Monitoring of Quality in Health Care Using Indicators: Challenges and Possible Solutions

A number of stakeholders identified the need to revise the national set of quality indicators. The objectives of monitoring quality indicators that were determined in 2010 for the most part were not accomplished. Key reasons include: insufficient communication between stakeholders after the indicator set was introduced, insufficient definition of human and financial resources necessary for indicators\u27 monitoring, lack of a thorough ICT structure that could support indicators\u27 monitoring and weak leadership for these activities. A new performance indicators\u27 set requires a clear identification of the objectives to be pursued and consequently of the theoretical framework for the indicators. Mostly it is necessary in addition to the identification of the challenges so far, to also recognize what are the possibilities to strengthen this area in the future

Zmogljivost sistema zdravstvenega varstva Slovenije z vidika Euro Health Consumer Index 2012

Health care systems are complex entities with several stakeholders that include patients, health care providers, payers, regulators and government. For lay and professional public, the methodology of health care system performance analysis, result interpretation and translation to policy making is not well understood. Slovenian health care system performance results from a Swedish health care analyst (Euro Health Consumer Index 2012) and opportunities for improvement are discussed. We specifically addressed methodological challenges of international health care system performance comparisons.Sistemi zdravstvenega varstva so kompleksni sistemi s številnimi deležniki, med katerimi so najpomembnejši uporabniki in izvajalci zdravstvenih storitev, plačniki, regulatorji in odločevalci. Metodologija ocenjevanja zmogljivosti sistemov zdravstvenega varstva, interpretacija rezultatov in prenos v načrtovanje zdravstvenih politik so tako za laično kot tudi za strokovno javnost pogosto slabo razumljivi. V prispevku predstavljamo rezultate, ki jih je v sklopu mednarodne primerjave sistemov zdravstvenega varstva Euro Health Consumer Index 2012 prejel slovenski sistem in razpravljamo o možnostih za izboljšanje. Posebej se osredotočamo na metodološke pomanjkljivosti, ki jih mednarodne primerjave sistemov zdravstvenega varstva lahko vsebujejo

Governance in/of Cancer Care and Stewardship in Cancer Control: Creation of Definitions

In the literature in the field of cancer care, especially in the literature concerning national cancer control programmes, the terms governance and stewardship in/of cancer care are used, but usually not explained or defined. Therefore, we planned a systematic literature review in order to find the definitions of the terms governance and stewardship in/of cancer care. It was planned to create new definitions of the mentioned terms in case of unsuccessful finds. A literature review using PubMed, Google and MeSH as well as an opportunistic search for extra articles and chapters from books and grey literature was performed. Most of the found and analysed articles did not give exact explanation of the terms governance/stewardship in/of cancer care or they cited older articles (published before the year 2000) where the terms are used mostly in the field of clinical governance or in the completely other fileds, mostly banking, economy, religion or spirituality. Therefore, it was decided in the working group of experts from different European countries collaborating within in the work package Governance of integrated and comprehensive cancer care in the frame of the Innovative Partnership for the Action Against Cancer Joint Action project on cancer to create new definitions which we are presenting for the first time. The new definitions will facilitate the understanding of the leadership tasks in the area of cancer care and cancer control and will be particularly useful in the field of cancer programmes

Mental health inequalities in Slovenian 15-year-old adolescents explained by personal social position and family socioeconomic status

INTRODUCTION: Mental health inequalities are an increasingly important global problem. This study examined the association between mental health status and certain socioeconomic indicators (personal social position and the socioeconomic status of the family) in Slovenian 15-year-old adolescents. METHODS: Data originate from the WHO-Collaborative cross-national ‘Health Behavior in School-aged Children’ study conducted in Slovenia in 2010 (1,815 secondary school pupils, aged 15). Mental health status was measured by: KIDSCREEN-10, the Strength and Difficulties questionnaire (SDQ), a life satisfaction scale, and one question about feelings of depression. Socioeconomic position was measured by the socioeconomic status of the family (Family Affluence Scale, perceived material welfare, family type, occupational status of parents) and personal social position (number of friends and the type of school). Logistic regression and a multivariate analysis of variance (MANOVA) were performed. RESULTS: Girls had 2.5-times higher odds of suffering feelings of depression (p < 0.001), 1.5-times higher odds of low life satisfaction (p = 0.008), and a greater chance of a lower quality of life and a higher SDQ score than boys (p = 0.001). The adolescents who perceived their family’s material welfare as worse had 4-times higher odds (p < 0.001) of a low life satisfaction, a greater chance of a low quality of life, and a higher SDQ score than those who perceived it as better (p < 0.001). Adolescents with no friends had lower KIDSCREEN-10 and higher SDQ scores than those who had more than three friends. CONCLUSIONS: Despite the fact that Slovenia is among the EU members with the lowest rates of social inequalities, it was found that adolescents with a lower socioeconomic position have poorer mental health than those with a higher socioeconomic position. Because of the financial crisis, we can expect an increase in social inequalities and a greater impact on adolescents’ mental health status in Slovenia in the future

