Global Health Systems

The analysis of different national models of health systems and how they measure up in achieving equitable access to health care and improving health outcomes. 

Opioid Prescribing After Surgery in the United States, Canada, and Sweden

Mark D. Neuman, MD
Sep. 4, 2019

Karim S. Ladha, Mark D. Neuman, Gabriella Broms, Jennifer Bethell, Brian T. Bateman, Duminda N. Wijeysundera, Max Bell, Linn Hallqvist, Tobias Svensson, Craig W. Newcomb, Colleen M. Brensinger, Lakisha J. Gaskins, Hannah Wunsch

Abstract [from journal]

Importance: Small studies and anecdotal evidence suggest marked differences in the use of opioids after surgery internationally; however, this has not been evaluated systematically across populations receiving similar procedures in different countries.

Objective: To determine whether there are differences in the frequency, amount, and type of opioids dispensed after surgery among the United States, Canada, and Sweden.

Design, Setting, and Participants: This cohort study included patients...

Penn’s Gant Family Precision Medicine Consortium Takes on Sustainable Targeted Oncology

Sep. 20, 2018

Biomedical advances in genomics and oncology, combined with rising costs for targeted cancer therapies, challenge the way we currently deliver and pay for cancer care. To foster the economic sustainability of targeted therapies, the University of Pennsylvania convened the Gant Family Precision Cancer Medicine Consortium, a multidisciplinary work group of experts from health care economics, policy, law, regulation, biomedical research, patient advocacy, and the pharmaceutical and insurance industry.

Implementation Strategies to Improve Cervical Cancer Prevention in Sub-Saharan Africa: A Systematic Review

Mar. 8, 2018

Lauren G. Johnson, Allison Armstrong, Caroline M. Joyce, Anne M. Teitelman, and Alison M. Buttenheim

ABSTRACT [From Journal]

BackgroundDeveloped countries, such as the USA, have achieved significant decreases in cervical cancer burden since the introduction of Pap smear-based programs in the 1960s. Due to implementation barriers and limited resources, many countries in sub-Saharan Africa (SSA) have been unable to attain such reductions. The purpose of this review is to evaluate implementation strategies used to improve the uptake and sustainability of cervical cancer prevention programs in SSA....

A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health

Feb. 28, 2018

Katherine S. Kellom, Meredith Matone, Aderinola Adejare, Frances K. Barg, David M. Rubin, Peter F. Cronholm

Abstract [from journal]

Objectives: The aim of this paper is to explore the process and impact of co-locating evidence-based maternal and child service models to inform future implementation efforts.

Methods: As part of a state-wide evaluation of maternal and child home visiting programs, we conducted semi-structured interviews with administrators and home visitors from home visiting agencies across Pennsylvania. We collected 33 interviews from 4 co-located agencies. We used the Consolidated Framework for...

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

Iliana Kohler
Nov. 7, 2017

Collin F. Payne, Iliana V. Kohler, Chiwoza Bandawe, Kathy Lawler, Hans-Peter Kohler

Abstract [from journal]

Cognitive health is an important dimension of well-being in older ages, but few studies have investigated the demography of cognitive health in sub-Saharan Africa’s growing population of mature adults (= persons aged 45+). We use data from the Malawi Longitudinal Study of Families and Health to document the age and gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age pattern of decline in cognitive health...

Comparison of Site of Death, Health Care Utilization, and Hospital Expenditures for Patients Dying With Cancer in 7 Developed Countries

Feb. 17, 2016

Justin Bekelman, Scott Halpern, Carl Rudolf Blankart, Julie Bynum, Joachim Cohen, Robert Fowler, Stein Kaasa, Lukas Kwietniewski, Hans Olav Melberg, Bregie Onwuteaka-Philipsen, Mariska Oosterveld-Vulg, Andrew Pring, Joans Schreyogg, Connie Ulrich...

In The Journal of the American Medical Association, Justin Bekelman and colleagues, including Scott Halpern, Connie Ulrich and Ezekiel Emanuel compare site of death, health care utilization and hospital expenditures in 7 countries: Belgium, Canada, England, Germany, the Netherlands, Norway and the United States. Using administrative and registry data, the researchers measured deaths in acute care hospital, along with inpatient and outpatient measures, and hospital expenditures paid by insurers. They find that a smaller proportion of decedents, older than 65, died in acute...

Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

Jan. 29, 2016

Hayley Germack, Peter Griffiths, Douglas Sloane, Anne Marie Rafferty, Jane Ball, Linda Aiken

In BMJ Open, Hayley Germack and colleagues, including Linda Aiken, examine the association between patient satisfaction with nursing care in National Health Service (NHS) hospitals in England and the proportion of non-UK educated nurses providing care. The authors used data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. They found a significant association between the percentage of non-UK educated nurses providing bedside care and patient satisfaction; hospitals with higher percentages of non-UK educated nurses had lower...