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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (1 September 2018) | Viewed by 40080

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Special Issue Editor

Prof. Dr. Ceri J. Phillips

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Guest Editor

College of Human and Health Sciences, Swansea University, Wales SA2 8PP, UK
Interests: economic evaluation; cost-effectiveness; public health; chronic conditions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Health policy issues will always be high on political agendas and demands on healthcare resources will always outstrip the available supply. Technological advancements, developments in medical science and increasing expectations of communities as to what is available from healthcare providers continue to focus attention on the healthcare dilemma, which means that choices will always have to be made regarding the level of resources allocated to healthcare and, within healthcare, which areas receive a greater share and which areas receive less. In making such choices an explicit set of priorities needs to be established and attitudes changed. The management of health and social care systems therefore presents major challenges, which arise from the strain that health problems impose on patients and their families, and increasingly on the sustainability of formal heath systems and informal care support. These challenges are manifest in a variety of personal, economic and social effects, which impinge, to varying degrees, on a range of stakeholders. Concerted action, which spans healthcare systems, other areas of government policy, non-governmental agencies, communities, patients and their families, with appropriate incentive schemes in place to address these challenges is therefore required. This Special Issue invites contributions that consider how these challenges might evolve, how they might be addressed and the evidence underpinning the effectiveness and efficiency of relevant interventions and policy initiatives.

Prof. Dr. Ceri J. Phillips
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

determinants of health
social, economic, environmental and cultural factors
inequalities
effectiveness and efficiency
resource allocation and distribution
policy development and evaluation

Published Papers (7 papers)

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Research

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18 pages, 332 KiB

Open AccessArticle

Environmental and Individual Predictors of Healthy Dietary Behaviors in a Sample of Middle Aged Hispanic and Caucasian Women

by Deborah J. Bowen, Jennifer M. Jabson, Wendy E. Barrington, Alyson J. Littman, Donald L. Patrick, Anne Vernez Moudon, Denise Albano and Shirley A. A. Beresford

Int. J. Environ. Res. Public Health 2018, 15(10), 2277; https://doi.org/10.3390/ijerph15102277 - 17 Oct 2018

Cited by 5 | Viewed by 2712

Abstract

The objective of this effort is to gather data to tailor interventions appropriately. Greater understanding of the correlates of socioeconomic status and obesogenic dietary behaviors was the focus of this manuscript. Using multistage sampling, women with varied education levels completed a baseline assessment in a longitudinal study of women aged 30 to 50 years. This study was conducted in low-SES areas of South King County, Washington State. This study included 530 Caucasian and 510 Hispanic women. Fruit and vegetable consumption was positively associated and soft drink consumption inversely associated with the level of education in Caucasian women. In contrast, percentage calories from fat was positively associated with the level of education in Hispanic women. In Hispanic women, level of education interacted significantly with food security in relation to percentage calories from fat, and with eating norms in relation to soft drink consumption. Neighborhood presence of ethnic food stores was associated with outcomes for Hispanic women, but for Caucasians, presence of fast food restaurants was important. Education was consistently associated with two of the three obesogenic dietary behaviors studied among Caucasian women. Education played a moderating role in the associations of food security and eating norms, independent of area level food availability, in two of three obesogenic dietary behaviors studied. However, these patterns differed for Hispanic women, indicating the need for more research into important variables to support change in Hispanic women. Women of differing ethnic groups did not respond similarly to environmental conditions and policy-relevant surroundings. These data have meaning for considering urban policy that impacts obesity levels in the population. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

14 pages, 741 KiB

Open AccessArticle

Prediction and Decomposition of Efficiency Differences in Chinese Provincial Community Health Services

by Qian Liu, Bo Li and Muhammad Mohiuddin

Int. J. Environ. Res. Public Health 2018, 15(10), 2265; https://doi.org/10.3390/ijerph15102265 - 16 Oct 2018

Cited by 21 | Viewed by 3205

Abstract

The objective of this paper is to analyze the provincial efficiency of the Chinese community health care service and its differences. This study allows us to predict the provincial differences in the efficiency of the Chinese community health care service from 2017 to 2026. This study analyzes the contributions of inter-regional and intra-regional differences in the total efficiency difference. We use the Super-SBM (Slacks-based Model) data envelopment analysis (DEA) model, Grey Model GM (1,1) for grey prediction, and the group-based Theil index decomposition method to study Chinese provincial panel data from 2008 to 2016. Results show that a fluctuating trend existed in the average provincial efficiency of community health services from 2008 to 2016. The community health services in a considerable number of provincial areas were inefficient. This study also reveals that there existed apparent inter-provincial differences in efficiency in Chinese community health services. The inter-provincial differences of the efficiency of Chinese community health services revealed by the Theil index declined at a relatively slow pace. With regard to the provincial efficiency difference of the Chinese community health service, the intra-regional efficiency difference is the most important structural reason for the overall efficiency difference, which explains the overall difference to a large extent. The inter-regional efficiency difference among the eastern, central, and western regions becomes the secondary structural reason, which should not be ignored. In conclusion, focus should be put on restructuring the investments into medical resources for community health service in each Chinese province. More attentions should be put into narrowing the inter-regional efficiency differences of the Chinese provincial community health service. The strategies targeted at reducing the inter-regional efficiency differences should not be ignored, so as to facilitate the improvement of overall efficiency of the Chinese community health service. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

