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Innovations in Health Economics, Social Policy and Health Management

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 70718

Special Issue Editors

Prof. Sotiris Soulis

E-Mail Website1 Website2
Guest Editor
Department of Business Administration, University of West Attica, 12243 Athens, Greece
Interests: health economics; health planning; demography; social policy; social system protection; strategic management; health and safety at work
Dr. Aspasia Goula

E-Mail Website
Guest Editor
Department of Business Administration, University of West Attica, 12243 Athens, Greece
Interests: social science research; health management; organizational behaviour; organizational culture; leadership; organizational change and development
Dr. Evridiki Kaba

E-Mail Website
Guest Editor
Department of Nursing, University of West Attica, 12243 Athens, Greece
Interests: qualitative research; grounded theory; primary health care nursing; health promotion; basic nursing; rehabilitation nursing; evidence-based nursing
Special Issues, Collections and Topics in MDPI journals
Prof. Martha Kelesi

E-Mail Website
Guest Editor
Department of Nursing, University of West Attica, 12243 Athens, Greece
Interests: quantitative research; systematic reviews; primary health care nursing; health promotion; basic nursing; evidence-based nursing; health management and health economics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The growing interest in health economics, social policy and health care management lies in the complexity and importance of operating the health sector both for the individual and for society as a whole. The right to equal access to health services, as well as the quality of the provided health services, concern both individuals and experts in health policy. At the same time, health expenditure absorbs an increasing share of the national income. The way in which these expenditures are financed is of great concern to those pursuing a health policy, as well as to the ever-widening deficits in the health sector. The aging of the population, the rise of the standard of living, the pollution of the environment, and the consumer model have an increasing effect on health expenditures. Health economics is influencing decision making at all levels of healthcare in the face of growing demands on scarce resources. 

This Special Issue focuses on health economics, social policy, and health management and aims to provide managers and policy makers with current knowledge regarding useful insights into how healthcare can be organized and financed and a framework to address a broad range of issues in an explicit and consistent manner. Additionally, papers explaining social phenomena that shape the health status of the population, social security, working conditions, inequalities, social discrimination and European and international health policies, modern methodological funding techniques, compensation methods, cost-benefit analysis, cost-effectiveness, utility costs, and cost minimization are encouraged. Papers following the application of quantitative, qualitative or mixed-methods approaches will be considered. 

We hope to be an open communication space that enhances dissemination and exchange of knowledge to a wider audience. 

This Special Issue will consider original articles, with a special focus on issues such as:

  • Macro- and/or microeconomics of healthcare financing;
  • Economic evaluation;
  • Health services research;
  • Health policy analysis;
  • Cost effectiveness in healthcare;
  • Financial resource allocation;
  • Organization and administration of health care systems;
  • Behavior of consumers, patients, and providers of health services;
  • Health inequalities;
  • Health technology assessment;
  • Empirical research in demography;
  • Quality of healthcare services;
  • Quality of life; disease prevention and health promotion;
  • Functioning of healthcare systems and health-affecting behaviors such as smoking, diabetes, and obesity;
  • Policies and reforms of health systems;
  • Health care services and human resource management;
  • Patient management, hospital management, and management of diseases;
  • Important economic aspects of environmental research and public health;
  • Environmental health and diseases;
  • The preservation or development of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in human beings;
  • Innovation, finance, and best practices promotion in health education;
  • Organizational behavior, leadership and complexity, human resource management, and total quality and performance management;
  • Management and performance practices; work, organization, and leadership dynamics.

Prof. Sotiris Soulis
Dr. Aspasia Goula
Dr. Evridiki Kaba
Prof. Martha Kelesi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health economics
  • health planning
  • monitoring
  • evaluation
  • efficiency
  • equity
  • public health
  • health promotion
  • quality of life
  • health management
  • health service quality

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  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (17 papers)

