A scoping review examining funding trends in health care professions education research from Taiwan (2006-2017).

BACKGROUND: Traditionally health care professions education research (HCPER) is poorly funded, despite it being key to success. PURPOSE: This unique study maps HCPER evolution within a single country during a period when significant national governmental HCPER funding is introduced. METHODS: A scoping review method examined Taiwan's HCPER landscape across 12-years. Literature searches across four databases (OVID Medline; Scopus; Web of Science; the Airiti Library), a manual scan of HCPE journals and hand searches. Endnote and ATLAS.ti managed the data. Demographic and content codes were developed. PRISMA guidelines are used. DISCUSSION: One thousand four hundred and ten articles across 310 journals, with a steady rise in funded studies. Science/Social Science Citation Index and English language publications increased. Nursing Students/Nurses and Medical Students/Physicians are the most common populations. Significant associations with funding was found for indexed and English language publications. National funding influenced quality and local funding positively. CONCLUSION: Caution around local vs. global needs is highlighted and national funding policies for HCPER are advocated.

Partnerships between universities and nonprofit transition coaching organizations to increase student success.

AIMS: This study aims to understand the motivations and benefits for universities and nonprofit college access and success organizations to develop formal partnerships. METHODS: Participants in this study were staff from a major urban research university (n = 22) and four nonprofit organizations (n = 17) that promote college access and success among underrepresented, low-income, and first-generation college students. Participants engaged in an audio-recorded interview that was transcribed and analyzed using thematic analysis. RESULTS: Data suggested that staff from the universities and nonprofit organizations were both holistic in their understanding of college student success. In addition, they were both motivated to form partnerships in an effort to reduce barriers to success, although they, at times, identified different barriers that they wanted the partnership to address. Both university and nonprofit staff saw increased effectiveness of their practice as a result of partnering and university staff gained a better understanding of the greater nonprofit college access and success community. CONCLUSION: Given the intense support that nonprofit organizations are able to provide with their level of funding, partnerships with universities can increase the success of underrepresented, low-income, and first-generation college students.

Maternal, Infant, and Early Childhood Home Visiting: A Call for a Paradigm Shift in States' Approaches to Funding.

Early home visiting is a vital health promotion strategy that is widely associated with positive outcomes for vulnerable families. To expand access to these services, the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program was established under the Affordable Care Act, and over $2 billion have been distributed from the Health Resources and Services Administration to states, territories, and tribal entities to support funding for early home visiting programs serving pregnant women and families with young children (birth to 5 years of age). As of October 2018, 20 programs met Department of Health and Human Services criteria for evidence of effectiveness and were approved to receive MIECHV funding. However, the same few eligible programs receive MIECHV funding in almost all states, likely due to previously established infrastructure prior to establishment of the MIECHV program. Fully capitalizing on this federal investment will require all state policymakers and bureaucrats to reevaluate services currently offered and systematically and transparently develop a menu of home visiting services that will best match the specific needs of the vulnerable families in their communities. Federal incentives and strategies may also improve states' abilities to successfully implement a comprehensive and diverse menu of home visiting service options. By offering a menu of home visiting program models with varying levels of service delivery, home visitor education backgrounds, and targeted domains for improvement, state agencies serving children and families have an opportunity to expand their reach of services, improve cost-effectiveness, and promote optimal outcomes for vulnerable families. Nurses and nursing organizations can play a key role in advocating for this approach.

The Impact of the National Institute for Pharmaceutical Technology and Education on Academic Research.

Surveys of institutional representatives of member institutions and faculty members engaged in the National Institute for Pharmaceutical Technology and Education (NIPTE) revealed that NIPTE is having a positive impact on academic research in the area of pharmaceutical technology by aligning research directions with FDA needs, by providing funding that may not be available elsewhere, and by creating a collegial and collaborative relationship among researchers in this area from various institutions. NIPTE is contributing to the viability of pharmaceutics and pharmaceutical engineering research in academic settings. Some responders cite the fluctuations in funding and relative low levels of funding received as a problem in maintaining programs, but most perceived a positive impact.

Activity-based funding in mental health: a disastrous path.

OBJECTIVES: On the basis of the experience of the Netherlands, this critical commentary will argue why activity-based funding (ABF) in mental health care is a disastrous path that Australia should not take. CONCLUSIONS: ABF leads to an exponential growth in health care spending as it encourages diagnostic inflation and overproductivity. It also leads to fraud and an increased bureaucracy that goes hand in hand with demoralisation among health workers. And finally, the increasing treatment claims leads to the reintroduction of productivity limitations, waiting lists and ultimately austerity measures in order to halt the untamed growth of spending.

