WorldWideScience

Sample records for care universal service

  1. Impact of Universal Health Care Coverage on patient demand for health care services in Thailand.

    Science.gov (United States)

    Panpiemras, Jirawat; Puttitanun, Thitima; Samphantharak, Krislert; Thampanishvong, Kannika

    2011-12-01

    Fully implemented in Thailand in 2002, the Universal Health Care Coverage (UC) Program aimed to provide cheap access to health care services, for 30 baht (less than 1 U.S. dollar) per visit, to all uninsured Thais. In this paper, we studied the impact of the UC in Thailand on the demand for health care services using hospital level data. We found that the UC program was successful in increasing outpatient demand for health care, particularly the demand from the elderly and the poor. However, outpatient demand for health care dramatically increased during the first year of the program and faded away quickly in subsequent years. In contrast to outpatient demand, the number of inpatient visits and the number of days for which the inpatients were admitted at hospitals declined after the UC program was launched. In this paper, we offer our explanation of these phenomena, highlight problems associated with the UC program, and provide policy recommendations to improve the program.

  2. Blending Community Service and Teaching to Open Vision Care and Eye Health Awareness to University Students

    Science.gov (United States)

    Do, Chi-wai; Chan, Lily Y. L.; Wong, Horace H. Y.; Chu, Geoffrey; Yu, Wing Yan; Pang, Peter C. K.; Cheong, Allen M. Y.; Ting, Patrick Wai-ki; Lam, Thomas Chuen; Kee, Chea-su; Lam, Andrew; Chan, Henry H. L.

    2016-01-01

    A vision care-based community service subject is offered to general university students for fulfillment of a service-learning compulsory credit requirement. Here, a professional health subject is taught in a way that caters to generalist learners. Students gain basic skills they can apply to provide vision screenings for the needy population. All…

  3. Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

    Directory of Open Access Journals (Sweden)

    Fabian Ling Ngai Tung

    2016-01-01

    Full Text Available Objectives: to explore nurses' knowledge of universal health coverage (UHC for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN or registered nurses (RN was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs. Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

  4. Utilization of Oral Health Care Services by University Undergraduates in Lagos, Nigeria.

    Science.gov (United States)

    Makanjuola, J O; Uti, O G; Sofola, O O

    2015-01-01

    Data on the utilization of the available oral health facilities by university undergraduates is scarce in Nigeria. To determine the level of utilization of oral health care services and to identify the barriers to seeking treatment among University of Lagos students. A cross-sectional survey was carried out among University of Lagos undergraduates. Systematic sampling was used to select participants after randomly selecting a male and female hostel. Self-administered questionnaires were distributed to participants and collected immediately. The data was analyzed using Epi info version 6.04 software. Statistical significance was evaluated with chi square test and p-value <0.05 was regarded as significant. About half (50.9%) of the respondents had visited the dentist previously while only 42.7% respondents had utilized dental services in the past 12 months. There was no significant association between the age, gender, year of undergraduate education, and the faculty of these students and their level of utilization of oral health care services. A high proportion of respondents that had attended the dental clinic went for dental checkup (33.6%) and extractions (30.9%).The major barriers to receiving dental treatment was a lack of perceived need for dental treatment (53.1%) followed by lack of time (27.1%), fear/anxiety (18.2%) and cost of treatment (18.2%). The low level of utilization among the undergraduates in Lagos, Nigeria shows that there is need for greater oral health awareness among the students, thereby increasing the use of oral health care facilities.

  5. Private health insurance and the use of health care services - a review of the theoretical literature with application to voluntary private health insurance in universal health care systems

    OpenAIRE

    Kiil, Astrid

    2012-01-01

    This paper reviews the theoretical literature on the demand for private health insurance and its effect on the use of health care services and applies the theoretical framework to the type of private health insurance that exists alongside a universal health care system. The predominant share of the theoretical literature on private health insurance is developed to model private health insurance in settings where this provides the primary source of coverage and the choice is between purchasing...

  6. Home Care Services

    Science.gov (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with ...

  7. Child Care Services Handbook.

    Science.gov (United States)

    Duval County School Board, Jacksonville, FL.

    A companion document to the curriculum guide for a secondary level child care services curriculum, this handbook contains a variety of administrative and program resources for the teacher: The vocational curriculum outline for child care services; a calendar of suggested public relations activities; procedures for building child care services…

  8. Incident reporting by acute pain service at a tertiary care university hospital

    Directory of Open Access Journals (Sweden)

    Aliya Ahmed

    2015-01-01

    Conclusion: Reporting of untoward incidents and their regular analysis by APS is recommended to ensure high-quality patient care and to provide guidance in making teaching strategies and guidelines to improve patient safety.

  9. Universal service policy in Vietnam

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten; Von Salakpi, Simeon

    2016-01-01

    Universal service provision is a key to bridge the digital divide. This paper provides an empirical examination of the Vietnamese universal policy introduced in 2015 for implementation up to 2020. Using the framework of King et al. (1994) the paper analyses the universal services policy in Vietnam...

  10. Quantitative comparisons of urgent care service providers.

    Science.gov (United States)

    Qin, Hong; Prybutok, Gayle L; Prybutok, Victor R; Wang, Bin

    2015-01-01

    The purpose of this paper is to develop, validate, and use a survey instrument to measure and compare the perceived quality of three types of US urgent care (UC) service providers: hospital emergency rooms, urgent care centres (UCC), and primary care physician offices. This study develops, validates, and uses a survey instrument to measure/compare differences in perceived service quality among three types of UC service providers. Six dimensions measured the components of service quality: tangibles, professionalism, interaction, accessibility, efficiency, and technical quality. Primary care physicians' offices scored higher for service quality and perceived value, followed by UCC. Hospital emergency rooms scored lower in both quality and perceived value. No significant difference was identified between UCC and primary care physicians across all the perspectives, except for interactions. The homogenous nature of the sample population (college students), and the fact that the respondents were recruited from a single university limits the generalizability of the findings. The patient's choice of a health care provider influences not only the continuity of the care that he or she receives, but compliance with a medical regime, and the evolution of the health care landscape. This work contributes to the understanding of how to provide cost effective and efficient UC services. This study developed and validated a survey instrument to measure/compare six dimensions of service quality for three types of UC service providers. The authors provide valuable data for UC service providers seeking to improve patient perceptions of service quality.

  11. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.

  12. Universal Services in the European Union.

    Science.gov (United States)

    Bauer, Johannes M.

    1999-01-01

    Discusses universal service policies in the European Union. Topics include information access; the demise of the public service model; the effects of competition on universal service; financing; national implementation of member states; programs for schools and libraries; and pertinent Web sites on European universal service policy. (LRW)

  13. Finding Health Care Services

    Science.gov (United States)

    If you have been diagnosed with cancer, finding a doctor and treatment facility for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  14. Universal health care in India: Panacea for whom?

    Directory of Open Access Journals (Sweden)

    Imrana Qadeer

    2013-01-01

    Full Text Available This paper examines the current notion of universal health care (UHC in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State′s responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care and omission (silence maintained on tertiary care will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all.

  15. Universal health care in India: Panacea for whom?

    Science.gov (United States)

    Qadeer, Imrana

    2013-01-01

    This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all.

  16. 75 FR 70149 - Universal Service Support Mechanisms

    Science.gov (United States)

    2010-11-17

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 54 Universal Service Support Mechanisms AGENCY: Federal Communications Commission... published a number of requirements related to the universal service support mechanisms. This...

  17. Advancing Service-Learning at Research Universities.

    Science.gov (United States)

    Furco, Andrew

    2001-01-01

    Offers three strategies for overcoming the challenges of advancing and institutionalizing service learning at research universities. The strategies address making service learning integral to faculty research, the university mission, and the disciplines. (EV)

  18. Care Services in Periurban Ghana

    Directory of Open Access Journals (Sweden)

    Paa Kobina Turkson

    2011-01-01

    Full Text Available The study used logistic regression modelling to determine predictors of satisfaction with delivery of animal health care services for 889 clients (livestock and poultry keepers in periurban Ghana. Of the 15 indicators tested as predictors of satisfaction in this study, 8 were included in the best fit model. These were accessibility, availability of services, service charge, effectiveness, efficiency, quality of services, meeting client needs, and getting help. Efficiency and effectiveness were perceived by the respondents to be synonymous, as were service quality and effectiveness, as suggested by ORs>10 when cross tabulated. Therefore, one or the other could be used in future studies but not both to avoid collinearity. The identified predictors could be targeted for improvement in quality of service delivery to livestock and poultry keepers in Ghana.

  19. Distance Learning Library Services in Ugandan Universities

    Science.gov (United States)

    Mayende, Jackline Estomihi Kiwelu; Obura, Constant Okello

    2013-01-01

    The study carried out at Makerere University and Uganda Martyrs University in 2010 aimed at providing strategies for enhanced distance learning library services in terms of convenience and adequacy. The study adopted a cross sectional descriptive survey design. The study revealed services provided in branch libraries in Ugandan universities were…

  20. [Intensive care services resources in Spain].

    Science.gov (United States)

    Martín, M C; León, C; Cuñat, J; del Nogal, F

    2013-10-01

    To identify the resources related to the care of critically ill patients in Spain, which are available in the units dependent of the Services of Intensive Care Medicine (ICM) or other services/specialties, analyzing their distribution according to characteristics of the hospitals and by autonomous communities. Prospective observational study. Spanish hospitals. Heads of the Services of ICM. Number of units and beds for critically ill patients and functional dependence. The total number of registries obtained with at least one Service of ICM was 237, with a total of 100,198 hospital beds. Level iii (43.5%) and level ii (35%) hospitals predominated. A total of 73% were public hospitals and 55.3% were non-university centers. The total number of beds for adult critically ill patients, was 4,738 (10.3/100,000 inhabitants). The services of ICM registered had available 258 intensive are units (ICUs), with 3,363 beds, mainly polyvalent ICUs (81%) and 43 intermediate care units. The number of patients attended in the Services of ICM in 2008 was 174,904, with a percentage of occupation of 79.5% A total of 228 units attending critically ill patients, which are dependent of other services with 2,233 beds, 772 for pediatric patients or neonates, were registered. When these last specialized units are excluded, there was a marked predominance of postsurgical units followed by coronary and cardiac units. Seventy one per cent of beds available in the Critical Care Units in Spain are characterized by attending severe adult patients, are dependent of the services of ICM, and most of them are polyvalent. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  1. 75 FR 26137 - High-Cost Universal Service Support, Federal-State Joint Board on Universal Service

    Science.gov (United States)

    2010-05-11

    ... advance universal service''; and (6) `` lementary and secondary schools and classrooms, health care... provided by mobile wireless service providers, large cable operators, and over-the-top VoIP providers. The... providers are constructing fixed or mobile networks that are capable of providing broadband as well as...

  2. Patient satisfaction- comparison of the comprehensive care model with traditional model of delivering dental services in Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Afsaneh Pakdaman

    2013-10-01

    Full Text Available   Background and Aims: One of the important aspects for evaluating an organization is assessing the level of satisfaction of the clients. This study was conducted to compare the level of satisfaction between traditional and new methods of delivering dental care in the clinic of Tehran University of Medical Sciences.   Materials and Methods: A cross-sectional study was conducted on 308 patients received dental care at the dental clinics of Tehran University of Medical Sciences in spring 2010. Data were collected from Comprehensive Care Unit (CCU in addition to 7 isolated clinics including restorative, periodontics, endodontics, radiology, and prosthodontics (fix and removable using translated version of the Dental Satisfaction Questionnaire (DSQ, consisted of 19 questions in three main domains in addition to demographic questions. Descriptive statistics was used as percentage of answers. In order to compare the mean score between domains ANOVA test was used.   Results: The standardized mean scores in each domain were: pain control 58±17, access 59±12, quality 68±11 and total Dental Satisfaction Index (DSI score of 62±10. 92.5% of the respondents reported that students were very careful when examining their patients. 96.8% reported that they treat their patients with respect . The most common reasons for dissatisfaction apart from waiting time and getting appointments were not providing preventive care and pain control.   Conclusion: The results of this study shows acceptable level of satisfaction with dental care in teaching clinics of this dental school, however efforts on implementing preventive care and pain control strategies are suggested.

  3. Indian Health Service: Find Health Care

    Science.gov (United States)

    ... and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Feedback ... Forgot Password IHS Home Find Health Care Find Health Care IMPORTANT If you are having a health ...

  4. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  5. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  6. ICT-Services in a University Environment

    DEFF Research Database (Denmark)

    Heilesen, Simon

    2010-01-01

    This case discusses the development and management of ICT-services at a Danish university. A special characteristic of the case is that the development has taken place on the basis of participatory design and voluntary adoption. On the one hand, this approach furthers the adoption of ICT-services......This case discusses the development and management of ICT-services at a Danish university. A special characteristic of the case is that the development has taken place on the basis of participatory design and voluntary adoption. On the one hand, this approach furthers the adoption of ICT......-services. On the other hand, it may hamper the development of a uniform and universally accepted set of services. Some concrete examples of ICT-services are discussed from the point of view of factors favorable to the adoption of technological innovations. These include services for administration, communication...

  7. Home care services for sick children

    DEFF Research Database (Denmark)

    Castor, Charlotte; Hallström, Inger; Hansson, Eva Helena

    2017-01-01

    AIMS AND OBJECTIVES: To explore healthcare professionals' conceptions of caring for sick children in home care services. BACKGROUND: Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised...... professionals to be part of the re-organising and implementation processes might facilitate the home care services for sick children. Enough time and good teamwork must be emphasised. Early referrals, continuous cooperation with paediatric clinics complemented with individualised support when a child...

  8. Improving Customer Service in Elderly Care

    OpenAIRE

    Nielsen, Chris

    2015-01-01

    The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...

  9. A Universal Duty to Care

    NARCIS (Netherlands)

    I.A.M. Robeyns (Ingrid)

    2011-01-01

    textabstractThe most basic and fundamental need that human beings have is the need to be properly cared for. Already before their birth, human beings need proper care, for example by being provided with the right nutrition, not being exposed to toxics, and receiving the right professional care to ch

  10. A Universal Duty to Care

    NARCIS (Netherlands)

    I.A.M. Robeyns (Ingrid)

    2011-01-01

    textabstractThe most basic and fundamental need that human beings have is the need to be properly cared for. Already before their birth, human beings need proper care, for example by being provided with the right nutrition, not being exposed to toxics, and receiving the right professional care to

  11. Universal Service Policies as Wealth Redistribution.

    Science.gov (United States)

    Mueller, Milton

    1999-01-01

    Offers a critical reassessment of the underlying rationale for universal service policies and argues that public policies designed to promote universal telecommunications access are simply a form of wealth redistribution. Considers economic and political issues and discusses how telecommunications can help ameliorate inequalities but not eliminate…

  12. Integrated Information Services in University Environments.

    Science.gov (United States)

    Wykoff, Leslie W.

    2001-01-01

    Explores integration of information services at universities. Provides a history of integrated information services, details successful mergers, and explores professional and organizational issues that create conflict instead of collaboration. Discusses how newer, more flexible higher education environments may be more conducive to integration,…

  13. 高校保健工作中的人文关怀%Humanistic Care of Health Service in Colleges and Universities

    Institute of Scientific and Technical Information of China (English)

    刘武晶

    2014-01-01

    随着人们文化生活水平的提高、健康观念的转变以及病人维权意识的增强,医患矛盾不断出现。高校保健工作也存在同样的问题,为了赢得师生的信任,我们应以人文关怀为基础,转变服务模式,改变服务态度,营造和谐医疗氛围,从而建立良好的医患关系。良好的医患关系有助于疾病的治疗和康复。%Along with the change of people’s cultural life level and health concept ,and with patient rights consciousness enhancement ,the doctor-patient conflict appears constantly .In order to win the trust of the teachers and students ,all we do should be based on the human-istic care ,and we should change service pattern ,change the service attitude ,build a harmonious medical atmosphere so as to establish a good doctor-patient relationship .Good doctor-patient relationship is helpful to the treatment and rehabilitation .

  14. [Universal coverage of health services in Mexico].

    Science.gov (United States)

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

  15. Universal Service for Socially Excluded Users

    Directory of Open Access Journals (Sweden)

    B. Bakmaz

    2009-06-01

    Full Text Available This paper is about defining special measures within a universal service for potential socially excluded users, as a part of Project on US in Serbia. In the centre of research are people with disabilities, low income households, and welfare institutions in the Republic of Serbia. After analyzing regulations and statistical data, proposals for telecommunications services for these users are analyzed together with the costs of their realizations. At the end preliminary results of research are discussed.

  16. Value added telecommunication services for health care.

    Science.gov (United States)

    Danelli-Mylonas, Vassiliki

    2003-01-01

    The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.

  17. The delivery of primary care services.

    NARCIS (Netherlands)

    Wilson, A.; Windak, A.; Oleszczyk, M.; Wilm, S.; Hasvold, T.; Kringos, D.

    2015-01-01

    This chapter will be devoted to the dimensions which have been grouped in the framework as “process” and that focus on essential features of service delivery in primary care. In addition to the breadth of services delivered, a comparative overview will be provided of variation in access to services,

  18. FAMILY TO PALLIATIVE CARE AND HOSPICE SERVICES IN NIG ...

    African Journals Online (AJOL)

    Departments of *Radiotherapy, + Nursing and ** Anaesthesia, College of Medicine, University oflbadan. ABSTRACT. Bacground: A palliative care and Hospice service is a neglected aspect of medical discipline ... 60% of new cases will occur in the less developed parts of ..... technology intervention and high cost of drugs 9.

  19. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions...

  20. International Student Support Services at Ontario Universities

    Science.gov (United States)

    Smith, Clayton; Whiteside, Brenda; Blanchard, Suzanne; Martin, Chris

    2013-01-01

    In this article, the Ontario Committee on Student Affairs and the Ontario Undergraduate Student Alliance partnered to examine the availability and use of international student support services at Ontario universities. Results of the recently administered Ontario Committee on Student Affairs, Canadian Bureau of International Education, and…

  1. A health services framework of spiritual care.

    Science.gov (United States)

    Daaleman, Timothy P

    2012-12-01

    To introduce a health services framework of spiritual care that addresses the empirical and applied issues surrounding spirituality and nursing practice. Despite over 20 years of study, the concept of spirituality is still under development, which limits application to nursing practice. Three studies using a health services framework are reviewed: (1) a survey study of dying patients and family that describes the providers, types and outcomes of spiritual care; (2) an exploratory study of the process of spiritual care; and (3) a multi-level study of the structure and outcomes of spiritual care in long-term care facilities. Spiritual care recipients identify family or friends (41%), clergy (17%) and health care providers (29%) as spiritual care providers. The most frequently reported type of spiritual care was help in coping with illness (87%). Just over half (55%) were satisfied with the care that they received. The processes of spiritual care involved: (1) presence, (2) opening eyes, and; (3) co-creating, which was a mutual and fluid activity between patients, family members and care providers. In long term care facilities, decedents who received spiritual care were perceived as receiving better overall care in the last month of life, when compared with those decedents who did not receive spiritual care. A health services framework provides a holistic view of spiritual care, one that is consistent with integrated nursing models. By focusing on the structure, process and outcome elements of spiritual care within organisational settings, nursing management can develop feasible approaches to implement, improve and evaluate the delivery of this unique type of care. © 2012 Blackwell Publishing Ltd.

  2. On Universal Telecommunication Service and West China Development

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    This paper aims at studying the relationship between universal telecommunication service and West China development. It, firstly, introduces our country's demands for universal telecommunication service; secondly, analyses the demand of West China development for the universal telecommunication service; thirdly, depicts the development status of telecommunication industry of the west region; fourthly, points out the significance of universal telecommunication service to the west area; and lastly, brings forward the connotation of universal telecommunication service of west area.

  3. SEQUenCE: a service user-centred quality of care instrument for mental health services.

    Science.gov (United States)

    Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul

    2015-08-01

    To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  4. Improving managed care value through customer service.

    Science.gov (United States)

    Tomczyk, Dennis J

    2002-06-01

    The ability of managed care providers to deliver high-quality customer service to managed care customers depends on their adoption of basic customer-service principles. To apply these principles effectively, providers need to understand and work to exceed the particular needs and expectations of these customers, which include boards of directors, senior executives, physicians, healthcare providers, clinical and patient financial services managers and staff, employers, brokers, and patients. Although these needs and expectations can be predicted to some extent, providers would be wise to implement regular surveys of customers and an open procedure for soliciting customer feedback about service issues. Better customer service for the broad range of managed care customers translates into higher levels of employer and patient satisfaction, which ultimately benefits providers.

  5. Counseling Services in Adult Day Care Centers.

    Science.gov (United States)

    Zaki, Gamal; Zaki, Sylvia

    Federal support for adult day care centers began in the United States approximately 10 years ago. To examine the counseling practices in the adult day care centers across the country and to explore how the services are affected by the staffing patterns at these centers, 135 centers completed a questionnaire. The questionnaire addressed…

  6. Day Care Services: Industry's Involvement. Bulletin 296.

    Science.gov (United States)

    Besner, Arthur

    This bulletin provides an overview of the need for services for the children of working mothers. Topics discussed include historical developments in industry day care programs, alternative roles for industry involvement, costs of operating day care centers, and income tax allowances. Also given are examples of unique programs which suggest various…

  7. 42 CFR 440.168 - Primary care case management services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related... services. (b) Primary care case management services may be offered by the State— (1) As a voluntary option...

  8. Universal health care: the changing international discourse.

    Science.gov (United States)

    Bisht, Ramila

    2013-01-01

    Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world's populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to "Health for All" was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC). It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited.

  9. Universal health care: The changing international discourse

    Directory of Open Access Journals (Sweden)

    Ramila Bisht

    2013-01-01

    Full Text Available Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world′s populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to "Health for All" was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC. It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited.

  10. A Redesign Approach for Improving Animal Care Services for Researchers.

    Science.gov (United States)

    Okpe, Orighomisan; Kovach, Jamison V

    2017-07-01

    Because a research institution's animal care and use program oversees the provision of services specified in approved protocols designed by researchers, the effective provision of services within these programs is paramount to ensuring the humane care and treatment of research animals in accordance with federal, state, and local regulations and institutional policies. To improve the services provided to researchers through animal care and use programs, we investigated the relationship between the researchers who conduct these types of studies and the veterinary operations that provide care and treatment for research animals. Through a case study conducted at a leading public research university, we used an action-research approach to redesign aspects of the process through which researchers and the veterinary operations interact by using the Design for Six Sigma methodology. Using this structured approach for building quality into the design of a process to better serve customers, we identified and prioritized researchers' expectations regarding the role of veterinary operations in supporting their animal research activities. In addition, ideas for addressing researchers' top-rated needs were generated through focus groups. By updating online resources, creating checklists and newsletters, and hiring additional veterinary staff, the services provided were amended to provide researchers with increased access to valuable information, improved clarity regarding the process for obtaining access to research facilities, and enhanced support for animal care services.

  11. Maternal Health Care Services Access Index and Infant Survival in

    African Journals Online (AJOL)

    GB

    ... reduce in Nigeria. KEYWORDS: Infant mortality, Maternal health care, Pregnancy care, Delivery care, Nigeria ... not go for antenatal care, and as a result may not access other cares ...... Inadequate Use of Prenatal Services Among. Brazilian ...

  12. Health Care Services in IBD: Factors Associated with Service Utilization and Preferences for Service Options for Routine and Urgent Care.

    Science.gov (United States)

    Bernstein, Matthew T; Walker, John R; Chhibba, Tarun; Ivekovic, Melony; Singh, Harminder; Targownik, Laura E; Bernstein, Charles N

    2017-09-01

    We aimed to explore factors associated with health service utilization and preference for services, including alternatives to attending the emergency department (ED) when experiencing mild to moderate or severe symptoms. A total of 1143 persons (46% response rate) aged 18 to 65 years in the population-based University of Manitoba IBD Research Registry participated in the survey. Although 61% had a gastroenterologist, when experiencing active symptoms, only 29% felt they could call their gastroenterologist for an urgent appointment, and 42% could call their gastroenterologist for telephone advice. Nine percent of the respondents visited the ED in the previous year. If having severe symptoms, 48% said that they would attend the ED. Visits to the ED were related to higher bowel symptom severity and high health anxiety. When experiencing severe symptoms, women, persons with Crohn's disease and those with high health anxiety, indicated that they would be more likely to use the ED. Considering services which could be available in the future respondents indicated that if acutely symptomatic they would be very likely or likely to use the following services: phone contact with inflammatory bowel disease nurse (77%), phone contact with a gastroenterologist (75%), and going to a walk-in gastroenterology clinic (71%). Persons with inflammatory bowel disease are receptive to options other than the ED when experiencing inflammatory bowel disease symptoms; however, attending the ED remains a prominent choice. Improved access to specialized care may improve timeliness of care and reduce ED attendance. Future research should include the impact of health anxiety on health care utilization.

  13. Health care as a universal right.

    Science.gov (United States)

    Nunes, Rui; Nunes, Sofia B; Rego, Guilhermina

    2017-01-01

    Most developed societies recognise the existence of a basic right of access to health care of appropriate quality, considering it a positive welfare right. It can even be one of the most important achievements of pluralistic and secular societies. The main objective of this study is to suggest the foundations for a universal right to health care, meaning the right of access to health care of appropriate quality. A second objective is to propose the necessary tools so that access to health care is viable in a specific commonwealth in accordance with available resources. To find this balance between an existing variable geometry and the actual level of resources of each specific commonwealth, the authors suggest the compatibility between Norman Daniels' "accountability for reasonableness" and the integrated view of health of the World Health Organisation through the "equal opportunity function". The equal opportunity function appears to be an ethically acceptable solution for the existing variable geometry because it allows for different levels of provision and promotes an ethical rationing fully respecting accountability for reasonableness. The basic right of access to health care of appropriate quality is a fundamental humanitarian principle that should be enjoyed by all citizens of all countries, and the international community should recognise the obligation to promote these ideals by any means available. Indeed, although social rights such as health care demand citizens' solidarity to be enjoyed, only with the universalisation of social rights will humanity be more equal in the future.

  14. Barriers to emergency obstetric care services

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

    2014-01-01

    Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay...... was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby. Conclusion: Delays in making the decision to seek care when obstetric complications occur, combined with delays in reaching...

  15. Making research integral to home care services.

    Science.gov (United States)

    Lang, Ariella; Shamian, Judith; Goodwin, Sharon

    2015-09-01

    Home care is the fastest growing segment of the Canadian healthcare system, yet research on patient safety has been conducted predominantly in institutional settings. This is a case example of how Victorian Order of Nurses Canada, a national not-for-profit home and community care provider, embedded a nurse researcher to create an environment in which health services research flourished. This model strategically propelled important issues such as home care safety on to the national research and policy agendas and helped leverage change in multiple levels of the healthcare system. This is a call to action for building partnerships to have a researcher as an integral team member in organizations providing home care services. © 2015 The Canadian College of Health Leaders.

  16. Patient satisfaction with health care services provided at HIV clinics ...

    African Journals Online (AJOL)

    Patient satisfaction with health care services provided at HIV clinics at Amana and ... with the general physical environment of the clinic and with services offered by ... Key words: Patient satisfaction, Antiretroviral therapy, HIV care services ...

  17. The challenge of nurse innovation in the Australian context of universal health care.

    Science.gov (United States)

    Cashin, Andrew

    2015-01-01

    As nursing pushes further into the realm of primary health care in Australia, an understanding of the challenges to achieving reasonable federal funding of nursing services needs to be understood. This understanding is underpinned by a comprehensive understanding of the concept of universal health care, how the concept relates to the Australian health care context, and the resultant challenges to innovation in health care service delivery in Australia. Universal health care is a global mission and was the most recent theme for the International Council of Nurses Congress in Australia. Universal health care as a concept represents a fundamental shift from the development and funding of discrete interventions or programmes, to that of developing systems of health care. The three critical elements required are a clear definition of what is considered health care and funded for who, how the system is financed, and evaluation. Australia has a system of universal health care and all three elements are addressed. Organised medicine, a key objector to the introduction of the current approach to universal health care in Australia, soon adapted to it, and now fiercely resists change. Medico centricity poses challenges to sustainability as innovation is inhibited. This challenge is illustrated through consideration of the implementation of the financial policy that gave Nurse Practitioners access as providers and prescribers within Medicare funded services.

  18. Robots and service innovation in health care.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Darzi, Ara

    2011-01-01

    Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.

  19. A primary care approach for adolescent care and counseling services.

    Science.gov (United States)

    Nair, M K C; Chacko, D S; Indira, M S; Siju, K E; George, Babu; Russell, P S

    2012-01-01

    Adolescents can have mental, emotional, and behavior problems that are a source of stress for the child as well as the family, school and community. These may disrupt the adolescent's ability to function normally. Adolescents also have reproductive concerns especially at menarche. Considering the extent of problems of adolescents and the lack of adolescent care and counseling services, it was felt that community adolescent care counseling services should be made available. This article describes the steps involved in the setting up of Taluk model of adolescent care and counseling services. Following steps were involved in setting up a Taluk model of adolescent care counseling service delivery system. Step I: Focus Group Discussions (FGDs) among Stakeholders. Step II: Conceptualization and Strategy planning for service delivery. III: Finalization of service delivery model Step IV: Workshops for finalization of TSQ-T 2008 version the tool to be used for assessing the adolescents in the ARSH clinics. Step V: Training Programme for Medical/Paramedical health staff. Step VI: Awareness programs for mothers of adolescents. Step VII: Setting up of ACS/ARSH clinics at Taluk hospitals. Step VIII: Evaluation of the utilization of services at Taluk hospitals. The clinic has been well utilized with 1,588 adolescents being seen in 2 years. Medical and Reproductive problems among adolescent girls were anemia, underweight, dysmenorrhoea, menstrual irregularities and symptoms of Polycystic Ovarian Syndrome, whereas among boys problems were mostly related to concerns about masturbation and its perceived ill effects. The psychosocial problems ranged from minor anxieties, sadness and adjustment problems to psychiatric disorders. Scholastic problems included poor concentration, poor study habits and low intelligence quotient. The success of the clinics in these five hospitals can be replicated in other parts of the state as well as the country. These will go a long way to ameliorate

  20. Integrated personal health and care services deployment

    DEFF Research Database (Denmark)

    Villalba, E.; Casas, I.; Abadie, F.

    2013-01-01

    Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessa...... of Integrated Personal Health and Care Services in European regions has increased. Further research will reveal the weight of each facilitator and which combinations of facilitators lead to rapid adoption.......Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...

  1. Home Care Service Diversification: A Pilot Investigation.

    Science.gov (United States)

    Jette, Alan M.; And Others

    1981-01-01

    Describes a diversified approach to delivering home care to vulnerable older people. This pilot program, funded by the Massachusetts Department of Elder Affairs, attempted to reduce the demand for scarce homemaker services. Results suggest homecare diversification did not alter consumer satisfaction but increased manager time. (Author/JAC)

  2. Marketing service guarantees for health care.

    Science.gov (United States)

    Levy, J S

    1999-01-01

    The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.

  3. Integrated personal health and care services deployment

    DEFF Research Database (Denmark)

    Villalba, E.; Casas, I.; Abadie, F.

    2013-01-01

    Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... for successful health systems integration. Results: Out of the 27 cases, we focused on 11 which continued beyond the pilot stage. The key facilitators that are necessary for successful deployment and adoption in the European regions of our study are reorganisation of services, patient focus, governance...

  4. Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting.

    Science.gov (United States)

    Gillette, Joyce L.; And Others

    1982-01-01

    Five hundred college students who had used Kent State University's School Health Service were surveyed to determine patient satisfaction with health care services. Overall satisfaction with the services was high, and satisfaction was significantly influenced by patients' perceptions of practitioners' technical competence and by the adequacy of the…

  5. Speak Up: Help Prevent Errors in Your Care: Laboratory Services

    Science.gov (United States)

    SpeakUP TM Help Prevent Errors in Your Care Laboratory Services To prevent health care errors, patients are ... making health care safe. That includes doctors, nurses, laboratory technologists, phlebotomists (health care staff who take blood), ...

  6. Service Users’ Involvement and Engagement in Interprofessional Care

    Directory of Open Access Journals (Sweden)

    Bachchu Kailash Kaini

    2016-12-01

    Full Text Available Interprofessional care is joint working between health care professionals by pooling their skills, knowledge and expertise, to make joint decisions and learn from each other for the benefits of service users and healthcare professionals. Service users involvement is considered as one of the important aspects of planning, management and decision making process in the delivery of health care to service users. Service users’ involvement is not the same as public involvement and partnership arrangements in health care. The active involvement and engagement of service users in health care positively contributes to improve quality of care, to promote better health and to shape the future of health services. Service users are always at the centre of health care professionals’ values, work ethics and roles. Moreover, service users centred interprofessional team collaboration is very important to deliver effective health services. Keywords: interprofessional; service users; health care; benefits; collaboration. | PubMed

  7. 42 CFR 405.440 - Emergency and urgent care services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency and urgent care services. 405.440 Section... Emergency and urgent care services. (a) A physician or practitioner who has opted-out of Medicare under this subpart need not enter into a private contract to furnish emergency care services or urgent care...

  8. 42 CFR 417.531 - Hospice care services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospice care services. 417.531 Section 417.531... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.531 Hospice care services. (a) If a Medicare enrollee of... receive hospice care services, payment for these services is made to the hospice that furnishes...

  9. Sustainability of comprehensive universal long-term care insurance in the Netherlands

    NARCIS (Netherlands)

    F.T. Schut (Erik); B. van den Berg (Bernard)

    2010-01-01

    textabstractThe Netherlands was the first country that introduced a universal mandatory social health insurance scheme for covering a broad range of long-term care (LTC) services provided in a variety of care settings. Compared with most other OECD countries, both total and public expenditure on LTC

  10. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    Science.gov (United States)

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  11. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    Science.gov (United States)

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  12. Anticoagulated patient management in primary care service

    Directory of Open Access Journals (Sweden)

    Marco Antonio Zapata Sampedro

    2008-05-01

    Full Text Available Out-patients undergoing anticoagulant treatment are attended by nursing staff, working with doctors.To be able to provide adequate medical care, nurses must have the minimum knowledge and skills needed to work with the programme described in this article. These include basic and specific knowledge of anticoagulation. The correct functioning of the service will help provide an optimum control of the INR (International Normalized Ratio and reduce the complications of bleeding, both of which are the main objectives of the nursing care of these patients.

  13. Barriers to emergency obstetric care services

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

    2014-01-01

    barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district. Elizabeth Echoka1,&, Anselimo Makokha2, Dominique Dubourg3, Yeri Kombe1, Lillian Nyandieka1, Jens Byskov4 Results: Findings indicate that pregnant women experienced delays in making...

  14. Teaching wound care to family medicine residents on a wound care service

    Directory of Open Access Journals (Sweden)

    Little SH

    2013-08-01

    Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

  15. Program management of telemental health care services.

    Science.gov (United States)

    Darkins, A

    2001-01-01

    Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.

  16. Home care for older people in Sweden: a universal model in transition.

    Science.gov (United States)

    Szebehely, Marta; Trydegård, Gun-Britt

    2012-05-01

    One aspect of universalism in Swedish eldercare services is that publicly financed and publicly provided services have been both affordable for the poor and attractive enough to be preferred by the middle class. This article identifies two trends in home care for older people in Sweden: a decline in the coverage of publicly funded services and their increasing marketisation. We explore the mechanisms behind these trends by reviewing policy documents and official reports, and discuss the distributional consequences of the changes by analysing two data sets from Statistics Sweden: the Swedish Level of Living surveys from 1988/1989 and 2004/2005 and a database on all users of tax deductions on household and care services in 2009. The analysis shows that the decline of tax-funded home care is not the result of changing eldercare legislation and was not intended by national policy-makers. Rather the decline was caused by a complex interplay of decision-making at central and local levels, resulting in stricter municipal targeting. The trend towards marketisation has been more clearly intended by national policy-makers. Legislative changes have opened up tax-funded services to private provision, and a customer-choice (voucher) model and a tax deduction for household- and care services have been introduced. As a result of declining tax-funded home-care services, older persons with lower education increasingly receive family care, while those with higher education are more likely to buy private services. The combination of income-related user fees, customer-choice models and the tax deduction has created an incentive for high-income older persons to turn to the market instead of using public home-care services. Thus, Swedish home care, as a universal welfare service, is now under threat and may become increasingly dominated by groups with less education and lower income which, in turn, could jeopardise the quality of care. © 2011 Blackwell Publishing Ltd.

  17. The cost of universal health care in India: a model based estimate.

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    Full Text Available INTRODUCTION: As high out-of-pocket healthcare expenses pose heavy financial burden on the families, Government of India is considering a variety of financing and delivery options to universalize health care services. Hence, an estimate of the cost of delivering universal health care services is needed. METHODS: We developed a model to estimate recurrent and annual costs for providing health services through a mix of public and private providers in Chandigarh located in northern India. Necessary health services required to deliver good quality care were defined by the Indian Public Health Standards. National Sample Survey data was utilized to estimate disease burden. In addition, morbidity and treatment data was collected from two secondary and two tertiary care hospitals. The unit cost of treatment was estimated from the published literature. For diseases where data on treatment cost was not available, we collected data on standard treatment protocols and cost of care from local health providers. RESULTS: We estimate that the cost of universal health care delivery through the existing mix of public and private health institutions would be INR 1713 (USD 38, 95%CI USD 18-73 per person per annum in India. This cost would be 24% higher, if branded drugs are used. Extrapolation of these costs to entire country indicates that Indian government needs to spend 3.8% (2.1%-6.8% of the GDP for universalizing health care services. CONCLUSION: The cost of universal health care delivered through a combination of public and private providers is estimated to be INR 1713 per capita per year in India. Important issues such as delivery strategy for ensuring quality, reducing inequities in access, and managing the growth of health care demand need be explored.

  18. Universal Service in a Participatory Democracy: A Perspective from Australia.

    Science.gov (United States)

    de Reuck, John; Joseph, Richard

    1999-01-01

    Discusses universal service policy in telecommunications in Australia in an historical context. Maintains that given the dynamic growth in information technologies, universal service should be reconceptualized within a knowledge-based discourse critically linked to considerations for deepening participatory democracy and that funding should be…

  19. 75 FR 10199 - Schools and Libraries Universal Service Support Mechanism

    Science.gov (United States)

    2010-03-05

    ... No. 02-6; FCC 10-33] Schools and Libraries Universal Service Support Mechanism AGENCY: Federal... the E-rate program (more formally, the schools and libraries universal service support program) to..., for purposes such as job searches and applications, digital literacy programs, and online access...

  20. 47 CFR 69.413 - Universal service fund expenses.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Universal service fund expenses. 69.413 Section... (CONTINUED) ACCESS CHARGES Apportionment of Expenses § 69.413 Universal service fund expenses. Expenses allocated to the interstate jurisdiction pursuant to §§ 36.631 and 36.641 shall be assigned to the...

  1. Counselling Services Utilisation in a Malaysia Private University

    Science.gov (United States)

    Yin-Fah, Benjamin Chan; Sok-Foon, Yeoh; Migin, Melissa W.

