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Mossenson AI, Livingston P, Brown JA, Khalid K, Rubio Martinez R. A competency framework for simulation facilitation in low-resource settings: a modified Delphi study. Anaesthesia 2024. [PMID: 39367574 DOI: 10.1111/anae.16446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2024] [Indexed: 10/06/2024]
Abstract
BACKGROUND Skilled facilitators are essential to drive effective simulation training in healthcare. Competency-based frameworks support the development of facilitation skills but, to our knowledge, there are no frameworks that specifically address context-sensitive priorities developed with practitioners working in low-resource settings. METHODS We aimed to develop a core competency framework for healthcare simulation facilitation in low-resource settings using a modified Delphi process. We drew on the domain expertise of members of the Vital Anaesthesia Simulation Training Community of Practice, with the study guided by a four-member steering group experienced in the conduct of simulation in low-resource settings. In survey round 1, participants (n = 54) were presented with an initial competency set derived from a previous qualitative study and co-created a set of 57 competencies for effective simulation facilitation in low-resource settings. In survey round 2, participants (n = 52) ranked competencies by relevance into three performance categories: techniques; artistry; and values. In survey round 3, participants (n = 50) ranked competencies on their importance. The steering group collated results and presented a draft core competency framework. In survey round 4, participants (n = 50) voted with 98% agreement that this framework represented the most relevant and important competencies for effective facilitation of simulation sessions in low-resource settings. RESULTS The final 32-item framework encompasses core competencies found in existing standards and includes important new concepts such as demonstration of cultural sensitivity; humility; ability to recognise and respond to potential language barriers; facilitation team collaboration; awareness of logistics; and contingency planning. DISCUSSION This competency-based framework highlights specific practices required for effective simulation facilitation in low-resource settings. Further work is required to refine and validate this tool to train simulation facilitators to deliver effective training to improve patient safety.
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Affiliation(s)
- Adam I Mossenson
- School of Medicine, Curtin University, Perth, Australia
- Department of Anaesthesia, St John of God Midland Public and Private Hospitals, Perth, WA, Australia
| | - Patricia Livingston
- Department of Anesthesia, Pain Management and Perioperative Care, Dalhousie University, Halifax, NS, Canada
| | - Janie A Brown
- School of Nursing, Curtin University, Perth, WA, Australia
- School of Nursing, Curtin University, Perth, WA, Australia
| | - Karima Khalid
- Department of Anesthesiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
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Benedetto V, De Vita E, Nuti S. Setting priorities in outpatient cardiovascular care to guarantee equitable access: the case of Tuscany region. RESEARCH IN HEALTH SERVICES & REGIONS 2024; 3:11. [PMID: 39177938 DOI: 10.1007/s43999-024-00047-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 07/15/2024] [Indexed: 08/24/2024]
Abstract
Universal healthcare systems orient their actions towards promoting, restoring, and improving public health with a particular focus on the need to guarantee equitable access to care. Unwarranted variation in healthcare delivery poses significant challenges to health systems globally, impacting quality of care, financial sustainability, and equity of access. It is therefore important to assist healthcare management in measuring unwarranted variation in order to prioritise intervention strategies to ensure continuity of care and equity. Through an investigation of geographical variation in visit rates and waiting times, the study identifies vulnerable health districts which need priority interventions for patients with cardiovascular disease in the Tuscany region (Italy). Furthermore, a benchmarking-based method for identifying a quantitative estimate of the supply gap to be reduced is proposed. Results illustrate variation in visit rates and waiting times across local health districts in 2021, with some districts experiencing substantially lower rates and longer waiting times compared to the regional median. To address this gap, two targeted interventions aimed at increasing visit volumes and reduced waiting times through advanced training activities, technology integration, and multidisciplinary collaborations are presented. This study contributes to the topic of unwarranted variation by highlighting the necessity of tailored interventions to address diverse healthcare challenges across heterogeneous geographical areas. As healthcare systems globally navigate evolving complexities, the findings and tools presented here offer valuable guidance for policymakers and managers, aiming towards more equitable, efficient, and responsive healthcare services.
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Affiliation(s)
- Vera Benedetto
- Interdisciplinary Research Center "Health Science", Scuola Superiore Sant'Anna, Via Cardinale Maffi 27, Pisa, Italy.
| | - Erica De Vita
- Interdisciplinary Research Center "Health Science", Scuola Superiore Sant'Anna, Via Cardinale Maffi 27, Pisa, Italy
| | - Sabina Nuti
- Interdisciplinary Research Center "Health Science", Scuola Superiore Sant'Anna, Via Cardinale Maffi 27, Pisa, Italy
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Li CI, Rogers SC, Bult CJ, Guerra CE, Talton A, Williams LB, Law W. Executing plans to enhance diversity across cancer centers in the United States: opportunities and challenges. J Natl Cancer Inst 2024; 116:1198-1205. [PMID: 38710483 PMCID: PMC11308197 DOI: 10.1093/jnci/djae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Lack of diversity in the cancer research workforce persists, which the new requirement for all National Cancer Institute (NCI)-designated cancer centers to have a Plan to Enhance Diversity (PED) seeks to address. However, it is not well understood how different cancer centers are approaching the development and execution of these plans. Our objective was to assess how cancer centers are establishing and pursuing their PED. METHODS We conducted a cross-sectional survey of members of the Cancer Center Diversity, Equity and Inclusion Network, which includes all NCI-designated cancer centers and several emerging centers. A total of 62 cancer centers (75% of those invited), including 58 NCI-designated cancer centers (81% of those with this designation), participated and completed a questionnaire that assessed PED leadership, major challenges, implementation strategies, and approach to evaluate PED progress. RESULTS The most common PED challenge identified is recruiting diverse faculty (68% of centers), and the most common strategy currently used to address this is reviewing and revising faculty recruitment practices (67%). The most common approach centers are using to measure PED progress is shifts in demographics (68%), and data on the demographics of faculty, leadership, and trainees are available at 79%, 81%, and 75% of centers, respectively. CONCLUSIONS Almost all centers have established a PED leadership structure, however, there is considerable variation in the approaches used to realize PED goals and in the resources provided to support PED work. Realizing opportunities to share and implement common best practices and exemplar programs has the potential to elevate the impact of PED efforts nationally.
