1
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Cordero DA. Community pantries: a health service of great quality for the most affected ones. Int J Qual Health Care 2023; 35:7058869. [PMID: 36847155 DOI: 10.1093/intqhc/mzad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/18/2022] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
The COVID-19 pandemic has continuously caused many people to suffer worldwide. The Philippine government had imposed a series of lockdowns that caused many citizens to be unemployed and hungry. As the crisis continues, ordinary citizens from different religious communities and non-governmental organizations willed to establish community pantries to aid their hungry and helpless neighbors. The spirit of volunteerism was also awakened for those who desired to serve and shared their time and effort.
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Affiliation(s)
- Dalmacito A Cordero
- Department of Theology and Religious Education (DTRE), De La Salle University, 2401 Taft Avenue, Manila, Philippines
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2
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Chen X, Zhou T, Wang D. The Impact of Multidimensional Health Levels on Rural Poverty: Evidence from Rural China. Int J Environ Res Public Health 2022; 19:4065. [PMID: 35409743 DOI: 10.3390/ijerph19074065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 12/22/2022]
Abstract
Poor health and poverty interact and restrict each other. While this relationship is acknowledged, little is known about the extent of its impact. By integrating multisource data, this study used spatial econometric models to quantitatively reveal the relationship between health and rural poverty and explore its intrinsic mechanisms. The results indicated that health-care system input, individual health status, and individual health-seeking behavior have a significantly positive effect on the eradication of rural poverty. The health-care system input is characterized by spatial spillover, significantly contributing to rural poverty alleviation in the region and neighboring regions, as well. However, the effect of health-care system services’ capability was negative. Thus, it is necessary to increase investment in the health-care system and pay attention to both the health status and healthy behaviors of rural residents. Moreover, further effort should be given to the supply-side reform of health services as a breakthrough point.
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3
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Trentini F, Marziano V, Guzzetta G, Tirani M, Cereda D, Poletti P, Piccarreta R, Barone A, Preziosi G, Arduini F, Valle PGD, Zanella A, Grosso F, Castillo G, Castrofino A, Grasselli G, Melegaro A, Piatti A, Andreassi A, Gramegna M, Ajelli M, Merler S. Pressure on the Health-Care System and Intensive Care Utilization During the COVID-19 Outbreak in the Lombardy Region of Italy: A Retrospective Observational Study in 43,538 Hospitalized Patients. Am J Epidemiol 2022; 191:137-146. [PMID: 34652416 PMCID: PMC8549288 DOI: 10.1093/aje/kwab252] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 08/19/2021] [Accepted: 10/08/2021] [Indexed: 12/30/2022] Open
Abstract
During the spring of 2020, the COVID-19 epidemic caused an unprecedented demand for intensive care resources in Lombardy, Italy. Using data on 43,538 hospitalized patients admitted between February 21 and July 12, 2020, we evaluated variations in intensive care unit (ICU) admissions and mortality over three periods: the early phase (February 20-March 13), the period of highest pressure on healthcare (March 14-April 25, when COVID-19 patients exceeded the ICU pre-pandemic bed capacity), and the declining phase (April 26-July 12). Compared to the early phase, patients above 70 years of age were admitted less often to an ICU during highest pressure on healthcare (odds ratio OR 0.47, 95%CI: 0.41-0.54) with longer delays (incidence rate ratio IRR 1.82, 95%CI: 1.52-2.18), and lower chances of death in ICU (OR 0.47, 95%CI: 0.34-0.64). Patients under 56 years of age reported more limited changes in the probability (OR 0.65, 95%CI: 0.56-0.76) and delay to ICU admission (IRR 1.16, 95%CI: 0.95-1.42) and an increased mortality (OR 1.43, 95%CI: 1.00-2.07). In the declining phase, all quantities decreased for all age groups. These patterns may suggest that limited healthcare resources during the peak epidemic phase in Lombardy forced a shift in ICU admission criteria to prioritize patients with higher chances of survival.