    2016-01-01

    University can be an exciting yet challenging transition for students. Many universities provide counselling services to students who need it during their tertiary studies but many students tend to avoid counselling. This study was conducted to identify the counselling service experience among undergraduate students. The emphasis was on the past…

  2. University Library Virtual Reference Services: Best Practices and Continuous Improvement

    Science.gov (United States)

    Shaw, Kate; Spink, Amanda

    2009-01-01

    The inclusion or not of chat services within Virtual Reference (VR) is an important topic for university libraries. Increasingly, email supported by a Frequently Asked Questions (FAQ) database is suggested in the scholarly literature as the preferred, cost-effective means for providing university VR services. This paper examines these issues and…

  3. Perceived Service Quality and Student Loyalty in an Online University

    Science.gov (United States)

    Martínez-Argüelles, María-Jesús; Batalla-Busquets, Josep-Maria

    2016-01-01

    This paper examines the influence that student perceived quality of service (PSQ) has on continuance intention and willingness to recommend a course in a fully online university. A holistic view of the service provided by the university is taken. It is not only the effect of the teaching which is examined, but also that of the administrative…

  4. Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service.

    Science.gov (United States)

    Dwyer, Trudy; Craswell, Alison; Rossi, Dolene; Holzberger, Darren

    2017-01-13

    Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia. Donabedian's structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardised interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings. Structural dimensions identified included the 'in-reach' nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction. This study provides valuable insights into the contribution of the NP model of care within an aged care

  5. Universal Health Coverage through Community Nursing Services: China vs. Hong Kong

    Science.gov (United States)

    Chan, Wai Yee; Fung, Ita M; Chan, Eric

    2017-01-01

    ABSTRACT Objective: this article looks at how the development of community nursing services in China and Hong Kong can enhance universal health coverage. Methods: literature and data review have been utilized in this study. Results: nursing services have evolved much since the beginning of the nursing profession. The development of community nursing services has expanded the scope of nursing services to those in need of, not just hospital-level nursing care, but more holistic care to improve health and quality of life. Conclusion: despite the one-country-two-systems governance and the difference in population and geography, Hong Kong and China both face the aging population and its complications. Community nursing services help to pave the road to Universal Health Coverage. PMID:28146178

  6. Developing a Business Plan for Critical Care Pharmacy Services.

    Science.gov (United States)

    Erstad, Brian L; Mann, Henry J; Weber, Robert J

    2016-11-01

    Critical care medicine has grown from a small group of physicians participating in patient care rounds in surgical and medical intensive care units (ICUs) to a highly technical, interdisciplinary team. Pharmacy's growth in the area of critical care is as exponential. Today's ICU requires a comprehensive pharmaceutical service that includes both operational and clinical services to meet patient medication needs. This article provides the elements for a business plan to justify critical care pharmacy services by describing the pertinent background and benefit of ICU pharmacy services, detailing a current assessment of ICU pharmacy services, listing the essential ICU pharmacy services, describing service metrics, and delineating an appropriate timeline for implementing an ICU pharmacy service. The structure and approach of this business plan can be applied to a variety of pharmacy services. By following the format and information listed in this article, the pharmacy director can move closer to developing patient-centered pharmacy services for ICU patients.

  7. Postrape care services to minors in Kenya: are the services healing or hurting survivors?

    Directory of Open Access Journals (Sweden)

    Wangamati CK

    2016-07-01

    Full Text Available Cynthia Khamala Wangamati,1 Viva Combs Thorsen,1 Abdi Ali Gele,2 Johanne Sundby1 1Department of Community Medicine, Faculty of Medicine, University of Oslo, 2Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway Abstract: Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors’ rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors’ rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused

  8. University Rankings: How Well Do They Measure Library Service Quality?

    Science.gov (United States)

    Jackson, Brian

    2015-01-01

    University rankings play an increasingly large role in shaping the goals of academic institutions and departments, while removing universities themselves from the evaluation process. This study compares the library-related results of two university ranking publications with scores on the LibQUAL+™ survey to identify if library service quality--as…

  9. University Rankings: How Well Do They Measure Library Service Quality?

    Science.gov (United States)

    Jackson, Brian

    2015-01-01

    University rankings play an increasingly large role in shaping the goals of academic institutions and departments, while removing universities themselves from the evaluation process. This study compares the library-related results of two university ranking publications with scores on the LibQUAL+™ survey to identify if library service quality--as…

  10. Quantitative comparison of measurements of urgent care service quality.

    Science.gov (United States)

    Qin, Hong; Prybutok, Victor; Prybutok, Gayle

    2016-01-01

    Service quality and patient satisfaction are essential to health care organization success. Parasuraman, Zeithaml, and Berry introduced SERVQUAL, a prominent service quality measure not yet applied to urgent care. We develop an instrument to measure perceived service quality and identify the determinants of patient satisfaction/ behavioral intentions. We examine the relationships among perceived service quality, patient satisfaction and behavioral intentions, and demonstrate that urgent care service quality is not equivalent using measures of perceptions only, differences of expectations minus perceptions, ratio of perceptions to expectations, and the log of the ratio. Perceptions provide the best measure of urgent care service quality.

  11. Students Delivering Health Care to a Vulnerable Appalachian Population through Interprofessional Service-Learning

    Science.gov (United States)

    Lee, Michelle L.; Hayes, Patricia A.; McConnell, Peggy; Henry, Robin M.

    2013-01-01

    Interprofessional student service-learning experiences are integrated into the preventive care of older adult residents of public housing in Appalachia. Receiving a Health Resources and Services Administration grant provided the College of Nursing at East Tennessee State University the opportunity to expand interprofessional clinical experiences…

  12. Mobile satellites - The possibility of universal service

    Science.gov (United States)

    Kiesling, John D.

    The characteristics of a mobile satellite service (MSS), which is a communications system capable of voice and data transmission and position location services using analogue and digital techniques, are described. Consideration is given to the use of the MSS for radio telephone and private mobile radio services, the costs of these services, and market demand for the MSS. The designs for the space segment and gateway network for the MSS are proposed. The requirements for the mobile radios and antennas of the MSS are discussed.

  13. Universities Improve Services with E-Commerce.

    Science.gov (United States)

    Palmer, Gina Adams

    2001-01-01

    This follow-up to a December 2000 article provides more details on Stanford University's venture into the "sell-side" of e-commerce, then describes another "sell-side" success story at the University of Wisconsin. Madison. Discusses experiences on the "buy-side" of e-commerce at the Massachusetts Institute of…

  14. Universities Improve Services with E-Commerce.

    Science.gov (United States)

    Palmer, Gina Adams

    2001-01-01

    This follow-up to a December 2000 article provides more details on Stanford University's venture into the "sell-side" of e-commerce, then describes another "sell-side" success story at the University of Wisconsin. Madison. Discusses experiences on the "buy-side" of e-commerce at the Massachusetts Institute of…

  15. Universities Improve Services with E-Commerce.

    Science.gov (United States)

    Palmer, Gina Adams

    2001-01-01

    This follow-up to a December 2000 article provides more details on Stanford University's venture into the "sell-side" of e-commerce, then describes another "sell-side" success story at the University of Wisconsin. Madison. Discusses experiences on the "buy-side" of e-commerce at the Massachusetts Institute of Technology, one of the first…

  16. Introducing Human Service Students to Service in the University Community.

    Science.gov (United States)

    Scudder, Mary C.

    1996-01-01

    Describes a substance abuse prevention program for college students. Human service students ran the program, using sociodrama as a teaching medium. Results indicate that teacher participants increased their knowledge of substance abuse and improved skills important to human service practice. Participants also learned about group dynamics in…

  17. Evaluating Service Quality in Universities: A Service Department Perspective

    Science.gov (United States)

    Smith, Gareth; Smith, Alison; Clarke, Alison

    2007-01-01

    Purpose: The purpose of the study is to report on an in-depth exploration of service quality in an Information Technology service department in a Higher Education Institute (HEI) and to evaluate the instrument used. Design/methodology/approach: The study surveys customers using the SERVQUAL instrument, which is one of the most widely used and…

  18. Development of a credit-bearing service leadership subject for university students in Hong Kong.

    Science.gov (United States)

    Shek, Daniel T L; Yu, Lu; Ma, Cecilia M S; Sun, Rachel C F; Liu, Ting Ting

    2013-01-01

    Given that service industries contribute to 93% of Hong Kong's GDP, an important question that should be asked is whether the education system can promote the development of service leadership among young people in Hong Kong. Unfortunately, service leadership programs specifically designed for university students are lacking in Hong Kong. In this paper, the basic tenets of the Service Leadership and Management framework are presented. Based on the fundamental postulation that effective service leadership is a function of moral character, competence and care (E=MC(2)), a subject called "Service Leadership" has recently been developed at The Hong Kong Polytechnic University. This paper outlines the objectives, intended learning outcomes, syllabus, assessment, and references of the subject. The proposed evaluation strategies are also described.

  19. Introduction of a university-based counselling service for older adults.

    Science.gov (United States)

    Bhar, Sunil S; Silver, Mark

    2014-03-01

    Despite the growing number of older adults in Australia, many do not access counselling, partly because of the lack of trained mental health professionals for older people. This paper describes an innovative solution for providing counselling services to older adults, and geropsychology training to postgraduate psychology students. A university-based counselling clinic for older adults was described – an outreach service for older adults living in the community or in residential aged care facilities in metropolitan Melbourne, Australia. Over its first 13 months, the clinic provided a total of 266 sessions of counselling to 57 clients (41 living in residential aged care), and involved six postgraduate students. This paper describes the potential benefits of the clinic for clients and students and the resources needed to support this model of service delivery. Thus, it provides a blueprint for other universities for developing similar services for older adults.

  20. Communicating for Quality in School Age Care Services

    Science.gov (United States)

    Cartmel, Jennifer; Grieshaber, Susan

    2014-01-01

    School Age Care (SAC) services have existed in Australia for over 100 years but they have tended to take a back seat when compared with provision for school-aged children and those under school age using early childhood education and care (ECEC) services. Many SAC services are housed in shared premises and many children attending preparatory or…

  1. Human resource issues in university health services.

    Science.gov (United States)

    Meilman, P W

    2001-07-01

    To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.

  2. Using the "customer service framework" to successfully implement patient- and family-centered care.

    Science.gov (United States)

    Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

    2011-01-01

    Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.

  3. Experiencing health care service quality: through patients' eyes.

    Science.gov (United States)

    Schembri, Sharon

    2015-02-01

    The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.

  4. Ten Reasons Service Science Matters to Universities

    Science.gov (United States)

    Spohrer, Jim; Fodell, Dianne; Murphy, Wendy

    2012-01-01

    Higher education is being reshaped little by little every day. Slowly but surely, from the smallest community colleges to the teaching institutions to the most prestigious research universities, a new set of key performance indicators (KPIs) is transforming what excellence means in higher education. For developed and emerging market nations…

  5. Ten Reasons Service Science Matters to Universities

    Science.gov (United States)

    Spohrer, Jim; Fodell, Dianne; Murphy, Wendy

    2012-01-01

    Higher education is being reshaped little by little every day. Slowly but surely, from the smallest community colleges to the teaching institutions to the most prestigious research universities, a new set of key performance indicators (KPIs) is transforming what excellence means in higher education. For developed and emerging market nations…

  6. Marriage, Cohabitation, and Men's Use of Preventive Health Care Services

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Marriage, Cohabitation, and Men's Use of Preventive Health Care ... health care visit in the past 12 months. Marriage was associated with greater likelihood of a health ...

  7. Satisfaction with health facility delivery care services and ssociated ...

    African Journals Online (AJOL)

    Satisfaction with health facility delivery care services and ssociated factors: The ... of care ranging from 30% reporting to be satisfied with management of labour pains ... women comfortable and satisfied with the process of delivery elsewhere.

  8. Service and its association with matching into a primary care residency

    Directory of Open Access Journals (Sweden)

    Khwaja A

    2015-03-01

    Full Text Available Ansab Khwaja, Douglas C Schaad, Richard W Arnold University of Washington School of Medicine, Seattle, WA, USA Background and objectives: There is a shortfall in the primary care workforce, and an effort is needed in learning more about what motivates students to work as generalists. There is enthusiasm about service as a potential motivator. The objective is to determine whether there is an association between high participation in service and selection of a primary care residency. Methods: This is a retrospective cohort analysis. The service award was used to delineate two groups, recipients and non-recipients, with the recipients considered high service participators. This was associated with residency match data using test of proportions to examine relationships between service and selection of a primary care residency and other secondary factors. Results: Of award recipients, 57.3% matched in primary care, compared to 52.8%, though this did not reach statistical significance. Service was linked with induction into Alpha Omega Alpha honor society (23.3% versus 14.6% and induction into the Gold Humanism Honor Society (22.6%. versus 10.4%, with statistical significance. Conclusion: This was an unsuccessful attempt to find a link between service and a primary care career choice, though there is a trend in the direction. The association with induction into the humanism honor society suggests that service is linked with development and/or retention of positively viewed qualities in medical students. Keywords: primary care, community service, medical education

  9. Education as Service: The Understanding of University Experience through the Service Logic

    Science.gov (United States)

    Ng, Irene C. L.; Forbes, Jeannie

    2009-01-01

    With the marketization of UK higher education, this paper develops a framework from services marketing that can assist universities in understanding what market orientation means and how students would value their offerings. Our study shows that the core service in a university experience is a learning experience that is cocreated and that the…

  10. The Future Role of Publishing Services in University Libraries

    Science.gov (United States)

    Walters, Tyler

    2012-01-01

    This study explores possible futures for university-based library publishing services (LPS) and uses scenario planning as its research method. The study posits that the major force in developing LPS is the level of funding from the host university, with the most uncertain factor being whether faculty will adopt LPS. The study participants…

  11. Utilization of health care services by depressed patients attending ...

    African Journals Online (AJOL)

    2011-06-15

    Jun 15, 2011 ... that patients with depression are high utilizers of medical services. Objectives: The ... people's health and quality of life. It accounts for more than ..... Charlson ME, et al. Depression and service utilization in elderly primary care.

  12. Consider long-term care as service alternative.

    Science.gov (United States)

    Loria, L S

    1987-04-01

    The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

  13. Parents' Perception on De La Salle University-Dasmarinas Services

    Science.gov (United States)

    Cortez-Antig, Carmelyn

    2011-01-01

    The study was conducted to find out the parents' perception on the De La Salle University-Dasmarinas services which are grouped as follows: (1) Academic instruction factor; (2) Quality of human ware (includes faculty, administration, staff support through medical services, guidance and discipline); (3) Quality of hardware (dorm facilities,…

  14. 75 FR 17584 - Schools and Libraries Universal Service Support Mechanism

    Science.gov (United States)

    2010-04-07

    ... input or retrieval including searching of databases for grades, student attendance files, or other... libraries universal service support mechanism, also known as the E-rate program. First, in the Report and... protocol (VoIP) and text messaging as eligible services under the E-rate program. Second, in the process of...

  15. 1970-1971 Annual Report: Extension Service Program, Silliman University.

    Science.gov (United States)

    Maturan, Eulalio G.

    The 1970-1971 annual report of the Extension Service Program of Silliman University, Dumaguete City, Philippines, treats the following projects: Mabinay Agricultural Extension, Mabinay Negrito Action-Research, Reforestation, and Livestock Dispersal. Also discussed are the Rural Publications Center and other extension services--a radio program,…

  16. An Empirical Study of State University Students' Perceived Service Quality

    Science.gov (United States)

    Sumaedi, Sik; Bakti, Gede Mahatma Yuda; Metasari, Nur

    2012-01-01

    Purpose: This paper aims to identify: university students' perceived service quality dimensions; the dimensions contributing most towards overall students' perceived service quality; and whether there is a difference in perceived quality level of each dimension based on students' year of study and gender in the context of undergraduate students of…

  17. Cloud Computing E-Communication Services in the University Environment

    Science.gov (United States)

    Babin, Ron; Halilovic, Branka

    2017-01-01

    The use of cloud computing services has grown dramatically in post-secondary institutions in the last decade. In particular, universities have been attracted to the low-cost and flexibility of acquiring cloud software services from Google, Microsoft and others, to implement e-mail, calendar and document management and other basic office software.…

  18. An Empirical Study of State University Students' Perceived Service Quality

    Science.gov (United States)

    Sumaedi, Sik; Bakti, Gede Mahatma Yuda; Metasari, Nur

    2012-01-01

    Purpose: This paper aims to identify: university students' perceived service quality dimensions; the dimensions contributing most towards overall students' perceived service quality; and whether there is a difference in perceived quality level of each dimension based on students' year of study and gender in the context of undergraduate students of…

  19. Satisfaction and expressed needs of pharmaceutical care services and challenges recognized by patients in South Korea

    Directory of Open Access Journals (Sweden)

    Kang J

    2017-08-01

    Full Text Available JiEun Kang,1,2,* Kiyon Rhew,3,* Jung Mi Oh,4 NaYoung Han,4 Iyn-Hyang Lee,5 Nam Kyung Je,6 Eunhee Ji,7 Euni Lee,4 Jeong-Hyun Yoon,6 Sandy Jeong Rhie1 1Division of Life and Pharmaceutical Sciences Graduate School, Ewha Womans University, Seoul, Republic of Korea; 2Department of Pharmacy, National Medical Center, Seoul, Republic of Korea; 3College of Pharmacy, Dongduk Women’s University, Seoul, Republic of Korea; 4College of Pharmacy, Seoul National University, Seoul, Republic of Korea; 5College of Pharmacy, Yeungnam University, Gyeongbuk, Republic of Korea; 6College of Pharmacy, Pusan National University, Busan, Republic of Korea; 7College of Pharmacy, Gachon University, Incheon, Republic of Korea *These authors contributed equally to this work Purpose: To assess the degree of satisfaction and expressed needs of pharmaceutical care services in patients with chronic diseases and explore the factors related to the needs from patients’ perspectives for the further development of pharmaceutical care service models. Patients and methods: A cross-sectional survey of 220 patients (mean age ± SD: 61.3±13.1, male:female: 104:116 was conducted. The questionnaire was structured to measure patients’ degree of satisfaction and expressed needs using a 5-point Likert scale. Additionally, preferred duration, methods of service delivery, and willingness to pay were surveyed. Responses were analyzed using an ordinal regression method to predict factors that were related to pharmaceutical care services. Results: Sixty-seven patients had experienced pharmaceutical care services. Their satisfaction levels were high in all categories; however, there were no significant differences between ­categories. The levels of expressed needs were similar among categories without significant differences. The preferred delivery method was a face-to-face conversation combined with being provided with written information (53.2%. The preferred duration was ≤10 min (70

  20. The Case of Roskilde University E-Services

    DEFF Research Database (Denmark)

    Heilesen, Simon

    2008-01-01

    , education, and integration. The chapter discusses several examples of e-services from the point of view of adoption of technological innovation. Further, it is argued that participatory design and voluntary adoption are factors favourable to, but also challenging to the adoption of e-services. The technical...... and organizational integration of e-services are also touched upon, as is the importance of maintaining a creative environment for developing the services. The chapter concludes by outlining some challenges to the continued diffusion of e-services in the organization.......Examining electronic services both as products and as organization, this chapter discusses the development and management of e-services at Roskilde University, Denmark. The services in question can be distinguished according to purpose into products meant for administration, communication...

  1. Long-Term Care Services for Veterans

    Science.gov (United States)

    2017-02-14

    VHA is statutorily required to conduct medical research into the special health care needs of veterans, to train health care professionals, to serve...also required the VA to provide non-institutional care, such as home-based care and adult day health care, to all enrolled veterans. In his signing...The Veterans’ Health Care Eligibility Reform Act of 1996 (P.L. 104-262) required the establishment of a national enrollment system to manage the

  2. What influences patients’ acceptance of a blood pressure telemonitoring service in primary care? A qualitative study

    Directory of Open Access Journals (Sweden)

    Abdullah A

    2016-01-01

    Full Text Available Adina Abdullah,1 Su May Liew,1 Nik Sherina Hanafi,1 Chirk Jenn Ng,1 Pauline Siew Mei Lai,1 Yook Chin Chia,1 Chu Kiong Loo2 1Department of Primary Care Medicine, Faculty of Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia Background: Telemonitoring of home blood pressure (BP is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients’ acceptance of such service in routine clinical care.Objective: This study aimed to explore patients’ acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM.Methods: A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis.Results: Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and

  3. The ethics of advertising for health care services.

    Science.gov (United States)

    Schenker, Yael; Arnold, Robert M; London, Alex John

    2014-01-01

    Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly.

  4. The Parent Satisfaction with Foster Care Services Scale

    Science.gov (United States)

    Kapp, Stephen A.; Vela, Rebecca H.

    2004-01-01

    Client satisfaction measures are an essential component of program evaluation. This article describes the development of a scale for measuring the satisfaction levels of parents whose children have received foster care services. Subjected to various statistical measures, the Parent Satisfaction with Foster Care Services Scale appears to be a…

  5. Democratic Citizenship and Service Learning: Advancing the Caring Self.

    Science.gov (United States)

    Rhoads, Robert A.

    2000-01-01

    Discusses how service learning can promote the development of a "caring self" in college students by drawing on the ideas of John Dewey, George Herbert Mead, and contemporary critical theorists. Links this caring self to democratic citizenship and uses students' narratives to illustrate how it develops through service learning contexts.…

  6. Making customer-service a priority in health care organizations.

    Science.gov (United States)

    O'Hagan, Joshua; Persaud, David

    2008-01-01

    Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.

  7. Essential case management services for young children in foster care.

    Science.gov (United States)

    Zlotnick, C; Kronstadt, D; Klee, L

    1999-10-01

    A growing number of children in the United States are being placed into foster care. Past studies indicate that effective case manager interventions have helped foster families with a variety of different problems. This study enrolled a randomly selected sample of 130 children under age four who had been newly placed into foster care. The purpose of this study was to identify the services needed by foster care families and determine which services require the most case manager effort. Consistent with other research, many foster care children in this study exhibited developmental, medical and psychosocial concerns. Nevertheless, we found that it was services aimed at the foster care parents, rather than the foster care children, that required the most labor-intensive case management services.

  8. Vigilance as a caring expression and Leininger's theory of cultural care diversity and universality.

    Science.gov (United States)

    Carr, J M

    1998-01-01

    Vigilance, or the close, protective involvement of families caring for hospitalized relatives, was explored in this study using holistic ethnography. Leininger's theory of cultural care diversity and universality provided direction for the researcher to generate substantive data about the meanings, patterns, and day-to-day experience of vigilance. Five categories of meaning were derived from the data: commitment to care, emotional upheaval, dynamic nexus, transition, and resilience. The research findings expand understanding of vigilance as a caring expression, suggest direction for nursing practice, and contribute to Leininger's theory of cultural care diversity and universality and the development of nursing science.

  9. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    Science.gov (United States)

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  10. Models for Primary Eye Care Services in India

    Directory of Open Access Journals (Sweden)

    Vasundhra Misra

    2015-01-01

    In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. Other models functioning with the newer technology of tele-ophthalmology or mobile clinics also add to the positive outcome in providing primary eye care services. This review highlights the strengths and weaknesses of various models presently functioning in the country with the idea of providing useful inputs for eye care providers and enabling them to identify and adopt an appropriate model for primary eye care services.

  11. 75 FR 62348 - Reimbursement Offsets for Medical Care or Services

    Science.gov (United States)

    2010-10-08

    ....010, Veterans Nursing Home Care; 64.011, Veterans Dental Care; 64.012, Veterans Prescription Service..., Alcoholism, Claims Day care, Dental health, Drug abuse, Foreign relations, Government contracts, Grant... records, Homeless, Medical and dental schools, Medical devices, Medical research, Mental health [[Page...

  12. Implementing Critical Health Services for Children in Foster Care.

    Science.gov (United States)

    Klee, Linnea; And Others

    1992-01-01

    Recommendations concerning California's efforts to provide for the health needs of its children were developed at the California Conference on Health Care for Children in Foster Care. The conference was organized to discuss California's implementation of the Child Welfare League of America's Standards for Health Care Services for Children in…

  13. Applying Universal Design to Disability Service Provision: Outcome Analysis of a Universal Design (UD) Audit

    Science.gov (United States)

    Beck, Tanja; Diaz del Castillo, Patricia; Fovet, Frederic; Mole, Heather; Noga, Brodie

    2014-01-01

    This article presents out an outcome analysis of a Universal Design (UD) audit to the various professional facets of a disability service (DS) provider's office on a large North American campus. The context of the audit is a broad campus-wide drive to implement Universal Design for Learning (UDL) in teaching practices. In an effort for consistency…

  14. Nurses\\' perception of caring behaviors in intensive care units in hospitals of Lorestan University of Medical Sciences, Iran

    Directory of Open Access Journals (Sweden)

    Asadi SE

    2014-11-01

    Full Text Available Background and Objective: Caring is the core of nursing however, different individules have different perceptions of it. Continuous assessment and measurement of caring behaviors results in the identification of their problems. The careful planning of interventions and problem solving will improve care. The aim of this study was to identify nurses' perception of caring behaviors in the intensive care units. Materials and Method: In this descriptive-analytic study, 140 nurses were selected from intensive care units of hospitals affiliated to Lorestan University of Medical Sciences, Iran, using the census method in 2012. The data collection tool was the Caring Behaviors Inventory for Elders (CBI-E. This questionnaire consisted of two parts including demographic information and 28 items related to care. Face and content validity of the Persian version of the questionnaire were provided by professionals, and after deletion of 4 items a 24-item questionnaire was provided. Cronbach's alpha coefficient was calculated to assess reliability (&alpha = 0.71. Data were analyzed using SPSS software version 18 and descriptive-analytic statistics (Kruskal-Wallis test and Mann-Whitney test. Results: Based on the findings, nurses paid more attention to the physical–technical aspects (95.71 ± 12.76 of care in comparison to its psychosocial aspects (75.41 ± 27.91. Nurses had the highest score in care behavior of "timely performance of medical procedures and medication administration". Conclusion: Since nurses paid more attention to the technical aspects of care than its psychosocial aspects, by providing nurses with a correct perception of care, patients can be provided with needs-based care. This will increase patient satisfaction with nursing care, and indirectly result in the positive attitude of patients and society toward the nursing profession and its services. Moreover, nursing education officials can use these results to assist nurses in meeting

  15. Marital Distress and Mental Health Care Service Utilization

    Science.gov (United States)

    Schonbrun, Yael Chatav; Whisman, Mark A.

    2010-01-01

    Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…

  16. The role of Stakeholders on implementing Universal Services in Vietnam

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten; Williams, Idongesit

    2015-01-01

    This paper looks at the universal services policy in Vietnam (interval 2005-2010) via analysing stakeholders in order to clarify how they exerted influence and how they implemented the policy. The stakeholder theory is employed to identify and categorize the stakeholders who participated...... in performing the policy. The authors are to examine the stakeholders such as the national government, international organizations, policy intermediaries, companies, and customers/citizens via applying the qualitative method to gather data and analyse the secondary document. The qualitative approach...... of interviews on some officials was also conducted. The results demonstrate that stakeholders had a huge impact on the success of the universal service policy....

  17. Clinical audit of structured pharmaceutical care plans recorded within a hospital pharmaceutical care service

    OpenAIRE

    Christensen, Marit Bergheim

    2008-01-01

    Background Pharmaceutical care as a health care service has already made its mark and been shown to make an important contribution to the health care system. However, there is still a demand from the NHS among others, that pharmacist to a greater extent must document their provision of pharmaceutical care. Tested out in this project, is the application of a Care Issue Categorisation System. Aims To compare two clinical settings in terms of the profile of pharmaceutical care deli...

  18. Improving palliative care outcomes for Aboriginal Australians: service providers’ perspectives

    OpenAIRE

    Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M.; Thompson, Sandra C

    2013-01-01

    Background: Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers’ experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. Methods: In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient a...

  19. Multimorbidity and quality of preventive care in Swiss university primary care cohorts.

    Directory of Open Access Journals (Sweden)

    Sven Streit

    Full Text Available BACKGROUND: Caring for patients with multimorbidity is common for generalists, although such patients are often excluded from clinical trials, and thus such trials lack of generalizability. Data on the association between multimorbidity and preventive care are limited. We aimed to assess whether comorbidity number, severity and type were associated with preventive care among patients receiving care in Swiss University primary care settings. METHODS: We examined a retrospective cohort composed of a random sample of 1,002 patients aged 50-80 years attending four Swiss university primary care settings. Multimorbidity was defined according to the literature and the Charlson index. We assessed the quality of preventive care and cardiovascular preventive care with RAND's Quality Assessment Tool indicators. Aggregate scores of quality of provided care were calculated by taking into account the number of eligible patients for each indicator. RESULTS: Participants (mean age 63.5 years, 44% women had a mean of 2.6 (SD 1.9 comorbidities and 67.5% had 2 or more comorbidities. The mean Charlson index was 1.8 (SD 1.9. Overall, participants received 69% of recommended preventive care and 84% of cardiovascular preventive care. Quality of care was not associated with higher numbers of comorbidities, both for preventive care and for cardiovascular preventive care. Results were similar in analyses using the Charlson index and after adjusting for age, gender, occupation, center and number of visits. Some patients may receive less preventive care including those with dementia (47% and those with schizophrenia (35%. CONCLUSIONS: In Swiss university primary care settings, two thirds of patients had 2 or more comorbidities. The receipt of preventive and cardiovascular preventive care was not affected by comorbidity count or severity, although patients with certain comorbidities may receive lower levels of preventive care.

  20. Does the distribution of health care benefits in Kenya meet the principles of universal coverage?

    Science.gov (United States)

    Chuma, Jane; Maina, Thomas; Ataguba, John

    2012-01-10

    The 58th World Health Assembly called for all health systems to move towards universal coverage where everyone has access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Universal coverage involves ensuring that health care benefits are distributed on the basis of need for care and not on ability to pay. The distribution of health care benefits is therefore an important policy question, which health systems should address. The aim of this study is to assess the distribution of health care benefits in the Kenyan health system, compare changes over two time periods and demonstrate the extent to which the distribution meets the principles of universal coverage. Two nationally representative cross-sectional households surveys conducted in 2003 and 2007 were the main sources of data. A comprehensive analysis of the entire health system is conducted including the public sector, private-not-for-profit and private-for-profit sectors. Standard benefit incidence analysis techniques were applied and adopted to allow application to private sector services. The three sectors recorded similar levels of pro-rich distribution in 2003, but in 2007, the private-not-for-profit sector was pro-poor, public sector benefits showed an equal distribution, while the private-for-profit sector remained pro-rich. Larger pro-rich disparities were recorded for inpatient compared to outpatient benefits at the hospital level, but primary health care services were pro-poor. Benefits were distributed on the basis of ability to pay and not on need for care. The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the Kenyan health system to address access barriers and ensure that all Kenyans benefit from health care when they need it.

  1. Does the distribution of health care benefits in Kenya meet the principles of universal coverage?

    Directory of Open Access Journals (Sweden)

    Chuma Jane

    2012-01-01

    Full Text Available Abstract Background The 58th World Health Assembly called for all health systems to move towards universal coverage where everyone has access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Universal coverage involves ensuring that health care benefits are distributed on the basis of need for care and not on ability to pay. The distribution of health care benefits is therefore an important policy question, which health systems should address. The aim of this study is to assess the distribution of health care benefits in the Kenyan health system, compare changes over two time periods and demonstrate the extent to which the distribution meets the principles of universal coverage. Methods Two nationally representative cross-sectional households surveys conducted in 2003 and 2007 were the main sources of data. A comprehensive analysis of the entire health system is conducted including the public sector, private-not-for-profit and private-for-profit sectors. Standard benefit incidence analysis techniques were applied and adopted to allow application to private sector services. Results The three sectors recorded similar levels of pro-rich distribution in 2003, but in 2007, the private-not-for-profit sector was pro-poor, public sector benefits showed an equal distribution, while the private-for-profit sector remained pro-rich. Larger pro-rich disparities were recorded for inpatient compared to outpatient benefits at the hospital level, but primary health care services were pro-poor. Benefits were distributed on the basis of ability to pay and not on need for care. Conclusions The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the Kenyan health system to address access barriers and ensure

  2. Human Rights and the Political Economy of Universal Health Care

    Science.gov (United States)

    2016-01-01

    Abstract Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good. PMID:28559677

  3. Proposal for an Information Service for University Administrators; Office of Specialized Services - Implementation.

    Science.gov (United States)

    Cassata, Mary B.; Palmer, Roger C.

    In response to a directive to the Director of Libraries, State University of New York at Buffalo, to investigate the possibility of establishing a resource/research office to handle the specialized reference needs of university administrators, this document outlines a proposed Office of Specialized Services (OSS). Staff, clientele and dates of…

  4. Assessing Learners' Satisfication towards Support Services Delivery in National Open University Nigeria: Implications for Counselling Services

    Science.gov (United States)

    Okopi, Fidel; Ofole, Ndidi

    2013-01-01

    This study aims at determining the level of students' satisfaction of learner support services in the study centres of NOUN--National Open University of Nigeria and whether the support services offered at the study centres have significant influence on the level of students' satisfaction. A descriptive survey of ex-post facto research design was…

  5. Student Experiences Utilizing Disability Support Services in a University Setting

    Science.gov (United States)

    Abreu, Marlene; Hillier, Ashleigh; Frye, Alice; Goldstein, Jody

    2016-01-01

    Students with disabilities are a growing population in post-secondary institutions, yet present poorer academic outcomes compared to students without disabilities. The current study examined university students' own perceptions and experiences with disability support services (SDS) including how helpful they found the accommodations they were…

  6. The Effect of Leadership on Service Delivery in Universities

    Science.gov (United States)

    Zvavahera, Promise

    2013-01-01

    This study was aimed at assessing leadership effectiveness on service delivery at the University of Namibia and all its campuses throughout the country. The study was carried out during the month of February 2013. The methodology consisted of document analysis, interviews through face to face, video and tele-conferencing. Purposive sampling was…

  7. The Russian Market of University Services: Social and Demographic Aspects

    Science.gov (United States)

    Bydanova, Elizaveta; Mushketova, Natalia; Rouet, Gilles

    2015-01-01

    Purpose: The purpose of this paper is to analyze the impact of demographic, social, economic and international aspects on the market of university services in Russia. It also reminds readers briefly of the evolution of the Russian higher education system during the last 20 years and considers some consequences of the current public policy and…

  8. The Russian Market of University Services: Social and Demographic Aspects

    Science.gov (United States)

    Bydanova, Elizaveta; Mushketova, Natalia; Rouet, Gilles

    2015-01-01

    Purpose: The purpose of this paper is to analyze the impact of demographic, social, economic and international aspects on the market of university services in Russia. It also reminds readers briefly of the evolution of the Russian higher education system during the last 20 years and considers some consequences of the current public policy and…

  9. Dental Care Utilization and Satisfaction of Residential University Students

    Directory of Open Access Journals (Sweden)

    Bamise CT

    2008-01-01

    Full Text Available Aim: The objective of this study was to provide information on the level of utilization and satisfaction of residential university students with the dental services provided by the dental clinic of a teaching hospital. Volunteers and Material: A stratified sampling technique was used to recruit volunteers from the outpatient clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Information was collected by a self-administered questionnaire composed of questions that measure the level of utilization and satisfaction with the dental services provided. Questionnaires were provided to 650 randomly chosen students residing in the University hostels. There were 39 refusals, and 6 incomplete questionnaires were discarded. This left a sample size of 605 volunteers. Results: Forty seven students (7.8% indicated that they visited the dental hospital within the last 12 months. Males and females utilized the dental services equally, and utilization increased with age and the number of years spent on campus. Anticipation of painful dental treatment, high dental charges, long waiting times and being too busy for a dental visit were cited as the most important impediments to seeking dental treatment. Females expressed greater satisfaction with the services. Conclusion: Dental service utilization among the students was found to be low. Oral health awareness campaigns, improving the quality of the services, and shortening the waiting time are expected to increase service utilization and satisfaction.

  10. Nutrition services in managed care: new paradigms for dietitians.

    Science.gov (United States)

    Laramee, S H

    1996-04-01

    Managed care systems are transforming the health care system in the United States. Dietitians will need to review practice opportunities in new and different settings, and develop additional skills to make a successful transition to the transformed health care environment. The shift in health care financing from a fee-for-service model to a capitated system will have the most dramatic impact on the profession. Not all the answers are available, but the focus for the future is clear--customer satisfaction, outcomes research, and cost-effective nutrition services.

  11. Review of Integrated Psychological Services in Primary Care.

    Science.gov (United States)

    Smith, Michele S

    2016-06-01

    Reviews the book, Integrated Psychological Services in Primary Care edited by William Scott Craig (see record 2016-01850-000). This book opens with an article by the editor, in which he outlines the behavioral health needs of primary care patients and the rationale behind integrating mental health services in primary care settings. Subsequent chapters address basic and practical information for a variety of practice locations, such as Patient Centered Medical Home clinics, the Veteran's Administration medical centers, and primary care settings where the concept of integrated health is new. This is an excellent primer for anyone planning to implement an integrated care program or for those considering moving from an independent practice, agency, or traditional health care/hospital environment into an integrated primary care environment. The authors' writing styles made difficult concepts easy to understand and their knowledge of the utility of integration was evident. (PsycINFO Database Record

  12. Service robots, care ethics, and design

    NARCIS (Netherlands)

    Wynsberghe, van A.

    2016-01-01

    It should not be a surprise in the near future to encounter either a personal or a professional service robot in our homes and/or our work places: according to the International Federation for Robots, there will be approx 35 million service robots at work by 2018. Given that individuals will interac

  13. Can service integration work for universal health coverage? Evidence from around the globe.

    Science.gov (United States)

    Lê, Gillian; Morgan, Rosemary; Bestall, Janine; Featherstone, Imogen; Veale, Thomas; Ensor, Tim

    2016-04-01

    Universal health coverage (UHC) is at the heart of the new 2030 Agenda for Sustainable Development. Health service integration is seen by World Health Organization as an essential requirement to achieve UHC. However, to date the debate on service integration has focused on perceived benefits rather than empirical impact. We conducted a global review in a systematic manner searching for empirical outcomes of service integration experiments in UHC countries and those on the path to UHC. Sixty-seven articles and reports were found. We grouped results into a unique integration typology with six categories - medical staff from different disciplines; patients and medical staff; care package for one medical condition; care package for two or more medical conditions; specialist stand-alone services with GP services; community locations. We showed that it is possible to integrate services in different human development contexts delivering positive outcomes for patients and clinicians without incurring additional costs. However, the improved outcomes shown were incremental rather than radical and suggest that integration is likely to enhance already well established systems rather than fundamentally changing the outcomes of care.

  14. The management of health care service quality. A physician perspective.

    Science.gov (United States)

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.

  15. 75 FR 25156 - High-Cost Universal Service Support, Federal-State Joint Board on Universal Service, Lifeline and...

    Science.gov (United States)

    2010-05-07

    ... jurisdiction's and an exceptionally high rate of poverty--causes us to believe that additional low- ] income... better advantage of existing universal service low-income support programs. Specifically, the Commission... Company (PRTC), the Commission acknowledges that there may be a significant number of low-income...

  16. Developing internet-based health services in health care organizations.

    Science.gov (United States)

    Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli

    2009-01-01

    It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland.

  17. Patient satisfaction with nursing care in an emergency service

    OpenAIRE

    Patrícia Fátima Levandovski; Maria Alice Dias da Silva Lima; Aline Marques Acosta

    2015-01-01

    To analyze patient satisfaction with nursing care received at a hospital emergency service. Methodology. This is a quantitative, descriptive, cross-sectional study. The sample was composed by 250 patients over 18 years old who used an emergency service in the south region of Brazil. Data were collected using an identification form and the Patient Satisfaction Instrument. Results. Results point to a good level of satisfaction of patients with the nursing care received, with the greatest mean f...

