Search

Background: Advanced practice nursing (APN) roles offer improved access to care and increased quality and more timely care. Despite the advantages of APN roles, there is a disparity between European countries when it comes to implementing APN roles. Aim: To explore the implementation of APN roles in a range of European countries and to explore what factors facilitate or hinder the implementation of these roles. Methods: A case study evaluation of the process of implementing APN roles. The sample included four countries where APN roles were well developed (Ireland, Spain, Norway and the United Kingdom) and four where APN roles were implemented (Estonia, Slovenia, Cyprus and Romania). Interviews were conducted with key informants (n = 28) from government departments, regulatory bodies, nursing associations and universities. The consolidated criteria for reporting qualitative research (CPREQ) has been used throughout. Limitations: The small number of countries when considering the size of the region and key informants representing the view of only three to four people in each country. Results: Four themes were identified, including the rationale for the development of the roles, influence, the evolutionary nature of role development and evidence. The data also revealed a mismatch between the perceptions of how the roles develop among the different countries in the early stages of implementation. Conclusion: Successful role implementation is dependent upon a tripartite approach between managers, practitioners and educators. An evolutionary approach to role development was used. Regulation and policy come later on in the process of implementation. Implications for nursing policy: APN policy should be based on patient needs rather than on the workforce or professional imperatives. The process of implementation can take 15–20 years in total. Recognising the importance of the relationships between service managers and educators is key to the early development of these roles. [ABSTRACT FROM AUTHOR]

The dramatic growth in health expenditures is an important health policy concern worldwide. Therefore, understanding the factors that increase health expenditures provides policy makers with evidence for decision-making. We aim to examine long-term effects of carbon dioxide emission, urbanization rate and GDP per capita on health expenditures. This study investigates the effect of carbon dioxide emission, urban population, and GDP per capita on health expenditure for 21 OECD countries over the period 1992–2018. Panel ARDL Approach and Gengenbach, Urbain and Westerlund Panel Co-integration Test have been used in the article. Test results indicate the long-run relationship among health expenditure and carbon dioxide emission, urban population, and GDP per capita. Effect of carbon dioxide emission (CO2), urban population, and GDP per capita is significant and positive on health expenditure. Rapid economic growths of OECD countries recently and environmental pollution have increased health expenditures in the long term. [ABSTRACT FROM AUTHOR]

Background In responding to Covid-19, governments have tried to balance protecting health while minimizing gross domestic product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalizations and deaths under 'mitigation' to modelled events under 'no mitigation' to 20 July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at £20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared with Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Results The UK saved 3.17 (0.32–3.65) million QALYs, £33 (8–38) billion healthcare costs and £1416 (220–1637) HRNB per capita at £20,000/QALY. Per capita, this is comparable to £1455 GDP loss using Sweden as comparator and offsets 46.1 (7.1–53.2)% of total £3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Conclusions Our exploratory analysis indicates the benefit of government Covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. [ABSTRACT FROM AUTHOR]