Engaging European society at the forefront of cancer research and care

Cancer prevention; Cancer research; PolicyPrevenció del càncer; Recerca del càncer; PolíticaPrevención del cáncer; Investigación del cáncer; PolíticaEuropean cancer research stakeholders met in October 2022 in Heidelberg, Germany, at the 5th Gago conference on European Cancer Policy, to discuss the current cancer research and cancer care policy landscape in Europe. Meeting participants highlighted gaps in the existing European programmes focusing on cancer research, including Europe's Beating Cancer Plan (EBCP), the Mission on Cancer (MoC), Understanding Cancer (UNCAN.eu), and the joint action CRANE, and put forward the next priorities, in the form of the Heidelberg Manifesto for cancer research. This meeting report presents all discussions that shed light on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public. In addition, we summarize recommendations on how to introduce frameworks for the digitalization of European cancer research. Finally, we discuss what structures, commitment, and resources are needed to establish a collaborative cancer research environment in Europe to achieve the scale required for innovation.Research discussed by Elena Garralda has been funded by CaixaResearch Advanced Oncology Research Program supported by Fundació La Caixa (LCF/PR/CE07/50610001) and by the European Union under grant agreements no. 965397 (CC-DART) and 101079984 (PCM4EU)

How to improve efficiency in cancer care: dimensions, methods, and areas of evaluation

Efficiency in healthcare is crucial since available resources are scarce, and the cost of inefficient allocation is measured in prior outcomes. This is particularly relevant for cancer. The aim of this paper is to gain a comprehensive overview of the areas and dimensions to improve efficiency, and establish the indicators, different methods, perspectives, and areas of evaluation, to provide recommendations for how to improve efficiency and measure gains in cancer care.Methods: We conducted a two-phase design. First, a comprehensive scoping literature review was conducted, searching four databases. Studies published between 2000 and 2021 were included if they described experiences and cases of efficiency in cancer care or methods to evaluate efficiency. The results of the literature review were then discussed during two rounds of online consultation with a panel of 15 external experts invited to provide insight and comments to deliberate policy recommendations.Results: 46 papers met the inclusion criteria. Based on the papers retrieved we identified six areas for achieving efficiency gains throughout the entire care pathway and, for each area of efficiency, we categorized the methods and outcomes used to measure efficiency gain.Conclusion: This is the first attempt to systemize a scattered body of literature on how to improve efficiency in cancer care and identify key areas of improvement. Policy summary: There are many opportunities to improve efficiency in cancer care. We defined seven policy recommendations on how to improve efficiency in cancer care throughout the care pathway and how to improve the measurement of efficiency gains

National plans and awareness campaigns as priorities for achieving global brain health

Neurological conditions are the leading cause of death and disability combined. This public health crisis has become a global priority with the introduction of WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP). 18 months after this plan was adopted, global neurology stakeholders, including representatives of the OneNeurology Partnership (a consortium uniting global neurology organisations), take stock and advocate for urgent acceleration of IGAP implementation. Drawing on lessons from relevant global health contexts, this Health Policy identifies two priority IGAP targets to expedite national delivery of the entire 10-year plan: namely, to update national policies and plans, and to create awareness campaigns and advocacy programmes for neurological conditions and brain health. To ensure rapid attainment of the identified priority targets, six strategic drivers are proposed: universal community awareness, integrated neurology approaches, intersectoral governance, regionally coordinated IGAP domestication, lived experience-informed policy making, and neurological mainstreaming (advocating to embed brain health into broader policy agendas). Contextualised with globally emerging IGAP-directed efforts and key considerations for intersectoral policy design, this novel framework provides actionable recommendations for policy makers and IGAP implementation partners. Timely, synergistic pursuit of the six drivers might aid WHO member states in cultivating public awareness and policy structures required for successful intersectoral roll-out of IGAP by 2031, paving the way towards brain health for all.</p

National plans and awareness campaigns as priorities for achieving global brain health

Neurological conditions are the leading cause of death and disability combined. This public health crisis has become a global priority with the introduction of WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP). 18 months after this plan was adopted, global neurology stakeholders, including representatives of the OneNeurology Partnership (a consortium uniting global neurology organisations), take stock and advocate for urgent acceleration of IGAP implementation. Drawing on lessons from relevant global health contexts, this Health Policy identifies two priority IGAP targets to expedite national delivery of the entire 10-year plan: namely, to update national policies and plans, and to create awareness campaigns and advocacy programmes for neurological conditions and brain health. To ensure rapid attainment of the identified priority targets, six strategic drivers are proposed: universal community awareness, integrated neurology approaches, intersectoral governance, regionally coordinated IGAP domestication, lived experience-informed policy making, and neurological mainstreaming (advocating to embed brain health into broader policy agendas). Contextualised with globally emerging IGAP-directed efforts and key considerations for intersectoral policy design, this novel framework provides actionable recommendations for policy makers and IGAP implementation partners. Timely, synergistic pursuit of the six drivers might aid WHO member states in cultivating public awareness and policy structures required for successful intersectoral roll-out of IGAP by 2031, paving the way towards brain health for all.</p

Engaging European society at the forefront of cancer research and care: How discussions at the 5th Gago Conference on European Science policy led to the Heidelberg Manifesto

European cancer research stakeholders met in October 2022 in Heidelberg, Germany, at the 5th Gago conference on European Cancer Policy, to discuss the current cancer research and cancer care policy landscape in Europe. Meeting participants highlighted gaps in the existing European programmes focusing on cancer research, including Europe's Beating Cancer Plan (EBCP), the Mission on Cancer (MoC), Understanding Cancer (UNCAN.eu), and the joint action CRANE, and put forward the next priorities, in the form of the Heidelberg Manifesto for cancer research. This meeting report presents all discussions that shed light on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public. In addition, we summarize recommendations on how to introduce frameworks for the digitalization of European cancer research. Finally, we discuss what structures, commitment, and resources are needed to establish a collaborative cancer research environment in Europe to achieve the scale required for innovation