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14 pages, 1426 KiB  
Article
Fair Funding Decisions: Consistency of the Time Horizons Used in the Calculation of Quality-Adjusted Life Years for Therapies for Very Rare Diseases by the National Institute for Health and Care Excellence in England
by Jasmin Barman-Aksözen, Nicole Hentschel, Mårten Pettersson, Eva Schupp, Francesca Granata, Cornelia Dechant, Mehmet Hakan Aksözen and Rocco Falchetto
Int. J. Environ. Res. Public Health 2024, 21(5), 616; https://doi.org/10.3390/ijerph21050616 - 13 May 2024
Viewed by 1465
Abstract
The National Institute for Health and Care Excellence (NICE) in England uses quality-adjusted life years (QALYs) to assess the cost-effectiveness of treatments. A QALY is a measure that combines the size of the clinical benefit of a treatment with the time the patient [...] Read more.
The National Institute for Health and Care Excellence (NICE) in England uses quality-adjusted life years (QALYs) to assess the cost-effectiveness of treatments. A QALY is a measure that combines the size of the clinical benefit of a treatment with the time the patient benefits from it, i.e., the time horizon. We wanted to know how consistently QALY gains are calculated at NICE. Therefore, we have analysed information on the time horizons used for the QALY calculations of the concluded evaluations conducted under the Highly Specialised Technologies programme for treatments of very rare diseases at NICE. For treatments with final guidance published by December 2023 (n = 29), a time horizon of median 97.5 years (range: 35 to 125 years) was used to calculate the QALY gains. For most QALY calculations, the accepted time horizon was longer than either the expected treatment duration or the estimated life expectancy. In contrast, for the only technology with a final negative funding decision, i.e., afamelanotide for treating the lifelong chronic disease erythropoietic protoporphyria, a time horizon that was shorter than the expected treatment duration was used. The fairness and consistency of the evaluation process of treatments for very rare diseases at NICE should be reviewed. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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12 pages, 981 KiB  
Article
Assessing the Efficiency and Productivity of the Hospital Clinics on the Island of Rhodes during the COVID-19 Pandemic
by Lorena Androutsou, Michail Kokkinos, Dimitra Latsou and Mary Geitona
Int. J. Environ. Res. Public Health 2022, 19(23), 15640; https://doi.org/10.3390/ijerph192315640 - 24 Nov 2022
Cited by 2 | Viewed by 2758
Abstract
(1) Background: The aim was to measure the efficiency and productivity of 15 specialty clinics during the COVID-19 pandemic period 2020–2021 in the General Hospital of Rhodes. (2) Methods: An input-oriented data envelopment analysis and the Malmquist productivity index are used. Labor and [...] Read more.
(1) Background: The aim was to measure the efficiency and productivity of 15 specialty clinics during the COVID-19 pandemic period 2020–2021 in the General Hospital of Rhodes. (2) Methods: An input-oriented data envelopment analysis and the Malmquist productivity index are used. Labor and capital were used as inputs, and in-patient discharges and days were used as outputs. (3) Results: Five out of the seven clinics in the pathology sector appeared fully efficient with an optimal productivity, and the rest showed progress in 2021. In 2020 the COVID-19 pathology clinic appeared to be inefficient and less productive, while in 2021, it showed a positive performance change. The surgical sector showed very high efficiency rates or even reached an optimal efficiency in both years. The productivity measurement, in most of the surgical clinics, was satisfactory to very high. In 2020 the COVID-19 surgical clinic appeared to be more efficient and productive than in 2021 when its performance declined. (4) Conclusions: The hospital responded to the pressure during the pandemic, by increasing its efficiency and productivity from 2020 to 2021. This was due to the accomplishment of the appropriate organizational changes in the infrastructure, human resources, and technology. The efficiency and productivity assessments should be incorporated in the hospitals’ decision making. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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16 pages, 350 KiB  
Article
Do Deep Regional Trade Agreements Improve Residents’ Health? A Cross-Country Study
by Zhizhong Liu, Qianying Chen, Guangyue Liu and Xu Han
Int. J. Environ. Res. Public Health 2022, 19(21), 14409; https://doi.org/10.3390/ijerph192114409 - 3 Nov 2022
Cited by 1 | Viewed by 1495
Abstract
The development trend of deepening regional trade agreements (RTAs) is becoming more prominent, traditional RTAs based on border terms continue to shift to deep RTAs based on the high level of border terms and a series of post-border terms, but the relationship between [...] Read more.
The development trend of deepening regional trade agreements (RTAs) is becoming more prominent, traditional RTAs based on border terms continue to shift to deep RTAs based on the high level of border terms and a series of post-border terms, but the relationship between deep RTAs and residents’ health has not drawn much attention. Based on Gallup World Poll data from 2009 to 2017 covering 786,040 respondents in 143 countries, this study empirically examined the impact of deep RTAs on the health of residents as well as its influence mechanisms by using the combination of fixed effects and stepwise regression. The results show that deep RTAs have a significantly positive impact on residents’ health, which means that an increase in the depth of RTAs can improve residents’ health. However, the impact of deep RTAs on residents’ health is heterogeneous, caused by the different terms of RTAs, the different income levels of different countries, and the different types of residents. Meanwhile, deep RTAs mainly improve the health of residents through employment effects and environmental effects. This study highlights the importance of deep RTAs for improving the health of residents and provides new ideas for governments to assist in the formulation of policies that can effectively improve their residents’ health. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