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Affiliation(s)
- Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Correspondence to Dr. Filippo Trentini, Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Via Roentgen 1, 20141 Milan, Italy ()
| | | | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Marcello Tirani
- Directorate General for Health, Lombardy Region, Milan, Italy
- Health Protection Agency of Milan, Milan, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Raffaella Piccarreta
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Department of Decision Sciences, Bocconi University, Milan, Italy
| | - Antonio Barone
- Regional Agency for Innovation and Procurement, Milan, Italy
| | | | - Fabio Arduini
- Regional Agency for Innovation and Procurement, Milan, Italy
| | - Petra Giulia Della Valle
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Alberto Zanella
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | | | | | - Giacomo Grasselli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessia Melegaro
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | | | - Aida Andreassi
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Maria Gramegna
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Marco Ajelli
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
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4
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Tang C, Plasek JM, Zhang S, Xiong Y, Zhu Y, Ma J, Zhou LI, Bates DW. The intersection of big data and epidemiology for epidemiologic research: The impact of the COVID-19 pandemic. Int J Qual Health Care 2021; 33:mzab134. [PMID: 34508642 PMCID: PMC8499918 DOI: 10.1093/intqhc/mzab134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/14/2022] Open
Abstract
Big data epidemiology facilitates pandemic response by providing data-driven insights by utilizing big data tools that differ from traditional methods. Aspects regarding 'garbage in, garbage out', such as insufficient data, inaccessibility of data, missing data, uncertainty in handling data and bias in analysis or common findings are addressable by combining techniques across disciplines.
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Affiliation(s)
- Chunlei Tang
- Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Clinical and Quality Analysis, Partners HealthCare System to Mass General Brigham, Boston, MA, USA
| | - Joseph M Plasek
- Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Suhua Zhang
- Department of Kidney Disease, Suzhou Kowloon Hospital, Jiangsu, China
| | - Yun Xiong
- Shanghai Key Laboratory of Data Science, School of Computer Science, Fudan University, Shanghai, China
| | - Yangyong Zhu
- Shanghai Key Laboratory of Data Science, School of Computer Science, Fudan University, Shanghai, China
| | - Jing Ma
- Harvard Medical School, Boston, MA, USA
| | - L I Zhou
- Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - David W Bates
- Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Clinical and Quality Analysis, Partners HealthCare System to Mass General Brigham, Boston, MA, USA
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5
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Coren F, Brown MK, Ikeda DJ, Tietz D, Steinbock C, Baim-Lance A, Agins BD. Beyond tokenism in quality management policy and programming: moving from participation to meaningful involvement of people with HIV in New York State. Int J Qual Health Care 2021; 33:6068878. [PMID: 33415331 DOI: 10.1093/intqhc/mzab004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/07/2020] [Accepted: 01/07/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Consumer involvement in health-care policy and quality management (QM) programming is a key element in making health systems people-centered. Involvement of health-care consumers in these areas, however, remains underdeveloped and under-prioritized. When consumer involvement is actively realized, few mechanisms for assessing its impact have been developed. The New York State Department of Health (NYSDOH) embraces consumer involvement of people with HIV in QM as a guiding principle, informed by early HIV/AIDS advocacy and a framework of people-centered quality care. METHOD HIV consumer involvement is implemented statewide and informs all quality of care programming as a standard for QM in health-care organizations, implemented through four key several initiatives: (i) a statewide HIV Consumer Quality Advisory Committee; (ii) leadership and QM trainings for consumers; (iii) specific tools and activities to engage consumers in QM activities at state, regional and health-care facility levels and (iv) formal organizational assessments of consumer involvement in health-care facility QM programs. RESULTS We review the literature on this topic and place the methods used by the NYSDOH within a theoretical framework for consumer involvement. CONCLUSION We present a model that offers a paradigm for practical implementation of routine consumer involvement in QM programs that can be replicated in other health-care settings, both disease-specific and general, reflecting the priority of active participation of consumers in QM activities at all levels of the health system.
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Affiliation(s)
- Freda Coren
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | | | - Daniel J Ikeda
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Daniel Tietz
- New York State Department of Health, AIDS Institute, 90 Church Street, New York, NY 10007, USA
| | - Clemens Steinbock
- New York State Department of Health, AIDS Institute, 90 Church Street, New York, NY 10007, USA
| | - Abigail Baim-Lance
- Veterans Health Administration James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA
| | - Bruce D Agins
- University of California, San Francisco Institute for Global Health Sciences 550 16th Street, Third Floor, San Francisco, CA 94158, USA
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6
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Yilmaz V. Rethinking Universal Health Coverage: A qualitative study of patient organisation perspectives on the Turkish health-care system. Sociol Health Illn 2021; 43:1372-1387. [PMID: 34086996 DOI: 10.1111/1467-9566.13306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
Universal health coverage (UHC) has been elevated to the status of a global policy target, but this was at the expense of losing its aspirational meaning. As a case in point, Turkey has been one of the countries that has achieved UHC, according to the technocratic definition. This article employs a combination of deductive and inductive thematic analysis methods to explore patient organisation (PO) perspectives on the Turkish health-care system based on 26 respondent interviews from 19 POs in Istanbul. Highlighting the inadequacy of the technocratic definition of UHC, the article maintains that an analysis of PO perspectives opens the way for a nuanced and bottom-up assessment of essential service coverage and financial protection by identifying elusive gaps in both dimensions that would otherwise be lost in generalist evaluations. The findings also underline the importance of keeping intact the UHC's aspirational element to enable POs to participate in the politics of priority setting in health care.
