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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6

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    PublicationOpen Access
    Health system modelling research: towards a whole-health-system perspective for identifying good value for money investments in health system strengthening
    (BMJ Publishing Group, 2019) Verguet, Stephane; Feldhaus, Isabelle; Kwete, Xiaoxiao Jiang; Aqil, Anwer; Atun, Rifat; Bishai, David; Cecchini, Michele; Guerra Junior, Augusto Afonso; Habtemariam, Mahlet Kifle; Jbaily, Abdulrahman; Kruk, Margaret E.; Haneuse, Sebastien; Norheim, Ole Frithjof; Smith, Peter C.; Tolla, Mieraf Taddesse; Zewdu, Solomon; Bump, Jesse; Department of Business Administration; Karanfil, Özge; Department of Business Administration; College of Administrative Sciences and Economics
    Global health research has typically focused on single diseases, and most economic evaluation research to date has analysed technical health interventions to identify 'best buys'. New approaches in the conduct of economic evaluations are needed to help policymakers in choosing what may be good value (ie, greater health, distribution of health, or financial risk protection) for money (ie, per budget expenditure) investments for health system strengthening (HSS) that tend to be programmatic. We posit that these economic evaluations of HSS interventions will require developing new analytic models of health systems which recognise the dynamic connections between the different components of the health system, characterise the type and interlinks of the system's delivery platforms; and acknowledge the multiple constraints both within and outside the health sector which limit the system's capacity to efficiently attain its objectives. We describe priority health system modelling research areas to conduct economic evaluation of HSS interventions and ultimately identify good value for money investments in HSS.
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    PublicationOpen Access
    The role of coping strategies in post-traumatic growth among Syrian refugees: a structural equation model
    (Multidisciplinary Digital Publishing Institute (MDPI), 2021) Acar, İbrahim H.; Alhiraki, Omar A.; Fahham, Ola; Erim, Yeşim; Department of Psychology; Acartürk, Ceren; Acar, Büşra; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A
    The Syrian conflict has led to a mass migration of Syrians to other countries and exposed them to many possible traumatic events and stressors in their country of origin and in the resettlement process. The possibility of positive psychological effects of adverse life events is less documented among Syrian refugees. Thus, the current study aimed to develop preliminary evidence for the identifying factors: traumatic experiences, post-migration stressors and coping strategies that are associated with post-traumatic growth (PTG) of Syrian refugees residing in Turkey. Structural equation modeling (SEM) was used in the current study to assess the associations among these factors. Data were obtained from Syrian refugees residing in the governorates of Hatay and Mardin. A total of 528 Syrians, aged between 18–77 years (M = 35.60, SD = 11.65) participated in this cross-sectional study. Results from the SEM indicated that past traumatic experiences and post-migration stressors were indirectly related to PTG. The results from the current study provide support for that the association between refugees’ traumatic experiences, post-migration stressors and PTG appear to be explained through the presence of coping strategies which could be addressed in the psychotherapies and psychosocial interventions for refugees to promote positive psychological change. Future studies should address the effects of post-migration stressors on PTG in detail.
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    PublicationOpen Access
    Prescribing behavior of general practitioners for generic drugs
    (Multidisciplinary Digital Publishing Institute (MDPI), 2020) Pagano, Sergio; De Santis, Mario; Cavallo, Pierpaolo; Department of Economics; Alpanda, Berna Tuncay; Teaching Faculty; Department of Economics; College of Administrative Sciences and Economics
    The factors influencing General Practitioners’ (GPs) prescribing behavior are diverse in terms of health care policies and regulations, GPs’ education and experience, demographic trends and disease profiles. Thus, it can be useful to analyze the specific local patterns, as they affect the quality of healthcare and the stability of the healthcare market. The aim of the present longitudinal retrospective study is to investigate the prescription of generic drugs in a database of about 4.6 million prescriptions from a sample of 38 GPs practicing in Salerno, Italy, within a timeframe of 15 years, from 2001 to 2015. The GPs in our study show a general tendency to increase prescriptions of generic drugs during the studied time span, to fulfill regulatory obligations and with some differences in prescription behavior according to age, gender and experience. The generics prescription depends also on the different diagnoses, with some diagnostic areas showing a greater generic drug prescription rate. Expanding this research to larger datasets would allow deepening the knowledge of the patterns of GPs’ prescribing decisions, to provide evidence to be used in comparison between different national settings.