A Social Network Analysis of the Financial Links Backing Health and Fitness Apps.

OBJECTIVES: To identify the major stakeholders in mobile health app development and to describe their financial relationships using social network analysis. METHODS: We conducted a structured content analysis of a purposive sample of prominent health and fitness apps available in November 2015 in the United States, Canada, and Australia. We conducted a social network analysis of apps' developers, investors, other funding sources, and content advisors to describe the financial relationships underpinning health app development. RESULTS: Prominent health and fitness apps are largely developed by private companies based in North America, with an average of 4.7 (SD = 5.5) financial relations, including founders, external investors, acquiring companies, and commercial partnerships. Network analysis revealed a core of 41 sampled apps connected to 415 other entities by 466 financial relations. This core largely comprised apps published by major technology, pharmaceutical, and fashion corporations. About one third of apps named advisors, many of whom had commercial affiliations. CONCLUSIONS: Public health needs to extend its scrutiny and advocacy beyond the health messages contained within apps to understanding commercial influences on health and, when necessary, challenging them.

Tropical countries may be willing to pay more to protect their forests.

Inadequate funding from developed countries has hampered international efforts to conserve biodiversity in tropical forests. We present two complementary research approaches that reveal a significant increase in public demand for conservation within tropical developing countries as those countries reach upper-middle-income (UMI) status. We highlight UMI tropical countries because they contain nearly four-fifths of tropical primary forests, which are rich in biodiversity and stored carbon. The first approach is a set of statistical analyses of various cross-country conservation indicators, which suggests that protective government policies have lagged behind the increase in public demand in these countries. The second approach is a case study from Malaysia, which reveals in a more integrated fashion the linkages from rising household income to increased household willingness to pay for conservation, nongovernmental organization activity, and delayed government action. Our findings suggest that domestic funding in UMI tropical countries can play a larger role in (i) closing the funding gap for tropical forest conservation, and (ii) paying for supplementary conservation actions linked to international payments for reduced greenhouse gas emissions from deforestation and forest degradation in tropical countries.

Hospitals benefiting from healthy bond market.

The bond market continues to be favorable for hospitals looking to finance projects, growth.

Private capital investments in health care provision through mergers and acquisitions: from long-term to acute care.

OBJECTIVES: This work aims to test whether different segments of healthcare provision differentially attract private capital and thus offer heterogeneous opportunities for private investors' diversification strategies. METHODS: Thomson Reuter's SDC Platinum database provided data on 2563 merger and acquisition (M&A) deals targeting healthcare providers in Western Europe between 1990 and 2010. Longitudinal trends of industrial and geographical characteristics of M&As' targets and acquirers are examined. RESULTS: Our analyses highlight: (i) a relative decrease of long-term care facilities as targets of M&As, replaced by an increasing prominence of general hospitals, (ii) a shrinking share of long-term care facilities as targets of financial service organizations' acquisitions, in favor of general hospitals, and (iii) an absolute and relative decrease of long-term care facilities' role as target of cross-border M&As. CONCLUSIONS: We explain the decreasing interest of private investors towards long-term care facilities along three lines of reasoning, which take into account the saturation of the long-term care market and the liberalization of acute care provision across Western European countries, regulatory interventions aimed at reducing private ownership to ensure resident outcomes and new cultural developments in favor of small-sized facilities, which strengthen the fragmentation of the sector. These findings advance the literature investigating the effect of private ownership on health outcomes in long-term facilities. Market, policy and cultural forces have emerged over two decades to jointly regulate the presence of privately owned, large-sized long-term care providers, seemingly contributing to safeguard residents' well-being. Copyright © 2016 John Wiley & Sons, Ltd.

The primary reasons behind data sharing, its wider benefits and how to cope with the realities of commercial data.

Data availability expectations have changed over the years in scientific publishing, nowhere more so than in the field of genomics. This field has spearheaded openness and transparency via public and structured deposition of data. BMC Genomics strongly encourages deposition and unrestricted availability of all primary data underlying research studies both as a way of ensuring reproducibility and standardisation, but also as part of overall community-driven expectation on data deposition and sharing. With funders and publishers moving towards more explicit mandates (regarding data availability), we examined the current barriers to unrestricted availability of data and explored different scenarios in which commercial agreements might run contrary to scientific convention and data sharing policies. In this editorial, Ross Tellam (CSIRO, Australia), Paul Rushton (Texas A&M AgriLife Research) and Peter Schuerman (University of California, Merced), give their views on the importance of data sharing and examine the current challenges in research fields like crop and livestock genomics, where often it is necessary to integrate the interests of academic and commercial stakeholders. We discuss the current approaches, highlight the importance of community-driven standards, and propose ways forward.