10 pages, 319 KiB  
Article
Access of People Living with HIV to Testing Services in Greece: A Challenge for Equity in Care
by Kyriakos Souliotis, George Tsiakalakis, Christina Golna, Dimitra Sifaki-Pistolla, Nikos Dedes and Marios Lazanas
Int. J. Environ. Res. Public Health 2022, 19(21), 14353; https://doi.org/10.3390/ijerph192114353 - 2 Nov 2022
Viewed by 1510
Abstract
(1) Background: Access to laboratory testing services for HIV in Greece is persistently challenged and this impacts both the continuum of care and, potentially, equity in access. (2) Methods: A cross-sectional study with two parts (first part: HIV-positive people/PLWHIV; second part: HIV clinicians) [...] Read more.
(1) Background: Access to laboratory testing services for HIV in Greece is persistently challenged and this impacts both the continuum of care and, potentially, equity in access. (2) Methods: A cross-sectional study with two parts (first part: HIV-positive people/PLWHIV; second part: HIV clinicians) was conducted in Greece to quantify challenges regarding access to laboratory testing for HIV. Data were collected through online surveys, during a one-month period, between 2019 and 2020. The total sample consisted of 153 PLWHIV and 26 HIV clinicians. (3) Results: Access to viral load testing varied significantly according to place of residence (p = 0.029) and year of diagnosis (p = 0.054). Patients diagnosed after 2015 reported worse access to viral load testing (72.7% vs. 85.9%). Over one third of respondents perceived viral load tests as being not at all accessible (11.4%) or somewhat accessible, only after facing multiple systemic obstacles (24.2%). Equally, most of HIV clinicians reported barriers or no access to baseline viral load testing (80%) and baseline genotype resistance tests (96%). (4) Conclusions: Access of people diagnosed with HIV to CD4 lymphocyte tests and genotype resistance screening is significantly challenged in Greece, especially after 2015. Addressing this challenge is critical in removing access barriers and achieving the UNAIDS 95-95-95 HIV elimination goals. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
11 pages, 332 KiB  
Article
The Effect of Depressive and Insomnia Symptoms in Quality of Life among Community-Dwelling Older Adults
by Konstantinos Tsaras, Maria Tsiantoula, Dimitrios Papagiannis, Ioanna V. Papathanasiou, Maria Chatzi, Martha Kelesi, Evridiki Kaba and Evangelos C. Fradelos
Int. J. Environ. Res. Public Health 2022, 19(20), 13704; https://doi.org/10.3390/ijerph192013704 - 21 Oct 2022
Cited by 5 | Viewed by 2423
Abstract
The purpose of this study was to investigate the effects of depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms on the quality of life among community-dwelling older adults in an urban area of central Greece. A cross-sectional study was conducted on [...] Read more.
The purpose of this study was to investigate the effects of depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms on the quality of life among community-dwelling older adults in an urban area of central Greece. A cross-sectional study was conducted on 200 older adults (aged ≥ 60) collected from five Open Care Centers for Elderly People of the Municipality of Larissa, Greece. Data were obtained through a questionnaire that included demographic, socioeconomic, and health-related characteristics; the World Health Organization Quality of Life (WHOQoL)-Bref questionnaire; the Geriatric Depression Scale; and the Athens Insomnia Scale. The prevalences of depression, insomnia, and comorbid depression and insomnia were 28% (95% confidence interval (95% CI): 21.8–34.2%), 40.5% (95% CI: 33.7–47.3%), and 19% (95% CI: 13.5–24.5%), respectively. The mean WHOQoL-Bref score for all domains was approximately 14.50, with the highest mean value observed for psychological health (14.79 ± 2.60), followed by the physical health (14.49 ± 2.66), social relationships (14.39 ± 2.03), and environmental domains (14.32 ± 1.90). All WHOQoL-Bref domains were negatively correlated with depression and insomnia. Older adults with depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms had lower scores in all quality of life dimensions compared with those without. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
16 pages, 1571 KiB  
Article
Transition from Laser to Intravitreal Injections for Diabetic Retinopathy: Hospital Utilization and Costs from an Extended Healthcare Perspective
by Silvia Nanjala Walekhwa Hertzberg, Øystein K. Jørstad, Beáta Éva Petrovski, Ragnheidur Bragadottir, Leif Arthur Steffensen, Morten Carstens Moe, Emily A. Burger and Goran Petrovski
Int. J. Environ. Res. Public Health 2022, 19(19), 12603; https://doi.org/10.3390/ijerph191912603 - 2 Oct 2022
Cited by 3 | Viewed by 2131
Abstract
Purpose: To describe the trends in hospital utilization and economic outcomes associated with the transition from laser to intravitreal injection (IVI) therapy for diabetic retinopathy (DR) at Oslo University Hospital (OUH), which provides the largest retina service in Norway. Methods: This descriptive study [...] Read more.
