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1.
Urol Clin North Am ; 48(2): 251-258, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33795059

RESUMEN

Awareness of the activities of federal and state legislative and regulatory activities is vital for physicians to avoid having their services misvalued and to protect patients' access to care. Professional organizations are encouraging physicians to develop political leadership and advocacy skills to protect patient care, research, and access to technology. The political polarization of the country and the public health emergency have had an impact on the ability and willingness of some to engage in policy discussions. This article reviews mechanisms by which urologists can engage in health policy and political activity and avenues to expand the number of urologists involved.


Asunto(s)
Política de Salud , Liderazgo , Rol del Médico , Urología , Política de Salud/legislación & jurisprudencia , Humanos , Sociedades Médicas , Estados Unidos , Urología/legislación & jurisprudencia
2.
Int J Equity Health ; 20(1): 86, 2021 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-33766049

RESUMEN

OBJECTIVE: Our research summarized policy disparities in response to the first wave of COVID-19 between China and Germany. We look forward to providing policy experience for other countries still in severe epidemics. METHODS: We analyzed data provided by National Health Commission of the People's Republic of China and Johns Hopkins University Coronavirus Resource Center for the period 10 January 2020 to 25 May 252,020. We used generalized linear model to evaluate the associations between the main control policies and the number of confirmed cases and the policy disparities in response to the first wave of COVID-19 between China and Germany. RESULTS: The generalized linear models show that the following factors influence the cumulative number of confirmed cases in China: the Joint Prevention and Control Mechanism; locking down the worst-hit areas; the highest level response to public health emergencies; the expansion of medical insurance coverage to suspected patients; makeshift hospitals; residential closed management; counterpart assistance. The following factors influence the cumulative number of confirmed cases in Germany: the Novel Coronavirus Crisis Command; large gathering cancelled; real-time COVID-19 risk assessment; the medical emergency plan; schools closure; restrictions on the import of overseas epidemics; the no-contact protocol. CONCLUSIONS: There are two differences between China and Germany in non-pharmaceutical interventions: China adopted the blocking strategy, and Germany adopted the first mitigation and then blocking strategy; China's goal is to eliminate the virus, and Germany's goal is to protect high-risk groups to reduce losses. At the same time, the policies implemented by the two countries have similarities: strict blockade is a key measure to control the source of infection, and improving medical response capabilities is an important way to reduce mortality.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Política de Salud/legislación & jurisprudencia , Pandemias/legislación & jurisprudencia , Pandemias/prevención & control , Salud Pública/legislación & jurisprudencia , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad
3.
Br J Hosp Med (Lond) ; 82(2): 1-4, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33646036

RESUMEN

The UK government recently decided to extend the interval between the first dose of the Pfizer BioNTech and AstraZeneca COVID-19 vaccines from 3 weeks to 12 weeks to maximise the number of people receiving the initial dose, despite the trials only providing vaccine efficacy data based on a schedule of 21 days between doses. This editorial discusses whether there is evidence to support this policy change.


Asunto(s)
Inmunogenicidad Vacunal , Cobertura de Vacunación , Vacunación , /epidemiología , /prevención & control , /inmunología , Esquema de Medicación , Medicina Basada en la Evidencia/métodos , Medicina Basada en la Evidencia/normas , Regulación Gubernamental , Política de Salud/legislación & jurisprudencia , Humanos , Formulación de Políticas , Reino Unido/epidemiología , Vacunación/métodos , Vacunación/normas , Vacunación/estadística & datos numéricos , Cobertura de Vacunación/métodos , Cobertura de Vacunación/normas
4.
J Psychiatr Pract ; 27(2): 121-125, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33656818

RESUMEN

There have been shifts over time in the value placed on long-term psychotherapeutic modalities even though they can be life-saving. For example, the province of Ontario in Canada has been dealing with a government proposal put forward in 2019 to limit the length of psychotherapy treatment. In response, stakeholders from numerous groups came together to advocate for the importance of continuing unrestricted access to long-term psychotherapy. Approaches to this advocacy then had to unexpectedly adapt to the Coronavirus Disease 2019 (COVID-19) pandemic that came to the forefront in 2020 and will continue to develop in response to this changing landscape.