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Affiliation(s)
- Christopher I Li
- Fred Hutchinson Cancer Center, Seattle, WA, USA
- Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium, Seattle, WA, USA
| | | | | | - Carmen E Guerra
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Lovoria B Williams
- University of Kentucky College of Nursing & Markey Comprehensive Cancer Center, Lexington, KY, USA
| | - Wendy Law
- Fred Hutchinson Cancer Center, Seattle, WA, USA
- Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium, Seattle, WA, USA
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Donelan K, Hesgrove B, Nooney JG, Liu H, Heely C, Kreiger N, Ziomek SB, Kepley HO. Nurse Corps' impact on increasing registered nurse staffing in critical shortage areas and facilities, 2017 to 2022. Nurs Outlook 2024; 72:102233. [PMID: 39033570 DOI: 10.1016/j.outlook.2024.102233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/10/2024] [Accepted: 06/22/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND The registered nurse (RN) workforce experienced critical pre-pandemic and pandemic shortages of labor in some areas in the United States. People living in these health professional shortage areas (HPSAs) may have less access to health services. The Bureau of Health Workforce within the Health Resources and Services Administration administers Nurse Corps scholarship and loan repayment programs to increase healthcare access by increasing the supply and distribution of RNs, nurse practitioners, and nurse faculty to HPSAs. The American Rescue Plan Act of 2021 (ARPA) made available considerable new resources for the program. PURPOSE This paper reports on Nurse Corps applications, awards, and distribution in 2 cohorts in the period 2017 to 2022 to assess the impact of receiving an additional $200 million appropriated in 2021. DISCUSSION Additional funds through ARPA were associated with nearly threefold increases in the number of Nurse Corps awards. Program participants worked in a total of 1,316 counties (42% of all U.S. counties) in 2020 to 2022, a 76% increase from 749 counties in 2017 to 2019. CONCLUSION Increased funding for scholarship and loan repayment can help to improve the distribution of nurse labor to a greater number of critical shortage areas in the United States.
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Affiliation(s)
- Karen Donelan
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA.
| | | | | | - Helen Liu
- Behavioral Health and Health Policy, Westat, Rockville, MD
| | - Casey Heely
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA
| | - Nina Kreiger
- Behavioral Health and Health Policy, Westat, Rockville, MD
| | - Stephanie B Ziomek
- National Center for Health Workforce Analysis, Bureau of Health Workforce, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD
| | - Hayden O Kepley
- National Center for Health Workforce Analysis, Bureau of Health Workforce, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD
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Myint MT, Yue H, Zalpuri I, Sharma N, Stewart C. Workforce Initiatives to Advance Health Equity and Diverse Representation. Child Adolesc Psychiatr Clin N Am 2024; 33:437-445. [PMID: 38823815 DOI: 10.1016/j.chc.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
The persistence of health inequity and the need for workforce diverse representation within child and adolescent psychiatry require systemic solutions. There are recommendations and strategies particularly for the training programs with "all of the above" approach to tackle these complex systemic issues. One of the ways is to think through existing and innovative training pipelines by making them less leaky, enhancing quality, expanding the type and size, and connecting them to reach children and adolescents in need.
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Affiliation(s)
- Myo Thwin Myint
- Tulane University, Children's Hospital New Orleans, 1430 Tulane Avenue, #8055, New Orleans, LA 70112, USA.
| | - Han Yue
- Tufts University, 800 Washington Street Pratt Building 2nd Floor, Boston, MA 02111, USA
| | - Isheeta Zalpuri
- Stanford University, 401 Quarry Road, Palo Alto, CA 94304, USA
| | - Neha Sharma
- Tufts University, 800 Washington Street Pratt Building 2nd Floor, Boston, MA 02111, USA
| | - Colin Stewart
- Georgetown University, 2115 Wisconsin Avenue Northwest, Washington, DC 20016, USA
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Collins S, Baker EB. Resident Recruitment in a New Era. Int Anesthesiol Clin 2024; 62:35-46. [PMID: 38855840 DOI: 10.1097/aia.0000000000000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
ABSTRACT This chapter focuses on resident recruitment and recent US National Resident Matching Program changes and the impact in the evaluation and ranking of applicants within the specialty of anesthesiology. Recruitment challenges are examined as well as program strategies and potential future directions. Also discussed are DEI initiatives within the recruitment process.