Factors affecting general practitioner charges and Medicare bulk-billing: results of a survey of Australians.

OBJECTIVE: To identify factors affecting bulk-billing by general practitioners in Australia. DESIGN, PARTICIPANTS AND SETTING: A community-based survey was administered to Australians aged 16 years or older in July 2013 via an online panel. Survey questions focused on patient characteristics, visit characteristics, practice characteristics. MAIN OUTCOME MEASURES: Factors associated with GP bulk-billing. RESULTS: 2477 respondents completed the survey, of whom 2064 (83.33%) reported that the practice that they went to for their most recent GP visit bulk billed some or all patients. Overall, 1763 respondents (71.17%) reported that their most recent GP visit was bulk billed. Taking into account the duration of visits and the corresponding Medicare Benefits Schedule rebate, the mean out-of-pocket cost for those who were not bulk billed was $34.09. RESULTS of a multivariate logistic regression analysis suggest that the odds of being bulk billed was negatively associated with larger practice size, respondents having had an appointment for their visit, higher household income and inner or outer regional area of residence. It was positively associated with the presence of a chronic disease, being a concession card holder and having private health insurance. There was no association between bulk-billing and duration of GP visit, age or sex. CONCLUSIONS: Our results indicate that there are associations between patient characteristics and bulk-billing, and between general practice characteristics and bulk-billing. This suggests that caution is needed when considering changes to GP fees and Medicare rebates because of the many possible paths by which patients' access to services could be affected. Our results do not support the view that bulk-billing is associated with shorter consultation times.

[Organisation and funding of the Berlin Psychoanalytic Polyclinic. The role of Max Eitingon]. / Organisation und Finanzierung der Berliner psychoanalytischen Poliklinik. Die Rolle Max Eitingons.

Based on unpublished archival material (Eitingon's yearly reports, account statements), this paper enriches and modifies the hitherto commonly accepted image of the Berlin Polyclinic. It highlights the fact that the indigent patients treated there contributed considerably to the budget by paying fees, albeit relatively low ones. While confirming that Eitingon largely funded the clinic, it also points out (what has hardly been known before) that he reduced his support in 1928 and stopped it altogether in 1931. Among other things, candidates were now required to pay some rent for the rooms where they analyzed their training cases. On the other hand, candidates could get stipends, funded by the course fees of the Berlin Psychoanalytic Institute. Besides a number of employed assistants, candidates did most of the treatments while the members of the psychoanalytic Society had to be repeatedly reminded of their formal obligation to take over one unpaid case from the Polyclinic. At the end, the paper discusses the "spirit" of the institution.

The alcohol industry, charities and policy influence in the UK.

BACKGROUND: Charities exist to pursue a public benefit, whereas corporations serve the interests of their shareholders. The alcohol industry uses corporate social responsibility activities to further its interests in influencing alcohol policy. Many charities also seek to influence alcohol and other policy. The aim of this study was to explore relationships between the alcohol industry and charities in the UK and whether these relationships may be used as a method of influencing alcohol policy. METHODS: The charity regulator websites for England and Wales and for Scotland were the main data sources used to identify charities involved in UK alcohol policy making processes and/or funded by the alcohol industry. RESULTS: Five charities were identified that both receive alcohol industry funding and are active in UK alcohol policy processes: Drinkaware; the Robertson Trust; British Institute of Innkeeping; Mentor UK and Addaction. The latter two are the sole remaining non-industry non-governmental members of the controversial responsibility deal alcohol network, from which all other public health interests have resigned. CONCLUSION: This study raises questions about the extent to which the alcohol industry is using UK charities as vehicles to further their own interests in UK alcohol policy. Mechanisms of industry influence in alcohol policy making globally is an important target for further investigations designed to assist the implementation of evidenced-based policies.

Investing in acute health services: is it time to change the paradigm?

