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Götz P, Auping WL, Hinrichs-Krapels S. Contributing to health system resilience during pandemics via purchasing and supply strategies: an exploratory system dynamics approach. BMC Health Serv Res 2024; 24:130. [PMID: 38267945 PMCID: PMC10807148 DOI: 10.1186/s12913-023-10487-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 12/16/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Health systems worldwide struggled to obtain sufficient personal protective equipment (PPE) and ventilators during the COVID-19 pandemic due to global supply chain disruptions. Our study's aim was to create a proof-of-concept model that would simulate the effects of supply strategies under various scenarios, to ultimately help decision-makers decide on alternative supply strategies for future similar health system related crises. METHODS We developed a system dynamics model that linked a disease transmission model structure (susceptible, exposed, infectious, recovered (SEIR)) with a model for the availability of critical supplies in hospitals; thereby connecting care demand (patients' critical care in hospitals), with care supply (available critical equipment and supplies). To inform the model structure, we used data on critical decisions and events taking place surrounding purchase, supply, and availability of PPE and ventilators during the first phase of the COVID-19 pandemic within the English national health system. We used exploratory modelling and analysis to assess the effects of uncertainties on different supply strategies in the English health system under different scenarios. Strategies analysed were: (i) purchasing from the world market or (ii) through direct tender, (iii) stockpiling, (iv) domestic production, (v) supporting innovative supply strategies, or (vi) loaning ventilators from the private sector. RESULTS We found through our exploratory analysis that a long-lasting shortage in PPE and ventilators is likely to be apparent in various scenarios. When considering the worst-case scenario, our proof-of-concept model shows that purchasing PPE and ventilators from the world market or through direct tender have the greatest influence on reducing supply shortages, compared to producing domestically or through supporting innovative supply strategies. However, these supply strategies are affected most by delays in their shipment time or set-up. CONCLUSION We demonstrated that using a system dynamics and exploratory modelling approach can be helpful in identifying the purchasing and supply chain strategies that contribute to the preparedness and responsiveness of health systems during crises. Our results suggest that to improve health systems' resilience during pandemics or similar resource-constrained situations, purchasing and supply chain decision-makers can develop crisis frameworks that propose a plan of action and consequently accelerate and improve procurement processes and other governance processes during health-related crises; implement diverse supplier frameworks; and (re)consider stockpiling. This proof-of-concept model demonstrates the importance of including critical supply chain strategies as part of the preparedness and response activities to contribute to health system resilience.
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Affiliation(s)
- Paula Götz
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Willem L Auping
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Saba Hinrichs-Krapels
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands.
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Copeland S, Hinrichs-Krapels S, Fecondo F, Santizo ER, Bal R, Comes T. A resilience view on health system resilience: a scoping review of empirical studies and reviews. BMC Health Serv Res 2023; 23:1297. [PMID: 38001460 PMCID: PMC10675888 DOI: 10.1186/s12913-023-10022-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/11/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Prompted by recent shocks and stresses to health systems globally, various studies have emerged on health system resilience. Our aim is to describe how health system resilience is operationalised within empirical studies and previous reviews. We compare these to the core conceptualisations and characteristics of resilience in a broader set of domains (specifically, engineering, socio-ecological, organisational and community resilience concepts), and trace the different schools, concepts and applications of resilience across the health literature. METHODS We searched the Pubmed database for concepts related to 'resilience' and 'health systems'. Two separate analyses were conducted for included studies: a total of n = 87 empirical studies on health system resilience were characterised according to part of health systems covered, type of threat, resilience phase, resilience paradigm, and approaches to building resilience; and a total of n = 30 reviews received full-text review and characterised according to type of review, resilience concepts identified in the review, and theoretical framework or underlying resilience conceptualisation. RESULTS The intersection of health and resilience clearly has gained importance in the academic discourse with most papers published since 2018 in a variety of journals and in response to external threats, or in reference to more frequent hospital crisis management. Most studies focus on either resilience of health systems generally (and thereby responding to an external shock or stress), or on resilience within hospitals (and thereby to regular shocks and operations). Less attention has been given to community-based and primary care, whether formal or informal. While most publications do not make the research paradigm explicit, 'resilience engineering' is the most prominent one, followed by 'community resilience' and 'organisational resilience'. The social-ecological systems roots of resilience find the least application, confirming our findings of the limited application of the concept of transformation in the health resilience literature. CONCLUSIONS Our review shows that the field is fragmented, especially in the use of resilience paradigms and approaches from non-health resilience domains, and the health system settings in which these are used. This fragmentation and siloed approach can be problematic given the connections within and between the complex and adaptive health systems, ranging from community actors to local, regional, or national public health organisations to secondary care. Without a comprehensive definition and framework that captures these interdependencies, operationalising, measuring and improving resilience remains challenging.
