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Tossaint-Schoenmakers R, Kasteleyn MJ, Rauwerdink A, Chavannes N, Willems S, Talboom-Kamp EPWA. Development of a quality management model and self-assessment questionnaire for hybrid health care: a concept mapping study (Preprint). JMIR Form Res 2022; 6:e38683. [PMID: 35797097 PMCID: PMC9305399 DOI: 10.2196/38683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rosian Tossaint-Schoenmakers
- Saltro Diagnostic Centre, Unilabs Netherlands, Utrecht, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Marise J Kasteleyn
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Anneloek Rauwerdink
- Department of Surgery, Gastroenterology and Metabolism, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Niels Chavannes
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Sofie Willems
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Esther P W A Talboom-Kamp
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- Unilabs Group, Geneve, Switzerland
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Olyaaeemanesh A, Jaafaripooyan E, Abdollahiasl A, Davari M, Mousavi SM, Delpasand M. Pharmaceutical subsidy policy in Iran: a qualitative stakeholder analysis. Health Res Policy Syst 2021; 19:150. [PMID: 34949207 PMCID: PMC8697451 DOI: 10.1186/s12961-021-00762-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/20/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Over the past three decades, allocation of foreign currency subsidies has been the primary strategy of various administrations in Iran to improve access to medicines. This strategy has resulted in several challenges, including stakeholder conflicts of interest. OBJECTIVE To identify the power, interest, and role of the stakeholders in allocating foreign currency subsidies to medicines in the Iranian health system. METHODS In this qualitative study, 39 semi-structured interviews were conducted. Key informants were recruited using a purposive sampling technique. The theoretical framework adopted by Varvasovszky and Brugha was employed. The data were analysed using directed content analysis. RESULTS The foreign currency subsidy for medicines included 21 stakeholders in five main categories: governmental organizations, Iranian Parliament, general population, nongovernmental organizations (NGOs), and the pharmaceutical industry. Stakeholders varied in their level of participation and support in the policy-making process. Among them, the Iranian Government, Planning and Budget Organization, the Ministry of Health and Medical Education (MoHME), and Iran Food and Drug Administration (IFDA) were the most important stakeholders, with highly supportive positions, while domestic drug manufacturers were the strongest opponents of this policy. The Government of Iran is the most powerful institution with regard to the ability to allocate foreign currency subsidies to medicines, followed by the MoHME and the IFDA. CONCLUSION This study demonstrated that identifying and analysing the stakeholders involved in allocating foreign currency subsidies to medicines can provide valuable information for policy-makers to enable a more comprehensive understanding and better capacity to determine whether or not to eliminate these subsidies. Moreover, decision-making in this process is a long-term issue that requires consensus among all stakeholders. Because of the political and social consequences of eliminating foreign currency subsidies, the necessary political will is not institutionalized. We recommend a step-by-step approach in eliminating foreign currency subsidies if the requirements are met (i.e., those related to the consequences of such interventions). Therefore, revision of the current policy along with these requirements, in addition to financial transparency and enhanced efficiency, will facilitate progress towards achieving the Sustainable Development Goals by improving access to medicines.
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Affiliation(s)
- Alireza Olyaaeemanesh
- Health Equity Research and National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Jaafaripooyan
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Abdollahiasl
- Pharmacoeconomics and Pharmaceutical Administration, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Davari
- Pharmacoeconomics and Pharmaceutical Administration, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Meysam Mousavi
- Management and Leadership in Medical Education Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Health Foresight and Innovation Research Center, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansoor Delpasand
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Social security organization, Tehran, Iran
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Mousavi SM, Takian A, Tara M. Sixteen years of eHealth experiences in Iran: a qualitative content analysis of national policies. Health Res Policy Syst 2021; 19:146. [PMID: 34895250 PMCID: PMC8665305 DOI: 10.1186/s12961-021-00795-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION As a building block of all health systems and a multi-sectoral domain, eHealth has a critical role to accelerate the achievement of sustainable development goals (SDGs), particularly universal health coverage (UHC). Our objective was to provide a better understanding of the recent experiences on eHealth policy, particularly in framing process of the policies and strategies, in an attempt to develop evidence-based recommendations that can inform future eHealth policy formulation, implementation, and development in Iran. METHODS We undertook an exploratory, descriptive, comparative, retrospective and longitudinal analysis of eHealth policies by using content analysis of upstream and other key national policy documents, guided by criteria for reporting qualitative research (COREQ). A systematic and purposive search was conducted to identify publicly-accessible documents related to eHealth policies in Iran, followed by in-depth, semi-structured, open-ended interviews with purposefully identified national key informants in the field of eHealth. MAXQDA® 12 was used to assist with qualitative data analysis. FINDINGS We retrieved and included 13 national policy documents demonstrating 16 years experiences of recorded eHealth policy in Iran, from 2004-2020. Our analysis revealed seven main categories as challenges of eHealth policies in Iran: (1) lack of comprehensive and big picture of all eHealth components; (2) lack of long-term and strategic plans on eHealth; (3) poor consistency among national policy documents; (4) unrealistic and non-operational timing of policy documents; (5) inappropriate identification and lack of involvement of key actors in development and implementation of eHealth policies; (6) low priority of eHealth in the national health system, and (7) unconventional focus and attention to Electronic Health Record (EHR). CONCLUSION The findings reveal almost two decades history of eHealth initiatives at the national and upstream policy level in Iran, with noticeable gaps between desired policies and achieved expectations. The inclusion of eHealth solutions in the policy documents has been controversial and challenging. eHealth seems to have not been meaningfully established in the minds and views of policy makers and senior manager, which might have led to the development of incomplete and contradictory policies. The health system in Iran needs, we advocate, the design of an evidence-informed eHealth roadmap, as well as continuous, systematic, and reasonably time-bounded strategic plans to establish eHealth as the building block of health system along the pathway towards sustainable health development.
