Health policy, implementation and effectiveness: an international perspective
In this welcome speech, Professor Paolucci introduces the overall project, and the multiple outcomes of the international collaboration between the University of Newcastle (Australia) and Aston University (UK).
The main aims of the project collaboration project between the University of Newcastle (Australia) and Aston University (UK) entailed an international comparison of health policy, implementation and effectiveness through the design of a conceptual framework that classifies modern healthcare systems hybridity, analyses the necessary conditions (under Eindhoven’s managed competition model) for maximising efficiency and equity of international healthcare systems and investigates the health of the global workforce and highlights inequalities amongst migrants which has been exacerbated by the effects of COVID-19. Moreover, as a result of the collaboration with Aston we were able to take the opportunity to respond to COVID-19 within the aims of the project to study the COVID-19 pandemic with respect to global health policy and technology as well as the investigation using a case study approach of the policy responses to COVID-19 in multiple countries around the world.
Below, join Jonathan Tritter, our Aston partner for a live presentation and debate, find our asynchronous research sessions and presentation of associated research.
Online Live Event
MONDAY 14 DECEMBER
7.15pm - 8.15pm (Sydney)
8.15am - 9.15am (London)
Jonathan Tritter is a Professor of Sociology and Policy at Aston University. His main research interests relate to public participation and lay experience in health and policy making, particularly in relation to cancer, mental health and environmental policy.
As part of the University of Newcastle - Aston University International Research Collaboration, Professor Tritter will be presenting one of his research and debating with Daniel Nyberg, Professor in Management and Organisational Studies at the University of Newcastle, on the following:
Bringing the State Back in: Reconsidering the response to global and planetary health
Abstract: The challenges to health at a population level are increasingly understood as global. Recent shifts have refocused the attention of the public health community, particularly the academic and research community, away from the nation state while international health has taken a comparative approach to nation states but has a tendency to fixate on developing countries. Echoing Theda Skocpol’s call to ‘bring the state back in’ I argue for the need to consider the nation state as the primary unit of analysis, recognising that it must respond to threats to the public’s health from within and without. Approaches to global health governance have not generated the necessary response at national level. Further that comparative analysis at state level is essential in revealing different responses to similar threats and to encourage collaborative and shared responses; a bottom-up approach rather than the global/planetary health top-down assumption.
Asynchronous Paper Presentations
Healthcare Systems Hybridity: A Conceptual Framework
Chiara Berardi, Heidi Wechtler, Adrian Melia, Francesco Paolucci, Jonathan Tritter, Gary Fooks, and Madeleine Hinwood
Highlights: Healthcare systems are the product of each country social, institutional, economic, political, and cultural experiences. They respond and adapt to the ongoing challenges such as increasing costs due to technology, aging population, and the COVID-19 pandemic. As a result, contemporary healthcare systems are diverging from pure types as defined by the traditional tripartite classification: NHS, SHI, and voluntary health insurance. We observe a convergence of all healthcare systems toward hybridisation of their financing and provision dimensions. Our research propose a conceptual hybridity framework. General propositions are formulated. Implications for research and practice are discussed.
The Health of the Global Workforce: A review and agenda in times of pandemic
Heidi Wechtler, Adrian Melia, Jonathan Tritter, Gary Fooks, Francesco Paolucci
Highlights: At the end of 2019, the number of international migrants was estimated to 272 million worldwide: While often associated with low status workers, migrants and expatriates are increasingly seen as by host countries as a pool of talents and represent a considerable global workforce. Only recently, the health of migrants has gained attention and the first studies related to the pandemic show that COVID-19 will only exacerbate existing inequalities. In this study, we conduct a bibliometric review on migrants’ health based on 1658 studies in order to take stock on the existing body of knowledge and consolidates the findings on global workforce health. The review organises the findings around the most influential research and the key underlying literatures to revive the debate on health equity and associated implications for organisations and health policies.
The Roadmaps to manage competition: Theory and practice
Josefa Henriquez, Wynand van de Ven, Francesco Paolucci, John Armstrong, Adrian Melia
Highlights: Health systems’ insurance and financing, as well as provision, can be organized in several ways. Some countries have adopted systems with a mixture of public-private involvement (e.g. Australia, Chile, and Ireland). Such an organization creates two-tier health systems, as by construction, it allows consumers (groups) to have preferential access to the basic standard of care (e.g. skipping waiting times). The degree to which, efficiency and equity are achieved in these types of systems is questioned. In this paper, we explore the integration of the two tiers by means of a managed competition model, which underpins Social Health Insurance – SHI- (e.g. The Netherlands, Germany). We elaborate a two-part conceptual framework that describes the preconditions and typologies of the roadmaps to achieve managed competition. We compare this framework with an application to three country case studies: Australia, Chile, and Ireland.