  18. Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

    Directory of Open Access Journals (Sweden)

    N. Mlenzana

    2012-12-01

    Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction

  19. A service model for delivering care closer to home.

    Science.gov (United States)

    Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

    2011-04-01

    Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

  20. Service quality perceptions in primary health care centres in Greece.

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2014-04-01

    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  1. Service quality perceptions in primary health care centres in Greece

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  2. Stakeholder Expectations of Service Quality in a University Web Portal

    Science.gov (United States)

    Tate, Mary; Evermann, Joerg; Hope, Beverley; Barnes, Stuart

    Online service quality is a much-studied concept. There is considerable evidence that user expectations and perceptions of self-service and online service quality differ in different business domains. In addition, the nature of online services is continually changing and universities have been at the forefront of this change, with university websites increasingly acting as a portal for a wide range of online transactions for a wide range of stakeholders. In this qualitative study, we conduct focus groups with a range of stakeholders in a university web portal. Our study offers a number of insights into the changing nature of the relationship between organisations and customers. New technologies are influencing customer expectations. Customers increasingly expect organisations to have integrated information systems, and to utilise new technologies such as SMS and web portals. Organisations can be slow to adopt a customer-centric viewpoint, and persist in providing interfaces that are inconsistent or require inside knowledge of organisational structures and processes. This has a negative effect on customer perceptions.

  3. Medical Service: 40 years of outpatient care

    CERN Multimedia

    2005-01-01

    On 1st June 2005 the Medical Service will be celebrating its fortieth birthday. This will mark forty years of service to the health of CERN's personnel by the Medical Service's small team of doctors, nurses, laboratory assistants and secretaries. Since 1965, 27 280 medical files have been archived and computerised. The Medical Service. From left to right, front row : Mireille Vosdey, Marloeke Bol and Nicole De Matos. From left to right, back row : Katie Warrilow-Thomson, Dr Eric Reymond, Dr Véronique Fassnacht, Isabelle Auvigne and Françoise Lebrun-Klauser. The Medical Service was founded on 1st June 1965, with a staff of four: the doctor, Jean-Paul Diss, a nurse, a laboratory assistant and a secretary. Previously, a private medical practitioner had come to CERN to perform the medical check-ups on the personnel and the Fire Brigade was responsible for first aid. However, in view of increasing staff numbers and the specific needs of a Laboratory like CERN, an on-site Medical Service had become ess...

  4. Understanding patient e-loyalty toward online health care services.

    Science.gov (United States)

    Martínez-Caro, Eva; Cegarra-Navarro, Juan Gabriel; Solano-Lorente, Marcelina

    2013-01-01

    Public health institutions are making a great effort to develop patient-targeted online services in an attempt to enhance their effectiveness and reduce expenses. However, if patients do not use those services regularly, public health institutions will have wasted their limited resources. Hence, patients' electronic loyalty (e-loyalty) is essential for the success of online health care services. In this research, an extended Technology Acceptance Model was developed to test e-loyalty intent toward online health care services offered by public health institutions. Data from a survey of 256 users of online health care services provided by the public sanitary system of a region in Spain were analyzed. The research model was tested by using the structural equation modeling approach. The results obtained suggest that the core constructs of the Technology Acceptance Model (perceived usefulness, ease of use, and attitude) significantly affected users' behavioral intentions (i.e., e-loyalty intent), with perceived usefulness being the most decisive antecedent of affective variables (i.e., attitude and satisfaction). This study also reveals a general support for patient satisfaction as a determinant of e-loyalty intent in online health care services. Policy makers should focus on striving to get the highest positive attitude in users by enhancing easiness of use and, mainly, perceived usefulness. Because through satisfaction of patients, public hospitals will enlarge their patient e-loyalty intent, health care providers must always work at obtaining satisfied users and to encourage them to continue using the online services.

  5. Prenatal Care Services in Aydin Province

    Directory of Open Access Journals (Sweden)

    Erdal BESER

    2007-04-01

    Full Text Available Aim of the study was to evaluate the quality and quantity of prenatal care in Aydin province. It was a cross-sectional study. 195 women (pregnant/women at postpartum period living in the Aydin province participated in the study. Cluster and simple random sampling method was used in the selection of women from 10 health centers (one rural-one urban health station each. Data obtained by face to face interview technique. Turkey Demografic Health Survey criteria were used for evaluation of the quantity of prenatal care as “sufficient” or “insufficient” and quality of prenatal care was scored as “1-2”(bad, “3-4”(moderate and “5-6”(good. Chi-square, Mann Whitney-U and t tests were used for analysis. One fifth of each pregnant women who were in last trimester and 11.3% of women in postpartum period stated that they were not followed up by an health personnel during pregnancy. One third of pregnant women who were in last trimester and 58.5% of women in postpartum period said they weren’t visited by an health personnel in the first trimester. Besides, quality points of prenatal care were found low, both in pregnant women and women in post partum period. It was found that living in urban areas, high education level and presence of social security effected getting adequate prenatal care. The quality and quantity of prenatal care was found less than expected in Aydin province which is located in the western region of Turkey. It is necessary that, health personnel must be more sensitive to convey “adequate” prenatal care especially women who are living in rural areas, who have low educational level and who have no social security. [TAF Prev Med Bull 2007; 6(2.000: 137-141

  6. Prenatal Care Services in Aydin Province

    Directory of Open Access Journals (Sweden)

    Erdal BESER

    2007-04-01

    Full Text Available Aim of the study was to evaluate the quality and quantity of prenatal care in Aydin province. It was a cross-sectional study. 195 women (pregnant/women at postpartum period living in the Aydin province participated in the study. Cluster and simple random sampling method was used in the selection of women from 10 health centers (one rural-one urban health station each. Data obtained by face to face interview technique. Turkey Demografic Health Survey criteria were used for evaluation of the quantity of prenatal care as “sufficient” or “insufficient” and quality of prenatal care was scored as “1-2”(bad, “3-4”(moderate and “5-6”(good. Chi-square, Mann Whitney-U and t tests were used for analysis. One fifth of each pregnant women who were in last trimester and 11.3% of women in postpartum period stated that they were not followed up by an health personnel during pregnancy. One third of pregnant women who were in last trimester and 58.5% of women in postpartum period said they weren’t visited by an health personnel in the first trimester. Besides, quality points of prenatal care were found low, both in pregnant women and women in post partum period. It was found that living in urban areas, high education level and presence of social security effected getting adequate prenatal care. The quality and quantity of prenatal care was found less than expected in Aydin province which is located in the western region of Turkey. It is necessary that, health personnel must be more sensitive to convey “adequate” prenatal care especially women who are living in rural areas, who have low educational level and who have no social security. [TAF Prev Med Bull. 2007; 6(2: 137-141

  7. Models for primary eye care services in India.

    Science.gov (United States)

    Misra, Vasundhra; Vashist, Praveen; Malhotra, Sumit; Gupta, Sanjeev K

    2015-01-01

    Blindness and visual impairment continues to be a major public health problem in India. Availability and easy access to primary eye care services is essential for elimination of avoidable blindness. 'Vision 2020: The Right to Sight - India' envisaged the need for establishing primary eye care units named vision centers for every 50,000 population in the country by the year 2020. The government of India has given priority to develop vision centers at the level of community health centers and primary health centers under the 'National Program for Control of Blindness'. NGOs and the private sector have also initiated some models for primary eye care services. In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. Other models functioning with the newer technology of tele-ophthalmology or mobile clinics also add to the positive outcome in providing primary eye care services. This review highlights the strengths and weaknesses of various models presently functioning in the country with the idea of providing useful inputs for eye care providers and enabling them to identify and adopt an appropriate model for primary eye care services.

  8. Palliative care services in The Netherlands: a descriptive study.

    NARCIS (Netherlands)

    Francke, A.L.; Kerkstra, A.

    2000-01-01

    In this paper several types of specialized palliative care services in The Netherlands are presented. These include palliative care units in homes for the elderly, in nursing homes, in a general hospital and in an oncology clinic. In addition, a description is given of private hospices and of a home

  9. Service learning at university: a strategy in training critical citizens

    Directory of Open Access Journals (Sweden)

    Andrea Francisco Amat

    2010-12-01

    Full Text Available Service Learning (SL is a proposal which emerges from the volunteer service to the community and from skills acquisition, combining them in a single articulated project. The goal of this article is to discuss an SL innovation experience which took place in the academic year 2009–2010 at the Universitat Jaume I in Castelló de la Plana (Spain. This initiative was implemented by an interdisciplinary teaching team formed by the academic staff in the Teaching Education, Psychopedagogy and Audiovisual Communication degrees. It aims to awaken critical awareness and promote citizen participation among all university members.

  10. Mobile emergency care service: the work on display

    OpenAIRE

    Velloso,Isabela Silva Cancio; Araújo,Meiriele Tavares; Nogueira,Jéssica Dias; Alves,Marília

    2014-01-01

    The aim of the present study was to discuss the way visibility constitutes a power device in the everyday practice of the Mobile Emergency Care Service in Belo Horizonte, Minas Gerais, Brazil. A qualitative case study was developed and data were collected through semi-structured interviews with 31 workers of the service (five physicians, 11 nurses, seven nursing assistants and eight ambulance drivers) and submitted to discourse analysis. The analysis of power relations in the service allowed ...

  11. [Quality evaluation of health care service for adolescents].

    Science.gov (United States)

    Costa, M C; Formigli, V L

    2001-04-01

    To evaluate the technical and scientific quality of care provided adolescents, pregnant adolescents and their offspring by the Emaús community's health service in Belém, state of Pará, Brazil, between 1994 and 1996. Data for population and health care assessment were collected from medical records and compared with the PAHO/WHO and Brazilian Ministry of Health guidelines. The following features were satisfactory: anthropometric measurements and sexual maturity in adolescent health care program; visits scheduling, weight and blood pressure recording and proceedings in the event of medical problem in prenatal care; early registration in the health program, completing of the immunization schedule, weight and motor development recording and adequacy of medical visits in children care. Other aspects were less satisfactory, such as poor recording of clinical procedures and high level of inadequate or partially adequate procedures for the adolescent group; late admission to prenatal care and low recording of pregnant anti-tetanus immunization in prenatal care; high prevalence of early weaning and poor recording of children's height. This easy-to-perform assessment allowed to evaluate the quality of care provided and made it possible to reallocate services and medical procedures to offer health care service better organized and of better quality to meet the population needs.

  12. Workforce planning for urgent care services.

    Science.gov (United States)

    Youd, Janet

    2015-07-01

    Due to major changes in how emergency care is delivered across different communities, one emergency department is no longer like another. Some have separate minor injury provision, some are general departments that cater for all types of patient, while others are designated major trauma centres. These differences in patient profile affect the required numbers and skill mix of nursing establishments so that the nursing workforce in each cannot be predicated on patient numbers alone. This article describes the development by the RCN Emergency Care Association of an evidence-based staffing tool and how it can be used in practice.

  13. An innovative night service program in home care.

    Science.gov (United States)

    Tennant, J; Narayan, M C

    1997-05-01

    Comprehensive night service by a home care agency has resulted in increased customer satisfaction and referrals to the agency. The description of this innovative night nurse program includes the job requirements and duties of a visiting night nurse and the tools the nurse uses to accomplish the task of nighttime care delivery. The use of self-directed work groups and mentorship to manage the demands of night service are discussed. Continuity of care, nurse safety, professional development, and program cost also are addressed.

  14. Facility Service Environments, Staffing, and Psychosocial Care in Nursing Homes

    Science.gov (United States)

    Zhang, Ning Jackie; Gammonley, Denise; Paek, Seung Chun; Frahm, Kathryn

    2008-01-01

    Using 2003 Online Survey Certification and Reporting (OSCAR) data for Medicare and Medicaid certified facilities (N=14, 184) and multinomial logistic regression this study investigated if (1) psychosocial care quality was better in facilities where State requirements for qualified social services staffing exceeded Federal minimum regulations and (2) facility service environments are associated with psychosocial care quality. For-profit status and higher percentage of Medicaid residents are associated with lower quality. Staffing, market demand, and market competition are associated with better quality. Psychosocial care quality is more associated with payer status and market forces and less with regulatory requirements. PMID:19361113

  15. The role of Stakeholders on implementing Universal Services in Vietnam

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten; Williams, Idongesit

    2015-01-01

    This paper looks at the universal services policy in Vietnam (interval 2005-2010) via analysing stakeholders in order to clarify how they exerted influence and how they implemented the policy. The stakeholder theory is employed to identify and categorize the stakeholders who participated in perfo......This paper looks at the universal services policy in Vietnam (interval 2005-2010) via analysing stakeholders in order to clarify how they exerted influence and how they implemented the policy. The stakeholder theory is employed to identify and categorize the stakeholders who participated...... in performing the policy. The authors are to examine the stakeholders such as the national government, international organizations, policy intermediaries, companies, and customers/citizens via applying the qualitative method to gather data and analyse the secondary document. The qualitative approach...

  16. Reimbursement for critical care services in India

    Directory of Open Access Journals (Sweden)

    Raja Jayaram

    2013-01-01

    Full Text Available There are significant variations in critical care practices, costs, and reimbursements in various countries. Of note, there is a paucity of reliable information on remuneration and reimbursement models for intensivists in India. This review article aims to analyze the existing reimbursement models in United States and United Kingdom and propose a frame-work model that may be applicable in India.

  17. Health care services, information systems & sustainability.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2010-01-01

    This chapter gives an educational overview of: * many competing characteristics within national health systems * national primary information and knowledge flows between health care entities * the role of information technologies in assisting health organizations become sustainable enterprises * the business of maintaining healthy populations for any nation * desirable e-health strategy objectives.

  18. Exploring care for human service profession

    DEFF Research Database (Denmark)

    Høy, Bente

    2015-01-01

    maintain their dignity, it is important to explore, how dignity is maintained in such situations. Views of dignity and factors influencing dignity have been studied from both the nursing homes residents´ and the care providers´ perspective. However, little is known about how the residents’ experience...

  19. Factors shaping intersectoral action in primary health care services.

    Science.gov (United States)

    Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

    2014-12-01

    To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

  20. [eLearning service for home palliative care].

    Science.gov (United States)

    Sakuyama, Toshikazu; Komatsu, Kazuhiro; Inoue, Daisuke; Fukushima, Osamu

    2008-12-01

    In order to support the home palliative care learning, we made the eLearning service for home palliative care (beta version) and tried to teach the palliative care to the medical staffs in the community. The various learners (such as nurses, pharmacists and the like) accessed to the online learning and used this eLearning service. After the learners finished eLearning for home palliative care, some questionnaires were distributed to the learners and analyzed by us. The analysis of questionnaires revealed that almost all were satisfied with our eLearning services. Especially the learners were not only interested in using the skills of opioids and the management of pain control, but they had a good cognition for the usage of opioids.

  1. Patient satisfaction with nursing care at a university hospital in Turkey.

    Science.gov (United States)

    Uzun, O

    2001-10-01

    Patient satisfaction is an important measure of service quality (SQ) in health care organizations. Patients' satisfaction and their expectations of care are valid indicators of quality nursing care. This article reports the results of a survey patient satisfaction with nursing care, administered by interview to 422 adults discharged from a university hospital in Turkey. The direct measurement of patient satisfaction with nursing care is a new phenomenon for this university hospital, and this was the first time that such an evaluation had been done in this particular hospital. In this study, SERVQUAL scale was used for determining patient satisfaction with nursing care. Weighted scores in dimensions of SERVQUAL were generally low, and there were statistically significant differences in means paired t-tests (p SERVQUAL (p < 0.5). According to results, the SQ gap scores for five dimensions were negative to meet expectations. The negative scores for tangibles, reliability, responsiveness, assurance, and empathy indicate areas needing improvement. In this hospital, results of this study support the need for nurses to take steps to improve patient satisfaction with nursing care.

  2. Health care services provided to type 1 and type 2 diabetic patients in Saudi Arabia

    Science.gov (United States)

    Al-Rubeaan, Khalid A.; Al-Manaa, Hamad A.; Khoja, Tawfik A.; Al-Sharqawi, Ahmad H.; Aburisheh, Khaled H.; Youssef, Amira M.; Alotaibi, Metib S.; Al-Gamdi, Ali A.

    2015-01-01

    Objectives: To assess health care services provided to type 1 and type 2 diabetic patients and diabetes health care expenditure in the Kingdom of Saudi Arabia (KSA). Methods: This study was part of a nationwide, household, population based cross-sectional survey conducted at the University Diabetes Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia between January 2007 and December 2009 covering 13 administrative regions of the Kingdom. Using patients’ interview questionnaires, health care services data were collected by trained staff. Results: A total of 5,983 diabetic patients were chosen to assess health care services and expenditure. Approximately 92.2% of health services were governmental and the remaining 7.8% were in private services. The mean annual number of visits to physicians was 6.5±3.9 and laboratories was 5.1±3.9. Diabetic patients required one admission every 3 years with a mean admission duration of 13.3±28.3 days. General practitioners managed 85.9% of diabetic cases alone, or shared with internists and/or endocrinologists. Health care expenditure was governmental in 90% of cases, while it was personal in 7.7% or based on insurance payment in 2.3%. Conclusion: Health services and its expenditure provided to diabetic citizens in Saudi Arabia are mainly governmental. Empowerment of the role of both the private sector and health insurance system is badly needed, aside from implementing proper management guidelines to deliver good services at different levels. PMID:26446334

  3. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

    Directory of Open Access Journals (Sweden)

    Lígia Giovanella

    2014-11-01

    Full Text Available The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date, and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.

  4. Homeless university students: Experiences with foyer-type service

    Directory of Open Access Journals (Sweden)

    Marty Grace

    2012-06-01

    Full Text Available Some young people who have been homeless during their secondary schooling manage to obtain a university place. These young people, and others who become homeless during their university courses, have the opportunity to build a sustainable exit from homelessness through education and support. Very little is known about how many young Australians are in this situation, or what can be done to assist them to complete their degrees. This article reports on research that aimed to document the experiences of 11 university students who had experienced homelessness. The research focussed on the difficulties that these young people faced, and the types of environments and service responses that can make a difference for them. The students were part of a larger study of a foyer-type service. The research found that these young people took longer than the standard duration to complete their degrees. Their study was facilitated by provision of stable, safe accommodation and support when they were acutely homeless, relief from other pressures such as family conflict, protection while maturing, time for overseas born including refugee young people to develop language, skills, and resources, support to heal from past damaging experiences and improve their health, assistance to gain entry to preferred university courses, and pathways into stable housing for the duration of their study.

  5. Budget Planning and the Quality of Educational Services in Uganda Public Universities: A Case Study of Kyambogo University

    Science.gov (United States)

    Basheka, Benon C.; Nabwire, Addah

    2013-01-01

    This paper examines the relationship between budget planning and the quality of educational services at Kyambogo University in Uganda. We argue that the manner in which the university's budget planning activities are conducted determines in a significant way (by 76.8%) the quality of the services offered by public universities in Uganda. The…

  6. Participative management in health care services

    Directory of Open Access Journals (Sweden)

    M. Muller

    1995-05-01

    Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

  7. Are social franchises contributing to universal access to reproductive health services in low-income countries?

    Science.gov (United States)

    Sundari Ravindran, T K; Fonn, Sharon

    2011-11-01

    A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming.

  8. Temporary services for patients in need of chronic care

    Directory of Open Access Journals (Sweden)

    Hesse Morten

    2008-06-01

    Full Text Available Abstract Background A project is a temporary endeavour undertaken to create a product or service. Projects are frequently used for the testing and development of new approaches in social work. Projects can receive grants from central, often national or international institutions, and allow for more experimentation than work placed within existing institutions. Discussion For socially marginalized groups who need continuing support and care, receiving help in a project means that the clients will have to be transferred to other services when the project ends. There is also a risk that clients will experience a decline in services, as staff members have to seek new employment towards the end of the project, or begin to focus more on the evaluation than the services. This raises some ethical issues concerning the use of human subjects in projects. Conclusion Project managers should consider ethical issues relating to continuity of services when serving vulnerable patients with a need for continuing care.

  9. Comparing public and private hospital care service quality.

    Science.gov (United States)

    Camilleri, D; O'Callaghan, M

    1998-01-01

    The study applies the principles behind the SERVQUAL model and uses Donabedian's framework to compare and contrast Malta's public and private hospital care service quality. Through the identification of 16 service quality indicators and the use of a Likert-type scale, two questionnaires were developed. The first questionnaire measured patient pre-admission expectations for public and private hospital service quality (in respect of one another). It also determined the weighted importance given to the different service quality indicators. The second questionnaire measured patient perceptions of provided service quality. Results showed that private hospitals are expected to offer a higher quality service, particularly in the "hotel services", but it was the public sector that was exceeding its patients' expectations by the wider margin. A number of implications for public and private hospital management and policy makers were identified.

  10. Developing a service model that integrates palliative care throughout cancer care: the time is now.

    Science.gov (United States)

    Partridge, Ann H; Seah, Davinia S E; King, Tari; Leighl, Natasha B; Hauke, Ralph; Wollins, Dana S; Von Roenn, Jamie Hayden

    2014-10-10

    Palliative care is a fundamental component of cancer care. As part of the 2011 to 2012 Leadership Development Program (LDP) of the American Society of Clinical Oncology (ASCO), a group of participants was charged with advising ASCO on how to develop a service model integrating palliative care throughout the continuum of cancer care. This article presents the findings of the LDP group. The group focused on the process of palliative care delivery in the oncology setting. We identified key elements for models of palliative care in various settings to be potentially equitable, sustainable, feasible, and acceptable, and here we describe a dynamic model for the integrated, simultaneous implementation of palliative care into oncology practice. We also discuss critical considerations to better integrate palliative care into oncology, including raising consciousness and educating both providers and the public about the importance of palliative care; coordinating palliative care efforts through strengthening affiliations and/or developing new partnerships; prospectively evaluating the impact of palliative care on patient and provider satisfaction, quality improvement, and cost savings; and ensuring sustainability through adequate reimbursement and incentives, including linkage of performance data to quality indicators, and coordination with training efforts and maintenance of certification requirements for providers. In light of these findings, we believe the confluence of increasing importance of incorporation of palliative care education in oncology education, emphasis on value-based care, growing use of technology, and potential cost savings makes developing and incorporating palliative care into current service models a meaningful goal.

  11. Enhancing Health-Care Services with Mixed Reality Systems

    Science.gov (United States)

    Stantchev, Vladimir

    This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

  12. [Users satisfaction with dental care services provided at IMSS].

    Science.gov (United States)

    Landa-Mora, Flora Evelia; Francisco-Méndez, Gustavo; Muñoz-Rodríguez, Mario

    2007-01-01

    To determine users' satisfaction with dental care services provided at Instituto Mexicano del Seguro Social in Veracruz. An epidemiological survey was conducted in 14 family medicine clinics located in the northern part of the state of Veracruz. The clinics were selected by stratified-random sampling. All users older than 20 years seeking medical or dental care services were interviewed; previously, their informed consent was obtained. We used the 6-items United Kingdom dental care satisfaction questionnaire (Spanish version) where question number four evaluates user satisfaction. From October to December 2005, 3601 users were interviewed. We excluded 279 questionnaires because the age of the interviewees was <20 years. The final analysis included 3322 interviews (92%); 73% were female with an average age of 45 +/- 16 years old. 82% were satisfied with dental care services and 91% never felt like making a complaint. Waiting time of less than 30 minutes and last visit to the dentist in the last year were the only variables related to satisfaction (p = 0.0001). There is a high level of satisfaction regarding dental care services among Mexican Institute of Social Security users. However, it would be possible to increase the level of satisfaction if the waiting time is reduced and the number of dental care users attending twice a year increases.

  13. Integration Strategies of Pharmacists in Primary Care-Based Accountable Care Organizations: A Report from the Accountable Care Organization Research Network, Services, and Education.

    Science.gov (United States)

    Joseph, Tina; Hale, Genevieve M; Eltaki, Sara M; Prados, Yesenia; Jones, Renee; Seamon, Matthew J; Moreau, Cynthia; Gernant, Stephanie A

    2017-05-01

    The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care. Pharmacist-provided care has been shown to reduce drug expenditures, hospital readmissions, length of stay, and emergency department visits. Although pharmacists have become key team members of interdisciplinary teams within traditional care settings, their role has often been overlooked in the primary care-based ACO. In 2015, Nova Southeastern University College of Pharmacy founded the Accountable Care Organization Research Network, Services, and Education (ACORN SEED), a team of pharmacy practice faculty dedicated to using innovative approaches to patient care, while providing unique learning experiences for pharmacy students by partnering with ACOs in the South Florida region. Five opportunities are presented for pharmacists to improve medication use specifically in primary care-based ACOs: medication therapy management, annual wellness visits, chronic disease state management, chronic care management, and transitions of care. Several challenges and barriers that prevent the full integration of pharmacists into primary care-based ACOs include lack of awareness of pharmacist roles in primary care; complex laws and regulations surrounding clinical protocols, such as collaborative practice agreements; provider status that allows compensation for pharmacist services; and limited access to medical records. By understanding and maximizing the role of pharmacists, several opportunities exist to better manage the medication-use process in value-based care settings. As more organizations realize

  14. Impact of pain and palliative care services on patients

    Directory of Open Access Journals (Sweden)

    S Santha

    2011-01-01

    Full Text Available Background: Palliative care has become an emerging need of the day as the existing health-care facilities play only a limited role in the care of the chronically ill in the society. Patients with terminal illness in most cases spend their lives in the community among their family and neighbors, so there is the need for a multi disciplinary team for their constant care. Volunteers are primary care givers who originate normally from the same locality with local knowledge and good public contact through which they can make significant contributions in a team work by bridging the gap between the patient community and outside world. Aim: The present study has been undertaken to analyze the impact of palliative care services on patients by considering 51 variables. Materials and Methods: The respondents of the study include 50 pain and palliative care patients selected at random from 15 palliative care units functioning in Ernakulam district. The analysis was made by using statistical techniques viz. weighted average method, Chi-square test, Friedman repeated measures analysis of variance on ranks and percentages. Results: The study revealed that the major benefit of palliative care to the patients is the reduction of pain to a considerable extent, which was unbearable for them earlier. Second, the hope of patients could be maintained or strengthened through palliative care treatment. Conclusion: It is understood that the services of the doctors and nurses are to be improved further by making available their services to all the palliative care patients in a uniform manner.

  15. Copayment for extended care services. Final rule.

    Science.gov (United States)

    2013-11-27

    This document promulgates Department of Veterans Affairs (VA) final regulations amending the definition of "spousal resource protection amount'' to reference the Maximum Community Spouse Resource Standard, which is adjusted and published each year by the Centers for Medicare and Medicaid Services (CMS). This change has the immediate effect of increasing the spousal resource protection amount from $89,280 to $115,920, and ensures that the spousal resource protection amount will stay consistent with the comparable protection for the spouses of Medicaid recipients.

  16. How to integrate social care services into primary health care? An experience from Iran

    Science.gov (United States)

    Montazeri, Ali; Riazi-Isfahani, Sahand; Damari, Behzad

    2016-01-01

    Background: Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. Methods: This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders. The main objective was to find a way to integrate social care into the Iranian PHC system. A conventional content analysis was performed to explore the data. Results: Overall, 20 experts were interviewed and the acquired data were classified into four major categories including priorities, implementation, requirements and stewardship. The main challenges were the existing controversies in the definition of social care, social service unit disintegration, multiple stewards for social care services, weaknesses of rules and regulations and low financing of the public budget. Social care services can be divided into two categories: Basic and advanced. Urban and rural health centers, as the first level of PHC, could potentially provide basic social care services for their defined population and catchment areas such as detecting social harms in high risk individuals and families and providing counseling for people in need. They can also refer the individuals to receive advanced services. Conclusion: Iran has a successful history of establishing the PHC System especially in rural areas. This network has an invaluable capacity to provide social health services. Establishing these services needs some prerequisites such as a reform PHC structure, macro support and technical intersectoral collaboration. They should also be piloted and evaluated before they could be implemented in the whole country. PMID:27683649

  17. A systematic review of integrated working between care homes and health care services

    Science.gov (United States)

    2011-01-01

    Background In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working. Methods A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis. Results Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in

  18. Interprofessional student teams augmenting service provision in residential aged care.

    Science.gov (United States)

    Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag

    2016-09-01

    The aim of this study was to determine the usefulness of student-led interprofessional consultations within residential aged care in augmenting patient care and enhancing student education. Volunteer fourth and final year health-care students conducted interprofessional consultations. In a mixed methods design, residents' health-care changes and perspectives were collected prospectively, and student and educator perceptions were measured by survey and interview. Sixteen aged care residents were consulted by interprofessional teams. Students identified two new health issues and proposed 17 recommendations for referrals and five changes to medication management. At six-weeks follow-up, two recommendations had been acted upon clinically, and two medication changes had been implemented. Reasons for the low uptake of recommendations were determined. Residents, students and educators reported high levels of satisfaction. Residential care facilities offer a useful interprofessional learning environment. Student consultations are positively regarded by patients, students and educators and may augment existing health services. © 2016 AJA Inc.

  19. Palliative care providers' perspectives on service and education needs.

    Science.gov (United States)

    Sellick, S M; Charles, K; Dagsvik, J; Kelley, M L

    1996-01-01

    To obtain the information necessary for coordinated regional program development, we examined (a) the multidisciplinary viewpoint of palliative care service provision and (b) the continuing education needs reported by non-physician service providers. Of 146 surveys distributed to care providers from multiple settings, 135 were returned. Respondents cited these problems: fragmented services, poor pain and symptom control, lack of education for providers, lack of public awareness, problems with the continuity and coordination of care, lack of respite, and lack of hospice beds. Stress management for caregivers, pain management, communication skills, and symptom assessment were rated as priorities in continuing education. Lectures, small group discussions, practicum, and regular medical centre rounds were the preferred learning formats, while costs and staff shortages were cited as educational barriers.

  20. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia

    OpenAIRE

    2016-01-01

    Background Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to...

  1. Service Users' and Caregivers' Perspectives on Continuity of Care in Out-of-Hours Primary Care.

    LENUS (Irish Health Repository)

    Gallagher, Niamh

    2012-12-20

    Modernization policies in primary care, such as the introduction of out-of-hours general practice cooperatives, signify a marked departure from many service users\\' traditional experiences of continuity of care. We report on a case study of accounts of service users with chronic conditions and their caregivers of continuity of care in an out-of-hours general practice cooperative in Ireland. Using Strauss and colleagues\\' Chronic Illness Trajectory Framework, we explored users\\' and caregivers\\' experiences of continuity in this context. Whereas those dealing with "routine trajectories" were largely satisfied with their experiences, those dealing with "problematic trajectories" (characterized by the presence of, for example, multimorbidity and complex care regimes) had considerable concerns about continuity of experiences in this service. Results highlight that modernization policies that have given rise to out-of-hours cooperatives have had a differential impact on service users with chronic conditions and their caregivers, with serious consequences for those who have "problematic" trajectories.

  2. Provision of universal broadband service in Japan: A policy challenge toward a sustainable ICT infrastructure

    OpenAIRE

    Mitomo, Hitoshi

    2014-01-01

    This presentation outlines a proposal for a new frame work for the provision of universal service aimed at solving the various issues inherent in community informatization, and goes on to look at the advantages and disadvantages of the proposed framework and review its feasibility. In order to ensure that telecommunications services are universally accessible, in less favored areas, universal service is currently provided for analog landline telephones by using a universal service fund system...

  3. Utilization of health care services by migrants in Europe

    DEFF Research Database (Denmark)

    Graetz, V.; Rechel, B.; Groot, W.

    2017-01-01

    Introduction: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries. Sources of data: A systematic literature review was performed......, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39. Areas of agreement: Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most...... countries for which evidence was available. In contrast, screening and outpatient visits for specialized care were generally used less often by migrants. Areas of controversy: Utilization of general practitioner services among migrants compared with non-migrants presents a diverging picture. Growing points...

  4. [Attitude of Danish physicians to the health care services].

    Science.gov (United States)

    Andreassen, U K; Hein, E

    1993-01-25

    In recent years, Danish society has focused on the service and the information available for patients in health care. A test sample out of 1,000 members of the Danish Medical Association selected at random revealed that the majority had positive attitudes to service and information in health care. The study also indicated that doctors do not consider that any particular dress code is particularly appropriate but consider that personal appearance and the way patients are addressed are individual matters. This individualistic attitude which is consistent with Mintzberg's sociological structural theory does not invariably seem appropriate.

  5. 76 FR 64882 - Inquiry Into Disbursement Process for the Universal Service Fund Low Income Program

    Science.gov (United States)

    2011-10-19

    ... COMMISSION 47 CFR Part 54 Inquiry Into Disbursement Process for the Universal Service Fund Low Income Program... Universal Service Fund low income support to eligible telecommunications carriers (ETCs) based upon claims... Universal Service Administrative Company (USAC) reimburses ETCs for low income support each month based...

  6. 47 CFR 54.709 - Computations of required contributions to universal service support mechanisms.

    Science.gov (United States)

    2010-10-01

    ... universal service support mechanisms. 54.709 Section 54.709 Telecommunication FEDERAL COMMUNICATIONS... Computations of required contributions to universal service support mechanisms. (a) Prior to April 1, 2003, contributions to the universal service support mechanisms shall be based on contributors'...

  7. Quality Assessment of University Studies as a Service: Dimensions and Criteria

    Science.gov (United States)

    Pukelyte, Rasa

    2010-01-01

    This article reviews a possibility to assess university studies as a service. University studies have to be of high quality both in their content and in the administrative level. Therefore, quality of studies as a service is an important constituent part of study quality assurance. When assessing quality of university studies as a service, it is…

  8. Developing supplemental activities for primary health care maternity services.

    Science.gov (United States)

    Panitz, E

    1990-12-01

    Supplemental health care activities are described in the context of the augmented product. The potential benefits of supplemental services to recipients and provider are discussed. The author describes a study that was the basis for (re)developing a supplemental maternity service. The implementation of the results in terms of changes in the marketing mix of this supplemental program is discussed. The effects of the marketing mix changes on program participation are presented.

  9. Implementing TQM in the health care service.

    Science.gov (United States)

    Lindberg, Eva; Rosenqvist, Urban

    2005-01-01

    The present study seeks to present a case study over four years following an implementation process of total quality management (TQM) on an ICU (intensive care unit). The aim was to describe consequences shown in the organisational climate, workload and staff wellbeing. A case study design was employed using a longitudinal method of data collection. Downsizing due to diminishing resources was a parallel process probably disturbing the TQM implementation. The workload increased by 20 per cent, whereas organisational and individual variables remained stable over time. However, sick leave increased dramatically and was higher than the general level within the Swedish population. The ICU had the capacity to adapt successfully by regulating working hours to workload. It is speculated that another cause behind sickness absence exists other than the general opinion. The literature used for the discussion departs from the relation between people's understanding and acting, sensemaking, and organisational theories describing complex adaptive systems emphasizing attraction patterns. Organisational ambiguity was a main finding in an earlier study that was used for interpretation of the result in the present study. As ambiguity seems to be a major and increasing problem, it has consequences for management as well as for continuous quality development. The implication of the study is the need to be able to successfully work in an ambiguous situation and use the quality system as a device in day-to-day work.

  10. Adolescents perception of reproductive health care services in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Agampodi Thilini C

    2008-05-01

    Full Text Available Abstract Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners

  11. Children in family foster care have greater health risks and less involvement in Child Health Services.

    Science.gov (United States)

    Köhler, M; Emmelin, M; Hjern, A; Rosvall, M

    2015-05-01

    This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS). Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups. The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care. Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high-quality preventive health care for this particularly vulnerable group of children. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. The costs and service implications of substituting intermediate care for acute hospital care.

    Science.gov (United States)

    Mayhew, Leslie; Lawrence, David

    2006-05-01

    Intermediate care is part of a package of initiatives introduced by the UK Government mainly to relieve pressure on acute hospital beds and reduce delayed discharge (bed blocking). Intermediate care involves caring for patients in a range of settings, such as in the home or community or in nursing and residential homes. This paper considers the scope of intermediate care and its role in relation to acute hospital services. In particular, it develops a framework that can be used to inform decisions about the most cost-effective care pathways for given clinical situations, and also for wider planning purposes. It does this by providing a model for evaluating the costs of intermediate care services provided by different agencies and techniques for calibrating the model locally. It finds that consistent application of the techniques over a period of time, coupled with sound planning and accounting, should result in savings to the health economy.

  13. Universal Service in a Broader Perspective: The European Digital Divide

    Directory of Open Access Journals (Sweden)

    Maria Concepcion GARCIA-JIMENEZ

    2009-01-01

    Full Text Available Ensuring universal service is a top objective in many countries in order that all the citizens can have access basic communications services. Although the ICT equipment in households and its usage by individuals are essential prerequisites for benefiting from ICTs, the situation in the European Union is far from uniform. This article provides a description of the European information society development scenario using the values reached by the member states in a set of indicators selected for measuring said progress in households. Two tools are used for providing a broader perspective of the digital divide: a composite index and the cluster analysis. Below, a study is provided on what variables are relevant for interpreting the situation that is presented.

  14. Health care of persons with disabilities in public health services: a literature study

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Vargas

    2016-10-01

    Full Text Available Background and Objectives: Health care for people with disabilities (PwD must be guaranteed by the state, health professionals and community involved, covering a multidisciplinary approach. This study aims to discuss the assistance to persons with disabilities in public health services. Method: This is a literature review of the descriptive study type with scientific publications on search sites Scielo, LILACS and Pubmed from descriptors: accessibility, people with disabilities, access to health services, totaling 514 articles, which fall under 22 the themes addressed. Results: Accessibility is a result of the availability of professionals and health services as well as access of Persons with Disabilities these services offered. We need planning actions by the multidisciplinary team, in order to seek to minimize the front inequalities behavioral barriers, architectural, geographical, which form gaps that prevent an egalitarian, unanimous and universal care as recommended by the health system. In oral health the principle of comprehensiveness includes the promotion, recovery and oral rehabilitation. Conclusion: Health promotion activities need to be encouraged so that it promotes the welfare of the health service user and that such actions occur in an integrated manner, adding resources from the comprehensive and multidisciplinary work. Accessibility to health services in conjunction with actions aimed at promoting the health of PwD can provide higher quality in health care and higher quality of life.

  15. Exit and voice: an investigation of care service users in Austria, Belgium, Italy, and Northern Ireland.

    Science.gov (United States)

    Egger de Campo, Marianne

    2007-06-01

    The past decades have seen an introduction of market elements in the provision of social care services (Finer 1999; Mabbett and Bolderson 1999). Welfare state reforms all over Europe have produced welfare pluralism and claims that the increased choice will enhance user participation, promote older persons' autonomy, and improve the quality of services. Within the Fifth FP Research Project CARMA (Care for the Aged at Risk of Marginalization) a case study among users of care services in Austria, Belgium, Italy, and Northern Ireland was conducted that focussed on friction and conflict between clients and service providers and investigated the reasons for discharge and denial of admission to a service. The data from this study can be interpreted in terms of Hirschman's (Exit, voice, and loyalty: responses to decline in firms, organizations, and states. Harvard University Press, Cambridge, 1970) theory on 'exit' and 'voice' as expressions of consumers' dissatisfaction with the quality of a product. Data were collected in different systems offering a variety of procedures for exit from one provider and the choice of a competitor. Also different practices of handling voice i.e., complaints have been documented. The paper questions to what extent various possibilities for exit and voice can enhance users' autonomy and increase the quality of the service supply. It thus contributes empirical findings to a debate that often emphasizes ideological arguments.