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Affiliation(s)
- Samantha Copeland
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Saba Hinrichs-Krapels
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands.
| | - Federica Fecondo
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Esteban Ralon Santizo
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Roland Bal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burg. Oudlaan 50, Rotterdam, The Netherlands
| | - Tina Comes
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
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Hinrichs-Krapels S, Tombo L, Boulding H, Majonga ED, Cummins C, Manaseki-Holland S. Barriers and facilitators for the provision of radiology services in Zimbabwe: A qualitative study based on staff experiences and observations. PLOS Glob Public Health 2023; 3:e0001796. [PMID: 37058456 PMCID: PMC10104335 DOI: 10.1371/journal.pgph.0001796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 03/14/2023] [Indexed: 04/15/2023]
Abstract
Despite its fundamental role in diagnostic and curative care, radiology has been described as a neglected essential service in many low and middle-income countries (LMICs). Previous studies have demonstrated basic equipment and infrastructure shortages in LMIC settings, but no studies to date have gone further in understanding the perceptions and experiences of staff delivering radiology services, as a way of identifying their perspectives on barriers and facilitators for delivering services, and the potential for where improvements can be made. Our qualitative study aimed to: (a) identify barriers for delivering radiology services, and (b) suggest potential facilitators for improvement of radiology service delivery in the Zimbabwean context; from the perspective of radiology staff. We conducted semi-structured interviews (n = 13) and three focus groups (n = 24 radiographers), followed by four half- to full- days of field observations to validate insights from the interviews and focus groups in all three public hospitals and one private hospital in the Harare metropolitan area. Our study identified four main barriers for delivering radiology services: (i) poor basic infrastructure, equipment, and consumables; (ii) suboptimal equipment maintenance; (iii) shortage of radiology staff and skills development; and (iv) lack of wider integration and support for radiology services. We also identified a strong sense of motivation among staff to keep radiology services, pointing to what may be an enabler and facilitator for improving radiology services. These findings point to potential risks to patient safety and quality of delivering radiology services. More importantly, we found a strong sense of personal motivation displayed by the staff, suggesting there is the potential to maintain and improve existing practices, but this would require investments to train and remunerate more radiology staff, as well as investing in continuing professional development.
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Affiliation(s)
- Saba Hinrichs-Krapels
- Faculty of Technology, Policy and Management, Delft University of Technology, Delft, The Netherlands
| | - Lazarus Tombo
- Radiology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Harriet Boulding
- The Policy Institute, King's College London, London, United Kingdom
| | - Edith D Majonga
- Department of Medical Physics and Imaging Sciences, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Carole Cummins
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Abstract
OBJECTIVES To systematically review academic literature for studies on any processes, procedures, methods or approaches to purchasing high-cost medical devices and equipment within hospitals in high-income countries. METHODS On 13 August 2020, we searched the following from inception: Cost-Effectiveness Analysis Registry, EconLit and ProQuest Dissertations & Theses A&I via ProQuest, Embase, MEDLINE, and MEDLINE in Process via Ovid SP, Google and Google Scholar, Health Management and Policy Database via Ovid SP, IEEE Xplore Digital Library, International HTA Database, NHS EED via CRD Web, Science Citation Index-Expanded, Conference Proceedings Citation Index-Science, and Emerging Sources Citation Index via Web of Science, Scopus, and Zetoc conference search. Studies were included if they described the approach to purchasing (also known as procurement or acquisition) of high-cost medical devices and/or equipment conducted within hospitals in high-income countries between 2000 and 2020. Studies were screened, data extracted and results summarised in tables under themes identified. RESULTS Of 9437 records, 24 were included, based in 12 different countries and covering equipment types including surgical robots, medical imaging equipment, defibrillators and orthopaedic implants. We found heterogeneity in methods and approaches; including descriptions of processes taking place within or across hospitals (n=14), out of which three reported cost savings; empirical studies in which hospital records or participant data were analysed (n=8), and evaluations or pilots of proposed purchasing processes (n=2). Studies emphasise the importance of balancing technical, financial, safety and clinical requirements for device selection through multidisciplinary involvement (especially clinical engineers and clinicians) in decision-making, and the potential of increasing evidence-based purchasing decisions using approaches such as hospital-based health technology assessments, ergonomics and device 'user trials'. CONCLUSIONS We highlight the need for more empirical work that evaluates purchasing approaches or interventions, and greater specificity in study reporting (eg, equipment type, evaluation outcomes) to build the evidence base required to influence policy and practice for medical equipment purchasing. PROTOCOL REGISTRATION This review was registered in Open Science Framework: Shokraneh F, Hinrichs-Krapels S, Chalkidou A et al. Purchasing high-cost medical equipment in hospitals in OECD countries: A systematic review. Open Science Framework 2021; doi:10.17605/OSF.IO/GTXN8. Available at: https://osf.io/gtxn8/ (accessed 12 February 2022).
