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Healthcare
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Healthcare Policy, Inequity, and Systems Research
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Healthcare Policy, Inequity, and Systems Research

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Health Policy".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 7097

Special Issue Editors

Prof. Dr. Mariusz Gujski

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Guest Editor
Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland
Interests: health care systems; evidence based health policy and public health; preventive medicine; health promotion; cancer control policies
Special Issues, Collections and Topics in MDPI journals
Dr. Mateusz Jankowski

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Guest Editor
Department of Population Health, School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
Interests: tobacco control; tobacco related diseases; e-cigarettes; heated tobacco products; lifestyle medicine; prevention programmes; health policy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare policy and systems research seeks to understand and improve how societies organize themselves in achieving collective health goals, and how different stakeholders interact in the policy and implementation processes to contribute to policy outcomes. Healthcare policy, inequity, and systems analyses may provide important evidence supporting public policies. The COVID-19 pandemic had a negative impact on population health, including limited access to healthcare, delay in diagnosis and treatment of non-communicable diseases as well as deepening health inequalities. There is a need to exchange international experiences in the field of healthcare policy and health system management that may support health policy planning and management globally, especially in low- and middle-income countries.

This Special Issue aims to present the diversity and progress of research in the field of healthcare policy, inequity, and systems research as well as evidence-based public health interventions to improve the health status of different populations.

In this Special Issue, we invite researchers in health policy, public health, epidemiology, management, quality assurance, preventive medicine, health economics, and other social sciences to submit high-quality original papers or systematical reviews related to the issues in this research area.

Prof. Dr. Mariusz Gujski
Dr. Mateusz Jankowski
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • healthcare
  • health policy
  • healthcare inequity
  • systems research
  • access to healthcare
  • universal health coverage
  • health policy programs
  • public health interventions

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Published Papers (6 papers)

