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Tapsoba Y, Silim A, Frimpong KA, Barroy H. Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries. Health Syst Reform 2024; 10:2298190. [PMID: 38225860 DOI: 10.1080/23288604.2023.2298190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
Public financial management (PFM) theory suggests that improvements in the allocation, execution, and monitoring of public funds can result in improved sectoral outcomes, including in health. However, the existing literature on the relationship between PFM quality and health outcomes provides limited empirical documentation and insufficient explanation of the mechanics of that relationship. This paper contributes to the literature by estimating the correlation between PFM quality and health outcomes from a sample of sub-Saharan African countries over the period 2005-2018, using a pooled ordinary least squares (OLS) estimator. The analysis uses Public Expenditure and Financial Accountability (PEFA) scores as proxies for PFM quality. The findings indicate that countries with high-quality PFM tended to have the lowest maternal, under-five and noncommunicable diseases (NCDs) mortality. Among the standard PFM dimensions, the one associated with the higher correlation with maternal and under-five mortality was "predictability and control in budget execution." Better PFM quality was significantly associated with a drop in maternal and under-five mortality in countries which allocated a higher proportion of their budget to the health sector. In countries allocating a lower proportion of their budget to health, the correlations between PFM quality and the three mortality indicators were not significant. The negative correlations between PFM quality and maternal and under-five mortality were significant only in countries with more effective governance. These findings support an emphasis on strengthening PFM as a means of improving health service provision and health outcomes.
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Affiliation(s)
- Yann Tapsoba
- Independent consultant, Ph.D. Health Economics, Ouagadougou, Burkina Faso
| | - Amna Silim
- Independent Consultant, Toronto, Ontario, Canada
| | | | - Hélène Barroy
- World Health Organization, Health Systems Governance and Financing Department, Geneva, Switzerland
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Leopold A, Gimm G, Lee W. Leveraging the Contribution of Volunteers: The Critical Role and Economic Value of Volunteers in Older Americans Act Programs. J Aging Soc Policy 2024; 36:443-459. [PMID: 36153829 DOI: 10.1080/08959420.2022.2127596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/24/2022] [Indexed: 10/14/2022]
Abstract
The United States is facing a surge in the aging population, which will increase the demand for services and supports that allow older adults to age independently. This study assessed the size and value of the volunteer labor force in two home- and community-based programs funded under the Older Americans Act (OAA). Using publicly available program data for fiscal years 2015-2019, we calculated the annual contribution of volunteers, based on the total number of volunteer hours and share of labor effort, and estimated the economic value of volunteers in these OAA programs. In fiscal year 2019, volunteers contributed a total value of $1.7 billion in the OAA Title III program and $14.0 million in the Title VII long-term care ombudsman program. These results highlight the value of volunteers in OAA programs and the need for policies to support volunteers in the aging services network.
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Affiliation(s)
- Anne Leopold
- Senior Program Manager, Research and Evaluation, New Editions Consulting, Inc ., Falls Church, Virginia, USA
| | - Gilbert Gimm
- Associate Professor, Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, USA
| | - Wooju Lee
- Junior Research Analyst, Research and Evaluation, New Editions Consulting, Inc, Falls Church, Virginia, USA
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Che Hassan N, Abdul-Rahman A, Ab. Hamid SN, Mohd Amin SI. What factors affecting investment decision? The moderating role of fintech self-efficacy. PLoS One 2024; 19:e0299004. [PMID: 38635510 PMCID: PMC11025860 DOI: 10.1371/journal.pone.0299004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/04/2024] [Indexed: 04/20/2024] Open
Abstract
This study aims to determine, from the perspective of investors, the factors that predict Islamic unit trust (IUT) investment intentions. Additionally, this paper examines the moderating effect of fintech self-efficacy (FSE) on the relationship between attitude and investment intention. A total of 392 data were collected from IUT investors in Malaysia and analyzed using partial least squares structural equation modeling. The findings reveal that subjective norms have the highest impact on investment intention, followed by attitude and FSE, while religiosity is not significantly associated with investment intention in Islamic unit trust funds. Attitude significantly mediates religiosity-intention and Islamic financial literacy-intention relationships. FSE significantly moderates the attitude-intention relationship. The results shed light on the key factors that increase investing behavior and have direct managerial implications with regard to marketing strategies and target markets. These findings suggest that IUT service providers should take the lead in attracting customers through effective and targeted marketing initiatives, particularly by enhancing customers' FSE and capabilities. This study provides empirical evidence on the interrelationships between Islamic financial literacy, religiosity, and FSE in examining investors' behavior using the Theory of Planned Behavior framework. The study explores the moderating role of FSE on the relationship between attitude and investment intention.
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Affiliation(s)
| | - Aisyah Abdul-Rahman
- Faculty of Economics and Management & Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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Kazungu J, Moturi AK, Kuhora S, Ouko J, Quaife M, Nonvignon J, Barasa E. Examining inequalities in spatial access to national health insurance fund contracted facilities in Kenya. Int J Equity Health 2024; 23:78. [PMID: 38637821 PMCID: PMC11027528 DOI: 10.1186/s12939-024-02171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/03/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Kenya aims to achieve universal health coverage (UHC) by 2030 and has selected the National Health Insurance Fund (NHIF) as the 'vehicle' to drive the UHC agenda. While there is some progress in moving the country towards UHC, the availability and accessibility to NHIF-contracted facilities may be a barrier to equitable access to care. We estimated the spatial access to NHIF-contracted facilities in Kenya to provide information to advance the UHC agenda in Kenya. METHODS We merged NHIF-contracted facility data to the geocoded inventory of health facilities in Kenya to assign facility geospatial locations. We combined this database with covariates data including road network, elevation, land use, and travel barriers. We estimated the proportion of the population living within 60- and 120-minute travel time to an NHIF-contracted facility at a 1-x1-kilometer spatial resolution nationally and at county levels using the WHO AccessMod tool. RESULTS We included a total of 3,858 NHIF-contracted facilities. Nationally, 81.4% and 89.6% of the population lived within 60- and 120-minute travel time to an NHIF-contracted facility respectively. At the county level, the proportion of the population living within 1-hour of travel time to an NHIF-contracted facility ranged from as low as 28.1% in Wajir county to 100% in Nyamira and Kisii counties. Overall, only four counties (Kiambu, Kisii, Nairobi and Nyamira) had met the target of having 100% of their population living within 1-hour (60 min) travel time to an NHIF-contracted facility. On average, it takes 209, 210 and 216 min to travel to an NHIF-contracted facility, outpatient and inpatient facilities respectively. At the county level, travel time to an NHIF-contracted facility ranged from 10 min in Vihiga County to 333 min in Garissa. CONCLUSION Our study offers evidence of the spatial access estimates to NHIF-contracted facilities in Kenya that can inform contracting decisions by the social health insurer, especially focussing on marginalised counties where more facilities need to be contracted. Besides, this evidence will be crucial as the country gears towards accelerating progress towards achieving UHC using social health insurance as the strategy to drive the UHC agenda in Kenya.
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Affiliation(s)
- Jacob Kazungu
- Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya.
| | - Angela K Moturi
- Population & Health Surveillance Group, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | | | - Julia Ouko
- National Health Insurance Fund, Nairobi, Kenya
| | - Matthew Quaife
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Justice Nonvignon
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana
- Health Economics and Financing Programme, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Edwine Barasa
- Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Center for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Van der Spek L, Sonneveld BGJS. Analyzing the impact of an MDG-Fund program on childhood malnutrition in Timor-Leste. J Health Popul Nutr 2024; 43:46. [PMID: 38576057 PMCID: PMC10993443 DOI: 10.1186/s41043-024-00539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Timor-Leste's food insecurity, propelled by political conflicts, a fragile economy and biophysical limitations that characterize mountainous Small Island Developing States (SIDS), is expressed in a high incidence (50%) of stunted children. Hence, the Millennium Development Goals Achievement Fund's Joint Program's (MDG-F JP) in 2009 was a timely intervention to reduce prevalence of underweight among under-fives. Since the impact of the program remains largely unclear, the current study investigates the contributions of the MDG-F JP on improving children's nutritional status in Timor-Leste, in order to inform policymakers on how to make future programs more effective. METHODS Using bivariate analyses and multiple linear regression models we analyzed Demographic and Health Survey (DHS) data from under-fives in 2009-2010 and 2016, combined with spatially explicit data from geographic information systems (GIS). The analyses generated trends and factors associated with undernutrition, which were used in a quasi-experimental setting to compare districts that received the MDG-F JP with similar districts that did not receive MDG-F JP interventions. RESULTS A comprehensive set of factors dependent on seasons, locations, and individuals determine undernutrition in Timor-Leste. A positive impact of the MDG-F JP was found for the average severity of wasting, but not for stunting and underweight. CONCLUSIONS The findings reinforce the pressing need for integrated and cross-sectoral programs, aimed especially at agricultural workers, mothers, and children. The agricultural challenge is to sustainably select, produce and conserve higher-yield and nutrient-rich crops, and educational enhancement should be aligned with local practices and research.