  16. Perceived nursing service quality in a tertiary care hospital, Maldives.

    Science.gov (United States)

    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

    The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality. © 2011 Blackwell Publishing Asia Pty Ltd.

  17. Underutilization of palliative care services in the liver transplant population

    Science.gov (United States)

    Kathpalia, Priya; Smith, Alexander; Lai, Jennifer C

    2016-01-01

    AIM To evaluate use of palliative care services in patients with end-stage liver disease who do not have access to liver transplant. METHODS Evaluated were end-stage liver disease patients who were removed from the liver transplant wait-list or died prior to transplant at a single transplant center over a 2-year period. Those who were removed due to noncompliance or ultimately transplanted elsewhere were excluded from this study. Patient characteristics associated with palliative care consultation were assessed using logistic regression analysis. RESULTS Six hundred and eighty-three patients were listed for liver transplant in 2013-2014 with 107 (16%) dying (n = 62) or removed for clinical decompensation prior to liver transplant (n = 45): Median age was 58 years, and the majority were male (66%), Caucasian (53%), had Child C cirrhosis (61%) or hepatocellular carcinoma (52%). The palliative care team was consulted in only 18 of the 107 patients (17%) who died or were removed, 89% of which occurred as inpatients. Half of these consultations occurred within 72 h of death. In univariable analysis, patients of younger age, white race, and higher end-stage liver disease scores at time of listing and delisting were more likely to receive palliative care services. Only younger age [Odds ratio (OR) = 0.92; P = 0.02] and Caucasian race (OR = 4.90; P = 0.02) were still associated with integration of palliative care services through multivariable analysis. CONCLUSION Palliative care services are grossly underutilized in older, non-white patients with cirrhosis on the liver transplant wait-list. We encourage early integration of these services into clinical decision-making in the transplant population, with further studies aimed at understanding barriers to consultation. PMID:27683638

  18. Universal Service in a Global Networked Environment: Selected Issues and Possible Approaches.

    Science.gov (United States)

    Bertot, John Carlo; McClure, Charles R.; Owens, Kimberly A.

    1999-01-01

    Presents selected issues related to the development of universal service to networked information resources and services in a global networked environment. Defines universal service as a set of telecommunications services to which users should have access, including appropriate funding and interconnected public telecommunications infrastructure…

  19. The University of Texas at Arlington's Virtual Reference Service: An Evaluation by the Reference Staff

    Science.gov (United States)

    Casebier, Katherine D.

    2006-01-01

    The University of Texas at Arlington's Library began using an online chat reference in 2002. The service, called Collaborative Digital Reference Service, later became "Ask a Librarian." Slightly over one year later, the library joined the University of Texas System's "Ask a Librarian" service. Both services are powered by…

  20. Providing primary health care through integrated microfinance and health services in Latin America.

    Science.gov (United States)

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  1. Barriers of access to oral health care among university students in southern Colombia, 2011. A multivariate analysis

    Directory of Open Access Journals (Sweden)

    Anderson Rocha-Buelvas

    2014-10-01

    Full Text Available Background. The right to health is considered to be a fundamental human right. Therefore, it is a starting point from which to combat unjust and immoral inequalities. It is essential to study the process through which a need for attention is completely satisfied. Objective. To analyze determinants of access to oral health care among university students in municipality of Pasto. Materials and methods. A sample of 338 university students answered a confidential survey that was based upon previous studies using a health care services utilization behavioral model. Results. In terms of enabling factors, the students that responded as ‘having a bad health state’ were those that used oral health care services the most in last year, while those students that responded as "being dissatisfied with the appearance of their teeth’ used oral health care services less. In relation to need factors, the students whose quality of life was not affected by physical impairment and physical pain used oral health care services less. Predisposing factors were not statistically significant. Conclusions. This study found that enabling and need factors were associated with recent dental consultations by university students in the municipality of Pasto.

  2. Federal Nursing Service Award. Impact of TriCare/managed care on total force readiness.

    Science.gov (United States)

    Ray, M A; Turkel, M C

    2001-04-01

    Mission readiness is dependent on a healthy total force and the response of military medical and nursing services. Managed care has become the norm in U.S. health care, including the Department of Defense Military Health System. Cost management, health maintenance organizations, and other health plans are defined as "managed care," an aggressive cost-control effort by health care purchasers and insurers to limit health care spending and services and advance a market-oriented, profit-driven system. The impact of managed care on mission readiness and retention of active and reserve personnel is and will continue to be profound. The purpose of this research was to conduct a qualitative, phenomenological study (life experiences) of TriCare/managed care to explore the impact and the meaning of the experience on total force mission readiness of the U.S. Air Force and how managed care has changed nursing practice. The results reveal the significance of the impact of TriCare/managed care on total force readiness by identifying, through themes, meta-themes, and a representative model, the negative effect that economics is having on active duty and reserve force health and well-being.

  3. Cloud based emergency health care information service in India.

    Science.gov (United States)

    Karthikeyan, N; Sukanesh, R

    2012-12-01

    A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the

  4. Marketing home health care medical services: the physician's view.

    Science.gov (United States)

    Ryan, E J; Phelps, R A

    1993-01-01

    The authors surveyed physicians serving the Jackson, Mississippi home health care market. They identified problems and studied physician perceptions regarding services provided by home health care agencies, private duty nursing agencies, and durable medical equipment suppliers. Respondents perceived home health care as providing: (1) increased patient satisfaction, (2) greater patient convenience, (3) earlier discharge, and (4) lowered patient costs. They least liked: (1) lack of control and involvement in the patient caring process, (2) paperwork, (3) quality control potential, and the possibility that patient costs could increase. Two sets of implications for health care marketers are presented that involve both national and regional levels. Overall results indicate that a growing and profitable market segment exists and is being served in an effective and socially responsible manner.

  5. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  6. Costing a feminist plan for a caring economy: The case of free universal childcare in the UK

    OpenAIRE

    de Henau, Jerome

    2015-01-01

    This paper makes the case for providing universal and free childcare services in the UK to contribute to building a care economy as a better alternative to austerity and spending cuts, one that would foster gender equality and quality employment. It estimates the total cost of such services using different assumptions on staff pay and coverage and the related direct employment effects. It discusses the different multipliers that could be derived from such 'investment' and the related tax reve...

  7. Factors influencing women's utilization of public health care services ...

    African Journals Online (AJOL)

    Background: Maternal mortality remains a public health challenge claiming ... across many developing countries around the world. .... 19.8. Community Factors place of residence. Rural. 13.0. 14.0. 13.3. Urban .... hood among women who were exposed to either radio or ..... maternal health care services in Southern India.

  8. A TE ATAL CARE SERVICE UTILIZATIO A D ASSOCIATED ...

    African Journals Online (AJOL)

    user

    However, the utilization of this service is very low even for women who have access to the ... associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, .... four Nurse Supervisors, who were fluent speakers of the local ... Verbal informed consent was obtained from each respondent ...

  9. A joint venture in providing home care and community service.

    Science.gov (United States)

    Reifsteck, S

    1987-01-01

    General discussion of a joint venture providing home care and community service including future possibilities, business and financial aspects and demand is presented. The author then provides a group practice joint venture model including descriptions of operating structure, contract arrangements and management.

  10. Collaboration in the provision of mental health care services

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Valius, L.; Lazarus, J.V.

    2012-01-01

    Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs and...

  11. 38 CFR 17.111 - Copayments for extended care services.

    Science.gov (United States)

    2010-07-01

    ... annuities, bonds, mutual funds, retirement accounts (e.g., IRA, 401Ks, annuities), art, rare coins, stamp... disability; (2) A veteran whose annual income (determined under 38 U.S.C. 1503) is less than the amount in... disability; (4) An episode of extended care services that began on or before November 30, 1999; (5)...

  12. Integrating service user participation in mental health care: what will it take?

    Directory of Open Access Journals (Sweden)

    Sharon Lawn

    2015-03-01

    Full Text Available Participation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience within mental health services, raising the visibility of service users as leaders and our teachers within services and redefining integrated care from the service user perspective.

  13. University psychiatry in Italy: organisation and integration of university clinics and the National Health Service

    Directory of Open Access Journals (Sweden)

    Pier Maria Furlan

    2013-09-01

    Full Text Available INTRODUCTION: In the Italian psychiatric system, community-based care has become increasingly important and widespread since the national reform of 1978. This report aims to provide an overview of the involvement of university medical schools in this process, considering their responsibility for teaching and training specialist practitioners and professionals. METHODS: The study was carried out between early 2010 and February 2011. An 18-items, self-administered, questionnaire was designed to investigate the number of faculty members that are responsible both for running a clinical ward and for providing community-based healthcare. RESULTS: Nine out of 53 faculty members (17% manage a Mental Health Department, 9 (17% manage a University Department, and 2 (3.8% manage both types of department. Less than half of the teachers have full responsibility (hospital and community; however the percentage reaches 73.2% if we include the hospital wards open to the community emergencies. The remaining 26.8% have no responsibility for community psychiatry. Moreover there were undoubtedly still too many universities with specialisation schools that are without an appropriate network of facilities enabling them to offer complex psychiatric training. DISCUSSION: As expected, there were several types of healthcare management that were not uniformly distributed throughout Italy and there were also marked differences between mental health care provision in the North, Centre, and South of Italy. The university involvement in clinical responsibility was great, but at the management level there was a lack of equality in terms of clinical care, which risks being reflected also on the institutional functions of teaching and research.

  14. Price elasticity of expenditure across health care services.

    Science.gov (United States)

    Duarte, Fabian

    2012-12-01

    Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled from administrative records from the Chilean private health insurance market, I estimate the price elasticity of expenditures across a variety of health care services. I find elasticities that range between zero for the most acute service (appendectomy) and -2.08 for the most elective (psychologist visit). Moreover, the results show that at least one third of the elasticity is explained by the number of visits; the rest is explained by the intensity of each visit. Finally, I find that high-income individuals are five times more price sensitive than low-income individuals and that older individuals are less price-sensitive than young individuals.

  15. [Agreements Between Syracuse University and Syracuse University Employees' Union, Local 200 of the General Service Employees' International Union.

    Science.gov (United States)

    Syracuse Univ., NY.

    Contained in this document are three labor contracts made by and between Syracuse University and Local 200 General Services Employees' Union, Service Employees' International Union, AFL-CIO. The purpose of the agreements is to promote and maintain good relations between the university, the union, and the employees represented by the union and to…

  16. Legitimizing Security in the Ivory Tower: Canadian University Corporate Security Services' Public Quest for Legitimacy.

    Science.gov (United States)

    Wilkinson, Blair

    2016-05-01

    This article examines how university corporate security (UCS) services engage in legitimation work in their attempts to make their university communities (i.e., faculty, staff, students) and political masters (i.e., university administrators, boards of governors, senators) believe that they are honest, trustworthy, and caring and have authority that should be deferred to. This is accomplished through the analysis of interview and observational data collected as part of a research project exploring UCS services at five Canadian universities and an examination of how UCS services at 14 Canadian universities communicate using the social media service Twitter. These UCS services were found to primarily use Twitter for the purposes of soliciting or requesting information and for networking. In communicating through Twitter, UCS services engage in public legitimation work in which they make claims about and attempt to demonstrate their expertise, authority, and accountability. This article argues that both UCS services' particular legitimacy problem (i.e., their possession of both private and public attributes) and the interactive nature of public legitimation work create tensions that may serve to disrupt UCS services' ability to attain legitimacy. Cet article examine la manière dont les services de sécurité d'entreprise à l'université (SEU) s'engagent à légitimer leurs tentatives de persuader leurs communautés universitaires (c'est-à-dire le corps professoral, le personnel et les étudiants) ainsi que la haute administration (c'est-à-dire les administrateurs de l'université, le conseil des gouverneurs et les sénateurs) qu'ils sont honnêtes, attentifs, dignes de confiance, et qu'ils possèdent un niveau d'autorité auquel quiconque devrait se référer. Ceci sera accompli en analysant un corpus d'entrevues et d'observations dans le cadre d'un projet de recherche examinant les services de type SEU dans cinq universités canadiennes, ainsi qu'une étude sur

  17. Factors affecting burnout when caring for older adults needing long-term care services in Korea.

    Science.gov (United States)

    Won, Seojin; Song, Inuk

    2012-01-01

    The purpose of this study was to address factors related to caregiver burnout as a result of caring for an older adult with a chronic disease. Characteristics of care recipients and caregivers as well as social support were included to identify the relationships with caregiver burnout. The analysis was based on a sample of 334 older adults and their caregivers in Korea. The logistic regression results indicated that the period of being in need of another's help among care-recipients, co-residence, caregivers' health condition, previous care experience, and caregivers' free time were correlated with the caregivers' future caregiving. Interestingly, the more experience caregivers had in caring for older adults, the more willing they were to provide care in the future. Thus, the discussion focuses on services for those who are new to providing care for older adults because they tend to have less coping skills.

  18. UNMET NEEDS FOR HEALTH CARE SERVICES IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Elka Atanasova

    2016-09-01

    Full Text Available Background: In all European countries, an important policy objective is the equity of access to health care. The factors that affect access to health care can differ as the demand- and supply-side factors. Moreover, there are many tools to assess the extent of inequity in access to services. One simple tool is the assessing reports of unmet needs for health care. Purpose: The study has two objectives: to examine the evidence of self-reported unmet needs and to analyze the relationship between foregone medical care and both type of residence and socioeconomic status. Materials and Methods: We use data from the European Union Statistics on Income and Living Conditions. The access to health care is measured using the concept of unmet need for medical examination or treatment during the last 12 months. The relationship between foregone medical care and both type of residence and socioeconomic status is examined through the representative survey conducted in 2014. Results: The Eurostat results show that treatment costs are the most common reason for foregone medical care in Bulgaria. We observe a gradual decrease in the share of people who reported having unmet needs due to being too expensive. According to the 2014 survey, significant differences between urban and rural areas as well as among the income groups are identified. The results show the problems in access to health care services mainly in small towns and villages. Conclusion: Although major essential changes were made in the Bulgarian health care system, the equity problems remain an important challenge to policy-makers.

  19. Assessment of Customer Service in Academic Health Care Libraries (ACSAHL): an instrument for measuring customer service*†

    Science.gov (United States)

    Crossno, Jon E.; Berkins, Brenda; Gotcher, Nancy; Hill, Judith L.; McConoughey, Michelle; Walters, Mitchel

    2001-01-01

    Objectives: In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries. Methods: Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys. Results: Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results. Conclusions: ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas. PMID:11337948

  20. Prioritizing Clinician Wellbeing: The University of Virginia's Compassionate Care Initiative.

    Science.gov (United States)

    Bauer-Wu, Susan; Fontaine, Dorrie

    2015-09-01

    Working in healthcare is increasingly challenging for nurses, physicians, and other health professionals. Ongoing high stress takes a toll on clinicians and interferes with the quality of their patient care. Fostering clinician wellbeing needs to be a priority; if not, the human and financial consequences are significant. To describe the University of Virginia (UVA) School of Nursing's Compassionate Care Initiative (CCI) as an example of an organizational case study that is engaged in multipronged efforts to cultivate a resilient healthcare workforce committed to high-quality, compassionate, relationship-based care. This case report describes the development, implementation, and evaluation of the CCI at UVA. Various elements of the program are reviewed, which include harnessing talents and interests of the larger institution in the establishment of Compassionate Care Ambassadors, outreach to the community, innovative student-specific educational activities, and a national media program. The UVA CCI is a successful model of an organizational effort to promote clinician wellbeing and resilience. Aspects from this program can be adapted to other organizations that are committed to addressing this critical issue in US healthcare today.

  1. Acute-care surgical service: a change in culture.

    Science.gov (United States)

    Parasyn, Andrew D; Truskett, Philip G; Bennett, Michael; Lum, Sharon; Barry, Jennie; Haghighi, Koroush; Crowe, Philip J

    2009-01-01

    The provision of acute surgical care in the public sector is becoming increasingly difficult because of limitation of resources and the unpredictability of access to theatres during the working day. An acute-care surgical service was developed at the Prince of Wales Hospital to provide acute surgery in a more timely and efficient manner. A roster of eight general surgeons provided on-site service from 08.00 to 18.00 hours Monday to Friday and on-call service in after-hours for a 79-week period. An acute-care ward of four beds and an operating theatre were placed under the control of the rostered acute-care surgeon (ACS). At the end of each ACS roster period all patients whose treatment was undefined or incomplete were handed over to the next rostered ACS. Patient data and theatre utilization data were prospectively collected and compared to the preceding 52-week period. Emergency theatre utilization during the day increased from 57 to 69%. There was a 11% reduction in acute-care operating after hours and 26% fewer emergency cases were handled between midnight and 08.00 hours. There was more efficient use of the entire theatre block, suggesting a significant cultural change. Staff satisfaction was high. On-site consultant-driven surgical leadership has provided significant positive change to the provision of acute surgical care in our institution. The paradigm shift in acute surgical care has improved patient and theatre management and stimulated a cultural change of efficiency.

  2. Progressivity of health care financing and incidence of service benefits in Ghana.

    Science.gov (United States)

    Akazili, James; Garshong, Bertha; Aikins, Moses; Gyapong, John; McIntyre, Di

    2012-03-01

    The National Health Insurance (NHI) scheme was introduced in Ghana in 2004 as a pro-poor financing strategy aimed at removing financial barriers to health care and protecting all citizens from catastrophic health expenditures, which currently arise due to user fees and other direct payments. A comprehensive assessment of the financing and benefit incidence of health services in Ghana was undertaken. These analyses drew on secondary data from the Ghana Living Standards Survey (2005/2006) and from an additional household survey which collected data in 2008 in six districts covering the three main ecological zones of Ghana. Findings show that Ghana's health care financing system is progressive, driven largely by the progressivity of taxes. The national health insurance levy (which is part of VAT) is mildly progressive while NHI contributions by the informal sector are regressive. The distribution of total benefits from both public and private health services is pro-rich. However, public sector district-level hospital inpatient care is pro-poor and benefits of primary-level health care services are relatively evenly distributed. For Ghana to attain an equitable health system and fully achieve universal coverage, it must ensure that the poor, most of whom are not currently covered by the NHI, are financially protected, and it must address the many access barriers to health care.

  3. Trends in the Aggressiveness of End-of-Life Cancer Care in the Universal Health Care System of Ontario, Canada

    National Research Council Canada - National Science Library

    Thi H. Ho; Lisa Barbera; Refik Saskin; Hong Lu; Bridget A. Neville; Craig C. Earle

    2011-01-01

    To describe trends in the aggressiveness of end-of-life (EOL) cancer care in a universal health care system in Ontario, Canada, between 1993 and 2004, and to compare with findings reported in the United States...

  4. Performance of the measures of processes of care for adults and service providers in rehabilitation settings

    Directory of Open Access Journals (Sweden)

    Bamm EL

    2015-06-01

    Full Text Available Elena L Bamm,1 Peter Rosenbaum,1,2 Seanne Wilkins,1 Paul Stratford11School of Rehabilitation Science, 2CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, CanadaIntroduction: In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts.Objective: The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A.Design: A validation studySettings: In-patient rehabilitation facilities.Main outcome measures: MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A.Results: Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71–0.88 for health care professionals, 0.82–0.90 for patients, and 0.87–0.94 for family members, as well as moderate to good correlations between domains (0.40–0.78 for health care professionals and 0.52–0.84 for clients supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A responses supported the multidimensionality of the questionnaire.Conclusion: MPOC-A and MPOC-SP(A are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.Keywords: client-centered care, service evaluation, MPOC, models of

  5. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2010-11-09

    ... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services... (c) $141.50 for the 21st through 100th day of extended care services in a skilled nursing facility...

  6. 78 FR 38346 - Advisory Council on Alzheimer's Research, Care, and Services; Meeting

    Science.gov (United States)

    2013-06-26

    ... HUMAN SERVICES Advisory Council on Alzheimer's Research, Care, and Services; Meeting AGENCY: Assistant... public meeting of the Advisory Council on Alzheimer's Research, Care, and Services (Advisory Council). The Advisory Council on Alzheimer's Research, Care, and Services provides advice on how to prevent or...

  7. 75 FR 81335 - Reasonable Charges for Medical Care or Services; 2011 Calendar Year Update

    Science.gov (United States)

    2010-12-27

    ... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation... and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and...

  8. Patient satisfaction with nursing care in a regional university hospital in southern Spain.

    Science.gov (United States)

    González-Valentín, Araceli; Padín-López, Susana; de Ramón-Garrido, Enrique

    2005-01-01

    Patient satisfaction is a valid indicator for measurement of service quality. Patients' opinions are important because dissatisfaction suggests opportunities for improvement. We evaluated the satisfaction of patients with nursing care in a regional university hospital in southern Spain and determined the relevant sociodemographic and attendance characteristics. A cross-sectional descriptive study was undertaken using the SERVQUAL questionnaire. Reliability and validity of the SERVQUAL instrument were established. The only interaction considered was gender and education level. Analysis of covariance showed that the only factors significantly associated with lower patient satisfaction were female gender, higher educational level, lower overall satisfaction with the hospital, and not knowing the name of the nurse.

  9. [Organization of health services and tuberculosis care management].

    Science.gov (United States)

    Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena

    2012-07-01

    The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.

  10. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

    Directory of Open Access Journals (Sweden)

    M Eugenia Socías

    Full Text Available Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC, sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC.Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access. Multivariable logistic regression analyses, using generalized estimating equations (GEE, were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013.In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4% women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%, limited hours of operation (36.5%, and perceived disrespect by health care providers (26.1%. In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10-1.94, workplace- (AOR = 1.31, 95% CI 1.05-1.63, and community-level violence (AOR = 1.41, 95% CI 1.04-1.92, as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03-1.69, a mental illness diagnosis (AOR = 1.66, 95% CI 1.34-2.06, and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59-7.57 emerged as independent correlates of institutional barriers to health services.Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex

  11. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

    Science.gov (United States)

    Socías, M Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10-1.94), workplace- (AOR = 1.31, 95% CI 1.05-1.63), and community-level violence (AOR = 1.41, 95% CI 1.04-1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03-1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34-2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59-7.57) emerged as independent correlates of institutional barriers to health services. Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex workers

  12. Behavioral Health Service Use and Costs among Children in Foster Care

    Science.gov (United States)

    Becker, Marion; Jordan, Neil; Larsen, Rebecca

    2006-01-01

    This article compares behavioral health service use and cost for foster care versus nonfoster care children; children before, during, and after foster care placement; and successfully reunified versus nonsuccessfully reunified foster care children. Behavioral health service costs for children in foster care were higher than for children not in…

  13. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Directory of Open Access Journals (Sweden)

    Mekonnen AB

    2013-03-01

    Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

  14. Polypharmacy and specific comorbidities in university primary care settings.

    Science.gov (United States)

    Aubert, Carole E; Streit, Sven; Da Costa, Bruno R; Collet, Tinh-Hai; Cornuz, Jacques; Gaspoz, Jean-Michel; Bauer, Doug; Aujesky, Drahomir; Rodondi, Nicolas

    2016-11-01

    Polypharmacy is associated with adverse events and multimorbidity, but data are limited on its association with specific comorbidities in primary care settings. We measured the prevalence of polypharmacy and inappropriate prescribing, and assessed the association of polypharmacy with specific comorbidities. We did a cross-sectional analysis of 1002 patients aged 50-80years followed in Swiss university primary care settings. We defined polypharmacy as ≥5 long-term prescribed drugs and multimorbidity as ≥2 comorbidities. We used logistic mixed-effects regression to assess the association of polypharmacy with the number of comorbidities, multimorbidity, specific sets of comorbidities, potentially inappropriate prescribing (PIP) and potential prescribing omission (PPO). We used multilevel mixed-effects Poisson regression to assess the association of the number of drugs with the same parameters. Patients (mean age 63.5years, 67.5% ≥2 comorbidities, 37.0% ≥5 drugs) had a mean of 3.9 (range 0-17) drugs. Age, BMI, multimorbidity, hypertension, diabetes mellitus, chronic kidney disease, and cardiovascular diseases were independently associated with polypharmacy. The association was particularly strong for hypertension (OR 8.49, 95%CI 5.25-13.73), multimorbidity (OR 6.14, 95%CI 4.16-9.08), and oldest age (75-80years: OR 4.73, 95%CI 2.46-9.10 vs.50-54years). The prevalence of PPO was 32.2% and PIP was more frequent among participants with polypharmacy (9.3% vs. 3.2%, pPolypharmacy is common in university primary care settings, is strongly associated with hypertension, diabetes mellitus, chronic kidney disease and cardiovascular diseases, and increases potentially inappropriate prescribing. Multimorbid patients should be included in further trials for developing adapted guidelines and avoiding inappropriate prescribing. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  15. Universal Design Patterns for stoma care away-from-home

    Directory of Open Access Journals (Sweden)

    Dirk De Meester

    2009-11-01

    Full Text Available Accommodating the real diversity of user populations,including those with physical and / or mental impairments and functional limitations, requires a large amount of designinformation in connection with human dis-abilities(limitations and possibilities. In order to collect andorganise this information for designers and decision makers, Universal Design Patterns (UD Patterns offer descriptive information about, on the one hand, CONFLICTS between users and built environments, and on the other hand,empirically evident design RESOLUTIONS. Directcollaboration with users / experts was tested in thedevelopment of a specific UD Pattern for a (Semi- ambulant accessible toilet for personal care, with specific emphasis onstoma-care in public facilities. The paper illustrates howpeople with ostomies and care-givers communicate with researchers, and how relevant design information is extracted and structured. On a more general level, results show how environment-related dimensions of human functioning differ from medical aspects, and how direct involvement of end-users enriches the content of design information.

  16. Determining the Level of Satisfaction of Patients in Nursing Care and Health Services

    Directory of Open Access Journals (Sweden)

    Sevban Arslan

    2012-12-01

    Full Text Available This study was conducted to determine patients’ satisfaction with nursing care and health services. This descriptive study was performed with 320 inpatients at University Hospital’s internal diseases and surgical units in July and November 2011. The data were collected by a questionnaire and the Visual Analog Patient Satisfaction Scale and the Scale of Patient Perception of Hospital Experience With Nursing. For statistical evalution , SPSS(Statistical Package for Social Science 15 percent by using the program, the Student t-test, ANOVA and Kruskal- Wallis analysis was done with. The mean total score was 8.65±1.52 on the Visual Analog Patient Satisfaction Scale. The Scale of Patient Perception of Hospital Experience With Nursing, the mean total score was 65.90±11.00. Consequently, Patients were satisfied with the nursing care and health services. [TAF Prev Med Bull 2012; 11(6.000: 717-724

  17. Partners in Learning: Exploring Two Transformative University and High School Service-Learning Partnerships

    Science.gov (United States)

    Bialka, Christa S.; Havlik, Stacey A.

    2016-01-01

    This study describes a service-learning partnership between a Mid-Atlantic university and two private, urban high schools by examining the perspectives of those engaged in the service experience. The purpose of this study was to explore the shared experiences of service-learning in schools from the perspectives of both university and high school…

  18. "Dropbox-like" service for the University of Vienna

    CERN Document Server

    CERN. Geneva

    2014-01-01

    The increasing popularity of dropbox and at the same time increasing awareness for data security did create the demand for an onsite "Dropbox-like" “sync and share” service at the University of Vienna. It has been decided that ownCloud would be a good start, since other academic institutions have been working on an ownCloud based solution as well. Based on ownCloud enterprise Version 6 the service is currently in test operation with campus wide availability for staff only planned for 12/2014. Major concerns were the scalability of the storage backend. So instead of using an enterprise storage solution we use Scality’s RING as backend. The RING is an object storage based solution using local storage nodes. Since the ownCloud architecture does so far not allow a RESTbased storage backend we use Scality’s FUSE connector to simulate a virtually limitless filesystem (POSIX). Based on the experiences reported by other academic facilities and our own, our main concerns have been database performance-scal...

  19. Customer Satisfaction Survey With Clinical Laboratory and Phlebotomy Services at a Tertiary Care Unit Level

    National Research Council Canada - National Science Library

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-01-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate...

  20. Patients' experience of Chinese Medicine Primary Care Services: Implications on Improving Coordination and Continuity of Care.

    Science.gov (United States)

    Chung, Vincent Ch; Yip, Benjamin Hk; Griffiths, Sian M; Yu, Ellen Lm; Liu, Siya; Ho, Robin St; Wu, Xinyin; Leung, Albert Wn; Sit, Regina Ws; Wu, Justin Cy; Wong, Samuel Ys

    2015-12-21

    Chinese medicine (CM) is major form of traditional and complementary medicine used by Chinese populations. Evaluation on patients' experience on CM service is essential for improving service quality. This cross sectional study aims (i) to assess how CM clinics with different administrative model differ in terms of quality from patients' perspective; and (ii) to investigate how quality varies with patients' demographic and health characteristics. Five hundred and sixteen patients were sampled from charity and semi-public CM clinics in Hong Kong, and were invited to assess their experience using the Primary Care Assessment Tool (PCAT). Results indicated that overall mean PCAT scoring is satisfactory, achieving 70.7% (91.26/129) of total score. Ratings were lower in areas of "coordination of patient information", "continuity of care", and "range of service provided". Impact of administrative models, including involvement of tax-funded healthcare system and outreach delivery, were minimal after adjusting for patient characteristics. Demographic and health characteristics of patients did not contribute to substantial variations in scoring. To improve patient experience, policy makers should consider strengthening care coordination, continuity and comprehensiveness in CM primary care services. Sharing of electronic records and establishing referral system are potential solutions for linking CM and conventional healthcare services.

  1. Status of maternal care and immunisation services in a hilly state of north India: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Anupam Parashar

    2016-08-01

    Conclusions: Overall, the utilisation of maternal health services and immunisation against maternal and neonatal Tetanus are excellent in the state. The coverage targets for key RMNCH and A, an interventions have been well achieved in the state. Further, sustained efforts with Supportive Supervision are required to achieve 100% universal coverage of immunisation and full utilisation of maternal health care services. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2607-2611

  2. A Hong Kong University first: Establishing service-learning as an academic credit-bearing subject

    Directory of Open Access Journals (Sweden)

    Carol Ma

    2013-10-01

    Full Text Available Service-learning, where university students are trained to serve or educate the less able for a defined number of voluntary work hours and where the service experience is relevant to the course into which the service is integrated, can be an effective means of community engagement. Many universities in the US have factored in a term for credit-bearing service-learning courses, so that students are oriented to developing a service mentality and nurturing a ‘giving culture’ on campus. In the Asia Pacific region, Lingnan University, with its liberal arts ethos, is the first university in Hong Kong to use service-learning as a vehicle for knowledge transfer between university and community. The first service-learning program was offered by the Faculty of Social Sciences in 2004 as an optional learning experience, and the university is now moving towards making service-learning a graduation requirement that bears academic credits. Service-learning is currently integrated in the majority of disciplines of the university, as part of the undergraduate program. In addition to detailing the history, development and operation of the service-learning program, this article discusses the lessons learned in the institutionalisation of service-learning, as well as the way forward for service-learning in higher education in Hong Kong. Keywords: service-learning, knowledge transfer, whole-person education, experiential education, higher education, campus-community partnerships

  3. Emergency Medical Services Capacity for Prehospital Stroke Care

    Centers for Disease Control (CDC) Podcasts

    2013-09-05

    In this audio podcast, lead author and Preventing Chronic Disease’s 2013 Student Research Contest Winner, Mehul D. Patel, talks about his article on stroke care and emergency medical services.  Created: 9/5/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/5/2013.

  4. Value-added service in health care institutions.

    Science.gov (United States)

    Umiker, W

    1996-12-01

    In today's highly competitive atmosphere, the survival of health care institutions depends largely on the ability to provide value-added services (VAS) at the lowest possible cost. Managers must identify their customers and delineate the needs and expectation of those customers. A strategy for satisfying these needs and expectations is essential. While technical advances and reasonable charges are important, a successful "high-tech," "high touch" approach demands the combination of process reengineering and employee training in customer relations.

  5. Tracking the route to sustainability: a service evaluation tool for an advance care planning model developed for community palliative care services.

    Science.gov (United States)

    Blackford, Jeanine; Street, Annette

    2012-08-01

    The study aim was to develop a service evaluation tool for an advance care planning model implemented in community palliative care. Internationally, advance care planning programmes usually measure success by completion rate of advance directives or plans. This outcome measure provides little information to assist nurse managers to embed advance care planning into usual care and measure their performance and quality over time. An evaluation tool was developed to address this need in Australian community palliative care services. Multisite action research approach. Three community palliative care services located in Victoria, Australia, participated. Qualitative and quantitative data collection strategies were used to develop the Advance Care Planning-Service Evaluation Tool. The Advance Care Planning-Service Evaluation Tool identified advance care planning progress over time across three stages of Establishment, Consolidation and Sustainability within previously established Model domains of governance, documentation, practice, education, quality improvement and community engagement. The tool was used by nurses either as a peer-assessment or self-assessment tool that assisted services to track their implementation progress as well as plan further change strategies. The Advance Care Planning-Service Evaluation Tool was useful to nurse managers in community palliative care. It provided a clear outline of service progress, level of achievement and provided clear direction for planning future changes. The Advance Care Planning-Service Evaluation Tool enables nurses in community palliative care to monitor, evaluate and plan quality improvement of their advance care planning model to improve end-of-life care. As the tool describes generic healthcare processes, there is potential transferability of the tool to other types of services. © 2012 Blackwell Publishing Ltd.

  6. Identifying profiles of service users in housing services and exploring their quality of life and care needs

    NARCIS (Netherlands)

    Bitter, N.A.; Roeg, D.P.K.; Van Nieuwenhuizen, Ch.; Van Weeghel, J.

    2016-01-01

    Background Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not

  7. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

    Directory of Open Access Journals (Sweden)

    Naoki Ikegami

    2016-05-01

    Full Text Available When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs.

  8. Exploration of Counsellors' Perceptions of the Redesigned Service Pathways: A Qualitative Study of a UK University Student Counselling Service

    Science.gov (United States)

    Randall, Eve M.; Bewick, Bridgette M.

    2016-01-01

    To address the mental health needs of students, UK universities offer bespoke student counselling services. Economic pressures have led services to find innovative ways of redesigning their service pathway. Few studies have investigated staff perceptions of these changes. The aim of this study was to investigate perceptions of staff employed as…

  9. Surgical care in the Solomon Islands: a road map for universal surgical care delivery.

    Science.gov (United States)

    Natuzzi, Eileen S; Kushner, Adam; Jagilly, Rooney; Pickacha, Douglas; Agiomea, Kaeni; Hou, Levi; Houasia, Patrick; Hendricks, Phillip L; Ba'erodo, Dudley

    2011-06-01

    Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized to the National Referral Hospital (NRH) on Guadalcanal, leaving a void of care in the provinces where more than 80% of the people live. To assess the ability to provide surgical care to the people living on outer islands in the Solomon Islands, the provincial hospitals were evaluated using the World Health Organization's Global Initiative for Emergency and Essential Surgical Care Needs Assessment Tool questionnaire. Data on infrastructure, workforce, and equipment available for treating surgical disease was collected at each provincial hospital visited. Surgical services are centralized to the NRH on Guadalcanal in Solomon Islands. Two provincial hospitals provide surgical care when a surgeon is available. Six of the hospitals evaluated provide only very basic surgical procedures. Infrastructure problems exist at every hospital including lack of running water, electricity, adequate diagnostic equipment, and surgical supplies. The number of surgeons and obstetricians employed by the Ministry of Health is currently inadequate for delivering care at the outer island hospitals. Shortages in the surgical workforce can be resolved in Solomon Islands with focused training of new graduates. Training surgeons locally, in the Pacific region, can minimize the "brain drain." Redistribution of surgeons and obstetricians to the provincial hospitals can be accomplished by creating supportive connections between these hospitals, the NRH, and international medical institutions.

  10. Health care financing in Nigeria: Implications for achieving universal health coverage.

    Science.gov (United States)

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

  11. Cancer patients, emergencies service and provision of palliative care

    Directory of Open Access Journals (Sweden)

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  12. ED services: the impact of caring behaviors on patient loyalty.

    Science.gov (United States)

    Liu, Sandra S; Franz, David; Allen, Monette; Chang, En-Chung; Janowiak, Dana; Mayne, Patricia; White, Ruth

    2010-09-01

    This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. Research assistants from Purdue University (West Lafayette, IN) conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites. The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 (did not occur) to 5 (high intensity). The observation included additional information, for example, caregiver roles, timing, and type of visit. Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend (loyalty) questions, patient perceptions of care, and demographic information. Common themes across all study sites emerged, including (1) the area that patients considered most important to an ED experience (prompt attention to their needs upon arrival to the emergency department); (2) the area that patients rated as least positive in their actual ED experience (prompt attention to their needs upon arrival to the emergency department); (3) caring behaviors that significantly affected patient loyalty (eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient); and (4) the impact of wait time to see a caregiver on patient loyalty. A number of correlations between caring behaviors and patient loyalty were statistically significant (P loyalty but that occurred least frequently. The study showed through factor analysis that some caring

  13. Comparative analysis of the expected demands for nursing care services among older people from urban, rural, and institutional environments

    Directory of Open Access Journals (Sweden)

    Borowiak E

    2015-02-01

    Full Text Available Ewa Borowiak,1,2,* Joanna Kostka,3,* Tomasz Kostka1 1Department of Geriatrics, Medical University of Lodz, Poland; 2Institute of Nursing, Medical University of Lodz, Poland; 3Department of Physical Medicine, Medical University of Lodz, Poland *These authors contributed equally to this work Background: Demand for nursing and social services may vary depending on the socio-demographic variables, health status, receipt of formal and informal care provided, and place of residence. Objectives: To conduct a comparative analysis of the expectations of older people from urban, rural, and institutional environments concerning nursing care with respect to the care provided and elements of a comprehensive geriatric assessment. Material and methods: The study comprised 2,627 individuals above the age of 65 years living in urban (n=935 and rural (n=812 areas as well as nursing homes (n=880. Results: Family care was most often expected both in urban (56.6% and rural (54.7% environments, followed by care provided simultaneously by a family and nurse (urban – 18.8%; rural – 26.1% and realized only by a nurse (urban – 24.6%; rural – 19.2%. Not surprisingly, nursing home residents most commonly expected nursing care (57.5% but 33.1% preferred care provided by family or friends and neighbors. In the whole cohort of people living in the home environment (n=1,718, those living with family demonstrated willingness to use primarily care implemented by the family (62.0%, while respondents living alone more often expected nursing services (30.3%. In the logistic regression model, among the respondents living in the city, only the form of care already received determined the expectations for nursing care. Among the respondents living in the county, the presence of musculoskeletal disorders, better nutritional status, and current care provided by family decreased expectations for nursing care. Higher cognitive functioning, symptoms of depression, and living alone

  14. Effects of health-care services and commodities cost on the patients ...

    African Journals Online (AJOL)

    Effects of health-care services and commodities cost on the patients at the primary ... the monthly income of the clients and the experience of financial stress and a ... Commodities, National Health Act, primary health care, regulation, services ...