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    PublicationOpen Access
    Turkey National Mesothelioma Surveillance and environmental asbestos exposure control program
    (Multidisciplinary Digital Publishing Institute (MDPI)) Metintaş, Selma; Batırel, Hasan Fevzi; Yılmaz, Ülkü; Karadağ, Mehmet; Ak, Güntülü; Metintaş, Muzaffer; N/A; Bayram, Hasan; Faculty Member; School of Medicine; 4890
    Malignant mesothelioma (MM) is an important health problem due to ongoing asbestos exposure. Environmental asbestos exposure leads to a high risk of MM in Turkey. The Turkish Mesothelioma Working Group and the Turkish Public Health Institute designed and performed the Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program (TUNMES-EAECP). The aim of this study was to analyze the results of the TUNMES-EAECP. Patients diagnosed with MM (code C45.0-C45.9) between 2008 and 2012 were identified. The "from case to the field" method was used to determine the villages with current or previous asbestos exposure. Special public health teams took soil samples from these villages, which were then examined using an X-ray diffractometer. Direct Standardized Average Annual Mesothelioma Incidence Rate (AMIR) and relative risk (RR) of MM were calculated. Finally, a projection on the incidence of MM between 2013 and 2033 was made. The number of confirmed MM cases was 5617 with a male to female ratio of 1.36. Mean age was 61.7 +/- 13.4 (20-96) years. The median survival was eight (95% CI 7.6-8.4) months. Asbestos exposure continues in 379 villages, with 158,068 people still living in high risk areas. The standardized AMIR was 2.33/100,000 per year. The risk of MM was higher in males, in both sexes over the age of 40, in asbestos-containing provinces, and in those where the TUNMES was organized. Among the population with continuing asbestos exposure in rural areas, the number of MM cases between 2013 and 2033 was estimated as 2511. As such, the incidence of MM in Turkey is as high as in industrialized countries. Asbestos exposure in rural areas continues to be a serious problem in Turkey, which obviates the necessity for effective preventive measures.
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    PublicationOpen Access
    Experiences with health care services in Switzerland among immigrant women with chronic illnesses
    (Frontiers, 2020) Frahsa, Annika; Farquet, Romaine; Bayram, Tevfik; De Araujo, Luna; Meyer, Sophie; Cattacin, Sandro; Abel, Thomas; Sakarya, Sibel; Faculty Member; School of Medicine; 172028
    Introduction: descriptive data indicate a high burden of chronic illness among immigrant women in Switzerland. Little is known about how immigrant women with chronic illnesses experience healthcare services. This paper presents a methodological approach theoretically informed by Sen's capability approach and Levesque's framework of access to healthcare to study patient-reported experiences (PREs) of Swiss healthcare services among immigrant women with chronic conditions. Methods: we conducted 48 semi-structured qualitative interviews in Bern and Geneva with Turkish (n = 12), Portuguese (n = 12), German (n = 12), and Swiss (n = 12) women. Participants were heterogenous in age, length of stay, SES, and educational attainment, illness types and history. We also conducted semi-structured interviews with healthcare and social service providers (n = 12). Interviewed women participated in two focus group discussions (n = 15). Interviews were transcribed verbatim and analyzed using Atlas.ti software, based on Gale et al.'s framework approach. Findings informed three stakeholder dialogues in which women as well as healthcare providers and policymakers from various territorial levels participated. Results: our methodological approach succeeded in integrating women's perspectives-from initial data collection in interviews to identify issues, focus group discussions to increase rigor, and stakeholder dialogues to develop tailored recommendations based on PREs. Discussion: this is one of the first studies in Switzerland that used PREs to research healthcare services and healthcare needs among immigrant women with chronic illnesses. This paper provides new insights on how to better understand existing challenges and potentially improve access to and quality of care.