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Affiliation(s)
- L Van der Spek
- Athena Institute, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - B G J S Sonneveld
- Amsterdam Centre for World Food Studies, Athena Institute, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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Loftus TJ, McDowell LD, Upchurch GR. Surgical leadership: Ensuring financial stability through growth. Surgery 2024; 175:1218-1223. [PMID: 37839969 DOI: 10.1016/j.surg.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
Maintaining financial stability is important for leaders in surgery because it (1) allows consistent, fair (market value) reimbursement for employees, which conveys that they are valued; (2) enables strategic investment in new programs that may not generate direct financial gains but are required; and (3) builds trust with stakeholders outside the department while strengthening the department's position in negotiations. Key strategies that we have used to increase revenue (income) over the past 6 years have been hiring more faculty, advocating for greater operating room and staffing capacity, staffing surgeons at other institutions using affiliation agreements, attempting to shift grant-funded efforts to non-clinical (research) faculty to mitigate National Institutes of Health salary cap penalties, and increasing efforts to identify external funding for educational and administrative tasks performed by surgeons (eg, increasing contact hours with medical students to secure a greater proportion of state general revenue). Using these strategies, our total revenue has increased 66% over the past 6 years, whereas Academic Support Agreement funds from the College of Medicine concurrently have decreased by 75%. Key strategies that we have used for curtailing expenses have been increasing clinic workflow efficiency; shifting advance practice provider contractual expenses and trainee indirect costs to the hospital; focusing on driving down delayed accounts receivable over time; and using net collections to preferentially invest in research likely to receive future external funding, for which indirect costs return to the department. Despite using these strategies, the total expenses of our department have increased 74% over the past 6 years, driven primarily by the doubling of clinic costs and contractual expenses for advance practice providers. These losses could theoretically be offset by (1) increasing billing by advance practice providers who can also facilitate excellent continuity of surgical care while allowing residents and fellows to shift their effort from service toward education and (2) increasing clinic capacity to generate increasing operative volumes. A department's financial stability is affected by complex interactions among several stakeholders, including the College of Medicine, faculty group practices, and hospitals, with competing interests. Leaders in surgery must understand and manage major categories of revenue and expenses to create a financially stable environment in which they can fulfill their multi-prong missions.
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Affiliation(s)
- Tyler J Loftus
- Department of Surgery, University of Florida Health, Gainesville, FL. https://twitter.com/_TylerLoftus
| | - Lonn D McDowell
- Department of Surgery, University of Florida Health, Gainesville, FL
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Osei Afriyie D, Loo PS, Kuwawenaruwa A, Kassimu T, Fink G, Tediosi F, Mtenga S. Understanding the role of the Tanzania national health insurance fund in improving service coverage and quality of care. Soc Sci Med 2024; 347:116714. [PMID: 38479141 DOI: 10.1016/j.socscimed.2024.116714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/19/2024] [Accepted: 02/20/2024] [Indexed: 04/20/2024]
Abstract
Health insurance is one of the main financing mechanisms currently being used in low and middle-income countries to improve access to quality services. Tanzania has been running its National Health Insurance Fund (NHIF) since 2001 and has recently undergone significant reforms. However, there is limited attention to the causal mechanisms through which NHIF improves service coverage and quality of care. This paper aims to use a system dynamics (qualitative) approach to understand NHIF causal pathways and feedback loops for improving service coverage and quality of care at the primary healthcare level in Tanzania. We used qualitative interviews with 32 stakeholders from national, regional, district, and health facility levels conducted between May to July 2021. Based on the main findings and themes generated from the interviews, causal mechanisms, and feedback loops were created. The majority of feedback loops in the CLDs were reinforcing cycles for improving service coverage among beneficiaries and the quality of care by providers, with different external factors affecting these two actions. Our main feedback loop shows that the NHIF plays a crucial role in providing additional financial resources to facilities to purchase essential medical commodities to deliver care. However, this cycle is often interrupted by reimbursement delays. Additionally, beneficiaries' perception that lower-level facilities have poorer quality of care has reinforced care seeking at higher-levels. This has decreased lower level facilities' ability to benefit from the insurance and improve their capacity to deliver quality care. Another key finding was that the NHIF funding has resulted in better services for insured populations compared to the uninsured. To increase quality of care, the NHIF may benefit from improving its reimbursement administrative processes, increasing the capacity of lower levels of care to benefit from the insurance and appropriately incentivizing providers for continuity of care.
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Affiliation(s)
- Doris Osei Afriyie
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Switzerland; University of Basel, Switzerland.
| | - Pei Shan Loo
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Switzerland; University of Basel, Switzerland.
| | - August Kuwawenaruwa
- Health Systems, Impact Evaluation and Policy Group, Ifakara Health Institute, Dar Es Salaam, United Republic of Tanzania.
| | - Tani Kassimu
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Switzerland; University of Basel, Switzerland; Health Systems, Impact Evaluation and Policy Group, Ifakara Health Institute, Dar Es Salaam, United Republic of Tanzania.
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Switzerland; University of Basel, Switzerland.
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Switzerland; University of Basel, Switzerland.
| | - Sally Mtenga
- Health Systems, Impact Evaluation and Policy Group, Ifakara Health Institute, Dar Es Salaam, United Republic of Tanzania; Institute of Health and Wellbeing, University of Glasgow, Ireland, UK.
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de Souza Sá ÁR, Santos Branco DK. Social fund and infant mortality: Evidence from an anti-poverty policy in Northeast Brazil. Health Econ 2024; 33:674-695. [PMID: 38148733 DOI: 10.1002/hec.4785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 10/12/2023] [Accepted: 10/19/2023] [Indexed: 12/28/2023]
Abstract
This paper evaluates the effects of a social fund that meets the needs of the poor in Northeast Brazil, the Fundos Estaduais de Combate e Erradicação da Pobreza (FECEP). The program could have improved infant health by reducing poverty and improving access to health care, sanitation, food, and housing. Using a difference-in-differences approach robust to heterogeneous treatment effects, we confirm that the program has effectively reduced poverty in treated areas. Furthermore, we document that this poverty reduction is associated with a significant decline in infant mortality. These findings provide consistent evidence that targeted public investments can improve living conditions in vulnerable regions.
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Harrington C, Mollot R, Braun RT, Williams D. United States' Nursing Home Finances: Spending, Profitability, and Capital Structure. Int J Soc Determinants Health Health Serv 2024; 54:131-142. [PMID: 38115716 PMCID: PMC10955796 DOI: 10.1177/27551938231221509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/12/2023] [Accepted: 11/06/2023] [Indexed: 12/21/2023]
Abstract
Little is known about nursing home (NH) financial status in the United States even though most NH care is publicly funded. To address this gap, this descriptive study used 2019 Medicare cost reports to examine NH revenues, expenditures, net income, related-party expenses, expense categories, and capital structure. After a cleaning process for all free-standing NHs, a study population of 11,752 NHs was examined. NHs had total net revenues of US$126 billion and a profit of US$730 million (0.58%) in 2019. When US$6.4 billion in disallowed costs and US$3.9 billion in non-cash depreciation expenses were excluded, the profit margin was 8.84 percent. About 77 percent of NHs reported US$11 billion in payments to related-party organizations (9.54% of net revenues). Overall spending for direct care was 66 percent of net revenues, including 27 percent on nursing, in contrast to 34 percent spent on administration, capital, other, and profits. Finally, NHs had long-term debts that outweighed their total available financing. The study shows the value of analyzing cost reports. It indicates the need to ensure greater accuracy and completeness of cost reports, financial transparency, and accountability for government funding, with implications for policy changes to improve rate setting and spending limits.
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Affiliation(s)
- Charlene Harrington
- Department of Social & Behavioral Sciences, University of California, San Francisco, CA, USA
| | | | | | - Dunc Williams
- Department of Health Care Leadership and Management, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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Hawn MT. Philanthropic support of academic programs. Surgery 2024; 175:1250-1251. [PMID: 38281853 DOI: 10.1016/j.surg.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/30/2024]
Abstract
Academic surgical departments must subsidize the research mission, as most funded research does not fully support the faculty effort and true costs of the investigation. Most departments support their research program with the margin from clinical revenue; however, increased pressure on clinical income poses a challenge to this strategy. Philanthropy is an increasingly important revenue source to fund academic missions. The opportunities and challenges of this funding source are discussed in this article.
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Affiliation(s)
- Mary T Hawn
- Stanford University School of Medicine, Stanford, CA.
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Wang F, Zhou X, Gan T. Can green funds improve corporate environmental, social, and governance performance? Evidence from Chinese-listed companies. PLoS One 2024; 19:e0301395. [PMID: 38547225 PMCID: PMC10977774 DOI: 10.1371/journal.pone.0301395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
Green funds play pivotal roles in driving corporate sustainable development. Utilizing data from Chinese publicly listed companies from 2010 to 2021, we examine the impact of green funds on corporate environmental, social, and governance (ESG) performance and the underlying mechanisms. The research findings claim that green funds positively affect corporate ESG performance. Mechanism analysis systematically demonstrates that green funds contribute to elevated corporate ESG performance by alleviating financial constraints, enhancing managerial efficiency, and fostering green innovation. Heterogeneity analysis further underscores that the effect of green funds is particularly potent in companies with high external attention. Furthermore, green funds also play significant roles in production capabilities and economic value. This research enriches the micro-level evidence on the development of green funds and furnishes substantial implications for sustainable development.
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Affiliation(s)
- Fangjun Wang
- School of Business, Ningbo University, Ningbo, China
| | - Xinmiao Zhou
- School of Business, Ningbo University, Ningbo, China
| | - Tian Gan
- School of Business, East China University of Science and Technology, Shanghai, China
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12
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Rosenstock TS, Yet B. Statistical modelling of determinants of child stunting using secondary data and Bayesian networks: a UKRI Global Challenges Research Fund (GCRF) Action Against Stunting Hub protocol paper. BMJ Paediatr Open 2024; 8:e001983. [PMID: 38519063 PMCID: PMC10961555 DOI: 10.1136/bmjpo-2023-001983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/11/2024] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION Several factors have been implicated in child stunting, but the precise determinants, mechanisms of action and causal pathways remain poorly understood. The objective of this study is to explore causal relationships between the various determinants of child stunting. METHODS AND ANALYSIS The study will use data compiled from national health surveys in India, Indonesia and Senegal, and reviews of published evidence on determinants of child stunting. The data will be analysed using a causal Bayesian network (BN)-an approach suitable for modelling interdependent networks of causal relationships. The model's structure will be defined in a directed acyclic graph and illustrate causal relationship between the variables (determinants) and outcome (child stunting). Conditional probability distributions will be generated to show the strength of direct causality between variables and outcome. BN will provide evidence of the causal role of the various determinants of child stunning, identify evidence gaps and support in-depth interrogation of the evidence base. Furthermore, the method will support integration of expert opinion/assumptions, allowing for inclusion of the many factors implicated in child stunting. The development of the BN model and its outputs will represent an ideal opportunity for transdisciplinary research on the determinants of stunting. ETHICS AND DISSEMINATION Not applicable/no human participants included.