  15. Utilization of Routine Primary Care Services Among Dancers.

    Science.gov (United States)

    Alimena, Stephanie; Air, Mary E; Gribbin, Caitlin; Manejias, Elizabeth

    2016-01-01

    This study examines the current utilization of primary and preventive health care services among dancers in order to assess their self-reported primary care needs. Participants were 37 dancers from a variety of dance backgrounds who presented for a free dancer health screening in a large US metropolitan area (30 females, 7 males; mean age: 27.5 ± 7.4 years; age range: 19 to 49 years; mean years of professional dancing: 6.4 ± 5.4 years). Dancers were screened for use of primary care, mental health, and women's health resources using the Health Screen for Professional Dancers developed by the Task Force on Dancer Health. Most dancers had health insurance (62.2%), but within the last 2 years, only approximately half of them (54.1%) reported having a physical examination by a physician. Within the last year, 54.1% of dancers had had a dental check-up, and 56.7% of female dancers received gynecologic care. Thirty percent of female participants indicated irregular menstrual cycles, 16.7% had never been to a gynecologist, and 16.7% were taking birth control. Utilization of calcium and vitamin D supplementation was 27.0% and 29.7%, respectively, and 73.0% were interested in nutritional counseling. A high rate of psychological fatigue and sleep deprivation was found (35.1%), along with a concomitant high rate of self-reported need for mental health counseling (29.7%). Cigarette and recreational drug use was low (5.4% and 5.4%); however, 32.4% engaged in binge drinking within the last year (based on the CDC definition). These findings indicate that dancers infrequently access primary care services, despite high self-reported need for nutritional, mental, and menstrual health counseling and treatment. More studies are warranted to understand dancers' primary health care seeking behavior.

  16. Nigerian university libraries and the challenges of users’ service demands in the 21st Century: what university administrators should know

    Directory of Open Access Journals (Sweden)

    Amanze O. Unagha

    2009-01-01

    Full Text Available The article focuses on the challenges facing Nigerian university libraries in meeting users’ service demands in the 21stcentury and the role of university administrators in assisting them in this regard. It identifies these challenges as non-application of technology to service delivery, increase in student intake with its attendant effect on the available limited resources, inefficient reference service, and competition from other service providers. The article recommends amongst others that knowledge and application of technology in service delivery in libraries is unavoidable in this century, quality service delivery in terms of selection and acquisition of appropriate materials should not be taken lightly, knowledge of human beings and human relationship is important, especially in reference service, library user education should be undertaken by library staff, staff training should be a continuous exercise, and university libraries should transform themselves into one-stop shopping centres for all information retrievals in the face of competition. The article concludes with lessons for Nigerian university administrators and advises that the administrators should fund the university libraries adequately and allow the university librarians to administer the fund without undue interference.

  17. Social Welfare Evaluation of Electric Universal Service in China: From the Perspective of Sustainability

    OpenAIRE

    Huiru Zhao; Sen Guo; Qi Zhang; Chunjie Li

    2014-01-01

    Electric universal service aims to improve the individual living quality in remote and underdeveloped areas, the implementation of which can promote the sustainable development of people’s lives and the local economy to some extent. A social welfare evaluation model of electric universal service was proposed, which was divided into economic and non-economic welfare evaluation models. After the factors influencing the social welfare sense of electric universal service were identified from the ...

  18. Librarianship and Information Education in Mentoury University and its role in Information Service Improvement

    Directory of Open Access Journals (Sweden)

    Mohamed AL-Saleh Nabti

    2006-09-01

    Full Text Available A Study about Librarianship and Information Education and it role in improvement of information service in Mentoury university, it deals librarianship education, and its programs in Mentoury university, Algeria. Then deals the current situation of Mentoury university library, and gives the factors of libraries development in the university.

  19. Postrape care services to minors in Kenya: are the services healing or hurting survivors?

    Science.gov (United States)

    Wangamati, Cynthia Khamala; Combs Thorsen, Viva; Gele, Abdi Ali; Sundby, Johanne

    2016-01-01

    Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors’ rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors’ rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused minors in Kenya require amendment. PMID:27445506

  20. Spatial analysis of elderly access to primary care services

    Directory of Open Access Journals (Sweden)

    Lozano-Gracia Nancy

    2006-05-01

    Full Text Available Abstract Background Admissions for Ambulatory Care Sensitive Conditions (ACSCs are considered preventable admissions, because they are unlikely to occur when good preventive health care is received. Thus, high rates of admissions for ACSCs among the elderly (persons aged 65 or above who qualify for Medicare health insurance are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. Results We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the U.S. in the late 1990s. Using 6,475 natural markets in the mainland U.S. defined by The Health Resources and Services Administration's Primary Care Service Area Project, spatial regression is used to estimate the model, controlling for disease severity using detailed information from Medicare claims files. Our evidence suggests that elderly living in impoverished rural areas or in sprawling suburban places are about equally more likely to be admitted for ACSCs. Greater availability of physicians does not seem to matter, but greater prevalence of non-physician clinicians and international medical graduates, relative to U.S. medical graduates, does seem to reduce ACSC admissions, especially in poor rural areas. Conclusion The relative importance of non-physician clinicians and international medical graduates in providing primary care to the elderly in geographic areas of greatest need can inform the ongoing debate regarding whether there is an impending shortage of physicians in the United States. These findings support other authors who claim that the existing supply of physicians is perhaps adequate, however the distribution of them across

  1. Expectations of Health Care Professionals Regarding the Services

    Directory of Open Access Journals (Sweden)

    Somayeh Hanafi

    2015-10-01

    Full Text Available Background: The provision of accurate and timely drug information to health care professionals is an important mechanism to promote safe and effective drug therapy for patients. World’s Drug and Poison Information Centers (DPICs are mainly affiliated to hospitals, rather rarely with faculties of pharmacy or with faculties of medicine and other related organizations.Methods: Data was collected from a questionnaire which was distributed among 400 health care providers in April 2009. Data were analyzed using SPSS software (version 17.Results: Medical reference books and drug information textbooks (36.7% and expert colleagues (29.7% were the “most commonly” used drug information resources. In addition, 77.8% of respondents “almost never” use DPICs. About 77% of respondents were non- acquainted with these centers’ activities. Five expectations were considered ‘very important’ by respondents: Provide information on IV drugs incompatibilities (74%, Provide drug interaction information (70.1%, Provide new drugs information (56.5%, Education/training of health care professionals regarding rational drug therapy and prevention of medication errors (54.9%, Providing information on dosage forms of drugs available in Iran (53.5%.Conclusion: Being non acquaintance with services of DPIC centers can be considered as the most important reason of not using them. Considering “announcement of availability of drugs in pharmacy” as one of the activities of DPICs, shows that the health care professionals are not acquainted with real services of these centers. It shows an urgent need for culture building activities to introduce them to these centers services.

  2. Patients’ experience of Chinese Medicine Primary Care Services: Implications on Improving Coordination and Continuity of Care

    Science.gov (United States)

    Chung, Vincent CH; Yip, Benjamin HK; Griffiths, Sian M; Yu, Ellen LM; Liu, Siya; Ho, Robin ST; Wu, Xinyin; Leung, Albert WN; Sit, Regina WS; Wu, Justin CY; Wong, Samuel YS

    2015-01-01

    Chinese medicine (CM) is major form of traditional and complementary medicine used by Chinese populations. Evaluation on patients’ experience on CM service is essential for improving service quality. This cross sectional study aims (i) to assess how CM clinics with different administrative model differ in terms of quality from patients’ perspective; and (ii) to investigate how quality varies with patients’ demographic and health characteristics. Five hundred and sixteen patients were sampled from charity and semi-public CM clinics in Hong Kong, and were invited to assess their experience using the Primary Care Assessment Tool (PCAT). Results indicated that overall mean PCAT scoring is satisfactory, achieving 70.7% (91.26/129) of total score. Ratings were lower in areas of “coordination of patient information”, “continuity of care”, and “range of service provided”. Impact of administrative models, including involvement of tax-funded healthcare system and outreach delivery, were minimal after adjusting for patient characteristics. Demographic and health characteristics of patients did not contribute to substantial variations in scoring. To improve patient experience, policy makers should consider strengthening care coordination, continuity and comprehensiveness in CM primary care services. Sharing of electronic records and establishing referral system are potential solutions for linking CM and conventional healthcare services. PMID:26686267

  3. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  4. Dimensions of quality of antenatal care service at Suez, Egypt

    Directory of Open Access Journals (Sweden)

    Hanan Abbas Abdo Abdel Rahman El Gammal

    2014-01-01

    Full Text Available Introduction: The 5 th millennium development goal aims at reducing maternal mortality by 75% by the year 2015. According to the World Health Organization, there was an estimated 358,000 maternal deaths globally in 2008. Developing countries accounted for 99% of these deaths of which three-fifths occurred in Sub-Saharan Africa. In primary health care (PHC, quality of antenatal care is fundamental and critically affects service continuity. Nevertheless, medical research ignores the issue and it is lacking scientific inquiry, particularly in Egypt. Aim of the Study: The aim of the following study is to assess the quality of antenatal care in urban Suez Governorate, Egypt. Materials and Methods: A cross-sectional primary health care center (PHCC based study conducted at five PHCC in urban Suez, Egypt. The total sample size collected from clients, physicians and medical records. Parameters assessed auditing of medical records, assessing provider and pregnant women satisfaction. Results: Nearly 97% of respondents were satisfied about the quality of antenatal care, while provider′s satisfaction was 61% and for file, auditing was 76.5 ° 5.6. Conclusion: The present study shows that client satisfaction, physicians′ satisfaction and auditing of medical record represent an idea about opportunities for improvement.

  5. 42 CFR 418.402 - Individual liability for services that are not considered hospice care.

    Science.gov (United States)

    2010-10-01

    ... considered hospice care. 418.402 Section 418.402 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Coinsurance § 418.402 Individual liability for services that are not considered hospice care. Medicare payment to the...

  6. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Science.gov (United States)

    2011-11-21

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care by Non-VA Providers... methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing payment for other...

  7. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Waivers for the delivery of health care service... for the delivery of health care service. In determining whether to request a waiver for an Exchange... the delivery of health care service: (a) The Exchange Visitor must submit a statement that he or...

  8. [Opinion of medical and nursing students on the autonomy of adolescents in health care services].

    Science.gov (United States)

    Fortes, P A; Kurita, G de P

    1998-12-01

    In an effort to better understand some of the ethical and legal dilemmas that health professionals face in their daily activities, this study identified and analyzed the opinions and expectations of medical and nursing students at the University of São Paulo, Brazil, regarding the autonomy of adolescents in receiving health care services. Over the 1995-1996 period, interviews were done with students in the first and last years of their programs in the School of Medicine and the School of Nursing of the University of São Paulo. The results from the first-year students were compared with those of the final-year students. The interview questions dealt with such issues as providing medical care to adolescents when a parent or guardian was not present, adolescents making their own decisions on health care services, the confidentiality of information that adolescents provide, the circumstances in which that information could be given to parents or guardians, and situations where there were conflicts between the decisions of parents and adolescents. Despite variations among the opinions and expectations of the students, the overall results suggest that most of the medical and nursing students do not accept the concept of "health adulthood" or autonomy for adolescents and that the students instead choose to rely on current legal definitions of adulthood.

  9. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

    Directory of Open Access Journals (Sweden)

    Bath B

    2011-12-01

    Full Text Available Brenna Bath1, Bonnie Janzen21School of Physical Therapy, College of Medicine, University of Saskatchewan, 2Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaPurpose: To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons.Methods: People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding.Results: A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction, negative (ie, lack of detail, time to follow-up, cost and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.Conclusion: The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given

  10. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Burton E

    2013-12-01

    Full Text Available Elissa Burton,1,2 Gill Lewin,1,2 Lindy Clemson,3 Duncan Boldy41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Health and Work Research Unit, The University of Sydney, Sydney, NSW, Australia; 4School of Nursing and Midwifery, Curtin University, Perth, WA, AustraliaBackground: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults.Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention or the structured exercise program currently being used in the service (control. Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability.Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program.Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes

  11. The Impact of Service-Learning Course Characteristics on University Students' Learning Outcomes

    Science.gov (United States)

    Moely, Barbara E.; Ilustre, Vincent

    2014-01-01

    Undergraduate students' reports of their service-learning course experiences and their gains from participation in those courses were investigated with a sample of 250 students at Tulane University. The students completed a survey in which they rated their service-learning courses in terms of three aspects: Value of Service, Focus on Service, and…

  12. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    Science.gov (United States)

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  13. Quality of Prenatal Care Services in Karabuk Community Health Center

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2012-04-01

    Full Text Available The aim of the study was to evaluate the quality and quantity of prenatal care services according to gestastional week in Karabuk Community Health Center (CHC. Methods: In this descriptive study 365 pregnant women was selected as sample among 753 pregnant women registered at Karabuk CHC in 18/01/2011. 93.0% of women in the selected sample has been visited in their homes and the face to face interviews were done. The questionnaire was prepared according to Prenatal Care Management Guidelines (PCMG of Ministry of Health. Findings The number of follow-ups was not complete in 23.7% of 15-24 month, 34.4% of 25-32 month, 52,1% of 33-42 month pregnant women. At least four follow-up visits were completed only in 66,7% of postpartum women. Timing of first visit was after 15th week in 15,6% of women. In follow up visits 62.5% of of women’s height were never measured, in 13,0% the women hearth sound of infants didn’t monitored at least once. Laboratory test numbers were under the level required by PCMG. The delivery conditions weren’t planned in 41,8% of last trimester and postpartum women and training about breastfeeding wasn’t given to 15,5 of the same group. Result In family medicine model in Karabuk CHC developments in number of prenatal follow-up visits were observed, but no substantial improvements were found in quality of prenatal visits. Regular in service trainings shoud be given to family doctors and midwives. The use of prenatal care guideline published by MoH should be increased. Keywords: Prenatal care, pregnancy, timing of first visit, qality of prenatal care [TAF Prev Med Bull 2012; 11(2.000: 153-162

  14. The Israeli Long-Term Care Insurance Law: selected issues in providing home care services to the frail elderly.

    Science.gov (United States)

    Schmid, Hillel

    2005-05-01

    The paper describes and analyses selected issues related to the provision of home care services to frail elderly people following the Israeli Long-Term Care Insurance Law (1988). The goals and principles of the Law, which mandates the provision of home care services to frail elderly people, are presented. The paper also evaluates its contribution toward enhancing the well-being of elderly clients. Several major dilemmas that arose following implementation of the Law are analysed and evaluated in comparison with other countries that have enacted and implemented similar laws. These dilemmas are community vs institutional care; services in kind vs monetary allowances; service provision through contracting out with nongovernmental agencies; unstable and unskilled labour force; and service quality. Finally, policy implications are discussed, mainly in the following areas: investment in human resources as a condition for achieving high service quality, and the need for coordination between the agencies that provide long-term care services to elderly people.

  15. Evaluation of community mental health services: comparison of a primary care mental health team and an extended day hospital service.

    Science.gov (United States)

    Secker, J; Gulliver, P; Peck, E; Robinson, J; Bell, R; Hughes, J

    2001-11-01

    Alongside mental health policies emphasising the need to focus on people experiencing serious, long-term problems, recent general healthcare policy is leading to the development in the UK of a primary care-led National Health Service. While most primary care-led mental health initiatives have focused on supporting general practitioners (GPs) in managing milder depression and anxiety, this article describes an evaluation comparing primary care-based and secondary care-based services for people with serious long-term problems. A survey of service users was carried out at three points in time using three measures: the Camberwell Assessment of Need, the Verona Satisfaction with Services Scales and the Lancashire Quality of Life Profile. Staff views were sought at two time intervals and carers' views were obtained towards the end of the 2-year study period. The results indicate that both services reduced overall needs and the users' need for information. The primary care service also reduced the need for help with psychotic symptoms whereas the secondary care service reduced users' need for help with benefits and occupation. There were no major differences in terms of satisfaction or quality of life. Primary care-based services therefore appear to have the potential to be as effective as more traditional secondary care services. However, a more comprehensive range of services is required to address the whole spectrum of needs, a conclusion supported by the views of staff and carers.

  16. Patients' perceptions of services and preferences for care in amyotrophic lateral sclerosis: A review.

    LENUS (Irish Health Repository)

    Foley, Geraldine

    2012-02-01

    Abstract Service providers and service users often have different perspectives on health and social care services. We have undertaken a systematic review of empirical data between 1988 and March 2011 relating to ALS service users\\' perspectives on health and social care services. Forty-seven texts were extracted and a narrative synthesis conducted. Few studies have explored ALS patients\\' experiences in relation to their satisfaction with services. Our review showed that ALS patients expect dignified care but they are often dissatisfied with health care services and have unmet expectations of their care. Most studies of decision-making and preferences for care have focused on end-of-life intervention. Various factors influence preferences for care from the service user perspective and people with ALS may adjust their use of services as they negotiate change. In conclusion, further research on the timeliness of services to meet changing needs of service users is required. The service user experience of allied health care services prior to end-of-life care also warrants investigation. Service providers need to support people with ALS as they negotiate feelings of acceptance and independence. Research to identify the key parameters of the ALS patient experience of services is required.

  17. Evaluation of health care service quality in Poland with the use of SERVQUAL method at the specialist ambulatory health care center

    Directory of Open Access Journals (Sweden)

    Manulik S

    2016-08-01

    Full Text Available Stanisław Manulik,1 Joanna Rosińczuk,2 Piotr Karniej3 1Non-Public Health Care Institution, “Ambulatory of Cosmonauts” Ltd. Liability Company, 2Department of Nervous System Diseases, Faculty of Health Science, 3Department of Organization and Management, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Introduction: Service quality and customer satisfaction are very important components of competitive advantage in the health care sector. The SERVQUAL method is widely used for assessing the quality expected by patients and the quality of actually provided services.Objectives: The main purpose of this study was to determine if patients from state and private health care facilities differed in terms of their qualitative priorities and assessments of received services.Materials and methods: The study included a total of 412 patients: 211 treated at a state facility and 201 treated at a private facility. Each of the respondents completed a 5-domain, 22-item SERVQUAL questionnaire. The actual quality of health care services in both types of facilities proved significantly lower than expected.Results: All the patients gave the highest scores to the domains constituting the core aspects of health care services. The private facility respondents had the highest expectations with regard to equipment, and the state facility ones regarding contacts with the medical personnel.Conclusion: Health care quality management should be oriented toward comprehensive optimization in all domains, rather than only within the domain identified as the qualitative priority for patients of a given facility. Keywords: health care service quality, patients’ expectations, qualitative priorities, outpatient health care facilities

  18. Frequency of use of the digital services in the library of the university polyclinic “Central Electronuclear”

    Directory of Open Access Journals (Sweden)

    María de los Reyes González Ramos

    2010-08-01

    Full Text Available Background: Information and Communication Technologies (ICT have pushed the evolution of library services and encouraged the development of libraries in the Primary Health Care System in Cuba, with the establishment of digital services. Objective: To determine the frequency of use of the digital services provided by the library of the university polyclinic " Central Electronuclear " in Cienfuegos. Methods: A descriptive study conducted during 2007, including a sample of 141 potential users of the library. The following variables were measured: users categories and use of the different digital services and perception of quality of those services. Results: the category of users who mostly use the digital services proved to be the professionals with 50%. The most commonly used digital services are the health intranet and the e-mail, with 97, 9 and 96%, 5%, in that order. The least used is the online reference, with 85.1%. Conclusions: the digital services of the library of the university polyclinic "Central Electronuclear " reach a high use frequency.

  19. The Patient Protection and Affordable Care Act and Utilization of Preventive Health Care Services

    Directory of Open Access Journals (Sweden)

    Victor Eno

    2016-02-01

    Full Text Available We examined how (a health insurance coverage, and (b familiarity with the Patient Protection and Affordable Care Act (ACA’s or ObamaCare mandate of cost-free access to preventive health services, affect the use of preventive services by residents of a minority community. It was based on primary data collected from a survey conducted during March to April 2012 among a sample of self-identified African American adults in Tallahassee-Leon County area of northwest Florida. The Statistical Package for the Social Sciences (SPSS Version 22 was used for running frequency analysis on the data set and multivariable regression modeling. The results showed that of 524 respondents, 382 (73% had health insurance while 142 (27% lacked insurance. Majority of insured respondents, 332 (87%, used preventive health services. However, the remaining 13% of respondents did not use preventive services because they were unfamiliar with the ACA provision of free access to preventive services for insured people. Regression analysis showed a high (91.04% probability that, among the insured, the use of preventive health services depended on the person’s age, income, and education. For uninsured residents, the lack of health insurance was the key reason for non-use of preventive health services, while among the insured, lack of knowledge about the ACA benefit of free access contributed to non-use of preventive services. Expansion of Medicaid eligibility can increase insurance coverage rates among African Americans and other minority populations. Health promotion and awareness campaigns about the law’s benefits by local and state health departments can enhance the use of preventive services.

  20. ACCREDITATION SERVIC ES FOR PRIVATE DENTA L CARE

    Directory of Open Access Journals (Sweden)

    Rosangela Simonelli Gavi

    2013-05-01

    Full Text Available The scarcity of information on accreditation in the field of dentistry motivated this study,which aimed to develop and test a structured questionnaire to simulate the evaluation foraccreditation in this area. This is a descriptive study with a quantitative approach. Weapplied the methodology of the ONA, level I, plus a structured questionnaire with specificnotes consisting of six sections: leadership and management, patient care, diagnostics,technical support, supplies and logistical support and infrastructure. TheCRO/ESselectedat random, 50 registered professionals for the development of the study.The sampleconsisted of 12 Dental Care Unit Service Providers, for individual persons.Theresultsshow that 100% of dental institutions visited were not accredited at Level I, according tothe Brazilian Accreditation Manual for institutions providing health services published bythe ONA in 2010 and the adjustments proposed by the authors. It isconcluded that thetoolwas adequate to simulate the process of evaluation for level I accreditation of dentalcare services, although adjustments are necessary for its validation

  1. Process of implementing collaborative care and its impacts on the provision of care and rehabilitation services to patients with a moderate or severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Talbot LR

    2014-07-01

    Full Text Available Lise R Talbot,1,2 Annie Lévesque,1 Josée Trottier1 1School of Nursing Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, 2Étienne-Le Bel Clinical Research Centre and the Research Centre on Aging, Sherbrooke, QC, Canada Objective: The introduction of new services in a rehabilitation center is a unique opportunity to introduce a new model of care and services between two institutions. A hospital and a rehabilitation center experienced a clinical management model inspired by an American approach – collaborative care. The purpose of this study was to describe the implementation of this approach and to provide a perception of the quality of care and services provided to patients with moderate or severe traumatic brain injury and to their caregivers. Materials and methods: In this qualitative study, individual semistructured interviews were conducted with patients and their caregivers in the hospital and rehabilitation center where the patients were treated. Individual semistructured interviews were conducted with administrators, and two focus groups were held with clinicians before and after the implementation. Results and conclusion: Ten days’ waiting time were saved with the collaborative approach. Implementing the collaborative care approach has been found to have several benefits, including improved communication, coordination of services between institutions, and better preparation, awareness, and involvement of patients and their families. Administrators, clinicians, patients, and caregivers expressed their opinions on the organization of care and services, the needs and expectations of patients and their caregivers, their participation in terms of roles and responsibilities, their perception of continuity of care, their satisfaction with the care process, and their suggestions for improvements. Keywords: traumatic brain injury, collaborative care, rehabilitation, quality of care

  2. Challenges and perspectives in Service Design curricula. The case of the Service Systems Design Master of Aalborg University in Copenhagen

    DEFF Research Database (Denmark)

    Götzen, Amalia De; Morelli, Nicola; Grani, Francesco

    2014-01-01

    In this paper the new Master program on Service Systems Design at Aalborg University in Copenhagen will be presented, focusing on the challenges of building such a curriculum and on its peculiar approach to Service Design through the Problem Based Learning methodology. All the semesters will be d......In this paper the new Master program on Service Systems Design at Aalborg University in Copenhagen will be presented, focusing on the challenges of building such a curriculum and on its peculiar approach to Service Design through the Problem Based Learning methodology. All the semesters...

  3. 77 FR 45717 - Proposed Information Collection (Food Service and Nutritional Care Analysis) Activity; Comment...

    Science.gov (United States)

    2012-08-01

    ... to determine patients' satisfaction with the quality of food and nutrition services. DATES: Written... level of patient satisfaction and quality of service resulting from advanced food preparation and... Information Collection (Food Service and Nutritional Care Analysis) Activity; Comment Request AGENCY:...

  4. University Students' Knowledge of Services and Programs in Relation to Satisfaction: A Case Study of a Private University in Lebanon

    Science.gov (United States)

    Nasser, Ramzi N.; Khoury, Bechara; Abouchedid, Kamal

    2008-01-01

    Purpose: The purpose of this paper is to survey students on their satisfaction with university services and programs in a coeducational Lebanese Catholic higher education institution. The study attempts to relate self-assessed knowledge of the university procedures, rules and regulations on six dimensions of satisfaction, being: academic…

  5. A Model for Assessing the Service Quality of University Library Websites

    Directory of Open Access Journals (Sweden)

    Chung-Min Wu

    2013-01-01

    Full Text Available Evaluating the e-service quality is essential to organizations. The future of e-libraries has a vital place in universities. Libraries need to use websites as means to provide access to information resources, news and events. The importance of assessing e-service quality of libraries is significant. Previous researchers have developed many methods for assessing e-service quality. However, most of them only focus on the independent hierarchical structure. In this paper, we would like to figure out the criteria for assessing the service quality of library websites from university students’ viewpoints. According to interdependent criteria, the analytic network process (ANP approach is employed to (i generate the priority weights of each criterion; (ii measure the service quality of university library websites. 12 web-based service criteria are identified according to 3144 university students’ viewpoints based on fuzzy Delphi method. On the basis of past studies, we divide 12 criteria into 3 perspectives, namely, system, efficiency, and information quality to measure the service quality of university library websites. On the basis of 3 perspectives and 12 important criteria, service quality of university library websites could be measured more effectively. Moreover, the practical application to measure the service quality of the old and new versions of one university library website presented in Section 5 is generic and also suitable to be exploited for Taiwanese universities.

  6. University Branding. An Analysis of University Services Delivered via the Internet

    Directory of Open Access Journals (Sweden)

    Catalin Vrabie

    2015-05-01

    Full Text Available The purpose of this article is to assess how the information can be more easily disseminated on the Web sites of higher education institutions. Marshall McLuhan saw the language developed in a book as a proof in favor of knowledge. “When information comes in contact with another information, the results are sensational and effective”. In terms of talent and how fast they adapt, the youth of today, Generation Net as Don Tapscott calls them, have the power to transform the present. They come up with new approaches on collaboration, sharing information and innovation in business and governance from around the world. There is strong evidence that organizations that embrace these new ways of working are more efficient registering a growth and greater success. We selected for this purpose a number of foreign students on master programs (based on the experience they have already from two prestigious universities Hacettepe in Ankara, Turkey and NUPSPA in Bucharest, Romania, and based on some questions and interviews we set up a strategy for how to improve quality management for university - Web services for students based on their perceptions. We started with the assumption that better e-integration, infrastructure, and Web-services will go to better quality management and from here to better results on intake of international students (with more successful students, research and education of high quality - assuming that internationalization yield increase higher education quality, public benefit, better competition, better access to funds etc. The SWOT analysis will be the centerpiece of our discussions with the students from those two groups – one from Hacettepe and the second one from NUPSPA.

  7. Teaching Medical Students about Quality and Cost of Care at Case Western Reserve University.

    Science.gov (United States)

    Headrick, Linda A.; And Others

    1992-01-01

    At Case Western University (Ohio), medical students critically analyze the quality and cost of asthma care in the community by studying patients in primary care practices. Each writes a case report, listing all medical charges and comparing them with guidelines for asthma care. Several recommendations for improved care have emerged. (MSE)

  8. Use of Health Care Services and Associated Factors among Women.

    Directory of Open Access Journals (Sweden)

    Nader Esmailnasab

    2014-01-01

    Full Text Available To estimate the prevalence and analyze factors associated with both public and private health services utilization in women population in a western district of Iran.A cross-sectional study with 1200 individuals aged 18-49 years carried out in different districts of Sanandaj City, western Iran, in 2012. The main outcome variable was use of health service in the previous 12 months. The in-dependent variables were age, education level, place of residence, marital and pregnancy status, household wealth, oc-cupation and duration time of employment, and rating of quality of health services.The prevalence of public and private health services utilization were 60.8% [95%CI: 57.8, 63.8] and 53.8% [95%CI: 50.8%, 56.8%], respectively (P=0.001. After controlling other investigated factors using logistic regression; the academic educational level (OR=1.36, 95%CI: 1.03, 1.80; OR=1.76, 95%CI: 1.33, 2.33, residents of urban (OR=1.65, 95%CI: 1.10, 2.47; OR=1.60, 95%CI: 1.10, 2.42, pregnancy status (OR=2.38, 95%CI: 1.60, 3.55; OR=2.36, 95%CI: 1.61, 3.47, and high level of quality of health services (OR=1.61, 95%CI: 1.15, 2.27; OR=1.70, 95%CI: 1.20, 2.40 were found to be predictors of utilization of both public and private health care respectively. There was also statistically relation between high level of household wealth (OR=3.01, 95% CI: 2.00, 4.57 and private health services utilization.Prevalence of health services utilization varied according to the individual and social factors of popula-tion studied. Present study emphasizes the need to develop care models that focus on the characteristics and demands of the subjects.

  9. Impact of a major hurricane on surgical services in a university hospital.

    Science.gov (United States)

    Norcross, E D; Elliott, B M; Adams, D B; Crawford, F A

    1993-01-01

    Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on September 17, hurricane damage by high winds and an 8.7-foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigeration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of temperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include: 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support.

  10. Japan's universal long-term care system reform of 2005: containing costs and realizing a vision.

    Science.gov (United States)

    Tsutsui, Takako; Muramatsu, Naoko

    2007-09-01

    Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. This article describes the recent reform initiated by the Japanese government to simultaneously contain costs and realize a long-term vision of creating a community-based, prevention-oriented long-term care system. The reform involves introduction of two major elements: "hotel" and meal charges for nursing home residents and new preventive benefits. They were intended to reduce economic incentives for institutionalization, dampen provider-induced demand, and prevent seniors from being dependent by intervening while their need levels are still low. The ongoing LTCI reform should be critically evaluated against the government's policy intentions as well as its effect on seniors, their families, and society. The story of this reform is instructive for other countries striving to develop coherent, politically acceptable long-term care policies.

  11. Ventilator withdrawal: procedures and outcomes. Report of a collaboration between a critical care division and a palliative care service.

    Science.gov (United States)

    O'Mahony, Sean; McHugh, Marlene; Zallman, Leah; Selwyn, Peter

    2003-10-01

    To describe an institutional procedure for ventilator withdrawal and to analyze patient responses to terminal extubation, the medical records of 21 patients who underwent withdrawal of mechanical ventilation according to the process followed by an interdisciplinary palliative care team were retrospectively reviewed. The cohort was a convenience sample of sequentially treated patients in a 1048-bed urban university-affiliated medical center. Sixteen of the 21 patients were on medical or surgical floors and five patients were in critical care units. Patients were assessed for discomfort, such as dyspnea, agitation, or anxiety. Sedative and analgesic medications were administered based on clinical parameters. Palliative care clinician observations of patient reports, tachypnea,use of accessory muscles, and signs of discomfort such as agitation or anxiety were recorded for the first 4 hours after extubation. Medication use and length of survival were recorded. Fifty-seven percent were symptomatic during the extubation process and required administration of either a benzodiazepine or opioid medication. The median survival of the 18 patients who died post-extubation was 0.83 hours (interquartile range 0.5-43.8). Bolus doses of opioid or benzodiazepine medications were effective for management of symptoms in about two-thirds of patients. One-third of patients required continuous infusions. Eighteen patients died following extubation in the medical center, and three of these patients were transferred to an inpatient hospice unit. Three patients (14%) survived to discharge from the hospital. The procedure followed provides a foundation for collaboration between palliative care and critical care services to ensure continuity of care across clinical settings/units.

  12. Determining service variations between and within ASAM levels of care.

    Science.gov (United States)

    Levine, Helen J; Turner, Winston; Reif, Sharon; Janas, Donna; Gastfriend, David R

    2003-01-01

    The American Society of Addiction Medicine (ASAM) Criteria Validity Study at Massachusetts General Hospital and Harvard Medical School randomized patients between programs in two levels of care. It therefore became critical to determine the extent to which programs met ASAM level of care (LOC) descriptions. Quantitative surveys (checklist) and qualitative case studies (field observation, key informant interviews) documented care variation within and between two ASAM LOCs in 12 substance abuse treatment units. These LOCs were: Level II (Intensive Outpatient Treatment) and Level III (Medically Monitored Residential Treatment). The Level II and Level III programs, as a group, met ASAM LOC criteria, but data showed major within-level variation by hours per day and number and type of skilled treatment services. Observational data suggest considerable within-level variation due to managed care and staff training. In multi-site PPC validity studies, it will be crucial to examine within-LOC variation and take into account payment sources and staff training when assessing patient outcomes.

  13. Universal Health Coverage through Community Nursing Services: China vs. Hong Kong.

    Science.gov (United States)

    Chan, Wai Yee; Fung, Ita M; Chan, Eric

    2017-01-30

    this article looks at how the development of community nursing services in China and Hong Kong can enhance universal health coverage. literature and data review have been utilized in this study. nursing services have evolved much since the beginning of the nursing profession. The development of community nursing services has expanded the scope of nursing services to those in need of, not just hospital-level nursing care, but more holistic care to improve health and quality of life. despite the one-country-two-systems governance and the difference in population and geography, Hong Kong and China both face the aging population and its complications. Community nursing services help to pave the road to Universal Health Coverage. este artigo analisa a forma como o desenvolvimento de serviços de enfermagem comunitários na China e Hong Kong pode melhorar a cobertura universal de saúde. literatura e revisão de dados foram utilizados neste estudo. serviços de enfermagem têm evoluído muito desde o início da profissão de enfermagem. O desenvolvimento dos serviços de enfermagem da comunidade ampliou o escopo dos serviços de enfermagem, para aqueles que precisam não apenas de cuidados de enfermagem de nível de hospital, mas cuidados mais holísticos para melhorar a saúde e qualidade de vida. apesar de ser "um-país-dois-sistemas" de governo, e as diferenças de população e geografia, Hong Kong e China enfrentam o envelhecimento da população e suas complicações. Os serviços de enfermagem da comunidade ajudam a pavimentar o caminho para a cobertura de saúde universal. este artículo analiza cómo el desarrollo de los servicios de enfermería comunitaria en China y Hong Kong pueden expandir la cobertura universal de salud. revisión de datos y literatura han sido utilizados en este estudio. los servicios de enfermería han evolucionado mucho desde el comienzo de la profesión. El desarrollo de los servicios de enfermería comunitaria han ampliado el alcance

  14. 75 FR 48235 - Rural Health Care Universal Service Support Mechanism

    Science.gov (United States)

    2010-08-09

    ... Commission's Electronic Comment Filing System (ECFS), (2) the Federal Government's eRulemaking Portal, or (3... telemedicine applications, are ineligible. Program administration or technical coordination, except for those... other network operations); Web server hosting; and Website portal development. Telemedicine...

  15. Planning the Marketing Activity in the Health Care Services

    Directory of Open Access Journals (Sweden)

    Violeta Radulescu

    2008-06-01

    Full Text Available The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access of population to basic services, etc.The formulation of the marketing strategies, in the marketing planning process, starts from the generic strategy chosen by the organization according to its mission and objectives. As it has to adapt to the environment where it acts, to cope with the changes that appear, the organization must benefit from a perspective vision, all its actions must be subordinated to this vision in a whole marketing policy.

  16. Experiences with provision of post-abortion care in a university teaching hospital in south-east Nigeria: a five year review.

    Science.gov (United States)

    Kalu, Collins A; Umeora, O U J; Sunday-Adeoye, I

    2012-03-01

    The objective of the study was to review the implementation of Post Abortion Care and effective linkage to other post abortion services in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. Data on PAC over a five year period (July, 2004 to June, 2009) were analyzed and a standardized questionnaire was administered to 45 direct PAC service providers. Abortion complications constituted 41.4% of all Gynaecological admissions. Maternal mortality from complications of abortion was 11.5% of all the maternal mortality at the centre. Women aged 19 years and less were 37 (7.1%) and single women were 132, constituting 25.3% of all cases. About 31% of the PAC care providers had formal training for the implementation of the PAC services. Fifteen percent of the care givers were satisfied with the linkage between PAC and the Family Planning services. There is poor integration between emergency post abortion care and other reproductive health services in the centre.

  17. Self-care of patients with diabetes mellitus cared for at an emergency service in Mexico.

    Science.gov (United States)

    Baquedano, Irasema Romero; dos Santos, Manoel Antônio; Martins, Tatiane Aparecida; Zanetti, Maria Lúcia

    2010-01-01

    This study examines the self-care ability of type 2 diabetes mellitus patients and relates it to sociodemographic and clinical variables. The study included 251 patients who were cared for by an emergency service in Mexico, in 2007. Data were obtained through structured interviews held at participants' households, through a form, a questionnaire and the Self-Care Ability Scale. Descriptive and correlation statistics were used for data analysis. The results show that 83 (33.5%) individuals displayed good self-care ability and 168 (66.5%) individuals displayed regular ability. A directly proportional correlation was found between self-care ability and schooling (r=0.124; preligion (rs=-0.435; p<0.05) and duration of disease evolution (r=-0.667; p<0.05). The conclusion is that most of the individuals with type 2 diabetes mellitus displayed regular ability for self-care. Self-care ability is related to multiple variables that should be taken into account by health professionals when suggesting educational programs.

  18. Access to Maternal Health Care Services in the Cape Coast Metropolitan Area, Ghana

    Directory of Open Access Journals (Sweden)

    D. Adei

    2012-02-01

    Full Text Available Maternal mortality can be prevented if mothers had routine obstetric care and access to emergency obstetric services. However, in accessing healthcare most expecting mothers will have to struggle with distance and financial problems. The study sought to; assess the barriers that discourage women from accessing antenatal, delivery and postnatal services in the Cape coast Metropolis and give recommendations to inform policy. Questionnaire was administered to 150 pregnant women and nursing mothers with babies less than one year from ten communities in the Cape Coast Metropolis. An institutional questionnaire was administered at the University of Cape Coast Hospital which provides health care services to the communities. The study revealed that challenges such as money (16.7%, distance (15.4%, and the behaviour of health personnel (20% were the dominant barriers to accessing antenatal, delivery and post natal services in the Cape Cost Metropolis. These barriers lead to the inability of 14% of pregnant women and nursing mothers with babies less than one year to adhere to the minimum antenatal visitation number of 5 recommended by the Royal College of Obstetricians and Gynaecologists. Again 15.3% of these respondents were delivered by Traditional Birth Attendants and family members, whiles 5.8% were unable to adhere to the minimum postnatal visitation of two times. NGO’s and government organizations for women should organize training programmes aimed at improving the livelihood or employment for women in these communities.

