The relationship between medical innovation and health expenditure before and after health reform

Telemedicine and the standard of care: a call for a new approach?

Telemedicine, understood as the provision of health care by a health professional to a patient who is physically not in the same location as the health professional, has many actual and potential benefits. It also has some disadvantages though, including a higher risk of misdiagnosis or another unfavorable outcome of certain remotely-provided services. In principle, the regime of legal liability for medical malpractice is the same for telemedicine as for traditional physical care. The general outline of the standard of care, which includes respect for medical science, the patient's individuality and objective possibilities, is abstract and flexible enough to be used for remote care without the need for redefinition. The quality of health care should be evaluated on the basis of the whole scale of risks and benefits it brings to a particular patient, including accessibility and comfort. In general, it should be permissible to provide a medical service remotely on the condition that its overall quality is at least as good as its comparable physical alternative. In other words, certain decrease in quality of some aspects of remote care can be compensated by other advantages. In terms of public health, support for telemedicine may bring a great improvement in the access to health care, and thus help significantly the individual members of the population. From the individual perspective, respect for personal autonomy implies that a patient should have every right to opt for a remote service, provided that there exists a true choice between meaningful options which is made on the basis of full information. If telemedicine is to fulfill its potential without sacrificing the protection of patients and their rights, reasonable guidelines for remote services need to be defined for particular medical fields, and for specific procedures within them. Among other issues, these guidelines must address the question of when it is necessary to refer the patient to physical care.

Policy innovation and emergence of innovative health technology: The system dynamics modelling of early COVID-19 handling in Indonesia

This article examines policy innovation, emergence of innovative health technology and its implication for a health system. The complexity of policy innovation implementation resulting from mixing public health resolution and economic interest will trigger the emergence of innovative health technology, which implies a health system improvement. The findings revealed that: First, policy innovation based on a science-mix category created the complexity of policy enforcement, affected the scale and speed of COVID-19 transmissions, and triggered the emergence of health innovative technology. Second, despite policy innovation in early COVID-19, handling was relatively less successful due to restricting factors in policy implementation but provided a new market for the emergence of innovative health technology. Third, the emergence of innovative health technology has strengthened health system preparedness during the pandemic, and provide an opportunity to re-examine the strengths and deficiencies of an entire health system for better health care.

On the Network Transmission Mechanisms of Disease-Specific Healthcare Expenditure Spillovers: Evidence from the Connectedness Network Analyses

Previous studies investigating factors influencing healthcare expenditure growth ignored the network transmission mechanisms of disease-specific healthcare expenditure spillovers and regarded the processes culminating in healthcare expenditure growth as a black box. In this study, we investigated factors influencing the network transmission mechanisms underlying the determinants of healthcare expenditure growth through the dynamic connectedness network and the robust least square regression analyses. Our results indicate that demographic transition and business cycles are key factors increasing interconnectedness of different disease-specific healthcare expenditures, and that promotion of primary care utilization would reduce total healthcare expenditure spillovers. In order to reduce diffusion of disease-specific healthcare expenditures, health promotion activities should focus on those clinical diagnosis-related groups of diseases classified as pure net transmitters of spillover, and preventive interventions targeting different diseases should be activated in different phrases of the business cycle.

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

In the study of the sustainable development of public health in China, academic circles have little to do with the unique hierarchical medical system and online appointment diagnosis system in China’s medical system. Therefore, based on the medical situation in Shanghai, China, in addition to the traditional dimension of medical expenses, this paper fully considers the impact of the current hierarchical medical policy, constructs a selection model for medical treatment behavior under the hierarchical medical system and online appointment diagnosis system, and carries out simulation analysis through the cellular automata grid dynamic model. This paper finds that the time-cost-oriented medical treatment behavior of Chinese patients will have different distribution under the current hierarchical medical system and online appointment diagnosis system. (1) When the medical treatment system neither allows online appointment nor referral, a large number of patients congregated in high-grade hospitals, with the most unreasonable distribution. (2) With the implementation of the system of allowing referral and online appointment, patients are gradually diverted to lower-grade hospitals or off-peak hours, and the distribution is relatively improved. (3) If the medical treatment system allows both referral and online appointment, the distribution of patients is the most reasonable. Therefore, China’s current hierarchical medical system and online appointment diagnosis system will, to a considerable extent, become a policy tool that affects patients’ choice of hospitals and an effective means to achieve the rational allocation of existing medical resources, which will play an important role in the sustainable development of public health in China.