Health Technology Assessment in Action
Year:2021 | Volume:5 | Issue:4|Papers Count:8

Antimicrobial resistance has been described as a “ slow-moving Tsunami” and one of the top global health threats that affect social groups inequitably, especially in low-and middle-income countries (LMICs). This paper analyses social inequities and ethical implications related to antibiotic use in India and how information systems can help mitigate them. India is a global antimicrobial resistance (AMR) hotspot, showing relative policy inertia in addressing this grand challenge. The paper describes two interconnected streams of work. First, it takes an ecosystem perspective to understand inequities in practices around the prescription, dispensing, and consumption of antibiotics. Second, it analyzes the digital’ s potential role in addressing these inequities. As a result, the paper identifies four key determinants of social inequity and their ethical implications. Next, the paper identifies the opportunities and challenges in applying digital to address these inequities. This paper thus seeks to make a vital contribution to IS research on an area of immense societal value, particularly in informing how the potential of the digital can be effectively materialized.

Introduction: The science of health technology policy-making has, in recent years, gone beyond merely conducting health technology assessment studies, systematic reviews or economic evaluations. In fact, sciences based on decision-making in operational research, such as multi-attribute and multi-objective decision-making methods, have been added to this field. Methods: Examining several prominent papers in the field of applying multi-criteria decision analysis to the science of health technology assessment, this study attempts to provide guidance for policy makers in the field of health technologies to acquaint them with the history, current challenges, and the future of this field. Results: Mathematical approaches based on multi-criteria decision analysis began to be used in the fields of health policy making and economics in 2006 and 2008. These approaches are still being completed to adapt to the field of health. The main challenges in this regard are the existence of attributes such as equity and ethical issues facing the use of technology in health systems. The quantitative assessment of such attributes is really demanding. It is also very difficult to weight the attributes in such a way that all the considerations regarding technology stakeholders can be taken into account. Conclusions: In general, the application of approaches from applied mathematics to the field of health technology policy making can help us clarify the prioritization process. At the same time, however, using the efforts made so far by researchers in this field from around the world, we have, to a large extent, been able to overcome the operational shortcomings in applying those approaches in the field of health.

Background: According to the characteristics of public hospitals, a review of the flexibility of the components of their management accounting system is necessary. Objectives: The present study aimed to identify the factors affecting the audit of the performance of executive managers of public hospitals. Methods: The present study is an applied qualitative study based on grounded theory. In this regard, semi-structured interviews were conducted using the expert sampling technique and interviewing 18 specialists and experts familiar with the financial affairs of public hospitals. The sample size for interviewing experts was finalized within the theoretical saturation framework. The data analysis was performed in 3 stages of grounded theory, including open coding, axial coding, and selective coding. Then, the effective factors were classified into 6 main categories: causal conditions, axial phenomena, contextual factors, intervening conditions, strategies, and consequences in the form of a paradigm model. Results: “ The field of auditing, the field of organizational management, and the field of the structure” were 3 categories related to causal conditions. “ Budgeting and financial reporting” were identified as 2 main phenomena factors affecting the audit performance of executive managers of public hospitals; also, “ establishment conditions, techniques, and requirements for auditing” were recognized as contextual conditions. “ Environmental factors, applicable laws, and regulations” were identified as mediating/intervening conditions. Strategic conditions included “ structural factors and behavioral factors at the level of medical universities” ; also, the categories of “ public sector productivity, economic efficiency, effectiveness, efficiency, and achievement of organizations” were recognized as outcomes related to auditing the performance of executive managers of public hospitals. Conclusions: Recognizing the factors affecting the performance audit of public hospital managers is extremely significant and should be designed based on its affecting components, a standard and integrated auditing system for auditing the performance of public hospital managers.

Background: Addiction is a pervasive problem that causes physical problems and affects the adaptation of addicts. This study investigates the effectiveness of acceptance and commitment group therapy (ACT) and cognitive-behavioral therapy (CBT) on individual and social adaptation of addicts referred to comprehensive health service centers in Birjand. Methods: The present experimental study utilized a pretest-posttest design with a control group. All addicted people referred to health centers in the suburb of Birjand, which is among the city’ s vulnerable areas, were selected in 2020. The subjects were selected by a convenience method and randomly divided into three groups of 32 persons according to the study’ s objectives. The study questionnaire was the California test of personality. Cognitive-behavioral group therapy and acceptance and commitment therapy based on treatment protocols were held in 12 sessions of 60 minutes. The questionnaires were completed before the intervention and one month after the intervention in the three groups. Then, the data were entered into SPSS version 16 software. Analysis of variance, paired t, independent t, and chi-square tests analyzed the data. In all analyses, a significance level of less than 05. 0 was considered. Results: There was no difference between the three groups regarding age, occupation, and education level. The mean scores of social adaptation after the intervention were 57. 47 ± 12. 33 and 47. 90 ± 5. 93 in the ACT and CBT groups, respectively. The variance analysis showed that the mean scores of social adaptation were significantly different in three groups before and after the intervention (P < 0. 001). Also, the mean score of social adaptation in the ACT group significantly increased after the intervention compared to before (P = 0. 02), but there was no significant difference in the CBT and control groups before and after the intervention. After controlling for social and individual adaptation before the intervention, the variance analysis showed a significant difference in the score of social adaptation between the ACT, CBT, and control groups (P < 0. 001). There was also a significant difference in individual adaptation scores between the three groups (P < 0. 001). Conclusions: Both treatments based on acceptance and commitment and cognitive-behavioral therapy were influential on the individual-social adaptation of addicts. Nevertheless, the acceptance and commitment therapy approach had a more significant impact on improving the social adaptation of addicts.