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Affiliation(s)
- Stephen Collins
- Department of Anesthesiology, University of Virginia Health, Charlottesville, Virginia
| | - E Brooke Baker
- Division of Regional Anesthesiology and Acute Pain Medicine, Department of Anesthesiology and Critical Care Medicine Chief, Faculty Affairs and DEI, Executive Physician for Claims Management, UNM Hospital System
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Mazaheri F, Tahmasbi M. Evaluating the attitudes of radiologic technology students and graduates toward their study major and career prospects: A cross-sectional study. Health Sci Rep 2024; 7:e2144. [PMID: 38817884 PMCID: PMC11136640 DOI: 10.1002/hsr2.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/11/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
Background and Objectives Understanding students' attitudes toward their study major and career prospects in healthcare is crucial. This study evaluates radiologic technology students and graduates' attitudes toward their study major and career prospects. Methods This cross-sectional study at Ahvaz Jundishapur University of Medical Sciences assessed 120 BSc radiologic technology students and graduates' attitudes toward their study major and career prospects using an online questionnaire. Data analysis was performed using SPSS 26, with results reported as mean ± standard deviation (SD). Significance was determined using the independent sample t-test and one-way analysis of variance (p < 0.05). Results Participants' age, averaged 24.13 ± 3.64 years and were predominantly females (58.3%). Among radiologic technology students, the mean scores ± SD for attitudes toward their academic major and career prospects were 19.75 ± 2.27 and 15.62 ± 2.28, respectively. For graduates, these values were 19.73 ± 3.85 and 14.73 ± 2.75, respectively. Most participants exhibited a positive attitude toward their study major (90.8%) and career prospects (85.0%). No statistically significant differences were observed in attitudes across demographic specifications for students and graduates, nor between the attitudes of students and graduates toward their study major and career prospects. Conclusions The evaluated students and graduates demonstrated a positive attitude toward their field of study and career prospects. Positive perceptions from peers and society and job opportunities for BSc graduates contribute to this. while our research highlights the prevailing positive attitudes within the radiologic technology profession, there is a clear need for ongoing evaluation and refinement to ensure continued success and satisfaction among students and graduates. Enhancing students' understanding of academic disciplines before major selection and providing effective counseling can reinforce these attitudes.
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Affiliation(s)
- Fatemeh Mazaheri
- Students Research CommitteeAhvaz Jundishapur University of Medical SciencesAhvazIran
- Department of Radiologic Technology, School of Allied Medical SciencesAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Marziyeh Tahmasbi
- Department of Radiologic Technology, School of Allied Medical SciencesAhvaz Jundishapur University of Medical SciencesAhvazIran
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Anders ME, Prince LY, Williams TB, McGehee RE, Thomas BR, Allen AR. Summer undergraduate biomedical research program for underrepresented minority students in a rural, low-income state. Front Public Health 2024; 12:1395942. [PMID: 38846599 PMCID: PMC11153754 DOI: 10.3389/fpubh.2024.1395942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Diversity can enhance the agenda and quality of biomedical research, but a dearth of underrepresented minorities and women serve as biomedical researchers. The study purpose was to examine the impact of the a summer undergraduate research program on self-efficacy in research, scientific communication, and leadership as well as scientific identity, valuing objectives of the scientific community, and intent to pursue a biomedical research career. Methods Underrepresented minority and female undergraduate students participated in a mentored research experience in a rural, low-income state. Results Students' self-efficacy in research, scientific communication, and leadership as well as scientific identity, valuing objectives of the scientific community, and intent to pursue a biomedical research career increased post-program compared to pre-program. Conclusion This study supports implementation of a biomedical summer undergraduate research program for URM and women in a poor, rural, settings.
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Affiliation(s)
- Michael E. Anders
- Academic Affairs, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Latrina Y. Prince
- Graduate School, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Tremaine B. Williams
- Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Robert E. McGehee
- Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Billy R. Thomas
- Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Antino R. Allen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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Santric Milicevic M, Scotter CDP, Bruno-Tome A, Scheerens C, Ellington K. Healthcare workforce equity for health equity: An overview of its importance for the level of primary health care. Int J Health Plann Manage 2024; 39:945-955. [PMID: 38348525 DOI: 10.1002/hpm.3790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Healthcare workforce crises often stem from healthcare workers' inequities. This study provides an overview of the main PHC workforce policy questions related to health equity, offering examples of evidence necessary to support the implementation of policies and strategies that increase equity in the health workforce and access to the PHC workforce and services. METHODS The equity-related policies in PHC and workforce were linked with the indicators listed in the Global Health Workforce Network Data and Evidence Hub and guidelines for health workforce management. RESULTS The policy-relevant questions in PHC cover many workforce issues such as the optimal size, equitable distribution, relevant competencies to ensure equitable healthcare access, and equitable approaches for retention, training, recruitment, benefits and incentive schemes and governance. This will require intersectionality evidence of the optimised staffing to PHC workload, that PHC practitioners' training demonstrates evidence-based knowledge aligned with locally relevant expertise. CONCLUSION Critical for equitable PHC access and health equity is the establishment of efficient measurement of PHC workforce equity and its implications for population health. Using indicators that measure health and workforce equity in research, policy, and practices may improve recruitment and retention, and respond more effectively to the PHC workforce crises.
