Accountability

Accountability
  • 文章类型: Journal Article
    背景:在研究作者中公平地纳入低收入和中等收入国家(LMIC)研究人员和妇女是一个优先事项。对世卫组织确定的优先事项的进展进行了审查,为审查2型单纯疱疹病毒(HSV-2)研究中作者身份的地理和性别分布提供了机会。
    方法:确定了在2000年至2020年期间出版的关于世卫组织研讨会优先考虑的五个领域的出版物。关于作者国家的数据,性别,作者职位和研究资金来源是通过手稿审查和互联网搜索收集的,并使用IBMSPSSV.26进行了分析。
    结果:已确定297份合格文件,(n=294)有多个作者。其中,241(82%)包括至少一位LMIC作者,143(49%)和122(41%)有LMIC第一和最后一位作者,分别。LMIC资助的研究包括LMIC第一作者或最后作者的可能性是高收入国家资助研究的两倍多(相对风险2.36,95%CI1.93至2.89)。分别,129(46%)和106(36%)研究有女性第一和最后一位作者。LMIC的第一和最后作者身份因HSV-2研究领域而异,并随着时间的推移增加到2015-2020年的65%和59%。
    结论:尽管研究本身位于LMIC环境中,在20年的时间里,LMIC研究人员仅持有少数第一和最后作者职位。虽然LMIC在这些职位上的代表性随着时间的推移而提高,重要的研究领域和妇女仍然存在重要的不平等。解决全球卫生研究中当前和历史的权力差距,研究基础设施及其资助方式可能是解决这些问题的关键。
    BACKGROUND: Equitable inclusion of low-income and middle-income country (LMIC) researchers and women in research authorship is a priority. A review of progress in addressing WHO-identified priorities provided an opportunity to examine the geographical and gender distribution of authorship in herpes simplex virus type-2 (HSV-2) research.
    METHODS: Publications addressing five areas prioritised in a WHO workshop and published between 2000 and 2020 were identified. Data on author country, gender, authorship position and research funding source were collected by manuscript review and internet searches and analysed using IBM SPSS V.26.
    RESULTS: Of, 297 eligible papers identified, (n=294) had multiple authors. Of these, 241 (82%) included at least one LMIC author and 143 (49%) and 122 (41%) had LMIC first and last authors, respectively. LMICs funded studies were more than twice as likely to include an LMIC first or last author as high-income country-funded studies (relative risk 2.36, 95% CI 1.93 to 2.89). Respectively, 129 (46%) and 106 (36%) studies had female first and last authors. LMIC first and last authorship varied widely by HSV-2 research area and increased over time to 65% and 59% by 2015-2020.
    CONCLUSIONS: Despite location of the research itself in LMIC settings, over the 20-year period, LMIC researchers held only a minority of first and last authorship positions. While LMIC representation in these positions improved over time, important inequities remain in key research areas and for women. Addressing current and historical power disparities in global health research, research infrastructure and how it is funded may be key addressing to addressing these issues.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    人们越来越意识到,对犯罪者的反应采取全系统的方法是解决家庭和家庭暴力(DFV)的关键。本文报告了范围审查的结果,该审查绘制了有关卫生专业人员如何在医院环境中识别和应对DFV肇事者的国际文献。使用了全面的范围审查方法。搜索,从2010年1月到2022年1月,从四个数据库产生了12380份出版物。纳入的资格包括同行评审的文献,以及任何涉及住院医院卫生专业人员识别或回应DFV肇事者的文献。最终审查中包括14篇文章。这篇综述介绍了按预防水平分类的文献,从小学,次要,直到三级预防性干预。添加了其他类别“其他做法”以捕获不适合现有级别的做法。尽管瞥见了卫生专业人员如何识别,并回应DFV的肇事者,当前的知识库是稀疏的。审查没有确定任何强制性或正式的程序来识别和/筛查或应对医院中的虐待行为。相反,对肇事者的反应不一致,依赖于动机,技能,以及卫生专业人员的自我效能,而不是由医院政策或程序驱动和了解的嵌入式实践。文献描绘了在医院环境中与DFV肇事者进行有意义的工作的错失机会,并强调了政策与实践之间的脱节。
    There is heightened awareness that a whole-of-systems approach to perpetrator responses is key to addressing domestic and family violence (DFV). This paper reports on the findings from a scoping review which mapped the international literature on how health professionals identify and respond to perpetrators of DFV within a hospital setting. A comprehensive scoping review methodology was used. The search, spanning January 2010 to January 2022, yielded 12,380 publications from four databases. Eligibility for inclusion included peer-reviewed literature with any reference to inpatient hospital health professionals identifying or responding to perpetrators of DFV. Fourteen articles were included in the final review. The review presents the literature categorized by levels of prevention, from primary, secondary, through to tertiary preventive interventions. An additional category \"other practices\" is added to capture practices which did not fit into existing levels. Despite glimpses into how health professionals can identify, and respond to perpetrators of