Asunto(s)
Defensa del Consumidor , Política de Salud/legislación & jurisprudencia , Salud Mental/legislación & jurisprudencia , Psicoterapia/legislación & jurisprudencia , Psicoterapia/métodos , Humanos , Ontario , Pandemias , Factores de Tiempo
7.
Am J Prev Med ; 60(4): 537-541, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33612337

RESUMEN

INTRODUCTION: Although many Medicare Advantage plans have waived cost sharing for COVID-19 hospitalizations, these waivers are voluntary and may be temporary. To estimate the magnitude of potential patient cost sharing if waivers are not implemented or are allowed to expire, this study assesses the level and predictors of out-of-pocket spending for influenza hospitalizations in 2018 among elderly Medicare Advantage patients. METHODS: Using the Optum De-Identified Clinformatics DataMart, investigators identified Medicare Advantage patients aged ≥65 years hospitalized for influenza in 2018. For each hospitalization, out-of-pocket spending was calculated by summing deductibles, coinsurance, and copays. The mean out-of-pocket spending and the proportion of hospitalizations with out-of-pocket spending exceeding $2,500 were calculated. A 1-part generalized linear model with a log link and Poisson variance function was fitted to model out-of-pocket spending as a function of patient demographic characteristics, plan type, and hospitalization characteristics. Coefficients were converted to absolute changes in out-of-pocket spending by calculating average marginal effects. RESULTS: Among 14,278 influenza hospitalizations, the mean out-of-pocket spending was $987 (SD=$799). Out-of-pocket spending exceeded $2,500 for 3.0% of hospitalizations. The factors associated with higher out-of-pocket spending included intensive care use, greater length of stay, and enrollment in a preferred provider organization plan (average marginal effect=$634, 95% CI=$631, $636) compared with enrollment in an HMO plan. CONCLUSIONS: In this analysis of elderly Medicare Advantage patients, the mean out-of-pocket spending for influenza hospitalizations was almost $1,000. Federal policymakers should consider passing legislation mandating insurers to eliminate cost sharing for COVID-19 hospitalizations. Insurers with existing cost-sharing waivers should consider extending them indefinitely, and those without such waivers should consider implementing them immediately.


Asunto(s)
Gastos en Salud/estadística & datos numéricos , Política de Salud/legislación & jurisprudencia , Hospitalización/economía , Gripe Humana/economía , Medicare Part C/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , /terapia , Seguro de Costos Compartidos/economía , Seguro de Costos Compartidos/legislación & jurisprudencia , Seguro de Costos Compartidos/estadística & datos numéricos , Costo de Enfermedad , Femenino , Política de Salud/economía , Hospitalización/estadística & datos numéricos , Humanos , Gripe Humana/terapia , Masculino , Medicare Part C/economía , Medicare Part C/legislación & jurisprudencia , Estados Unidos
13.
Harm Reduct J ; 18(1): 17, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568156

RESUMEN

BACKGROUND: A range of civil society organisations (CSOs) such as drug user groups, non-governmental/third sector organisations and networks of existing organisations, seek to shape the development of drugs policy at national and international levels. However, their capacity to do so is shaped by the contexts in which they operate nationally and internationally. The aim of this paper is to explore the lived experience of civil society participation in these contexts, both from the perspective of CSOs engaged in harm reduction advocacy, and the institutions they engage with, in order to inform future policy development. METHODS: This paper is based on the presentations and discussions from a workshop on 'Civil Society Involvement in Drug Policy hosted by the Correlation - European Harm Reduction Network at the International Society for the Study of Drugs Policy (ISSDP) annual conference in Paris, 2019. In the aftermath of the workshop, the authors analysed the papers and discussions and identified the key themes arising to inform CSI in developing future harm reduction policy and practice. RESULTS: Civil society involvement (CSI) in policy decision-making and implementation is acknowledged as an important benefit to representative democracy. Yet, the accounts of CSOs demonstrate the challenges they experience in seeking to shape the contested field of drug policy. Negotiating the complex workings of political institutions, often in adversarial and heavily bureaucratic environments, proved difficult. Nonetheless, an increase in structures which formalised and resourced CSI enabled more meaningful participation at different levels and at different stages of policy making. CONCLUSIONS: Civil society spaces are colonised by a broad range of civil society actors lobbying from different ideological standpoints including those advocating for a 'drug free world' and those advocating for harm reduction. In these competitive arena, it may be difficult for harm reduction orientated CSOs to influence the policy process. However, the current COVID-19 public health crisis clearly demonstrates the benefits of partnership between CSOs and political institutions to address the harm reduction needs of people who use drugs. The lessons drawn from our workshop serve to inform all partners on this pathway.


