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http://dx.doi.org/10.1016/j.gaceta.2016.02.013 | DOI Listing |
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
September 2025
School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Clarice Pears Building, 90 Byres Road, G12 8TB, Glasgow, UK.
The rate of improvement in life expectancy and mortality slowed considerably in a number of high-income countries from the early 2010s, predating the COVID-19 pandemic by almost a decade. Evidence for different countries, including the separate nations of the United Kingdom (e.g.
View Article and Find Full Text PDFHealth Soc Care Deliv Res
September 2025
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Background: Remote services (in which the patient and staff member are not physically colocated) and digital services (in which a patient encounter is digitally mediated in some way) were introduced extensively when the COVID-19 pandemic began in 2020. We undertook a longitudinal qualitative study of the introduction, embedding, evolution and abandonment of remote and digital innovations in United Kingdom general practice. This synoptic paper summarises study design, methods, key findings, outputs and impacts to date.
View Article and Find Full Text PDFMilbank Q
July 2025
School of Public Health, University of Illinois Chicago.
Unlabelled: Policy Points Community health centers (CHCs) are mandated to simultaneously maintain collaborative relationships with all other health care providers in their service area while consistently expanding their footprint to serve more patients, creating a contradictory policy environment. This study suggests that CHCs may respond to competitive shocks by engaging in a turf war with encroaching rivals at the expense of their financial solvency and social mission. Compounded in part by mounting fiscal austerity that may exacerbate competitive pressures, new approaches are needed that strengthen guardrails against patient selection and create incentives for CHCs to move into persistently underserved communities.
View Article and Find Full Text PDFHealth Soc Care Deliv Res
June 2025
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Background: United Kingdom general practices transitioned rapidly to remote-by-default services in 2020 and subsequently considered whether and how to continue these practices. Their diverse responses provided a unique opportunity to study the longer-term embedding, adaptation and abandonment of digital innovations. Research questions: What was the range of responses to the expansion of remote and digital triage and consultations among United Kingdom general practices in the period following the acute phase of the coronavirus disease discovered in 2019 (COVID-19) pandemic? What can we learn from this example about the long-term impacts of crisis-driven sociotechnical change in healthcare settings?
Methods: We collected longitudinal data from 12 general practices from 2021 to 2023, comprising 500 hours of ethnographic observation, 163 interviews in participating practices and linked organisations (132 staff, 31 patients), 39 stakeholder interviews and 4 multi-stakeholder workshops (210 participants), with additional patient and public involvement input.
Background: Over the past two decades, the Italian National Health Service has been gradually decentralised, with Italy's 21 regional governments now responsible for managing their health services. This change, coupled with austerity measures and a steadily ageing population, has adversely affected universal health coverage and equity, exacerbating inequalities and regional disparities. This study aimed to analyse time trends and subnational differences in the burden of disease from 2000 to 2019, and from 2019 to 2021 to capture the effects of the COVID-19 pandemic.
View Article and Find Full Text PDF