DFV, the current knowledge base is sparse. The review did not identify any mandated or formal procedures for identifying and/screening or responding to perpetration of abuse in hospitals. Rather, responses to perpetrators are inconsistent and rely on the motivation, skill, and self-efficacy of health professionals rather than an embedded practice that is driven and informed by hospital policy or procedures. The literature paints a picture of missed opportunities for meaningful work with perpetrators of DFV in a hospital setting and highlights a disjuncture between policy and practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    背景:医院,作为具有临床的复杂组织,金融,和社会功能,以合理的成本提供高质量和安全的服务面临不同的障碍。在医院治理中开展了各种举措,以提高质量,安全,和问责制。这项研究旨在确定使医院治理负责的结构和维度。
    方法:本研究使用Arksey和O\'Malley的范围审查框架来检查有关医院治理结构和问责制的研究文献。文献综述包括PubMed,WebofScience,Embase,ScopusProQuest,谷歌搜索引擎,和2010年至2023年的谷歌学者数据库。采用内容分析法对数据进行分析。
    结果:排除不相关和重复的来源,该研究包括40篇文章和报告。根据组织类型对研究进行了回顾和分析,源的类型,出版年份,目标,和关键发现。从选定的文章和报告中提取了可负责的治理功能。四大主题包括包容性治理,对问责制的承诺,问责制规划,自治治理。从研究文献中提取了13个子主题。
    结论:各国针对公立医院治理结构的改革实施了各种举措。其中许多改革旨在改善财务和临床问责制。研究结果可用于确定使医院治理负责的结构和维度。
    BACKGROUND: Hospitals, as complex organizations with clinical, financial, and social functions, face different barriers to providing high-quality and safe services at reasonable costs. Various initiatives have been carried out in hospital governance to improve quality, safety, and accountability. This research aims to identify the structures and dimensions that make hospital governance accountable.
    METHODS: The research used Arksey and O\'Malley\'s scoping review framework to examine the research literature on hospital governance structure and accountability. The literature review included PubMed, Web of Science, Embase, Scopus ProQuest, Google search engine, and Google Scholar databases from 2010 to 2023. Data were analyzed using the content analysis method.
    RESULTS: Excluding unrelated and duplicate sources, 40 articles and reports were included in the study. The studies were reviewed and analyzed based on organizational type, type of source, year of publication, objectives, and key findings. Accountable governance features were extracted from the selected articles and reports. The four main themes include inclusive governance, commitment to accountability, planning for accountability, and autonomous governance. Thirteen subthemes were extracted from the study literature.
    CONCLUSIONS: Various initiatives have been implemented regarding the reform of the governance structure of public hospitals in different countries. Many of these reforms aim to improve financial and clinical accountability. The study results could be used to identify the structures and dimensions that make hospital governance accountable.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    为了更好地为人们的复杂需求服务,随后转向以人为中心的综合护理,需要通过领域总体网络和联盟进行组织间合作和服务提供。在这些网络的发展过程中,探索哪种问责制方法适合本地组织间医疗保健治理是相关的。因此,在范围审查中,我们研究了荷兰医疗保健问责制的知识和实践现状.我们发现,纳入的41项研究中有两项显示了对医疗保健的问责特征,具有整合护理组成部分的特征,例如将服务与相应的问责制安排相结合,并发展网络问责制。在报告综合护理问责制的文献中发现了第一批研究。有了这一点,我们增加了关于问责制作为综合护理治理的一个方面的国际讨论,通过深入了解荷兰医疗保健的问责制现状。
    For better serving people\'s complex needs the subsequent movement to person-centred integrated care, requires inter-organisational cooperation and service provision by domain-overarching networks and alliances. In the development to these networks, it is relevant to explore which accountability approaches are appropriate for local inter-organisational healthcare governance. Therefore, in a scoping review we studied the current state of knowledge and practice of accountability in healthcare in the Netherlands. We found that two of the included 41 studies show characteristics of accountability towards healthcare with characteristics of integration care components, such as integration of services with accompanying accountability arrangements and development of networked accountability. The first studies are found in the literature which report on accountability in integrated care. With this we add to the international discussion about accountability as an aspect of integrated care governance, by providing insight into the current state of art of accountability in Dutch healthcare.