Purpose: To describe the trends in hospital utilization and economic outcomes associated with the transition from laser to intravitreal injection (IVI) therapy for diabetic retinopathy (DR) at Oslo University Hospital (OUH), which provides the largest retina service in Norway. Methods: This descriptive study analyzed hospital administrative data and determined the average utilization and treatment proportions of laser therapy, IVIs and vitrectomy for each patient per year. The Chi-square test was used to compare resource use between treatment groups. From an extended healthcare perspective, the annual cost per patient was calculated using Norwegian tariff data from 2020 and the National Medication Price Registry for patients seen between 2010 and 2018. Bootstrapping was performed to generate 95% confidence intervals for the cost per patient per year. Results: Among the 1838 (41% female) patients treated for DR between 2005 and 2018, OUH provided on average 1.09 laser treatments per DR patient and 0.54 vitrectomies per DR patient in 2005, whose utilization declined to 0.54 and 0.05 treatments per DR patient, respectively, by 2018. Laser treatments declined from 64% to 10%, while vitrectomies declined from 32% to 1%. In contrast, IVI treatments increased from 4.5% to 89% of the total share, representing an average increase, from 0.08 injections per patient in 2005 to 4.73 injections per patient in 2018. Both the increasing number of DR patients and the shift in the type of treatment increased the economic costs of treating DR from a total of EUR 0.605 million (EUR 2935 per patient) in 2010 to EUR 2.240 million (EUR 3665 per patient) in 2018, with IVIs contributing considerably to these costs. Conclusions: Despite the decline in the use of vitrectomies, the transition from laser to IVI therapy for DR increased the healthcare resource utilization and economic costs of its treatment over the observed time. A main cost driver was the need for long-term IVIs, in addition to the drug cost itself. Trade-offs can be achieved through effective alternative IVI delivery or appropriate drug choice that balances patient needs with the economic burden of treating DR. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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17 pages, 517 KiB  
Article
Empirical Research into the Development Mechanism of Industry Innovation of Health and Wellness Tourism in the Context of the Sharing Economy
by Li Li and Xuejun Chen
Int. J. Environ. Res. Public Health 2022, 19(19), 12479; https://doi.org/10.3390/ijerph191912479 - 30 Sep 2022
Cited by 6 | Viewed by 2393
Abstract
Health and wellness tourism has become an emerging form of tourism economy. In the era of the sharing economy, it is of theoretical and practical significance to study the development mechanism of the industry innovation (II) of health and wellness tourism. Based on [...] Read more.
Health and wellness tourism has become an emerging form of tourism economy. In the era of the sharing economy, it is of theoretical and practical significance to study the development mechanism of the industry innovation (II) of health and wellness tourism. Based on theoretical analysis, hypotheses were proposed for the relationships of industry sharing (IS) as well as its constitutional dimensions with the resource acquisition capability (RAC), policy support (PS), and II of health and wellness tourism. The constitutional dimensions of IS include public operational resources (PORs), infrastructures, and industry cooperation networks (ICNs). In addition, a model for the influencing mechanism of IS on the II of health and wellness tourism was established. Questionnaire surveys were conducted with 542 managers of health and wellness tourism enterprises in 21 provinces (or municipalities) in China, using the empirical research method, and the survey data are subjected to mathematical statistical analysis. Results show that the PORs, infrastructures, and ICNs of the IS of health and wellness tourism have significant positive influences on the II. RAC has a partial mediating effect between the IS and the II of health and wellness tourism. PS exerts a moderating effect between the IS and the II of health and wellness tourism. Finally, suggestions for promoting the II development of health and wellness tourism are proposed from the perspective of optimizing IS. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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20 pages, 2527 KiB  
Article
Identifying and Predicting Healthcare Waste Management Costs for an Optimal Sustainable Management System: Evidence from the Greek Public Sector
by Anastasios Sepetis, Paraskevi N. Zaza, Fotios Rizos and Pantelis G. Bagos
Int. J. Environ. Res. Public Health 2022, 19(16), 9821; https://doi.org/10.3390/ijerph19169821 - 9 Aug 2022
Cited by 17 | Viewed by 5103
Abstract
The healthcare sector is an ever-growing industry which produces a vast amount of waste each year, and it is crucial for healthcare systems to have an effective and sustainable medical waste management system in order to protect public health. Greek public hospitals in [...] Read more.