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16 pages, 1003 KiB

Open AccessArticle

Integrating Refined Kano Model and QFD for Service Quality Improvement in Healthy Fast-Food Chain Restaurants

by Kai-Jung Chen, Tsu-Ming Yeh, Fan-Yun Pai and Der-Fa Chen

Int. J. Environ. Res. Public Health 2018, 15(7), 1310; https://doi.org/10.3390/ijerph15071310 - 22 Jun 2018

Cited by 43 | Viewed by 12471

Abstract

People are paying greater attention to health. To maintain a good health status and obtain food fast, customers may go to healthy fast-food chain restaurants such as Subway more often than before in China and Taiwan. Healthy fast-food chain restaurants come with a healthy spin, seeking to differentiate themselves from other fast-food restaurants. This paper combined the refined Kano model and the quality function deployment (QFD) method. The refined Kano model was used to understand how customers perceive service attributes developed based on DINESERV measurements. QFD was employed to describe the relationships among the critical service attributes and corresponding improvements as well as to identify the priority for these improvements. The analysis results revealed that providing limited offers (due to periods, seasons, and regions) should be at the top of their improvement list, followed by staff suggestions for ingredients, and a temperature display to enhance the image of fresh ingredients. Other improvement actions include providing regular launches of new flavors/products, designing new and attractive slogans, and providing restaurant apps. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

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12 pages, 295 KiB

Open AccessArticle

Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China

by Man Li, Renyao Zhong, Shanwen Zhu, Lauren C. Ramsay, Fen Li and Peter C. Coyte

Int. J. Environ. Res. Public Health 2018, 15(6), 1184; https://doi.org/10.3390/ijerph15061184 - 06 Jun 2018

Cited by 5 | Viewed by 3233

Abstract

Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

10 pages, 354 KiB

Open AccessArticle

Disability-Adjusted Life Years for Cancer in 2010–2014: A Regional Approach in Mexico

by Efrén Murillo-Zamora, Oliver Mendoza-Cano, Mónica Ríos-Silva, Ramón Alberto Sánchez-Piña, Martha Alicia Higareda-Almaraz, Enrique Higareda-Almaraz and Agustin Lugo-Radillo

Int. J. Environ. Res. Public Health 2018, 15(5), 864; https://doi.org/10.3390/ijerph15050864 - 26 Apr 2018

Cited by 6 | Viewed by 3812

Abstract

The disability-adjusted life years (DALYs) were used to estimate the regional (state of Colima, Mexico) cancer burden in 2010–2014. The years of life lost (YLL) were estimated with mortality data and years lived with disability (YLD) using incidence data. The DALYs were calculated as the arithmetic addition of YLL and YLD. Sex and cancer site-specific estimations were made and DALY rates were used to identify the leading causes of disease burden. Data from 2532 deaths were analyzed and, for all malignant tumors combined, 18,712.9 DALYs and 20,243.3 DALYs were estimated in males and females respectively. The overall contribution of YLL in DALY estimates was higher among females (93.7% vs. 87.4%). Age-standardized DALY rates (and 95% confidence intervals, CI) per 100,000 inhabitants were used to rank the leading causes of disease burden and, among males, malignant tumors from the prostate, lower respiratory tract, and colon and rectum accounted the highest rates (45.7, 95% CI 32.7–59.3; 37.6, 95% CI 25.7–49.9; and 25.9, 95% CI 16.0–36.1 DALYs). Breast, cervix uteri, and lower respiratory tract cancer showed the highest burden in females (66.0, 95% CI 50.3–82.4; 44.4, 95% CI 31.5–57.7; and 20.9, 95% CI 12.0–30.0 DALYs). The present study provides an indication of the burden of cancer at the regional level, underscoring the need to expand cancer prevention, screening, and awareness programs, as well as to improve early diagnosis and medical treatment. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

Review

Jump to: Research

22 pages, 2425 KiB

Open AccessReview

Making the Case for “Whole System” Approaches: Integrating Public Health and Housing

by Richard A. Sharpe, Tim Taylor, Lora E. Fleming, Karyn Morrissey, George Morris and Rachel Wigglesworth

Int. J. Environ. Res. Public Health 2018, 15(11), 2345; https://doi.org/10.3390/ijerph15112345 - 24 Oct 2018

Cited by 42 | Viewed by 10566

Abstract

Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. Today, the traditional public health emphasis on the type and quality of housing merges with other wider determinants of health. These include the neighbourhood, community, and “place” where a house is located, but also the policies which make access to a healthy house possible and affordable for everyone. Encouragingly, these approaches to policy and action on housing have the potential to contribute to the “triple win” of health and well-being, equity, and environmental sustainability. However, more effective housing policies (and in public health in general) that adopt more systemic approaches to addressing the complex interactions between health, housing, and wider environment are needed. This paper illustrates some of the key components of the housing and health challenge in developed countries, and presents a conceptual model to co-ordinate activities that can deliver the “triple win.” This is achieved by offering a perspective on how to navigate more effectively, inclusively and across sectors when identifying sustainable housing interventions. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

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22 pages, 944 KiB

Open AccessReview

Dimensions, Dialectic, Discourse. Three Political Perspectives on the Sustainability of the German Healthcare System

by Matthias Fischer and Harald Heinrichs

Int. J. Environ. Res. Public Health 2018, 15(7), 1526; https://doi.org/10.3390/ijerph15071526 - 19 Jul 2018

Viewed by 3584

Abstract

This review article deals with the topic of sustainability in the German healthcare system and presents an overview of how the six articles of our research relate to one another. After introducing to the context of the research, its internal principles, and the methods applied, three perspectives are presented, each also discussed in terms of the respective literature in sustainability science and political science. The review concludes by presenting a circular model and by discussing the general limitations as well as the practical implications of our research. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

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