  19. Research on the cultivation path of smart home-based care service mode in Internet+ vision

    Directory of Open Access Journals (Sweden)

    Peng Qingchao

    2016-01-01

    Full Text Available Home-based care for the aged is an effective method to solve the problem of caring the aged in China. This thesis analyzes some problems existing in the development of current home-based care service for the aged in our country and the positive effects brought by Internet+ in home-based care service. It proposes a new service mode of care for the aged--Internet+ home-based care service, and explains the establishment of this system and the responsibilities of the participants. Also, it explores the path to realize the establishment of Internet+ home-based care service mode so as to promote the healthy development of home-based care service in China.

  20. E-Resources, Services and User Surveys in Tsinghua University Library

    Science.gov (United States)

    Min, Shao; Yi, Yang

    2010-01-01

    Purpose: The paper aims to provide an overview of the e-resources and services in Tsinghua University Library, Beijing, and describe five campus-wide user surveys. It states how these user surveys play an important role in service quality enhancement. Design/methodology/approach: Following a brief history of Tsinghua University Library, a summary…

  1. Perceptions of International Students on Service Quality Delivery in a Malaysian Public University

    Science.gov (United States)

    Njie, Baboucarr; Asimiran, Soaib; Baki, Roselan

    2012-01-01

    Purpose: The purpose of this study is to explore the perceptions of international students of service quality delivery (SQD) in a Malaysian public university. Design/methodology/approach: The study was limited to the University's immediate physical environment and its associated human and systems-based services. The physical environment in this…

  2. 47 CFR 54.701 - Administrator of universal service support mechanisms.

    Science.gov (United States)

    2010-10-01

    ... mechanisms. 54.701 Section 54.701 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON... support mechanisms. (a) The Universal Service Administrative Company is appointed the permanent Administrator of the federal universal service support mechanisms, subject to a review after one year by...

  3. Rethinking Universal Service for a Next Generation Network Environment. OECD Digital Economy Papers, No. 113

    Science.gov (United States)

    Xavier, Patrick

    2006-01-01

    There is a clear need, in view of significant competitive, technological and service changes taking place in the telecommunications sector, to review universal service obligations, their coverage, how they are financed and who is responsible for providing them. In many OECD countries, a primary longer term issue is how to provide universal service…

  4. Expectations versus Realities of Higher Education: Gap Analysis and University Service Examination

    Science.gov (United States)

    Yooyen, Ayooth; Pirani, Mohammed; Mujtaba, Bahaudin G.

    2011-01-01

    The university education providers are waking to student recruitment challenges, competition, and the realities of marketing. With these changes, a related and equally important issue has emerged; that is, the student service quality and evaluating of the educational encounter. Using university services as the primary study setting, the study…

  5. Perceptions of International Students on Service Quality Delivery in a Malaysian Public University

    Science.gov (United States)

    Njie, Baboucarr; Asimiran, Soaib; Baki, Roselan

    2012-01-01

    Purpose: The purpose of this study is to explore the perceptions of international students of service quality delivery (SQD) in a Malaysian public university. Design/methodology/approach: The study was limited to the University's immediate physical environment and its associated human and systems-based services. The physical environment in this…

  6. From apartheid to integration: the role of the Witwatersrand Medical library in health care services in Johannesburg, South Africa.

    Science.gov (United States)

    Myers, G

    1995-01-01

    Adapting to change is always difficult; all the more so when changes in the administrative structure of health care are part of a national political transformation toward democracy. As South Africa moves from apartheid to integration in its health services, the Witwatersrand Medical Library (WML) will have to adopt innovative strategies to cope with increasing demands on its resources by sub-Saharan African medical libraries and with expected decreases in state funding for health and education. WML also will have to address the lack of hospital library services in the Johannesburg region by expanding its academic branches at University of the Witwatersrand Medical School's teaching hospitals to serve both hospital and academic health care staff. This article discusses these challenges in the context of rapidly changing academic health care services in Johannesburg. PMID:7703943

  7. THE SERVICES QUALITY LEVEL ASSESSESMENT IN THE TECHNICAL UNIVERSITY WITH SERVQUAL METHOD APPLYING

    Directory of Open Access Journals (Sweden)

    STASIAK-BETLEJEWSKA, Renata

    2014-12-01

    Full Text Available Contemporary universities services quality level concerns mainly the education efficiency evaluation that results from the learning outcomes realization and innovative features of the teaching programs that differ universities offers. Technical universities attention is focused on ministerial requirements fulfillment which are strictly concentrated on the students skills obtaining in the relation to the employers’ market. The university services quality analysis ignores common expectations of students and candidates for students related to the technical or functional quality, such as university facilities and administrative workers empathy. The aim of this study is to identify the expectations of both students and candidates for studies at technical universities, what allows to identify university services quality level and areas needs improvement in terms of not only the educational services but also technical university facilities. Results show significant importance of the all examined service quality aspects in the context of expectations of candidates and students’ perception. Research findings allow not only to identify the technical university services quality, but also to support the university development within the scientific research process assistance.

  8. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

    Directory of Open Access Journals (Sweden)

    Abiiro Gilbert

    2012-10-01

    Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

  9. The integration of a telemental health service into rural primary medical care.

    Science.gov (United States)

    Davis, G L; Boulger, J G; Hovland, J C; Hoven, N T

    2007-07-01

    Mental health care shortages in rural areas have resulted in the majority of services being offered through primary medical care settings. The authors argue that a paradigm shift must occur so that those in need of mental health care have reasonable, timely access to these services. Changes proposed include integrating mental health services into primary medical care settings, moving away from the traditional view of mental health care services (one therapist, one hour, and one client), and increasing the consultative role of psychologists and other mental health care providers in primary medical care. Characteristics of mental health providers that facilitate effective integration into primary medical care are presented. The results of a needs assessment survey and an example of a telemental health project are described. This project involved brief consultations with patients and their physicians from a shared care model using a broadband internet telecommunications link between a rural clinic and mental health service providers in an urban area.

  10. Satisfaction of students with the reference services at the National and University Library Of Kosova

    OpenAIRE

    Mekolli, Bedrije

    2015-01-01

    Service quality is essential in changing the work culture among the employees and generates their involvement in the services of the library. It should focus on continuous improvement of products and services, with greater employee involvement and an increased emphasis on customer needs. This study explores satisfaction of students with the reference services at the National and University Library of Kosova (NULK). Furthermore, this work investigates students% perceptions of reference service...

  11. Support services for higher degree research students: a survey of three Australian universities

    Science.gov (United States)

    Silva, Pujitha; Woodman, Karen; Taji, Acram; Travelyan, James; Samani, Shamim; Sharda, Hema; Narayanaswamy, Ramesh; Lucey, Anthony; Sahama, Tony; KDV Yarlagadda, Prasad

    2016-09-01

    A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

  12. Challenges and perspectives in Service Design curricula. The case of the Service Systems Design Master of Aalborg University in Copenhagen

    DEFF Research Database (Denmark)

    Götzen, Amalia De; Morelli, Nicola; Grani, Francesco

    2014-01-01

    In this paper the new Master program on Service Systems Design at Aalborg University in Copenhagen will be presented, focusing on the challenges of building such a curriculum and on its peculiar approach to Service Design through the Problem Based Learning methodology. All the semesters...

  13. Bowie State University Student Support Services Admitted Student Survey 1991.

    Science.gov (United States)

    Gill, Wanda E.

    TRIO programs offer support services to students beginning at the 7th grade and continuing through to graduate school. Student Support Services projects provide instruction, tutoring, counseling, learning skills, and writing skills to primarily low income and first generation or disabled college students. Student Support Services projects are…

  14. [Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

    Science.gov (United States)

    Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

    2015-10-01

    The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

  15. [PUBLIC ADMINISTRATION OF PERSONNEL POLICY IN REFORMING OF UKRAINIAN HEALTH CARE SYSTEM USING THE EXAMPLE OF DERMATOVENEREOLOGICAL SERVICE].

    Science.gov (United States)

    Korolenko, V V; Dykun, O P; Isayenko, R M; Remennyk, O I; Avramenko, T P; Stepanenko, V I; Petrova, K I; Volosovets, O P; Lazoryshynets, V V

    2014-01-01

    The health care system, its modernization and optimization are among the most important functions of the modern Ukrainian state. The main goal of the reforms in the field of healthcare is to improve the health of the population, equal and fair access for all to health services of adequate quality. Important place in the health sector reform belongs to optimizing the structure and function of dermatovenereological service. The aim of this work is to address the issue of human resources management of dermatovenereological services during health sector reform in Ukraine, taking into account the real possibility of disengagement dermatovenereological providing care between providers of primary medical care level (general practitioners) and providers of secondary (specialized) and tertiary (high-specialized) medical care (dermatovenerologists and pediatrician dermatovenerologists), and coordinating interaction between these levels. During research has been found, that the major problems of human resources of dermatovenereological service are insufficient staffing and provision of health-care providers;,growth in the number of health workers of retirement age; sectoral and regional disparity of staffing; the problem of improving the skills of medical personnel; regulatory support personnel policy areas and create incentives for staff motivation; problems of rational use of human resources for health care; problems of personnel training for dermatovenereological service. Currently reforming health sector should primarily serve the needs of the population in a fairly effective medical care at all levels, to ensure that there must be sufficient qualitatively trained and motivated health workers. To achieve this goal directed overall work of the Ministry of Health of Uktaine, the National Academy of Medical Sciences of Ukraine, medical universities, regional health authorities, professional medical associations. Therefore Ukrainian dermatovenereological care, in particular

  16. Politics and care: a study of Czech Americans within Leininger's theory of culture care diversity and universality.

    Science.gov (United States)

    Miller, J

    1997-01-01

    The domain of inquiry for this study was the influence of the American political environmental context on professional and generic care patterns, expressions, and meanings of Czech American immigrants. The purpose of the research was to document, describe, interpret, and analyze the diversities and universalities of professional and generic care for this cultural group, to provide culturally congruent care to Czech Americans, and to explicate the role of politics as an influence on care patterns, health, and well being. The researcher's former transcultural ethnonursing study in Prague, Czechoslovakia in 1991 served as a stimulus for this in-depth study on politics and care. Twelve key and twenty general informants were interviewed. Five major themes were identified. The researcher discovered that the capitalist economic market structure of the United States influenced informant lifeways in all dimensions of Leininger's Theory of Culture Care Diversity and Universality, as depicted in the Sunrise Model. Specific care patterns discovered included care as choice, care as responsibility, and care as helping each other. Findings related to professional and generic care supported researcher predictions that generic culture care patterns would be important to immigrants. Provisions for culturally congruent nursing care were articulated based on research findings.

  17. The Role of Universities in Preparing Graduates to Use Software in the Financial Services Workplace

    Science.gov (United States)

    Tickle, Leonie; Kyng, Tim; Wood, Leigh N.

    2014-01-01

    The role of universities in preparing students to use spreadsheet and other technical software in the financial services workplace has been investigated through surveys of university graduates, university academics, and employers. It is found that graduates are less skilled users of software than employers would like, due at least in part to a…

  18. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations...

  19. Product and service design for patient centered diabetes care

    Directory of Open Access Journals (Sweden)

    Soumitri Varadarajan

    2009-11-01

    Full Text Available Design plays a marginal part in the discourse of diabetes care, mainly in visualizing the form and packaging of medical technologies. The authors however have a practice that advocates that design orientated solutions can add much needed dimensions to problems that havetraditionally been the exclusive preserve of expert discourses. This position has for long been a validated and largely accepted approach in design’s engagement withissues in sustainability and development studies. A similar approach in the area of medicine has been constructed bythe authors and marks out a position of advocacy where the designer takes on agency to intervene on behalf of the user community. This position contains a healthy critique of thetraditional approach of product design for manufacture while simultaneously amplifying a desire to intervene and make a substantial improvement in the quality of life ofpeople with diabetes. This article first opens out contemporary diabetes care as a contested domain and then goes on to sketch out the key aspects of a design practice focussed upon delivering positive health outcomes in diabetes care. The specific context of discussion for this article is the practice of teaching in design studios wherestudents of design listen to the voices of people with diabetes and visualize ways for design to provide products and service solutions that transform the lived experiences of people with diabetes.

  20. MEDICAL TOURISTS' EXPECTATIONS WHEN CHOOSING LITHUANIA FOR HEALTH CARE SERVICES

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    Miglė Eleonora Černikovaitė

    2015-07-01

    Full Text Available Purpose – Identify medical expectations of tourists choosing Lithuania as medical tourism country and to make comparative analysis with situation in Thailand. Medical tourism is one of the most promising fields of business in the world. International trade in medical services also has huge economic potential and gradually increasing outcome for the global economy (Bookman & Bookman, 2007. Major medical tourism destinations: Thailand, India, Singapore and Malaysia attracted more than 2.5 million medical travellers (United Nations Economic and Social Commission for Asia and the Pacific, 2008. Lithuania is among the major emerging markets in medical tourism that is increasing every year. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good quality services with affordable prices and location, while people choosing Thailand – mainly is affected by advertising. The main recommendation for attracting medical tourists to Lithuania is to initiate the advertising campaign to the targeted audiences. Design/methodology/approach – The comparative analysis of scientific literature and empirical comparative quantitative research was executed for acquiring the expectations for medical tourists in Lithuania. Findings – Overview of health and medical tourism situation in Lithuania and other emerging markets. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services and other. Comparative empirical analysis of medical tourist expectations in Lithuania and Thailand. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good

  1. Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

    Directory of Open Access Journals (Sweden)

    Ken Russell Coelho

    2011-01-01

    Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

  2. Home and community care services: a major opportunity for preventive health care

    Directory of Open Access Journals (Sweden)

    Lujic Sanja

    2010-05-01

    Full Text Available Abstract Background In Australia, the Home and Community Care (HACC program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive services to those at high risk. Methods We obtained questionnaire data from the 45 and Up Study for 103,041 men and women aged 45 years and over, sampled from the general population of New South Wales, Australia in 2006-2007, and linked this with administrative data about HACC service use. We compared the characteristics of HACC clients and non-clients according to a range of variables from the 45 and Up Study questionnaire, and estimated crude and adjusted relative risks for HACC use with generalized linear models. Results 4,978 (4.8% participants used HACC services in the year prior to completing the questionnaire. Increasing age, female sex, lower pre-tax household income, not having a partner, not being in paid work, Indigenous background and living in a regional or remote location were strongly associated with HACC use. Overseas-born people and those speaking languages other than English at home were significantly less likely to use HACC services. People who were underweight, obese, sedentary, who reported falling in the past year, who were current smokers, or who ate little fruit or vegetables were significantly more likely to use HACC services. HACC service use increased with decreasing levels of physical functioning, higher levels of psychological distress, and poorer self-ratings of health, eyesight and memory. HACC clients were more likely to report chronic health conditions, in particular diabetes, stroke, Parkinson's disease, anxiety and depression, cancer, heart attack or angina, blood clotting problems, asthma and osteoarthritis

  3. Structuring a palliative care service in Brazil: experience report.

    Science.gov (United States)

    Garcia, João Batista Santos; Rodrigues, Rayssa Fiterman; Lima, Sara Fiterman

    2014-01-01

    in Brazil, palliative care (PC) is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. the hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. this experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  4. [Structuring a palliative care service in Brazil: experience report].

    Science.gov (United States)

    Garcia, João Batista Santos; Rodrigues, Rayssa Fiterman; Lima, Sara Fiterman

    2014-01-01

    In Brazil, palliative care (PC) is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. The hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. This experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Structuring a palliative care service in Brazil: experience report

    Directory of Open Access Journals (Sweden)

    João Batista Santos Garcia

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: in Brazil, palliative care (PC is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. EXPERIENCE REPORT: the hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. CONCLUSION: this experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals.

  6. Health care demand elasticities by type of service.

    Science.gov (United States)

    Ellis, Randall P; Martins, Bruno; Zhu, Wenjia

    2017-09-01

    We estimate within-year price elasticities of demand for detailed health care services using an instrumental variable strategy, in which individual monthly cost shares are instrumented by employer-year-plan-month average cost shares. A specification using backward myopic prices gives more plausible and stable results than using forward myopic prices. Using 171 million person-months spanning 73 employers from 2008 to 2014, we estimate that the overall demand elasticity by backward myopic consumers is -0.44, with higher elasticities of demand for pharmaceuticals (-0.44), specialists visits (-0.32), MRIs (-0.29) and mental health/substance abuse (-0.26), and lower elasticities for prevention visits (-0.02) and emergency rooms (-0.04). Demand response is lower for children, in larger firms, among hourly waged employees, and for sicker people. Overall the method appears promising for estimating elasticities for highly disaggregated services although the approach does not work well on services that are very expensive or persistent. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. The Implementation of Mental Health Clinical Triage Systems in University Health Services

    Science.gov (United States)

    Rockland-Miller, Harry S.; Eells, Gregory T.

    2006-01-01

    The increase in the level of severity of student psychological difficulties and the growing need for psychological services in higher education settings has placed considerable pressure on college and university mental health services to respond effectively to this demand. One way several of these services have responded has been to implement…

  8. A sensitivity analysis of the Children's Treatment Network trial: a randomized controlled trial of integrated services versus usual care for children with special health care needs

    Directory of Open Access Journals (Sweden)

    Ye C

    2013-09-01

    Full Text Available Chenglin Ye,1,2 Gina Browne,1,3 Joseph Beyene,1 Lehana Thabane1,2 1Department of Clinical Epidemiology and Biostatistics, McMaster University, 2Biostatistcs Unit, St Joseph's Healthcare Hamilton, 3School of Nursing, McMaster University, Hamilton, ON, Canada Background: The value of integrated care through comprehensive, coordinated, and family-centered services has been increasingly recognized for improving health outcomes of children with special health care needs (CSHCN. In a randomized controlled trial (RCT, the integrated care provided through the Children's Treatment Network (CTN was compared with usual care in improving the psychosocial health of target CSHCN. In this paper, we aimed to estimate the effect of CTN care by conducting multiple analyses to handle noncompliance in the trial. Methods: The trial recruited target children in Simcoe County and York Region, ON, Canada. Children were randomized to receive CTN or usual care and were followed for 2 years. The CTN group received integrated services through multiple providers to address their specific needs while the usual care group continued to receive care directed by their parents. The outcome was change in psychosocial quality of life at 2 years. We conducted intention-to-treat, as-treated, per-protocol, and instrumental variable analyses to analyze the outcome. Results: The trial randomized 445 children, with 229 in the intervention group and 216 in the control group. During follow-up, 52% of children in the intervention group did not receive complete CTN care for various reasons. At 2 years, we did not find a significant improvement in psychosocial quality of life among the children receiving CTN care compared with usual care (intention-to-treat mean difference 1.50, 95% confidence interval −1.49 to 4.50; P = 0.32. Other methods of analysis yielded similar results. Conclusion: Although the effect of CTN care was not significant, there was evidence showing benefits of integrated

  9. Contrasting experiences with child health care services by mothers and professional caregivers in transitional housing.

    Science.gov (United States)

    Amen, Maisha M; Pacquiao, Dula F

    2004-07-01

    The study examined experiences of mothers and health care providers with preventive child health care services using qualitative methods at a primary care clinic located in transitional housing for homeless families in an urban community with predominantly Black American residents. Participants were 20 mothers and 4 health care professionals. Three major domains emerged: (a). the infrastructure of the clinic and health care delivery poses barriers to mothers' access and use of services for their children; (b). specialized, biomedical-driven care produces fragmented care delivery not responsive to the comprehensive nature of problems of mothers and their children; and (c). organizational strategies for improving access and use of health care services are directed by health care providers' value orientations. Findings support existence of infrastructural characteristics of the health care system that maintains differential value orientations and power structure, and care delivery processes that are non responsive to racially diverse and poor mothers.

  10. Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services.

    Science.gov (United States)

    Vujicic, Marko; Buchmueller, Thomas; Klein, Rachel

    2016-12-01

    The Affordable Care Act is improving access to and the affordability of a wide range of health care services. While dental care for children is part of the law's essential health benefits and state Medicaid programs must cover it, coverage of dental care for adults is not guaranteed. As a result, even with the recent health insurance expansion, many Americans face financial barriers to receiving dental care that lead to unmet oral health needs. Using data from the 2014 National Health Interview Survey, we analyzed financial barriers to a wide range of health care services. We found that irrespective of age, income level, and type of insurance, more people reported financial barriers to receiving dental care, compared to any other type of health care. We discuss policy options to address financial barriers to dental care, particularly for adults.

  11. Cases from the Osler Medical Service at Johns Hopkins University.

    Science.gov (United States)

    Habas, Allison B; Kim, Yuli; Jefferson, Brian K

    2003-12-01

    A 50-year-old African American woman presented with bilateral lower extremity pain, a history of falls during the past several months, and personality and behavior changes. She had been in good health until approximately 5 months before admission, when she began to fall with increasing frequency, often while going down a flight of stairs. She described these falls as her "legs giving out" and feeling very heavy and unsteady. There was no head trauma or loss of consciousness. Her daughter noticed that her gait had become somewhat unsteady during the last several months. Her family also noted a change in her personality at this time. Previously, she had been a very tidy person who took great care with her appearance, who was working as a customer service representative. However, she had become less social and very withdrawn. She had been observed putting on dirty clothes after showering, as well as eating constantly. The patient denied any fevers, chills, night sweats, headaches, vision changes, or tinnitus. She also denied any rashes, muscle pain, or intolerance to heat or cold. There was no history of seizure disorder or depression. Her past medical history was notable only for hypertension and being a passenger in a motor vehicle crash 1 year before admission. She denied any alcohol, tobacco, or illicit drug use, and had no travel history other than coming to the United States, as she was originally from Trinidad. On physical examination, she was a moderately obese African American woman with a flat affect, psychomotor slowing, and alopecia of the scalp. She was alert and oriented to person, place, and time, but had a score of 26 out of 30 on the Mini-Mental State Examination. She lost points only for recall; she had no difficulty with serial 7s. Her cranial nerves were intact and her speech was fluent, although sparse, and she did not make any paraphasic errors. Her muscle strength was 5/5 in both the upper and lower extremities. Reflexes were 2+ in the upper

  12. The development of postgraduate anaesthesia and intensive care training at the University of the West Indies.

    Science.gov (United States)

    Scarlett, M D; Crawford-Sykes, A; Harding, H E; Chen, D R

    2012-07-01

    The one-year Diploma in Anaesthetics (DA) was the first postgraduate programme offered by the then Faculty of Medicine of The University of the West Indies (UWI). It was instituted in 1966, when the need for trained physician anaesthetists became paramount. Over 200 physicians have been awarded the DA which was discontinued in 1994. The four-year Doctor of Medicine in Anaesthetics [DM (Anaesthetics)] was commenced in 1974 and continues to train most of the region's physician anaesthetists. The majority of the 119 graduates (as of December 2011) are providing invaluable services to the people of the Caribbean. The time has come for the establishment of a regional certifying body, the Caribbean College of Anaesthetists. This college would determine the standards for the training and clinical practice of anaesthetists as perioperative physicians including: the conduct of anaesthesia, critical care, acute and chronic pain management. It would also facilitate continuing medical education and recertification of all practising anaesthetists within the region.

  13. 48 CFR 831.7001-4 - Medical services and hospital care.

    Science.gov (United States)

    2010-10-01

    ... hospital care. 831.7001-4 Section 831.7001-4 Federal Acquisition Regulations System DEPARTMENT OF VETERANS... and Procedures 831.7001-4 Medical services and hospital care. (a) VA may pay the customary student... Government. (b) When the customary student's health fee does not cover medical services or hospital care, but...

  14. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Science.gov (United States)

    2013-05-06

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, this rulemaking will only affect home health and hospice care providers who do...

  15. Performance of private sector health care: implications for universal health coverage.

    Science.gov (United States)

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-06

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole.

  16. Lean implementation in primary care health visiting services in National Health Service UK.

    Science.gov (United States)

    Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K

    2010-10-01

    This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.

  17. Performance Measurement in Social Care Services for Older People

    Directory of Open Access Journals (Sweden)

    Mihaela GHENŢA

    2015-12-01

    Full Text Available Taking into account the current social and economic environment, managers of social organizations are under a constant pressure to get results and to optimize costs with an efficient allocation of resources. Performance management allows measuring the results of public and private organizations which provide social care for the elderly. The potential of social services to respond to current challenges is linked not only to financial resources, but also to the ability of social managers to develop methods, techniques and innovative practices. Since innovation requires change, the providers should promote management practices and structures that favour the expression of new ideas. The article presents the results of a mixed-type research methodology based on qualitative and quantitative methods, such as the in-depth semi-structured interview, focus-group, and questionnaire with public policymakers, as well as with private and public providers of social services for older people. Research was conducted during October – November 2014 and the instruments were developed by the team members. The aim of the research has been to find out the importance of performance and performance measurement among public and private managers of social services for older people, and also from the perspective of policymakers. Conclusions reveal that the managers of social services for elderly should be aware that measurement alone is not sufficient, as long as the information obtained is not used in other decision-making processes like: strategic planning, quality management, budgeting activities, increased productivity. The findings have implications for practitioners, researchers and policymakers.

  18. Cancer preventive services, socioeconomic status, and the Affordable Care Act.

    Science.gov (United States)

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2017-05-01

    Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Using Medicare claims data, this study identified women who were 70 years old or older and had not undergone mammography in the previous 2 years and men and women who were 70 years old or older, were at increased risk for colorectal cancer, and had not undergone colonoscopy in the past 5 years. The receipt of procedures in the 2-year period before the ACA's implementation (2009-2010) and after its implementation (2011 to September 2012) was also identified. Multivariate generalized estimating equation models were used to determine the independent association and county-level quartile of median income and education with the receipt of testing. For mammography, a lower SES quartile was associated with less uptake, but the post-ACA disparities were smaller than those in the pre-ACA period. In addition, mammography rates increased from the pre-ACA period to the post-ACA period in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and, to some extent, income. However, there were no appreciable changes in colonoscopy and SES after implementation of the ACA. The removal of out-of-pocket expenditures may overcome a barrier to the receipt of recommended preventive services, but for colonoscopy, other procedural factors may remain as deterrents. Cancer 2017;123:1585-1589. © 2017 American Cancer Society. © 2017 American Cancer Society.

  19. Technologies for HIV prevention and care: challenges for health services

    Directory of Open Access Journals (Sweden)

    Ivia Maksud

    2015-09-01

    Full Text Available ABSTRACTThis article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP and pre-exposure prophylaxis (PrEP, treatment as prevention (TASP and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  20. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  1. 77 FR 14804 - Advisory Council on Alzheimer's Research, Care, and Services; Request for Nominations

    Science.gov (United States)

    2012-03-13

    ... HUMAN SERVICES Advisory Council on Alzheimer's Research, Care, and Services; Request for Nominations... member of the Advisory Council on Alzheimer's Research, Care, and Services to fill the position of... information (current mailing address, email address, and telephone number) and current curriculum vitae...

  2. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Intermediate care facility (ICF/MR) services. 440....150 Intermediate care facility (ICF/MR) services. (a) “ICF/MR services” means those items and services... level of room and board; (2) The primary purpose of the ICF/MR is to furnish health or rehabilitative...

  3. 45 CFR 98.20 - A child's eligibility for child care services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Eligibility for Services § 98.20 A child's eligibility for child...

  4. Physicians' perceptions about the quality of primary health care services in transitional Albania

    NARCIS (Netherlands)

    Kellici, Neritan; Dibra, Arvin; Mihani, Joana; Kellici, Suela; Burazeri, Genc

    2015-01-01

    AIM: To date, the available information regarding the quality of primary health care services in Albania is scarce. The aim of our study was to assess the quality of primary health care services in Albania based on physicians' perceptions towards the quality of the services provided to the general p

  5. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    Directory of Open Access Journals (Sweden)

    Sekandi Juliet

    2011-03-01

    Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism

  6. Is There Time Enough? Temporal Resources and Service Performance in the Danish Home Care Sector

    DEFF Research Database (Denmark)

    Tufte, Pernille

    2013-01-01

    approaches of analysis. A central focus of analysis is the concept of “additional care services.” The use of the concept reflects different understandings of care. Relying on the logic of standardization, managers articulate additional services as definite items, which could (and should) be left out...... constitutes a challenge to care workers’ own sense and valuation of their work. The article is informed by two theoretical perspectives: standardization of care services and performance of care work in private homes. Empirically, the article examines how care workers perceive the relations between...... of the performance of care work. Care workers do, however, not accept this notion. Relying on their experience of work, they perceive additional services as an ambiguous concept, which recognizes the multiple character of care work. Conclusions are that time scarcity constitutes a pressure on work performance...

  7. Measuring primary care services performance: issues and opportunities from a home care pilot experience in the Tuscan health system.

    Science.gov (United States)

    Cinquini, Lino; Vainieri, Milena

    2008-08-01

    In recent years in Italy, as in other European countries, profound changes have been introduced in health care both at central and regional levels. Most of them were oriented towards a shift from 'hospital-centred' health care to health care based more on primary care services. This transition pursues two objectives: giving more effective responses to citizens' needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. The paper provides the results obtained through the experience of modelling a measurement system for primary care carried out in 2004 and 2005 by some territorial managers and controllers in the Tuscan Health system, and the main issues in measuring primary care services emerging from this pilot experience focused on integrated home care services.

  8. A Child Care Primer, 2000: Key Facts about Child Care and Early Education Services in New York City.

    Science.gov (United States)

    Letts, Kenea; Simpson, Kristen; Torres, Marlyn; Kolben, Nancy

    This Child Care Primer provides a detailed overview of child care funding, supply, and demand in New York City. The Primer utilizes data available from public agencies to create a picture of the availability of child care and early education services. The statistical portrait covers New York City demographics, enrollment in regulated child care…

  9. ALLTALK™- A Windows Phone Messenger With Cross Language Communication For Customer Care Services

    Directory of Open Access Journals (Sweden)

    Akhil Abraham

    2014-05-01

    Full Text Available In day to day life, messengers or chatting applications provide facility for instant messaging over the internet. Exchange of messages takes place in universally used languages like English, French, etc. where both the users know how to communicate in a common language. Thus chatting on mobile phones is a luxury when both the parties involved know a common language. When any company wants to provide customer care services to its customer they use mediums like talking to the customers over the telephone which requires employees that are proficient in speaking various languages and set up large numbers of call centers to serve the customers worldwide. Hence we have implemented ALLTALK™ which is a Windows 8 phone based chatting application which makes cross language communication possible using mobile programming and networking technology. This application will enable the communication between two persons irrespective of the language each user wishes to use individually. The various modes of communication available in this messenger are through text and voice. Due to the best processing power provided among the available smartphones and high battery life we choose to work on windows 8 platform. This application provides a facility which enables service providers companies to provide customer care services to their customers in their native languages without the need of employees being skilled in various languages. Thus we have successfully eliminated the language barrier and enabled ease of communication through this application.

  10. Provider Behavior Under Global Budgeting and Policy Responses: An Observational Study on Eye Care Services in Taiwan.

    Science.gov (United States)

    Chang, Chao-Kai; Xirasagar, Sudha; Chen, Brian; Hussey, James R; Wang, I-Jong; Chen, Jen-Chieh; Lian, Ie-Bin

    2015-01-01

    Third-party payer systems are consistently associated with health care cost escalation. Taiwan's single-payer, universal coverage National Health Insurance (NHI) adopted global budgeting (GB) to achieve cost control. This study captures ophthalmologists' response to GB, specifically service volume changes and service substitution between low-revenue and high-revenue services following GB implementation, the subsequent Bureau of NHI policy response, and the policy impact. De-identified eye clinic claims data for the years 2000, 2005, and 2007 were analyzed to study the changes in Simple Claim Form (SCF) claims versus Special Case Claims (SCCs). The 3 study years represent the pre-GB period, post-GB but prior to region-wise service cap implementation period, and the post-service cap period, respectively. Repeated measures multilevel regression analysis was used to study the changes adjusting for clinic characteristics and competition within each health care market. SCF service volume (low-revenue, fixed-price patient visits) remained constant throughout the study period, but SCCs (covering services involving variable provider effort and resource use with flexibility for discretionary billing) increased in 2005 with no further change in 2007. The latter is attributable to a 30% cap negotiated by the NHI Bureau with the ophthalmology association and enforced by the association. This study demonstrates that GB deployed with ongoing monitoring and timely policy responses that are designed in collaboration with professional stakeholders can contain costs in a health insurance-financed health care system. © The Author(s) 2015.

  11. College and University Summer Camps: Creative Alternatives to Day Care.

    Science.gov (United States)

    Wever, Matthew F.

    1995-01-01

    The successful summer day camp program of Saint Louis University (Missouri) is described. Program rationale, philosophy, objectives, structure, staffing, activities, and benefits to the university community are discussed. A majority of the children served by the camp are the children, ages 6 to 12, of university employees. (MSE)

  12. A Study on Universal Service in Vietnam from an Institutional Perspective

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten; Williams, Idongesit

    2016-01-01

    Applying the institutional theory to examine the universal services policy in Vietnam, the paper looked at the institutional factors influencing the formulation and deployment of “the Program on provision of universal service till 2010”. The formulation of universal services policy in Vietnam...... was remarkably affected by directives of the Communist Party of Vietnam as well as the international commitments that Vietnam participated in. It is of a different feature compared to other countries. Furthermore, the implementation of this Program revealed the loose co-operations between central government...... services, and households could get the same subsidies from two or three operators. The outcome of this paper recommends that the central government should emphasize the role of DICs and encourage them to be more involved in the formulation and implementation of universal services policy....

  13. Health care expenditure, laboratory services and IVD market.

    Science.gov (United States)

    Veronesi, E; Mambretti, C; Gazzaniga, P

    1997-01-01

    What has been written until now should not be misinterpreted: without doubt there is wastage in the Italian health care expenditure which must be rationalized. Moreover, the public deficit-now over two million billion lira-will probably prevent any reinvestment in health care of resources liberated through the above-mentioned rationalization process. In the near future, the attention of the authorities should be focused on how to reduce public spending, which probably also includes spending on health care. The message which needed to be passed on here does not refuse to recognize the possibility of rationalizing health care expenditure in Italy nor does it reject the need for this course of action. Instead it tries to give the following warning: in the light of the above circumstances-or the fact that even now the authorities cannot admit to spending "much" in the absolute sense, especially with regard to technology, or the fundamental role of IVDs in health care processes, or the difficulties in which the companies of the sector have been placed-it is possible to state that any blind, or worse still, ill-equipped, intervention in this field would have the undoubted effect of damaging the health care sector, or even place many companies on their knees, without receiving the expected benefits on the balance sheet. Benefits in the form of efficiency and saving can only be obtained from an effective reorganisation of the health structures, in line with the reforms provided for by legislative decree n. 502/92 (and subsequent modifications)--which, due to aspects too numerous to mention, is still a dead letter--and by taking steps towards valuing the laboratory services. As already stated, to talk of inefficiency in general terms means talking of unproductive expenditure: this occurs when utilizing factors whose cost is "too high" and/or productivity is "too low". It is with this distinction in mind that intervention must come; assessing factors not individually but

  14. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  15. 75 FR 32692 - Schools and Libraries Universal Service Support Mechanism

    Science.gov (United States)

    2010-06-09

    ... application designed to enhance the operation of Internet access service. Only a few categories of software... descriptive title of the category would more accurately reflect the type of services eligible. We seek comment... secondary school libraries, academic libraries, certain research libraries and private libraries where the...

  16. Business Students' Perception of University Library Service Quality and Satisfaction

    Science.gov (United States)

    Hsu, Maxwell K.; Cummings, Richard G.; Wang, Stephen W.

    2014-01-01

    The main purpose of this study is to examine the college students' perception of library services, and to what extent the quality of library services influences students' satisfaction. The findings depict the relationship between academic libraries and their users in today's digital world and identify critical factors that may sustain a viable…

  17. Quality of health care: the responsibility of health care professionals in delivering high quality services.

    Science.gov (United States)

    Giangrande, A

    1998-11-01

    According to a recent definition, quality of care consists of the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge; a definition that introduces both requirements of outcomes and the appropriateness of the process used. Clearly many different figures are interested in quality assessment initiatives in the health care field and these include patients, administrators and doctors each having different perspective. Doctors obviously pay greater attention to technical quality and results, giving greater emphasis to the health of the individual patient, tending to give priority to technical excellence and interaction between patient and doctor. Although the perspective of health care professionals is widely acknowledged to be important and useful, other perspectives on quality have been emphasised in recent years. The most important of these is the recognition that care must be responsive to the preferences and values of the consumers of health care services. In complete harmony with one's own professional commitment, the attention to the perspectives of patients must give physician the chance to identify methods of measuring and verifying quality which take account of the expectations of the many groups with an interest in improving the functioning of the health system. A global approach in the health field is needed the more specialization advances. The quality of medicine lies in its capacity to integrate what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator.

  18. The University Hospital Zurich Offers a Medical Online Consultation Service for Men With Intimate Health Problems.

    Science.gov (United States)

    Schmidt-Weitmann, Sabine; Schulz, Urs; Schmid, Daniel Max; Brockes, Christiane

    2017-05-01

    The University Hospital of Zurich offers a text-based, Medical Online Consultation Service to the public since 1999. Users asked health questions anonymously to tele-doctors. This study focused on the characteristics of male enquirers with intimate health problems, the content of their questions, the medical advice given by tele-doctors and the rating of the service to prove the benefit of an online service for medical laymen. This retrospective study included 5.1% of 3,305 enquiries from 2008 to 2010 using the International Classification of Diseases-10 and International Classification of Primary Care codes relevant for intimate and sexual health problems in men. A professional text analysis program (MAXQDA) supported the content analysis, which is based on the procedure of inductive category development described by Mayring. The average age was 40 years, 63.1% enquirers had no comorbidity, in 62.5% it was the first time they consulted a doctor, and 70.2% asked for a specific, single, intimate health issue. In 64.3%, the most important organ of concern was the penis. Overall, 30.4% asked about sexually transmitted diseases. In 74.4% a doctor visit was recommended to clarify the health issue. The rating of the problem solving was very good. The service was mainly used by younger men without comorbidity and no previous contact with a doctor with regard to an intimate health problem. The anonymous setting of the teleconsultation provided men individual, professional medical advice and decision support. Teleconsultation is suggested to empower patients by developing more health literacy.

  19. The Army Primary Health Care Service: from foundation to future.

    Science.gov (United States)

    Burgess, J

    2010-09-01

    Following the British Government's implementation of policies to improve quality and introduce clinical governance into healthcare delivery in the late 1990s, the British Army commissioned a study into how primary healthcare for the Regular Army should best be delivered in UK. The study recommended a unitary command structure, with more central control based upon a model of a main headquarters and seven regions. The change has been largely successful and has been subject to external scrutiny. Areas still to be developed include improving information management and benchmarking standards against the NHS, improvements in practice management, plus developments in occupational health and the nursing cadres. The forthcoming Strategic Defence and Security Review and other ongoing studies are likely to have a profound influence on how the current Army Primary Health Care Service develops.

