Recognizing the future leaders of Health Services is fundamental to safeguarding tomorrow's driving force in innovation. This collection will showcase the high-quality work of internationally recognized researchers in the early stages of their careers. We aim to highlight research by leading scientists of the future across the entire breadth of Health Policy and Organization, and present advances in theory, experiment and methodology with applications to compelling problems. Please note, contributions to the collection are by invitation only. Please inform the Editorial Office at healthservices.submissions@frontiersin.org once you are prepared to submit. All Rising Star researchers will be suggested by established Editors within our board in recognition of their influence on the future directions in their respective fields. While future innovations in Health Policy and Organization are yet to be discovered, this Research Topic will give us a hint at whom to follow.

King's College London

Frontiers in Health Services

Health Policy and Management

Rising Stars in Health Policy and Management: 2022

IntroductionPopulation-based cancer registries are the main source of data for population-level analysis of cancer stage at diagnosis. This data enables analysis of cancer burden by stage, evaluation of screening programs and provides insight into differences in cancer outcomes. The lack of standardised collection of cancer staging in Australia is well recognised and is not routinely collected within the Western Australia Cancer Registry. This review aimed to explore how cancer stage at diagnosis is determined in population-based cancer registries.</sec>MethodsThis review was guided by the Joanna-Briggs Institute methodology. A systematic search of peer-reviewed research studies and grey literature from 2000 to 2021 was conducted in December 2021. Literature was included if peer-reviewed articles or grey literature sources used population-based cancer stage at diagnosis, and were published in English between 2000 and 2021. Literature was excluded if they were reviews or only the abstract was available. Database results were screened by title and abstract using Research Screener. Full-texts were screened using Rayyan. Included literature were analysed using thematic analysis and managed through NVivo.</sec>ResultsThe findings of the 23 included articles published between 2002 and 2021 consisted of two themes. (1) “Data sources and collection processes” outlines the data sources used, as well as the processes and timing of data collection utilised by population-based cancer registries. (2) “Staging classification systems” reveals the staging classification systems employed or developed for population-based cancer staging, including the American Joint Committee on Cancer's Tumour Node Metastasis and related systems; simplified systems classified into localised, regional, and distant categories; and miscellaneous systems.</sec>ConclusionsDifferences in approaches used to determine population-based cancer stage at diagnosis challenge attempts to make interjurisdictional and international comparisons. Barriers to collecting population-based stage at diagnosis include resource availability, infrastructure differences, methodological complexity, interest variations, and differences in population-based roles and emphases. Even within countries, disparate funding sources and funder interests can challenge the uniformity of population-based cancer registry staging practices. International guidelines to guide cancer registries in collecting population-based cancer stage is needed. A tiered framework of standardising collection is recommended. The results will inform integrating population-based cancer staging into the Western Australian Cancer Registry.</sec>

Introduction: Population-based cancer registries are the main source of data for population-level analysis of cancer stage at diagnosis. This data enables analysis of cancer burden by stage, evaluation of screening programs and provides insight into differences in cancer outcomes. The lack of standardised collection of cancer staging in Australia is well recognised and is not routinely collected within the Western Australia Cancer Registry. This review aimed to explore how cancer stage at diagnosis is determined in population-based cancer registries.Methods: This review was guided by the Joanna-Briggs Institute methodology. A systematic search of peer-reviewed research studies and grey literature from 2000 to 2021 was conducted in December 2021. Literature was included if peer-reviewed articles or grey literature sources used population-based cancer stage at diagnosis, and were published in English between 2000 and 2021. Literature was excluded if they were reviews or only the abstract was available. Database results were screened by title and abstract using Research Screener. Full-texts were screened using Rayyan. Included literature were analysed using thematic analysis and managed through NVivo.Results: The findings of the 23 included articles published between 2002 and 2021 consisted of two themes. (1) “Data sources and collection processes” outlines the data sources used, as well as the processes and timing of data collection utilised by population-based cancer registries. (2) “Staging classification systems” reveals the staging classification systems employed or developed for population-based cancer staging, including the American Joint Committee on Cancer's Tumour Node Metastasis and related systems; simplified systems classified into localised, regional, and distant categories; and miscellaneous systems.Conclusions: Differences in approaches used to determine population-based cancer stage at diagnosis challenge attempts to make interjurisdictional and international comparisons. Barriers to collecting population-based stage at diagnosis include resource availability, infrastructure differences, methodological complexity, interest variations, and differences in population-based roles and emphases. Even within countries, disparate funding sources and funder interests can challenge the uniformity of population-based cancer registry staging practices. International guidelines to guide cancer registries in collecting population-based cancer stage is needed. A tiered framework of standardising collection is recommended. The results will inform integrating population-based cancer staging into the Western Australian Cancer Registry.