The Influence of Healthcare System on Amenable Mortality: A configurational approach
Heidi Wechtler, Chiara Berardi, Josefa Henriquez, Shannen Higginson, Jonathan Tritter, Gary Fooks, Adrian Melia, and Francesco Paolucci.
Highlights: The past 50 years have seen health expenditures of countries belonging to the OECD constantly increasing, raising concerns to the sustainability of financing of healthcare systems. One approach to capture the contribution of health care to population health is the concept of amenable mortality, i.e., the premature death from causes that should not occur in the presence of timely and effective healthcare. Our study investigates the different paths that lead to poorer healthcare quality measured by the extent of amenable mortality (e.g., Kamarudeen, 2010) within the OECD countries in order to bring light on the conjoint factors that allow the system to efficiently contribute to national health quality. We focus in particular on the causal conditions that lead OECD countries to poorer healthcare quality than their OECD counterparts. Conducting a Qualitative Comparative Analysis on a sample of 27 OECD countries, our analysis discusses the role of spatial disparity and social orientation, provision mismatch, and, ageing and lack of public health investments in relation to poorer healthcare quality among OECD countries.
The COVID-19 pandemic provided an opportunity to investigate (consistent with the aims of the project) a comparison of health care system responses to COVID-19 and what lessons can be learnt internationally. Four projects were undertaken in this regard and have been published in 2020 in Health Policy and Technology [access the special issue here]. These can be found below:
VheP founder Francesco Paolucci, Doowon Lee (both from the University of Newcastle) Jonathan Tritter (Aston University), and Naomi Moy (the University of Bologna) were the guest editors of the Special Issue "The COVID-19 pandemic: Global health policy and technology responses in the making" that highlights the importance and timeliness of this issue.
Highlights: This issue focuses on the importance of context - country and health system overview, the time period - January 2020 – August 2020 COVID-19 trends, policy interventions and responses by health bodies and governments, and the impact of interventions on the economy – and interventions to support the economy. Over 30 countries are included in the country-specific response of this Special Issue, ranging across different types of health and political systems.
Cite: Lee, D., Moy, N., Tritter, J., & Paolucci, F. (2020). The COVID-19 pandemic: Global health policy and technology responses in the making. Health Policy and Technology. [read here]
The COVID-19 Pandemic in Norway: The Dominance of Social Implications in Framing the Policy Response
Highlights: This article provides insights into the evolution and implications of the Norwegian policy response to the COVID-19 crisis. Three different agendas motivated the Norwegian policy response: limiting disease spread, mitigating economic effecs and engaging with the social consequences. The oil and gas industry and the Sovereign Wealth Fund insulate Norway from the full economic consequences of the pandemic and policy response. The social implications of the policy response and the pandemic, particularly on young people are a key consideration for the emergence from the crisis.
Cite: Ursin, G., Skjesol, I., & Tritter, J. (2020). The COVID-19 pandemic in Norway: The dominance of social implications in framing the policy response. Health Policy and Technology. Access here.
COVID-19: The Need for an Australian Economic Pandemic Response Plan
Shannen Higginson, Katarina Milovanovic, James Gillespie, Laura Wall, Naomi Moy, Madeleine Hinwood, Andrew Matthews, Christopher Williams, Adrian Melia, and Francesco Paolucci
Highlights: Australian government COVID-19 pandemic policy response impacts GDP, unemployment. Government policymaker guide for holistic, robust solutions to health emergencies. Australian Economic Pandemic Response Plan: effective fiscal and monetary policy. Healthcare system demand and supply shocks PPE, ICU bed capacity, surgery, PHI. Epidemiological and econometric modelling, disease transmission and risky behavior.
Cite: Higginson, S., Milovanovic, K., Gillespie, J., Matthews, A., Williams, C., Wall, L., ... & Paolucci, F. (2020). COVID-19: the need for an Australian Economic Pandemic Response Plan. Health policy and technology. Access here.
COVID-19 Pandemic in the United Kingdom
Darren Flynn, Eoin Moloney, Nawaraj Bhattari, Jason Scott, Matthew Breckons, Leah Avery, and Naomi Moy
Highlights: 472 COVID-19 cases and 70 deaths per 100,000 UK population as of 12th Aug 2020. Majority of deaths from COVID-19 were amongst people aged ≥60 years. COVID-19 mortality was higher in Black, Asian and Minority Ethnic (BAME) groups. Emergency department attendance and patient referrals have declined. Emergency ambulance and non-urgent (NHS111) calls have increased.
Cite: Flynn, D., Moloney, E., Bhattarai, N., Scott, J., Breckons, M., Avery, L., & Moy, N. (2020). COVID-19 pandemic in the United Kingdom. Health Policy and Technology. Access here.