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Affiliation(s)
- Volkan Yilmaz
- Social Policy, Institute for Graduate Studies in Social Sciences & Social Policy Forum Research Centre, Bogazici University, Istanbul, Turkey
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7
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Ellis LA, Pomare C, Gillespie JA, Root J, Ansell J, Holt J, Wells L, Tran Y, Braithwaite J, Zurynski Y. Changes in public perceptions and experiences of the Australian health-care system: A decade of change. Health Expect 2020; 24:95-110. [PMID: 33215857 PMCID: PMC7879549 DOI: 10.1111/hex.13154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/02/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022] Open
Abstract
Background The views and experiences of the Australian public are an important barometer of the health system. This study provides key findings about the changing views held by Australians over time regarding their individual experiences and perceptions of the overall performance of the health system. Methods A population‐based online survey was conducted in 2018 (N = 1024). Participants were recruited through market research panels. The results were compared with previous Australian population survey data sets from 2008 (N = 1146), 2010 (N = 1201) and 2012 (N = 1200), each of which used different population samples. The survey included questions consistent with previous surveys regarding self‐reported health status, and questions about use, opinions and experiences of the health system. Results Overall, there has been a shift in views from 2008 to 2018, with a higher proportion of respondents now viewing the Australian health‐care system more positively (X2 (2, N = 4543) = 96.59, P < .001). In 2018, areas for attention continued to include the following: the need for more doctors, nurses and other health workers (29.0%); lower costs for care or Orion medicines (27.8%); more access to care (13.1%); and enhancements in residential aged care (17.3% rated these services as ‘bad’ or ‘very bad’). Conclusions This research suggests that Australians’ perceptions of their health‐care system have significantly improved over the last decade; however, concerns have emerged over access to medicines, inadequate workforce capacity and the quality of aged care facilities. Our study highlights the value of periodically conducting public sentiment surveys to identify potential emerging health system problems.
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Affiliation(s)
- Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Chiara Pomare
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - James A Gillespie
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Jo Root
- Consumers Health Forum of Australia, Canberra, ACT, Australia
| | - James Ansell
- Consumers Health Forum of Australia, Canberra, ACT, Australia
| | - Joanna Holt
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Leanne Wells
- Consumers Health Forum of Australia, Canberra, ACT, Australia
| | - Yvonne Tran
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
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Heshmati H, Shakibazadeh E, Foroushani AR, Sadeghi R. A comprehensive model of health education barriers of health-care system in Iran. J Educ Health Promot 2020; 9:106. [PMID: 32642462 PMCID: PMC7325757 DOI: 10.4103/jehp.jehp_23_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 02/03/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND According to the importance of health education (HE) in disease control and prevention and inadequacy of HE in the Iran's health-care system, clarifying the HE barriers is necessary. OBJECTIVES This study aimed to clarifying the comprehensive model of HE barriers of health-care system in Iran. METHODS This qualitative study was conducted in 2019. Twenty-one health experts and physicians at different levels of the health system, a former health deputy of the Ministry of Health, and 26 community health workers (CHWs) were selected through purposive sampling. Data were collected through semi-structured individual interviews and group discussions and analyzed simultaneously by conventional content analysis. RESULTS Five themes were extracted including individual barriers (most important categories: inadequate ability of CHWs in HE, poor motivational factors at individual level, and educator's wrong beliefs), interpersonal (most important categories: weakness of other health-care providers in the education of CHWs, lack of proper understanding by health authorities of scientific and correct HE, inappropriate communication, unrealistic expectations from CHWs, problems with monitoring and supervision, poor work commitment, and client-related problems), organizational (most important categories: high workload of CHWs, problems related to educational resources, inappropriate attitude of managers and officials, and inappropriate evaluation and monitoring), community (most important categories: not believing CHWs by people, people's disinterest and lack of motivation in education, cultural problems, problems with the Internet and virtual social networks, and weak cross-sectoral cooperation), and contextual barriers (most important categories: barriers related to universities, broadcasting, the nature of HE science, as well as gap between practical education and theory). CONCLUSION Considering the multidimensional barriers such as individual, interpersonal, organizational, community, and contextual barriers, compiling and executing a comprehensive document with the participation of authorities, specialists, and service providers is recommended to remove barriers. This is in line with the Ottawa Charters' "reorienting health services."
