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      Ten health policy challenges for the next 10 years

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          Abstract

          Health policies and associated research initiatives are constantly evolving and changing. In recent years, there has been a dizzying increase in research on emerging topics such as the implications of changing public and private health payment models, the global impact of pandemics, novel initiatives to tackle the persistence of health inequities, broad efforts to reduce the impact of climate change, the emergence of novel technologies such as whole-genome sequencing and artificial intelligence, and the increase in consumer-directed care. This evolution demands future-thinking research to meet the needs of policymakers in translating science into policy. In this paper, the Health Affairs Scholar editorial team describes “ten health policy challenges for the next 10 years.” Each of the ten assertions describes the challenges and steps that can be taken to address those challenges. We focus on issues that are traditionally studied by health services researchers such as cost, access, and quality, but then examine emerging and intersectional topics: equity, income, and justice; technology, pharmaceuticals, markets, and innovation; population health; and global health.

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          Most cited references77

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          Structural racism and health inequities in the USA: evidence and interventions

          The Lancet, 389(10077), 1453-1463
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            Traveling towards disease: transportation barriers to health care access.

            Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.
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              Patient and family engagement: a framework for understanding the elements and developing interventions and policies.

              Patient and family engagement offers a promising pathway toward better-quality health care, more-efficient care, and improved population health. Since definitions of patient engagement and conceptions of how it works vary, we propose a framework. We first present the forms engagement can take, ranging from consultation to partnership. We discuss the levels at which patient engagement can occur across the health care system, from the direct care setting to incorporating patient engagement into organizational design, governance, and policy making. We also discuss the factors that influence whether and to what extent engagement occurs. We explore the implications of our multidimensional framework for the development of interventions and policies that support patient and family engagement, and we offer a research agenda to investigate how such engagement leads to improved outcomes.
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                Author and article information

                Contributors
                Journal
                Health Aff Sch
                Health Aff Sch
                haschl
                Health Affairs Scholar
                Oxford University Press (US )
                2976-5390
                July 2023
                20 June 2023
                20 June 2023
                : 1
                : 1
                : qxad010
                Affiliations
                UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS), University of California, San Francisco , San Francisco, CA 94143, United States
                Department of Clinical Pharmacy, University of California, San Francisco , San Francisco, CA 94143, United States
                Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco , San Francisco, CA 94158, United States
                Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta T2N 4Z6, Canada
                Alberta Children's Hospital Research Institute, Department of Medicine, Cumming School of Medicine, University of Calgary , Calgary, Alberta T2N 4Z6, Canada
                USC-Brookings Schaeffer Initiative for Health Policy, Brookings Institution , Washington, DC 90089, United States
                Department of Health Policy and Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115, United States
                Department of Medicine, Brigham & Women's Hospital and Harvard Medical School , Boston, MA 02115, United States
                Department of Health Policy and Management, School of Public Health, Texas A&M University , College Station, TX 77843, United States
                Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco , San Francisco, CA 94158, United States
                Department of Family and Community Medicine, University of California, San Francisco , San Francisco, CA 94110, United States
                Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA 02115, United States
                Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego , San Diego, CA 92093, United States
                Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles , Los Angeles, CA 90095, United States
                UCLA Center for Health Policy Research, University of California, Los Angeles , Los Angeles, CA 90024, United States
                Division of Health Policy and Management, School of Public Health, University of Minnesota , Minneapolis, MN 55455, United States
                Author notes
                Corresponding author: Department of Clinical Pharmacy, University of California, 490 Illinois Street, San Francisco, CA 94143, United States. Email: Kathryn.Phillips@ 123456ucsf.edu

                Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials.

                Author information
                https://orcid.org/0000-0003-0822-4968
                https://orcid.org/0000-0002-8467-8008
                https://orcid.org/0000-0002-9804-4049
                https://orcid.org/0000-0003-3811-257X
                https://orcid.org/0000-0003-0077-6047
                https://orcid.org/0000-0003-0730-4077
                https://orcid.org/0000-0002-0118-4986
                https://orcid.org/0000-0001-7862-7928
                Article
                qxad010
                10.1093/haschl/qxad010
                10986244
                38756834
                712c21a1-77f4-4413-be91-e69bb48445ad
                © The Author(s) 2023. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 04 April 2023
                : 05 April 2023
                : 14 April 2023
                : 20 June 2023
                Page count
                Pages: 8
                Funding
                Funded by: National Institutes of Health, DOI 10.13039/100000002;
                Award ID: R01 HG011792
                Categories
                Commentary
                AcademicSubjects/MED00862
                AcademicSubjects/SOC02360
                haschl/pt_55

                health policy
                health policy

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