  20. UR Well Eye Care: a model for medical student ophthalmology education and service in the community

    Directory of Open Access Journals (Sweden)

    MacLean K

    2014-11-01

    Full Text Available Kyle MacLean,1 Holly B Hindman2,3 1University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 2The Flaum Eye Institute, University of Rochester, Rochester, NY, USA; 3Center for Visual Science, University of Rochester, Rochester, NY, USA Purpose: To assess medical student ophthalmic educational exposure and service provided through the University of Rochester’s UR Well Eye Care (URWEC program, a student-run initiative in which medical students provide supervised eye care to an uninsured urban population.Design: Retrospective chart review.Subjects: Consecutive patients seen at the student-run URWEC in Rochester, NY, USA between June 2008 and June 2013.Methods: One hundred and forty-five of 148 charts of consecutive patients seen at URWEC over the 5-year period were identified and reviewed. Data on patient demographics, reason for visit, history, examination, diagnoses, and management were collected into a database. Main outcome measures: Main outcome measures included reasons for referral, student performance of ophthalmic examination components, ophthalmic diagnoses, and hours of volunteer service rendered. Results: Patients came from a variety of countries and educational and racial backgrounds. The most common reason for referral to URWEC was diabetic screening eye exams (66/145, 46%. Student volunteers performed the following examination components in 79%–100% of visits under direct supervision of an attending ophthalmologist: visual acuity, pupils, extraocular movements, confrontation visual fields, intraocular pressure, drop administration, slit-lamp examination, and dilated fundoscopic exam. The most common diagnosis other than refractive error was cataract (29/145, 20%. Almost half of patients (66/145, 46% were diagnosed with potentially vision-threatening conditions. Six hundred and thirty hours of community service were rendered by students and attending ophthalmologists during the 5-year period

  1. [Upgrading a pediatric pharmaceutical care service in Quebec].

    Science.gov (United States)

    Leroux, A; Guérin, A; Bussières, J-F; Lebel, D; Tremblay, S; Roy, H; Métras, M-E; Beauchemin, M; Bédard, P

    2016-02-01

    Clinical pharmacy has developed since the 1960s in North America, with large disparities in the presence of decentralized pharmacists in hospital units between healthcare programs. Decentralized pharmacists have been present in pediatrics since the 1970s. The main objective of this study was to describe the steps used to upgrade the pediatrics department's pharmaceutical care. A descriptive study was conducted to upgrade the pharmaceutical care provided by two full-time equivalents in two pediatric sectors including 81 beds of a tertiary mother-child hospital. The upgrade includes three steps: a structured literature review, a description of the department, and a description of the practice upgrades proposed by the research team, in consensus with the clinical pharmacy team. Out of the 236 articles initially identified, 13 relevant articles were found on the role and impact of pharmacists in pediatrics. Nine pharmaceutical activities were supported by high-quality data. Following the literature review and concerted reflection, 15 improvements were identified as feasible without increasing the staff. There are data on the impact of pharmacists in pediatrics. This descriptive study illustrates a method that was used to upgrade the pediatrics sector in a university mother-child health center. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. [Internationalized medical care services increase need of health care providers to improve English communication skills].

    Science.gov (United States)

    Yang, Chia-Ling

    2011-02-01

    English is the most important language used in international communication. Nurses today have significantly more opportunities to come into contact with clients of different nationalities. Therefore, English communication abilities are a critical to the effective care of foreign clients. Miscommunication due to language barriers can endanger the health and safety of foreign clients and hinder their access to healthcare resources. Basic English communicate skills allow nurses to better understand the feelings of foreign clients and to affect their satisfaction with healthcare services provided. The majority of clinical nurses in Taiwan are inadequately prepared to communicate with foreign clients or use English when delivering nursing care services. Although English is not an official language in Taiwan, strengthening English communication skills is necessary for Taiwan's healthcare service system. Faced with increasing numbers of foreign clients in their daily work, first-line nursing staffs need more training to improve English proficiency. In order to do so, support from the hospital director is the first priority. The second priority is to motivate nursing staffs to learn English; the third is to incorporate different English classes into the medical system and schedule class times to meet nurse scheduling needs; and the fourth is to establish international medical wards, with appropriate incentives in pay designed to attract and retain nursing staff proficient in English communication.

  3. Developing integrated health and social care services for older persons in Europe

    Directory of Open Access Journals (Sweden)

    Kai Leichsenring

    2004-09-01

    Full Text Available Purpose: This paper is to distribute first results of the EU Fifth Framework Project ‘Providing integrated health and social care for older persons—issues, problems and solutions’ (PROCARE—http://www.euro.centre.org/procare/. The project's first phase was to identify different approaches to integration as well as structural, organisational, economic and social-cultural factors and actors that constitute integrated and sustainable care systems. It also served to retrieve a number of experiences, model ways of working and demonstration projects in the participating countries which are currently being analysed in order to learn from success—or failure—and to develop policy recommendations for the local, national and European level. Theory: The paper draws on existing definitions of integrated care in various countries and by various scholars. Given the context of an international comparative study it tries to avoid providing a single, ready-made definition but underlines the role of social care as part and parcel of this type of integrated care in the participating countries. Methods: The paper is based on national reports from researchers representing ten organisations (university institutes, consultancy firms, research institutes, the public and the NGO sector from 9 European countries: Austria, Denmark, Finland, France, Germany, Greece, Italy, the Netherlands, and the UK. Literature reviews made intensive use of grey literature and evaluation studies in the context of at least five model ways of working in each country. Results: As a result of the cross-national overview an attempt to classify different approaches and definitions is made and indicators of relative importance of the different instruments used in integrating health and social care services are provided. Conclusions: The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on

  4. Caring for a Bedouin Female Patient with Breast Cancer: An Application of Leininger’s Theory of Culture Care Diversity and Universality

    Directory of Open Access Journals (Sweden)

    Abdul Qadir J. Nashwan

    2013-07-01

    Full Text Available Leininger’s theory is to provide care measures that are in harmony with an individual or group’s cultural beliefs, practices, and values. In the 1960’s she coined the term culturally congruent care, which is the primary goal of Transcultural nursing practice. Recently, there is a noticeable increase in the usage of the advanced hospitals’ health services by the Bedouin; as their awareness developed in term of health issues, and this put the health care providers (especially nurses in a great chance to face this Bedouin’s culture in clinical areas. So we have to enrich our understanding of the Bedouin’s culture to deliver a culturally congruent and satisfying care. A personal experience of two oncology nurses in working with a female patient with breast cancer and her Bedouin family described, with application of Madeleine Leininger’s theory of culture care diversity and universality. Concluding that understanding, considering and valuing cultural differences when delivering nursing care are vital to ensure providing a culturally congruent nursing care as well as avoid conflicts.

  5. Quality of care in psychosis and bipolar disorder from the service user perspective.

    Science.gov (United States)

    Skelly, Niamh; Schnittger, Rebecca I; Butterly, Lisa; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul

    2013-12-01

    According to the recovery model of mental health care, service development should incorporate the expert knowledge of service users. To date, there has been limited research into conceptualizations of mental health care quality among services users diagnosed with bipolar disorder or psychosis. To investigate service user perspectives on quality of care, we conducted six focus groups (N = 29) with inpatients and outpatients of an independent Irish mental health service. We undertook an inductive thematic analysis of the data. Participants identified proactive staff, meaningful and warm staff-patient interactions, and safety and sociability in the inpatient environment as components of good quality mental health care. Participants also discussed how the implementation of best practice guidelines does not necessarily improve quality of care from the service user perspective. This and similar qualitative research should be used to inform service development and the creation of evaluation instruments compatible with the recovery model.

  6. Utilization of preventive care services and their effect on cardiovascular outcomes in the United States

    Directory of Open Access Journals (Sweden)

    Varun Vaidya

    2011-01-01

    Full Text Available Varun Vaidya, Gautam Partha, Jennifer HowePharmacy Health Care Administration, Department of Pharmacy Practice, University of Toledo College of Pharmacy, Toledo, OH, USAObjective: To describe and analyze utilization of preventive care services and their effect on cardiovascular outcomes in the United States.Methods: Data from the 2007 Medical Expenditure Panel Survey (MEPS were used to analyze utilization of preventive care services and their effect on cardiovascular outcomes. Recommendations by the Seventh Report of the Joint Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and the National Cholesterol Education Program were used to determine appropriate levels of preventive care utilization. Utilization of blood pressure screening and cholesterol checkup services were used as the dependent variable, while age, gender, race, ethnicity, insurance status, and perceived health status were used as independent variables. Since guidelines differ for people with elevated blood pressure, respondents with elevated blood pressure were identified in the MEPS database by self-reported diagnosis. Descriptive statistics were used to describe the population, while a multivariate logistic regression model was built to predict odds of utilizing appropriate levels of preventive services.Results: Total number of adult respondents for which data were available for blood pressure checkup and cholesterol checkup was 20,523 and 15,784, respectively. Overall, MEPS respondents were found to adhere to guideline recommendations for preventive care utilization. Multivariate logistic regression showed that odds of utilization of preventive care services were higher for elderly patients (age >65 years for blood pressure (odds ratio [OR] = 2.39, 95% confidence interval [CI]: 1.92–2.97 and cholesterol (OR = 3.05, 95% CI: 2.18–4.27 preventive services compared with younger population (age 18–54 years. Males had much lower odds of

  7. Poverty, food security and universal access to sexual and reproductive health services: a call for cross-movement advocacy against neoliberal globalisation.

    Science.gov (United States)

    Sundari Ravindran, T K

    2014-05-01

    Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation.

  8. Efektivitas Customer Service Care Nokia Terhadap Kepuasan Pelanggan Di Medan Fair Plaza

    OpenAIRE

    Wita, Shinta Fina

    2011-01-01

    Skripsi ini meneliti mengenai hubungan Efektivitas Customer Service Care Nokia terhadap Kepuasan Pelanggan. Adapun tujuan dari penelitian ini adalah untuk mengetahui bagaimana kegiatan yang dilakukan oleh petugas customer service care Nokia dalam usaha memberi kepuasan kepada pelanggan dan untuk mengetahui bagai mana hubungan antara Efektivitas Customer Service Care Nokia terhadap Kepuasan Pelanggan di Medan Fair Plaza. Teori yang digunakan dalam penelitian ini adalah S-O-R yang merupakan...

  9. Integration of health service with electronic nursery care process

    Directory of Open Access Journals (Sweden)

    Merih Yeliz Doğan

    2017-01-01

    Full Text Available You This study aims to provide to integrate the health service with electronic nursery care process and so do create lingua franca. This research has been done between April 2010 and January 2012 in a teaching and research hospital where is specialized on obstetrician and gynecology. 280 nurse are the sample of the study. The datas are collected by using a survey with 22 questions. After the observations and evaluations, in case of standards 40 nursery care process about most experienced problems in gynecology, obstetrician and pediatry clinics is formed and its infrastructure for integrating these flow diagrams to the data processing system is prepared. For working the new system, instructive sessions is done. After the applications, the using of process approach in nursery care service and the pleasure of the nurses are analysed. The datas are analysed by using percentage calculation, t-test and variant analysis test in case of SPSS programme. In this study, 3 different application for the usage of process approach is used. These applications are done in different 15 bedded clinics and in differrent times. In the first application, empty forms which have standard format, are given to the nurses to complete.In the second application, the forms which special nursery activity has been wrritten on, are given to the nurses to sign their own activity and in the third application, the standard process approach which has been integrated to electronic system and which is special to patient, is requested to use. After all aplications, according to analysation of the results, the usage of the process’ method rates are; 10% is for first method, 40% is for second method and 90% is for third method. Especially, the nursery process approach which has been integrated to electronic system is used more desirous. According to the nurses’ opinion, this system increases the creation of lingua franca, data security and effective time management. It is

  10. Enhancing health service delivery through a university-local governemnt partnership model, issues and experiences from Uganda

    Directory of Open Access Journals (Sweden)

    Gad Razaaza Ndaruhutse

    2013-12-01

    Full Text Available A number of approaches have been adopted in medical education geared towards training health professionals that can improve access to health care by communities most vulnerable to inequalities and injustices in health systems. Relevant health professions education is vital for improvements in health and health care access. A symbiotic medical education can improve the quality of health care and impact on career choice, yet the challenge to sustain equitable access to improved health and healthcare particularly for those most in need remains a major global challenge ( Ssewankambo, 2012. Within a decentralized system, such as in Uganda, Local Governments are mandated to ensure health promotion and equitable healthcare for the population under their jurisdiction. Whereas public service reforms have mainly focused on decentralization and good governance (Mamdani, 2012, Stiglitz, 2012, the role of curriculum reforms in addressing health and health care challenges through needs-based education of health professionals has been largely ignored. Through an analysis of the challenges of health care within a decentralized Local Government setting, this paper, by presenting experiences from one public university in Uganda, reveals how a partnership between Universities and Local Government can go a long way in addressing health disparities and reduction of morbidity and mortality.

  11. Enhancing health service delivery through a university-local governemnt partnership model, issues and experiences from Uganda

    Directory of Open Access Journals (Sweden)

    Gad Razaaza Ndaruhutse

    2013-12-01

    Full Text Available A number of approaches have been adopted in medical education geared towards training health professionals that can improve access to health care by communities most vulnerable to inequalities and injustices in health systems. Relevant health professions education is vital for improvements in health and health care access. A symbiotic medical education can improve the quality of health care and impact on career choice, yet the challenge to sustain equitable access to improved health and healthcare particularly for those most in need remains a major global challenge ( Ssewankambo, 2012. Within a decentralized system, such as in Uganda, Local Governments are mandated to ensure health promotion and equitable healthcare for the population under their jurisdiction. Whereas public service reforms have mainly focused on decentralization and good governance (Mamdani, 2012, Stiglitz, 2012, the role of curriculum reforms in addressing health and health care challenges through needs-based education of health professionals has been largely ignored. Through an analysis of the challenges of health care within a decentralized Local Government setting, this paper, by presenting experiences from one public university in Uganda, reveals how a partnership between Universities and Local Government can go a long way in addressing health disparities and reduction of morbidity and mortality.

  12. Strengthening Integrated Care Through Population-Focused Primary Care Services: International Experiences Outside the United States.

    Science.gov (United States)

    Loewenson, Rene; Simpson, Sarah

    2017-03-20

    Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health-oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles. It presents ways in which early first contact and continuity of PC, PC coordination of referral, multidisciplinary team approaches, investment in PC competencies, and specific payment and incentive models have all supported comprehensive approaches. These experiences locate PC as a site of innovation, where information technology and peer-to-peer learning networks support learning from practice.

  13. Medical Care for Interned Enemy Aliens: A Role for the US Public Health Service in World War II

    Science.gov (United States)

    Fiset, Louis

    2003-01-01

    During World War II, the US Public Health Service (USPHS) administered health care to 19 000 enemy aliens and Axis merchant seamen interned by the Justice Department through its branch, the Immigration and Naturalization Service (INS). The Geneva Prisoners of War Convention of 1929, which the United States applied to civilian internees, provided guidelines for belligerent nations regarding humanitarian treatment of prisoners of war, including for their health. The INS forged an agreement with the USPHS to meet these guidelines for the German, Italian, and Japanese internees and, in some cases, their families. Chronic shortages and crowded camps continuously challenged USPHS administrators. Nevertheless, the USPHS offered universal access to care and provided treatment often exceeding care received by many American citizens. PMID:14534217

  14. Level-of-care criteria for peer support services: a best-practice guide.

    Science.gov (United States)

    Daniels, Allen S; Cate, Rebecca; Bergeson, Susan; Forquer, Sandra; Niewenhous, Gerard; Epps, Beth

    2013-12-01

    Peer support services (PSS) are an expanding part of the continuum of care provided for behavioral health conditions. These services have been deemed an evidence-based reimbursable model of care by the Centers for Medicare and Medicaid Services. States, counties, employers, and health plans are increasingly covering PSS in benefit plans. Controlled and experimental studies are building the evidence base for these services. Medicaid and the states have not developed level-of-care or medical necessity criteria for PSS, even though these criteria are standards for determining coverage and reimbursement. This review of emerging level-of-care criteria for PSS provides a framework for the further development of these resources.

  15. Perceived needs of pharmaceutical care services among healthcare professionals in South Korea: a qualitative study.

    Science.gov (United States)

    Lee, Iyn-Hyang; Rhie, Sandy Jeong; Je, Nam Kyung; Rhew, Ki Yon; Ji, Eunhee; Oh, Jung Mi; Lee, Euni; Yoon, Jeong-Hyun

    2016-10-01

    Purpose To explore the need for pharmaceutical care services, key features of desirable pharmacy services, and perceived barriers for advancing the services in hospital environments with doctors and nurses who are key co-workers of the interdisciplinary team care services.Methods Semi-structured, in-depth interviews with eighteen doctors and fifteen nurses employing purposive and snowballing sampling strategies were conducted in ten hospitals in South Korea. Results The level of pharmaceutical care was varied across regions or institutions in South Korea. The concept of pharmaceutical care was insufficiently defined, and tended to be limited to some parts of medication counseling. Through pharmaceutical care services, doctors desired to acquire comprehensive drug information from and to share clinical responsibilities with pharmacists. Nurses wished to lower their burdens of medication counseling services from their daily practices. Doctors and nurses asked for pharmacists providing essential and carefully selected medication information to their patients in a patient-centered manner. The listed barriers to pharmaceutical care included the lack of appropriate systems for reward, insufficient accessibility to patient records by pharmacists, ambiguous role descriptions of pharmacist, and absence of effective communication among professionals. Conclusion A successful pharmaceutical care service model should allow efficient exchange of information among healthcare professionals to build inter-professional trust and to provide a continuity of care both in terms of time and setting. As prerequisites of such system, it was warranted to develop clinical evidence and an appropriate reward system for pharmaceutical care services.

  16. Webcasting in home and hospice care services: virtual communication in home care.

    Science.gov (United States)

    Smith-Stoner, Marilyn

    2011-06-01

    The access to free live webcasting over home computers was much more available in 2007, when three military leaders from West Point, with the purpose of helping military personnel stay connected with their families when deployed, developed Ustream.tv. There are many types of Web-based video streaming applications. This article describes Ustream, a free and effective communication tool to virtually connect staff. There are many features in Ustream, but the most useful for home care and hospice service providers is its ability to broadcast sound and video to anyone with a broadband Internet connection, a chat room for users to interact during a presentation, and the ability to have a "co-host" or second person also broadcast simultaneously. Agencies that provide community-based services in the home will benefit from integration of Web-based video streaming into their communication strategy.

  17. Nature and determinants of customer expectations of service recovery in health care.

    Science.gov (United States)

    Dasu, S; Rao, J

    1999-01-01

    Service recovery refers to the service provider's response to a dissatisfied customer. This article proposes a model of customer expectations of service recovery in health care services. The model discusses two types of service recovery expectations: will and should. An exploratory study indicates that industry reputation and personal experiences drive customers' "will-expectations" of service recovery while "should-expectations" can be explained via norm, fairness, social contract and hospitality theories.

  18. Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle, Pharm.D.

    2012-01-01

    Full Text Available This study explored primary care providers’ (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2 “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3 “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4 “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6 “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients

  19. PRE-SERVICE SCIENCE TEACHERS’ PERCEPTIONS ABOUT EFFECTIVE DESIGN OF BLENDED UNIVERSITY CHEMISTRY COURSES

    Directory of Open Access Journals (Sweden)

    Zehra OZDILEK

    2013-07-01

    Full Text Available The aim of the study is to examine how blended learning can be used more effectively for university chemistry courses, based on the perceptions of students. The sample included 179 pre-service science teachers in year one through year four who had taken a university chemistry class. Qualitative data were gathered through open-ended questions and semi-structured interviews. The data were analyzed by using descriptive statistics and thematic content analysis. The results revealed necessary design characteristics for an effective blended chemistry course from students’ point of view regarding content of online instruction, the teaching methods, interface design, use of media and other visual elements, usability, design techniques, and facilitator role. The results showed that instruction should be carefully planned and must be appropriate to student needs and characteristics, the content should not be too long or complicated, content should be prepared by experts in chemistry, include reliable and valid information, designed to promote the learning process by choosing appropriate visual elements and media, be consistent with the learning outcomes, and include evaluation questions. Blended instruction should include various updated and easily accessible technological resources and tools to facilitate learning. The results also revealed that blended learning environment is most suitable for specific topics such as organic chemistry, acids and bases, the structure of atom and matter. Finally, a blended learning component matrix was created and suggested to show the interactions between the categories based on the perceptions of the participants. The results of this study, therefore, suggest important implications for instructors when designing effective blended chemistry courses for pre-service science teachers.

  20. How Primary Care Networks Can Help Integrate Academic and Service Initiatives in Primary Care

    Science.gov (United States)

    Thomas, Paul; Graffy, Jonathan; Wallace, Paul; Kirby, Mike

    2006-01-01

    PURPOSE Theory of effective network operation in primary care is underdeveloped. This study aimed to identify how primary care networks can best integrate academic and service initiatives. METHODS We performed a comparative case study of 4 primary care research networks in North London, England, for the years 1998–2002. Indicators were selected to assess changes in (1) research capacity, (2) multidisciplinary collaboration, and (3) research productivity. We compared the profiles of network outcome with descriptions of their contexts and organizational types from a previous evaluation. RESULTS Together, the networks supported 133 viable projects and 30 others; 399 practitioners, managers, and academics participated in the research teams. How the networks organized themselves was influenced by the circumstances in which they were formed. Different ways of organizing were associated with different outcome profiles. Shared projects and learning spaces helped participants to develop trusted relationships. A top-down, hierarchical approach based on institutional alliances and academic expertise attracted more funding and appeared to be stable. The bottom-up, individualistic network with research practices was good at reflecting on practical primary care concerns. Whole-system methods brought together stakeholder contributions from all parts of the system. CONCLUSIONS Networks can help integrate academic research and service development initiatives by facilitating interorganizational interactions and in shared leadership of projects. Researchers and practitioners stand to gain considerably from an integrated approach in both the short and the long term. Success requires agreement about a set of pathways, learning spaces, and feedback mechanisms to harness the insights and efforts of stakeholders throughout the whole system. PMID:16735525

  1. Quality evaluation in health care services based on customer-provider relationships.

    Science.gov (United States)

    Eiriz, Vasco; Figueiredo, José António

    2005-01-01

    To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. Systematic review of the literature. Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

  2. Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

    Science.gov (United States)

    Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

    2017-01-01

    Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful

  3. Effects of Health-Care Services and Commodities Cost on the ...

    African Journals Online (AJOL)

    2017-09-14

    Sep 14, 2017 ... services and commodities cost on the patients at the primary health facilities in Zaria ... the payment for health- care services is a major problem in many developing ... Standardization of prices of services and commodities and the ..... The demand for an essential service might be low not necessarily ...

  4. Maternal Health Care Services Utilization in Tea Gardens of ...

    African Journals Online (AJOL)

    Mubeen

    Conclusion: The present study revealed low utilization of pregnancy-related health care utilization ... KEY WORDS: Antenatal care, institutional delivery, maternal health care utilization, postnatal care ... care (e.g., clinic availability, distance to facility).[11]. Despite ..... practices and the overall lower level of education among.

  5. 78 FR 23877 - Schools and Libraries Universal Service Support Mechanism and A National Broadband Plan for Our...

    Science.gov (United States)

    2013-04-23

    ... COMMISSION 47 CFR Part 54 Schools and Libraries Universal Service Support Mechanism and A National Broadband... schools and libraries universal service support program (E-rate program) requirements for bundling devices... (Bureau) seeks comment on a proposal to clarify the schools and libraries universal service...

  6. 25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

    Science.gov (United States)

    2010-04-01

    ... placed in foster care or residential care facility? 20.509 Section 20.509 Indians BUREAU OF INDIAN... Assistance Foster Care § 20.509 What must the social services worker do when a child is placed in foster care or residential care facility? When a child is placed in foster care or a residential care facility...

  7. Care, Thoughtfulness, and Tact: A Conceptual Framework for University Supervisors

    Science.gov (United States)

    Cuenca, Alexander

    2010-01-01

    The pedagogical work of university supervisors has received little attention in teacher education literature. Based on this concern, this paper provides a conceptual framework for university supervisors, recasting their role as teacher pedagogues focused on responding to the particular contextual needs of student teachers as they learn to teach.…

  8. Offering a model for measuring service brand equity in the field of services : Testing and implementation in a virtual university.

    Directory of Open Access Journals (Sweden)

    Mehdi Giahchin

    2013-09-01

    Full Text Available Nowadays brand in businesses around the world including service provider companies, has a special role and a great importance.Brand equity is also a powerful tool in the marketing competitionthus managing the brand equity measurement is consequential. In this study we are trying to find some effective dimensions of the brand equity in the service firms and companies and after that we are going to offer some significant dimensions as a comprehensive model in education and e-learning at the level of higher education with considering different aspects of the products and services and also with considering the different aspects of service businesses on the services spectrumthen test the model statistically in a virtual university. Data collection was done through a questionnaire distributed to all 1031 faculty, students and staff of Mehralborz university and 300 responses were received. Sampling was done through random method and the sample volume based on Cochran's formula was 280 persons. Cronbach's alpha was used to ensure the reliability of the questionnaire and structural equation modeling was used to test the model. The consequences of statistical analysis showed that among the factors related to the customers, just experiences and psychological characteristics of faculty, students and staff are effective on the service brand equity of Mehralborz university.And also among the factors related to the brand awareness,just marketing activities are effective on the service brand equity of Mehralborz uiversity. Among the characteristics offered for the brand image,just symbolic characteristics and servicescape and also servise provider characteristics are effective on the service brand equity of Mehralborz university.

  9. The Impact of Human Rights on Universalizing Health Care in Vermont, USA.

    Science.gov (United States)

    MacNaughton, Gillian; Haigh, Fiona; McGill, Mariah; Koutsioumpas, Konstantinos; Sprague, Courtney

    2015-12-10

    In 2010, Vermont adopted a new law embracing human rights principles as guidelines for health care reform, and in 2011, Vermont was the first state in the US to enact framework legislation to establish a universal health care system for all its residents. This article reports on the Vermont Workers' Center's human rights-based approach to universal health care and the extent to which this approach influenced decision makers. We found the following: (1) by learning about the human right to health care and sharing experiences, Vermonters were motivated to demand universal health care; (2) mobilizing Vermonters around a unified message on the right to health care made universal health care politically important; (3) using the human rights framework to assess new proposals enabled the Vermont Workers' Center to respond quickly to new policy proposals; (4) framing health care as a human right provided an alternative to the dominant economics-based discourse; and (5) while economics continues to dominate discussions among Vermont leaders, both legislative committees on health care use the human rights principles as guiding norms for health care reform. Importantly, the principles have empowered Vermonters by giving them more voice in policymaking and have been internalized by legislators as democratic principles of governance.

  10. 25 CFR 20.508 - What must the social services agency do when a child is placed in foster care, residential care...

    Science.gov (United States)

    2010-04-01

    ... placed in foster care, residential care or guardianship home? 20.508 Section 20.508 Indians BUREAU OF... PROGRAMS Child Assistance Foster Care § 20.508 What must the social services agency do when a child is placed in foster care, residential care or guardianship home? The social services agency must make...

  11. Automatic Biometric Student Attendance System: A Case Study Christian Service University College

    OpenAIRE

    Abilimi, Christopher Ayaaba; Opoku-Mensah, Dr Ing Edward; Yeboah, Dr Thomas

    2013-01-01

    In many tertiary institutions in Ghana such as Christian Service University the attendance of students is very important factor since it forms part of the students assessment and evaluation. It has therefore become imperative that proper measures should be put in place to ensure that no student signs for another. It has been observed that at Christian Service University College lecturers sometimes give the attendance book to students to sign without actually supervising them to see whether th...

  12. Encouraging innovation: ten research priorities for achieving universal access to HIV/AIDS prevention, treatment and care in Europe by 2010

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Laukamm-Josten, Ulrich; Atun, Rifat A;

    2008-01-01

    there have been many declarations and strategies addressing HIV/AIDS, today the goal is universal access to HIV/AIDS prevention, treatment, care and support services by 2010. The articles included in this thematic issue of the Central European Journal of Public Health on HIV/AIDS reflect this, while the ten...

  13. INTELLIGENT SEARCH ENGINE-BASED UNIVERSAL DESCRIPTION, DISCOVERY AND INTEGRATION FOR WEB SERVICE DISCOVERY

    Directory of Open Access Journals (Sweden)

    Tamilarasi Karuppiah

    2014-01-01

    Full Text Available Web Services standard has been broadly acknowledged by industries and academic researches along with the progress of web technology and e-business. Increasing number of web applications have been bundled as web services that can be published, positioned and invoked across the web. The importance of the issues regarding their publication and innovation attains a maximum as web services multiply and become more advanced and mutually dependent. With the intension of determining the web services through effiective manner with in the minimum time period in this study proposes an UDDI with intelligent serach engine. In order to publishing and discovering web services initially, the web services are published in the UDDI registry subsequently the published web services are indexed. To improve the efficiency of discovery of web services, the indexed web services are saved as index database. The search query is compared with the index database for discovering of web services and the discovered web services are given to the service customer. The way of accessing the web services is stored in a log file, which is then utilized to provide personalized web services to the user. The finding of web service is enhanced significantly by means of an efficient exploring capability provided by the proposed system and it is accomplished of providing the maximum appropriate web service. Universal Description, Discovery and Integration (UDDI.

  14. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    LENUS (Irish Health Repository)

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  15. Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Montu Bose

    2015-01-01

    Full Text Available Background Out of eight commonly agreed Millennium Development Goals (MDG, six are related to the attainment of Universal Health Coverage (UHC throughout the globe. This universalization of health status suggests policies to narrow the gap in access and benefit sharing between different socially and economically underprivileged classes with that of the better placed ones and a consequent expansion of subsidized healthcare appears to be a common feature for most of the developing nations. The National Health Policy in India (2002 suggests expansion of market-based care for the affording class and subsidized care for the deserving class of the society. So, the benefit distribution of this limited public support in health sector is important to examine to study the welfare consequences of the policy. This paper examines the nature of utilizationto inpatient care by different socio-economic groups across regions and gender in West Bengal (WB, India. The benefit incidence of public subsidies across these socio-economic groups has also been verified for different types of services like medicines, diagnostics and professional care etc. Methods National Sample Survey Organization (NSSO has collected information on all hospitalized cases (60th round, 2004 with a recall period of 365 days from the sampled households through stratified random sampling technique. The data has been used to assess utilization of healthcare services during hospitalization and the distribution of public subsidies among the patients of different socio-economic background; a Benefit Incidence Analysis (BIA has also been carried out. Results Analysis shows that though the rate of utilization of public hospitals is quite high, other complementary services like medicine, doctor and diagnostic tests are mostly purchased from private market. This leads to high Out-of-Pocket (OOP expenditure. Moreover, BIA reveals that the public subsidies are mostly enjoyed by the relatively better

  16. The role of universities in preparing graduates to use software in the financial services workplace

    Science.gov (United States)

    Tickle, Leonie; Kyng, Tim; Wood, Leigh N.

    2014-02-01

    The role of universities in preparing students to use spreadsheet and other technical software in the financial services workplace has been investigated through surveys of university graduates, university academics, and employers. It is found that graduates are less skilled users of software than employers would like, due at least in part to a lack of structured formal training opportunities in the workplace, and a lack of targeted, coherent learning opportunities at university. The widespread and heavy use of software in the workplace means that there is significant potential for productivity gains if universities and employers address these issues.

  17. An Analysis of the Effectiveness of University Counselling Services

    Science.gov (United States)

    Murray, Aja L.; McKenzie, Karen; Murray, Kara R.; Richelieu, Marc

    2016-01-01

    It is important to demonstrate replicable evidence of the effectiveness of counselling procedures. The study aimed to contribute to the currently limited evidence base examining the effectiveness of university student counselling in the UK. Information on therapeutic outcome [based on Clinical Outcomes in Routine Evaluation-Outcome Measure…

  18. Developing world class commissioning competencies in care services in England: the role of the service improvement agency.

    Science.gov (United States)

    Cornes, Michelle; Manthorpe, Jill; Huxley, Peter; Waddington, Paul; Stevens, Martin; Evans, Sherrill

    2010-05-01

    This article provides an insight into the support needs of health and social care commissioners seeking to develop world class commissioning competencies and the role of service improvement agencies in meeting these needs. Reporting findings from the evaluation of one service improvement agency based in England, we focus on the 'improvement supports' (the products and services) that were delivered by the 'Care Services Improvement Partnership' through its 'Better Commissioning Programme'. In-depth interviews were carried out with 25 care commissioners (n = 25) exploring how the Programme was used in their day to day work, its perceived value and limitations. Given the lack of employer-led training and induction we conclude that service improvement agencies play an important role in developing commissioners' skills and competencies. However, we suggest that achieving world class commissioning may depend on a more fundamental rethink of commissioning organisations' approaches to learning and development.

  19. 2009 Report (Uniformed Services University of the Health Sciences)

    Science.gov (United States)

    2009-01-01

    TSC patients who received care between 2004 and 2006. In an article to appear in the journal Neuroepidemiology, Hong, Darling and Lee report that...disease development. The pathogen infects more than half of the world’s population, causing a range of maladies, including gastritis , ulcer disease and

  20. 39 CFR 3050.30 - Information needed to estimate the cost of the universal service obligation. [Reserved

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Information needed to estimate the cost of the universal service obligation. 3050.30 Section 3050.30 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.30 Information needed to estimate the cost of the universal service obligation....

  1. Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals.

    Science.gov (United States)

    Michie, Lucy; Cameron, Sharon T; Glasier, Anna

    2013-10-01

    Abortion services should provide high-quality contraceptive care. The community sexual and reproductive health (SRH) services may be well placed to deliver more abortion care in the UK. We wished to determine the views of health professionals working in SRH regarding their attitudes towards providing more abortion services and also the views of staff within one community SRH centre in Scotland where a service providing early medical abortion (EMA) was due to commence. An anonymous questionnaire distributed to attendees at a UK SRH scientific meeting collected data on demographics, current practice of and attitude to abortion, and views on delivery of abortion services. An internet questionnaire distributed by e-mail to staff at a community SRH clinic in Scotland sought demographics, views regarding the planned introduction of an EMA service and willingness to participate in it. 165 questionnaires were completed out of 200 distributed at the scientific meeting (an 82% response rate). 128 (78%) respondents felt that abortion services were suited to community clinics and 115 (70%) stated that they would be willing to participate in them. 62/90 (69%) staff from the SRH clinic responded to the internet questionnaire. 44 (71%) felt the plan to introduce abortion services was a natural extension to services already offered and the same number would be willing to be involved in such a service. There is clear support amongst health professionals in community SRH in the UK towards greater participation in the provision of abortion care services.

  2. Urban-rural disparity in utilization of preventive care services in China.

    Science.gov (United States)

    Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan

    2016-09-01

    Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban-rural disparity in utilization of preventive care services in China, and determined how much of the urban-rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder-Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban-rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (-1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between

  3. Measuring quality of dental care: Caries prevention services for children.

    Science.gov (United States)

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-08-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  4. Knowledge Construction and Personal Relationship: Insights about a UK University Mentoring and Coaching Service

    Science.gov (United States)

    Hargreaves, Eleanore

    2010-01-01

    This article examines interview data from 12 mentors/coaches and eight of their clients in order to explore a mentoring and coaching service among UK university staff. Both mentors/coaches and clients were administrative or academic employees of the Institute of Education or affiliated colleges at London University, UK. Their roles related to the…

  5. What to Do about Being Overwhelmed: Graduate Students, Stress and University Services

    Science.gov (United States)

    Oswalt, Sara B.; Riddock, Christina C.

    2007-01-01

    Few studies have examined graduate students and stress. At a large, Southeastern university, 223 graduate students completed a survey about factors contributing their stress, current coping strategies and related university services. A majority felt stressed (48.9%) or very stressed (24.7%). There were significant differences in coping strategies…

  6. The Effectiveness of Coursework Assessment in Mathematics Service Courses--Studies at Two Universities.

    Science.gov (United States)

    Jackman, Susan; Goldfinch, Judy; Searl, John

    2001-01-01

    Describes the introduction and evaluation of the effectiveness of a single group project given at a new university, and 10 individual tasks at an ancient university, to devise appropriate and relevant assessments for first-year service mathematics courses for science and engineering. Studies the effects of these tasks on attitudes toward…

  7. The Views of International Students Regarding University Support Services in Australia: A Case Study

    Science.gov (United States)

    Roberts, Pam; Boldy, Duncan; Dunworth, Katie

    2015-01-01

    This paper reports on a study aimed at developing an improved understanding of the support needs of international students. Using a case study approach at one Australian university, a three stage data collection process was adopted: interviews with key support service providers in the university, student focus groups, and a large-scale survey.…

  8. The Need for a Special Services Project at Bowie State University.

    Science.gov (United States)

    Gill, Wanda E.; And Others

    The history of Bowie State University (BSU) in Maryland, is reviewed, from its establishment by the Baltimore Association for the Moral and Educational Improvement of Colored People in 1865 to its attainment of university status in 1988. Its mission to provide educational programs and services to Maryland citizens of all races is outlined.…

  9. New Educational Services Development: Framework for Technology Entrepreneurship Education at Universities in Egypt

    Science.gov (United States)

    Abou-Warda, Sherein Hamed

    2016-01-01

    Purpose: The overall objective of the current study is to explore how universities can better developing new educational services. The purpose of this paper is to develop framework for technology entrepreneurship education (TEPE) within universities. Design/Methodology/Approach: Qualitative and quantitative research approaches were employed. This…

  10. Adding a Community University Educational Summit (CUES) to Enhance Service Learning in Management Education

    Science.gov (United States)

    Levitt, Catherine; Schriehans, Cynthia

    2010-01-01

    For this study, one hundred and twenty student reflection papers (undergraduate and graduate) from a service learning extracurricular event titled, "Community University Educational Summit" (CUES) was analyzed. Over a two-year period, this event was held on one Saturday during the month of October at California State University San…

  11. New Educational Services Development: Framework for Technology Entrepreneurship Education at Universities in Egypt

    Science.gov (United States)

    Abou-Warda, Sherein Hamed

    2016-01-01

    Purpose: The overall objective of the current study is to explore how universities can better developing new educational services. The purpose of this paper is to develop framework for technology entrepreneurship education (TEPE) within universities. Design/Methodology/Approach: Qualitative and quantitative research approaches were employed. This…

  12. Improving access to computer-based library and drug information services in patient-care areas.

    Science.gov (United States)

    Tobia, R C; Bierschenk, N F; Knodel, L C; Bowden, V M

    1990-01-01

    A project to increase access to drug and biomedical information through electronic linkage of drug information and library services to three patient-care areas is described. In February 1987, microcomputer work stations were installed in the Bexar County Hospital District's hospital emergency department, medical residents' office, and ambulatory-care clinic, as well as in The University of Texas Health Science Center's library reference area and drug information service office. Drug information was available on compact disk through the Micromedex Computerized Clinical Information System (CCIS) database, which includes DRUGDEX, POISINDEX, EMERGINDEX, and IDENTIDEX. Each work station was also connected to the library's computer via modem, allowing access to the Library Information System, books, journals, audiovisual materials, miniMEDLINE, and an electronic mail system. During the six-month project, the system was used 5487 times by 702 people. The system was successful in providing drug and other information in clinical settings and in introducing clinical staff members to new information technology. To increase access to the system after the project ended, the CD-ROM version was discontinued, and the distributed tape version of CCIS for VAX computers was added to the library's online information system, making drug information more available throughout the campus and teaching hospitals. In 1988-89 an average of 200 people accessed the tape version of CCIS each month. Although it is difficult to replace the convenience of an onsite library, at least some drug and biomedical information needs in the clinical setting can be met through computer networking.