The healthcare sector is an ever-growing industry which produces a vast amount of waste each year, and it is crucial for healthcare systems to have an effective and sustainable medical waste management system in order to protect public health. Greek public hospitals in 2018 produced 9500 tons of hazardous healthcare wastes, and it is expected to reach 18,200 tons in 2025 and exceed 18,800 tons in 2030. In this paper, we investigated the factors that affect healthcare wastes. We obtained data from all Greek public hospitals and conducted a regression analysis, with the management cost of waste and the kilos of waste as the dependent variables, and a number of variables reflecting the characteristics of each hospital and its output as the independent variables. We applied and compared several models. Our study shows that healthcare wastes are affected by several individual-hospital characteristics, such as the number of beds, the type of the hospital, the services the hospital provides, the number of annual inpatients, the days of stay, the total number of surgeries, the existence of special units, and the total number of employees. Finally, our study presents two prediction models concerning the management costs and quantities of infectious waste for Greece’s public hospitals and proposes specific actions to reduce healthcare wastes and the respective costs, as well as to implement and adopt certain tools, in terms of sustainability. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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15 pages, 1535 KiB  
Article
Differences and Influencing Factors of Relative Poverty of Urban and Rural Residents in China Based on the Survey of 31 Provinces and Cities
by Hong Sun, Xiaohong Li, Wenjing Li and Jun Feng
Int. J. Environ. Res. Public Health 2022, 19(15), 9015; https://doi.org/10.3390/ijerph19159015 - 25 Jul 2022
Cited by 21 | Viewed by 4451
Abstract
China achieved comprehensive poverty eradication under the current standards in 2020, but eliminating absolute poverty does not mean the end of poverty alleviation and reduction; relative poverty will exist for a long time and has become the subject of poverty study. In this [...] Read more.
China achieved comprehensive poverty eradication under the current standards in 2020, but eliminating absolute poverty does not mean the end of poverty alleviation and reduction; relative poverty will exist for a long time and has become the subject of poverty study. In this paper, the social poverty line (SPL) index is utilized to establish the relative poverty standard, and CHFS2017 is used to compare the regional distribution of relative poverty in China. The results show that the relative poverty in rural areas is more serious than that in urban areas. The rural relative poverty rate in five provinces and cities including Beijing is over 60%, and the rural relative poverty rate in Qinghai is low. The urban relative poverty rate in many provinces and cities of the central and western regions is below 40%, and the relatively high relative poverty rate in the eastern region has drawn attention to the issue of the income distribution. Moreover, a logit model for binary is employed for the influencing factor analysis of the relative poverty of urban and rural residents. The results show that the education year has a negative effect on the relative poverty of urban and rural residents. Happiness has a positive effect on urban residents, government financial expenditure and financial support for agriculture have different effects on rural residents and urban residents. Therefore, we put forward aiming at relative poverty in the rural areas of the central and western regions to reduce financial pressure and increase the benefits of poverty reduction. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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21 pages, 3795 KiB  
Article
Inclusive Aging in Korea: Eradicating Senior Poverty
by Jooyeon Kang, Jungmin Park and Jaemin Cho
Int. J. Environ. Res. Public Health 2022, 19(4), 2121; https://doi.org/10.3390/ijerph19042121 - 14 Feb 2022
Cited by 22 | Viewed by 6538
Abstract
Poverty for the elderly is one of the most urgent social problems when discussing the social problems facing Korean society. The purpose of this study is to identify the causes of elderly poverty problems and to seek countermeasures. According to a systematic analysis [...] Read more.
Poverty for the elderly is one of the most urgent social problems when discussing the social problems facing Korean society. The purpose of this study is to identify the causes of elderly poverty problems and to seek countermeasures. According to a systematic analysis of the economic difficulties of the elderly population that applies a socioecological model, the cause of elderly poverty is complicated by the specificity of the labor market and pension system in Korean society. This is compounded by the lack of a public support system that can overcome insufficient family care and a lack of individual preparation. To alleviate elderly poverty, this paper recommends three policy alternatives. First, a robust multipillar retirement income security system must be established. To secure a minimal retirement income for the elderly in poverty, who have been marginalized from the public pension system design, the basic pension should be raised for the bottom 70% of senior citizens. Second, in order to tackle labor market duality and early retirement, the seniority-oriented wage system should be reformed into a job-based wage system. Third, to minimize unemployment and promote quality among re-employment jobs, the government should strengthen vocational skills development by expanding programs tailored to older people. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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14 pages, 307 KiB  
Article
Attitudes and Practices Regarding Research among Romanian Medical Undergraduate Students
by Andreea Iulia Pop, Lucia Maria Lotrean, Anca Dana Buzoianu, Soimita Mihaela Suciu and Mira Florea
Int. J. Environ. Res. Public Health 2022, 19(3), 1872; https://doi.org/10.3390/ijerph19031872 - 8 Feb 2022
Cited by 6 | Viewed by 2302
Abstract
Objectives: This study focuses on the assessment of attitudes and practices regarding research among undergraduate medical students from Cluj-Napoca, Romania. Material and Methods: A cross-sectional study was performed thorough anonymous questionnaires (May–June 2018) among 510 third- and fifth-year students of Iuliu Hatieganu University [...] Read more.