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Affiliation(s)
- M Santric Milicevic
- University of Belgrade Faculty of Medicine, Institute of Social Medicine, Laboratory for Strengthening the Capacity and Performance of Health Systems and Health Workforce for Health Equity, Belgrade, Serbia
| | - C D P Scotter
- HRH Policy Advisor WHO Europe, Copenhagen, Denmark
- Adjunct Faculty, RCSI Graduate School of Healthcare Management, Dublin, Ireland
| | - A Bruno-Tome
- Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Scheerens
- Department of Primary Care and Public Health, Ghent University, Ghent, Belgium
- United Nations University - CRIS, Bruges, Belgium
| | - K Ellington
- World House Medicine, New York, New York, USA
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Boyer L, Fond G, Auquier P, Khouani J, Boussat B, Wu AW. Enhancing healthcare worker resilience and health in underserved communities and rural areas: Lessons and strategies for global health. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202529. [PMID: 38632932 DOI: 10.1016/j.jeph.2024.202529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Affiliation(s)
- Laurent Boyer
- CEReSS - Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France.
| | - Guillaume Fond
- CEReSS - Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
| | - Pascal Auquier
- CEReSS - Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
| | - Jeremy Khouani
- CEReSS - Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France; Department of General Practice, Aix-Marseille University, Marseille, France
| | - Bastien Boussat
- Department of Clinical Epidemiology, Grenoble University Hospital, Grenoble Alps University, Grenoble, France; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Albert W Wu
- Johns Hopkins University School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Demir E, Yakutcan U, Page S. Using simulation modelling to transform hospital planning and management to address health inequalities. Soc Sci Med 2024; 347:116786. [PMID: 38493680 DOI: 10.1016/j.socscimed.2024.116786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
Health inequalities are a perennial concern for policymakers and in service delivery to ensure fair and equitable access and outcomes. As health inequalities are socially influenced by employment, income, and education, this impacts healthcare services among socio-economically disadvantaged groups, making it a pertinent area for investigation in seeking to promote equitable access. Researchers widely acknowledge that health equity is a multi-faceted problem requiring approaches to understand the complexity and interconnections in hospital planning as a precursor to healthcare delivery. Operations research offers the potential to develop analytical models and frameworks to aid in complex decision-making that has both a strategic and operational function in problem-solving. This paper develops a simulation-based modelling framework (SimulEQUITY) to model the complexities in addressing health inequalities at a hospital level. The model encompasses an entire hospital operation (including inpatient, outpatient, and emergency department services) using the discrete-event simulation method to simulate the behaviour and performance of real-world systems, processes, or organisations. The paper makes a sustained contribution to knowledge by challenging the existing population-level planning approaches in healthcare that often overlook individual patient needs, especially within disadvantaged groups. By holistically modelling an entire hospital, socio-economic variations in patients' pathways are developed by incorporating individual patient attributes and variables. This innovative framework facilitates the exploration of diverse scenarios, from processes to resources and environmental factors, enabling key decision-makers to evaluate what intervention strategies to adopt as well as the likely scenarios for future patterns of healthcare inequality. The paper outlines the decision-support toolkit developed and the practical application of the SimulEQUITY model through to implementation within a hospital in the UK. This moves hospital management and strategic planning to a more dynamic position where a software-based approach, incorporating complexity, is implicit in the modelling rather than simplification and generalisation arising from the use of population-based models.
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Affiliation(s)
- Eren Demir
- Hertfordshire Business School, University of Hertfordshire, AL10 9AB, Hatfield, United Kingdom.
| | - Usame Yakutcan
- Hertfordshire Business School, University of Hertfordshire, AL10 9AB, Hatfield, United Kingdom
| | - Stephen Page
- Hertfordshire Business School, University of Hertfordshire, AL10 9AB, Hatfield, United Kingdom
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Ladha P, Curry CW, Badrinathan A, Imbroane MR, Bhamre RV, Como JJ, Tseng ES, Ho VP. Pediatric Trauma Care Disparities: Association of Race and Sex With High Acuity Trauma Hospital Admissions. J Surg Res 2024; 296:751-758. [PMID: 38377701 DOI: 10.1016/j.jss.2023.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION For adult trauma patients, the likelihood of receiving treatment at a hospital properly equipped for trauma care can vary by race and sex. This study examines whether a pediatric patient's race/ethnicity and sex are associated with treatment at a high acuity trauma hospital (HATH). MATERIALS AND METHODS Using the 2017 National Inpatient Sample, we identified pediatric trauma patients ( ≤16 y) using International Classification of Diseases-10 codes. Because trauma centers are not defined in National Inpatient Sample, we defined HATHs as hospitals which transferred 0% of pediatric neurotrauma. We used logistic regression to examine associations between race/ethnicity, sex, age, and treatment at a HATH, adjusted for factors including Injury Severity Score, mechanism of injury, and region. RESULTS Of 18,085 injured children (median Injury Severity Score 3 [IQR 1-8]), 67% were admitted to a HATH. Compared to White patients, Hispanic (odds ratio [OR] 0.85 [95% confidence interval [CI] 0.79-0.93]) and other race/ethnicity patients (OR 0.85 [95% CI 0.78-0.93]) had a significantly lower odds of treatment at a HATH. Children aged 2-11 (OR 1.36 [95% CI 1.27-1.46]) were more likely to be treated at a HATH compared to adolescents (age 12-16). After adjustment for other factors, sex was not associated with treatment at a HATH. CONCLUSIONS Our study demonstrated racial and ethnic disparities in access to HATHs for pediatric trauma patients. Hispanic and other race/ethnicity pediatric trauma patients have lower odds of treatment at HATHs. Further research is needed to study the root causes of these disparities to ensure that all children with injuries receive equitable and high-quality care.