Determining cancer stage at diagnosis in population-based cancer registries: A rapid scoping review

ObjectiveTo explore the impact of implementation of the comprehensive public hospital reform policy (CPHRP) on medicine costs, revenues and medical expenditures in tertiary public hospitals in China.</sec>MethodsThe data of this study was collected from local administrations to obtain operational data of healthcare institutions and medicine procurement data for 103 tertiary public hospitals from 2014 to 2019. The propensity matching score method and the difference-in-difference method were used jointly to assess the impact of reform policies on tertiary public hospitals.</sec>ResultsAfter the implementation of the policy, drug revenue in the intervention group decreased by ¥ 86.3 million (p = 0.076) compared to the control group; medical service revenue increased by ¥ 108.5 million (p < 0.001); government financial subsidies increased by ¥ 20.3 million (p = 0.085); the average medicine cost per outpatient and emergency visit decreased by ¥ 15.2 (p = 0.062); the average medicine cost per hospitalization decreased by ¥ 504 (p = 0.040); however, the medicine cost decreased by ¥ 38.2 million (p = 0.351), the average cost per visit for outpatient and emergency decreased by ¥ 0.562 (p = 0.966), the average cost per hospitalization decreased by ¥ 152 (p = 0.844), which are not significant.</sec>ConclusionsThe implementation of reform policies has changed the revenue structure of public hospitals; the proportion of drug revenue decreased, while the proportion of service income increased, especially in service income and government subsidies. Meanwhile, the average medicine cost of outpatient, emergency, and inpatient visits per time were all reduced, which played a certain role in reducing the disease burden of patients.</sec>

Objective: To explore the impact of implementation of the comprehensive public hospital reform policy (CPHRP) on medicine costs, revenues and medical expenditures in tertiary public hospitals in China.Methods: The data of this study was collected from local administrations to obtain operational data of healthcare institutions and medicine procurement data for 103 tertiary public hospitals from 2014 to 2019. The propensity matching score method and the difference-in-difference method were used jointly to assess the impact of reform policies on tertiary public hospitals.Results: After the implementation of the policy, drug revenue in the intervention group decreased by ¥ 86.3 million (p = 0.076) compared to the control group; medical service revenue increased by ¥ 108.5 million (p &lt; 0.001); government financial subsidies increased by ¥ 20.3 million (p = 0.085); the average medicine cost per outpatient and emergency visit decreased by ¥ 15.2 (p = 0.062); the average medicine cost per hospitalization decreased by ¥ 504 (p = 0.040); however, the medicine cost decreased by ¥ 38.2 million (p = 0.351), the average cost per visit for outpatient and emergency decreased by ¥ 0.562 (p = 0.966), the average cost per hospitalization decreased by ¥ 152 (p = 0.844), which are not significant.Conclusions: The implementation of reform policies has changed the revenue structure of public hospitals; the proportion of drug revenue decreased, while the proportion of service income increased, especially in service income and government subsidies. Meanwhile, the average medicine cost of outpatient, emergency, and inpatient visits per time were all reduced, which played a certain role in reducing the disease burden of patients.

The impacts of public hospital comprehensive reform policies on hospital medicine cost, revenues and healthcare expenditures 2014–2019: An analysis of 103 tertiary public hospitals in China