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Affiliation(s)
| | - Barbaros Yet
- Department of Cognitive Science, Graduate School of Informatics, Middle East Technical University, Ankara, Turkey
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13
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Wang X, Wang R, Zhang Y. Cross-asset momentum and the hybrid fund transmission mechanism in China's stock and bond markets. PLoS One 2024; 19:e0300781. [PMID: 38512872 PMCID: PMC10956777 DOI: 10.1371/journal.pone.0300781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
The allocation of assets across different markets is a crucial element of investment strategy. In this regard, stocks and bonds are two significant assets that form the backbone of multi-asset allocation. Among publicly offered funds (The publicly offered funds in China correspond to the mutual funds in the United States, with different names and details in terms of legal form and sales channels), the stock-bond hybrid fund gives investors a return while minimizing the risk through capital flow between the stock and bond markets. Our research on China's financial market data from 2006 to 2022 reveals a cross-asset momentum between the stock and bond markets. We find that the momentum in the stock market negatively influences the bond market's return, while the momentum in the bond market positively influences the stock market's return. Portfolios that exploit cross-asset momentum have excess returns that other asset pricing factors cannot explain. Our analysis reveals that hybrid funds play an intermediary role in the transmission mechanism of cross-asset momentum. We observe that the more flexible the asset allocation ratio of the fund, the more crucial the intermediary role played by the fund. Hence, encouraging the development of hybrid funds and relaxing restrictions on asset allocation ratios could improve liquidity and pricing efficiency. These findings have significant implications for investors seeking to optimize their asset allocation across different markets and for policymakers seeking to enhance the efficiency of China's financial market.
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Affiliation(s)
- Xiaowei Wang
- School of Economics, Xihua University, Chengdu, Sichuan, China
| | - Rui Wang
- School of Economics, Xihua University, Chengdu, Sichuan, China
| | - Yichun Zhang
- School of Economics, Xiamen University, Xiamen, Fujian, China
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Limb M. Tackling poverty should have equal priority with lowering waiting lists, says King's Fund. BMJ 2024; 384:q674. [PMID: 38499290 DOI: 10.1136/bmj.q674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
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Abstract
Investor pledges $1 million for science whistleblowers.
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Sarangarajan R, Ewuoso C. Does the South African government have a duty to fund influenza vaccination of adults 65 years and older? Front Public Health 2024; 12:1303949. [PMID: 38510358 PMCID: PMC10950910 DOI: 10.3389/fpubh.2024.1303949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
In this paper, we draw on the thinking about solidarity, reciprocity and distributive justice grounded in Afro-communitarian ethics from the Global South to argue for institutions, particularly the South African (SA) government, have a prima facie duty to foster influenza vaccine uptake for adults 65 years and older. Although we focus specifically on the South African government to defend our position, we believe that our argument extends to all governments. Notably, these duties are that the SA government ought to make influenza vaccines freely available for the older adult in both the public and private health facilities, provided financial allocation and their extant relationships allow for this. Further, the SA government has a duty to improve influenza vaccine procurement and availability in the country, preferably through increasing manufacturing capabilities. This paper is intrinsically valuable to promote epistemic justice, thereby contributing toward the decolonization of the global healthcare system. Moreover, this project has social significance in contributing to mitigation efforts against future public health challenges associated with population aging in resource-limited developing African nations, wherein the impact of population transition will be felt most.
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Affiliation(s)
- Ruach Sarangarajan
- Steve Biko Center for Bioethics, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa
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17
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Hübner V, Staab M, Hilbe C, Chatterjee K, Kleshnina M. Efficiency and resilience of cooperation in asymmetric social dilemmas. Proc Natl Acad Sci U S A 2024; 121:e2315558121. [PMID: 38408249 DOI: 10.1073/pnas.2315558121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
Direct reciprocity is a powerful mechanism for cooperation in social dilemmas. The very logic of reciprocity, however, seems to require that individuals are symmetric, and that everyone has the same means to influence each others' payoffs. Yet in many applications, individuals are asymmetric. Herein, we study the effect of asymmetry in linear public good games. Individuals may differ in their endowments (their ability to contribute to a public good) and in their productivities (how effective their contributions are). Given the individuals' productivities, we ask which allocation of endowments is optimal for cooperation. To this end, we consider two notions of optimality. The first notion focuses on the resilience of cooperation. The respective endowment distribution ensures that full cooperation is feasible even under the most adverse conditions. The second notion focuses on efficiency. The corresponding endowment distribution maximizes group welfare. Using analytical methods, we fully characterize these two endowment distributions. This analysis reveals that both optimality notions favor some endowment inequality: More productive players ought to get higher endowments. Yet the two notions disagree on how unequal endowments are supposed to be. A focus on resilience results in less inequality. With additional simulations, we show that the optimal endowment allocation needs to account for both the resilience and the efficiency of cooperation.
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Affiliation(s)
- Valentin Hübner
- Institute of Science and Technology Austria, Klosterneuburg 3400, Austria
| | - Manuel Staab
- School of Economics, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Christian Hilbe
- Max Planck Research Group Dynamics of Social Behavior, Max Planck Institute for Evolutionary Biology, Plön 24306, Germany
| | | | - Maria Kleshnina
- Institute for Advanced Study in Toulouse, Toulouse 31000, France
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18
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Gaidarov GM, Alekseevskaya TI, Demidova TV, Sofronov OY. [The financial activity of district hospitals of the Irkutsk general-governorship in the end of XIX century]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2024; 32:267-276. [PMID: 38640224 DOI: 10.32687/0869-866x-2024-32-2-267-276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/02/2023] [Indexed: 04/21/2024]
Abstract
The article presents results of the study of archive sources and reference publications. The unknown facts of subsidization of district hospitals of the Irkutsk general-governorship, items and amount of current and supernumerary expenses and sources of financial allocations are revealed. The scope of financial accountability made up by directors and hospital supervisors, office and council of hospitals as well care of charge of patients is impressive. The concrete data concerning food allowance of employees and servants of civilian hospitals and provision of clothing and salaries is presented. The prices of bread, forage and goods permit to evaluate income level of physicians working in the Eastern Siberia. The role of the Department of Public Charity in financing of civil hospitals of the Irkutsk general-governorship in last third of the XIX century is revealed. The article uses terminology corresponding to analyzed time period.
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Affiliation(s)
- G M Gaidarov
- The Federal State Budget Educational Institution of Higher Education "The Irkutsk State Medical University" of Minzdrav of Russia, 664003, Irkutsk, Russia
| | - T I Alekseevskaya
- The Federal State Budget Educational Institution of Higher Education "The Irkutsk State Medical University" of Minzdrav of Russia, 664003, Irkutsk, Russia,
| | - T V Demidova
- The Federal State Budget Educational Institution of Higher Education "The Irkutsk State Medical University" of Minzdrav of Russia, 664003, Irkutsk, Russia
| | - O Yu Sofronov
- The Federal State Budget Educational Institution of Higher Education "The Irkutsk State Medical University" of Minzdrav of Russia, 664003, Irkutsk, Russia
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Gao Y, Hoepner AGF. Virtues of impact financing: Do financial institutions benefit from considering the environmental impact on financing decisions? J Environ Manage 2024; 354:120259. [PMID: 38350274 DOI: 10.1016/j.jenvman.2024.120259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/15/2024]
Abstract
The impact investing literature largely focuses on private equity investing and overlooks the investments made through debt financing that actually dominate the market. To address this research gap, this paper investigates whether impact financing is associated with financial benefits. By using COVID-19 as an exogenous shock to China's stock market, this paper applies fixed effects panel data analysis with a difference-in-differences research design to provide robust empirical outcomes. The results reveal those financial institutions that better integrated environmental impacts into their financing process experienced positive stock return changes in response to the shock. This study answers the question of how well an impact scales. The findings suggest that impact financing is an effective model, as the impacts incorporated in the debt can be scaled up compared to impact investing funds with low volumes. Impact financing has enormous potential for financial institutions to engage in the green transition since they can derive pecuniary utility while delivering environmental impacts. The revelation of financial benefits also contributes to overcoming the lack of knowledge about impact financing and helps to remove the barriers that advance industry growth.
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Affiliation(s)
| | - Andreas G F Hoepner
- Michael Smurfit Graduate Business School, University College Dublin, Carysfort Avenue, Blackrock, Co. Dublin, Ireland Platform on Sustainable Finance, DG FISMA, European Commission, Brussels, Belgium
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20
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Fell M, Chadha A, van Eeden S. Are NHS cleft services in England ready for delegation to integrated care systems? Br Dent J 2024; 236:443-446. [PMID: 38519672 DOI: 10.1038/s41415-024-7172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 03/25/2024]
Abstract
Cleft care services in the UK have been nationally funded since centralisation 25 years ago and during this time have been able to demonstrate improved clinical outcomes. Integrated care systems have been introduced into legislature as part of the Health Care Act of 2022 and will be responsible for the paradigm shift of allocating funds on a regional basis for cleft care services in England from 2024. The proposed population-based funding formulas present an opportunity to improve current inequities in cleft care, including access to speech therapy and adult services. However, the regional footprint of integrated care systems does not align with that of the centralised cleft service system and represents a threat to the standardised patient-centred care that has taken two decades to build. Awareness needs to be raised so that cleft care providers can proactively adapt to this mandatory change to service funding to ensure that clinical standards are maintained and continue to improve.