Objectives: This study focuses on the assessment of attitudes and practices regarding research among undergraduate medical students from Cluj-Napoca, Romania. Material and Methods: A cross-sectional study was performed thorough anonymous questionnaires (May–June 2018) among 510 third- and fifth-year students of Iuliu Hatieganu University of Medicine and Pharmacy from Cluj-Napoca, Romania. Results: More than 60% of the third- and fifth-year students declared that they were interested and willing to perform research during medical studies, while more than two-thirds were interested in doing so after graduation. In total, 6% of third-year students and 31% of fifth-year students declared that they had prepared a scientific presentation for a medical congress at least once. Around 9% of the third-year students contributed to the writing of a scientific article and participated in research projects. Among fifth-year students, one-quarter were involved in writing scientific papers, and 21% participated in research projects. Conclusions: To the best of our knowledge, this study assesses, for the first time in Romania, the perspectives and behaviors of medical undergraduate students with regard to involvement in research activities. The results show that Romanian medical students value opportunities for conducting research, which encourages institutional initiatives that support their involvement in curricular and extracurricular research activities. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
17 pages, 882 KiB  
Article
Internal Quality and Job Satisfaction in Health Care Services
by Aspasia Goula, Theodoros Rizopoulos, Maria-Aggeliki Stamouli, Martha Kelesi, Evridiki Kaba and Sotirios Soulis
Int. J. Environ. Res. Public Health 2022, 19(3), 1496; https://doi.org/10.3390/ijerph19031496 - 28 Jan 2022
Cited by 15 | Viewed by 4767
Abstract
(1) Background: The main purpose of this study was to evaluate the health services’ internal quality level in Greek public hospitals and to investigate whether there is a relation between internal quality and health care professionals’ job satisfaction. (2) Material and Methods: A [...] Read more.
(1) Background: The main purpose of this study was to evaluate the health services’ internal quality level in Greek public hospitals and to investigate whether there is a relation between internal quality and health care professionals’ job satisfaction. (2) Material and Methods: A cross-sectional study was conducted in six public hospitals (four general and two specialized hospitals). The following tools were used to collect data: (a) the SERVQUAL questionnaire, which is designed to measure service quality through five dimensions, and (b) the Job Satisfaction Survey (JSS) questionnaire, which is designed to measure employees’ job satisfaction. Convenience sampling was used as a sampling technique. (3) Results: The level of internal quality service was found to be low as regards the dimensions of: reliability, assurance, responsiveness, and empathy, while the “tangibles” dimension was the only one which was assessed as having a satisfactory internal quality level. Τhe results also revealed a positive correlation between the job satisfaction subscales and the quality dimensions. Regarding demographic characteristics and their effect on employees’ perceptions of internal quality dimensions, the study found that the gender and the educational factor had no effect while younger employees have a more positive perception of the quality of responsiveness dimension in the health organizations where they work. In terms of profession, administrative staff had a lower perception of the quality of tangibles dimension than doctors and nurses. Concerning years of experience, the results indicated that employees with more previous working experience had a worse perception of the quality of reliability, responsiveness, and assurance dimensions. (4) Conclusions: According to the results, establishing a sense of trust and understanding between management and health professionals through effective communication, transparent evaluation, and reward is critical to developing, enhancing, and promoting an internal quality culture in a hospital setting. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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16 pages, 856 KiB  
Article
Assessment of Health Professionals’ Attitudes on Radiation Protection Measures
by Aspasia Goula, Athanasios Chatzis, Maria-Aggeliki Stamouli, Martha Kelesi, Evridiki Kaba and Emmanouil Brilakis
Int. J. Environ. Res. Public Health 2021, 18(24), 13380; https://doi.org/10.3390/ijerph182413380 - 19 Dec 2021
Cited by 13 | Viewed by 5078
Abstract
(1) Background: Health professionals’ knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals’ average knowledge level and captures the beliefs, perceptions, and behaviours in a [...] Read more.
(1) Background: Health professionals’ knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals’ average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals’ lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals’ trust and sense of security by significantly improving their working environment. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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14 pages, 2053 KiB  
Article
Reshaping the Regional Order of Health Care Resources in China: The Institutional Participants in an Inter-City Integrated Delivery System
by Xuanyi (Maxwell) Nie and Haobin (Bruce) Fan
Int. J. Environ. Res. Public Health 2021, 18(17), 9176; https://doi.org/10.3390/ijerph18179176 - 31 Aug 2021
Cited by 2 | Viewed by 2880
Abstract