BackgroundCould the COVID-19 pandemic prompt shifts in Americans' basic views on health mindset and policy solutions to health crises?</sec>MethodsA sample of 1,637 individuals rated the extent to which items (e.g., the role of environmental vs. individual factors) “may affect people's health and wellbeing,” both before (2018) and during the pandemic. In summer 2020 and fall 2021 they responded to questions about vaccination status and perceptions of COVID-19 related policies. We assessed changes in health mindset using repeated measures logistic regression, and used cross-sectional logistic regressions to assess whether variations in mindset explain COVID-19 related attitudes and behavior.</sec>ResultsBetween 2018 and 2021 respondents gave increasing weight to where people live and genetic factors and less weight to the role of individual health choices. Views on the importance of access to healthcare did not change appreciably. Those who reported that health care and place have a strong effect on health and wellbeing were significantly more likely to get vaccinated. Moreover, those who strongly believed that place is important were significantly less likely to agree that their local government went too far in restricting their freedom and that the local economy should have been left alone.</sec>ConclusionRespondents were more likely in 2021 than in 2018 to recognize social determinants of health, and this is associated with a greater openness to pandemic-control measures. It remains to be seen, however, whether the changes in health mindset will persist over time and contribute to changes in policy and practice.</sec>

Background: Could the COVID-19 pandemic prompt shifts in Americans' basic views on health mindset and policy solutions to health crises?Methods: A sample of 1,637 individuals rated the extent to which items (e.g., the role of environmental vs. individual factors) “may affect people's health and wellbeing,” both before (2018) and during the pandemic. In summer 2020 and fall 2021 they responded to questions about vaccination status and perceptions of COVID-19 related policies. We assessed changes in health mindset using repeated measures logistic regression, and used cross-sectional logistic regressions to assess whether variations in mindset explain COVID-19 related attitudes and behavior.Results: Between 2018 and 2021 respondents gave increasing weight to where people live and genetic factors and less weight to the role of individual health choices. Views on the importance of access to healthcare did not change appreciably. Those who reported that health care and place have a strong effect on health and wellbeing were significantly more likely to get vaccinated. Moreover, those who strongly believed that place is important were significantly less likely to agree that their local government went too far in restricting their freedom and that the local economy should have been left alone.Conclusion: Respondents were more likely in 2021 than in 2018 to recognize social determinants of health, and this is associated with a greater openness to pandemic-control measures. It remains to be seen, however, whether the changes in health mindset will persist over time and contribute to changes in policy and practice.

Has COVID-19 changed how people think about the drivers of health? If so, does it matter?

Sri Lanka's healthcare systems attempts to provides access to universal healthcare services for all citizens and is designed to be free of out-of-pocket payments. Despite a 30-year civil conflict, natural disasters, and COVID-19, the healthcare system within the country remains robust and strong. However, due to a lack of formalized pathways and centralized record keeping, the pattern of service utilization is still relatively unknown, which raises concerns regarding effective allocation of scarce resources and efficiency of referral pathways. To address this gap in knowledge, part of the parent study (COMGAP-S), consisted of a survey on healthcare service use conducted among adults attending primary care facilities. The results from this quantitative data analysis indicate the majority of people seeking care originate from rural areas, are older (50+), attend divisional hospitals, and report paying fees at point of contact. Our findings indicate a need for more efficient use of healthcare services, creation of referral routes to ensure limited healthcare resources are used effectively. Additionally, further investment in services is needed to ensure Sri Lanka's healthcare system meets the standard of universal healthcare as proposed by the World Health Organization. These findings address a gap in knowledge for national decision-makers within Sri Lanka along with other similar post-conflict healthcare settings across the globe.

Sri Lanka&apos;s healthcare systems attempts to provides access to universal healthcare services for all citizens and is designed to be free of out-of-pocket payments. Despite a 30-year civil conflict, natural disasters, and COVID-19, the healthcare system within the country remains robust and strong. However, due to a lack of formalized pathways and centralized record keeping, the pattern of service utilization is still relatively unknown, which raises concerns regarding effective allocation of scarce resources and efficiency of referral pathways. To address this gap in knowledge, part of the parent study (COMGAP-S), consisted of a survey on healthcare service use conducted among adults attending primary care facilities. The results from this quantitative data analysis indicate the majority of people seeking care originate from rural areas, are older (50+), attend divisional hospitals, and report paying fees at point of contact. Our findings indicate a need for more efficient use of healthcare services, creation of referral routes to ensure limited healthcare resources are used effectively. Additionally, further investment in services is needed to ensure Sri Lanka&apos;s healthcare system meets the standard of universal healthcare as proposed by the World Health Organization. These findings address a gap in knowledge for national decision-makers within Sri Lanka along with other similar post-conflict healthcare settings across the globe.