Asunto(s)
Control de Medicamentos y Narcóticos/métodos , Reducción del Daño , Política de Salud/legislación & jurisprudencia , Organizaciones/legislación & jurisprudencia , Formulación de Políticas , Humanos
17.
Milbank Q ; 99(1): 126-170, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33464689

RESUMEN

Policy Points This analysis finds that government obesity policies in England have largely been proposed in a way that does not readily lead to implementation; that governments rarely commission evaluations of previous government strategies or learn from policy failures; that governments have tended to adopt less interventionist policy approaches; and that policies largely make high demands on individual agency, meaning they rely on individuals to make behavior changes rather than shaping external influences and are thus less likely to be effective or equitable. These findings may help explain why after 30 years of proposed government obesity policies, obesity prevalence and health inequities still have not been successfully reduced. If policymakers address the issues identified in this analysis, population obesity could be tackled more successfully, which has added urgency given the COVID-19 pandemic. CONTEXT: In England, the majority of adults, and more than a quarter of children aged 2 to 15 years live with obesity or excess weight. From 1992 to 2020, even though the government published 14 obesity strategies in England, the prevalence of obesity has not been reduced. We aimed to determine whether such government strategies and policies have been fit for purpose regarding their strategic focus, nature, basis in theory and evidence, and implementation viability. METHOD: We undertook a mixed-methods study, involving a document review and analysis of government strategies either wholly or partially dedicated to tackling obesity in England. We developed a theory-based analytical framework, using content analysis and applied thematic analysis (ATA) to code all policies. Our interpretation drew on quantitative findings and thematic analysis. FINDINGS: We identified and analyzed 14 government strategies published from 1992 to 2020 containing 689 wide-ranging policies. Policies were largely proposed in a way that would be unlikely to lead to implementation; the majority were not interventionist and made high demands on individual agency, meaning that they relied on individuals to make behavior changes rather than shaping external influences, and are thus less likely to be effective or to reduce health inequalities. CONCLUSIONS: The government obesity strategies' failure to reduce the prevalence of obesity in England for almost 30 years may be due to weaknesses in the policies' design, leading to a lack of effectiveness, but they may also be due to failures of implementation and evaluation. These failures appear to have led to insufficient or no policy learning and governments proposing similar or identical policies repeatedly over many years. Governments should learn from their earlier policy failures. They should prioritize policies that make minimal demands on individuals and have the potential for population-wide reach so as to maximize their potential for equitable impacts. Policies should be proposed in ways that readily lead to implementation and evaluation.


Asunto(s)
Política de Salud/legislación & jurisprudencia , Obesidad/prevención & control , /epidemiología , Inglaterra/epidemiología , Gobierno , Política de Salud/economía , Humanos , Obesidad/epidemiología , Pandemias , Evaluación de Programas y Proyectos de Salud , Salud Pública/legislación & jurisprudencia
18.
Nat Med ; 27(2): 239-243, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33479500

RESUMEN

Substantial global effort has been devoted to curtailing the tobacco epidemic over the past two decades, especially after the adoption of the Framework Convention on Tobacco Control1 by the World Health Organization in 2003. In 2015, in recognition of the burden resulting from tobacco use, strengthened tobacco control was included as a global development target in the 2030 Agenda for Sustainable Development2. Here we show that comprehensive tobacco control policies-including smoking bans, health warnings, advertising bans and tobacco taxes-are effective in reducing smoking prevalence; amplified positive effects are seen when these policies are implemented simultaneously within a given country. We find that if all 155 countries included in our counterfactual analysis had adopted smoking bans, health warnings and advertising bans at the strictest level and raised cigarette prices to at least 7.73 international dollars in 2009, there would have been about 100 million fewer smokers in the world in 2017. These findings highlight the urgent need for countries to move toward an accelerated implementation of a set of strong tobacco control practices, thus curbing the burden of smoking-attributable diseases and deaths.


Asunto(s)
Política de Salud/legislación & jurisprudencia , Política Pública/legislación & jurisprudencia , Fumar/legislación & jurisprudencia , Tabaco/efectos adversos , Adolescente , Adulto , Femenino , Política de Salud/economía , Humanos , Masculino , Persona de Mediana Edad , Política Pública/economía , Fumar/economía , Fumar/epidemiología , Fumar/psicología , Impuestos , Organización Mundial de la Salud/economía , Adulto Joven
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