasing number of hospitalisation days. Projected increases in total hospitalisation days under different scenarios have highlighted that the contribution of ageing will become even more prominent after 2022. <br /> <br />Conclusion <br />Hong Kong is facing increasing healthcare burden caused by the rapid increase in demand for inpatient services due to ageing. Better management of inpatient services with the aim of increasing efficiency and reducing LOS, avoidable hospitalisation and readmission, without compromising patient satisfaction and quality of service, are crucial for containing the rapid and enormous increases in total hospitalisation days for Hong Kong. The results would be relevant to many rapidly ageing societies in this region.https://www.ijhpm.com/article_3256_2131f8ecf18db66a758f718dc729e00e.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301Business as Usual: A Lack of Institutional Innovation in Global Health Governance; Comment on “Global Health Governance Challenges 2016 – Are We Ready?”165168325810.15171/ijhpm.2016.113ENKelleyLeeFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada0000-0002-3625-1915Journal Article20160731There were once again high expectations that a major global health event - the Ebola virus outbreak of 2014-2015 - would trigger meaningfully World Health Organization (WHO) reform and strengthen global health governance (GHG). Rather than a “turning point,” however, the global community has gone back to business as usual. This has occurred against a backdrop of worldwide political turmoil, characterised by a growing rejection of existing political leaders and state-centric institutions. Debates about GHG so far have given insufficient attention to the need for institutional innovation. This entails rethinking the traditional bureaucratic model of postwar intergovernmental organizations which is disconnected from the transboundary, fast-paced nature of today’s globalizing world.https://www.ijhpm.com/article_3258_485843481a7edacbfce101ecb1e4d2a8.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301A New Gilded Age, and What It Means for Global Health; Comment on “Global Health Governance Challenges 2016 – Are We Ready?”169171325910.15171/ijhpm.2016.115ENTedSchreckerSchool of Medicine, Pharmacy and Health, Durham University, Durham, UKJournal Article20160712New contours of global inequality present new challenges for global health, and require that we consider new kinds of health issues as global. I provide a number of illustrations, arguing the need for a political science of health that goes beyond conventional preoccupations with formal institutional and interstate interactions and takes into account how globalization has affected the health policy landscape and restructured the distribution of economic and political power not only among countries, but also within them.https://www.ijhpm.com/article_3259_a87d27f712df362cd22c7a8ef823e987.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301The Devil Is in the Details! On Regulating Cannabis Use in Canada Based on Public Health Criteria; Comment on “Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts”173176326310.15171/ijhpm.2016.114ENJürgenRehmInstitute for Mental Health Policy Research, Centre for Addiction and
Mental Health (CAMH), Toronto, ON, CanadaAddiction Policy, Dalla
Lana School of Public Health, University of Toronto, Toronto, ON, CanadaInstitute of Medical Science, University of Toronto, Faculty of Medicine,
Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto,
Toronto, ON, CanadaInstitute of Clinical Psychology and Psychotherapy,
Technische Universität Dresden, Dresden, GermanyCenter of
Clinical Epidemiology and Longitudinal Studies (CELOS), Technische
Universität Dresden, Dresden, GermanyCampbell Family Mental Health
Research Institute, CAMH, Toronto, ON, CanadaJean-FrançoisCrépaultCommunications and
Partnerships, CAMH, Toronto, ON, CanadaBenediktFischerInstitute for Mental Health Policy Research, Centre for Addiction and
Mental Health (CAMH), Toronto, ON, CanadaInstitute of Medical Science, University of Toronto, Faculty of Medicine,
Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto,
Toronto, ON, CanadaCentre for Applied Research
in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser
University, Vancouver, BC, CanadaJournal Article20160701This commentary to the editorial of Hajizadeh argues that the economic, social and health consequences of legalizing cannabis in Canada will depend in large part on the exact stipulations (mainly from the federal government) and on the implementation, regulation and practice of the legalization act (on provincial and municipal levels). A strict regulatory framework is necessary to minimize the health burden attributable to cannabis use. This includes prominently control of production and sale of the legal cannabis including control of price and content with ban of marketing and advertisement. Regulation of medical marijuana should be part of such a framework as wellhttps://www.ijhpm.com/article_3263_f8037f94e53f17a2cc301033ca86d278.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301Current Models of Investor State Dispute Settlement Are Bad for Health: The European Union Could Offer an Alternative; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?”177179326210.15171/ijhpm.2016.116ENMartinMcKeeECOHOST, Department of Health Services Research and Policy,
London School of Hygiene and Tropical Medicine, London, UK0000-0002-0121-9683DavidStucklerDepartment of Sociology, University of Oxford, Oxford, UK0000-0002-1288-8401Journal Article20160804In this commentary, we endorse concerns about the health impact of the trans-pacific partnership (TPP), paying particular attention to its mechanisms for investor state dispute settlement. We then describe the different, judgeled approach being advocated by the European Commission team negotiating the Trans-Atlantic Trade and Investment Partnership, arguing that, while not perfect, it offers significant advantages.https://www.ijhpm.com/article_3262_8a50bae297807da9e97722a0b3fd8f27.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396320170301Legalizing Marijuana in Canada — A Double-Edged Sword: A Response to Recent Commentaries181182329910.15171/ijhpm.2016.152ENMohammadHajizadehSchool of Health Administration, Dalhousie University, Halifax, NS, Canada0000-0002-4591-8531Journal Article20161207https://www.ijhpm.com/article_3299_7371364b3d72ac9a3ed8638e6f0be2c9.pdf