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Affiliation(s)
- Saba Hinrichs-Krapels
- Faculty of Technology, Policy and Management, Delft University of Technology, Delft, The Netherlands
- The Policy Institute, King's College London, London, UK
| | - Bor Ditewig
- Faculty of Technology, Policy and Management, Delft University of Technology, Delft, The Netherlands
| | | | - Anastasia Chalkidou
- King's Technology Evaluation Centre (KiTEC), London Institute for Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Jamie Erskine
- King's Technology Evaluation Centre (KiTEC), London Institute for Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Farhad Shokraneh
- King's Technology Evaluation Centre (KiTEC), London Institute for Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Hinrichs-Krapels S, Diehl JC, Hunfeld N, van Raaij E. Towards sustainability for medical devices and consumables: The radical and incremental challenges in the technology ecosystem. J Health Serv Res Policy 2022; 27:253-254. [PMID: 35739079 DOI: 10.1177/13558196221110416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Erik van Raaij
- 6984Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
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Boulding H, Hinrichs-Krapels S. Factors influencing procurement behaviour and decision-making: an exploratory qualitative study in a UK healthcare provider. BMC Health Serv Res 2021; 21:1087. [PMID: 34645449 PMCID: PMC8512597 DOI: 10.1186/s12913-021-07065-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/20/2021] [Indexed: 11/11/2022] Open
Abstract
Background In 2016 the UK Department of Health and Social Care published the results of a comprehensive review of efficiency in hospitals, identifying “unwarranted variation” in procurement (or purchasing) practices for materials, supplies and devices. Addressing this variation in materials and supplies procurement practice has been identified as particularly important for creating efficiencies in health service delivery. However, little is known about the behaviour and experiences of front-line individuals who make these procurement decisions, which has implications for the development of strategies to improve efficiency. The objective of this study is to improve understanding of the factors influencing procurement behaviour and decisions among requisitioners who use an internal electronic procurement portal for medical supplies and equipment, and identify areas where efficiency could be improved. Methods Qualitative semi-structured individual interview study, following approximately 70 h of exploratory observations on site. The study context was a large London National Health Service (NHS) healthcare provider (the Trust), where we focussed primarily on purchases managed by a large hospital. Participants were drawn from requisitioners from multiple directorates across the Trust (n = 15; of these n = 2 clinical staff members, n = 13 non-clinical). Results Four factors stood out in our analysis as directly affecting procurement decisions: (1) a high level of variation in electronic purchasing and inventory management procedures throughout the Trust, (ii) an inaccurate and cumbersome search facility on the internal electronic procurement platform, exacerbated by poor IT skills training and support (iii) an inefficient purchase approvals system and (iv) multiple working sites and cluttered environments. We observed that these factors led requisitioners to employ a variety of strategies or so-called ‘workarounds’ to overcome the challenges they encountered, including stockpiling, relying on internal and supplier relationships, by-passing procedures to save time, purchasing outside existing agreements to save cost, and (re) delegating purchasing responsibilities among requisitioner staff - which both addressed and created difficulties. Conclusions Working with the assumption that staff ‘workarounds’ indicate where main issues lie, we offer four possible explanations to why they occur: (a) to maintain services and prepare for future care requirements, (b) to save on costs for the organisation, (c) to develop skills and development in purchasing and (d) to break silos and work collaboratively. These four explanations help provide initial starting points for improving efficiencies in health supplies’ procurement processes. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07065-0.
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Affiliation(s)
| | - Saba Hinrichs-Krapels
- King's College London, London, WC2R 2LS, England.,Delft University of Technology, Jaffalaan 5, 2628, Delft, BX, Netherlands
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Seward N, Murdoch J, Hanlon C, Araya R, Gao W, Harding R, Lund C, Hinrichs-Krapels S, Mayston R, Kartha M, Prince M, Sandall J, Thornicroft G, Verhey R, Sevdalis N. Implementation science protocol for a participatory, theory-informed implementation research programme in the context of health system strengthening in sub-Saharan Africa (ASSET-ImplementER). BMJ Open 2021; 11:e048742. [PMID: 34244274 PMCID: PMC8268893 DOI: 10.1136/bmjopen-2021-048742] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES ASSET (Health System Strengthening in sub-Saharan Africa) is a health system strengthening (HSS) programme involving eight work-packages (ie, a research study that addresses a specific need for HSS) that aims to develop solutions that support high-quality care. Here we present the protocol for the implementation science (IS) theme within ASSET (ASSET-ImplmentER) that aims to understand what HSS interventions work, for whom and how, and how IS methodologies can be adapted to improve the HSS interventions within resource-poor contexts. SETTINGS Publicly funded health facilities in rural and urban areas in in Ethiopia, South Africa, Sierra Leone, and Zimbabwe. PARTICIPANTS Research staff including principal investigators, coinvestigators, field staff, PhD students, and research assistants. INTERVENTIONS Work-packages use a mixed-methods effectiveness-effectiveness hybrid designs. At the end of the pre-implementation phase, a workshop is held whereby the IS theme, jointly with ASSET work-packages apply IS determinant frameworks to research findings to identify factors that influence the effectiveness of delivering evidence-informed care. Determinants are used to select a set of HSS interventions for further evaluation, where work-packages also theorise selective mechanisms.In the piloting and rolling implementation phase, work-packages pilot the HSS interventions. An iterative process then begins involving evaluation, reflection and adaptation. Throughout this phase, IS determinant frameworks are applied to monitor and identify barriers/enablers to implementation. Selective mechanisms of action are also investigated. Implementation outcomes are evaluated using qualitative and quantitative methods. The psychometric properties of outcome measures including acceptability, appropriateness and feasibility are also evaluated. In a final workshop, work-packages come together, to reflect and explore the utility of the selected IS methods and provide suggestions for future use.Structured templates are used to organise and analyse common and heterogeneous patterns across work-packages. Qualitative data are analysed using thematic analysis and quantitative data are analysed using means and proportions. CONCLUSIONS We use a novel combination of IS methods at a programmatic level to facilitate comparisons of determinants and mechanisms that influence the effectiveness of HSS interventions in achieving implementation outcomes across different contexts. The study also contributes conceptual development and clarification at the underdeveloped interface of IS, HSS and global health.The ASSET-ImplementER theme is considered minimal risk as we only interview researchers involved in the different work-packages. To this effect we have received approval from King's College London Ethics Committee for research that is considered minimal risk (Reference number: MRA-20/21-21772).
