Assessing needs-based supply of physicians: a criteria-led methodological review of international studies in high-resource settings.

Background: Many health systems embrace the normative principle that the supply of health services ought to be based on the need for healthcare. However, a theoretically grounded framework to operationalize needs-based supply of healthcare remains elusive. The aim of this paper is to critically assess current methodologies that quantify needs-based supply of physicians and identify potential gaps in approaches for physician planning.

Assessing patients' acceptable and realised distances to determine accessibility standards for the size of catchment areas in outpatient care.

Healthcare planning aims to ensure availability of care in a needs-based, evenly distributed and locally available manner. However, many planning mechanisms lack accessibility standards. To determine standards, catchment areas must be derived from health-related travel assessments and a population's distance acceptance for different medical specialisation levels.

What makes a good quality indicator set? A systematic review of criteria.

Background: While single indicators measure a specific aspect of quality (e.g. timely support during labour), users of these indicators, such as patients, providers and policy-makers, are typically interested in some broader construct (e.

[DNVF Memorandum Health Literacy (Part 1) - Background, Relevance, Research Topics and Questions in Health Services Research].

More than half of the German population has difficulties in dealing with health information. It is an important task of health services research to examine how healthcare professionals and health care organizations can meet this challenge. The DNVF Memorandum Health Literacy (Part 1) defines the terms of individual and organizational health literacy, presents the national and international state of research and ethical aspects of health literacy research in health care settings.

[DNVF Memorandum Health Literacy (Part 1) - Background, Relevance, Research Topics and Questions in Health Services Research: Short Version].

More than half of the German population has difficulties in dealing with health information. It is an important task of health services research to examine how healthcare professionals and health care organizations can meet this challenge. This short version of the DNVF Memorandum Health Literacy (Part 1) defines the terms of individual and organizational health literacy, presents the national and international state of research and ethical aspects of health literacy research in health care settings.

Exploring the role of hospitals and office-based physicians in timely provision of statins following acute myocardial infarction: a secondary analysis of a nationwide cohort using cross-classified multilevel models.

Objectives: To examine the role of hospitals and office-based physicians in empirical networks that deliver care to the same population with regard to the timely provision of appropriate care after hospital discharge.

Design: Secondary data analysis of a nationwide cohort using cross-classified multilevel models.

Setting: Transition from hospital to ambulatory care.

[New Forms of Cooperation Between The Outpatient and Inpatient Sectors: An Innovative Funding Concept].

Introduction: Continuity in information and care at the interface between inpatient and outpatient sectors is not always guaranteed. The aim of the study was to develop a funding concept to improve transitional situations such as admission and discharge from inpatient care and to meet the coordination needs of patients with complex diseases or multiple risk factors.

Methodology: Conceptual foundations to support cross-sectoral cooperation were developed by the Bavarian State Working Group on Health Services Research (LAGeV).

[Travel times of patients to ambulatory care physicians in Germany].

Background: The time needed by patients to get to a doctor's office represents an important indicator of realised access to care. In Germany, findings on travel times are only available from surveys or for some regions.

Objective: For the first time, this study examines nationwide and physician group-specific travel times in the ambulatory care sector in Germany and describes demographic, supply-side and spatial determinants of variations.

Variation in Utilization and Need for Tympanostomy Tubes across England and New England.

Objectives: To compare rates of typmanostomy tube insertions for otitis media with effusion with estimates of need in 2 countries.

Study Design: This cross-sectional analysis used all-payer claims to calculate rates of tympanostomy tube insertions for insured children ages 2-8 years (2007-2010) across pediatric surgical areas (PSA) for Northern New England (NNE; Maine, Vermont, and New Hampshire) and the English National Health Service Primary Care Trusts (PCT). Rates were compared with expected rates estimated using a Monte Carlo simulation model that integrates clinical guidelines and published probabilities of the incidence and course of otitis media with effusion.

Developing robust composite measures of healthcare quality - Ranking intervals and dominance relations for Scottish Health Boards.

Although composite indicators are widely used to inform health system performance comparisons, such measures typically embed contentious assumptions, for instance about the weights assigned to constituent indicators. Moreover, although many comparative measures are constructed as ratios, the choice of denominator is not always straightforward. The conventional approach is to determine a single set of weights and to choose a single denominator, even though this involves considerable methodological difficulties.

Complementary logics of target-setting: hierarchist and experimentalist governance in the Scottish National Health Service.

Where policy ends are contested and means for change are ambiguous, imposing central targets on local organisations - what we call hierarchist governance - is problematic. The concept of experimentalist governance suggests that target-setting should rather be a learning process between central regulators and local organisations. However, the relationship between experimentalist and hierarchist governance remains unclear.

Explaining differences in stakeholder take up of disease management programmes: A comparative analysis of policy implementation in Austria and Germany.

Purpose: Understanding why policies to improve care for people with chronic conditions fail to be implemented is a pressing issue in health system reform. We explore reasons for the relatively high uptake of disease management programmes (DMPs) in Germany, in contrast to low uptake in Austria. We focus on the motivation, information and power of key stakeholder groups (payers, physician associations, individual physicians and patients).

Using an epidemiological model to investigate unwarranted variation: the case of ventilation tubes for otitis media with effusion in England.

Objectives: To investigate unwarranted variation in ventilation tube insertions for otitis media with effusion in children in England. This procedure is known to be 'overused' from clinical audits, as only one in three ventilation tube insertions conforms to the appropriateness criteria of the National Institute for Health and Care Excellence (NICE); but audits cannot identify the scale of 'underuse' - i.e.

From data to decisions? Exploring how healthcare payers respond to the NHS Atlas of Variation in Healthcare in England.

Purpose: Although information on variations in health service performance is now more widely available, relatively little is known about how healthcare payers use this information to improve resource allocation. We explore to what extent and how Primary Care Trusts (PCTs) in England have used the NHS Atlas of Variation in Healthcare, which has highlighted small area variation in rates of expenditure, activity and outcome.

Methods: Data collection involved an email survey among PCT Chief Executives and a telephone follow-up to reach non-respondents (total response: 53 of 151 of PCTs, 35%).

Value-based cost sharing in the United States and elsewhere can increase patients' use of high-value goods and services.

This article reviews efforts in the United States and several other member countries of the Organization for Economic Cooperation and Development to encourage patients, through cost sharing, to use goods such as medications, services, and providers that offer better value than other options--an approach known as value-based cost sharing. Among the countries we reviewed, we found that value-based approaches were most commonly applied to drug cost sharing. A few countries, including the United States, employed financial incentives, such as lower copayments, to encourage use of preferred providers or preventive services.

Securing funds for health promotion: lessons from health promotion foundations based on experiences from Austria, Australia, Germany, Hungary and Switzerland.

Worldwide, countries face the challenge of securing funds for health promotion. To address this issue, some governments have established health promotion foundations, which are statutory bodies with long-term and recurrent public resources. This article draws on experiences from Austria, Australia, Germany, Hungary and Switzerland to illustrate four lessons learned from the foundation model to secure funding for health promotion.