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Affiliation(s)
- Prerna Ladha
- Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio.
| | - Caleb W Curry
- School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | | | - Marisa R Imbroane
- School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Rasika V Bhamre
- Department of Pediatrics, MetroHealth Medical Center, Cleveland, Ohio
| | - John J Como
- Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio
| | - Esther S Tseng
- Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio
| | - Vanessa P Ho
- Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio; Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
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Wiedermann CJ, Barbieri V, Engl A, Piccoliori G. Relational Coordination at the Primary-Secondary Care Interface: Insights from a Cross-Sectional Survey in the South Tyrolean Healthcare System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:425. [PMID: 38673336 PMCID: PMC11050390 DOI: 10.3390/ijerph21040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. This suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency.
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Affiliation(s)
- Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria
| | - Verena Barbieri
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
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Torres ME, Maguire S, Kogan J. "I Was Told to Think Like a Middle-Aged White Woman": A Survey on Identity and the Association of Social Work Boards Exam. SOCIAL WORK 2024; 69:185-196. [PMID: 38366956 DOI: 10.1093/sw/swae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 02/19/2024]
Abstract
The release of the 2022 Association of Social Work Boards (ASWB) exam passage rate report confirmed what many test takers who failed their exam believe. The ASWB exams are biased, with differential passage rates based on the test taker's race, age, and "English as a second language" status. However, the report only offered basic descriptive statistics and lacked insight into the test takers' experience. The present study addresses this gap. Results are from a 2022 survey of individuals who had taken the ASWB master's level licensing exam (N = 1,045) highlighting test taker identity and experience. Thirty percent of the study sample identified as neurodivergent, 29.1 percent as primary caregivers, and 27.1 percent as Black, Indigenous, or persons of color. White respondents had the highest first-attempt passing rates (95.7 percent), followed by Latinx and Black respondents (84.9 percent and 78.2 percent, respectively). Forty-four respondents reported taking the test three or more times before passing. Among this group, 52 percent identified as Black, 25 percent as White, and 18 percent as Latinx. Respondents were asked how they felt their identity impacted their experience, and three interrelated themes emerged: privilege, challenges, and critique of the exam. Respondents discussed the impact of having or not having privilege; the emotional, physical, and financial challenges of preparing for the exam; and the ways in which they experienced the exam as biased.
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Affiliation(s)
- Maria Elena Torres
- Maria Elena Torres, PhD, is assistant professor, School of Social Welfare, Stony Brook University, 101 Nicolls Road, Health Sciences Center, Level 2, Stony Brook, NY 11794, USA
| | | | - Jennie Kogan
- LMSW, is a clinical social worker, Brooklyn, NY, USA
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15
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Levi BH, Ekpa N, Lin A, Smith CW, Volpe RL. The Experience of Medical Scribing: No Disparities Identified. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:153-160. [PMID: 38476633 PMCID: PMC10929157 DOI: 10.2147/amep.s439826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/20/2023] [Indexed: 03/14/2024]
Abstract
Introduction The chronic failure to significantly increase the number of underrepresented minorities (URM) in medicine requires that we look for new mechanisms for channelling URM students through pre-medical education and into medical school. One potential mechanism is medical scribing, which involves a person helping a physician engage in real-time documentation in the electronic medical record. Methods As a precursor to evaluating this mechanism, this survey pilot study explored individuals' experiences working as a medical scribe to look for any differences related to URM status. Of 248 scribes, 159 (64% response rate) completed an online survey. The survey was comprised of 11 items: demographics (4 items), role and length of time spent as a scribe (2 items), and experience working as a scribe (5 items). Results The vast majority (>80%) of participants reported that working as a medical scribe gave them useful insight into being a clinician, provided valuable mentoring, and reinforced their commitment to pursue a career in medicine. The experiences reported by scribes who identified as URM did not differ from those reported by their majority counterparts. Discussion It remains to be seen whether medical scribing can serve as an effective pipeline for URM individuals to matriculate into medical school. But the present findings suggest that the experience of working as a medical scribe is a positive one for URM.
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Affiliation(s)
- Benjamin H Levi
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Ndifreke Ekpa
- University of Houston, HCA Houston Healthcare Kingwood, Houston, TX, USA
| | - Andrea Lin
- Penn State College of Medicine, Hershey, PA, USA
| | | | - Rebecca L Volpe
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA
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16
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Sadri H, Fraser ND. The role of innovative technologies in reducing health system inequity. Healthc Manage Forum 2024; 37:101-107. [PMID: 37861228 DOI: 10.1177/08404704231207509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
The scarcity of Health Human Resources (HHR), regional disparities, and decentralized healthcare systems have profoundly affected health equity in Canada. Adequate HHR allocation is essential for equitable healthcare delivery, and the COVID-19 pandemic has revealed the importance of resilient and culturally diverse organizational HHR. Geography and infrastructure shortcomings aggravate healthcare equity. This study examines the role of innovative technologies in reducing inequity and provides four practice-based examples in different therapeutic areas. Long-term solutions such as collaborative networks, infrastructure improvements, and effective HHR planning can mitigate current challenges. However, in the short and medium terms, advanced medical technologies, digital health, and artificial intelligence can reduce health inequities by improving access, reducing disparities, optimizing resource utilization, and providing skill development opportunities for healthcare professionals.
