To nudge, or not to nudge, that is the question

The use of techniques from behavioural science to nudge populations in subtle ways to choose behaviours and activities positive to their health and wellbeing is certainly fashionable. One question, yet to be resolved, is whether these nudges will become integral components of public health policy or just passing fads. There should be scope for nudging to play an important role augmenting other elements of health promotion and public health policy. This is likely to depend on whether or not the evidence base on the effectiveness and cost effectiveness of different types of health nudges, targeted at different population groups and in different settings, develops sufficiently

Providing emergency medical care (New Eurohealth issue)

Providing timely emergency medical services for life-threatening situations as well as urgent care appropriate to patients’ clinical needs are the most enduring challenges facing national health care systems, particularly in light of rising numbers of unnecessary emergency department attendances in many countries. The latest issue of Eurohealth (volume 21, issue 4), which has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), tackles this issue

Health system developments in former Soviet countries

Nearly 25 years after the dissolution of the Soviet Union all of the countries in the region are actively engaged in the process of reforming their health care systems, with various degrees of success. The latest issue of Eurohealth (volume 21, issue 2), just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), analyses developments in these countries

Israel: health system review

The Health Systems in Transition (HiT) series consists of country-based reviews that provide a detailed description of a health system and of reform and policy initiatives in progress or under development in a specific country. Each review is produced by country experts in collaboration with the Observatory’s staff. In order to facilitate comparisons between countries, reviews are based on a template, which is revised periodically. The template provides detailed guidelines and specific questions, definitions and examples needed to compile a report. HiTs seek to provide relevant information to support policy-makers and analysts in the development of health systems in Europe. They are building blocks that can be used: • to learn in detail about different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; • to describe the institutional framework, the process, content and implementation of health-care reform programmes; • to highlight challenges and areas that require more in-depth analysis; • to provide a tool for the dissemination of information on health systems and the exchange of experiences of reform strategies between policymakers and analysts in different countries; and • to assist other researchers in more in-depth comparative health policy analysis. Compiling the reviews poses a number of methodological problems. In many countries, there is relatively little information available on the health system and the impact of reforms. Due to the lack of a uniform data source, quantitative data on health services are based on a number of different sources, including the World Health Organization (WHO) Regional Office for Europe’s European Health for All database, data from national statistical offices, Eurostat, the Organisation for Economic Co-operation and Development (OECD) Health Data, data from the International Monetary Fund (IMF), the World Bank’s World Development Indicators and any other relevant sources considered useful by the authors. Data collection methods and definitions sometimes vary, but typically are consistent within each separate review. A standardized review has certain disadvantages because the financing and delivery of health care differ across countries. However, it also offers advantages, because it raises similar issues and questions. HiTs can be used to inform policy-makers about experiences in other countries that may be relevant to their own national situation. They can also be used to inform comparative analysis of health systems. This series is an ongoing initiative and material is updated at regular intervals. Comments and suggestions for the further development and improvement of the HiT series are most welcome and can be sent to [email protected]. HiTs and HiT summaries are available on the Observatory’s web site http://www.healthobservatory.eu

Eurohealth Volume 20, issue 2: Health behaviours and incentives

The last decade has seen an increasing interest in some countries of the potential of using behavioural science to inform our understanding and influence policy design. The Eurohealth Observer section kicks off with a look at the fashionable area of applying the principles of behavioural science to nudge populations towards better health and wellbeing. It discusses the growth in popularity of these health nudges and questions the evidence base on their effectiveness and cost effectiveness. It goes on to suggest where these principles may have a role to play in enhancing elements of health promotion and public health policy

The changing role of nursing (New Eurohealth issue)

There is no doubt that the role of nurses has been changing over the past few decades, not only in terms of their evolving clinical and managerial responsibilities but also in terms of their education and training. These processes have been affected in many ways by developments at the European level, not least through directives on the free movement of professionals as well as the mutual recognition of professional qualifications. The latest issue of Eurohealth (volume 22, issue 1), which has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), looks at the changing role of nursing

What do we know about the strengths and weakness of different policy mechanisms to influence health behaviour in the population?

With health care systems under increasing pressure the development of a well defined and effective public health strategy has never been more important. Many health problems are potentially avoidable and governments have long had tools at their disposal to influence population health and change individual behaviours, directed both ‘upstream’ at some of the underlying causes of poor health, as well as at ‘downstream’ challenges when poor health behaviours are already manifest. But how effective are these different actions? This policy summary briefly maps out what is known about some of these mechanisms, including approaches that have come to recent prominence from behavioural economics and psychology. Combinations of taxation, legislation and health information remain the core components of any strategy to influence behavioural change. There remain many unanswered questions on how best to design new innovative interventions that can complement, and in some instances augment, these well-established mechanisms