OBJECTIVE: Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. METHODS: This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000-01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. RESULTS: Although the average annual capital investment over the decade from 2000-01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012-13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year. CONCLUSIONS: Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock. WHAT IS KNOWN ABOUT THE TOPIC?: Deeble's comprehensive hospital-based review of capital investment and costs, published in 2002, found that investment averages of between 7.1% and 7.9% of recurrent costs primarily replaced existing assets. In 2009, the Productivity Commission and the National Health and Hospitals Reform Commission (NHHRC) recommended capital, for the replacement of buildings and medical equipment, be included in activity-based funding. However, there have been persistent concerns about the reliability and quality of the information on the value of hospital capital assets. WHAT DOES THIS PAPER ADD?: This is the first paper for over a decade to look at hospital capital costs and investment in terms of the services they support. Although health services seek to reap dividends from technology in health care, this study demonstrates that investment relative to services costs has been below sustainable levels for most of the past 10 years. The study questions the helpfulness of the highly aggregated information on capital for public hospital managers striving to improve on the efficient price for services. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS?: Using specific and accurate information on capital allocations at the DRG level assists health services managers advance their production functions for the efficient delivery of services.

Ripple effects of reform on capital financing.

Healthcare leaders should inventory and quantify the capital initiatives deemed critical for success under changing business models. Key considerations in planning such initiatives are opportunity costs and potential impact on productivity. Senior leaders also should create rolling five-year estimates of expenditures in addition to a one-year budget. Approaches to paying for such initiatives include borrowing from cash reserves, partnering to share cash and other resources, and developing new revenue sources derived from the initiatives themselves.

Impact of COVID-19 on Characteristics and Funding of U.S. Healthcare Startups: Retrospective Review.

BACKGROUND: The rise of telehealth and telemedicine during the pandemic allowed patients and providers to develop a sense of comfort with telehealth, which may have increased the demand for virtual-first care solutions with spillover effects into venture capital funding. OBJECTIVE: We aimed to understand the size and type of digital health investments occurring in the prepandemic and pandemic periods. METHODS: We examined health care companies founded from March 14, 2019, to March 14, 2020 (prepandemic) versus those founded from March 15, 2020, to March 14, 2022, after pandemic onset. Data were obtained from Crunchbase, a publicly available database that catalogs information about venture capital investments for companies. We also compared companies founded prepandemic to those founded after the first year of the pandemic (pandemic steady-state). We performed a Wilcoxon rank sum test to compare median funding amounts. We compared the 2 groups of companies according to the type of funding round raised, geography, health care subcategory, total amount of funding per year since founding, and number of founders. RESULTS: There were 2714 and 2218 companies founded prepandemic and during the pandemic, respectively. The companies were similarly distributed across geographies in the prepandemic and pandemic periods (P=.46) with no significant differences in the number of founders (P=.32). There was a significant difference in total funding per year since founding between prepandemic and pandemic companies (US $10.8 million vs US $20.9 million; P<.001). The distribution of funding rounds differed significantly for companies founded in prepandemic and pandemic periods (P<.001). On excluding data from the first year of the pandemic, there were 581 companies founded in the pandemic steady-state period from March 14, 2021, to March 14, 2022. Companies founded prepandemic had a significantly greater mean number of founders than those founded during the pandemic (P=.02). There was no significant difference in total funding per year since founding between prepandemic and steady-state pandemic companies (US $10.8 million vs US $14.4 million; P=.34). The most common types of health care companies included wellness, biotech/biopharma, and software companies. Distributions of companies across health care subcategories were not significantly different before and during the pandemic. However, significant differences were identified when data from the first year of the pandemic were excluded (P<.001). Companies founded during the steady-state pandemic period were significantly more likely to be classified as artificial intelligence (7.3% vs 4.7%; P=.005), software (17.3% vs 12.7%; P=.002), and insurance (3.3% vs 1.7%; P=.003), and were significantly less likely to be classified as health care diagnostics (2.4% vs 5.1%; P=.002). CONCLUSIONS: We demonstrate no significant changes in the types of health care companies founded before versus during the pandemic, although significant differences emerge when comparing prepandemic companies to those founded after the first year of the pandemic.

Impact of dual control system of energy consumption and intensity on cost of debt financing: micro-evidence from Chinese listed companies.

Capital providers have placed increasing importance on risks associated with transitioning to a low-carbon economy. This study investigates the causal link between energy regulation and cost of debt financing by exploiting regional variations in stringency of the dual control system of total energy consumption and energy intensity (dual controls) to construct a continuous difference-in-difference model. We use a sample of A-share listed firms in 2010-2020 and find that tighter energy regulation leads to higher cost of debt financing. We find that the underlying mechanism is risk premium brought by compliance cost and uncertainties. Further analysis indicates that the impact of dual controls is mainly driven by non-state-owned firms. Lastly, capital providers did not differentiate the interest rates they charge companies based on their level of green transition.