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Affiliation(s)
| | - Neil D Fraser
- Independent MedTech Consultant, Toronto, Ontario, Canada
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17
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Wang Z, Lin T, Xing X, Cai B, Chen Y. Dynamic distribution, regional differences and convergence of health workforce allocation in township health centers in China. Heliyon 2024; 10:e23857. [PMID: 38192759 PMCID: PMC10772724 DOI: 10.1016/j.heliyon.2023.e23857] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
This study evaluated the dynamic distribution, regional differences, and convergence of health workforce allocation in Township Health Centers in China during 2011-2020 using data obtained from the China Health Statistics Yearbook (2012-2021). The Gini coefficient and kernel density estimation were chosen to examine the dynamic distribution and regional differences in health workforce allocation in Township Health Centers in China and their components. σ convergence and β convergence were used to investigate the change trend of health workforce allocation in Township Health Centers. The results show that between 2011 and 2020, the number of licensed doctors and registered nurses per thousand population in Township Health Centers both increased largely and regional disparities still exist. In 2020, the largest differences in the density of licensed doctors and registered nurses were found in the eastern and central regions, respectively, and the intensity of trans-variation contributed the most to the overall disparities. The allocation of licensed doctors and registered nurses both exhibited σ convergence, absolute and conditional β convergence, indicating that the regional differences in health workforce in THCs among provinces will decrease. The growth of healthcare workforce was positively impacted by the urbanization rate, growth rate of government health expenditures and growth domestic product per capita, but negatively impacted by population density in rural areas and fiscal self-sufficiency.
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Affiliation(s)
- Zuobao Wang
- School of Humanities and Law, Northeastern University, Shenyang, 110169, China
| | - Tianrun Lin
- School of Humanities and Law, Northeastern University, Shenyang, 110169, China
| | - Xinyi Xing
- School of Humanities and Law, Northeastern University, Shenyang, 110169, China
| | - Bingshu Cai
- School of Humanities and Law, Northeastern University, Shenyang, 110169, China
| | - Yao Chen
- School of Management, Shenyang Urban Construction University, Shenyang, 110167, China
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18
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Malika N, Herman PM, Whitley M, Coulter I, Maiers M, Chesney M, Rogers R. Qualitative Assessment CIH Institutions' Engagement With Underserved Communities to Enhance Healthcare Access and Utilization. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241244759. [PMID: 38545335 PMCID: PMC10966973 DOI: 10.1177/27536130241244759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 05/26/2024]
Abstract
Background In North America, there is a notable underutilization of complementary and integrative health approaches (CIH) among non-White and marginalized communities. Objectives This study sought to understand how CIH educational instutitions are proactively working to redress this disparity in access and utilization among these communities. Methods We conducted interviews with 26 key informants, including presidents, clinicians, and research deans across 13 CIH educational institutions across the US and Canada. Thematic analysis included deductive codes based on the interview guide during interview scripts review. Results Six themes were identified: (1) CIH institutions often had a long and varied history of community engaged care through partnerships to increase access and utilization; (2) CIH institutions' long-standing community outreach had been intentionally designed; (3) CIH institutions provided an array of services to a wide range of demographics and communities; (4) addressing healthcare access and utilization through community partnerships had a strong positive impact; (5) funding, staffing and COVID-19 were significant challenges that impeded efforts to increase CIH access through community engaged work; (6) identified gaps in community partnerships and services to increase access and utilization were recognized. Conclusion These findings underscore significant efforts made to enhance healthcare access and utilization among marginalized, underserved, and racial and ethnic communities. However, barriers such as funding constraints, resource allocation, and the need for proper measurement and accountability hinder proactive initiatives aimed at redressing disparities in CIH utilization within these communities.