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Affiliation(s)
- Nadine Seward
- Centre for Implementation Science, Department of Health Services and Population Research, King's College London, London, UK
| | - Jamie Murdoch
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Charlotte Hanlon
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK
- School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Ricardo Araya
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK
| | - Wei Gao
- Department of Palliative Care and Policy, King's College London, London, UK
| | - Richard Harding
- Department of Palliative Care and Policy, King's College London, London, UK
| | - Crick Lund
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Saba Hinrichs-Krapels
- The Policy Institute, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
| | - Rosie Mayston
- King's Global Health Institute, King's College London, London, UK
- Global Health and Social Medicine, King's College London, London, UK
| | | | - Martin Prince
- King's Global Health Institute, King's College London, London, UK
| | - Jane Sandall
- Dept of Women and Children's Health, School of Life Course Sciences, FoLSM, King's College London, London, UK
| | - Graham Thornicroft
- Centre for Implementation Science, Department of Health Services and Population Research, King's College London, London, UK
| | - Ruth Verhey
- Research Support Centre, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nick Sevdalis
- Centre for Implementation Science, Department of Health Services and Population Research, King's College London, London, UK
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Bricknell M, Hinrichs-Krapels S, Ismail S, Sullivan R. Understanding the structure of a country’s health service providers for defence health engagement. BMJ Mil Health 2020; 167:454-456. [PMID: 32503861 PMCID: PMC8639950 DOI: 10.1136/bmjmilitary-2020-001502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/02/2022]
Abstract
There are a variety of structural and systems frameworks for describing the building blocks of country’s public health and health systems. In this paper, we propose a conceptual framework for a holistic view of a country’s health service providers in order to inform the plan for Defence Health Engagement activities with partner countries. This includes all potential government ministries involved in healthcare provision, the independent, private sector and the non-government organisation/charity sector. The framework provides a visualisation to support the analysis of a country’s health services providers. We propose that recognising and analysing the different contributions of all these national health providers is essential for understanding the wider political economy of a nation’s health systems. This can inform a plan of Defence Health Engagement for capacity building in crisis response, development and health systems strengthening.
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Affiliation(s)
- Martin Bricknell
- Conflict and Health Research Group, King's College London-Strand Campus, London, UK
| | | | - S Ismail
- Department of Primary Care and Public Health, Imperial College London Faculty of Medicine, London, UK
| | - R Sullivan
- Conflict and Health Research Group, King's College London, London, UK
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Flint-O'Kane M, von Dadelszen P, Makanga PT, Sevene E, Roca A, Dukes P, Hinrichs-Krapels S, Craik R, Magee LA, Temmerman M. Harnessing the PRECISE network as a platform to strengthen global capacity for maternal and child health research in sub-Saharan Africa. Reprod Health 2020; 17:52. [PMID: 32354358 PMCID: PMC7191677 DOI: 10.1186/s12978-020-0876-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network has been established as a platform to strengthen global capacity for research focused on the improvement of maternal, fetal and newborn health in sub-Saharan Africa.Best practice principles outlined in an ESSENCE on Health Research report have been considered in relation to the PRECISE Network capacity-building activities described in this paper. These activities are described at the individual, programmatic and institutional levels, and successes, challenges and recommendations for future work are outlined.The paper concludes that the PRECISE leadership have an opportunity to review and refresh activity plans for capacity building at this stage in the project to build on achievements to date.
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Affiliation(s)
- Meriel Flint-O'Kane
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences and Medicine, King's College London, London, UK.
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Peter von Dadelszen
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Esperança Sevene
- Department of Physiological Science, Clinical - Pharmacology, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
- Centro de Investigação em Saúde de Manhiça, Manhiça, Maputo Province, Mozambique
| | - Anna Roca
- Medical Research Council Unit (The Gambia) at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Peter Dukes
- Africa Research Excellence Fund, Fajara, The Gambia, UK
- Africa Research Excellence Fund, London, UK
| | | | - Rachel Craik
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Laura A Magee
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, East Africa, Aga Khan University, Nairobi, Kenya
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Boulding H, Kamenetzky A, Ghiga I, Ioppolo B, Herrera F, Parks S, Manville C, Guthrie S, Hinrichs-Krapels S. Mechanisms and pathways to impact in public health research: a preliminary analysis of research funded by the National Institute for Health Research (NIHR). BMC Med Res Methodol 2020; 20:34. [PMID: 32075580 PMCID: PMC7031933 DOI: 10.1186/s12874-020-0905-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/20/2020] [Indexed: 11/23/2022] Open
Abstract
Background The mechanisms and pathways to impacts from public health research in the UK have not been widely studied. Through the lens of one funder (NIHR), our aims are to map the diversity of public health research, in terms of funding mechanisms, disciplinary contributions, and public health impacts, identify examples of impacts, and pathways to impact that existing reporting mechanisms may not otherwise have captured, and provide illustrations of how public health researchers perceive the generation of non-academic impact from their work. Methods A total of 1386 projects were identified as ‘public health research’ by the NIHR and listed in the NIHR Public Health Overview database (2000–2016). From these, a subset of 857 projects were matched as potentially having begun reporting impacts via an external data-gathering platform (Researchfish). Data on the 857 projects were analyzed quantitatively, and nine projects were selected to investigate further through semi-structured interviews with principal investigators. Two workshops took place to validate emerging and final findings and facilitate analysis. Results In addition to the NIHR School for Public Health Research and the NIHR Public Health Research Programme, 89% of projects contained in the NIHR Public Health Overview portfolio as ‘public health research’ are funded via other NIHR research programmes, suggesting significant diversity in disciplines contributing to public health research and outcomes. The pathways to impact observed in our in-depth case studies include contributing to debates on what constitutes appropriate evidence for national policy change, acknowledging local ‘unintended’ impacts, building trusted relationships with stakeholders across health and non-health sectors and actors, collaborating with local authorities, and using non-academic dissemination channels. Conclusions Public health as a discipline contributes substantially to impact beyond academia. To support the diversity of these impacts, we need to recognise localized smaller-scale impacts, and the difference in types of evidence required for community and local authority-based impacts. This will also require building capacity and resources to enable impact to take place from public health research. Finally, support is required for engagement with local authorities and working with non-health sectors that contribute to health outcomes.
