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Healthcare Policy = Politiques de Sante Nov 2020Excluding capital projects, spending on hospitals, physicians and drugs makes up more than two thirds of provincial and territorial governments' healthcare spending...
Excluding capital projects, spending on hospitals, physicians and drugs makes up more than two thirds of provincial and territorial governments' healthcare spending (CIHI 2019). One expects that health services and policy research would be aligned with where the money flows and yet, there is a misalignment. For example, research as published by Healthcare Policy, is not so neatly aligned with provincial and territorial governments' healthcare spending patterns. In this issue, for instance, there are only two such articles - one related to medication adherence and cost, and another related to payment policy associated with a hospital's alternative level of care utilization. The previous issue of Healthcare Policy was similarly focused, with only two articles the study settings of which were primary care.
Topics: Delivery of Health Care; Financing, Government; Government; Health Care Costs; Health Policy; Health Priorities; Health Services; Health Services Research; Humans; Public Expenditures
PubMed: 33337309
DOI: 10.12927/hcpol.2020.26358 -
American Journal of Public Health Mar 2021
Topics: Budgets; Disaster Planning; Financing, Government; Humans; Pandemics; Public Health; United States; United States Dept. of Health and Human Services
PubMed: 33566658
DOI: 10.2105/AJPH.2020.306068 -
Cell Feb 2021Our nationwide network of BME women faculty collectively argue that racial funding disparity by the National Institutes of Health (NIH) remains the most insidious...
Our nationwide network of BME women faculty collectively argue that racial funding disparity by the National Institutes of Health (NIH) remains the most insidious barrier to success of Black faculty in our profession. We thus refocus attention on this critical barrier and suggest solutions on how it can be dismantled.
Topics: Black or African American; Biomedical Research; Financial Management; Humans; National Institutes of Health (U.S.); Racial Groups; Research Personnel; United States
PubMed: 33503447
DOI: 10.1016/j.cell.2021.01.011 -
PloS One 2022Amidst the Coronavirus crisis, many fundraising projects have emerged to relieve financial burdens resulting from social distancing policies. Crowdfunding is a way to... (Review)
Review
Amidst the Coronavirus crisis, many fundraising projects have emerged to relieve financial burdens resulting from social distancing policies. Crowdfunding is a way to raise money to fund a business, project or charity, through either social media or other online platforms to reach hundreds of potential sponsors. We developed guidelines for effective donation-based crowdfunding through online platforms. Using Futures Research (FR) technique, we conducted our analyses in 3 phases. In Phase 1, we reviewed relevant literature and conducted in-depth interviews of related parties. In Phase 2, we interviewed experts using Ethnographic Futures Research (EFR) technique. In Phase 3, we visualized the future using the principles of Futures Wheel, Cross-impact Matrix and Scenarios. Based on our findings, effective donation-based crowdfunding platforms should adopt Blockchain technology for transparency and accountability, and incentivize donations to keep backers loyal. Founders should be required to obtain fundraising licenses from relevant regulators. Finally, laws and regulations that protect platform users should be standardized internationally. Our proposed guidelines hope to improve the quality and transparency of future fundraising activities.
Topics: Humans; Crowdsourcing; Fund Raising; Financial Management; Social Media
PubMed: 36367868
DOI: 10.1371/journal.pone.0275898 -
Journal of Evaluation in Clinical... Oct 2022Screening is a useful tool for identifying potential health issues; however, it can also lead to overtreatment. Consequently, patients are sometimes harmed by...
Screening is a useful tool for identifying potential health issues; however, it can also lead to overtreatment. Consequently, patients are sometimes harmed by unnecessary treatments and there are cost implications. Overtreatment can also occur in other areas of medicine besides screening and sometimes medical interventions are used to improve performance rather than to treat disease. In this paper, a distinction is made between the perspectives of the patient and the government. For patients, autonomy is important, and they can refuse life-saving treatments, assuming they have decision-making capacity. They can also choose to be treated to avoid a very small risk or to improve their performance. For a government with limited funds, it is important to focus on outcomes and fund those screening programmes and other medical interventions that can potentially save the most lives or prevent severe disability. Governments also have the power to legislate to enable a level playing field by prohibiting medications that improve performance, but there is no general consensus about this, and regulations can only be applied to specific, well-defined activities. The problem with overtreatment results from the different interests involved: autonomy is the guiding idea for patients and outcome is the guiding measure for societies. A general solution will not be possible because of these inherent conflicting interests. However, medical research may improve the identification and predictions surrounding any anomalies detected during scans and reduce the problem in practice for specific conditions.
Topics: Biomedical Research; Conflict of Interest; Financial Management; Humans; Medicine
PubMed: 34693594
DOI: 10.1111/jep.13632 -
BMC Public Health May 2022The Chinese government launched health care reforms in 2009 and introduced a national list of essential public health services (EPHS) as an integral part of the plan to...
BACKGROUND
The Chinese government launched health care reforms in 2009 and introduced a national list of essential public health services (EPHS) as an integral part of the plan to deliver health care for all. EPHS was also built into the national plan to promote the equalisation of public services across the country. A national standard was set for financial input to EPHS. As the services are co-funded by the central and local governments, a robust intergovernmental fiscal system is essential to guarantee that the hundreds of thousands of service providers have adequate financing to meet the service commitment.