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Affiliation(s)
| | | | | | | | - Michele Maiers
- Northwestern Health Sciences University, Bloomington, MN, USA
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19
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Kohut OB, Wang Z, Sanchez RR, Rausch JC, Nieto A, Minguez MM. Assessing the impact of a 6-year health sciences enrichment program for underrepresented minority youth on healthcare workforce diversity, career path, and public health. Front Public Health 2023; 11:1244593. [PMID: 37900043 PMCID: PMC10602669 DOI: 10.3389/fpubh.2023.1244593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Background Improving the quality of care for a diverse population requires a diverse healthcare workforce which necessitates high educational attainment among underrepresented communities. Programs aimed to address healthcare workforce diversity gaps also serve as a public health intervention by offering avenues to improve the health of local communities by providing students with the knowledge and skills to promote healthy behaviors, foster scientific literacy, and inspire future public health professionals - who in turn serve their local communities to advance health outcomes. We interviewed alumni of the New York Presbyterian Hospital Lang Youth Medical Program (LYMP), a high school health sciences mentoring and enrichment program for underrepresented minority youth in Upper Manhattan, from graduating classes between 2012 and 2021 to explore their perspectives on what aspects of the program had the most impact on their academic and career paths. Method This is a qualitative study using in-depth, semi-structured individual interviews. All interviews were analyzed using the constant comparative method for developing grounded theory, following a convenience sampling method. Results 106 codes were organized into 24 themes, which were further arranged into 4 topic areas: demonstrated program success, intangible program drivers, improvement opportunities, and barriers to program participation. Topic areas captured participants' perspectives on how the program is designed to foster an environment of personal, academic, and professional development; ways aspects of the program organically worked together to provide unanticipated positive facilitators; opportunities for program improvements, and external factors that influenced decision-making. Conclusion Through this study, we found that the LYMP had a positive influence in helping participants set and achieve personal, academic, and professional goals. Alumni reported activities and experiences offered by the program that foster key youth development constructs linked to healthier and more resilient communities. Importantly, the vast majority of participants described how the synergism between program features, staff support, family involvement, and professional development and networking created an environment of achievement that went beyond the scope of the program design. Findings from this study offer a blueprint for other organizations to craft a similarly successful enrichment program that improves health outcomes, reduces health disparities, and promotes overall population health.
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Affiliation(s)
- Oscar B. Kohut
- Division of Community and Population Health, New York-Presbyterian Hospital, New York, NY, United States
| | - Zhiru Wang
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Ronald R. Sanchez
- Division of Community and Population Health, New York-Presbyterian Hospital, New York, NY, United States
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - John C. Rausch
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Andy Nieto
- Division of Community and Population Health, New York-Presbyterian Hospital, New York, NY, United States
| | - Mara M. Minguez
- Division of Community and Population Health, New York-Presbyterian Hospital, New York, NY, United States
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
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20
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Agarwala A, Patel J, Stephens J, Roberson S, Scott J, Beckie T, Jackson EA. Implementation of Prevention Science to Eliminate Health Care Inequities in Achieving Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation 2023; 148:1183-1193. [PMID: 37698007 DOI: 10.1161/cir.0000000000001171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Prevention of cardiovascular and related diseases is foundational to attaining ideal cardiovascular health to improve the overall health and well-being of individuals and communities. Social determinants of health and health care inequities adversely affect ideal cardiovascular health and prevention of disease. Achieving optimal cardiovascular health in an effective and equitable manner requires a coordinated multidisciplinary and multilayered approach. In this scientific statement, we examine barriers to ideal cardiovascular health and its related conditions in the context of leveraging existing resources to reduce health care inequities and to optimize the delivery of preventive cardiovascular care. We systematically discuss (1) interventions across health care environments involving direct patient care, (2) leveraging health care technology, (3) optimizing multispecialty/multiprofession collaborations and interventions, (4) engaging local communities, and (5) improving the community environment through health-related government policies, all with a focus on making ideal cardiovascular health equitable for all individuals.
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21
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Njie H, Ilboudo PGC, Gopinathan U, Chola L, Wangen KR. Preferences of healthcare workers for provider payment systems in The Gambia's National Health Insurance Scheme. BMC Health Serv Res 2023; 23:853. [PMID: 37568233 PMCID: PMC10422797 DOI: 10.1186/s12913-023-09885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 08/08/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The Government of The Gambia introduced a national health insurance scheme (NHIS) in 2021 to promote universal health coverage (UHC). Provider payment systems (PPS) are strategic purchasing arrangements that can enhance provider performance, accountability, and efficiency in the NHIS. This study assessed healthcare workers' (HCWs') preferences for PPS across major service areas in the NHIS. METHODS A facility-based cross-sectional study was conducted using a probability proportionate to size sampling technique to select an appropriate sample size. Health care workers were presented with options for PPS to choose from across major service areas. Descriptive statistics explored HCW socio-demographic and health service characteristics. Multinomial logistic regressions were used to assess the association between these characteristics and choices of PPS. RESULTS The majority of HCW did not have insurance coverage, but more than 60% of them were willing to join and pay for the NHIS. Gender, professional cadre, facility level, and region influenced HCW's preference for PPS across the major service areas. The preferred PPS varied among HCW depending on the service area, with capitation being the least preferred PPS across all service areas. CONCLUSION The National Health Insurance Authority (NHIA) needs to consider HCW's preference for PPS and factors that influence their preferences when choosing various payment systems. Strategic purchasing decisions should consider the incentives these payment systems may create to align incentives to guide provider behaviour towards UHC. The findings of this study can inform policy and decision-makers on the right mix of PPS to spur provider performance and value for money in The Gambia's NHIS.
