Healthcare System Digital Transformation across Four European Countries: A Multiple-Case Study

Multiple-case study; Digital transformation; Digital healthEstudio de casos múltiples; Transformación digital; Salud digitalEstudi de casos múltiples; Transformació digital; Salut digitalDigitization has become involved in every aspect of life, including the healthcare sector with its healthcare professionals (HCPs), citizens (patients and their families), and services. This complex process is supported by policies: however, to date, no policy analysis on healthcare digitalization has been conducted in European countries to identify the main goals of digital transformation and its practical implementation. This research aimed to describe and compare the digital health policies across four European countries; namely, their priorities, their implementation in practice, and the digital competencies expected by HCPs. A multiple-case study was performed. Participants were the members of the Digital EducationaL programme invoLVing hEalth profEssionals (DELIVER), a project funded by the European Union under the Erasmus+ programme, involving three countries (Denmark, Italy, and Slovenia) and one autonomous region (Catalonia—Spain). Data were collected using two approaches: (a) a written interview with open-ended questions involving the members of the DELIVER project as key informants; and (b) a policy-document analysis. Interviews were analysed using the textual narrative synthesis and the word cloud policy analysis was conducted according to the Ready, Extract, Analyse and Distil approach. Results showed that all countries had established recent policies at the national level to address the development of digital health and specific governmental bodies were addressing the implementation of the digital transformation with specific ramifications at the regional and local levels. The words “health” and “care” characterized the policy documents of Denmark and Italy (309 and 56 times, 114 and 24 times, respectively), while “development” and “digital” (497 and 478 times, respectively) were common in the Slovenia document. The most used words in the Catalonia policy document were “data” and “system” (570 and 523 times, respectively). The HCP competencies expected are not clearly delineated among countries, and there is no formal plan for their development at the undergraduate, postgraduate, and continuing educational levels. Mutual understanding and exchange of good practices between countries may facilitate the digitalization processes; moreover, concrete actions in the context of HCP migration across Europe for employment purposes, as well as in the context of citizens’ migration for healthcare-seeking purposes are needed to consider the differences emerged across the countries

Privatisation and the quality of health-care services

As social services have a special mission, privatisation of social services should not be approved if it is unable to assure the same or an increased quality of life. Quality of life, of course, does not depend solely on a greater number of services but also and especially on the higher quality of those services. Since higher quality is often one of the motives for the privatisation of health services and as it is also stated as a goal in national documents and health care programmes, the author evaluates the privatisation of health services and its impact on the quality of the health services. She finds users as the most important stakeholders in this evaluation since they experience the entire process of a health service and its outcome. Evaluation is limited to the primary health level of the services of the general physician and dentist

QUALITY OF AN ACADEMIC STUDY PROGRAMME - EVALUATION MODEL

Quality of an academic study programme is evaluated by many: employees (internal evaluation) and by external evaluators: experts, agencies and organisations. Internal and external evaluation of an academic programme follow written structure that resembles on one of the quality models. We believe the quality models (mostly derived from EFQM excellence model) don’t fit very well into non-profit activities, policies and programmes, because they are much more complex than environment, from which quality models derive from (for example assembly line). Quality of an academic study programme is very complex and understood differently by various stakeholders, so we present dimensional evaluation in the article. Dimensional evaluation, as opposed to component and holistic evaluation, is a form of analytical evaluation in which the quality of value of the evaluand is determined by looking at its performance on multiple dimensions of merit or evaluation criteria. First stakeholders of a study programme and their views, expectations and interests are presented, followed by evaluation criteria. They are both joined into the evaluation model revealing which evaluation criteria can and should be evaluated by which stakeholder. Main research questions are posed and research method for each dimension listed

NEW MODEL OF QUALITY ASSESSMENT IN PUBLIC ADMINISTRATION - UPGRADING THE COMMON ASSESSMENT FRAMEWORK (CAF)

In our study, we developed new model of quality assessment in public administration. The Common Assessment Framework (CAF) is frequently used in continental Europe for this purpose. Its use has many benefits, however we believe its assessment logic is not adequate for public administration. Upgraded version of CAF is conceptually different: instead of analytical and linear CAF we get the instrument that measures organisation as a network of complex processes. Original and upgraded assessment approaches are presented in the paper and compared in the case of self-assessment of selected public administration organisation. The two approaches produced different, sometimes contradictory results. The upgraded model proved to be logically more consistent and it produced higher interpretation capacity

The study of health-care users: sampling and methodology

The privatisation process of health care introduced mixed economy of care and agreater assortment of health services which has resulted in a variety of experiences among users of the same type of service. This process devided users of a particular service in a three groups according to the way of payment of the service: users of public health services, who do not pay directly (health insurance), users of health services at private practitioner with concession (health insurance), users of health services (most often at private practitioner) who pay directly for the service. In the research we compared users\u27 experience of health services and their satisfaction with services among the three groups of users. More specificly, in users\u27 evaluation of health services we were exploring: percieved changes of health services (both public and private) after the adoption of the new health legislation (the Law on Health Activities) in 1992, percieved changes in the level of health protection, user behaviour pattern in the event of dissatisfaction with the service, user aspirations regarding health services

IZAZOVI PROBLEMA KOCKANJA U SLOVENIJI

Debates on gambling and related policy‐making are rarely based on conclusive and reliable data about this sector’s social effects. The said is also true for Slovenia. In this paper, we are calculating social costs of gambling in Slovenia and in the Goriška region in view of plans of possible investments into new resort casinos. In the first section, we review the gambling history and the current gambling market. After that we estimate the extent of the current problem and pathological gambling on the basis of the limited available data and develop scenarios of possible future trends. After that we examine strategies used in Slovenia to help and care for pathological and problem gamblers, and evaluate existing mechanisms. At the end of the paper we present two conclusions. Firstly, preventing gambling addiction is a difficult task, although expansion of the gambling sector does not necessarily imply a steep increase in social costs of gambling. Comprehensive system of responsible gambling including preventive measures and treatment of gambling addiction is the key issue. Secondly, available data on trends and developments regarding problem gambling in Slovenia is insufficient. Therefore, it is vital that we establish an observatory for longitudinal research on these issues and it should become part of a comprehensive system of socially responsible gambling.Rasprave o kockanju i politici prema kockanju u Sloveniji se ne temelje na mjerodavnim i pouzdanim podacima o socijalnim učincima ove pojave. U ovom tekstu procjenjujemo socijalne troškove kockanja u Sloveniji i Goriškoj, imajući u vidu planove za moguće ulaganje u kasina. U prvom dijelu prikazali smo povijest kockanja i trenutno stanje na kockarskom tržištu. Nakon toga procijenili smo rasprostranjenost ovog problema i patološkog kockanja na temelju ograničenih dostupnih podataka te razvili scenarij mogućih trendova u budućnosti. Nakon toga ispitali smo kako Slovenija skrbi i pomaže patološkim i problematičnim kockarima i evaluirali postojeće mehanizme. Na kraju smo došli do dva zaključka. Prvo, prevencija ovisnosti o kockanju je težak zadatak, iako ekspanzija u kockarskom sektoru nužno ne dovodi do povećanja socijalnih troškova kockanja. Cjelovit sustav odgovornog kockanja, koji uključuje preventivne mjere i tretman kockarske ovisnosti je ključni cilj. Drugo, imamo malo podataka na raspolaganju o trendovima i razvoju problematičnog kockanja u Sloveniji. Od vitalne je važnosti da smo ustanovili polazište za longitudinalno istraživanje o ovoj temi koje treba postati dijelom cjelovitog sustava socijalno odgovornog kockanja