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Affiliation(s)
- Hashem Heshmati
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Voitl P, Meyer R, Woditschka A, Sebelefsky C, Böck A, Schneeberger V. Occurrence of patients compared in a pediatric practice and pediatric hospital outpatient clinic. J Child Health Care 2019; 23:512-521. [PMID: 31129994 DOI: 10.1177/1367493519853431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The frequency of consultations and the waiting times in pediatric hospital outpatient clinics are steadily increasing. The aim of this study was to compare the occurrence of patients in a large pediatric group practice and a hospital-based general pediatric outpatient clinic. Primary parameters were the most common reasons for consultation, the waiting times and the reasons for selecting a certain institution. Most frequent diagnoses in the pediatric practice were upper respiratory tract infections (22.7% (n = 141/621)), otitis media (5.2% (n = 32/621)), and viral pharyngitis (3.9% (n = 24/621)). Most common reasons for consultation in the hospital outpatient clinic were upper respiratory tract infections (18.4% (n = 121/658)) and bacterial pharyngitis (17.9% (n = 118/658)). In the pediatric practice, bacterial pharyngitis was only diagnosed in 3.1% (n = 19/621) of the cases. Only slight differences exist between the two institutions regarding the observed entities, which mainly comprise mild to moderate acute illnesses. It can be concluded from this that the majority of patients might as well be treated in the nonhospital setting. Facilitating the communication and coordination between practices and hospitals might allow a better utilization of capacities. Thereby, waiting times, unnecessary reexaminations, and costs in the health-care system could be reduced.
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Affiliation(s)
- Peter Voitl
- First Vienna Pediatric Medical Center, Vienna, Austria
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10
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Currie G, Szabo J. 'It would be much easier if we were just quiet and disappeared': Parents silenced in the experience of caring for children with rare diseases. Health Expect 2019; 22:1251-1259. [PMID: 31466132 PMCID: PMC6882256 DOI: 10.1111/hex.12958] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 07/22/2019] [Accepted: 08/15/2019] [Indexed: 11/27/2022] Open
Abstract
Background Parent experiences of caring for children with neurodevelopmental disease have been silenced and constrained by social, political and health influences. There is a need to co‐construct new meanings and interpretations of parenting a child with complex disabilities by having an increased understanding of the struggles and barriers for parents. Methods A hermeneutic phenomenology approach was applied in this inquiry. Fifteen parents of children with rare neurodevelopmental diseases participated in semi‐structured interviews. Results Parents experienced silencing or being silenced within interactions with health‐care and social care systems and providers. Interpretive thematic analysis revealed three insights: (a) parents experience a sense of disconnect and silencing as little is known or understood by health‐care providers about the experience of caring for children at home; (b) parents make strong efforts to be heard and acquire services within health and social systems as fighters, saviours and navigators; and (c) parents sacrifice themselves to the caregiving role and become therapists and caregivers to their medically fragile children at the cost of losing themselves as parents. Conclusion An understanding of parents’ experiences in caring for a child with a rare neurodevelopmental disease may provide insight to systemic health and social support challenges faced by families and mitigate appropriate and supportive policies and services.