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Affiliation(s)
- Hassan Njie
- Department of Community Medicine and Global Health, University of Oslo, Postboks 1130, Blindern, Oslo, 0318, Norway.
| | | | - Unni Gopinathan
- Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Lumbwe Chola
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Knut Reidar Wangen
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
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22
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Patterson LD, Wheeler RM, Edge N, Daniel G. The High School to Higher Education Pipeline Program: A focus on Black male representation in nursing. J Prof Nurs 2023; 47:15-24. [PMID: 37295908 DOI: 10.1016/j.profnurs.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Increasing the number of Black men in nursing can enhance racial, ethnic, and gender diversity within the nursing workforce. However, there is a lack of nursing pipeline programs that specifically focus on Black men. PURPOSE The purposes of this article are to describe the High School to Higher Education (H2H) Pipeline Program as an approach to increasing representation of Black men in nursing and to describe H2H Program participants' perspectives of the program after the first year. METHODS A descriptive qualitative approach was used to explore Black males' perceptions of the H2H Program. Twelve of the 17 program participants completed questionnaires. Data collected were analyzed to identify themes. FINDINGS Four themes emerged during data analysis regarding the participants' perspectives of the H2H Program: 1) Coming to realize, 2) Managing stereotypes, stigma, and social norms, 3) Making connections, and 4) Expressing gratitude. CONCLUSION Results indicated that the H2H Program provided participants with a support network that fostered a sense of belonging. The H2H Program was beneficial for program participants in their development and engagement in nursing.
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Affiliation(s)
- LaDonia D Patterson
- High School to Higher Education Pipeline Program, P.O. Box 683, Lithia Springs, GA 30122, USA; Georgia Nursing Leadership Coalition, 245 North Highland Ave., Suite 230-468, Atlanta, GA 30307, USA; Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA 30322, USA.
| | - Rebecca M Wheeler
- Georgia Nursing Leadership Coalition, 245 North Highland Ave., Suite 230-468, Atlanta, GA 30307, USA
| | - Naph'tali Edge
- High School to Higher Education Pipeline Program, P.O. Box 683, Lithia Springs, GA 30122, USA; Cayuga Health System, 101 Dates Drive, Ithaca, NY 14850, USA
| | - Gaea Daniel
- High School to Higher Education Pipeline Program, P.O. Box 683, Lithia Springs, GA 30122, USA; Georgia Nursing Leadership Coalition, 245 North Highland Ave., Suite 230-468, Atlanta, GA 30307, USA; Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA 30322, USA
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23
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Okoli CZ. Diversity as a Solution to Health Inequities and Disparities. J Am Psychiatr Nurses Assoc 2023; 29:171-173. [PMID: 36782082 DOI: 10.1177/10783903231153872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- Chizimuzo Zim Okoli
- Chizimuzo (Zim) Okoli, PhD, MPH, MSN, PMHNP-BC, FAAN, American Psychiatric Nurses Association, Falls Church, VA, USA
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24
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Balogun M, Banke-Thomas A, Galvin S, Boateng GO. Editorial: Social inequality and equity in community actions for health. Front Public Health 2023; 11:1144910. [PMID: 36860396 PMCID: PMC9969116 DOI: 10.3389/fpubh.2023.1144910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 02/15/2023] Open
Affiliation(s)
- Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria,*Correspondence: Mobolanle Balogun ✉
| | - Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, United Kingdom,Department of Infectious Diseases and Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shannon Galvin
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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25
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Abstract
Lay Summary
Even though there have been numerous advances in medicine and technology in the past few decades, the length and quality of life vary significantly based on a person’s race, ethnicity, gender identity, sexual orientation, disability status, geographic residence, and/or socioeconomic status. In fact, membership in one or more marginalized sociodemographic groups is particularly associated with worse healthcare access and health outcomes. Behavioral medicine is uniquely equipped to advance health equity through inclusive and innovative research and practice and exerted influence on policies and practices that contribute to health disparities.
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Affiliation(s)
- Monica L Baskin
- UAB: University of Alabama at Birmingham Medicine , 1717 11th Ave SMT 618, 35294-4410, 9968 Birmingham, AL , USA
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26
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Gouger DH, Sankaran Raval M, Hussain RS, Bastien A. Examining intersectionality in anesthesiology training, academics, and practice. Curr Opin Anaesthesiol 2022; 35:201-207. [PMID: 35165234 DOI: 10.1097/aco.0000000000001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Intersectionality, or the overlapping nature of social categorizations, such as race, class, and gender, creates interdependent systems of discrimination, disadvantage, and health disparities. The present review examines common shortcomings to diversity management, and proposes targeted improvement frameworks for anesthesiology departments that would offer competitive advantage in training, hiring, and retention, and improved care delivery aimed toward reducing health disparities. RECENT FINDINGS Studies highlight that physicians equipped to care for diverse populations enhance patient-doctor interactions and reduce health disparities. Moreover, untrained providers and staff who engage in disrespectful behaviors like microaggressions can lead to staff turnover and millions of dollars in lost revenue. Underrepresented minorities continue to have lower faculty academic rank in anesthesiology, fewer partnership opportunities in private practice, and disparate research funding. Diversity-based education and training often overlooks intersectionality and reductively illustrates diverse groups as internally homogenous. Even these developing diversity efforts have become politicized and are perceived as uninteresting, irrelevant to medical practice, or unable to create organizational change. SUMMARY The synergy of intersectionality mounts considerable challenges that impact patients, colleagues, and communities of practice. Examining intersectionality in education and workplace policy affords tremendous opportunity for improving quality of care for marginalized populations, reducing healthcare costs, and normalizing culture that is inclusive, equitable, and empowering.
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Affiliation(s)
- Daniel H Gouger
- Department of Anesthesiology, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Marie Sankaran Raval
- Department of Anesthesiology, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Rashid S Hussain
- Department of Anesthesiology, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Alexandra Bastien
- Montefiore Medical Center of the Albert Einstein College of Medicine, Bronx, New York, USA
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