Over the past decades, pro-growth policies in China led to rapid economic development but overlooked the provision of health care services. Recently, increasing attention is paid to the emergence of integrated delivery systems (IDS) in China, which is envisioned to consolidate regional health [...] Read more.
Over the past decades, pro-growth policies in China led to rapid economic development but overlooked the provision of health care services. Recently, increasing attention is paid to the emergence of integrated delivery systems (IDS) in China, which is envisioned to consolidate regional health care resources more effectively by facilitating patient referral among hospitals. IDS at an inter-city scale is particularly interesting because it involves both the local governments and the hospitals. Incentives among them will affect the development of an inter-city IDS. This paper thereby builds an economic model to examine both the inter-local government and inter-hospital incentives when participating in an inter-city IDS in China. The findings suggest that while inter-hospital incentives matter, inter-local government incentives should also be considered because the missing incentives at the local government level may oppose the development of inter-city IDSs. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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15 pages, 351 KiB  
Article
“Living with a Stoma”: Exploring the Lived Experience of Patients with Permanent Colostomy
by Areti Stavropoulou, Dimitrios Vlamakis, Evridiki Kaba, Ioannis Kalemikerakis, Maria Polikandrioti, Georgia Fasoi, Georgios Vasilopoulos and Martha Kelesi
Int. J. Environ. Res. Public Health 2021, 18(16), 8512; https://doi.org/10.3390/ijerph18168512 - 12 Aug 2021
Cited by 32 | Viewed by 14170
Abstract
Introduction: Living with a permanent colostomy brings severe changes in patients’ lives. The general health status as well as the personal, social and professional life of patients are significantly affected. Aim: The aim of the present study was to investigate the lived experience [...] Read more.
Introduction: Living with a permanent colostomy brings severe changes in patients’ lives. The general health status as well as the personal, social and professional life of patients are significantly affected. Aim: The aim of the present study was to investigate the lived experience of patients undergoing permanent colostomy. Material and Methods: A qualitative research design based on interpretive phenomenology was carried out. Semi-structured interviews were conducted as the data collection method to obtain in-depth information regarding the research topic. The study sample consisted of eight (8) patients who had undergone a permanent colostomy. The data analysis was performed by the method of content analysis. Results: From the analysis of the data, three main themes emerged, namely: (A) Experiencing a traumatic event; (B) Living a new reality; (C) Efforts to improve quality of life. Five subthemes were formulated which were encompassed within the respective main themes accordingly. Conclusion: Patients with permanent colostomy face significant life changes that are experienced in a traumatic way. Issues such as autonomy, family and organizational support, self-management and empowerment can significantly improve the patients’ quality of life. Further research, regarding caregivers’ experience, improved community nursing care as well as nurses’ views on the needs of colostomy patients and their families, is suggested. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
13 pages, 327 KiB  
Article
Physicians’ Knowledge, Attitude and Practice of Generic Substitution in China: A Cross-Sectional Online Survey
by Mingyue Zhao, Lingyi Zhang, Zhitong Feng and Yu Fang
Int. J. Environ. Res. Public Health 2021, 18(15), 7749; https://doi.org/10.3390/ijerph18157749 - 21 Jul 2021
Cited by 7 | Viewed by 2798
Abstract
The purpose of this study is to investigate physicians’ knowledge, attitudes and practice of generic medicine substitutions in China. We conducted a cross-sectional online questionnaire survey on physicians from secondary or tertiary hospitals in China from 2020 December to 2021 April. Descriptive statistical [...] Read more.
The purpose of this study is to investigate physicians’ knowledge, attitudes and practice of generic medicine substitutions in China. We conducted a cross-sectional online questionnaire survey on physicians from secondary or tertiary hospitals in China from 2020 December to 2021 April. Descriptive statistical and ordered logistic regression were used for analysis. A total of 1225 physicians were included in the final analysis, and only 330 (26.94%) of them scored 4 or above in the knowledge part, which means that the physicians have a good knowledge of generic substitutions. Of the total, 586 (47.83%) agreed or strongly agreed that generic drugs could be substituted for originator drugs and 585 (47.75%) always or often prescribed generic medicines. The percentage of physicians with a positive attitude toward or that practice prescribing generic medicine is below 50%, which needs to be improved in China. Physicians’ knowledge, their attitude toward generic substitution, if familiar with the policy of generic substitution, and incentives for prescribing generic medicines are influencing factors for the practice of generic substitution. Our studies show that the practice of generic substitution by physicians could be improved by several measures in China. We suggested that the physicians should be taught more about the bulk-buy policy and the generic-originator equivalence evaluation policy. Moreover, government incentives to promote generic substitution should be established. Our study also suggested that physicians with less working experience and female physicians should learn more about generic substitution. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)