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Affiliation(s)
- Matthew Fell
- Cleft Collective, University of Bristol, UK; Spires Cleft Centre, Oxford and Salisbury, UK.
| | - Ambika Chadha
- Cleft.Net.East, Addenbrookes Hospital, Cambridge University NHS Hospitals Trust, UK; Department of Perinatal Imaging, King´s College London, UK
| | - Simon van Eeden
- Alder Hey Children´s and Aintree University Hospitals, Liverpool, UK
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21
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Wangler J, Jansky M. Experiences with Innovation Fund healthcare models in primary care: a qualitative study amongst German general practitioners. Wien Med Wochenschr 2024; 174:53-60. [PMID: 35503146 PMCID: PMC10896771 DOI: 10.1007/s10354-022-00935-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022]
Abstract
The Innovation Fund was set up in 2015 with the aim of improving medical care in the German statutory health insurance system. Primary care needs to be involved in testing interventions and new forms of care for effectiveness and inclusion in standard care. There has so far been hardly any research on how far Innovation Fund models accommodate the primary care setting, or on the experience general practitioners have had with these models. Between September 2021 and January 2022, 36 semi-standardized individual interviews were performed with general practitioners who had already participated in Innovation Fund projects. Eleven regional physician networks in Rhineland-Palatinate, Hesse, North Rhine-Westphalia, and Schleswig-Holstein were involved in the recruitment process. Most of the interviewees associated the Innovation Fund with potential and opportunity including intensification of application-oriented healthcare research, independent financing, and general healthcare involvement. Even so, many general practitioners were unsure as to how far primary care in particular would stand to benefit from the Innovation Fund in the long term. A mostly positive balance was drawn from participation in care models-benefit of intervention as well as cost-benefit ratio. However, some also reported hurdles and stress factors such as documentation requirements and disruption in everyday office routine. Innovation Fund projects will need to be suitable for general practitioners especially regarding medical decision-making leeway, limits to documentation requirements, preserving established office routine, greater involvement in research planning, and improvements to the primary care setting to encourage willingness to participate in Innovation Fund projects amongst general practitioners.
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Affiliation(s)
- Julian Wangler
- Centre for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany.
| | - Michael Jansky
- Centre for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany
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Gulzar R, Bhat AA, Mir AA, Athari SA, Al-Adwan AS. Green banking practices and environmental performance: navigating sustainability in banks. Environ Sci Pollut Res Int 2024; 31:23211-23226. [PMID: 38413528 DOI: 10.1007/s11356-024-32418-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/07/2024] [Indexed: 02/29/2024]
Abstract
The growing concerns about global climate change have thrust green banking and green finance into the forefront of discussions. The research suggests that green banking plays a pivotal role in advancing environmental sustainability. This study focuses on examining the profound impact of green banking practices on the environmental performance of banks, with a specific focus on both private and public sector banks operating in India through a survey involving 500 bank employees the study employed partial least squares structural equation modelling (PLS-SEM). The findings highlight various aspects of green banking, encompassing employee-related practices, operational procedures, customer engagement, and policy adherence, and significantly contribute to the promotion of green finance, resulting in substantial positive effects. Moreover, the study underscores the substantial and positive influence of banks' green financing on their environmental performance. Interestingly, the operational features of green banking practices emerged as having a notable impact on banks' environmental performance, whereas aspects related to employees, policies, and customers did not directly and significantly influence environmental performance. The results of the study carry significant policy implications, especially for India's banking sector, in the pursuit of environmental sustainability.
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Affiliation(s)
| | - Aijaz Ahmad Bhat
- Department of Management Studies, University of Kashmir, Srinagar, J&K, India.
| | - Ajaz Akbar Mir
- Department of Management Studies, University of Kashmir, Srinagar, J&K, India
| | - Seyed Alireza Athari
- Department of Business Administration, Faculty of Economics and Administrative Sciences, Cyprus International University, Northern Cyprus, Turkey
| | - Ahmad Samed Al-Adwan
- Department of Business Technology, Business School, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
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23
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Malcomson FC, Parra-Soto S, Lu L, Ho F, Celis-Morales C, Sharp L, Mathers JC. Socio-demographic variation in adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations within the UK Biobank prospective cohort study. J Public Health (Oxf) 2024; 46:61-71. [PMID: 37986550 PMCID: PMC10901269 DOI: 10.1093/pubmed/fdad218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 08/22/2023] [Accepted: 10/15/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The 2018 (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are evidence-based lifestyle recommendations which aim to reduce the risk of cancer worldwide. Sociodemographic factors modulate lifestyle behaviours, and both cancer incidence and survival are socio-economically patterned. We investigated adherence to these recommendations and examined patterns of adherence across sociodemographic subgroups in the UK Biobank cohort. METHODS We included 158 415 UK Biobank participants (mean age 56 years, 53% female). Total adherence scores were derived from dietary, physical activity and anthropometric data using the 2018 WCRF/AICR standardized scoring system. One-Way analysis of variance (ANOVA) was used to test for differences in total scores and in values for individual score components according to sociodemographic factors and Pearson's Χ2 test to investigate associations between sociodemographic factors according to tertiles of adherence score. RESULTS Mean total adherence score was 3.85 points (SD 1.05, range 0-7 points). Higher total scores were observed in females, and older (>57 years), Chinese or South Asian, and more educated participants. We found significant variations in adherence to individual recommendations by sociodemographic factors including education, Townsend deprivation index and ethnicity. CONCLUSIONS Identifying and understanding lifestyle and dietary patterns according to sociodemographic factors could help to guide public health strategies for the prevention of cancers and other non-communicable diseases.
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Affiliation(s)
- Fiona C Malcomson
- Faculty of Medical Sciences, Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Faculty of Medical Sciences, Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Solange Parra-Soto
- College of Medical, Veterinary and Life Sciences, School of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
- College of Medical, Veterinary and Life Sciences, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Liya Lu
- Faculty of Medical Sciences, Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Frederick Ho
- College of Medical, Veterinary and Life Sciences, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Carlos Celis-Morales
- College of Medical, Veterinary and Life Sciences, School of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Faculty of Medical Sciences, Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - John C Mathers
- Faculty of Medical Sciences, Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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24
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Messori A, Trippoli S, Marinai C. In-hospital expenditure for medical devices in relation to funds from diagnosis-related groups and ambulatory activity: temporal trend from 2019 to 2022. Eur J Hosp Pharm 2024; 31:179-180. [PMID: 36822845 PMCID: PMC10895170 DOI: 10.1136/ejhpharm-2023-003723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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25
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Rimmer A. Fund "broken" mental health services based on current need, demands BMA. BMJ 2024; 384:q447. [PMID: 38378194 DOI: 10.1136/bmj.q447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
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Shimokihara S, Ikeda Y, Matsuda F, Tabira T. Association of mobile device proficiency and subjective cognitive complaints with financial management ability among community-dwelling older adults: a population-based cross-sectional study. Aging Clin Exp Res 2024; 36:44. [PMID: 38367133 PMCID: PMC10874308 DOI: 10.1007/s40520-024-02697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/03/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Mobile devices have been used by many older adults and have the potential to assist individuals with subjective cognitive complaints (SCCs) in daily living tasks. Financial management is one of the most complex daily activity for older adults, as it is easily impaired in the prodromal stage of dementia and cognitive impairment. AIM To investigate financial management ability among older adults from SCCs and mobile device proficiency. METHODS A self-administered questionnaire was sent to 529 participants who were ≥ 65 years and regularly use mobile devices. Participants were divided into four groups based on SCC prevalence and scores of the Mobile Device Proficiency Questionnaire (MDPQ-16). Financial management abilities were compared between groups using the Process Analysis of Daily Activities for Dementia subscale. Regression model and crosstabulation table were used to investigate associations in detail. RESULTS A significant difference in financial management ability was observed among the four groups (p < 0.001), with the dual impairment group showed significantly lower than the robust and SCC groups (p < 0.001). Educational history, sex, and MDPQ-16 score were significantly associated with participants' financial management ability (p ≤ 0.01). The proportion of participants who could use ATMs and electronic money independently was significantly lower among those with low proficiency in mobile devices (LPM), regardless of SCC (p < 0.05). CONCLUSION The LPM group showed an impaired ability to manage their finances, particularly in situations where they would use information devices. Therefore, healthcare professionals should assess not only the SCC but also their proficiency with mobile devices to predict their impairment in activities of daily living.
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Affiliation(s)
- Suguru Shimokihara
- Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan.
- Research Fellowship for Young Scientists, Japan Society for the Promotion of Science, 5-3-1, Kojimachi, Chiyoda-Ku, Tokyo, 102-0083, Japan.
| | - Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Fumiyo Matsuda
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
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Burgdorf CE, Riley WT, Akbar F, Zuehlke AD, Bibb K, Eshleman HD, Shah A, Belis D, Spittel M, Fearon P. Analysis of the health economics portfolio funded by the National Institutes of Health in response to published guidance. PLoS One 2024; 19:e0284235. [PMID: 38354126 PMCID: PMC10866517 DOI: 10.1371/journal.pone.0284235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Health services, economics, and outcomes research (referred to as health economics research hereinafter) is one of the interdisciplinary sciences that the National Institutes of Health (NIH) supports in order to pursue its overall mission to improve health. In 2015, NIH guidance was published to clarify the type of health economics research that NIH would continue to fund. This analysis aimed to determine if there were changes in the number of health economics applications received and funded by NIH after the release of the guidance. Health economics applications submitted to NIH both before and after publication of the guidance were identified using a machine learning approach with input from subject matter experts. Application and funding trends were examined by fiscal year, method of application (solicited vs. unsolicited), and activity code. This study found that application and funding rates of health economics research were decreasing prior to guidance. Following publication of this guidance, the application and funding rate of health economics applications increased.