  13. 75 FR 69374 - Supplement to Universal Service Reform Mobility Fund

    Science.gov (United States)

    2010-11-12

    ... at its Web site: http://www.BCPIWEB.com . When ordering documents from BCPI, please provide the... comparisons would be appropriate. d. Distributing Mobility Fund Support Among Unserved Areas 23. The National... seeking support to deploy service in multiple unserved areas. The Commission seeks comment on...

  14. Queueing and Service Patterns in a University Teaching Hospital FO ...

    African Journals Online (AJOL)

    acer

    algorithms at a service points such as the ones obtainable in the ... determines the measure of performance of waiting lines such as ... the queue based on some order of priority. (Taha, 2007). ..... time get faster later in the day. The reason for.

  15. Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services.

    Science.gov (United States)

    Cranwell, K; Polacsek, M; McCann, T V

    2017-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments. Introduction Mental health service users with medical co-morbidity frequently experience difficulties accessing appropriate treatment in medical hospitals, and often there is poor collaboration within and between services. Little is known about mental health nurses' perspectives on how to address these problems. Aim To explore mental health nurses

  16. 38 CFR 21.6240 - Medical treatment, care and services.

    Science.gov (United States)

    2010-07-01

    ... services (including services related to blindness and deafness) including: (i) Language training, speech and voice correction, training in ambulation, and one-hand typewriting; (ii) Orientation, adjustment...

  17. Unblocking Occluded Genres in Graduate Writing: Thesis and Dissertation Support Services at North Carolina State University

    Science.gov (United States)

    Autry, Meagan Kittle; Carter, Michael

    2015-01-01

    In 2013, the Graduate School at North Carolina State University launched Thesis and Dissertation Support Services, a rhetorical, genre-based approach to assisting students with their graduate writing. Through a description of the program's founding, goals, and first year of services, we summarize this genre-based approach that is informed by the…

  18. The student health services at the University of Pretoria from 2000 to 2005

    Directory of Open Access Journals (Sweden)

    A M Koorts

    2007-01-01

    Full Text Available The University of Pretoria’s Student Health Services provides free, voluntary, family-medicine-orientated health services with an emphasis on offering preventative medicine and health education to enrolled students. ABSTRAK Die Universiteit van Pretoria se Gesondheidsdienste voorsien gratis, vrywillige gesins-medisyne-georiënteerde gesondheidsdienste met die klem op voorkomende medisyne en gesondheidsopvoeding aan ingeskrewe studente.

  19. Career Services at Colleges and Universities: A 30-Year Replication Study

    Science.gov (United States)

    Vinson, Bonita M.; Reardon, Robert C.; Bertoch, Sara C.

    2014-01-01

    This study examines career planning programs and career services offices at colleges and universities in the United States as viewed by senior student affairs officers (SSAOs). Findings from a 1979 study of career services offices (CSOs) were compared to the current findings. Additionally, new areas of research were examined in order to provide…

  20. Is Service-Learning the Kind Face of the Neo-Liberal University?

    Science.gov (United States)

    Raddon, Mary-Beth; Harrison, Barbara

    2015-01-01

    The emergence of service-learning pedagogies in Canada has received a variety of critical responses. Some regard service-learning as a public relations effort of universities and colleges; others see it as a countermovement to academic corporatization; still others consider it part of a wider cultural project to produce self-responsible and…

  1. Support Services for Higher Degree Research Students: A Survey of Three Australian Universities

    Science.gov (United States)

    Silva, Pujitha; Woodman, Karen; Taji, Acram; Travelyan, James; Samani, Shamim; Sharda, Hema; Narayanaswamy, Ramesh; Lucey, Anthony; Sahama, Tony; Yarlagadda, Prasad K. D. V.

    2016-01-01

    A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services…

  2. The Effects of Service Learning and Volunteerism Activities on University Students in Turkey

    Science.gov (United States)

    Boru, Nese

    2017-01-01

    The general purpose of this study is to determine the awareness and acquisitions obtained with service activities by the students studying on undergraduate level in Eskisehir Anadolu University in 2016-2017 education year and involve in service learning and volunteerism activities. The study was designed according to qualitative research method…

  3. Standards for Reference Service at the University of Michigan--Dearborn Library.

    Science.gov (United States)

    Galligan, Sara

    Few standards for reference services have appeared in the past, therefore guidelines for reference librarians at the University of Michigan--Dearborn library are offered. The guidelines presented are based upon reference standards prepared by the Reference and Adult Services Division (RASD) Standards Committee for the ALA Centennial Conference in…

  4. Counseling and Connecting with the Military Undergraduate: The Intersection of Military Service and University Life

    Science.gov (United States)

    Bonar, Ted C.; Domenici, Paula L.

    2011-01-01

    The majority of military undergraduates at universities are National Guard and Reserve personnel and prior-service military veterans, all difficult to identify on campus. These students face unique cultural challenges. Though the academic literature primarily addresses disability services and administrative programs often focus on "wounded…

  5. Developing a Services Science Graduation Programme at the University of Twente

    NARCIS (Netherlands)

    Sorathia, V.S.; Ferreira Pires, Luis; Pires, L.F.; van Sinderen, Marten J.; Wijnhoven, Alphonsus B.J.M.

    2010-01-01

    The recent growth in the services sector implies that more people must be trained in this area. This inspired us to develop a Services Science Graduation Programme at the University of Twente, the Netherlands. We propose a study programme of five years, consisting of a Master phase of two years and

  6. Status of ICT-enabled library and information services in university ...

    African Journals Online (AJOL)

    Status of ICT-enabled library and information services in university of Nigeria, ... providing access to e -journals, e -books and to internet and internet services. ... be budget provision for digital library projects and series and that private sector ...

  7. Creating a Successful Training Program for Frontline Staff: The University of Minnesota's Integrated Student Services Model

    Science.gov (United States)

    Peterson, Heather L.; Otto, Carrie L.

    2011-01-01

    Successfully preparing frontline counseling staff in an integrated student services model is a challenge--one that management staff in One Stop Student Services at the University of Minnesota, Twin Cities (UMTC) have been fine-tuning for almost ten years. The effort has required collaboration across units in a series of trial and error attempts…

  8. Student Identities and the Tourist Gaze in International Service-Learning: A University Project in Belize

    Science.gov (United States)

    Prins, Esther; Webster, Nicole

    2010-01-01

    This qualitative study explores how 11 university students in a U.S. service-learning course in Belize understood and represented their identities during the project, particularly their use of "the tourist" as a construct to interpret their experiences. Drawing on literature in international service-learning (ISL) and tourism studies,…

  9. Service Quality in Higher Education--A Case Study of Universiti Brunei Darussalam

    Science.gov (United States)

    Alani, Farooq; Yaqoub, Yasir; Hamdan, Mahani

    2015-01-01

    No one doubts the value and importance of quality education, and quality assurance is one major driving force to achieve this. Measuring the performance of service quality of education services of Universiti Brunei Darussalam (UBD), as part of the quality assessment, was assessed based on Parasuraman's five Servqual dimensions. The assessment was…

  10. Columbia University's Competency and Evidence-based Acute Care Nurse Practitioner Program.

    Science.gov (United States)

    Curran, Christine R.; Roberts, W. Dan

    2002-01-01

    Columbia University's acute care nurse practitioner curriculum incorporates evaluation strategies and standards to assess clinical competence and foster evidence-based practice. The curriculum consists of four core courses, supporting sciences, and specialty courses. (Contains 17 references.) (SK)

  11. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate

    National Research Council Canada - National Science Library

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P. K; McDermott, John

    2014-01-01

    .... CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole‐of‐society paradigm...

  12. Pennsylvania: Penn State University Integrated Pest Management Project (A Former EPA CARE Project)

    Science.gov (United States)

    Penn State University (PSU) is the recipient of a Level II CARE cooperative agreement targeting environmental risks in Philadelphia communities. PSU is involved in developing IPM management practices recommendations and policies.

  13. Knowledge, Awareness and Compliance with Universal Precautions among Health Care Workers at the University Hospital of the West Indies, Jamaica

    Directory of Open Access Journals (Sweden)

    R Irving

    2010-09-01

    Full Text Available Background: Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV.Objective: To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica.Method: A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions.Results: Almost two-thirds (64.0% of the respondents were very knowledgeable of universal precautions with significantly more females (75.4% than males (42.9% (p<0.0001. More nurses (90.0%, medical doctors (88.0% and medical technologists (70% were very knowledgeable of universal precautions (p<0.0001. More respondents (92.9% who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001. 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001.Conclusions: There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

  14. Co-creating and Evaluating a Web-app Mapping Real-World Health Care Services for Students: The servi-Share Protocol.

    Science.gov (United States)

    Montagni, Ilaria; Langlois, Emmanuel; Wittwer, Jérôme; Tzourio, Christophe

    2017-02-16

    University students aged 18-30 years are a population group reporting low access to health care services, with high rates of avoidance and delay of medical care. This group also reports not having appropriate information about available health care services. However, university students are at risk for several health problems, and regular medical consultations are recommended in this period of life. New digital devices are popular among the young, and Web-apps can be used to facilitate easy access to information regarding health care services. A small number of electronic health (eHealth) tools have been developed with the purpose of displaying real-world health care services, and little is known about how such eHealth tools can improve access to care. This paper describes the processes of co-creating and evaluating the beta version of a Web-app aimed at mapping and describing free or low-cost real-world health care services available in the Bordeaux area of France, which is specifically targeted to university students. The co-creation process involves: (1) exploring the needs of students to know and access real-world health care services; (2) identifying the real-world health care services of interest for students; and (3) deciding on a user interface, and developing the beta version of the Web-app. Finally, the evaluation process involves: (1) testing the beta version of the Web-app with the target audience (university students aged 18-30 years); (2) collecting their feedback via a satisfaction survey; and (3) planning a long-term evaluation. The co-creation process of the beta version of the Web-app was completed in August 2016 and is described in this paper. The evaluation process started on September 7, 2016. The project was completed in December 2016 and implementation of the Web-app is ongoing. Web-apps are an innovative way to increase the health literacy of young people in terms of delivery of and access to health care. The creation of Web-apps benefits

  15. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    NARCIS (Netherlands)

    N.J.A. van Exel (Job); M.A. Koopmanschap (Marc); J.D.H. van Wijngaarden (Jeroen); W.J.M. Scholte op Reimer (Wilma)

    2003-01-01

    textabstractBackground. Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses

  16. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    NARCIS (Netherlands)

    M.A. Koopmanschap (Marc); W.J.M. Scholte op Reimer (Wilma); J.D.H. van Wijngaarden (Jeroen); N.J.A. van Exel (Job)

    2003-01-01

    textabstractBACKGROUND: Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. Th

  17. Faculty Involvement in Inservice Education--Research and Service in a Teaching University.

    Science.gov (United States)

    Baden, Donald J.

    Faculty members in schools, colleges, and departments of education can and should be actively involved in research, teaching, and service. Research and service functions are as integral to the mission of the school of education as teaching, and should be scheduled with as much care and planning. In one school of education, a 5-year plan to…

  18. A Service-Learning Project to Eliminate Barriers to Oral Care for Children with Special Health Care Needs

    Science.gov (United States)

    DeMattei, Ronda R.; Allen, Jessica; Goss, Breanna

    2012-01-01

    Children with special health care needs face many barriers to oral care and are at high risk for oral disease. School nurses are in a unique position to promote oral wellness in this vulnerable population. Collaboration between school nurses and dental hygiene faculty resulted in the formation of a partnership between a university-based dental…

  19. Universal mental health screening in pediatric primary care: a systematic review.

    Science.gov (United States)

    Wissow, Lawrence S; Brown, Jonathan; Fothergill, Kate E; Gadomski, Anne; Hacker, Karen; Salmon, Peter; Zelkowitz, Rachel

    2013-11-01

    Universal mental health screening in pediatric primary care is recommended, but studies report slow uptake and low rates of patient follow-through after referral to specialized services. This review examined possible explanations related to the process of screening, focusing on how parents and youth are engaged, and how providers evaluate and use screening results. A narrative synthesis was developed after a systematic review of 3 databases (plus follow-up of citations, expert recommendations, and checks for multiple publications about the same study). Searching identified 1,188 titles, and of these, 186 full-text articles were reviewed. Two authors extracted data from 45 articles meeting inclusion criteria. Published studies report few details about how mental health screens were administered, including how clinicians explain their purpose or confidentiality, or whether help was provided for language, literacy, or disability problems. Although they were not addressed directly in the studies reviewed, uptake and detection rates appeared to vary with means of administration. Screening framed as universal, confidential, and intended to optimize attention to patient concerns increased acceptability. Studies said little about how providers were taught to explore screen results. Screening increased referrals, but many still followed negative screens, in some cases because of parent concerns apparently not reflected by screen results but possibly stemming from screen-prompted discussions. Little research has addressed the process of engaging patients in mental health screening in pediatric primary care or how clinicians can best use screening results. The literature does offer suggestions for better clinical practice and research that may lead to improvements in uptake and outcome. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. General view of university students “Marmara University Vocational School of Health Services Case”

    Directory of Open Access Journals (Sweden)

    Akyurt Nuran

    2016-01-01

    Full Text Available The aim of this study was to determine the attitude towards the socio-economic conditions and demographic characteristics and the university life of medical students. To determine the students’ sociodemographic characteristics “Personal Information Form” was used developed by researchers according to literature. The form contains expressions of the students such as the economic situation, future concerns, finding a job, university life, social & recreational activities, build up relationships with people and parents education level. Target group of the study were 349 students from Marmara University Vocational School of health. The environment of the survey was limited to the students studying in all programs at Marmara University Vocational School of Health. The research was carried out with students at Marmara University Vocational School of Health in the fall semester of 2014-2015.

  1. Advancing adolescent health and health services in Saudi Arabia: exploring health-care providers' training, interest, and perceptions of the health-care needs of young people

    Directory of Open Access Journals (Sweden)

    AlBuhairan FS

    2014-09-01

    Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have

  2. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    Science.gov (United States)

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important.

  3. Service-learning from the views of university teachers: a qualitative study based on focus groups.

    Science.gov (United States)

    Shek, Daniel T L; Chan, Stephen C F

    2013-01-01

    Under the New Undergraduate Curriculum at The Hong Kong Polytechnic University (PolyU), students are required to take a 3-credit subject to fulfill service-learning requirements. To understand the views of teachers regarding service-learning, five focus group interviews (n=33) are conducted to examine the perceived characteristics and myths of service-learning as well as colleagues' views on the policy at PolyU. Results showed that most informants are aware of service-learning and have seen its benefits to both students and teachers. Most informants also possess positive views about service-learning. Nevertheless, in terms of service-learning at PolyU, three different groups of views on service-learning are observed, namely, positive, negative, and mixed views. This paper also discusses teachers' views on the anticipated difficulties of service-learning implementation and the ways, by which to promote the subject in the PolyU context.

  4. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Food service payments to sponsoring organizations for... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day care homes. (a) Payments shall be made only to sponsoring organizations operating under an agreement...

  5. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    Science.gov (United States)

    2013-02-28

    ... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction to... Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code....

  6. Care coordinators: a controlled evaluation of an inpatient mental health service innovation.

    Science.gov (United States)

    Stewart, Malcolm W; Wilson, Michael; Bergquist, Karla; Thorburn, John

    2012-02-01

    The study aimed to evaluate the impact of introducing designated care coordinators into an acute mental health inpatient unit in terms of service delivery, clinical outcomes, and service user and significant other perceptions. A pre-post-controlled design was implemented with a consecutive sample of 292 service users admitted and staying more than 5 days in two wards, with care coordinators introduced in one ward. Data were obtained from clinical records, standard measures, and service user and significant other surveys. Care coordinator input was associated with significant improvements in service delivery and stronger involvement of significant others and community resources. Care-coordinated clients showed significantly better clinical outcomes, including the Health of Nations Outcome Scales behaviour subscale, less time in the intensive care subunit, less community crisis team input in the week following discharge, and lower rates of readmission in the month following discharge. Care-coordinated service users and their significant others gave higher ratings of service delivery, outcome, and satisfaction. The results indicate that designated care coordinators significantly improve care processes, outcomes, and service user experience in acute inpatient mental health settings. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  7. Racial/Ethnic Differences in Use of Health Care Services for Diabetes Management

    Science.gov (United States)

    Chandler, Raeven Faye; Monnat, Shannon M.

    2015-01-01

    Research demonstrates consistent racial/ethnic disparities in access to and use of health care services for a variety of chronic conditions. Yet we know little about whether these disparities exist for use of health care services for diabetes management. Racial/ethnic minorities disproportionately suffer from diabetes, complications from diabetes,…

  8. Racial/Ethnic Differences in Use of Health Care Services for Diabetes Management

    Science.gov (United States)

    Chandler, Raeven Faye; Monnat, Shannon M.

    2015-01-01

    Research demonstrates consistent racial/ethnic disparities in access to and use of health care services for a variety of chronic conditions. Yet we know little about whether these disparities exist for use of health care services for diabetes management. Racial/ethnic minorities disproportionately suffer from diabetes, complications from diabetes,…

  9. 42 CFR 482.57 - Condition of participation: Respiratory care services.

    Science.gov (United States)

    2010-10-01

    ... be adequate numbers of respiratory therapists, respiratory therapy technicians, and other personnel... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services....

  10. Bottleneck analysis approach to accelerate newborn care services in two regions in Ghana: implications for national newborn care.

    Science.gov (United States)

    Yawson, A E; Awoonor-Williams, J K; Sagoe-Moses, I; Aboagye, P K; Yawson, A O; Senaya, L K; Bonsu, G; Eleeza, J B; Agongo, E E A; Banskota, H K

    2016-12-01

    The aim of this work is to describe application of a data-driven approach (bottleneck analysis [BNA] approach process) to accelerate newborn care services in two regions and what effect it had on national-level newborn care interventions in Ghana. A mixed-method approach was used for the study. The BNA tool generated quantitative data and group discussions provided phenomenological explanations to identified service gaps. Regional newborn care health service assessments were conducted in November 2013 through desk reviews, field and health facility visits and coaching/mentorship. The BNA tool (an excel-based tool) directly utilized service coverage data and programme monitoring and review reports in Ghana. Outputs were generated based on service coverage indicators: supply side/health system factors (commodities, human resource and access), demand side (service utilization) and quality/effective coverage. National targets were used as benchmarks to assess gaps in coverage indicators. Key health system bottlenecks included absence/stock-out of essential newborn care commodities/resuscitation kits and absence of updated policies at services delivery points. In both regions, less than 55% of health facilities had at least 80% of midwives trained to provide essential obstetric and newborn care, management of preterm babies, resuscitation and inpatient paediatric care. In addition, less than 35% of pregnant women were assisted by a skilled birth attendant (midwife) and monitored with a partograph in the two regions. Demand-side bottlenecks included cultural preference for home deliveries, limited knowledge on importance of postnatal care and poor community involvement.The BNA approach in the two regions resulted in the development of national and other regional operational plans and monitoring and evaluation framework for newborn care services in Ghana over the period 2012-2016, and a relative improvement in neonatal mortality at the regional and national level. The BNA

  11. Social Welfare Evaluation of Electric Universal Service in China: From the Perspective of Sustainability

    Directory of Open Access Journals (Sweden)

    Huiru Zhao

    2014-08-01

    Full Text Available Electric universal service aims to improve the individual living quality in remote and underdeveloped areas, the implementation of which can promote the sustainable development of people’s lives and the local economy to some extent. A social welfare evaluation model of electric universal service was proposed, which was divided into economic and non-economic welfare evaluation models. After the factors influencing the social welfare sense of electric universal service were identified from the perspective of sustainability, the economic welfare evaluation model was built based on Atkinson’s social welfare function, and the non-economic welfare evaluation model was constructed based on the ideological connotation of prospect theory. Taking Yunnan province in China as the example, a social welfare evaluation of electric universal service was performed. The result shows that the social welfare of electric universal service for Yunnan rural areas has increased by 9.79% from 2006 to 2011, and the “electric service realization degree” is the most sensitive indicator.

  12. Service-learning, personal development, and social commitment: a case study of university students in Hong Kong.

    Science.gov (United States)

    Ngai, Steven Sek-yum

    2006-01-01

    Service-learning, which combines academic study with community service, is becoming increasingly popular throughout the world. It is ideally suited to achieving both the personal and academic goals of students and the broader goals of civic responsibility and social justice. This paper describes the design of a local service-learning program the author implemented at a university in Hong Kong. Based on survey data collected from 93 university student participants in the program, it illustrates the impact of service-learning on student outcomes. Results show that the majority of the students benefitted as follows: (1) By developing personal autonomy through real world experiences, students develop a recognition of and faith in their potential. It enhances self-assurance, assumption of new responsibilities, and achievement of individual growth. (2) Students move toward becoming responsible citizens and agents of social change. By learning to care for deprived groups in the community, they are assuming meaningful roles and responding to real issues in ways that have a long-lasting impact on their own lives. Recommendations, based on the shortcomings we have witnessed and the changes we have implemented, are also made.

  13. 78 FR 76413 - Reasonable Charges for Medical Care or Services; V3.14, 2014 Calendar Year Update and National...

    Science.gov (United States)

    2013-12-17

    ... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation...; physician and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and...

  14. A Guide for Foodservice Education; Health Care; Community Care and School Feeding in California. Dietetic Service Supervision Curriculum Guide.

    Science.gov (United States)

    Schickling, Clarice; And Others

    This curriculum guide is intended to help California community college educators understand and develop a vocational program in health care, community care, and school food service. It establishes the general need for such a program, and provides guidelines to help educators determine if there is a need for such a program in their geographic…

  15. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ..., 2010, at 75 FR 41793. Child and Adult Care Food Program (CACFP) [Per meal rates in whole or fractions... 48 FR 29114, June 24, 1983.) This notice has been determined to be not significant and was reviewed... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  16. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ..., 2009, at 74 FR 34295. Child and Adult Care Food Program (CACFP) Lunch and Centers Breakfast supper \\1... related notice published at 48 FR 29114, June 24, 1983.) This notice has been determined to be not... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  17. Students’ experiences of university social responsibility and perceptions of satisfaction and quality of service

    Directory of Open Access Journals (Sweden)

    José Luis Vázquez

    2015-03-01

    Full Text Available The principal aim of this paper is to identify the factors that define students’ perceptions of university social responsibility (USR in a Spanish university, and analyse the impact of that view on their perceptions of satisfaction and quality of service. Particularly, it is hypothesized that the overall perception of university social responsibility has a positive effect on students’ experiences of satisfaction, partially mediated by the assessment regarding the quality of university services. In doing that, a self-report study was conducted with a total sample of 400 undergraduate students of the University of León, in Spain. Structural equation modeling with PLS was used to test the students’ overall perception of USR in order to achieve higher standards of quality of service and satisfaction. Results supported a structure of six factors explaining students’ views regarding university social responsibility, of which only internal management affects the overall perception. Likewise, quality of service and satisfaction are strongly correlated among them. Implications of these findings for marketing in university settings are discussed.

  18. Universal(ly Bad) Service: Providing Infrastructure Services to Rural and Poor Urban Consumers. Policy Research Working Paper.

    Science.gov (United States)

    Clarke, George R. G.; Wallsten, Scott J.

    Utility services (telecommunications, power, water, and gas) throughout the world were traditionally provided by large, usually state-owned, monopolies. However, encouraged by technological change, regulatory innovation, and pressure from international organizations, many developing countries are privatizing state-owned companies and introducing…

  19. Universal(ly Bad) Service: Providing Infrastructure Services to Rural and Poor Urban Consumers. Policy Research Working Paper.

    Science.gov (United States)

    Clarke, George R. G.; Wallsten, Scott J.

    Utility services (telecommunications, power, water, and gas) throughout the world were traditionally provided by large, usually state-owned, monopolies. However, encouraged by technological change, regulatory innovation, and pressure from international organizations, many developing countries are privatizing state-owned companies and introducing…

  20. 75 FR 25113 - High-Cost Universal Service Support, Federal-State Joint Board on Universal Service, Lifeline and...

    Science.gov (United States)

    2010-05-07

    ... those of rural carriers, PRTC's embedded costs are actually too low to make it eligible for support... carriers. PRTC argues that the Commission must adopt its proposed embedded cost-based mechanism because: (1... comparable service; they ``include low-income consumers and those in rural, insular and high cost...

  1. 75 FR 56494 - High-Cost Universal Service Support and Federal-State Joint Board on Universal Service

    Science.gov (United States)

    2010-09-16

    ...) by filing paper copies. See Electronic Filing of Documents in Rulemaking Proceedings, 63 FR 24121... service fund reform. Verizon Wireless and Sprint Nextel, in separate transactions in 2008, each committed... reclaimed from Verizon Wireless and Sprint Nextel be redistributed to other competitive...

  2. Nurse case managers: patient care implications at a Pakistani university.

    Science.gov (United States)

    Walani, Laila

    The role of the nurse in hospital is varied and some are choosing to incorporate more managerial and administrative skills into their clinical role. One such role is that of the nurse case manager (NCM). This particular role concentrates on involving the family and the patient in his or her own care, facilitation of the care plan, and open discussions between the patient, medics and nursing staff. NCMs in the author's hospital have made a remarkable contribution to patient care. It is a challenging and exceedingly demanding role in both developing and developed countries, but one that is increasingly important. The NCMs are involved in coordination, facilitation of core process and mobilization of resources, not only in hospital but at the patient's home. In this short introductory article the role of NCM is highlighted and the author discusses how this diverse role is concerned with patient care. NCMs work with multidisciplinary teams to enhance the patient's care process. Their attention is also given to cost reduction and clinical pathway management.

  3. Experiences of Burnout, Self-Care, and Recovery of Female University Counsellors in Taiwan

    Science.gov (United States)

    Lin, Yii-Nii

    2012-01-01

    The purpose of this study was to describe the burnout, self-care, and recovery experiences of female university counsellors working at a university counselling centre in Taiwan. The 9 participants had an average age of 42.44 years and had worked at the centre for an average of 11.3 years. A qualitative method of phenomenology with in-depth…

  4. The status of maternal and newborn care services in Sierra Leone 8 years after ceasefire.

    Science.gov (United States)

    Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip; Kanu, Rugiatu; Shoo, Rumishael; Daoh, Kizito

    2011-08-01

    To conduct a needs assessment for emergency obstetric care (EmOC) to address the unacceptably high maternal and newborn mortality indices in Sierra Leone 8 years after the end of the civil war. From June to August 2008, a cross-sectional survey was conducted of health facilities in Sierra Leone offering delivery services. Assessment tools were local adaptations of tools developed by the Averting Maternal Death and Disability program at Columbia University, New York, USA. There were enough comprehensive EmOC (CEmOC) facilities in the country but they were poorly distributed. There were no basic EmOC (BEmOC) facilities. Few facilities (37% of hospitals and 2% of health centers) were able to perform assisted vaginal delivery (AVD), and 3 potentially BEmOC facilities did not meet the standard only because they did not perform AVD. Severe shortages in staff, equipment, and supplies, and unsatisfactory supply of utilities severely hampered the delivery of quality EmOC services. Demand for maternity and newborn services was low, which may have been related to the poor quality and the high/unpredictable out-of-pocket cost of such services. Significant increases in the uptake of institutional delivery services, the linkage of remote health workers to the health system, and the recruitment of midwives, in addition to rapid expansion in the training of health workers (including training in midwifery and obstetric surgery skills), are urgently needed to improve the survival of mothers and newborns. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. What Proportion of Terminally Ill and Dying People Require Specialist Palliative Care Services?

    Directory of Open Access Journals (Sweden)

    Donna M. Wilson

    2014-01-01

    Full Text Available Currently, around 55 million people die each year worldwide. That number is expected to increase rapidly with accelerating population aging. Despite growth in the number of palliative care specialists and specialist services in most countries, the prospect of an increasing number of terminally ill and dying persons is daunting. This paper attempts to answer the question: what proportion of terminally ill and dying persons require specialist palliative care services? To address this question and highlight which persons require specialist palliative care, the current state of access to specialist palliative care services and specialists in Canada and other countries is highlighted, along with available evidence-based information on specialist services utilization and the care needs of terminally ill and dying persons. Current evidence and information gaps reveal that this question cannot be answered now, but it should be answered in advance of a crisis of unmet end-of-life care needs with the rising death toll.

  6. Health Care Service Utilization of Dementia Patients before and after Institutionalization: A Claims Data Analysis

    Science.gov (United States)

    Schwarzkopf, Larissa; Hao, Yi; Holle, Rolf; Graessel, Elmar

    2014-01-01

    Background Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse. Methods We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization. Results In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy) remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles. Conclusion Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care. PMID:25337076

  7. Health Care Service Utilization of Dementia Patients before and after Institutionalization: A Claims Data Analysis

    Directory of Open Access Journals (Sweden)

    Larissa Schwarzkopf

    2014-06-01

    Full Text Available Background: Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse. Methods: We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization. Results: In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles. Conclusion: Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care.

  8. Coaching to Quality: Increasing Quality in Early Care and Education Programmes through Community-University Partnership

    Science.gov (United States)

    Gilbert, Jaesook Lee; Harte, Helene Arbouet

    2013-01-01

    This paper describes efforts to increase the quality in early care and education through targeted coaching. A collaborative including several community agencies and a university developed a framework of support for early care and education providers, using coaching as its foundational basis, called Coaching to Quality (CTQ). This paper provides a…

  9. Brief Behavioral Interventions for Symptoms of Depression and Insomnia in University Primary Care

    Science.gov (United States)

    Funderburk, Jennifer S.; Shepardson, Robyn L.; Krenek, Marketa

    2015-01-01

    Objective: To describe how behavioral activation (BA) for depression and stimulus control (SC) for insomnia can be modified to a brief format for use in a university primary care setting, and to evaluate preliminarily their effectiveness in reducing symptoms of depression and insomnia, respectively, using data collected in routine clinical care.…

  10. Expected Impact of Health Care Reform on the Organization and Service Delivery of Publicly Funded Addiction Health Services.

    Science.gov (United States)

    Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence

    2017-07-01

    Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.

  11. Pre-service Teachers’ Knowledge Base at La Salle University

    Directory of Open Access Journals (Sweden)

    Anderson Cárdenas

    2009-12-01

    Full Text Available This paper reports on the outcomes of a recent study carried out at Universidad de La Salle, which intended to describe and reflect upon what five (5 pre-service teachers from last semesters pointed out as the most important elements of knowledge base that teachers should know in order to become English language teachers. The instruments utilized in this qualitative research to gather information from the participants were students’ journals, a phenomenological interview and a survey. Results indicate that elements such as the language (English command, students’ preferences and realities, and the control of a class, among others, come to be essential areas teachers should be knowledgeable in.

  12. Assessing the acceptability of community pharmacy based pharmaceutical care services in Karachi

    OpenAIRE

    Muhammad Amir, B.Pharmacy, MSc. MBA, Assistant Professor/Clinical Pharmacist

    2011-01-01

    Provision of pharmaceutical care services in community pharmacies is a new trend in pharmacy practice worldwide. Published literature from developed countries is available showing benefits of pharmaceutical care services provided in community pharmacies. However, relatively little published literature is available from developing countries in which unique market environments are encountered. This study was conducted to assess the acceptability of community pharmacy based pharmaceutical care s...

  13. A Universal Anaphylaxis Emergency Care Plan: Introducing the New Allergy and Anaphylaxis Care Plan From the American Academy of Pediatrics.

    Science.gov (United States)

    Pistiner, Michael; Mattey, Beth

    2017-09-01

    Anaphylaxis is a life-threatening emergency. In the school setting, school nurses prepare plans to prevent an emergency, educating staff and students on life-threatening allergies. A critical component of any emergency plan is a plan of care in the event of accidental ingestion or exposure to an antigen to prevent the sequelae of untreated anaphylaxis. A universal anaphylaxis emergency care plan developed by the American Academy of Pediatrics and reviewed by NASN offers an opportunity for schools, family, and health care providers to use one standard plan and avoid confusion. The plan and benefits of use are described in this article.

  14. Pharmaceutical services in a Mexican pain relief and palliative care institute

    OpenAIRE

    Escutia Gutierrez R; Cortéz Alvarez CR; Álvarez Alvarez RM; Flores Hernandez JL; Gutiérrez Godinez J; López y Lopez JG

    2007-01-01

    Neither the purchase nor the distribution of pharmaceuticals in hospitals and community pharmacies in Mexico is under the care of pharmacists. Some are under control of physicians.This report presents the results of the implementation of somef pharmaceutical services for the Jalisco Pain Relief, and Palliative Care Institute (Palia Institute), under the direction of the Secretary of Health, Government of Jalisco. The services implemented were drug distribution system, Drug Information Service...

  15. Improving client-centred care and services : the role of front/back-office configurations

    NARCIS (Netherlands)

    Broekhuis, Manda; de Blok, C.; Meijboom, B.

    2009-01-01

    Improving client-centred care and services: the role of front/back-officeconfigurations. This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfa

  16. Implementation of the Care Programme Approach across Health and Social Services for Dual Diagnosis Clients

    Science.gov (United States)

    Kelly, Michael; Humphrey, Charlotte

    2013-01-01

    Background: Care for clients with mental health problems and concurrent intellectual disability (dual diagnosis) is currently expected to be provided through the care programme approach (CPA), an approach to provide care to people with mental health problems in secondary mental health services. When CPA was originally introduced into UK mental…

  17. Coordination of care in the Chinese health care systems: a gap analysis of service delivery from a provider perspective.

    Science.gov (United States)

    Wang, Xin; Birch, Stephen; Zhu, Weiming; Ma, Huifen; Embrett, Mark; Meng, Qingyue

    2016-10-12

    Increases in health care utilization and costs, resulting from the rising prevalence of chronic conditions related to the aging population, is exacerbated by a high level of fragmentation that characterizes health care systems in China. There have been several pilot studies in China, aimed at system-level care coordination and its impact on the full integration of health care system, but little is known about their practical effects. Huangzhong County is one of the pilot study sites that introduced organizational integration (a dimension of integrated care) among health care institutions as a means to improve system-level care coordination. The purposes of this study are to examine the effect of organizational integration on system-level care coordination and to identify factors influencing care coordination and hence full integration of county health care systems in rural China. We chose Huangzhong and Hualong counties in Qinghai province as study sites, with only Huangzhong having implemented organizational integration. A mixed methods approach was used based on (1) document analysis and expert consultation to develop Best Practice intervention packages; (2) doctor questionnaires, identifying care coordination from the perspective of service provision. We measured service provision with gap index, overlap index and over-provision index, by comparing observed performance with Best Practice; (3) semi-structured interviews with Chiefs of Medicine in each institution to identify barriers to system-level care coordination. Twenty-nine institutions (11 at county-level, 6 at township-level and 12 at village-level) were selected producing surveys with a total of 19 schizophrenia doctors, 23 diabetes doctors and 29 Chiefs of Medicine. There were more care discontinuities for both diabetes and schizophrenia in Huangzhong than in Hualong. Overall, all three index scores (measuring service gaps, overlaps and over-provision) showed similar tendencies for the two conditions

  18. A Retrospective Evaluation of Critical Care Blood Culture Yield - Do Support Services Contribute to the "Weekend Effect"?

    Science.gov (United States)

    Morton, Ben; Nagaraja, Shankara; Collins, Andrea; Pennington, Shaun H; Blakey, John D

    2015-01-01

    The "weekend effect" describes an increase in adverse outcomes for patients admitted at the weekend. Critical care units have moved to higher intensity working patterns to address this with some improved outcomes. However, support services have persisted with traditional working patterns. Blood cultures are an essential diagnostic tool for patients with sepsis but yield is dependent on sampling technique and processing. We therefore used blood culture yield as a surrogate for the quality of support service provision. We hypothesized that blood culture yields would be lower over the weekend as a consequence of reduced support services. We performed a retrospective observational study examining 1575 blood culture samples in a university hospital critical care unit over a one-year period. Patients with positive cultures had, on average, higher APACHE II scores (p = 0.015), longer durations of stay (p = 0.03), required more renal replacement therapy (pculture yield decreased with repeated sampling with an increased proportion of contaminants. Blood cultures were 26.7% less likely to be positive if taken at the weekend (p = 0.0402). This effect size is the equivalent to the impact of sampling before and after antibiotic administration. Our study demonstrates that blood culture yield is lower at the weekend. This is likely caused by delays or errors in incubation and processing, reflecting the reduced provision of support services at the weekend. Reorganization of services to address the "weekend effect" should acknowledge the interdependent nature of healthcare service delivery.

  19. Health care service for ostomy patients: profile of the clientele

    Directory of Open Access Journals (Sweden)

    Vanessa Damiana Menis Sasaki

    2012-09-01

    Full Text Available The study aimed to identify the profile of ostomy patients in a Health Care Service in São José do Rio Preto, São Paulo, Brazil. This is an exploratory, descriptive and retrospective study. Data were obtained by registration forms of patients assisted from January 1st, 2000, to December 31st, 2010. Out of the 252 ostomy patients, 51.1% were females and 48.9% were males; the age group with the highest concentration was from 68 to 78 years old (26.3% for both genders, with mean age of 73 years old. The main reason for making the stoma was rectal (35.0% and colon neoplasm (14.1%. The prevalent stoma was temporary colostomy (41.4% and the period of permanence of the collecting equipment was longer than 36 months. Even though the service provides full assistance to the ostomy patients, it is necessary to review human resources aspects to provide appropriate assistance to its clientele.O estudo teve como objetivo identificar o perfil de pacientes estomizados de um Serviço de Atenção ao Estomizado de São José do Rio Preto e Região. A pesquisa é exploratória, descritiva e retrospectiva. Os dados foram obtidos das fichas cadastrais dos pacientes atendidos no período de 1º de janeiro de 2000 a 31 de dezembro de 2010. Dos 252 estomizados, 51,1% eram mulheres e 48,9% homens, a faixa etária de maior concentração encontrou-se, em ambos os sexos, entre 68 a 78 anos (26,3% com média de idade de 73 anos. O principal motivo da confecção do estoma foi a neoplasia de reto (35,0% e cólon (14,1%. O estoma prevalente foi a colostomia temporária (41,4% e o tempo de permanência do equipamento coletor foi superior a 36 meses. O Serviço, embora proporcione assistência integral ao estomizado, necessita rever aspectos de recursos humanos à assistência adequada à clientela.

  20. Client expectations and satisfaction of quality in home care services. A consumer perspective.

    Science.gov (United States)

    Samuelsson, G; Wister, A

    2000-12-01

    This study examines clients' expectations of quality in home care services and their perceived satisfaction with services among a random sample of 76 home care recipients in Vancouver, Canada. The researchers conducted face-to-face interviews that applied Multiattribute Utility Technology, a procedure that organizes several quality attributes of "ideal" home care into a tree structure to compare their relative importance and ranking from the clients' perspective. Participants also were asked to state their satisfaction or dissatisfaction with the services received in these domains. Among the five main quality attributes identified, the subjects ranked suitability of the home helper and its subset, personal competence, as the most important indicators of quality, followed by continuity in service. In addition, clients tended to have a high level of satisfaction with regard to the attributes of overall home care services. The highest level of satisfaction was reported for elements of personal dispositions of home care staff. The lowest level of satisfaction involved the time/availability components of the service. Finally, comparisons between client expectations and satisfaction of received home care services showed the highest discrepancy for the attributes of influence and time/availability and the greatest congruence for personal attributes of the staff. The results are discussed in terms of their implications for the delivery of home care services.