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Affiliation(s)
- Harriet Boulding
- The Policy Institute, King's College London, 22 Kingsway, London, WC2B 6LE, UK
| | - Adam Kamenetzky
- The Policy Institute, King's College London, 22 Kingsway, London, WC2B 6LE, UK
| | - Ioana Ghiga
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
| | - Becky Ioppolo
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
| | | | - Sarah Parks
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
| | | | - Susan Guthrie
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
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Kamenetzky A, Hinrichs-Krapels S. How do organisations implement research impact assessment (RIA) principles and good practice? A narrative review and exploratory study of four international research funding and administrative organisations. Health Res Policy Syst 2020; 18:6. [PMID: 31959198 PMCID: PMC6971910 DOI: 10.1186/s12961-019-0515-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
Background Public research funding agencies and research organisations are increasingly accountable for the wider impacts of the research they support. While research impact assessment (RIA) frameworks and tools exist, little is known and shared of how these organisations implement RIA activities in practice. Methods We conducted a review of academic literature to search for research organisations’ published experiences of RIAs. We followed this with semi-structured interviews from a convenience sample (n = 7) of representatives of four research organisations deploying strategies to support and assess research impact. Results We found only five studies reporting empirical evidence on how research organisations put RIA principles into practice. From our interviews, we observed a disconnect between published RIA frameworks and tools, and the realities of organisational practices, which tended not to be reported. We observed varying maturity and readiness with respect to organisations’ structural set ups for conducting RIAs, particularly relating to leadership, skills for evaluation and automating RIA data collection. Key processes for RIA included efforts to engage researcher communities to articulate and plan for impact, using a diversity of methods, frameworks and indicators, and supporting a learning approach. We observed outcomes of RIAs as having supported a dialogue to orient research to impact, underpinned shared learning from analyses of research, and provided evidence of the value of research in different domains and to different audiences. Conclusions Putting RIA principles and frameworks into practice is still in early stages for research organisations. We recommend that organisations (1) get set up by considering upfront the resources, time and leadership required to embed impact strategies throughout the organisation and wider research ‘ecosystem’, and develop methodical approaches to assessing impact; (2) work together by engaging researcher communities and wider stakeholders as a core part of impact pathway planning and subsequent assessment; and (3) recognise the benefits that RIA can bring about as a means to improve mutual understanding of the research process between different actors with an interest in research.
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Affiliation(s)
- Adam Kamenetzky
- National Institute for Health Research Central Commissioning Facility, Twickenham, TW1 3NL, United Kingdom. .,Policy Institute at King's College London, Strand Campus, London, WC2B 6LE, United Kingdom.
| | - Saba Hinrichs-Krapels
- Policy Institute at King's College London, Strand Campus, London, WC2B 6LE, United Kingdom.,King's Global Health Institute, King's College London, Denmark Hill, London, SE5 9RJ, United Kingdom
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Plochg T, Hinrichs-Krapels S, Keijsers J. Health is not for sale, is it? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue/problem
Health is not for sale, given that one cannot buy health as a guaranteed commodity. Human beings co-produce their health every day together with their (social) ecosystems. As such, being healthy is a co-adaptive, complex, and self-organizing enterprise. However, our current economies thrive on citizens who consume themselves ill, and buy health care to fix their diseases. With spiralling costs of healthcare, a shift is urgently needed towards making a business case for health.
Description of the problem
From 2014 onward, the Dutch Federation for Health invested in the development of a business case for health. They explored the following questions: 1) Why is a business case for health warranted? 2) What could such a business model theoretically look like? 3) How could it be co-created in practice?
Results
We found there is a business case to keep diseases going, driving healthcare expenditure up. Literature suggests that this business case for disease is untenable. Inevitably we need new incentives that keep ‘health’ going rather than disease. We need a mechanism to make the business care for health. We have begun to model one approach named the ‘vitality contract’, featuring 10 organizational principles which provide guidance on how to construct the right market structure for health to be co-produced and sold on the premises of an ecosystem. The Federation for Health has been championing this vitality contract, and succeeded to get it on the national policy agenda. However, co-creation is essential for it to work: only few coalitions have risen to the challenge to make such a ‘vitality contract’ work in practice.
Lessons
The business case for health is needed. The vitality contract might provide one approach to demonstrate how it could be co-created in different local contexts and different public health systems. To be more impactful, further co-creation and collaboration from national coalitions and other European countries may be required.
Key messages
With spiraling costs of healthcare, a shift is urgently needed towards making a business case for health. The Dutch ‘vitality contract’ might provide one approach to demonstrate how a business case for health could be co-created.