Context: Access of innovative medicinal products remains ever-tortuous path due to affordability challenges (1), lengthy evidence generation process (2), and regulatory stringencies (3). As a result, significant delay in treatments are envisaged, sometimes even compromising the life of the patient. To avoid such negative consequences despite promising potential of the medicines and to provide value-based healthcare, manufacturers often consider entering into a formal agreement with third party payers for timely access of such products, known as managed entry agreements (MEA) (4). In other words, MEA is a formal document which facilitates market access to several key medicinal products despite the uncertainty of its financial or clinical impact. Given their purpose to reduce financial and outcomes related risk, they are also known as pharmaceutical risk-based sharing agreement (PRBSA). Popular nomenclature for PRBSA includes outcomes-based schemes, risk-sharing agreements, coverage with evidence development (CED), access with evidence development, patient access schemes (PASs), conditional licensing, and managed entry schemes (5)...

Context: The internet of things (IoT) is a system of wireless, interconnected and digital devices that can collect and store data in a network without needing to establish human-to-human or human-to-computer interactions. Objectives: Due to the importance of adopting up-to-date technologies in hospitals and health centers, this systematic review aimed to explore all aspects of the IoT applicable in hospitals. Methods: The present study was a systematic review conducted in 4 August 2021 according to PRISMA guidelines. The internet searches were performed to access three scientific databases of PubMed, Scopus, and ISI Web of Science using a combination of keywords, such as the IoT and hospital. Finally, the required data were extracted from original research articles investigating the IoT application in hospitals and were entered into EndNote X8 software. Quality assessment of the studies was carried out by two researchers independently. Results: A total of 18 articles were included in the study. The application of IoT had been introduced by 13 articles as an effective method in reducing and controlling dust levels as well as improving the quality of health in wards. Moreover, the possibility of using and installing IoT systems on mobile phones as well as their application for monitoring health improvement had been investigated by two articles. The advantages of using the IoT to save time and keep users’ information confidential had also been discussed by some other reviewed articles. Conclusions: It was concluded that the application of IoT system in hospitals increased the quality of healthcare and improved the patient satisfaction. It was also found that adopting IoT technology may have been extremely effective in controlling various hospital infections. Moreover, this technology was detected to have the true potential for improving the security of devices and databases in the hospital. Overall, the application of IoT was confirmed to increase the efficiency of hospitals and health centers.

Context: Coronavirus disease 2019 (COVID-19) has affected people’ s lives in all aspects. One of the most critical yet neglected features is parenting and the experience of mindful parenting for kids and their parents. Objectives: This study systematically reviewed the strategies for mindful parenting during the COVID-19 outbreak. Methods: In this systematic review, all related databases, including Web of Science, Scopus, PubMed, Google Scholar, and SID (Persian), were used to explore and search for the most relevant articles that had addressed mindfulness in parenting during the COVID-19 pandemic. A content analysis approach was applied to categorize the data. Codes were specified to every helpful strategy, and the codes were put in different themes and subthemes subjectively using a framework thematic analysis. Results: Three studies were included in our review. The two dimensions of mindfulness were considered as two subgroups for strategies identified to improve mindfulness in parenting in the final articles: (1) being in the moment, which means concentrating on the living moment and not worrying, thinking, or ruminating about other problems; and (2) non-judgmental approach, which means avoiding cognitive biases, such as pre-judgment. All suggested strategies could be classified into the mentioned categories. Conclusions: Strategies such as mindfulness in parenting are becoming more necessary for enhancing the quality of life for kids and their parents. Consequently, there is a need for policymakers and planners to facilitate parenting through social support systems and adjusting to the new situation, which will be on the agenda for a while.

Background: The mental health of addicts and the selection of appropriate treatment methods are essential. Given the role of spirituality and social health of addicts in relapse prevention and treatment, this study aimed to assess cognitive-behavioral group therapy (CBT) and acceptance and commitment therapy (ACT) in the mental, spiritual, and social health of addicted people. Methods: This interventional study utilized a pretest-posttest design with a control group. Addicts referred to the health centers of Birjand were selected in 2018-2019 through a convenience sampling method. According to the study’ s objectives, eligible individuals were randomly divided into three groups of 32 people. The Social Well-being Questionnaire of Keyes, the Spiritual Health Questionnaire of Alison and Palowtzin, and the General Health Questionnaire of Goldberg were used in the study. Cognitive-behavioral group therapy and acceptance and commitment therapy were held in 12 60-minute sessions based on treatment protocols. After one month, the questionnaires were completed again. The chi-square test, paired t-test, and analysis of variance were used to analyze the data at a significance level of less than 0. 05. Results: The three groups were similar in age, occupation, and education level. The mean scores of religious and existential health were significantly higher in the ACT group than in the control group after the intervention. Also, the paired t-test showed that the mean score of religious and existential health in the ACT group and the mean score of religious health in the CBT group significantly increased after the intervention compared to before (P < 0. 001). Also, the mean scores of social actualization, social solidarity, social cohesion, social acceptance, and social participation were significantly higher in the ACT group than in the control group after the intervention. The paired t-test showed that the mean scores of social actualization, solidarity, cohesion, and participation in the ACT group and the mean scores of social acceptance and cohesion in the CBT group significantly increased after the intervention compared to before. After the intervention, the mean scores of physical health, low anxiety, non-dysfunction, and low depression were significantly higher in the ACT and CBT groups than in the control group (P < 0. 001). Conclusions: Both ACT and CBT are influential in the mental, spiritual, and social health of addicts. Nevertheless, ACT has a more significant impact on the mental, spiritual, and social health of addicts.