METHODS
We examined the flow of funds through China's complex intergovernmental fiscal system to see whether the promise of equal funding for EPHS was implemented, and how the costs were distributed across levels of government. Information was collated from funding documents issued by all levels of governments involved, for a sample that includes the central government, 12 provincial governments, eight prefectural governments and 11 county-level governments. For each level of government, we examined: (i) when and how much funding they disbursed or received from higher levels; (ii) when and how much matching funds were made; and (iii) the allocation rules adopted.
RESULTS
Overall, we found the central government met its commitments for the program on time and in full, and good compliance from local governments in passing through funding from higher levels and as well as meeting their own financial responsibilities. However, we also found the following problems: (i) the involvement of so many levels of government resulted in delays in the disbursement of funds; (ii) the use of outdated population data in calculating required funding resulted in some under-allocation; and (iii) localities that needed funding the most were not well targeted by the distribution of funds.
CONCLUSION
This study traces how the 2018 subsidy for EPHS was disbursed from the central government to service providers, focusing on the roles played by intermediate levels of subnational governments-provinces, prefectures and counties. In this way, it identifies gaps in the current intergovernmental financing of EPHS and points to areas for further improvement.
Topics: China; Delivery of Health Care; Financing, Government; Health Care Reform; Health Services; Humans; Local Government
PubMed: 35534861
DOI: 10.1186/s12889-022-13300-y -
Industry funding of patient and health consumer organisations: systematic review with meta-analysis.BMJ (Clinical Research Ed.) Jan 2020To investigate pharmaceutical or medical device industry funding of patient groups. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate pharmaceutical or medical device industry funding of patient groups.
DESIGN
Systematic review with meta-analysis.
DATA SOURCES
Ovid Medline, Embase, Web of Science, Scopus, and Google Scholar from inception to January 2018; reference lists of eligible studies and experts in the field.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Observational studies including cross sectional, cohort, case-control, interrupted time series, and before-after studies of patient groups reporting at least one of the following outcomes: prevalence of industry funding; proportion of industry funded patient groups that disclosed information about this funding; and association between industry funding and organisational positions on health and policy issues. Studies were included irrespective of language or publication type.
REVIEW METHODS
Reviewers carried out duplicate independent data extraction and assessment of study quality. An amended version of the checklist for prevalence studies developed by the Joanna Briggs Institute was used to assess study quality. A DerSimonian-Laird estimate of single proportions with Freeman-Tukey arcsine transformation was used for meta-analyses of prevalence. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to assess the quality of the evidence for each outcome.
RESULTS
26 cross sectional studies met the inclusion criteria. Of these, 15 studies estimated the prevalence of industry funding, which ranged from 20% (12/61) to 83% (86/104). Among patient organisations that received industry funding, 27% (175/642; 95% confidence interval 24% to 31%) disclosed this information on their websites. In submissions to consultations, two studies showed very different disclosure rates (0% and 91%), which appeared to reflect differences in the relevant government agency's disclosure requirements. Prevalence estimates of organisational policies that govern corporate sponsorship ranged from 2% (2/125) to 64% (175/274). Four studies analysed the relationship between industry funding and organisational positions on a range of highly controversial issues. Industry funded groups generally supported sponsors' interests.
CONCLUSION
In general, industry funding of patient groups seems to be common, with prevalence estimates ranging from 20% to 83%. Few patient groups have policies that govern corporate sponsorship. Transparency about corporate funding is also inadequate. Among the few studies that examined associations between industry funding and organisational positions, industry funded groups tended to have positions favourable to the sponsor. Patient groups have an important role in advocacy, education, and research, therefore strategies are needed to prevent biases that could favour the interests of sponsors above those of the public.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42017079265.
Topics: Consumer Organizations; Disclosure; Drug Industry; Financial Management; Observational Studies as Topic; Organizational Policy
PubMed: 31969320
DOI: 10.1136/bmj.l6925 -
JMIR MHealth and UHealth Jul 2019The widespread adoption of smartphones provides researchers with expanded opportunities for developing, testing and implementing interventions. National Institutes of... (Comparative Study)
Comparative Study Review
BACKGROUND
The widespread adoption of smartphones provides researchers with expanded opportunities for developing, testing and implementing interventions. National Institutes of Health (NIH) funds competitive, investigator-initiated grant applications. Funded grants represent the state of the science and therefore are expected to anticipate the progression of research in the near future.
OBJECTIVE
The objective of this paper is to provide an analysis of the kinds of smartphone-based intervention apps funded in NIH research grants during the five-year period between 2014 and 2018.
METHODS
We queried NIH Reporter to identify candidate funded grants that addressed mHealth and the use of smartphones. From 1524 potential grants, we identified 397 that met the requisites of including an intervention app. Each grant's abstract was analyzed to understand the focus of intervention. The year of funding, type of activity (eg, R01, R34, and so on) and funding were noted.
