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I completed my undergraduate degree in economics at the University of Economics, Varna, Bulgaria. I spent the year following my graduation working and travelling, which brought into focus my future career plans and aspirations. I then took a Masters degree in European Studies at Exeter University, United Kingdom. My MA studies broadened my perspective on European law, economics and public policy and prompted my interest into how the socio-economic and political background of different European states impacted on their health care provision as a social institution. My final dissertation entitled “The British and German Health Care Systems Compared – Differences, Similarities, Convergence” analysed and compared the British and the German health care system, giving insight into each system’s strengths and weaknesses. The writing up stage of my MA dissertation (summer of 2003) coincided with the first year of operation of EGENIS, the then newly set up ESRC Centre for Genomics in Society. After the successful completion of my MA, I approached the Centre with an idea conceived jointly with Dr. Christine Hauskeller of a research project dealing with the adoption of new genetic technologies in different health care institutions, or how well prepared each system is to make best use of medical innovation.
PhD thesis title: How gene tests travel: Bi-national comparison of the institutional pathways taken by diagnostic genetic testing for Maturity Onset Diabetes of the Young (MODY) through the British and the German health care systemMy thesis studies how medical innovation of a particular "niched" type, that is genetic testing for single-gene disorders with clear diagnostic and treatment benefits, channels through different health care systems. I explore different models of health care provision and how each fosters or blocks this type of medical innovation, and the extent to which the translation from research to the diagnostic clinic ensures that the technology is utilized to its full potential for patient care. I focus on diagnostic genetic testing for Maturity Onset Diabetes of the Young (MODY) as an example and analyze its assimilation in two different health care systems, the British NHS and the German Statutory Health Insurance system (SHI). The thesis combines elements of an econometric model based on regression analysis with institutional theory and social analysis. In brief, the comparison of MODY between Germany and Britain and the degree to which it reached patients successfully shows that both systems are not optimally set up to exploit what MODY genetic testing has to offer, but that the vertical structure and centralization in the UK system fit the needs of genetic medical innovations better than the horizontal, diversified and market oriented structures dominating the German health care system.
Since I obtained my PhD, I have been involved in several international projects led by the World Health Organization (WHO):1) “Priority Medical Devices”, WHO Geneva Switzerland, in collaboration with the Government of the Netherlands. The project aims to determine whether medical devices for high-burden diseases, which are currently on the market, are meeting the needs of health care providers and end-users throughout the world and if not, to propose research to identify—and action to remedy—inadequacies or shortcomings.2) “Palliative care for older people: Better practices”, King’s College London, in collaboration with the WHO European Regional Office, Copenhagen, Denmark. My current work at King’s College London involves leading a systematic literature review of the literature on understanding preferences for place of care and death for patients with non malignant conditions.
My contact details are as follows:
Dr. Hristina PetkovaResearch AssociateKing's College LondonDepartment of Palliative Care, Policy & RehabilitationCicely Saunders InstituteBessemer Road, Denmark HillLondon, SE5 9PJ