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Affiliation(s)
- Caitlin E. Burgdorf
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - William T. Riley
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Farheen Akbar
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Abbey D. Zuehlke
- Lexical Intelligence, Rockville, Maryland, United States of America
| | - Katrina Bibb
- Lexical Intelligence, Rockville, Maryland, United States of America
| | | | - Ami Shah
- Lexical Intelligence, Rockville, Maryland, United States of America
| | - Deshiree Belis
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Michael Spittel
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Paula Fearon
- Lexical Intelligence, Rockville, Maryland, United States of America
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Huang A, Zhao Y, Cao C, Lyu M, Tang K. Development assistance, donor-recipient dynamic, and domestic policy: a case study of two health interventions supported by World Bank-UK and Global Fund in China. Glob Health Res Policy 2024; 9:7. [PMID: 38310321 PMCID: PMC10838425 DOI: 10.1186/s41256-024-00344-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND This study views sustainability after the exit of development assistance for health (DAH) as a shared responsibility between donors and recipients and sees transitioning DAH-supported interventions into domestic health policy as a pathway to this sustainability. It aims to uncover and understand the reemergent aspects of the donor-recipient dynamic in DAH and how they contribute to formulating domestic health policy and post-DAH sustainability. METHODS We conducted a case study on two DAH-supported interventions: medical financial assistance in the Basic Health Services Project supported by the World Bank and UK (1998-2007) and civil society engagement in the HIV/AIDS Rolling Continuation Channel supported by the Global Fund (2010-2013) in China. From December 2021 to December 2022, we analyzed 129 documents and interviewed 46 key informants. Our data collection and coding were guided by a conceptual framework based on Walt and Gilson's health policy analysis model and the World Health Organization's health system building blocks. We used process tracing for analysis. RESULTS According to the collected data, our case study identified three reemergent, interrelated aspects of donor-recipient dynamics: different preferences and compromise, partnership dialogues, and responsiveness to the changing context. In the case of medical financial assistance, the dynamic was characterized by long-term commitment to addressing local needs, on-site mutual learning and understanding, and local expertise cultivation and knowledge generation, enabling proactive responses to the changing context. In contrast, the dynamic in the case of HIV/AIDS civil society engagement marginalized genuine civil society engagement, lacked sufficient dialogue, and exhibited a passive response to the context. These differences led to varying outcomes in transnational policy diffusion and sustainability of DAH-supported interventions between the cases. CONCLUSIONS Given the similarities in potential alternative factors observed in the two cases, we emphasize the significance of the donor-recipient dynamic in transnational policy diffusion through DAH. The study implies that achieving post-DAH sustainability requires a balance between donor priorities and recipient ownership to address local needs, partnership dialogues for mutual understanding and learning, and collaborative international-domestic expert partnerships to identify and respond to contextual enablers and barriers.
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Affiliation(s)
- Aidan Huang
- Vanke School of Public Health, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, China
- Institute for International and Area Studies, Tsinghua University, Beijing, China
| | - Yingxi Zhao
- Vanke School of Public Health, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, China
- Department of Medicine, University of Oxford, Nuffield Oxford, UK
| | - Chunkai Cao
- Vanke School of Public Health, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, China
| | - Mohan Lyu
- Vanke School of Public Health, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, China.
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Van den Broeck K, Bielen L, Maelstaf H, Van Roy K, Versele A. Well-being Effects of a Subsidy Retention Fund for Renovation of Dwellings of Locked-in Owners in Ghent. J Urban Health 2024; 101:170-180. [PMID: 38347275 PMCID: PMC10897071 DOI: 10.1007/s11524-023-00793-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 02/28/2024]
Abstract
With its subsidy retention fund, the city of Ghent targets homeowners, who live in a dwelling of bad quality and do not have the resources to renovate or move out. Being in this no-choice situation, they are locked-in homeowners. Through this innovative policy instrument, Ghent aims to improve the quality of its housing stock targeting households who may not take up other renovation-encouraging instruments. To reach the households who would otherwise not be able to renovate, important efforts in outreaching and offering technical and social guidance accompany the renovation subsidy. Guidance activities substantially increase the cost of the instrument, but in reaching the households living in bad-quality houses, it has the potential to create major benefits not only technically but also socially as housing quality is related to well-being. Generally, the identification of a causal relationship is difficult as well-being and its mediators are complex matters. This case offered a unique opportunity to collect information from the beneficiaries on a range of well-being domains both before the renovation of their dwelling and after the renovation. Even though the research was restricted to short-term effects, the results suggest that improvements in different domains of well-being can be linked to the improvement of housing quality. These improvements in well-being in Ghent show that (local) government spending in housing renovation of locked-in homeowners can be an instrument to achieve social progress.
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Affiliation(s)
| | - Leontien Bielen
- Faculty of Engineering Technology, Building Physics & Sustainable Design, KU Leuven, Technology Campus Ghent, Ghent, Belgium
| | - Hilde Maelstaf
- Department of Health and Well-Being, Artesis Plantijn Hogeschool Antwerpen, Noorderplaats 2, 2000, Antwerp, Belgium
| | - Kaatje Van Roy
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Alexis Versele
- Faculty of Engineering Technology, Building Physics & Sustainable Design, KU Leuven, Technology Campus Ghent, Ghent, Belgium
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Daoud A, Johansson FD. The impact of austerity on children: Uncovering effect heterogeneity by political, economic, and family factors in low- and middle-income countries. Soc Sci Res 2024; 118:102973. [PMID: 38336420 DOI: 10.1016/j.ssresearch.2023.102973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 07/26/2023] [Accepted: 12/07/2023] [Indexed: 02/12/2024]
Abstract
Which children are most vulnerable when their government imposes austerity? Research tends to focus on either the political-economic level or the family level. Using a sample of nearly two million children in 67 countries, this study synthesizes theories from family sociology and political science to examine the heterogeneous effects on child poverty of economic shocks following the implementation of an International Monetary Fund (IMF) program. To discover effect heterogeneity, we apply machine learning to policy evaluation. We find that children's average probability of falling into poverty increases by 14 percentage points. We find substantial effect heterogeneity, with family wealth and governments' education spending as the two most important moderators. In contrast to studies that emphasize the vulnerability of low-income families, we find that middle-class children face an equally high risk of poverty. Our results show that synthesizing family and political factors yield deeper knowledge of how economic shocks affect children.
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Affiliation(s)
- Adel Daoud
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Boston MA, USA; Institute for Analytical Sociology, Linköping University, Sweden; The Division of Data Science and Artificial Intelligence, The Department of Computer Science and Engineering, Chalmers University of Technology, Sweden.
| | - Fredrik D Johansson
- The Division of Data Science and Artificial Intelligence, The Department of Computer Science and Engineering, Chalmers University of Technology, Sweden
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Theaker S. BDA Benevolent Fund articles. Br Dent J 2024; 236:147-148. [PMID: 38332060 DOI: 10.1038/s41415-024-7090-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/10/2024]
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Baraniuk C. Northern Ireland's doctors are relieved as Stormont is set to return-but will funds go far enough? BMJ 2024; 384:q270. [PMID: 38296346 DOI: 10.1136/bmj.q270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
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Limb M. Give mayors the power and funds to tackle areas of poor health says commission. BMJ 2024; 384:q143. [PMID: 38242583 DOI: 10.1136/bmj.q143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
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Wahdi AE, Sutanto E, Setyawan A, Astrini YP, Adani N, Mardani H, Maulana N, Pattnaik A, Trihono T, Wilopo SA. National health insurance contribution to family planning program funding in Indonesia: A fund flow analysis. Gates Open Res 2024; 7:105. [PMID: 38605912 PMCID: PMC11006955 DOI: 10.12688/gatesopenres.14642.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 04/13/2024] Open
Abstract
Background Launched in 2014, Indonesia's national health insurance system (JKN) aimed to provide universal health coverage, including contraceptive services, to its population. We aim to evaluate the contribution of JKN to the overall spending for the family planning program in Indonesia. Methods Data from the Indonesian Demographic Health Survey, Survey on Financial Flows for Family Planning, Indonesia Motion Tracker Matrix, World Population Prospect, and Indonesian ministries' budget accountability reports were entered into the CastCost Contraceptive Projection Tool to define budgetary allocation and spending for the family planning program at the national level in 2019. Results Indonesia's family planning program in 2019 was financed mostly by the national budget (64.0%) and out-of-pocket payments (34.6%). There were three main ministries responsible for family planning financing: the National Population and Family Planning Board (BKKBN) (35.8%), the Ministry of Finance (26.2%), and the Ministry of Health (2.0%). Overall, JKN contributed less than 0.4% of the funding for family planning services in Indonesia in 2019. The majority of family planning spending was by public facilities (57.3%) as opposed to private facilities (28.6%). Conclusion JKN's contribution to funding Indonesia's family planning programs in 2019 was low and highlights a huge opportunity to expand these contributions. A coordinated effort should be conducted to identify possible opportunities to realign BKKBN and JKN roles in the family planning programs and lift barriers to accessing family planning services in public and private facilities. This includes a concerted effort to improve integration of private family planning providers into the JKN program.
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Affiliation(s)
- Amirah Ellyza Wahdi
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health & Nursing, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, 55281, Indonesia
- Center for Reproductive Health, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, 55281, Indonesia
| | - Edward Sutanto
- ThinkWell, Central Jakarta, Jakarta Special Capital District, 10350, Indonesia
| | - Althaf Setyawan
- Center for Reproductive Health, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, 55281, Indonesia
| | - Yufan Putri Astrini
- Center for Reproductive Health, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, 55281, Indonesia
| | - Nadhila Adani
- ThinkWell, Central Jakarta, Jakarta Special Capital District, 10350, Indonesia
| | - Halimah Mardani
- ThinkWell, Central Jakarta, Jakarta Special Capital District, 10350, Indonesia
| | - Nirwan Maulana
- ThinkWell, Central Jakarta, Jakarta Special Capital District, 10350, Indonesia
| | - Anooj Pattnaik
- ThinkWell, 1519 York Road, Lutherville, Maryland, 21093, USA
| | - Trihono Trihono
- ThinkWell, Central Jakarta, Jakarta Special Capital District, 10350, Indonesia
| | - Siswanto Agus Wilopo
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health & Nursing, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, 55281, Indonesia
- Center for Reproductive Health, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, 55281, Indonesia
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Yu W, Wang Q, Qiao Z. Study on the time and scale of mutual aid for aging care under the background of active aging. Front Public Health 2024; 11:1196411. [PMID: 38288428 PMCID: PMC10823878 DOI: 10.3389/fpubh.2023.1196411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/26/2023] [Indexed: 01/31/2024] Open
Abstract
Background China has entered an aging society and will likely become the fastest-aging country in the world. The demand for aging care services has greatly increased. In recent years, the model of mutual aid for aging care has met the needs of older adults, especially those in rural areas. In this case, how much time should be spent on mutual aid for the older adult in terms of time and how much influence the size of the group has in terms of space are two very important questions when studying mutual aid for aging care. Methods An overlapping generations model is built in this article, which includes representative agents, representative enterprises, the endowment insurance system constructed by the government, and the behavior of representative agents in mutual aid for aging care under the background of active aging. Results In the base case, the optimal proportion of time to participate in the mutual aid group is 9.31%, and the optimal proportion of time is influenced by the benchmark time of care and the size of the care group. With the increase in the benchmark time of care, the optimal proportion of time increases correspondingly, but the increase is decreasing. With the increase in the size of the care group, the optimal proportion of time decreases, but after the size reaches 4 or 5, the impact becomes very small. When parents' psychological preference coefficient changes from 0.1 to 0.9, that is, when parents change from introverted to extroverted personalities, the optimal proportion of time and parents' utility will also change. Conclusion For children who usually take care of their parents for a long benchmark time, the optimal time to participate in the mutual aid group based on personal utility maximization is also long. Second, as the size of the group increases, the time for representative agents to participate in the mutual aid group gradually decreases. In addition, the model of mutual aid for aging care is highly correlated with parents' personalities, and extrovert parents benefit more from this model.