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Affiliation(s)
- Genevieve Currie
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
| | - Joanna Szabo
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
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11
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Qin C, Wu X, Yang P, Hu J. An untreated giant left atrium, surprising, or unsurprising? J Card Surg 2019; 34:1350-1351. [PMID: 31449698 DOI: 10.1111/jocs.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Chaoyi Qin
- Department of Cardiovascular Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Xuelin Wu
- Operating Room of West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan, 610007, China
| | - Peng Yang
- Department of Cardiovascular Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jia Hu
- Department of Cardiovascular Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
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12
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Yesuf EA, Grill E, Fröschl G, Koller D, Haile-Mariam D. Administrators, health service providers, and consumers perspectives of functions of district health-care systems in Oromia region, Ethiopia: A qualitative study. Int J Health Plann Manage 2019; 34:836-850. [PMID: 30729577 DOI: 10.1002/hpm.2742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 11/08/2022] Open
Abstract
The practice of functions of district health-care systems in Ethiopia is not clear. The aim of this study was to investigate the perspectives of administrators, health service providers, and health-care consumers regarding functions of district health-care systems as currently practiced. Grounded theory approach was applied using interviews and desk review of documents. This study was set up in Oromia National Regional State, Ethiopia. Inductive analysis of interviews was done. Interviews and document reviews were mirrored. Eleven functions of district health-care systems emerged in this study organized by level with relationships and commonality of few activities. The 11 functions of district health-care systems were creating capacity of health centers and health professionals for the provision of health care; creating access for the provision of health care; ensuring equitable access to health care; regulation of private health-care providers; disaster preparedness; monitoring risk factors and diseases in the district; provision of health promotive, preventive, and curative health care for communicable diseases and maternal health conditions; monitoring intermediate outcomes of care; developing capacity of health post and villagers toward demand creation for health care; provision of maternal and child health services; and helping health posts in reaching mothers and sick individuals.
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Affiliation(s)
- Elias Ali Yesuf
- CIHLMU Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.,Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Eva Grill
- Institute for Medical Data Processing, Biometry and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
| | - Günter Fröschl
- CIHLMU Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, Medical Centre of Ludwig-Maximilians Universität, Munich, Germany
| | - Daniela Koller
- Institute for Medical Data Processing, Biometry and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
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13
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Andreassen T, Hansen BT, Engesaeter B, Hashim D, Støer NC, Tropé A, Moen K, Ursin G, Weiderpass E. Psychological effect of cervical cancer screening when changing primary screening method from cytology to high-risk human papilloma virus testing. Int J Cancer 2019; 145:29-39. [PMID: 30549273 PMCID: PMC6590646 DOI: 10.1002/ijc.32067] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/09/2018] [Accepted: 11/21/2018] [Indexed: 11/23/2022]
Abstract
From 2015, Norway has implemented high‐risk human papilloma virus (hrHPV) testing in primary screening for cervical cancer. Women aged 34–69 years, living in four counties, have been pseudo‐randomly assigned (1:1 randomization) to either hrHPV testing every 5 years (followed by cytology if hrHPV is positive), or cytology testing every 3 years (followed by hrHPV testing if low‐grade cytology is detected). We compared anxiety and depression scores among participants by screening arm and results. In total, 1,008 women answered a structured questionnaire that included the validated Patient Health Questionnaire‐4 (PHQ‐4). The Relative Risk Ratio (RRR) of mild vs. normal anxiety and depression scores, and moderate/severe vs. normal anxiety and depression scores, were estimated by multinomial logistic regression with 95% confidence intervals (95% CIs). Compared to women who were screened with cytology, women randomized to hrHPV testing were not more likely to have mild anxiety and depression scores (RRR 0.96, CI 0.70–1.31) nor more likely to have moderate/severe anxiety and depression scores (RRR 1.14, CI 0.65–2.02). Women with five different combinations of abnormal screening test results were not more likely to have mild or moderate/severe vs. normal anxiety and depression scores than women with normal screening results. The likelihood of having abnormal long‐term (4–24 months after the screening) anxiety or depression scores among women 34 years and older was not affected by screening method or screening results. The results of our study suggest that a change to hrHPV testing in primary screening would not increase psychological distress among participants. What's new? Norway is one of the first countries to implement high‐risk human papilloma virus (hrHPV) testing in primary cervical‐cancer screening. Does this newer type of testing impact the emotional well‐being of patients? In this study, the authors found no significant difference in either anxiety or depression scores between the viral‐screening arm and standard cytology screening. These findings could be useful for other countries considering implementing hrHPV testing, and are reassuring for the ongoing implementation process in Norway.