Review

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14 pages, 414 KiB  
Review
Climate Changes Exacerbate the Spread of Ixodes ricinus and the Occurrence of Lyme Borreliosis and Tick-Borne Encephalitis in Europe—How Climate Models Are Used as a Risk Assessment Approach for Tick-Borne Diseases
by Chrysa Voyiatzaki, Sevastiani I. Papailia, Maria S. Venetikou, John Pouris, Maria E. Tsoumani and Effie G. Papageorgiou
Int. J. Environ. Res. Public Health 2022, 19(11), 6516; https://doi.org/10.3390/ijerph19116516 - 27 May 2022
Cited by 34 | Viewed by 4997
Abstract
Climate change has influenced the transmission of a wide range of vector-borne diseases in Europe, which is a pressing public health challenge for the coming decades. Numerous theories have been developed in order to explain how tick-borne diseases are associated with climate change. [...] Read more.
Climate change has influenced the transmission of a wide range of vector-borne diseases in Europe, which is a pressing public health challenge for the coming decades. Numerous theories have been developed in order to explain how tick-borne diseases are associated with climate change. These theories include higher proliferation rates, extended transmission season, changes in ecological balances, and climate-related migration of vectors, reservoir hosts, or human populations. Changes of the epidemiological pattern have potentially catastrophic consequences, resulting in increasing prevalence of tick-borne diseases. Thus, investigation of the relationship between climate change and tick-borne diseases is critical. In this regard, climate models that predict the ticks’ geographical distribution changes can be used as a predicting tool. The aim of this review is to provide the current evidence regarding the contribution of the climatic changes to Lyme borreliosis (LB) disease and tick-borne encephalitis (TBE) and to present how computational models will advance our understanding of the relationship between climate change and tick-borne diseases in Europe. Full article
(This article belongs to the Special Issue Innovations in Health Economics, Social Policy and Health Management)
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