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Research

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13 pages, 248 KiB  
Article
A Cross-Sectional Survey to Identify Sociodemographic Factors Associated with the Frequency of Urinalysis in a Representative Sample of Adults in Poland, 2024
by Gabriela Moczeniat, Mateusz Jankowski, Aneta Duda-Zalewska and Mariusz Gujski
Healthcare 2024, 12(15), 1475; https://doi.org/10.3390/healthcare12151475 - 25 Jul 2024
Viewed by 668
Abstract
A general urine test is considered one of the basic diagnostic tests using in healthcare. This study aimed to analyze sociodemographic factors associated with the frequency of urine testing in Poland. This cross-sectional survey was conducted using computer-assisted web interviewing (CAWI) between 1 [...] Read more.
A general urine test is considered one of the basic diagnostic tests using in healthcare. This study aimed to analyze sociodemographic factors associated with the frequency of urine testing in Poland. This cross-sectional survey was conducted using computer-assisted web interviewing (CAWI) between 1 March and 4 March 2024. A representative sample of 1113 adults in Poland (aged 18–86 years, 52.5% of whom were females) took part in the study. The survey showed that 46.3% of adults in Poland had a urinalysis in the last 12 months. One-fifth (20.7%) of the participants had a urinalysis more than a year ago but not more than 2 years ago. Moreover, 26.7% had a urinalysis performed 2–3 years ago. Among all participants, female gender (OR = 1.31 [1.01–1.68]; p < 0.05), being aged 70 years and over (OR = 2.22 [1.23–4.02]; p < 0.01), having children (OR = 1.45 [1.01–2.09]; p < 0.05), and having urologic diseases (OR = 2.34 [1.79–3.02]; p < 0.001) were significantly associated with having urinalysis in the last 12 months. Among respondents without urologic diseases, female gender (OR = 1.33 [1.02–1.74]; p < 0.05), being aged 60 years and over (p < 0.05), and being married (OR = 1.45 [1.09–1.94]; p < 0.05) were significantly associated with having a urinalysis in the last 12 months. There was no significant impact of educational level, occupational status, or financial situation on the frequency of urinalysis. Full article
(This article belongs to the Special Issue Healthcare Policy, Inequity, and Systems Research)
13 pages, 282 KiB  
Article
Bridging the Gap: Dental Students’ Attitudes toward Persons with Disabilities (PWDs)
by Faris Yahya I. Asiri, Marc Tennant and Estie Kruger
Healthcare 2024, 12(14), 1386; https://doi.org/10.3390/healthcare12141386 - 11 Jul 2024
Cited by 1 | Viewed by 1452
Abstract
Background: Persons with disabilities (PWDs) face significant barriers in accessing dental care, resulting in poorer oral health outcomes compared to the general population. To reduce dental healthcare disparities, dental professionals must develop positive attitudes and acquire the necessary skills to treat PWDs effectively. [...] Read more.
Background: Persons with disabilities (PWDs) face significant barriers in accessing dental care, resulting in poorer oral health outcomes compared to the general population. To reduce dental healthcare disparities, dental professionals must develop positive attitudes and acquire the necessary skills to treat PWDs effectively. This study aimed to assess the experiences, education, training levels, and attitudes of dental students and interns toward PWDs, and to explore the relationships between their exposure to PWDs, their education/training regarding managing PWDs, and their attitudes toward PWDs. Methods: Participants were recruited using convenience sampling. From May to June 2023, a pretested, validated online questionnaire (developed based on existing survey instruments and modified to fit the study context) was distributed to 98 eligible dental students and interns at King Faisal University. Descriptive and analytical statistics were used for analysis. Results: The response rate was 88.78%. There was a statistically positive correlation between students’ exposure to PWDs and their attitudes (p < 0.05). Statistically significant relationships were found between students’ education/training and their attitudes towards educational experiences and instructors (p < 0.01) and interpersonal interactions with PWDs (p < 0.05). No statistically significant relationship existed between the year of study and future encounters with PWDs (p = 0.176). Additionally, 42.5% of students felt inadequately prepared to treat PWDs, and 88.5% expressed a desire for further education. Notably, 20.7% reported no training on PWDs, while 70.1% preferred clinical education. Conclusions: The study underscores the importance of exposure and training in shaping dental students’ attitudes toward PWDs. Dental schools should prioritize structured teaching, greater contact with the disabled community, and hands-on experiences to ensure dental professionals are both well prepared and positively inclined to treat PWDs. These findings have significant implications for improving dental education curricula. Full article
(This article belongs to the Special Issue Healthcare Policy, Inequity, and Systems Research)
15 pages, 1314 KiB  
Article
Resident Impact of the Single Site Order Restricting Staff Mobility across Long-Term Care Homes in British Columbia, Canada
by Farinaz Havaei, Sabina Staempfli, Andy Ma, Joanie Sims-Gould, Thea Franke and Minjeong Park
Healthcare 2023, 11(24), 3190; https://doi.org/10.3390/healthcare11243190 - 17 Dec 2023
Viewed by 1086
Abstract
The Single Site Order (SSO)—a policy restricting staff from working at multiple long-term care (LTC) homes—was mandated by the Public Health Agency of Canada to control the spread of COVID-19 in LTC homes, where nearly 70% of COVID-19-related deaths in Canada occurred. This [...] Read more.
The Single Site Order (SSO)—a policy restricting staff from working at multiple long-term care (LTC) homes—was mandated by the Public Health Agency of Canada to control the spread of COVID-19 in LTC homes, where nearly 70% of COVID-19-related deaths in Canada occurred. This mixed methods study assesses the impact of the SSO on LTC residents in British Columbia. Interviews were conducted (residents (n = 6), family members (n = 9), staff (n = 18), and leadership (n = 10) from long-term care homes (n = 4)) and analyzed using thematic analysis. Administrative data were collected between April 2019 and March 2020 and between April 2020 and March 2021 and analyzed using descriptive statistics and data visualization. Qualitative and quantitative data were triangulated and demonstrated that staffing challenges became worse during the implementation of the SSO, resulting in the mental and physical health deterioration of LTC residents. Qualitative data demonstrated decreased time for personalized and proactive care, increased communication challenges, and increased loneliness and isolation. Quantitative data showed a decline in activities of daily living, increased antipsychotic medication use, pressure ulcers, behavioural symptoms, and an increase in falls. Addressing staff workload and staffing shortages during SSO-related policy implementation is essential to avoid resident health deterioration. Full article
(This article belongs to the Special Issue Healthcare Policy, Inequity, and Systems Research)
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Review