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Affiliation(s)
- Trude Andreassen
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Bo T Hansen
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway
| | - Birgit Engesaeter
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway
| | - Dana Hashim
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway.,Department of Haematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nathalie C Støer
- Oslo University Hospital, Norwegian National Advisory Unit on Women's Health, Oslo, Norway
| | - Ameli Tropé
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway
| | - Kåre Moen
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Giske Ursin
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,University of Southern California, Department of Preventive Medicine, Los Angeles, CA
| | - Elisabete Weiderpass
- Cancer Registry of Norway, Institute of PopulationBased Cancer Research, Oslo, Norway.,Folkhälsan Research Centre, Genetic Epidemiology Group, and Faculty of Medicine, Helsinki University, Helsinki, Finland.,Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Yarmohammadian MH, Khorasani E, Darab MG, Etemadi M, Mohammadi M. Inputs of Iranian health system reform plan from health sector managers and policy-makers' points of view. J Educ Health Promot 2018; 7:126. [PMID: 30505854 PMCID: PMC6225403 DOI: 10.4103/jehp.jehp_16_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/13/2018] [Indexed: 05/31/2023]
Abstract
CONTEXT Health system reform plan refers to conducting some fundamental, systematic, and sustainable changes. AIMS The aim of the present study was to evaluate different required inputs of Iran Health Transformation Plan from experts' viewpoints. SETTINGS AND DESIGN The data of this qualitative study were collected using semi-structured interviews. SUBJECTS AND METHODS The purposive sampling method led to 18 participant selection and then they were interviewed. Interviewees were assured about confidentiality of information. STATISTICAL ANALYSIS USED The thematic analysis method and MAXQDA software were employed for analyzing the data. RESULTS There were 4 main themes and 35 subthemes extracted including management requirements for health development plan, human resources, information resources, and financial resources. Each theme had subthemes such as "resource allocation," "development of required standards for human resources," "human resources' motivation," "failures in IT infrastructures," "hospital information management software," "guidelines and instructions," "costs controlling," and "financing the plan". CONCLUSIONS Results of the present study put significant emphasis on the path of improving the effectiveness and efficacy of applying the discussed inputs, which can be a light for revising past policies and taking better future steps, it also can be a resource guide for policy-makers and managers of the health-care system.
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Affiliation(s)
- Mohammad Hossein Yarmohammadian
- School of Management and Medical Information Sciences, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elahe Khorasani
- Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Students’ Scientific Research Center, Tehran, Iran
| | - Mohsen Ghaffari Darab
- School of Management and Information Sciences, Health Human Resources Research Center, Medical University of Shiraz, Shiraz, Iran
| | - Manal Etemadi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahan Mohammadi
- School of Management and Medical Information Sciences, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Yazdannik A, Yousefy A, Mohammadi S. Discourse analysis: A useful methodology for health-care system researches. J Educ Health Promot 2017; 6:111. [PMID: 29296612 PMCID: PMC5747223 DOI: 10.4103/jehp.jehp_124_15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 10/31/2017] [Indexed: 05/06/2023]
Abstract
Discourse analysis (DA) is an interdisciplinary field of inquiry and becoming an increasingly popular research strategy for researchers in various disciplines which has been little employed by health-care researchers. The methodology involves a focus on the sociocultural and political context in which text and talk occur. DA adds a linguistic approach to an understanding of the relationship between language and ideology, exploring the way in which theories of reality and relations of power are encoded in such aspects as the syntax, style, and rhetorical devices used in texts. DA is a useful and productive qualitative methodology but has been underutilized within health-care system research. Without a clear understanding of discourse theory and DA it is difficult to comprehend important research findings and impossible to use DA as a research strategy. To redress this deficiency, in this article, represents an introduction to concepts of discourse and DA, DA history, Philosophical background, DA types and analysis strategy. Finally, we discuss how affect to the ideological dimension of such phenomena discourse in health-care system, health beliefs and intra-disciplinary relationship in health-care system.
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Affiliation(s)
- Ahmadreza Yazdannik
- Nursing and Midwifery Care Research Center, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Yousefy
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepideh Mohammadi
- Department of Nursing and Midwifery Ramsar, Babol University of Medical Sciences, Ramsar, I.R Iran
- Address for correspondence: Dr. Sepideh Mohammadi, Department of Nursing and Midwifery Ramsar, Babol University of Medical Sciences, Ramsar, I.R Iran. E-mail:
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Heyeres M, McCalman J, Tsey K, Kinchin I. The Complexity of Health Service Integration: A Review of Reviews. Front Public Health 2016; 4:223. [PMID: 27800474 PMCID: PMC5066319 DOI: 10.3389/fpubh.2016.00223] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research. METHOD The review was developed by systematically searching nine electronic databases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardized assessment tool was used to analyze the study design quality of included reviews. Data relating to the integration types, methods, and reported outcomes of integration were synthesized. RESULTS Seventeen publications met the inclusion criteria. Eleven (65%) reviews were published during the past 5 years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%), USA (3/18%), and Australia (3/18%). Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/integrated care models, and integration of different types of health care. Most (53%) of the reviews reported on the cost-effectiveness of service integration, e.g., positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low. CONCLUSION There is no "one size fits all" approach to health service integration. Instead, this literature review highlighted the complexity of service integration, which in most primary studies involved a range of strategies. Rigorous assessments of cost-effectiveness and reporting on consumer involvement are required in future research.