RESULTS
We identified 13 categories of strategies employed in funded smartphone intervention apps. Most grants included either one (35.0%) or two (39.0%) intervention approaches. These included artificial intelligence (57 apps), bionic adaptation (33 apps), cognitive and behavioral therapies (68 apps), contingency management (24 apps), education and information (85 apps), enhanced motivation (50 apps), facilitating, reminding and referring (60 apps), gaming and gamification (52 apps), mindfulness training (18 apps), monitoring and feedback (192 apps), norm setting (7 apps), skills training (85 apps) and social support and social networking (59 apps). The most frequently observed grant types included Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) grants (40.8%) and Research Project Grants (R01s) (26.2%). The number of grants funded increased through the five-year period from 60 in 2014 to 112 in 2018.
CONCLUSIONS
Smartphone intervention apps are increasingly competitive for NIH funding. They reflect a wide diversity of approaches that have significant potential for use in applied settings.
Topics: Artificial Intelligence; Bionics; Cognitive Behavioral Therapy; Education; Financial Management; Financing, Organized; Humans; Information Management; Mobile Applications; National Institutes of Health (U.S.); Research Personnel; Small Business; Smartphone; Technology Transfer; Telemedicine; United States
PubMed: 31359866
DOI: 10.2196/14655 -
Inquiry : a Journal of Medical Care... 2022This narrative review aimed to clarify the characteristics of international government support for sepsis research, trends in published literature on sepsis, and... (Review)
Review
This narrative review aimed to clarify the characteristics of international government support for sepsis research, trends in published literature on sepsis, and potential contributions of government-source grants to progress in sepsis research between fiscal years 2010 and 2019. The data in this study were collected from the National Institutes of Health (NIH, https://projectreporter.nih.gov/reporter.cfm/) of the United States of America (USA), National Natural Science Foundation of China (NSFC, https://isisn.nsfc.gov.cn/egrantweb/), and Japan Society for the Promotion of Science (JSPS, https://kaken.nii.ac.jp/). All sepsis-related projects approved by the NIH, NSFC, and JSPS were retrieved by searching the project titles, abstracts, and key words for "sepsis," "septic shock," or "sepsis inflammatory response syndrome" between 2010 and 2019. Representative sepsis-related studies published between Jan 2010 and Aug 2020 by the first/corresponding authors from these countries were obtained by searching the PubMed database using Medical Subject Heading terms for "sepsis" in representative journals, including , Cell, Science, The Lancet, New England Journal of medicine (New Engl J Med), The Journal of American Medical Association (JAMA), Critical Care Medicine (CCM), Intensive Care Medicine (ICM), Chest, Annals of Emergency Medicine (Ann Emerg Med), and American Thoracic Society journals (ATS). The total/annual institutional budgets, major funding mechanisms and schemes, superior institutions and individual principal investigators, and published original research articles in the field of sepsis in the USA, China, and Japan during the past decade were investigated. The national supporting schemes of the NIH, NSFC, and JSPS were similar. Support from these institutions is quite important for the development of the field of "sepsis" which was acknowledged in 57-64% of original research articles published in CCM. For the future development of precision medicine in sepsis, more government funding support is necessary.
Topics: China; Financial Management; Government; Humans; Medicine; Sepsis; United States
PubMed: 35179074
DOI: 10.1177/00469580221078513 -
Health Policy and Planning Jan 2024Development assistance is a major source of financing for health in least developed countries. However, persistent aid fragmentation has led to inefficiencies and health... (Review)
Review
Development assistance is a major source of financing for health in least developed countries. However, persistent aid fragmentation has led to inefficiencies and health inequities and constrained progress towards Universal Health Coverage (UHC). Malawi is a case study for this global challenge, with 55% of total health expenditure funded by donors and fragmentation across 166 financing sources and 265 implementing partners. This often leads to poor coordination and misalignment between government priorities and donor projects. To address these challenges, the Malawi Ministry of Health (MoH) has developed and implemented an architecture of aid coordination tools and processes. Using a case study approach, we documented the iterative development, implementation and institutionalization of these tools, which was led by the MoH with technical assistance from the Clinton Health Access Initiative. We reviewed the grey literature, including relevant policy documents, planning tools and databases of government/partner funding commitments, and drew upon the authors' experiences in designing, implementing and scaling up these tools. Overall, the iterative use and revision of these tools by the Government of Malawi across the national and subnational levels, including integration with the government's public financial management system, was critical to successful uptake. The tools are used to inform government and partner resource allocation decisions, assess financing and gaps for national and district plans and inform donor grant applications. As Malawi has launched the Health Sector Strategic Plan 2023-2030, these tools are being adapted for the 'One Plan, One Budget and One Report' approach. However, while the tools are an incremental mechanism to strengthen aid alignment, success has been constrained by the larger context of power imbalances and misaligned incentives between the donor community and the Government of Malawi. Reform of the aid architecture is therefore critical to ensure that these tools achieve maximum impact in Malawi's journey towards UHC.
Topics: Humans; Malawi; Universal Health Insurance; Budgets; Databases, Factual; Developing Countries
PubMed: 38253443
DOI: 10.1093/heapol/czad102