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    由于机构能力和财政资源的限制,全民健康覆盖(UHC)之路涉及艰难的政策选择。为了协助这些选择,学者和政策制定者在评估卫生筹资政策实质性公平性的标准方面做了大量工作:它们对权利分配的影响,职责,在通往UHC的道路上的利益和负担。然而,对卫生筹资决策的程序公平性关注较少。合理性问责框架(A4R),广泛应用于评估程序公正性,主要用于采购决策的优先级设置,收入调动和汇集受到的关注有限。此外,A4R框架的四个标准(宣传,相关性,修订和上诉,和执法)受到质疑。此外,政治理论和公共行政(包括协商民主)研究,公共财政,环境管理,心理学,卫生筹资研究了程序公平性的关键特征,但是,这些见解尚未综合为卫生筹资中公平决策过程的综合标准。还缺乏对这些标准如何应用于与卫生筹资有关的决策情况和其他领域的系统研究。本文通过范围审查来解决这些差距。它认为,可以将许多学科的文献综合为具有共同哲学基础的10个核心标准。这些超越了A4R,涵盖了平等,公正,随着时间的推移一致性,给出理由,透明度,信息的准确性,参与,包容性,可修订性和强制执行性。这些标准可用于评估和指导不同国家收入水平和卫生筹资安排的UHC筹资决策过程。审查还提供了如何将这些标准应用于卫生筹资和其他部门决策的示例。
    Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework\'s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Letter
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在这篇文章中,我们提出了一种新颖的账户持有强度概念化-定义为账户持有的频率和勤奋-作为分析欧盟机构问责制格局中账户持有人行为的工具。我们通过互补的混合方法方法研究了六个主要机构欧盟账户持有人的账户持有强度,该方法结合了定量调查数据和从欧盟机构董事和高级管理人员收集的定性访谈数据。账户持有强度是通过调查数据来衡量的,采访数据提供了详细的见解,说明为什么一些账户持有人比其他人更活跃/更不活跃和/或更勤奋。此外,对调查和访谈数据进行了三角剖分,并对帐户持有人进行了深入访谈,并对帐户持有强度进行了不显眼的指标。这相当于对欧盟机构机构问责关系的全面实证审查,这揭示了不同的账户持有人是如何由与不同账户持有强度相关的不同制度逻辑驱动的。
    In this article, we propose a novel conceptualization of account-holding intensity - defined as both the frequency and diligence of account-holding - as an instrument for analysing the behaviour of account-holders in the accountability landscape of EU agencies. We examine the account-holding intensity of six major institutional EU account-holders through a complementary mixed-methods approach that combines quantitative survey data and qualitative interview data collected from directors and senior managers of EU agencies. Account-holding intensity is measured through the survey data, with the interview data providing detailed insight into why some account-holders are more/less active and/or diligent than others. The survey and interview data are furthermore triangulated with in-depth interviews with account-holders and unobtrusive indicators of account-holding intensity. This amounts to a comprehensive empirical review of the EU agencies\' institutional accountability relationships, which reveals how different account-holders are driven by different institutional logics that are associated with different account-holding intensities.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    在COVID-19大流行期间,迫切需要获得医疗用品,这导致绕过了管理全球药品供应链的控制措施,增加腐败的风险。因此,推动反腐败,透明度,供应链和采购中的问责制(ACTA)从未如此重要。采用数字工具,如果设计和实施得当,可以降低腐败的风险。
    遵循PRISMA准则,我们对健康/医学进行了跨学科的系统综述,人文/社会科学,工程,和计算机科学文献,目的是确定用于药品供应链和采购优化的技术,并审查它们是否涉及ACTA机制以加强药品治理。我们的审查确定了四个不同类别的数字解决方案:电子采购和公开签约;跟踪和跟踪技术;防伪技术;和区块链技术。
    研究结果表明,改善药品供应链和采购功能的技术研究有所增加;然而,大多数技术没有被用来直接解决ACTA或全球健康结果。一些区块链和RFID技术结合了ACTA机制,并提到了具体的政策/治理框架。但是需要更有目的的联系。研究结果表明,需要有针对性的政策制定和治理,以激活这些创新技术,从而改善全球健康。
    UNASSIGNED: The urgent need to acquire medical supplies amidst the COVID-19 pandemic has led to bypassing of controls that govern the global pharmaceutical supply chain, increasing the risk of corruption. Hence, promoting anti-corruption, transparency, and accountability (ACTA) in supply chain and procurement has never been more important. The adoption of digital tools, if designed and implemented appropriately, can reduce the risks of corruption.
    UNASSIGNED: Following PRISMA guidelines, we conducted an interdisciplinary systematic review of health/medicine, humanities/social sciences, engineering, and computer science literature, with the aims of identifying technologies used for pharmaceutical supply chain and procurement optimization and reviewing whether they address ACTA mechanisms to strengthen pharmaceutical governance. Our review identified four distinct categories of digital solutions: e-procurement and open contracting; track-and-trace technology; anti-counterfeiting technology; and blockchain technology.