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Affiliation(s)
- Marion Heyeres
- The Cairns Institute, James Cook University, Cairns, QLD, Australia
| | - Janya McCalman
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Komla Tsey
- The Cairns Institute, James Cook University, Cairns, QLD, Australia
| | - Irina Kinchin
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
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Krupic F, Sadic S, Fatahi N. CONTACT WITH HEALTH-CARE SERVICE EXPECTATION AND REALITY OF SITUATION EXPERIENCED BY IMMIGRANTS SEEKING SWEDISH HEALTH-CARE. Mater Sociomed 2016; 28:141-5. [PMID: 27147923 PMCID: PMC4851493 DOI: 10.5455/msm.2016.28.141-145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/15/2016] [Indexed: 11/21/2022] Open
Abstract
Aim: The aim of the study was to investigate how immigrants from Bosnia and Herzegovina, Somalia and Kosovo experienced contact with Swedish health-care regarding meeting with health-care professionals. Material and Methods: Eighteen participants, nine men and nine women from Bosnia and Herzegovina, Somalia and Kosovo participated in focus group interviews (FGI). Data were collected from April 2013 to April 2014 through three group interviews using open-ended questions. A qualitative approach, incorporating a critical incident technique (CIT) was used. Results: The findings highlighted patient’s negative experiences regarding the Swedish health care system. Their main complaints concerned delayed ambulances, lack of doctors in outpatient clinics, long journeys to the hospital and long waiting time at the emergency department. Lack of information about the disease, difficulties seeing a doctor in the department, poor language skills and insufficient interpreters were some of other difficulties that mentioned by participants. Conclusions: In order to provide satisfactory health care to patient with different ethnic backgrounds, it is important to be aware of their vulnerable situation and their limit capacity to express their needs. This research could be a starting point in developing strategies for reducing ethnicity-based misunderstandings and inequalities in the health-care system.
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Affiliation(s)
- Ferid Krupic
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Sahmir Sadic
- Orthopaedic and Traumatology Clinic, University Clinical Centre Tuzla, Bosnia and Herzegovina
| | - Nabi Fatahi
- Institute of health and care sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Abstract
Over the past few decades, the longest extension in life expectancy in the world has been observed in Japan. However, the sophistication of medical care and the expansion of the aging society, leads to continuous increase in health-care costs. Medical expenses as a part of gross domestic product (GDP) in Japan are exceeding the current Organization for Economic Co-operation and Development (OECD) average, challenging the universally, equally provided low cost health care existing in the past. A universal health insurance system is becoming a common system currently in developed countries, currently a similar system is being introduced in the United States. Medical care in Japan is under a social insurance system, but the injection of public funds for medical costs becomes very expensive for the Japanese society. In spite of some urgently decided measures to cover the high cost of advanced medical treatment, declining birthrate and aging population and the tendency to reduce hospital and outpatients' visits numbers and shorten hospital stays, medical expenses of Japan continue to be increasing.
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Affiliation(s)
- Toshiyuki SASAKI
- Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo
| | - Masahiro IZAWA
- Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo
| | - Yoshikazu OKADA
- Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo
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Palese A, Vianello C, Cassone A, Polonia M, Bortoluzzi G. Financial austerity measures and their effects as perceived in daily practice by Italian nurses from 2010 to 2011: A longitudinal study. Contemp Nurse 2015; 48:168-80. [PMID: 25549710 DOI: 10.5172/conu.2014.48.2.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract Most western economies have in recent years been experiencing one of the longest and deepest economic recessions since the Great Depression. During a recession health-care expenditures are often among the first to be cut. However, what is occurring in daily practice from the point of view of care has not been documented to date. Describing the cost containment interventions undertaken and their effects as perceived in daily practice by Italian nurses was the aim of the study. A longitudinal study design was adopted from 2010 to 2011 involving 1,001 nurses each year. In the 2-year period taken into consideration, participants reported a significant increase in the number of cost containment measures adopted by their health-care organisations. The effects of these cost containment measures have been perceived by nurses especially in terms of (1) increased stress levels, (2) increased number of patients with social problems, and (3) increased nursing workloads. In addition, greater difficulties in finding clinical placement for nursing students and fewer resources devoted to nursing professional development were reported, indicating that some cost containment measures will have long-term effects. The economic crisis seems to affect mainly the most vulnerable groups of society. Innovative solutions for the need to reduce the costs of National Health Services do not seem to emerge from the findings.