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Affiliation(s)
- Seyyed Meysam Mousavi
- Management and Leadership in Medical Education Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Health Foresight and Innovation Research Center, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahmood Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Hua J, Shi X, Cui M, Xiao Y, Xie J, Geng G. Study protocol: A cross-sectional study on instrumental support for transitional care among older adults with chronic diseases. Nurs Open 2021; 8:1990-1997. [PMID: 33675582 PMCID: PMC8186703 DOI: 10.1002/nop2.837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/28/2021] [Accepted: 02/17/2021] [Indexed: 01/31/2023] Open
Abstract
Aims In this paper, we present a study aiming to develop a questionnaire on instrumental support for transitional care as a tool for investigating services, staff, equipment and supplies, and funds of transitional care and conduct a cross‐sectional study on the current instrumental support for transitional care in older adults with chronic diseases. Design A cross‐sectional study combining instrumental support with transitional care through a mixed‐method approach. Methods Data are collected through two sources: distribution of the questionnaire to older adults with chronic diseases and interviews with experts from different specialties such as nursing, clinical medicine, geriatrics, sociology and government. Results The developed questionnaire and expert interviews will be used to investigate the current instrumental support for transitional care among older adults with chronic diseases in China. These findings can help leaders identify areas for improvement in transitional care and contribute to the long‐term positive development of transitional care.
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Affiliation(s)
- Jianing Hua
- School of Medical, Nantong University, Nantong, China
| | - Xiaoliu Shi
- School of Medical, Nantong University, Nantong, China
| | - Min Cui
- School of Medical, Nantong University, Nantong, China
| | - Yuhua Xiao
- Department of Medical Rehabilitation, The Second People's Hospital of Nantong, Nantong, China
| | - Juan Xie
- Department of Information Management, The Affiliated Hospital of Nantong University, Nantong, China
| | - Guiling Geng
- School of Medical, Nantong University, Nantong, China
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Mousavi SM, Takian A. More value from health IT in low and middle-income countries. HEALTH POLICY AND TECHNOLOGY 2020. [DOI: 10.1016/j.hlpt.2020.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mauco KL, Scott RE, Mars M. Validation of an e-health readiness assessment framework for developing countries. BMC Health Serv Res 2020; 20:575. [PMID: 32576174 PMCID: PMC7313186 DOI: 10.1186/s12913-020-05448-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/19/2020] [Indexed: 11/10/2022] Open
Abstract
Background Studies document e-health as having potential to improve quality of healthcare services, resulting in both developed and developing countries demonstrating continued interest in e-health uptake and use. e-Health implementations are not always successful as high failure rates have been reported in both developed and developing countries. These failures are often a result of lack of e-health readiness. e-Health readiness has been defined as the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to information and communication technologies. As such it is critical to conduct an e-health readiness assessment prior to implementation of e-health innovations so as to reduce chances of project failure. Noting the absence of an adequate e-health readiness assessment framework (eHRAF) suitable for use in developing countries, the authors conceptualised, designed, and created a developing country specific eHRAF to aid in e-health policy planning. The aim of this study was to validate the developed eHRAF and to determine if it required further refinement before empirical testing. Methods Published options for a framework validation process were adopted, and fifteen globally located e-health experts engaged. Botswana experts were engaged using saturation sampling, while international experts were purposively selected. Responses were collated in an Excel spreadsheet, and NVivo 11 software used to aid thematic analysis of the open ended questions. Results Analysis of responses showed overall support for the content and format of the proposed eHRAF. Equivocal responses to some open ended questions were recorded, most of which suggested modifications to terms within the framework. One expert from the developed world had alternate views. Conclusions The proposed eHRAF provides guidance for e-health policy development and planning by identifying, in an evidence based manner, the major areas to be considered when preparing for an e-health readiness assessment in the context of developing countries.
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Affiliation(s)
- Kabelo Leonard Mauco
- Department of TeleHealth, University of KwaZulu-Natal, Durban, South Africa. .,Botho University, P O BOX 501564, Gaborone, Botswana.
| | - Richard E Scott
- Department of TeleHealth, University of KwaZulu-Natal, Durban, South Africa.,NT Consulting - Global e-Health Inc, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Maurice Mars
- Department of TeleHealth, University of KwaZulu-Natal, Durban, South Africa.,Flinders University, Adelaide, South Australia, Australia
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