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Affiliation(s)
- T Plochg
- Federation for Health, Amersfoort, Netherlands
| | - S Hinrichs-Krapels
- King’s Global Health Institute, London, UK
- The Policy Institute, London, UK
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Adam P, Ovseiko PV, Grant J, Graham KEA, Boukhris OF, Dowd AM, Balling GV, Christensen RN, Pollitt A, Taylor M, Sued O, Hinrichs-Krapels S, Solans‐Domènech M, Chorzempa H. ISRIA statement: ten-point guidelines for an effective process of research impact assessment. Health Res Policy Syst 2018; 16:8. [PMID: 29422063 PMCID: PMC5806262 DOI: 10.1186/s12961-018-0281-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 01/10/2018] [Indexed: 11/11/2022] Open
Abstract
As governments, funding agencies and research organisations worldwide seek to maximise both the financial and non-financial returns on investment in research, the way the research process is organised and funded is becoming increasingly under scrutiny. There are growing demands and aspirations to measure research impact (beyond academic publications), to understand how science works, and to optimise its societal and economic impact. In response, a multidisciplinary practice called research impact assessment is rapidly developing. Given that the practice is still in its formative stage, systematised recommendations or accepted standards for practitioners (such as funders and those responsible for managing research projects) across countries or disciplines to guide research impact assessment are not yet available.In this statement, we propose initial guidelines for a rigorous and effective process of research impact assessment applicable to all research disciplines and oriented towards practice. This statement systematises expert knowledge and practitioner experience from designing and delivering the International School on Research Impact Assessment (ISRIA). It brings together insights from over 450 experts and practitioners from 34 countries, who participated in the school during its 5-year run (from 2013 to 2017) and shares a set of core values from the school's learning programme. These insights are distilled into ten-point guidelines, which relate to (1) context, (2) purpose, (3) stakeholders' needs, (4) stakeholder engagement, (5) conceptual frameworks, (6) methods and data sources, (7) indicators and metrics, (8) ethics and conflicts of interest, (9) communication, and (10) community of practice.The guidelines can help practitioners improve and standardise the process of research impact assessment, but they are by no means exhaustive and require evaluation and continuous improvement. The prima facie effectiveness of the guidelines is based on the systematised expert and practitioner knowledge of the school's faculty and participants derived from their practical experience and research evidence. The current knowledge base has gaps in terms of the geographical and scientific discipline as well as stakeholder coverage and representation. The guidelines can be further strengthened through evaluation and continuous improvement by the global research impact assessment community.
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Affiliation(s)
- Paula Adam
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005 Barcelona, Spain
| | - Pavel V. Ovseiko
- Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU United Kingdom
| | - Jonathan Grant
- The Policy Institute, King’s College London, Strand Campus, London, WC2R 2LS United Kingdom
| | | | | | - Anne-Maree Dowd
- Commonwealth Scientific and Industrial Research Organisation, PO Box 883, Kenmore, Brisbane, 4069 Australia
| | - Gert V. Balling
- Novo Nordisk Foundation, Tuborg Havnevej 19, DK-2900 Hellerup, Denmark
| | | | - Alexandra Pollitt
- The Policy Institute, King’s College London, Strand Campus, London, WC2R 2LS United Kingdom
| | - Mark Taylor
- National Institute for Health Research, Central Commissioning Facility, Grange House 15, Church Street, Twickenham, TW1 3NL United Kingdom
| | - Omar Sued
- Fundación Huésped, Pasaje A. Peluffo 3932, Buenos Aires, C1202ABB Argentina
| | - Saba Hinrichs-Krapels
- The Policy Institute, King’s College London, Strand Campus, London, WC2R 2LS United Kingdom
| | - Maite Solans‐Domènech
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005 Barcelona, Spain
| | - Heidi Chorzempa
- Alberta Innovates, 10104-103 Avenue NW, Edmonton, AB T5J 4A7 Canada
| | - for the International School on Research Impact Assessment (ISRIA)
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005 Barcelona, Spain
- Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU United Kingdom
- The Policy Institute, King’s College London, Strand Campus, London, WC2R 2LS United Kingdom
- Alberta Innovates, 10104-103 Avenue NW, Edmonton, AB T5J 4A7 Canada
- Qatar National Research Fund, PO Box 5825, Doha, Qatar
- Commonwealth Scientific and Industrial Research Organisation, PO Box 883, Kenmore, Brisbane, 4069 Australia
- Novo Nordisk Foundation, Tuborg Havnevej 19, DK-2900 Hellerup, Denmark
- National Institute for Health Research, Central Commissioning Facility, Grange House 15, Church Street, Twickenham, TW1 3NL United Kingdom
- Fundación Huésped, Pasaje A. Peluffo 3932, Buenos Aires, C1202ABB Argentina
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14
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Gill AJ, Hinrichs-Krapels S, Blanke T, Grant J, Hedges M, Tanner S. Insight workflow: Systematically combining human and computational methods to explore textual data. J Assoc Inf Sci Technol 2017. [DOI: 10.1002/asi.23767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Saba Hinrichs-Krapels
- The Policy Institute at King's, King's College London; Virginia Woolf Building, 22 Kingsway London WC2B 6LE UK
| | - Tobias Blanke
- Department of Digital Humanities; King's College London; 26-29 Drury Lane London WC2B 5RL UK
| | - Jonathan Grant
- The Policy Institute at King's, King's College London; Virginia Woolf Building, 22 Kingsway London WC2B 6LE UK
| | - Mark Hedges
- Department of Digital Humanities; King's College London; 26-29 Drury Lane London WC2B 5RL UK
| | - Simon Tanner
- Department of Digital Humanities; King's College London; 26-29 Drury Lane London WC2B 5RL UK
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15
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Affiliation(s)
- Kai Ruggeri
- Policy Research Group, Department of Psychology, University of Cambridge , Cambridge , UK
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16
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Ovseiko PV, Greenhalgh T, Adam P, Grant J, Hinrichs-Krapels S, Graham KE, Valentine PA, Sued O, Boukhris OF, Al Olaqi NM, Al Rahbi IS, Dowd AM, Bice S, Heiden TL, Fischer MD, Dopson S, Norton R, Pollitt A, Wooding S, Balling GV, Jakobsen U, Kuhlmann E, Klinge I, Pololi LH, Jagsi R, Smith HL, Etzkowitz H, Nielsen MW, Carrion C, Solans-Domènech M, Vizcaino E, Naing L, Cheok QHN, Eckelmann B, Simuyemba MC, Msiska T, Declich G, Edmunds LD, Kiparoglou V, Buchan AMJ, Williamson C, Lord GM, Channon KM, Surender R, Buchan AM. A global call for action to include gender in research impact assessment. Health Res Policy Syst 2016; 14:50. [PMID: 27432056 PMCID: PMC4950803 DOI: 10.1186/s12961-016-0126-z] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/24/2016] [Indexed: 11/21/2022] Open
Abstract
Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we – a group of scholars and practitioners from Africa, America, Asia and Europe – argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.
