Health equity principles for oncology real world evidence studies.

BACKGROUND: Real-world research on cancer care in the community should address social determinants of health (SDOH) to advance health equity in cancer diagnosis, treatment, and survivorship. We sought patient and stakeholder perspectives to co-develop research principles to guide researchers when using patient record data to address health equity in their research protocols. MATERIALS AND METHODS: Key informant interviews with 13 individuals elicited perspectives and insights related to health equity and SDOH when conducting research using data from community-based oncology care. Interviews included a brief overview of a prior scoping review and related questions in the interview guide. Key informants included experts in health equity and SDOH, and patient and community advisory board members. Rapid qualitative analysis was used to identify key themes, patterns, and insights from the interview data. Principles were developed based on the results of the analysis. RESULTS: Three overarching categories for promoting health equity were (1) education; (2) community engagement; and (3) research design and implementation. Education principles highlight the necessity of training in relevant skills to address health equity. Community engagement principles highlight various actions that researchers can take to conduct research inclusive of community concerns regarding health equity. The research design and implementation category provides practical guidelines for researchers in planning, conducting, and disseminating community-based oncology research to address health equity. CONCLUSION: Our principles guide oncology real-world research protocols to address SDOH in community settings and promote health equity. These principles should be tailored to specific cancer topics and communities.

Can social capital play a role in contracting services of family doctors in China? Reflections based on an integrative review.

BACKGROUND: The family doctors' contract service problem is not about government management alone, but an interaction of a complex social environment. Consequently, the effect of contracted services of family doctors not only depends on policy incentives but also needs to win the participation, acknowledgement, and confidence of community residents. The purpose of this integrative review is to examine whether there is any significant evidence that social capital in the form of social networking groups and other forms of social groups have any positive impact on the acceptance and the effectiveness of family doctors' contractual services. METHOD: Research on qualitative, quantitative and hybrid methods published in peer-reviewed journals on the social capital role in the process of contract service of family doctors were eligible for inclusion. In view of the increasing attention paid to the contract service effect of family doctors during this period, a 10-year time scale was selected to ensure full coverage of relevant literature in the same period. In total, 809 articles were determined in the database retrieval results which were downloaded and transferred to the Mendeley reference application software. RESULTS: Twelve articles met the inclusion criteria for this integrative review and the quality of the included studies were assessed using the published criteria for the critical appraisal of quantitative and qualitative research methods. Majority of the articles assessed reported that there was evidence of a positive link between social support, especially a sense of belonging and the presence of regular family doctors. The influencing factors of patients' contract behavior of studies conducted in China were social interaction of social capital, acceptance of the first contact in the community, year of investigation, and exposure to the public. CONCLUSION: The study affirms previous studies that suggest that social resources have the propensity to improve relationship between patients and clients and between doctors and peers for the benefit of the patients and the stability of the overall healthcare system. Through the integration of various social resources family doctor systems accelerate the development of community construction. These social capital (social network groups) can guide residents to use family doctor services to maintain health. Social capital can also help residents have a regular and reliable family doctor.

The impact of China's latest population policy changes on maternity insurance-a case study in Jiangsu Province.

This study aims to examine the impact of China's population policy changes on social insurance. Nearly 4 decades ago, China ushered in the 1-child policy as a family planning policy to control the adverse effect of high population growth. The current maternity insurance system in China is designed to fit the operations of the 1-child policy. However, the implementation of the comprehensive 2-child policy can pose a challenge to the sustainability of the current maternity insurance scheme hence the call for reform. The study empanels a novel and comprehensive system dynamic model that incorporates all the related factors that influence the income and expenditure of maternity insurance in the Jiangsu Province. Data are mainly derived from the historical data of the Statistical Yearbook of Jiangsu Province and the National Bureau of Statistics of China. These are used to construct and simulate a system dynamic model to determine a sustainable contribution rate for maternity insurance. In conclusion, if the rate of contribution of the current maternity insurance policy is not increased, the burden of implementing the comprehensive 2-child policy will exacerbate the current deficit balance of the maternity insurance fund. The existing maternity insurance benefits thus cannot be maintained, and women's health will be threatened. In the short term, the study proposes an increase in the rate of premium payment to prolong the life of the maternity insurance. In the long term, there is a need to improve the level of coordination and expand the coverage of maternity insurance.

Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China.

BACKGROUND: While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. METHODS: Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. RESULTS: We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. CONCLUSIONS: The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

Towards an equitable healthcare in China: evaluating the productive efficiency of community health centers in Jiangsu Province.

