Assessment of incentivizing effects for cancer care frameworks

Haier, Jörg; Sleeman, Jonathan; Schäfers, Jürgen

doi:10.1007/s10585-020-10046-y

Cited by 4 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, the resulting consequences, such as treatment compliance, abandonment, the acceptance of care, impaired QoL, etc., depend on the specific environment of each cancer patient. This requires setting the right incentives to motivate all participating groups, including patients, healthcare providers, healthcare politicians and the society [99,100], and should be accompanied by evaluation strategies.…”

Section: Discussionmentioning

confidence: 99%

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

Haier

Schaefers

2022

Cancers

View full text Add to dashboard Cite

Within healthcare systems in all countries, vulnerable groups of patients can be identified and are characterized by the reduced utilization of available healthcare. Many different reasons can be attributed to this observation, summarized as implementation barriers involving acceptance, accessibility, affordability, acceptability and quality of care. For many patients, cancer care is specifically associated with the occurrence of vulnerability due to the complex disease, very different target groups and delivery situations (from prevention to palliative care) as well as cost-intensive care. Sociodemographic factors, such as educational level, rural/remote location and income, are known determinants for these vulnerable groups. However, different forms of financial burdens likely influence this vulnerability in cancer care delivery in a distinct manner. In a narrative review, these socioeconomic challenges are summarized regarding their occurrence and consequences to current cancer care. Overall, besides direct costs such as for treatment, many facets of indirect costs including survivorship costs for the cancer patients and their social environment need to be considered regarding the impact on vulnerability, treatment compliance and abundance. In addition, individual cancer-related financial burden might also affect the society due to the loss of productivity and workforce availability. Healthcare providers are requested to address this vulnerability during the treatment of cancer patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

Haier

Schaefers

2022

Cancers

View full text Add to dashboard Cite

show abstract

“…In contrast, the HRH availability appeared to need priority in remote regions, in combination with telemedicine approaches, for PHC availability and referral guidance. These challenges will require the continuous control and implementation of the corresponding reporting and analytical pathways ( 36 ). Thus, these analyses should be based on high-quality pragmatic designs and focus on later-stage implementation outcomes ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Availability and Accessibility of Primary Care for the Remote, Rural, and Poor Population of Indonesia

Wenang

Schaefers

Afdal³

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

Background: Adopting Universal Health Coverage for implementation of a national health insurance system [Jaminan Kesehatan Nasional (JKN)/Badan Penyelenggara Jaminan Sosial or the Indonesian National Social Health Insurance Scheme (BPJS)] targets the 255 million population of Indonesia. The availability, accessibility, and acceptance of healthcare services are the most important challenges during implementation. Referral behavior and the utilization of primary care structures for underserved (rural/remote regions) populations are key guiding elements. In this study, we provided the first assessment of BPJS implementation and its resulting implications for healthcare delivery based on the entire insurance dataset for the initial period of implementation, specifically focusing on poor and remote populations.Methods: Demographic, economic, and healthcare infrastructure information was obtained from public resources. Data about the JKN membership structure, performance information, and reimbursement were provided by the BPJS national head office. For analysis, an ANOVA was used to compare reimbursement indexes for primary healthcare (PHC) and advanced healthcare (AHC). The usage of primary care resources was analyzed by comparing clustered provinces and utilization indices differentiating poor [Penerima Bantuan Iur (PBI) membership] and non-poor populations (non-PBI). Factorial and canonical discrimination analyses were applied to identify the determinants of PHC structures.Results: Remote regions cover 27.8% of districts/municipalities. The distribution of the poor population and PBI members were highly correlated (r2 > 0.8; p < 0.001). Three clusters of provinces [remote high-poor (N = 13), remote low-poor (N = 15), non-remote (N = 5)] were identified. A discrimination analysis enabled the >82% correct cluster classification of infrastructure and human resources of health (HRH)-related factors. Standardized HRH (nurses and general practitioners [GP]) availability showed significant differences between clusters (p < 0.01), whereas the availability of hospital beds was weakly correlated. The usage of PHC was ~2-fold of AHC, while non-PBI members utilized AHC 4- to 5-fold more frequently than PBI members. Referral indices (r2 = 0.94; p < 0.001) for PBI, non-PBI, and AHC utilization rates (r2 = 0.53; p < 0.001) were highly correlated.Conclusion: Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members.

show abstract

“…When considering the importance and complex effects of sociocultural incentives, it becomes clear that the entire cancer care community including all professionals groups, providers, organizations and policy makers needs to focus more on balancing the various types of incentives for all participants in the cancer care processes [ 5 ]. Reducing negative sociocultural incentives and barriers as well as setting supportive motivational frameworks can be targeted esp.…”

Section: Responsibilities For the Cancer Care Communitymentioning

confidence: 99%