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Affiliation(s)
- Pavel V Ovseiko
- Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom.
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Woodstock Road, Oxford, OX2 6GG, United Kingdom
| | - Paula Adam
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005, Barcelona, Spain
| | - Jonathan Grant
- The Policy Institute, King's College London, Strand Campus, London, WC2R 2LS, United Kingdom
| | - Saba Hinrichs-Krapels
- The Policy Institute, King's College London, Strand Campus, London, WC2R 2LS, United Kingdom
| | - Kathryn E Graham
- Alberta Innovates - Health Solutions, 10104-103 Avenue NW, Edmonton, AB, T5J 4A7, Canada
| | - Pamela A Valentine
- Alberta Innovates - Health Solutions, 10104-103 Avenue NW, Edmonton, AB, T5J 4A7, Canada
| | - Omar Sued
- Fundación Huésped, Pasaje A. Peluffo 3932 (C1202ABB), Buenos Aires, Argentina
| | | | | | - Idrees S Al Rahbi
- Department of Studies and Planning, The Research Council, P.O. Box 1422, Al Azaiba, 130, Oman
| | - Anne-Maree Dowd
- Commonwealth Scientific and Industrial Research Organisation, P.O. Box 883, Kenmore, Brisbane, 4069, Australia
| | - Sara Bice
- Melbourne School of Government, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Tamika L Heiden
- School of Population Health, University of Western Australia, Perth, WA, 6009, Australia.,Knowledge Translation Australia Pty Ltd., Melbourne, Victoria, Australia
| | - Michael D Fischer
- Faculty of Business and Economics, University of Melbourne, 198 Berkeley Street, Parkville, Victoria, 3010, Australia.,Saïd Business School, University of Oxford, Park End Street, Oxford, OX1 1HR, United Kingdom
| | - Sue Dopson
- Saïd Business School, University of Oxford, Park End Street, Oxford, OX1 1HR, United Kingdom
| | - Robyn Norton
- The George Institute for Global Health, University of Oxford, 34 Broad Street, Oxford, OX1 3BD, United Kingdom.,The George Institute for Global Health, University of Sydney, P.O. Box M201, Missenden Road, Sydney, NSW 2050, Australia
| | - Alexandra Pollitt
- The Policy Institute, King's College London, Strand Campus, London, WC2R 2LS, United Kingdom
| | - Steven Wooding
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom
| | - Gert V Balling
- Novo Nordisk Foundation, Tuborg Havnevej 19, DK-2900, Hellerup, Denmark
| | - Ulla Jakobsen
- Lundbeck Foundation, Scherfigsvej 7, DK-2100, Copenhagen, Denmark
| | - Ellen Kuhlmann
- Institute for Economics, Labour and Culture, Goethe-University Frankfurt, Senckenberganlage 31, 60325, Frankfurt am Main, Germany.,Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavaegen 18a, 171 77, Stockholm, Sweden
| | - Ineke Klinge
- Horizon 2020 Advisory Group for Gender, European Commission, Brussels, Belgium
| | - Linda H Pololi
- National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Brandeis University Women's Studies Research Center, 415 South Street, MS 079, Waltham, MA, 02454, United States of America
| | - Reshma Jagsi
- Department of Radiation Oncology, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, 48109, United States of America
| | - Helen Lawton Smith
- Department of Management, Birkbeck, University of London, Malet Street, London, WC1E 7HX, United Kingdom
| | - Henry Etzkowitz
- Department of Management, Birkbeck, University of London, Malet Street, London, WC1E 7HX, United Kingdom.,International Triple Helix Institute, 1520 Sand Hill Road, A210, Palo Alto, CA, 94304, United States of America
| | - Mathias W Nielsen
- Gendered Innovations, History Department, Stanford University, 450 Serra Mall, Stanford, CA, 94305, United States of America
| | - Carme Carrion
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005, Barcelona, Spain.,Health Sciences Department, Universitat Oberta de Catalunya, Av. Tibidabo 39-43, ES-08035, Barcelona, Spain
| | - Maite Solans-Domènech
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005, Barcelona, Spain
| | - Esther Vizcaino
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, ES-08005, Barcelona, Spain
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei Darussalam
| | - Quentin H N Cheok
- Faculty of Integrated Technologies, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei Darussalam
| | - Baerbel Eckelmann
- QS Intelligence Unit, Quacquarelli Symonds Ltd, 4 Heathgate, Agincourt Rd, London, NW3 2NT, United Kingdom
| | - Moses C Simuyemba
- Department of Public Health, School of Medicine, University of Zambia, Nationalist Rd, Lusaka, Zambia
| | - Temwa Msiska
- Research Support Centre, College of Medicine, University of Malawi, P.O. Box 360, Chichiri, Blantyre 3, Malawi
| | - Giovanna Declich
- Assembly of Women for Development and the Struggle against Social Exclusion (ASDO), via Guido Reni 56, 00196, Rome, Italy
| | - Laurel D Edmunds
- Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
| | - Vasiliki Kiparoglou
- NIHR Oxford Biomedical Research Centre, Joint Research Office, Churchill Hospital, Oxford, OX3 7LE, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
| | - Alison M J Buchan
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Catherine Williamson
- Women's Health Academic Centre, King's College London, Guy's Hospital, London, SE1 1UL, United Kingdom.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, Guy's Hospital, London, SE1 9RT, United Kingdom.,Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, SE1 9RT, United Kingdom
| | - Graham M Lord
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, Guy's Hospital, London, SE1 9RT, United Kingdom.,Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, SE1 9RT, United Kingdom.,MRC Centre for Transplantation, King's College London, Guys' Hospital, London, SE1 9RT, United Kingdom
| | - Keith M Channon
- Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom.,NIHR Oxford Biomedical Research Centre, Joint Research Office, Churchill Hospital, Oxford, OX3 7LE, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