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Affiliation(s)
- Keith Humphreys
- Medical Centers, Veterans Affairs Health Care System and Stanford University, Stanford, CA, USA.
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21
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Abstract
Person-centred care (PCC) is defined as the health-care providers selecting and delivering interventions or treatments that are respectful of and responsive to the characteristics, needs, preferences and values of the individual person. This model of care puts the person at the centre of care delivery. The World Health Organization suggests that PCC is one of the essential dimensions of health care and as such is an important indicator of health-care quality. However, how PCC is implemented differs between countries in response to local cultures, resources and consumer expectations of health care. This article discusses person-centred care in the Indonesian health-care system.
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Affiliation(s)
- Wan Nishfa Dewi
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia; School of Nursing, University of Riau, Pekanbaru, Riau, Indonesia
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Chen J, Vargas-Bustamante A. Treatment compliance under physician-industry relationship: a framework of health-care coordination in the USA. Int J Qual Health Care 2013; 25:340-7. [PMID: 23407823 DOI: 10.1093/intqhc/mzt017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Factors associated with treatment compliance have been well studied. However, no study has examined treatment compliance under the context of physician-industry relationship. This study developed a conceptual framework of physician-industry relationship and treatment compliance, and empirically tested patients' treatment compliance and affordability under the physician-industry relationship in the USA. DESIGN We first proposed a conceptual framework to analyze different scenarios, where the physician-industry relationship could impact patients' treatment compliance and affordability, taking into consideration the role of health insurers. We then employed a nationally representative data set to investigate these relationships. Multivariable logistic regressions were employed to examine the physician-industry relationship and the physicians' perception of patients' treatment compliance. SETTING AND PARTICIPANTS 2008 Health Tracking Physician Survey. RESULTS Our results showed that physicians with closer industry relationships were more likely to report rejection of care by insurers [odds ratios (ORs): 1.24-1.85, P < 0.001], patients' non-compliance with treatment (OR: 1.34, P < 0.01) and patients' inability to pay (OR: 1.42, P < 0.01) as the major problems affecting their ability to provide high quality care, when compared with physicians without industry relationships. CONCLUSIONS Our results shed light on the lack of articulation among industry, physicians and health insurers in the USA. It is important to make sure that different agents in the health-care marketplace, such as physicians, industry, and health insurers, coordinate more efficiently to provide quality and consistent care to patients.
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Affiliation(s)
- Jie Chen
- Department of Health Services Administration, School of Public Health, University of Maryland, College Park, 3310A SPH Building, College Park, MD 20742, USA.
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Pelone F, Kringos DS, Spreeuwenberg P, De Belvis AG, Groenewegen PP. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe. Int J Qual Health Care 2013; 25:381-93. [PMID: 23407822 DOI: 10.1093/intqhc/mzt020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. DESIGN Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment ANALYSIS models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. SETTING PC systems in 22 European countries in 2009/2010. MAIN OUTCOME MEASURES Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. RESULTS There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. CONCLUSIONS Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.
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Affiliation(s)
- Ferruccio Pelone
- Department of Public Health, Population Medicine Unit, Catholic University ‘Sacro Cuore’, Largo F. Vito, n.1, Rome, Italy
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Burnett S, Renz A, Wiig S, Fernandes A, Weggelaar AM, Calltorp J, Anderson JE, Robert G, Vincent C, Fulop N. Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries. Int J Qual Health Care 2013; 25:1-7. [PMID: 23292003 PMCID: PMC3557961 DOI: 10.1093/intqhc/mzs079] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2012] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). MAIN CHALLENGES IDENTIFIED The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. CONCLUSION Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries.
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Affiliation(s)
- Susan Burnett
- Centre for Patient Safety and Service Quality, Faculty of Medicine, Imperial College London, Room 508 Medical School Building, St Mary's Campus, Norfolk Place, W2 1PG London, UK.
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