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26 pages, 751 KiB  
Review
Socioeconomic Inequalities as a Cause of Health Inequities in Spain: A Scoping Review
by Guillem Blasco-Palau, Jara Prades-Serrano and Víctor M. González-Chordá
Healthcare 2023, 11(23), 3035; https://doi.org/10.3390/healthcare11233035 - 24 Nov 2023
Viewed by 1591
Abstract
The objectives of this review were to identify the population groups most frequently studied, to determine the methods and techniques most commonly used to show health inequities, and to identify the most frequent socioeconomic and health indicators used in the studies on health [...] Read more.
The objectives of this review were to identify the population groups most frequently studied, to determine the methods and techniques most commonly used to show health inequities, and to identify the most frequent socioeconomic and health indicators used in the studies on health inequities due to socioeconomic inequalities that have been carried out on the Spanish healthcare system. A scoping review was carried out of the studies conducted in the Spanish State and published in literature since 2004, after the publication of the Law of Cohesion and Quality of the National Health System. The PRISMA extension for scoping reviews was followed. The methodological quality of the studies was assessed using the critical reading guides of the Joanna Briggs Institute and an adaptation of the STROBE guide for ecological studies. A total of 58 articles out of 811 articles were included. Most of the articles were (77.59%, n = 45) cross-sectional studies, followed by ecological studies (13.8%, n = 8). The population group used was uneven, while the main geographical area under investigation was the whole state (51.7%, n = 30) compared to other territorial distributions (48.3%, n = 28). The studies used a multitude of health and socioeconomic indicators, highlighting self-perception of health (31.03%, n = 19) and social class (50%, n = 29). The relationship between better health and better socioeconomic status is evident. However, there is variability in the populations, methods, and indicators used to study health equity in Spain. Future health research and policies require greater systematization by public institutions and greater cooperation among researchers from disciplines such as sociology, economics, and health. Full article
(This article belongs to the Special Issue Healthcare Policy, Inequity, and Systems Research)
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Other

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18 pages, 442 KiB  
Systematic Review
eHealth Platforms Facilitate Prostate Cancer Shared Care: A Systematic Review
by David C. Homewood, Jodie Mcdonald, Zina Valaydon, Cindy Ogluszko, Olga A. Sukocheva, Edmund Tse, Niall M. Corcoran and Guru Iyngkaran
Healthcare 2024, 12(17), 1768; https://doi.org/10.3390/healthcare12171768 - 4 Sep 2024
Viewed by 479
Abstract
Background: Prostate cancer survivorship care is essential for the early identification of cancer recurrence and progression and the monitoring of adverse effects. Prostate cancer survivorship programs have enabled care to be shared between specialists using digital healthcare platforms. We systematically reviewed the literature [...] Read more.
Background: Prostate cancer survivorship care is essential for the early identification of cancer recurrence and progression and the monitoring of adverse effects. Prostate cancer survivorship programs have enabled care to be shared between specialists using digital healthcare platforms. We systematically reviewed the literature to examine if prostate cancer survivorship care had been successfully digitalised. Methods: English language articles were searched on PubMed, Embase, and Cochrane Libraries. The search terms included combinations of “eHealth”, “digital health”, “prostate cancer”, “shared care”, and related keywords (studies published between [1 January 1946 and 20 March 2023]). Results: Our search strategy yielded 1722 publications, of which 17 studies were included in our final review. Diverse eHealth interventions (web platforms, apps, patient portals) for digital prostate cancer shared care enabled communication, symptom management, and holistic assessment, with potential for reducing anxiety, enhancing outcomes, and increasing engagement. The studies (9 months to 5 years duration) involved participants across different care phases (16 to 3521 participants). We identified ten eHealth platforms, which provided successful symptom tracking, needs assessment, and communications. The platform-based interventions improved some aspects of communication, symptom management, and care delivery. The ongoing clinical need for a robust digital platform that caters to all domains of shared care was identified. Conclusions: eHealth will certainly play a central role in digital prostate cancer shared care, providing better health outcomes and care delivery. Future larger studies in this field should address the implementation barriers, including cost-effectiveness and primary care remuneration. It is also crucial to refine application useability and workflow, focusing on standardization and patient-centred approaches. Full article
(This article belongs to the Special Issue Healthcare Policy, Inequity, and Systems Research)
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19 pages, 2276 KiB  
Systematic Review
Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review
by Askhat Shaltynov, Ulzhan Jamedinova, Yulia Semenova, Madina Abenova and Ayan Myssayev
Healthcare 2024, 12(10), 1051; https://doi.org/10.3390/healthcare12101051 - 20 May 2024
Viewed by 1225
Abstract
Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure [...] Read more.
Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration. Full article
(This article belongs to the Special Issue Healthcare Policy, Inequity, and Systems Research)
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