BACKGROUND: While the demand for the health service keeps escalating at the grass root or rural areas of China, a substantial portion of healthcare resources remains stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, the Deepening Health Care Reform in 2012 China was intended to flush out these discrepancies and promote a more equitable and efficient distribution of health resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. METHODS: We divided Jiangsu Province into 3 zones according to the level of economic and social development i.e. developed, developing, and undeveloped areas. Using a hybrid of Panel data analysis and an augmented Data Envelopment Analysis (DEA), we model human resources, capital inputs of Community Health Centers to comprehensively determine the technical and scale efficiency of community health resources in 3 zones in Jiangsu Province. RESULTS: We sampled data and analysed efficiency and productivity growth of 75 Community Health Centers in 13 cities of Jiangsu Province from 2011 to 2015, which shows that a significant productive growth among Community Health Centers between 2011 and 2015. Mirroring the behavior of Community Health Centers, technological progress was the underlying force for the growth and the deterioration in efficiency change was found. This can be credited partly to the Deepening Health Care Reform measures aimed at improving technology availability in health centers in sub-urban areas. The regional summary of the DEA result shows that the stage of economic development and the efficiency performance of hospital did not necessarily go hand in hand among the 3 zones of Jiangsu. CONCLUSIONS: The government of China in general and Jiangsu province in particular could improve the efficiency of health resources allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources and enhancing the level of health of financial resources allocation.

The effect of herd formation among healthcare investors on health sector growth in China.

BACKGROUND: China has become the world's second largest healthcare market based on a recent report by the World Health Organization. Eventhough China achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history achieved; health inequality remains endemic in China. Lessons from the effect of market crisis on health equity in Europe and other places has reignited interest in exploring the potential healthcare market aberrations that can trigger distributive injustice in healthcare resource allocation among China's provinces. Recently, many healthcare investors in China have become more concerned about capital preservation, and are responding by abandoning long term investments strategies in healthcare. This investment withdrawal en mass is perceived to be influenced by herding tendencies and can trigger or consolidate endemic health inequality. METHODS: Our study simultaneously employs four testing models (two state spaced models and two return dispersion models) to establish the existence of procyclical (herding) behavior among the stocks and its health equity implications. These are applied to a large set of data to compare and contrast results of herd formation among investors in fourteen healthcare sectors in China. RESULTS: The study reveals that apart from the cross sectional standard deviation (CSSD) model, the remaining two models and our augmented state space model yields significant evidence of herding in all subsectors of the healthcare market. We also find that the herding effect is more prominent during down movements of the market. CONCLUSION: Herding behavior may lead to contemporaneous loss of investor confidence and capital withdrawal and thereby deprive the healthcare sector of the much needed capital for expansion. Thus there may be obvious delay in efforts to bridge the gap in access to healthcare facilities, medical support services, medical supplies, pharmaceuticals, biotechnology, diagnostic substances, medical laboratory and advanced medical equipment across China. Moreover, a potential crash in the healthcare market is possible in the healthcare sector as a result of persistent herding tendencies among investors and that may have more damaging consequences for health inequality in China.

Which social determinants of health have the highest impact in community oncology to advance patient care equity and improve health outcomes? A scoping review.

INTRODUCTION: To better understand the SDOH-health equity landscape within a community oncology setting to answer the research question, "Which SDOH can have the highest impact in community oncology to advance patient care equity and improve health outcomes?" METHODS: Arksey and O'Malley's scoping review framework was used to identify evidence related to SDOH and health equity in community oncology. The study was guided by the "10-Step Framework for Continuous Patient Engagement" and a Community Advisory Board to assure relevance to patients and community providers. Literature was retrieved from literary databases and oncology organizations' websites. Eligible studies included discussion of SDOH and health equity as outlined by the World Health Organization and Centers for Disease Control and Prevention, respectively, and involved community oncology/cancer care in outpatient settings. Studies were excluded if the SDOH-health equity relationship was not discussed. RESULTS: The review resulted in 61 exploratory and 17 confirmatory "intervention" studies addressing the impact of SDOH on health equity in community oncology settings. The most frequently SDOH-health equity pairs identified were the SDOH categories, social inclusion and non-discrimination, income and social protection, and structural conflict, all paired with the health equity category, access to care/treatment. Confirmatory studies focused on income and social protection (SDOH) and access to care/treatment (health equity); the SDOH categories, social inclusion and non-discrimination and health/general literacy-patient, paired with the health equity category, and adherence/compliance. CONCLUSIONS: Literature highlights the SDOH and health equity relationship within the realm of oncology. Most studies on SDOH/health inequities in the community oncology setting are exploratory. There is the need to shift from documentation of cancer inequities to implementing solutions.