| | - Rebecca Surender
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, OX1 2ER, United Kingdom.,Institute of Social and Economic Research, Rhodes University, P.O. Box 94, Grahamstown, 6140, South Africa
| | - Alastair M Buchan
- Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom.,NIHR Oxford Biomedical Research Centre, Joint Research Office, Churchill Hospital, Oxford, OX3 7LE, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
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Rubin JK, Hinrichs-Krapels S, Hesketh R, Martin A, Herman WH, Rubino F. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results. Diabetes Care 2016; 39:954-63. [PMID: 27222554 PMCID: PMC5864132 DOI: 10.2337/dc15-2781] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/24/2016] [Indexed: 02/03/2023]
Abstract
Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-six stakeholders participated in the Policy Lab, including academics, clinicians, policy-makers, industry leaders, and patient representatives. Participants were provided with a summary of available evidence about the cost-effectiveness of bariatric/metabolic surgery and the costs of increasing the use of bariatric/metabolic surgery, using U.K. and U.S. scenarios as examples of distinct health care systems. There was widespread agreement among this group of stakeholders that bariatric/metabolic surgery is a legitimate and cost-effective approach to the treatment of type 2 diabetes in obese patients. The following four building blocks were identified to facilitate policy changes: 1) communicating the scale of the costs and harms associated with rising prevalence of type 2 diabetes; 2) properly articulating the role of bariatric/metabolic surgery for certain population groups; 3) identifying new funding sources for bariatric/metabolic surgery; and 4) incorporating bariatric/metabolic surgery into the appropriate clinical pathways. Although more research is needed to identify specific clinical scenarios for the prioritization of bariatric/metabolic surgery, the case appears to be strong enough to engage relevant policy-makers and practitioners in a concerted discussion of how to better use metabolic surgical resources in conjunction with other interventions in good diabetes practice.
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Affiliation(s)
- Jennifer K Rubin
- The Policy Institute at King's, King's College London, London, U.K
| | | | - Rachel Hesketh
- The Policy Institute at King's, King's College London, London, U.K
| | | | | | - Francesco Rubino
- Metabolic and Bariatric Surgery, Division of Diabetes and Nutritional Sciences, King's College London and King's College Hospital, London, U.K
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18
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Permanyer-Miralda G, Hinrichs-Krapels S, Adam P. The Social Impact of Cardiology Research: Beyond Management. ACTA ACUST UNITED AC 2016; 69:639-43. [PMID: 27236276 DOI: 10.1016/j.rec.2016.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Gaietà Permanyer-Miralda
- Unidad de Epidemiología, Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Agència de Qualitat i Avaluació Sanitària de Catalunya (AQuAS), Barcelona, Spain
| | | | - Paula Adam
- Agència de Qualitat i Avaluació Sanitària de Catalunya (AQuAS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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19
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Hinrichs-Krapels S, Bussmann S, Dobyns C, Kácha O, Ratzmann N, Holm Thorvaldsen J, Ruggeri K. Key Considerations for an Economic and Legal Framework Facilitating Medical Travel. Front Public Health 2016; 4:47. [PMID: 27066467 PMCID: PMC4814659 DOI: 10.3389/fpubh.2016.00047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 03/08/2016] [Indexed: 11/17/2022] Open
Abstract
Medical travel has the capacity to counter increasing costs of health care by creating new markets and increased revenue for health services, potentially benefiting local populations, economies, and health-care systems. This paper is part of a broad, comprehensive project aimed at developing a global health access policy (GHAP). It presents key issues to consider in terms of ensuring economic viability, sustainability, and limiting risk to the many stakeholders involved in the rapidly expanding industry of medical travel. The noted economic and legal barriers to medical travel are based on a synthesis of themes found in an extensive review of the available literature. Economic considerations, when setting up a GHAP, include a dynamic approach to pricing that is fair to the local population. Legal considerations include the implementation of international quality standards and the protection of the rights of those traveling as well as those of local populations in recipient countries. By taking into account these opportunities, the GHAP will more adequately address existing gaps in the economic and legal regulation of medical travel.
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Affiliation(s)
| | - Sarah Bussmann
- Department of Psychology, University of Cambridge , Cambridge , UK
| | - Christopher Dobyns
- Department of Politics and International Relations, University of Oxford , Oxford , UK
| | - Ondřej Kácha
- Department of Psychology, Faculty of Arts, Masaryk University , Brno , Czech Republic
| | - Nora Ratzmann
- Department of Social Policy, London School of Economics , London , UK
| | - Julie Holm Thorvaldsen
- Department of Psychology, Norwegian University of Science and Technology , Trondheim , Norway
| | - Kai Ruggeri
- Policy Research Group, Department of Psychology, University of Cambridge, Cambridge, UK; Engineering Design Centre, Department of Engineering, University of Cambridge, Cambridge, UK
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