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Affiliation(s)
- Wenguang Yu
- School of Insurance, Shandong University of Finance and Economics, Jinan, China
| | - Qi Wang
- School of Statistics and Mathematics, Shandong University of Finance and Economics, Jinan, China
| | - Zhi Qiao
- School of Insurance, Central University of Finance and Economics, Beijing, China
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Maiba J, Singh NS, Cassidy R, Mtei G, Borghi J, Kapologwe NA, Binyaruka P. Assessment of strategic healthcare purchasing and financial autonomy in Tanzania: the case of results-based financing and health basket fund. Front Public Health 2024; 11:1260236. [PMID: 38283298 PMCID: PMC10811957 DOI: 10.3389/fpubh.2023.1260236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/03/2023] [Indexed: 01/30/2024] Open
Abstract
Background Low-and middle-income countries (LMICs) are implementing health financing reforms toward Universal Health Coverage (UHC). In Tanzania direct health facility financing of health basket funds (DHFF-HBF) scheme was introduced in 2017/18, while the results-based financing (RBF) scheme was introduced in 2016. The DHFF-HBF involves a direct transfer of pooled donor funds (Health Basket Funds, HBF) from the central government to public primary healthcare-PHC (including a few selected non-public PHC with a service agreement) facilities bank accounts, while the RBF involves paying providers based on pre-defined performance indicators or targets in PHC facilities. We consider whether these two reforms align with strategic healthcare purchasing principles by describing and comparing their purchasing arrangements and associated financial autonomy. Methods We used document review and qualitative methods. Key policy documents and articles related to strategic purchasing and financial autonomy were reviewed. In-depth interviews were conducted with health managers and providers (n = 31) from 25 public facilities, health managers (n = 4) in the Mwanza region (implementing DHFF-HBF and RBF), and national-level stakeholders (n = 2). In this paper, we describe and compare DHFF-HBF and RBF in terms of four functions of strategic purchasing (benefit specification, contracting, payment method, and performance monitoring), but also compare the degree of purchaser-provider split and financial autonomy. Interviews were recorded, transcribed verbatim, and analyzed using a thematic framework approach. Results The RBF paid facilities based on 17 health services and 18 groups of quality indicators, whilst the DHFF-HBF payment accounts for performance on two quality indicators, six service indicators, distance from district headquarters, and population catchment size. Both schemes purchased services from PHC facilities (dispensaries, health centers, and district hospitals). RBF uses a fee-for-service payment adjusted by the quality of care score method adjusted by quality of care score, while the DHFF-HBF scheme uses a formula-based capitation payment method with adjustors. Unlike DHFF-HBF which relies on an annual general auditing process, the RBF involved more detailed and intensive performance monitoring including data before verification prior to payment across all facilities on a quarterly basis. RBF scheme had a clear purchaser-provider split arrangement compared to a partial arrangement under the DHFF-HBF scheme. Study participants reported that the RBF scheme provided more autonomy on spending facility funds, while the DHFF-HBF scheme was less flexible due to a budget ceiling on specific spending items. Conclusion Both RBF and DHFF-HBF considered most of the strategic healthcare purchasing principles, but further efforts are needed to strengthen the alignment towards UHC. This may include further strengthening the data verification process and spending autonomy for DHFF-HBF, although it is important to contain costs associated with verification and ensuring public financial management around spending autonomy.
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Affiliation(s)
- John Maiba
- Department of Health System, Impact Evaluation, and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Neha S. Singh
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rachel Cassidy
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Gemini Mtei
- Abt Associates Inc., USAID Public Sector Systems Strengthening (PS3+) Project, Dar es Salaam, Tanzania
| | - Josephine Borghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ntuli A. Kapologwe
- President's Office, Regional Administration, and Local Government Tanzania – (PO-RALG), Dodoma, Tanzania
| | - Peter Binyaruka
- Department of Health System, Impact Evaluation, and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
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Stuikyte R, Varentsov I, Cook C, Dvoriak S. Measuring sustainability of opioid agonist therapy programs in the context of transition from global fund support. Harm Reduct J 2024; 21:7. [PMID: 38212809 PMCID: PMC10785371 DOI: 10.1186/s12954-024-00931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Programmatic and financial sustainability of health responses dependent on donor funding has risen as a major concern. In the HIV field in particular, it generated a number of instruments and assessments on sustainability and processes related to donor transition planning. The authors aimed to develop an instrument specific to opioid agonist therapy (OAT) programs as they were addressed only marginally by the HIV-specific assessments. METHODS The development of the OAT sustainability instrument used desk review of existing HIV sustainability concepts and tools, an International Advisory Board, and piloting to validate the instrument. RESULTS The new OAT sustainability instrument is comprised of the three parts: the conceptual framework, methodological guidelines and a practical implementation tool for assessing the degree of OAT sustainability at the country level. It measures sustainability in the three broad areas for sustainability measuring-Policy & Governance; Finance & Resources; and Services. The selection of indicators and their composites for the three sustainability areas extensively used the United Nations and World Health Organization's guidance on health system building blocks, on care and HIV and viral hepatitis prevention among people using opioids and for opioid dependence, and the definition of access to health framed by the United Nations Convent on Economic, Social and Cultural Rights. The instrument's methodological guidelines require the engagement of a national consultant to conduct desk review, key informant interviews and focus groups for measuring discrete milestones and adding qualitative information for interpretation of the data, progress and opportunities. The guidelines advise engaging a country-specific multi-stakeholder advisory group for planning, validation and follow-up of the assessment. The pilot of the instrument in 3 countries in 2020 validated it and required minor adjustments in the instrument. By mid-2023, the instrument has been successfully applied in 5 countries. CONCLUSIONS The developed instrument enables a comprehensive review of the resilience of OAT programs and their ability to scale up and to inform a roadmap for improved sustainability. While developed in the context of Eastern Europe and Central Asia, it has been reviewed by a global advisory panel and could be easily adapted outside this regional context.
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Affiliation(s)
| | - Ivan Varentsov
- Eurasian Harm Reduction Association (EHRA), Vilnius, Lithuania
| | | | - Sergii Dvoriak
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
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Jha A, Kolesar RJ, Comas S, Gribble J, Ugaz J, Gonzalez-Pier E. Getting ready for reduced donor dependency: the co-financing of family planning commodities. Health Policy Plan 2024; 39:87-93. [PMID: 37987720 PMCID: PMC10775212 DOI: 10.1093/heapol/czad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/04/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
Family planning (FP) programmes in low and lower-middle income countries are confronting the dual impact of reduced external donor commitments and stagnant or reduced domestic financing, worsened by economic consequences of the COVID-19 pandemic. Co-financing-a donor-government agreement to jointly fund aspects of a programme, with transition towards the government assuming increasing responsibility for total cost-can be a powerful tool to help build national ownership, fiscal sustainability and programme visibility. Using Gavi's successful co-financing model as reference, the current paper draws out a set of key considerations for developing policies on co-financing of FP commodities in resource-poor settings. Macroeconomic and contextual sensitivities must be incorporated while classifying countries and determining co-financing obligations-using the actual GNI per capita on a scale or sovereign credit ratings, in conjunction with programmatic indicators, may be preferred. It is also important for policies to allow sufficiently long time for countries to transition-dependent on the country context, may be up to 10 years as allowed under the US Agency for International Development FP graduation policy and flexibility to revisit the terms following externalities that can influence the fiscal space for health. Incentivizing new domestic financing to pay for co-financing dues is critical, so as not to displace government funding from related health or social sector programs. Pragmatic ways to ensure country compliance can include engaging both the ministries of health and finance as co-signatories to identify and address known administrative and fiscal challenges; establishing dedicated co-financing account with the finance ministry; and instituting a mutual monitoring mechanism. Lastly, the overall process of policymaking can benefit from an alignment of goals and interests of the key development partners.