On the momentum toward vaccine self-sufficiency in the BRICS: an integrative review of the role of pharmaceutical entrepreneurship and innovation.

Background: With the perspicuous effect of COVID-19 on vaccine demand, academic and business interest in vaccine production in the BRICS nations (Brazil, the Russian Federation, India, China, and South Africa) has reached a crescendo. Aware of a "dark" past when the BRICS depended heavily on vaccines and pharmaceuticals from other parts of the world, academic curiosity on how the BRICS countries have leveraged vaccine self-sufficiency and become the hub of global vaccine production and supply is justifiable, especially in times of ineffable pandemics. Methods: The articles were searched from November 2020 to December 2022. Within this period, an electronic search of 13 reputable healthcare and public databases was conducted. The initial searches from the designated databases yielded a total of 3,928 articles. Then, duplicated studies were removed through a two-step process, articles without titles and abstracts were excluded, and the remaining 898 articles that met the qualification assessment criteria were evaluated for article quality. Results: The main entrepreneurial innovations that have quickened the pace of vaccine self-sufficiency in the BRICS include investment in artificial intelligence (AI), Big Data Analytics, and Blockchain technologies. These help to speed up the drug delivery process by enhancing patient identification or optimizing potential drug candidates for clinical trials and production. Conclusion: Over the past 20 years, the BRICS nations have achieved major strides in vaccine development, regulation, and production. The creation of the BRICS Vaccine Research and Development (R&D) Center will have a significant impact on vaccine cost and accessibility given the anticipated development of stronger research capability, production, and distribution technology, as well as stronger standardization to improve vaccine production quality in the near future. It is anticipated that the BRICS' contributions to vaccine development will alter the global vaccination market and hasten the availability of vaccinations in developing nations. The challenge is turning these hopes into concrete plans of action and outcomes.

An Emerging Market: The Impact of User Selection on the Decision-Making Behavior of Mobile Medical Businesses in China.

Background: User selection is an important guarantee for the sustainable development of mobile medical businesses. Under the background of increasingly fierce competition, the decision-making behavior of mobile medical businesses will directly affect the choice of the behavior of users. Methods: The study constructs the decision-making behavior model of mobile medical business based on the user choice and adds the role of people in government. It uses the game method to explore the relationship between the government, mobile medical business, and users. Finally, it makes an example analysis. Empirical research is conducted to demonstrate the influence of different parameter changes on the results. Results: The results show that in the absence of government intervention, users' choice of filtering information will create a bad environment for mobile medical businesses, and further will be reduced, and the expected utility of businesses will not be affected causing a reduction in expected utility of companies. Similarly, government regulations can effectively improve the mobile medical environment and enhance the expected utility of mobile medical companies. Conclusion: The government needs to formulate relevant laws and regulations to ensure the orderly operation of the mobile medical market and strengthen government supervision. It is necessary to conduct publicity and education to protect the fundamental interests of users and businesses.

The Contributing Factors to Nurses' Behavioral Intention to Use Hospital Information Technologies in Ghana.

BACKGROUND: Medical care facilities in both developed and developing countries around the world continue to invest in hospital information technologies (HITs). Nevertheless, it has been discovered that user acceptance of these technologies is one of the imperative issues during their implementation and management in developing countries such as Ghana. PURPOSE: Notably, the technology acceptance assessment of nurses is a timely one since they play a very important role in the medical sector. Based on the model of "Unified Theory of Acceptance and Use of Technology," this study explored the factors that affect Ghanaian nurses' acceptance of HIT.Design/Method/Approach: A descriptive nonexperimental research design was employed in this study to recruit 660 nurses (404 females and 256 males) from 3 teaching and 2 regional hospitals in Ghana. A standardized electronic platform questionnaire (based on the Unified Theory of Acceptance and Use of Technology model) was designed on smartphones and was self-administered, while the data collected were analyzed via the SmartPLS Structural Equation Modeling path analysis. The "Social Influence" (t = 3.656, p < .001), "Attitude towards the Use of Technology" (t = 5.861, p < .001), and "Facilitating Conditions" (t = 2.616, p < .001) were the main predictors of the nurses' behavioral intention to use HIT. The effects of the aforementioned constructs explained 60.7% (R 2 = 0.607) of the variance in the nurses' intentions to use the HIT systems. CONCLUSIONS: Precisely, HIT systems are essential in the quality and the enhancement of nursing services provision and in the effectiveness of the performance of nursing staff. This study, therefore, offers a piece of empirical evidence for hospital administrators in developing countries especially Ghana, to assess the success probability of new HITs before and after their implementation.