    UNASSIGNED: Findings demonstrate an increase in research of technologies to improve pharmaceutical supply chain and procurement functions; however, most technologies are not being leveraged to directly address ACTA or global health outcomes. Some blockchain and RFID technologies incorporated ACTA mechanisms and mentioned specific policy/governance frameworks, but more purposeful linkage is needed. Findings point to the need for targeted policy development and governance to activate these innovative technologies to improve global health .
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    以提供商为中心的问责制,定义为患者与其提供者之间的社交互动的预期,增加患者对处方治疗的依从性。基于问责制的数字依从性干预措施在促进依从性方面可能特别有效。当前的研究旨在评估有关数字依从性干预措施的出版物是否讨论了问责制,包括与问责制相关的干预部分,并衡量患者责任感的结果。
    PubMed在2010年1月至2021年3月期间接受了查询,以确定纳入数字依从性干预措施的随机对照试验。对全文文章进行了参与者人口统计学评估,利用的干预措施,结果,干预效果。
    共有131种出版物符合纳入标准。只有四篇出版物讨论了问责制是影响患者依从性的潜在因素。尽管11%的出版物包括直接问责的干预,只有一个是设计的。纳入的研究都没有评估作为结果的责任感。
    虽然以提供商为中心的问责制有可能提高数字依从性干预措施的效力,问责制很少被纳入此类干预措施的研究中。
    关于问责制对依从性干预措施的影响的进一步调查将允许将这些干预措施发展为适用于所有患者的有效工具。
    Provider-centered accountability, defined as the anticipation of a social interaction between a patient and their provider, increases patients\' adherence to prescribed treatment. Digital adherence interventions based on accountability may be especially effective at promoting adherence. The current study aimed to assess whether publications on digital adherence interventions discuss accountability, include intervention components related to accountability, and measure feelings of patient accountability as an outcome.
    PubMed was queried between January 2010 and March 2021 to identify randomized controlled trials incorporating digital adherence interventions. Full-text articles were assessed for participant demographics, interventions utilized, outcomes, and intervention effectiveness.
    A total of 131 publications met inclusion criteria. Only four publications discussed accountability as a potential factor influencing patient adherence. Although 11% of publications included an intervention with direct accountability, only one did so by design. None of the included studies assessed feelings of accountability as an outcome.
    While provider-centered accountability has the potential to boost the efficacy of digital adherence interventions, accountability is rarely incorporated in studies of such interventions.
    Additional investigation into the influence of accountability on adherence interventions will allow for the development of these interventions as effective tools applicable to the full range of patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    引发问责制的干预措施利用社会行为来提高依从性,但与提醒不同。然而,对问责制在基于提醒的依从性干预中的影响知之甚少.通过文献综述,我们的目标是确定在基于提醒的干预研究中问责的频率和有效性.
    在PubMed和Psycarticles中搜索基于提醒的依从性研究。文章被归类为仅提醒或带有问责制研究的提醒。研究的特点是结局指标,在使用电子监测设备的研究中,比较了对照组和干预组之间的差异。
    165项研究符合纳入标准;154项使用无责任提醒(93%)。与对照组相比,154项仅提醒研究中的79项(51%)改善了干预组的依从性。165项研究中有11项(6.6%)包括问责制。在11项问责制研究的提醒中,干预组的依从性优于对照组(91%)。
    虽然与提醒不同,问责制可以纳入基于提醒的干预措施。然而,它通常不包括在基于提醒的干预措施中.
    重要的是要考虑问责制对鼓励患者服药依从性的影响。增加问责干预措施可能会进一步提高依从性,但目前很少有研究纳入这些类型的干预措施。
    Interventions to elicit accountability capitalize on social behaviors to improve adherence but are distinct from reminders. However, little is known about the impact of accountability in reminder-based adherence interventions. Through a literature review, we aim to identify the frequency and effectiveness of accountability in reminder-based intervention studies.
    PubMed and PsycArticles were searched for reminder-based adherence studies. Articles were categorized as reminder-only or reminder with accountability studies. Studies were characterized by outcome measures, and differences between control and intervention groups were compared for studies that used electronic monitoring devices.
    165 studies met the inclusion criteria; 154 used reminders without accountability (93%). 79 of the 154 reminder-only studies (51%) improved adherence in intervention groups compared to controls. Eleven of the 165 studies (6.6%) included an accountability aspect. The intervention group had better adherence than controls in 10 out of the 11 reminder with accountability studies (91%).
    Although distinct from reminders, accountability can be incorporated in reminder-based interventions. However, it is not commonly included in reminder-based interventions.
    It is important to consider accountability\'s effects on encouraging patient medication adherence. The addition of accountability interventions may further boost adherence, but few studies currently incorporate these types of interventions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号