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Affiliation(s)
- Ayan Jha
- Palladium Group, 1331 Pennsylvania Avenue NW, Suite 600, Washington, DC 20004, USA
| | - Robert John Kolesar
- Palladium Group, 1331 Pennsylvania Avenue NW, Suite 600, Washington, DC 20004, USA
| | - Sophia Comas
- Palladium Group, 1331 Pennsylvania Avenue NW, Suite 600, Washington, DC 20004, USA
| | - Jay Gribble
- Palladium Group, 1331 Pennsylvania Avenue NW, Suite 600, Washington, DC 20004, USA
| | - Jorge Ugaz
- Palladium Group, 1331 Pennsylvania Avenue NW, Suite 600, Washington, DC 20004, USA
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Peng Y, Bassett JK, Hodge AM, Melaku YA, Afshar N, Hopper JL, MacInnis RJ, Lynch BM, Smith-Warner SA, Giles GG, Milne RL, Jayasekara H. Adherence to 2018 WCRF/AICR Cancer Prevention Recommendations and Risk of Cancer: The Melbourne Collaborative Cohort Study. Cancer Epidemiol Biomarkers Prev 2024; 33:43-54. [PMID: 37943161 DOI: 10.1158/1055-9965.epi-23-0945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/05/2023] [Accepted: 11/07/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND We examined associations between adherence to adaptations of the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and total, exposure-related and site-specific cancer risk. METHODS A total of 20,001 participants ages 40 to 69 years at enrollment into the Melbourne Collaborative Cohort Study in 1990 to 1994, who had diet, body size, and lifestyle reassessed in 2003 to 2007 ("baseline"), were followed-up through June 2021. We constructed diet and standardized lifestyle scores based on core WCRF/AICR recommendations on diet, alcohol intake, body size and physical activity, and additional scores incorporating weight change, sedentary behavior, and smoking. Associations with cancer risk were estimated using Cox regression, adjusting for confounders. RESULTS During follow-up (mean = 16 years), 4,710 incident cancers were diagnosed. For highest quintile ("most adherent") of the standardized lifestyle score, compared with lowest ("least adherent"), a HR of 0.82 [95% confidence interval (CI): 0.74-0.92] was observed for total cancer. This association was stronger with smoking included in the score (HR = 0.74; 95% CI: 0.67-0.81). A higher score was associated with lower breast and prostate cancer risk for the standardized score, and with lung, stomach, rectal, and pancreatic cancer risk when the score included smoking. Our analyses identified alcohol use, waist circumference and smoking as key drivers of associations with total cancer risk. CONCLUSIONS Adherence to WCRF/AICR cancer prevention recommendations is associated with lower cancer risk. IMPACT With <0.2% of our sample fully adherent to the recommendations, the study emphasizes the vast potential for preventing cancer through modulation of lifestyle habits.
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Affiliation(s)
- Yang Peng
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Public Health, The University of Queensland, Queensland, Australia
| | - Julie K Bassett
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Yohannes Adama Melaku
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- FHMRI Sleep, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Nina Afshar
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Stephanie A Smith-Warner
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Harindra Jayasekara
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Yu Z, Chen J, Yu R. Dose the increasing burden of social endowment affect sustainable development of economy? PLoS One 2024; 19:e0296512. [PMID: 38165985 PMCID: PMC10760761 DOI: 10.1371/journal.pone.0296512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/13/2023] [Indexed: 01/04/2024] Open
Abstract
The rapid increase in the number of older people under the background of population aging has gradually changed the disease spectrum of society, making aging diseases more prevalent, and increasing the demand for health care services, medical and health services, and health insurance among older people, ultimately leading to increasing household and social spending on old age. This study is conducted to assess the impact of those spending burden on the sustainable development of economy and find out some practical and effective solutions. This paper constructs a theoretical model to illustrate the relationship between the old-age dependency ratio and the marginal product of capital (MPK), and then establishes a two-way fixed effect model based on transnational panel data of 81 countries from 1981 to 2017 to verify this relationship empirically. This paper finds that, after controlling a series of variables, an increased burden of old-age dependency leads to a decline in the MPK, a key macroeconomic variable and also a sustainable development criteria, but in which health care, health security systems, and technological innovation play a key and moderating role. The conclusion is also valid after tackling the problem of endogeneity with different methods, like two-stage least squares (TSLS) and the generalized methods of moments (GMM). Overall, before population aging, countries that are old-but-not-rich should encourage more supply-side investments in public health system or technological innovation, and adjust retirement system, or gradually encourage childbearing to strive for time and space for later sustainable development of public health system and economy.
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Affiliation(s)
- Zhiyang Yu
- School of Banking and Finance, University of International Business and Economics, Beijing, China
| | - Jin Chen
- School of Banking and Finance, University of International Business and Economics, Beijing, China
| | - Runfa Yu
- College of Foreign Languages, Xinjiang University, Urumqi, Xinjiang, China
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Modise GL, Uys K, Masenge A, du Plooy E. Relationship between demographic characteristics and return-to-work for loss of income claimants at the Motor Vehicle Accident Fund, Botswana. Work 2024; 77:1101-1114. [PMID: 37781840 DOI: 10.3233/wor-220712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND The Motor Vehicle Accident (MVA) Fund Botswana compensates claimants who lose their incomes due to road traffic accidents. In Botswana, road traffic accidents are becoming more frequent, and the MVA Fund is experiencing escalating claims. We describe the demographic characteristics of loss of income (LOI) claimants of the MVA Fund Botswana. We assess whether demographic characteristics are related to return to work (RTW). OBJECTIVE We retrospectively reviewed records of MVA Fund claimants and extracted demographic information. We investigated the demographic profile and the relationship between demographic information and RTW. METHODS We reviewed 432 LOI claims received by MVA Fund from January 1, 2015 to December 31, 2020. We descriptively analysed the demographic profiles of claimants. We used a univariate analysis and multivariate logistic regression to determine the association between independent demographic variables and the dependent variable, RTW. RESULTS MVA Fund claimants were on average 37-years-old. Claimants were mostly from low-income socio-economic backgrounds. RTW was significantly associated with injury severity, type of injury, and having a RTW plan offer. The final predictors of RTW, using logistic regression, were time away from work and severity of injury. CONCLUSION In Botswana, claimants who had severe injuries and who stayed away from work for longer were less likely to RTW. The MVA Fund Botswana must recognise the demographic profiles of claimants which are likely to influence RTW.
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Affiliation(s)
- Gofaone Lady Modise
- Department of Occupational Therapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa
| | - Kitty Uys
- Department of Occupational Therapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa
| | - Andries Masenge
- Department of Statistics, Faculty of Natural and Agriculture Sciences, University of Pretoria, South Africa
| | - Eileen du Plooy
- School of Therapeutic Sciences, Faculty of Health Sciences, eFundanathi, University of the Witwatersrand, Johannesburg, South Africa
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Wang X, Wang X, Zhai Y. Advancing sustainable financial management in greening companies through big data technology innovation. Environ Sci Pollut Res Int 2024; 31:5641-5654. [PMID: 38123775 DOI: 10.1007/s11356-023-30950-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023]
Abstract
Incorporating sustainability into financial management procedures has emerged as a critical component in the modern business landscape for organizations looking to strengthen their environmental stewardship while guaranteeing financial viability. The study "Advancing Sustainable Financial Management in Greening Companies through Big Data Technology Innovation" explains the crucial role that big data technologies play in empowering businesses to incorporate environmental sustainability into their financial management strategies. The research the strong link between big data analytics and the optimization of sustainable financial management in businesses from year 1990 to 2022. The study's findings show that big data analytics enables firms to make data-driven decisions, significantly increasing the effectiveness of their sustainability activities. With the enormous amounts of data that big data technologies can analyze, businesses can access actionable insights that make it easier to identify and reduce environmental impacts, use resources more efficiently, and streamline supply chains to support sustainability. To emphasizes the businesses can match their financial goals with sustainability objectives through big data technology without sacrificing profitability. Big data analytics may help businesses assess environmental risks and find possibilities for sustainable investment, enabling them to make well-informed financial decisions consistent with their commitment to environmental stewardship. The conclusion emphasizes the businesses to adopt big data technology focusing on long-term financial management strategically. The growing environmental problems that endanger the world's ecosystems underscore even more how crucial it is to include these advancements. Therefore, integrating sustainability into financial management using big data technology is not just a choice but a requirement for businesses to succeed in this century. The study demonstrated that the businesses, decision-makers, and other stakeholders to understand and use big data technologies' potential to advance sustainable financial management and build more resilient and sustainable corporate environments.
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Affiliation(s)
- Xueyan Wang
- School of Accounting and Finance,Shijiazhuang Vocational College of Finance and Economics, Shijiazhuang, 050000, Hebei, China
| | - Xiaoli Wang
- Department of Law and Economic Trade, Hebei Vocational College of Labour Relations, Shijiazhuang, 050000, Hebei, China.
| | - Yingying Zhai
- School of Accounting and Finance,Shijiazhuang Vocational College of Finance and Economics, Shijiazhuang, 050000, Hebei, China
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Longo F, Locatelli F, Del Vecchio M, Di Giulio P, Giordano S, Odone A, Ranieri VM, Vineis P. Tackling the crisis of the Italian National Health Fund. Lancet Public Health 2024; 9:e6-e7. [PMID: 38176843 DOI: 10.1016/s2468-2667(23)00277-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Francesco Longo
- Centre for Research on Health and Social Care Management-Scuola di Direzione Aziendale, Department of Social and Political Sciences, Bocconi University, Milan 20136, Italy.
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology and Department of Cell and Gene Therapy, Istituto Di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù, Catholic University of the Sacred Heart, Rome, Italy
| | - Mario Del Vecchio
- Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | - Paola Di Giulio
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Silvia Giordano
- Department of Oncology, University of Turin, Turin, Italy; Candiolo Institute, Fondazione del Piemonte per l'Oncologia, Istituto di Ricovero e Cura a Carattere Scientifico, Turin, Italy
| | - Anna Odone
- Department of Public Health, University of Pavia, Pavia, Italy
| | - Vito Marco Ranieri
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Paolo Vineis
- School of Public Health, Imperial College London, London, UK
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Ham C. Think tanks and health policy in the United Kingdom: The role of the King's Fund. J Health Serv Res Policy 2024; 29:51-55. [PMID: 37878662 PMCID: PMC10729535 DOI: 10.1177/13558196231207808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The King's Fund is a long-established health policy think tank involved in work on evidence-based policy in the United Kingdom. There have been few accounts of how think tanks operate. This essay seeks to partially fill that gap by reviewing the work of the Fund between 2010 and 2018, when the author was its chief executive. The essay outlines the history and status of the Fund, its funding and staffing, and the range of activities undertaken. Examples of policy areas in which the Fund was active and its impact on both policymakers in central government and leaders working in the National Health Service are discussed.
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Affiliation(s)
- Chris Ham
- School of Social Policy, University of Birmingham, Birmingham, UK
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Lebenbaum M, Gagnon F, de Oliveira C, Laporte A. Genetic endowments for social capital: An investigation accounting for genetic nurturing effects. Econ Hum Biol 2024; 52:101316. [PMID: 38056316 DOI: 10.1016/j.ehb.2023.101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 12/08/2023]
Abstract
Despite social capital having been shown to be important for health and well-being, relatively little research has examined genetic determinants. Genetic endowments for education have been shown to influence human, financial, and health capital, but few studies have examined social capital, and those conducted have yet to account for genetic nurturing. We used the Add-Health data to study the effect of genetic endowments on individual social capital using the education polygenic score (PGS). We used sibling fixed effects models and controlled for the family environment to account for genetic nurturing. After accounting for the family environment, we found moderately large significant associations between the education PGS and volunteering, but associations with religious service attendance and number of friends were completely attenuated in sibling fixed effects models. These findings highlight that genetic endowments play an important role in influencing volunteering and the importance of accounting for genetic nurturing.
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Affiliation(s)
- Michael Lebenbaum
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Canadian Centre for Health Economics, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada.
| | - France Gagnon
- The Dalla Lana School of Public Health (DLSPH), University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
| | - Claire de Oliveira
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Canadian Centre for Health Economics, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Centre for Health Economics and the Hull York Medical School, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Audrey Laporte
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Canadian Centre for Health Economics, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada
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McFall L. Life funds, urban development, and the experimental practices of financial sociology. Br J Sociol 2024; 75:73-92. [PMID: 37811775 DOI: 10.1111/1468-4446.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
How did the Norwich Union, a life and general insurance company, come to see itself as a 'local developer with people always at the centre of our planning'? This article explores how a small number of insurance companies, capitalising on their long history of property investment, used their investment funds, or 'life funds', to transform the built environment of UK in the twentieth century. In the postwar period life funds were contracted by local governments to finance, plan and develop solutions to urban issues that paralleled those targeted by post-war welfare reforms. This involved companies in developing expertise, working practices, instruments and collaborative arrangements that are not adequately represented as financial investment. Ventures into development on this scale had also to be ventures in futures planning, calculated bets on how people would - and how they should - live, work and spend. These are enterprises that I characterise as 'experimental practices of financial sociology' as a provocation that acknowledges first, that non-sociologists sometimes devise huge sociological experiments and second, that the separation of economics from sociology, and of finance from society, is a disciplinary move that is far less strictly enacted outside the academy.
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Affiliation(s)
- Liz McFall
- Sociology and Edinburgh Futures Institute, University of Edinburgh, Edinburgh, UK
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Yonzan N, Timilsina L, Kelly IR. Economic incentives surrounding fertility: Evidence from Alaska's permanent fund dividend. Econ Hum Biol 2024; 52:101334. [PMID: 38070225 DOI: 10.1016/j.ehb.2023.101334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 02/10/2024]
Abstract
The Alaska Permanent Fund Dividend provided an incentive that increased fertility. This paper estimates the impact of the dividend transfer on fertility rates in Alaska compared to other states using the synthetic control methodology. For the period from 1982 to 1988, fertility on average increased annually in Alaska by 11.3 births per 1000 women aged 15-44-a 13.1 percent increase over the counterfactual. This was driven by women over 20. Fertility increased for women aged 20-24 by 12.4 percent, those aged 25-34 by 14.3 percent, and those aged 35-44 by 16.9 percent. The paper also finds support that narrowing the gap between births, increase in total fertility rate, and no change in abortion are potential channels for the observed increase in fertility. No change in the fertility for the adolescents combined with no change in abortion suggests that the increase in fertility in Alaska was planned.
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Affiliation(s)
| | - Laxman Timilsina
- Department of Economics, Connecticut College, United States of America
| | - Inas Rashad Kelly
- Department of Economics, Loyola Marymount University, United States of America; National Bureau of Economic Research, United States of America.
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Sunakawa Y, Kondo M, Yamamoto Y, Inomata T, Inoue Y, Mori D, Mizuno T. Design of Cell-Adhesive Shellac Derivatives and Endowment of Photoswitchable Cell-Adhesion Properties. ACS Appl Bio Mater 2023; 6:5493-5501. [PMID: 37978057 DOI: 10.1021/acsabm.3c00684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The emergence of new biodegradable cell-adhesion materials is an attractive topic in biomaterial chemistry, particularly for the development of cell incubation scaffolds and drug encapsulation materials used in in situ regenerative therapy. Shellac is a natural resin with unique film-forming properties and high miscibility with various chemicals, in addition to being biodegradable and nontoxic to biological systems. However, since native shellac does not adhere to mammalian cells, there have been no reports of using shellac to develop cell-adhesive biomaterials. In this study, we report on the development of cell-adhesive shellac derivatives through slight chemical modification. Shellac is a mixture of oligoesters that consists of hydroxyl fatty acids and resin acids, and therefore, all oligomers have one carboxylic acid group at the terminal. We discovered that a simple modification of hydrophobic chemical groups, particularly those containing aromatic groups in the ester form, could dramatically improve cell-adhesion properties for mammalian cells. Furthermore, by using photocleavable esters containing aromatic groups, we successfully endowed photoswitchable properties in cell adhesion. Given that shellac is a low-cost, biodegradable, and nontoxic natural resin, the modified shellacs have the potential to become new and attractive biomaterials applicable to in situ regenerative therapy.
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Affiliation(s)
- Yurino Sunakawa
- Department of Life Science and Applied Chemistry, Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
| | - Mai Kondo
- Department of Life Science and Applied Chemistry, Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
| | - Yasushi Yamamoto
- Department of Life Science and Applied Chemistry, Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
| | - Tomohiko Inomata
- Department of Life Science and Applied Chemistry, Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
| | - Yasumichi Inoue
- Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1 Tanabe-dori, Mizuho-ku, Nagoya 467-8603, Japan
| | - Daisuke Mori
- Gifu Shellac Manufacturing Co., Ltd., 1-41, Higashiuzura, Gifu-shi, Gifu 500-8618, Japan
| | - Toshihisa Mizuno
- Department of Life Science and Applied Chemistry, Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
- Department of Nanopharmaceutical Sciences, Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
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Lesego A, Tsegaye T, Were LPO, Sakvarelidze G, Garg S, Morrison L, Nigussie S, Githendu P, Achoki T. Assessment of the Global Fund-supported procurement and supply chain reforms at the Ethiopian Pharmaceuticals Supply Agency: a mixed-methods study. BMJ Open 2023; 13:e073390. [PMID: 38101834 PMCID: PMC10729206 DOI: 10.1136/bmjopen-2023-073390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) partnered with the Ethiopian Pharmaceutical Supply Agency (EPSA) in 2018-2019 to reform procurement and supply chain management (PSCM) procedures within the Ethiopian healthcare system. This assessment sought to determine the impact of the reforms and document the lessons learnt. DESIGN Mixed-methods study incorporating qualitative and quantitative analysis. Purposive and snowballing sampling techniques were applied for the qualitative methods, and the data collected was transcribed in full and subjected to thematic content analysis. Descriptive analysis was applied to quantitative data. SETTING The study was based in Ethiopia and focused on the EPSA operations nationally between 2017 and 2021. PARTICIPANTS Twenty-five Ethiopian healthcare decision-makers and health workers. INTERVENTION Global Fund training programme for health workers and infrastructural improvements OUTCOMES: Operational and financial measures for healthcare PSCM. RESULTS The availability of antiretrovirals, tuberculosis and malaria medicines, and other related commodities, remained consistently high. Line fill rate and forecast accuracy were average. Between 2018 and 2021, procurement lead times for HIV and malaria-related orders reduced by 43.0% relative to other commodities that reported an increase. Many interview respondents recognised the important role of the Global Fund support in improving the performance of EPSA and provided specific attributions to the observed successes. However, they were also clear that more needs to be done in specific critical areas such as financing, strategic reorganisation, data and information management systems. CONCLUSION The Global Fund-supported initiatives led to improvements in the EPSA performance, despite several persistent challenges. To sustain and secure the gains achieved so far through Global Fund support and make progress, it is important that various stakeholders, including the government and the donor community, work together to support EPSA in delivering on its core mandate within the Ethiopian health system.
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Affiliation(s)
| | - Tsion Tsegaye
- Ethiopian Procurement and Supply Agency, Addis Ababa, Ethiopia
| | | | - George Sakvarelidze
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | - Sunil Garg
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | - Linden Morrison
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | | | - Patrick Githendu
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | - Tom Achoki
- Africa Institute for Health Policy, Nairobi, Kenya
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Puto G, Cybulski M, Kędziora-Kornatowska K, Doroszkiewicz H, Muszalik M. Sleep Quality in Older People: The Impact of Age, Professional Activity, Financial Situation, and Chronic Diseases During the SARS-CoV-2 Pandemic. Med Sci Monit 2023; 29:e941648. [PMID: 38083823 PMCID: PMC10725042 DOI: 10.12659/msm.941648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic negatively affected health and social life, notably deteriorating sleep quality in older adults. Studies report inconsistent findings on sleep disturbances during this period, influenced by various physiological, emotional, and sociodemographic factors. This study aimed to identify these determining factors. MATERIAL AND METHODS The study was conducted among 342 people 60 years of age or older participating in online classes of randomly selected Senior Clubs and the University of the Third Age in the southern regions of Poland. RESULTS Sleep problems (PSQI >5 points) were diagnosed in 250 subjects (83.6%). Logistic regression analysis showed that the quality of sleep significantly depends on: age, as people aged 66-70 were more likely to have better sleep quality than people aged 60-65 (OR=3.07), and those over 70 scored better than people aged 60-65 (OR=2.87); current job - employed people have a better chance of better sleep quality (OR=3.08) than unemployed people; financial situation, people assessing their financial situation as very good/good had a better chance of better sleep quality (OR=2.00) compared to people assessing their financial situation as very bad, bad/average; chronic diseases, people without chronic diseases had a chance of better sleep quality (OR=2.45) than people with chronic diseases. CONCLUSIONS Age, financial situation, current job, and chronic disease were the most important factors determining sleep quality in older people. The identification of factors affecting sleep quality can be used as important data to develop interventions and programs to improve sleep quality.
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Affiliation(s)
- Grażyna Puto
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Białystok, Białystok, Poland
| | - Kornelia Kędziora-Kornatowska
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | | | - Marta Muszalik
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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